Labour Days

With this little fella arriving five days late it’s not as if we were taken by surprise, but he kept us guessing right up to the end. The last week of Jane’s pregnancy was a trial every time I had to head into work, wondering whether I would be called straight back again by her first contractions. On Friday afternoon I went to Boots on Princes Street to rent a tens machine, one of those things you’ll never have heard of if you haven’t been through this. Jane hadn’t been sure whether she wanted one, but one of my fellow first aid students recommended them, so we gave it a go. More on this later.

On Saturday there was still nothing, so we wandered up the road to a last lunch with a friend as just the two of us. The afternoon was a final chance to wonder when and how our lives would change, and whether this baby was a boy or a girl: two possibilities so equally delightful that I was feeling wistful it couldn’t be both. That evening we watched a DVD of Planet Earth as we lay in bed, watching cameramen in balloons wheel around baobab trees in Madagascar, and just as we were going to sleep Jane’s preliminary cramps of the past week turned into her first contractions.

We did sleep for a few hours, but at 4.30 next morning—or 3.30 by our body clocks, as the clocks had just gone forward—she was hurting and we were up and ready to go. Now it was a new waiting game, noting down the time of every contraction and a rough estimate of its length, waiting to reach the 3-4 minutes between one-minute contractions that marks when you should dash to the hospital.

We had a shared point of reference to measure how painful things were for Jane. Have you ever had muscle cramps in your leg? I’ve been getting them since my late twenties, every now and then waking up in the dark, turning the wrong way while still half-asleep, and having my brain send a jolt into my calf telling every muscle to fire at once. Once it starts you can’t do a damn thing except ride it out, and at the end of it your leg is sore for days. It really is excruciating. Jane gets them too at times, so that was our benchmark: a scale of one to ten where ten equals stabby leg. We’d just watched season one of House starring Dr Infarction himself, which made it seem even more appropriate.

The first hour after waking saw eight contractions, some of them weaker than others, about five to ten minutes apart. On the stabby leg scale, Jane rated them about a one; they weren’t comfortable, certainly, but she wasn’t in serious distress. After the first hour they were still erratic in timing, sometimes every five minutes, others fifteen, so the challenge now was to get them closer together. Walking around helps, so at the two-hour mark we went twice around the block in the fog and dark. It helped during the walk, but back in the flat they slowed down again. At the three-hour mark Jane tried a bath, and for the next hour she was getting decent-length contractions of 45-50 seconds, but still not frequent enough.

At the 8.30 mark I dozed on the couch for 45 minutes, kept from actual sleep by occasional sounds through the bedroom wall of my wife in pain. Once I was awake again I comforted her as best I could, which included making a batch of pancakes to keep her energy up. Like any good Canadian, this kid would be born with maple syrup in its veins.

The morning dragged on; Jane’s contractions intensified at times to a three. I put on one of our favourite CDs, and at around noon she drifted off to sleep to the sounds of Lemon Jelly’s “Nice Weather for Ducks”. But sleep wasn’t what we wanted, because it meant she went 52 minutes between contractions, and slowed back down to 10-15 minutes afterwards. So much for the baby arriving by early afternoon.

Now was the time to get serious about the various tips and tricks we had learned in pre-natal classes. If you’ve visited the house of a pregnant woman you may have seen a big colourful rubber ball rolling around the living room, about a metre across. Sitting on these helps to stretch the pelvis and push the baby down onto the cervix, accelerating contractions. At one pre-natal class a midwife asked Jane if she had one of these balls.

“No,” replied Jane, “but I do have a spacehopper.”

Cue look of horror as midwife pictures Jane’s fetus bouncing off her uterine walls as she boings across a field.

Apart from the handles, though, it’s the same thing, so I got out the air-mattress pump and blew up the Giant Hopper we’d bought in the Christmas sales. (“Can take the weight of a fully grown business executive.”) For the next hour or two Jane rolled around on that between contractions, its authentic 1970s stencilled face grinning at us.

