Saturday, December 22, 2007

Keita Lafleur - A Birth Story

Well now that we're all settled in at home, with a routine pretty well established and things figured out a bit, I figured I'd take the time to write down the story of little Keita's birth.

On the evening of Monday, December 10th, we had just finished dinner and were getting set to relax for the evening when Yoshiko's water broke. Of course, we didn't quite know this at the time, since there wasn't really a large volume and there were no contractions. Figuring this was only the mucous plug, or pink show, we settled in for the night with plans on a trip to see the doctor first thing in the morning. After an uneventful night's sleep, and still no contractions, we got ready and headed on out to see Dr. Finestone to see what he had to say. The good Dr., upon hearing our tale, opted to send us over to the Civic hospital for a test which would determine if it was amniotic fluid or something else. Off we went to the Obstetrical Assessment Unit where after a few examinations and a little paper strip test, we were told that Yoshiko's waters had in fact broken and that we had 2 options. Option 1: go home and wait and see if labour starts and come back in the evening (24 hour post water breaking) to be induced if it didn't. Option 2: Induce now and get this show on the road.

Now, the shock of it took a little while to settle, but we opted on option 1. Yoshiko headed on home with my mother to get ready and I went to work to clean things up and shut down my desk. Having planned on another week of work, with the baby not due until December 23rd, I was not quite where I wanted to be in my projects, but managed to shuffle them all off for others to take care of during my 6 week parental leave. After a few hours at work, punctuated by many "what the heck are you still doing here?" comments from the staff, and many a worried look out the window at the storm bringing heaps of snow down on the city, I headed on home for a quick nap and dinner with the family as my final acts before parenthood.

Around 7PM, having braved the worsening storm and made the trip to the hospital, the system's efficiency promptly swept us up. After registering at the front desk and meeting our first nurse, we were brought into room 12 in the birthing unit, which I'm told is the nicest of them all with a nice view of the Experimental Farm and plenty of room to move around in. Here is the room, or at least a section of it... say about half.

Once we got settled in and got the preliminary stuff out of the way and Yoshiko changed out of her street clothes, our night nurse came in and started the IV after one failed attempt... not bad but unfortunately a sign of things to come. Since her water had broken 24 hours previously, and no contractions had started yet, it was time to bring out the Oxytocin and get the process started. Part and parcel with being hooked up to the IV, Yoshiko had to be hooked up into a machine for constant fetal monitoring. Luckily, these are now wireless sensors which women can wear and still be mobile throughout the ward, including in the shower and everything! Very cool! Certainly much better than being stuck in bed for the duration of labour.

Within a half hour or so of starting the IV, contractions started, so at about 8PM. This is the display on the fetal monitor, top line showing baby's heart rate, bottom one showing contractions of the Uterus.

While this was going on, the snow kept on piling up outside.

So here we were, in for the long haul, contractions started and labour progressing. As the doctors came by to examine the progress every once in a while, we got to 2 centimeters dilated by the early morning hours... Yoshiko's mother's story of a fast and easy birth went right out the window! Regardless, my little Yo-chan was doing fantastically well. It was at this point that we lost our fan club, with my mother and brother heading home for some sleep, tired of playing crib out in the waiting room and waiting for my updates... quite the little troopers they were! Sebastien, in an attempt to do what he could, kept offering to get Yoshiko jello, which added some comic relief to an otherwise difficult night. As the contractions got progressively stronger and closer together, we opted for pain management and narcotics were introduced into the IV every once in a while to take the edge off the contractions. At about 4-5AM, she was 4-5 centimeters dilated and it was time to start the epidural as a more constant method of pain relief, keeping in mind it had taken over 8 hours to get this far! An anesthesiologist was called and arrived just in time as things were really starting to get rolling and quite painful. The epidural went in quite well, with Yoshiko working through a number of contractions in the process, and this is where we hit the first bump in the road.

