Halloween Birth Storm
I'm the writing-midwife for this blog. I write to provide health information regarding pregnancy, birth, baby, and the early days of parenthood; so that parents may soak up this journey with full joy and only a little fear.
Every Halloween, memories from my 2015 Halloween birth storm resurface. I recollect annually the arrivals of these four special babies into their awaiting families. I was a midwifery student in my last year of training, and my mentor midwife, Grace, had become more of a friend.
This retelling, true to that day, is long.
PRE-HALLOWEEN DAY AFTERNOON TEA
It was after clinic, and for some reason or another which I can’t recall, I was walking with Grace to her home, stepping through the colourful crunch of fall leaves on the cold, grey, Toronto pavement. I think we must have had a home visit or a labour assessment planned for later that evening. We were taking the few hours in between to have tea. I met her mother and her daughter was still at daycare. It was a calm and overcast afternoon, just as you’d want a pre-Halloween day to be.
Sometime later, we got a page. Things are kind of a blur here. I can’t remember who we got the page from, and what we proceeded to do afterwards, but based on who I remember being at the hospital with and my knowledge of how we typically managed these situations, I’d say that we were perhaps called in to relieve another midwife.
Oh yeah, I remember now: that October day was a birth storm for everyone. Now come to think of it, Grace and I could not have been as calm as to have tea if we were expecting a labour call. It must have been a preplanned 37 week home visit that we were waiting to do together.
Yes, Grace and I were enjoying our sliver of peace this autumn afternoon while all the other midwives at our clinic were busying themselves in a frenzy around us.
Ha, but we did not escape it.
One way or another, I found myself late in the evening perhaps around ten or eleven, with a lovely first-time mum, we’ll call, Alice. Dinner was skipped.
Alice was lying semi-comfortably on the hospital bed, her partner taking a rest. Grace and I had dimmed the room to just one light above where we sat by Alice’s bed, monitoring baby’s heart rate. She had an epidural. I think we relieved another midwife because I can’t remember the exhaustion and home visits that must have come before this stage. But we met this lovely lady and her partner and sent off our dear friend for some sleep. It was turning out to be quite a lovely, still relaxed evening.
Other then a few annoying calls to the anesthesiologist to deal with a partially-functioning epidural, all continued smoothly.
Oct 31, 2015. 02:00-03:00ish
I got a page. I stepped outside to take it.
As I was in my final year of training, and I was what we call a “clerkship” student, clients were more comfortably directly paging me, and it happened often.
This time, it was a client of ours. Someone we had gotten to know over the weeks of pregnancy and visited at home. I began to anticipate the arrival of their little one beyond the excitement of a mere care provider.
It was Kate. Her water had broken. Lovely!
Normally, it would be fine to take some time and wait for contractions to start on their own. For reasons from previous testing, in Kate's case, I offered the same option, or coming into the hospital for medication to kickstart the labour.
Seeing as it was some ungodly hour, though anxious about waiting too long, Kate decided to stay home, rest, and monitor. She was excited labour was happening as her partner had REALLY wanted to have a Halloween baby!
I thought it was a fine idea for Kate to get some rest and give her body time. I relayed this back to Grace, got her stamp of approval, and we went back to focusing on our Alice.
'Is it sunrise or sunset, I've lost track of time...'
Oct 31, 2018. 06:00
Kate calls again. Contractions have started on their own. Grace and I would have under normal circumstances slugged ourselves out of bed, gotten into our cars bracing the sub zero night air, and driven across the city to her home to do an assessment. But we had been up all night in the same clothes we wore to clinic the day before, already at the hospital. Kate was happy to come in for her assessment, seeing as she was planning a hospital birth and her condition meant she could be admitted to the hospital (she can stay, and not be sent home). I prepared the room while waiting for her to arrive. Alice was still labouring away with her labour cocktail of an IV drip giving her contractions while she was starting to get increasingly uncomfortable.
Busier now, but still manageable.
Around 8 in the morning, either Alice’s midwife or another midwife-student team from our clinic came to relieve us the reliever midwives. Grace went home for some sleep. After all, we had been up for 24 hours. It’s easy to forget we had a whole day of clinic leading up to our interrupted tea the day before.
So, Alice’s little baby was actually not one of the four in my Halloween birth storm. It started with her labour, and the others cooked up the rest.
OUR FIRST HALLOWEEN BABY
[ "This baby better be frickin' cute." ]
I stayed with Kate. Another midwife came in to mentor me. I remember labouring with Kate in the hospital bathroom. She was in the tub. In between contractions she uttered once, “this baby better be frickin cute”. We laughed. She asked for an epidural at some point, she was 4 cm dilated. At just the cusp of active labour, we recommended some different positions, moving around, and some water therapy. Kate was a good sport. Sometime around now, I remember some other midwives from our clinic arriving at the hospital. One of which, Grace and I were the second midwives. Background: In this particular community I worked in, in Toronto, Ontario, two midwives were present at every birth, whether it was a hospital birth or not: the primary and the second midwives. This meant I could be pretty sure to anticipate work lined up after Kate’s birth.