Mid-afternoon, when ten minutes had slowed to twenty, we went for another walk, lapping a nearby park twice. Families were out walking their dogs, their kids tricycling among the daffodils. If only ours would come out and play. But no, it was still 10, 20 minutes between each pause in the conversation and wince on Jane’s face.

I’m writing this blow-by-blow account from a string of times written on post-it notes stuck edge-to-edge, which alternate between Jane’s and my handwriting. On this one, in hers, is written “3:50—m.p.”—more pain. An hour or so afterwards, it was time to bring out the next line of defence: the tens machine.

The name stands for “Transcutaneous Electrical Nerve Stimulator”, a small plastic device with wires to four sticky pads that go on the mid and lower back, either side of the spine. Three AA batteries deliver small electric shocks to interrupt the pain signals from the abdominal area which travel up that way. We called it her baby taser.

The device is controlled by the woman herself, using a few different buttons to select mode and intensity of pulse. Of course, it helps if the woman tries out those different modes before her partner has applied the sticky pads to her back, and doesn’t learn the hard way that it remembers the settings from the previous customer, who presumably stopped using it when the highest was no longer strong enough. Ten seconds after I had plugged in the leads, Jane yelped “Woooo!” and jumped back three feet, only narrowly avoiding tripping over the spacehopper. If the kid emerged with Einstein hair, we would know why.

She had the hang of it soon, though, and said that it did provide some relief. Mainly this was of the “distraction from pain by introducing a new and different form of pain” variety. She kept it on throughout the evening, because the labour went on throughout the evening. At seven o’clock she called the hospital again to see if she should come in. We were still looking at seven to ten minute gaps, though, and they said no, we should wait.

That night is a bit of a blur. We were both hanging in there, because the handwriting is still both of ours, but there were a couple of points where I must have dozed off on the couch. Jane rested in bed for an hour from 7.30, went for another walk around the block at 10.30, called the hospital yet again at 1 a.m. Come in when the pain is no longer bearable, they said. Isn’t one person’s bearable another’s agony? Jane had already borne twenty-four hours of this. The pregnancy books give a normal range for the first stage of labour as anywhere between one hour and twenty. We were in uncharted waters, and they hadn’t even broken.

After 1 a.m. on Monday she had a string of contractions 4-6 minutes apart for about 90 minutes. The last time written on our post-its is 3.08. That was when her cries of pain gained new notes of urgency and I started dialling for a taxi. This time, we didn’t call the hospital to ask if we should come in; if they turned us away we would deal with it then.

Our taxi driver wasn’t fazed by the prospect of carrying a woman in labour to hospital, which was a relief; we’d been warned that some of them could be. There can be few better vehicles for the journey than a British black cab, though. Their big boxy passenger areas are easy to climb in and out of, and I was able to face Jane and comfort her during the ride. Three contractions later, we were at the Edinburgh Royal Infirmary at Little France.

Her initial inspection revealed that the cervix was 4-5 cm dilated (with a target of 8-10), which indicated we had come in at the right time. They took us upstairs then to one of the private labour rooms, with a deep bath in the bathroom, big rubber ball, plastic-covered bean bag and couch, as well as the usual hospital bed. A midwife (actually a few different ones on different shifts) came in and out from time to time to monitor progress.

We ran the bath and took off the tens machine, which Jane had been wearing for twelve hours. It had been useful, she said, but it wasn’t doing much any more. She climbed in and stayed semi-floating for some time. The support of the water around her body seemed helpful, even if it did invite comparisons with certain aquatic mammals. (I wasn’t the one making them, I hasten to add.)

By now, both of us were seriously fatigued; our last full night’s sleep had been 48 hours earlier. While Jane floated, I discovered that fatigued partners aren’t well-catered for by NHS furnishings. The couch was barely a metre long, and I am most definitely not, so lying down was more a concertina than a full stretch. The bean bag was okay, but I had to give it up when Jane took a break from the bath and used that and the ball to lean on.

I’ve lost track of how many contractions Jane went through on Monday; we stopped keeping count once we left home. The count at home was about 150. They filled eleven large-sized post-its.