While the anesthesiologist was putting in the epidural, Yoshiko needed to stay sitting on the bed, with her back curled outwards so that the catheter could be inserted properly. Seems that during this maneuver, the baby got into a position he didn't like and his heart rate started to cause some concern, dropping significantly during every contraction. For the next little while, nurses would come in to reposition Yoshiko to see if pressure could be relieved somehow, but in the meantime, I noticed a disturbing trend of different doctors coming in and talking to each other and mentioning a number of phone calls to Dr. Finestone. At this point, I knew we were right on the line for a c-section. Luckily, one of the positions finally worked and the baby's heart rate returned to normal. Dr. Finestone ended up coming in around 5:30 to check things out and I overheard them discussing the fact that they wouldn't burden us with how close we'd gotten to being wheeled down the hall. Funny how people assume you can't hear things... Meanwhile, the storm had moved on out of town.

Once things settled down, we were told to nap and managed a couple of hours of rest. Around 9AM I woke up to a disturbing discovery. The catheter tubing was filled with bloody urine, a new and disturbing development. We were told this was due to the baby's position and that Yoshiko's bladder was taking a beating, another flag went up in the mind of the medical staff. Another examination told us we were just about there, hovering real close to the target 10 centimeters, but the little guy threw us for another loop. Despite being face down and bum up to Yoshiko's stomach for the later part of the pregnancy, the little guy had decided he didn't want to come out into the world looking down and had proceeded to flip. He was in OPL position, which means face up and slightly tilted to the left, as opposed to face straight down to the spine. To make matters worse, he didn't have his chin down to his chest, instead having his neck tilted up thus presenting the largest possible part of his body in a very non-friendly way for labour. Again, the positions came into play as they tried to get little baby to flip back. After an hour of that, they decided it was all for naught and decided we should start pushing and warned us of a long road still ahead.

Once she got the hang of it, my little lady pushed like a trooper and the nurse was pleased to see the baby progressing past +1 and out to +2. There was still much discussion about the position and whether or not he was coming along well enough but the progress made thus far told them to keep on going. Then, all hell promptly broke loose. During one of the pushes, the IV came out of Yoshiko's arm. Initially, this was fine, and the nurse started working on getting it in again. First poke, no go. Second poke, no go. She decided to call for reinforcements, and 2 subsequent nurses had their go at it turning my wife into their personal pincushion. Finally, the team lead got a line in and the Oxycontin started flowing again. Unfortunately, 30 minutes had elapsed with no drugs to keep the labour going. We were disheartened to learn that the baby had retreated down to the spine and that the work done earlier was for nothing and a temp check on mom noted a high of 39 degrees. Then the baby's heart rate headed up quite high and the flow of doctors once again increased in the room. This was to be the last straw. Some time after 12:30PM, following over 16 hours of labour, we were told the best option was a cesarean section. The mix of observations overnight plus the baby's heart rate told everyone that both mom and baby were stressed and we needed to get this baby out now to ensure their continued health. At this point, we were both exhausted and we took the news with a mix of shock and relief, knowing it would now soon be over and we'd have our little boy in our arms. Once we tearfully nodded our acceptance, things started moving quite quickly with release papers signed and a flurry of activity. Yoshiko was quickly wheeled out and down the hall to be prepped and I was left behind in a daze gathering our things and getting them to my mother and brother who'd come back to the hospital a few hours back. A nurse threw a tray of food at me and told me to eat before I changed into scrubs and I was walked into the OR Suite where I was told not to touch a number of people and things. There was quite the crowd in there already as I came in with Yoshiko already on the table ready to go. I took my seat at her head where one arm was accessible and held her hand as the surgeons did their thing. Within a matter of minutes, they said they were after the baby and he still kept struggling and giving them a hard time, finally at 1:22PM on December 12th, they had him and he was lifted up and quickly whisked away to a table to get cleaned off and pinked up. Within moments he started to shriek and both of us burst into tears. Out little boy had finally arrived! After a quick hello to mom, he was returned to the table to get cleaned up, I cut the cord and then the pediatrician took over checking him.