I later heard through the midwives’ chatter that another client for whom I was the second midwife was also in labour, and I would likely miss that birth needing yet another midwife to fill in. No rest for the wicked.
I think that was the day I really felt the joy and pride to be a part of this circle of working women. To see a familiar tired face walking down the hospital hallway, a knowing sheepish smile, and some wise old words of support: it was the best social network one could ask for.
Oct 31, 12:00ish
Somehow, we stumbled into midday of Halloween.
At the next check, I felt Kate’s baby to be posterior. A position that makes labour a bit more labourious. Her cervix was swollen. She was resting at 4 cm, and exhausted. We settled her in with an epidural for some rest, and her partner’s gentle snoring soon filled the room.
I might have gotten a chance to get some food at this point. The last thing I had consumed was tea at Grace’s house the afternoon before.
Passenger (the baby)
component of labour
Psyche, component of labour
A few hours went by.
I monitored the baby. I chatted with Kate. I walked around the hallways when she slept.
Something was brewing next door as well, so my temporary mentor, Leah, was going back and forth to help our colleague and supervise me.
After some time, I checked Kate again. With an epidural, along with pain, the signs of labour progress also dull out. She was fully dilated! We waited a little, asked Kate to stop pressing the magical button that gives the epidural a boost, and to do some trial pushes. Kate did really well! We woke up Kate’s partner, and we pushed! Oh, and because I was a senior student, I could be in the position of the second midwife on my own. So it was just Leah and I, as we supported Kate with pushing.
The head was born.
Kate pushed again. The shoulders didn’t come with the next contraction. It seemed a tiny bit wedged. I ran to the next room to grab our midwife colleague. We came back, and with a push the shoulders slipped out. I guess this kid chose the trick part of trick-or-treat.
Kate’s Halloween baby was here!
A JANE AUSTEN NOVEL BIRTH
Oct. 31, sometime in the late afternoon.
Grace returned to the hospital after an 8 hour rest. We tucked Kate and her baby into their car, and sent them home. We would see them at home the next day.
We stopped by our colleague’s labour room. We were the second midwives for her client. She gave us an update, and let us know it’ll yet be some time. As we got ready to leave the hospital, Grace informed me that the client of another midwife in the clinic seemed to be in labour. I can’t remember if this other midwife was at another birth, or on a holiday, but either way, we were covering for them. This client was a lovely woman we’ll call Mary. This was her fourth baby. She was planning a home birth. I hopped into Grace’s car, and we drove to her home to pick up the home birth equipment. Luckily, Mary lived nearby.
I helped Grace load the vehicle. As I lifted the birth bag, I saw Grace’s mother. It snuck up on me that I had only just met her yesterday, having tea, and had not slept since I last saw her. It felt like weeks had gone by.
We pulled into a spot along the road at Mary’s house. Children were walking back from school in costumes. Her beautiful house was framed by two tall trees and an orange mane of leaves. We rang the bell.
Her three children answered.
“Sorry we’re not ready for trick-or-treaters yet!”, said her oldest.
Ah if only we were here for trick-or-treating!
“But I think your mum is ready to have a baby? We are here to help her.”
The kids let us in.
Mary was upstairs in a bath of warm water that her husband had just filled. He was rushing around trying to manage the kids and get towels. A grandmother came over to mind the children. We called yet another set of amazing colleagues to step in as the second midwives, as us, the original second midwives were just bumped up to primary. We sat with Mary in her bathroom. She was in good spirits. The contractions seemed quite irregular and she was still chatting with us. The conversations that flow during these times are the most whimsical and intimate.
Their dark wooded house exuded an old kind of cosy. Their children’s names were like characters out of a Jane Austen book. Adeline, Carson, Bennett. These were not their actual names, but I picked some equally Jane Austen-esque ones.
I learned that her husband was a radiologist, and so, even though the sex of their baby was not reported, he had caught a glimpse of the ultrasound screen and thought he might have an idea.
For the rest of us, we awaited the surprise.
Slowly, each contraction became more intense. Mary was uncomfortable in the water. If I recall, she did not want to birth in the bath. As we moved from tub to bed, splash! Her water broke in the most dramatic way. We quickly helped her to the bed as I swiftly did an internal check to make sure that the baby’s head, which was still quite high in the pelvis when we arrived, had descended with the contraction. He had. The second midwife and student examined the fluid colour and loaded the floor with towels as Mary bore down strongly with the next contraction. The baby was ready. Her body was ready. We would be joined by an additional member of the family very soon.