After a couple of hours of the bath Jane switched to Entonox, a 50-50 oxygen/nitrous oxide mix that comes in gas cylinders with mask attached. At first she took a few breaths of it at the onset of contractions, but as time wore on she started sucking big draughts of it throughout like Dennis Hopper in Blue Velvet. It helped take the top off the pain, she said, but started making her feel light-headed.

It was around now that Jane took up the midwife on her offer to break her waters to help things along. It’s a sign of the different priorities which emerge in this situation that one can agree not only to having a cold rubber-gloved hand thrust into a warm area designed for something less prehensile, but also a long plastic stick with a hook on the end. “This is all getting a bit too biological,” said Jane, B.Sc. Hons in Biology.

Around 11 a.m. it was time to ramp up from the Hopper juice to some full-on Trainspotting. Another of the pain-relief options (short of an epidural, which Jane was striving to avoid if at all possible) was to have injections of morphine into your buttocks, which could be repeated after two hours and then a further four. It isn’t ideal, as the morphine does pass into the baby’s system, but the pain and fatigue were now so bad that Jane agreed to it, if only to get some rest. It didn’t take long to kick in, and afterwards she did seem better than she had in hours; she still felt the contractions, but they didn’t strike with full intensity every time. Once Jane was able to relax—a little—so was I. I wedged a plastic pillow into the end of the pygmy couch, folded my knees up as I’d done on countless bus and plane trips, and slept fitfully for about an hour. That hour of rest saw both of us through the rest of the day.

After inspecting Jane at around noon, the midwife told us that she was only 6 cm dilated, much less than they would have expected by this point. The usual option at this point was to put her on a drip of syntocinon, a hormone that speeds and intensifies contractions. Thirty-six hours since the first ones of late Saturday, this seemed like a plan.

There was no need to tie up the bath and bean bag when she was on a drip, so the midwives moved Jane to another room—a standard hospital room, with a strip of outlets along the wall behind her bed, a sink and bathroom opposite, and little else. I sat beside her on her right, while the midwife, who had been in and out all morning, stayed sitting on her left and monitoring progress for the duration. She put on two straps with heart-monitors for the baby like we had seen on a previous visit to the hospital when Jane’s blood pressure had been a bit high, for continuous monitoring rather than the occasional checks up to that point. It was fine.

As the midwife went to put an IV line into her left wrist, Jane warned that her veins can be problematic; the last time she gave a blood sample she ended up with a bruise on her arm for a fortnight. The midwife said she could get a doctor to do it if Jane liked, but no, said Jane, “I trust you.” After promising to be careful, the midwife administered a local anaesthetic and then the IV needle. “I’m getting flashback,” she said, and pulled it straight out again. Another fortnight-long bruise...

That meant trying again on the other arm, this time getting one of the doctors to do it. I moved out of the way to let her in, which meant that instead of being shielded from the sight of the needle going in I had a clear view as it happened, like a nail pushed into Jane’s wrist. No anaesthetic this time, but with all her contractions she said she hardly felt it. The drip tube went in soon after that. The effect was rapid, and soon so were Jane’s contractions.

Between contractions Jane was herself, but getting tired. Because it seemed that nothing would happen right away, she encouraged me to go and get something to eat—neither of us had had more than a muesli bar in hours. Somewhat reluctantly, I left the room. “No giving birth in the next twenty minutes,” I joked, and then knew it wasn’t that funny. Walking along hospital corridors past everyday people felt out of order, as if the world was wilfully ignoring her pain. The food court was even worse. Why was I eating a cold chicken baguette and a cup of scalding coffee when I should be back there with her? I didn’t even finish the coffee before heading back.

Walking into the room was like walking into a psychological experiment, like Stanley Milgram encouraging his subjects to crank up the voltage on their victims. She had gone way past ten on the stabby leg scale by now. Jane’s latest contraction soon ebbed, though, and I was back by her side.

So began the longest hours of the day. Every few minutes Jane would roll over towards me, gripping my hand and grimacing, withdrawing into herself to concentrate on dealing with the pain. All I could do was study the creases around her eyes, wishing there was some way I could make them go away. All I felt was helplessness—that, and a measure of guilt at setting this in motion nine months ago with one wriggling cell.