As the surgeons started their work of putting my dear wife back together, baby was brought over to a scale and weighed in at 2773 grams. Here's the poor little guy wondering what the heck is going on after almost 9 months of nice, quiet warmth inside mommy!

The process of sewing everything back together was the longest part of the operation, but it eventually finished up and they wrapped Yoshiko up for the trip to the recovery room. She got to hold the baby on the way out and the doctors reported that everything went fine and both baby and mom did a fantastic job. After being rolled into recovery and cleaned up a bit, mom got to breastfeed for the first time and the little guy did a great job right from the beginning with the nurses saying we were lucky to have a natural breastfeeder. By 5PM or so, we were in our hospital room and the most stressful and intense 24 hours of our lives was over.

Gladly, the 24 hours following our entry into parenthood were TONS better than the 24 hours preceding! All in all not exactly what we had envisioned for the birth of our first child, but since the goal is a healthy mom and baby, Mission Accomplished and a great big Otsukare sama to Yoshiko for all her hard work!


Blogger Christelle said...

Congratulations again and thanks for sharing that story. I am keenly interested in birth stories right now as you can imagine. As you know, I am currently living in a country where pain relievers are not available. I get to go through all of that "au naturel". Ugh! You may remember the wonderful Japanese thinking regarding pain ("gaman"). My favourite quotes that I've heard here are "it's only for one day" and "it's childbirth, it's supposed to hurt" and "itami ni omakase".

Anyways, glad to hear everything turned out alright despite some "stresses".

I'd like to wish you and your family a very merry Christmas spent with your very own little miracle!

10:40 AM  
Blogger Michel Lafleur said...

Hey there Christelle,

From what I understand, some OBs do offer pain meds, so if yours doesn't you may want to consider finding another one! Where do you live? Maybe countryside docs don't believe in drugs... but certainly major centers would offer them?


10:46 AM  
Blogger Christelle said...

Hey. I did check into that but kind of like strawberry cake for Christmas, epidurals for childbirth here are not what they are back home. The one place that does offer it requires you make a reservation long before and they start the epidural then induce you- it's all very unnatural and since they only use it with 5 percent of the patients, they don't have the experience like back home. Plus, if the baby came before the epidural reservation the epidural wouldn't be available anyway. I decided it was better for the baby and myself to just do it the Japanese way- but made the doctor promise a C-section if I was taking too long. Most foreign wives here have all gone through the same thing so I've gotten lots of good books and videos and advice to help prepare myself. Ganbarimasu!
Having a baby here will be a whole new cultural experience in some ways too, complete with shrine visits. You can check out my updates on my blog "Countdown to Baby"
It'd be nice if our families could meet in Ottawa someday- we're hoping to move there in a couple of years so who knows! Early Happy New Year!

ps- I wanted to qualify why I put "stresses" in quotes in my earlier comment- it was because what you went through seemed way more than stressful to me what with the baby's heartbeat slowing etc. It sounds like you both did a great job in there!

1:20 AM  
Blogger godzilla_rabbit said...

Hi Michel,
Sorry for my late comment.
Thank you for sharing the great story and pictures with us. I felt as if I had been in the same labor room in Canada with you. Furthermore, I envy Keita of having such a great documentary left. This story must become one of his treasures.

4:10 AM  
Anonymous Kinuk said...

I'm a little late with this, but CONGRATULATIONS to you and Yoshiko! That sounds like quite a long birth and I hope you're all recovering and that Mum and son (and Dad) are well.

5:02 AM  
Blogger Michel Lafleur said...

Thanks! We will be coming to Japan in May to visit with Yoshiko's family... I hope to see you then!

Thanks, both mom and baby are doing fantastically well!

6:44 PM  

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