Grace and I were ready. We recalled that Mary has big babies. Her previous three were all well above nine pounds, or 4000g. Grace subtly gestured to me to be prepared for some kinks in the delivery of the shoulders. Mary was on her bed, leaning on the headboard for support, on her knees. With the next urge of bearing down, we saw the head. As with experienced birthing bodies, the sliver of a head we see doesn’t disappear in between contractions, but the unbearable urge to push continues and the head keeps coming, and coming, and coming.
Out came the baby - head and shoulders, smooth as butter!
There was our second Halloween baby boy!
Mary caught her breath while her amazing partner tended to her, and I took in the power of the atmosphere. A new midwife, an experienced midwife, a senior student, a student in just her first year, a beaming dad, an experienced mum who was a new mum once again, and a brand new little babe. It didn't take long for all his siblings to join us too. All three of them, and a joyful grandmother.
We weighed this little hunker and he beat out all his siblings at 10lbs and 15 ounces! We talked about hospital protocol for “big babies” because we worry about their blood sugars, but Mary knew what she was doing, and was aware to keep him warm and fed. He latched on within half an hour of being born, and did not look like he was going to let go anytime soon.
My tired self would have loved to extend that moment. I would have happily curled into bed with this new family and slept off the rest of my Halloween day. Alas, Grace and I tucked in the new family, and headed back to the hospital.
A REDEMPTIVE BIRTH
Oct 31, 2015 19:00ish
It must have been around 7 or 8 pm now. Remember our colleague-friend who was at the hospital? They needed us now. I can’t remember the details of what or how it happened, but I am pretty sure Grace and I were bumped up to primary midwives again for Leslie’s birth.
Leslie was a client who had some social work follow-up. We weren’t 100% sure what was this follow-up. Leslie was well aware and we communicated openly. The baby might have needed some urine or stool tests. A social worker might needed to be called into the hospital. We were ready to advocate for Leslie. She had been anticipating her baby for so long with attentiveness and care. I let Leslie know I would call them to clarify, and informed her of the plan. She was understanding, and enthralled with her son.
I stepped into the hallway to make this uncomfortable call. The social worker who picked up was comforting and kind. She informed me that Leslie’s case has been closed, no tests needed to be done on baby, and no one needed to be there who didn’t need to be there. I passed on the happy news to Leslie. It felt like a cover being lifted!
We left Leslie with her perfect boy and all the encouragements. She was staying in the hospital longer because of the forceps birth. I think she was fine with not moving anywhere for some time, although her partner was not so eager to spend another night on the hospital’s partner special bed: mattress on the ground.
We tucked them in, and went home.
LET'S SNEAK ANOTHER ONE IN
Oct 31, 2015 21:00ish
I walked over to another delivery room across the hall. Here, another mama was in labour. Her second baby. Her first baby was born in Brazil, the labour was smooth, but the care was harsh. For this birth, I don’t recall if she wanted an epidural or didn’t want one. Either way, she felt strongly about one of them. I was the second midwife assigned to her, and as I was in my final year, I had to grow up from Grace and went over on my own.
I stepped into the room at precisely the right moment. She was pushing. I remember some other people in the room but their faces and purpose for being there is a blur. I think the phone was on speaker. Gil spoke Portuguese and I could swear we had an interpreter on the phone during the birth. What a day for that interpreter!
I think we had some baby heart rate drama near the end of pushing. But as it wasn’t Gil’s first rodeo and her body knew the way, the baby was born without drama. Maybe the pediatrician was in the room.
Maybe we sent him out shortly after baby was born. Or maybe, the baby declared his arrival with a loud cry and the pediatrician, knowingly, slipped out of the room.
The rest of that birth was a blur. My mind was on autopilot. My body was on muscle memory. But she had a brand new baby in her arms and her young son had become a big brother. I think her husband was also there.
Amidst the Halloween birth storm of '15, I discovered my love for this job, and the appreciation and love for the group of midwives around me.
I lived close to the hospital in my last midwifery student year. I could run from the hospital to my apartment. I stepped into the streets and breathed in some birth-fluid-free air deep into my lungs. On my way home, walking through the crisp night air of Toronto, I stopped by the new 24-hour coffee shop. I bought some soup and a sandwich and hurried home before it cooled. I remember sitting at the breakfast bar in my apartment, inhaling the sandwich, my hands shaking as I slurped up spoonfuls of soup. I was so tired. I eat, shower, and finally, after a day of tucking in mum and babies, tuck myself into bed.
Just like that, Halloween came to a close, and it was November.
For my fellow midwives and friends: Y’all know that I probably skipped that shower, but I couldn’t bear to write that truth in the story. Pick two out of three: sleep, shower, food, is too real.