The midwife discussed pain management options. One was an epidural—“most people would have had one long ago”—but, hoping that the end was near, Jane was still holding out. It was three hours since the last morphine shot, so she could have another of those, and did.

Around 3 p.m., a fresh inspection revealed that Jane’s cervix was at... six centimetres. Hours on the torture juice, and it hadn’t moved at all. “Oh no,” she sighed in dismay.

It wasn’t long before a doctor came to talk to her about the options. At this stage, they would expect the cervix to be fully dilated. It was clear from the inspection that the baby was stuck. Although head down, which is good, it was face out instead of facing the spine, which can lead to difficult deliveries like this one. The baby’s body was slightly off to the side, so although its head was engaged in the pelvis it couldn’t get moving.

The options were to keep trying for a couple of hours, which was looking unlikely to help much, or to have a caesarean. They gave us a few minutes to talk about it.

It was Jane’s call, of course, but it was hard to resist the conclusion that if it had to be a caesar it was better sooner rather than later, while the baby wasn’t in any distress. Obviously it wasn’t how she had wanted things to end—particularly a labour of this length—but she was so tired that it seemed that going on would only make it harder. When the doctor came back Jane asked if there were any other options, but beyond more of the same there really weren’t. Okay then, she said. Let’s do it.

Everything moved quickly then. The drip came out. After having the risks formally explained to her, Jane signed a release, and an anaesthetist explained to us what would be happening in the theatre. They wheeled Jane’s bed out of the room and directed me to a changing room, where I took off my clothes and put on green hospital scrubs.

I walked through another door into the theatre area, and a few feet from there into a brightly-lit white room. All those episodes of House had led me to expect a shadowy night-time ambiance, but of course it makes sense to have surgeons being able to see what they’re doing.

Jane had my camera (where did that come from?), and took a photo of me in scrubs. My face is the definition of a worried smile. By the time I had turned the camera on her, she was already having another contraction. Those few photos are time-stamped just after four.

Jane was sitting up on the bed so that the anaesthetist could give her a spinal injection of local anaesthetic. After avoiding an epidural for all those hours, she was effectively getting one anyway. I tried not to think about what was going on behind her back; we both trusted the doctors, of course, but it was still a relief to hear that it had gone in cleanly. After Jane had been lying down a few minutes, they asked her to raise her left leg, and then her right... which she did. The anaesthetist dabbed her skin with a swab of cold solution to see what she could feel. Above her breasts, yes, she could feel it; and on her waist, yes... and on her thighs... and her calves. For some reason, the first dose hadn’t taken.

So they had to administer a second. Jane sat up again, and—after another contraction passed—kept perfectly still. Again the needle went in cleanly. Again she lay down on the bed. Could she raise her left leg? Yes. And her right? Yes. Could she feel the cold swab? Yes... yes... yes... yes.

“In this situation,” said the anaesthetist, “what I’ll do is ask a colleague from the next operating theatre to come and administer the third dose, just in case.” Soon he was in the room with us. “I’ll be very careful,” he said, “but if this doesn’t work we’re going to have to put you to sleep.”

I tried not to think of what could go wrong with a general anaesthetic; Jane had had one before, but you can never be quite sure how the body will react. And to sleep through the arrival of the baby after all this was an awful prospect. Jane told me later that at this moment she was wondering if she could back out of the caesarean and keep trying for a natural birth.

Could she raise her left leg? Yes, damn it. And her right. Could she feel the cold swab? Yes... no... no... no.

That was enough. The lack of feeling on the skin meant she wouldn’t feel pain, so the doctors prepared for the operation. A screen went up over her midriff, and I moved my chair so I was sitting by her left side, next to her head. I held her hand and watched her face, nervous tears in our eyes.

The first anaesthetist talked us through the operation, telling Jane what to expect at each point. “You won’t feel pain, but you will feel some movement...” Our NHS prenatal classes had also given us an idea of what happens in the operating theatre during a caesarean, so it had been worth going to those.

It all happened quickly. A few moments of chatter, and we heard some noises that weren’t made by an adult. “Dad, do you want to stand up and see your baby?”—they had told us I would have the chance to look over the screen at the newly emerged infant, but I declined, not wanting to risk seeing Jane cut open, and wanting to share that first glimpse with her. Seconds later, a doctor was standing by her head, showing us—

A boy. A crying, glistening, purple boy, with a yellow-green cord trailing from his belly, and—the detail I most remember—filigree lines of red and silver traced over his skin, around his eyes and nose.

Intense sobs of relief and happiness overcame us. “Hello, William,” I said. “Welcome to the world.” It was just after five o’clock.

William is named for his great-great-great grandfather, the Ewins who emigrated from Britain to Australia and then on to Fiji, where his grandson and great-grandson (my father) were born; and, for his second name, after Jane’s father, another fellow migrant. This also makes his full name the same as the elder William’s eldest son, my father’s grandfather.

The doctors took him away a moment to clean and weigh him and clip a peg onto his cord. They brought him back swaddled in a towel and handed him to me. I held him close to Jane’s face while the surgeons stitched her up on the other side of the curtain.

“He’s a big boy!” they said. And so he was: 4.3 kg, or nine pounds seven in old money. But he seemed small and perfect to me. His head was covered in dark hair, matted with mucus from his attempted exit; his skin was still a strong pink. His skull was a little moulded from being wedged into Jane’s pelvis, but within a day or so it returned to a normal round shape.

“We’re going to have such fun together,” I said to him, as he squinted at the fluorescent lights and his newborn blue eyes took in his surroundings.

When Jane was stitched up the doctors nestled William next to her face and wheeled her out to the ward where the two of them would spend the next few days together. My first photo of the two of them was taken twenty-five minutes after his birth.

The three of us stayed together in the ward for four more hours—throughout his first feed—and Jane and I studied his face, his wrinkled feet, the loose-fitting skin of his hands, the soft folds of his back. I cradled him in my arms, then lay him down in bed next to his brave and wonderful mother, who was already dozing off. It was time to leave before I did the same, but leaving the two of them was the last thing I wanted to do.

Outside the overheated neonatal ward, the night was cold fog and iced-over puddles. In the taxi home, my mind roamed over the previous hours—41 hours of labour, counting from Jane’s first contractions.

In the shower after I got home, I was in helpless tears thinking about all Jane had been through, and out of relief that they were both okay. I don’t know how I would have coped if she hadn’t been. I was relieved, too, that William was born in 2007 and not in the time of his namesakes, because in that day and age they might not have survived such an arduous labour.

In the following few days, though, the tears were of happiness as I caught myself thinking that this little guy is our son, and that I won’t have to spend any more of my life wondering when or if he’ll arrive.

He made it. And we made him.

William's foot

9 April 2007 · Journal

Oh man. Rory, that was an incredible read. All misty-eyed here!

I am in awe of that long and grueling labour (not to mention terrified)! But what a prize at the end, eh? :)

Added by shauna on 9 April 2007.

I am in awe too. 41 hours. Wow. Glad both are fine.

But little feet! Cute.

Added by K on 10 April 2007.

Misty-eyed? Man, I've got tears streaming down my face. Rory, that was an AMAZING blog entry to read, what a beautiful experience. When he reads it, William is bound to think so too. The love that comes through your writing is inspiring, babe. Awesome. Awesome.

Added by Nomes on 12 April 2007.

Many thanks, everyone. It’s good to know that the lasting record has hit the right note.

Added by Rory on 13 April 2007.

I am in tears... Beautiful story and beautiful pics. Congratulations.

Added by Niki on 13 April 2007.

Hee hee, I had a spacehopper I used as a birthing ball when in labour with my first son!

I even had the occasional bounce.

Lovely moving post, btw.

Added by Clare on 14 April 2007.

What a lovely post. (And son too.) Bests to all three of you.

Added by Peter on 18 April 2007.

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