The Birth of Baby Oliver Sims

A labour and birth story in the time of a pandemic, written by his mother, Pamela Sims. 

​We got pregnant quickly, but at the right time. 
​We had​ just moved into our first home.
As the embryo began to grow the world was falling into a new type of chaos.
The Covid 19 pandemic was arriving in Alberta and this would impact my whole pregnancy experience.
Perfectly timed in a pandemic summarizes the experience.
We moved into the house just before the first case in Alberta.
​The morning we found out we were pregnant was the first morning of remote learning.
I received my continuing contract.

Good timing in a pandemic. 

The pregnancy was full of anxiety with little reason. I was sure that since we got pregnant quickly that it would end just as quickly. I was sure that because I was pregnant I would lose my chance at a contract. I was sure that I would get Covid and it would hurt the fetus. I was anxious. But all of the anxiety was misplaced energy. 

As we got closer to my due date I began to worry that COVID rules were going to prevent my doula, or worse Mike, from being there. The day before my water broke, I cried telling Mike that I was worried about us seeing people because if he got sick, he wouldn’t be able to be with me. I already knew that if I was induced that he wouldn’t be able to be with me until I was moved into labour and delivery. I wanted to make sure that he could be with me for as much of the experience as possible. 

​I was 39 weeks pregnant on a Sunday morning around 8am when I noticed that there was a bit of fluid in my underwear. I was starting to wonder if it could be my water breaking so I googled “how to tell if my water broke or if I peed my pants.” I was mortified. 
When Mike came into the bedroom to get ready I said, “I just want to give you a heads up about where I am” as I showed him what I had searched. He laughed; so, I laughed. Fluid was definitely coming out! I burst into tears! I was immediately overwhelmed. Mike suggested we call Sonya, our doula. Sonya quickly confirmed that it was most likely my water. I laugh-cried. I couldn’t believe that I had just called another adult to ask if I peed my pants. 
We made our way to the hospital. Because of Covid Mike had to leave me at the front door and I was brought up by a porter. Earlier in the pregnancy being separated was my worst fear. I was so grateful for Sonya because she had prepared me for having to go up on my own. 

They checked both me and the baby’s vitals and did a swab of the fluid. I was one centimetre dilated. While I waited for the results, I put my hair into French braids. Having my hair in French braids felt like it was going to be a difference-maker in my labour experience. The doctor came in and explained that my water had indeed broken, but with no contractions. I had to decide if I wanted to wait to see if they would start or if I wanted to be induced right away.
I called Mike and then we conference called Sonya. We discussed the options and Sonya explained the process. I decided to go home and see if the contractions would start on their own. I really wanted to avoid being induced. I knew that typically contractions from an induction hurt more and that increased the use of an epidural. I wasn’t against pain medication, but I wanted to limit what was used and how much if possible. I knew the induction would make those choices harder. I also knew that if I was induced that Mike wouldn’t be able to join me until I was in active labour. That could be hours. I didn’t want to be separated from him.
We went home and finished getting ready for baby. Mike had some work he had to get done that week so he also made good use of that time. We ordered dinner and mom came over to rebraid my hair. Again, this was an essential part of my birth plan.

At 8 pm we made our way back to the hospital. Mike took me to the door and then went back to the car. I went up to be assessed. I was still one centimetre dilated with no contractions so the doctor and nurses began preparing for me to be induced.
We were very fortunate. Good timing in a pandemic. It was a slow day in labour and delivery so I was moved to labour and delivery right away. Normally, they don’t move you until you are in active labour. I was terrified that Mike wouldn’t be able to support me through this time and he would be in the car for hours. Because they were able to move me in right away, he was able to support me through the whole experience. 

Contractions did not start right away. All night the nurses checked on me and the baby every 30 minutes because I was on the highest dose of oxytocin they can give. Around 8 the next morning I stated to feel minor contractions.

They escalated quickly. Mike texted Sonya to ask her to join us. By then the contractions felt like my pelvis was splitting in two. I decided that they could “cut the baby out” if they wanted to. I just needed the pain to stop.
​I waited to make any decisions about pain management until Sonya arrived. Once she was there we discussed comfort measures and pain medication. I decided to try fentanyl.
They didn’t want to give me morphine incase
I wanted an epidural later and the morphine could still be in my system. The nurse was really concerned that I would need an epidural and would not be able to have one.
I felt strongly about starting with a smaller type of pain medication before going all in.
I’m so happy I did. The fentanyl work perfectly for me. I dozed between contractions and no longer wanted them to cut the baby out. 
As the contractions became more frequent and intense I needed Mike beside me. Sonya supported us in this need as well. She made sure he had everything he needed so he didn’t have to leave me. Mike supported me by doing double hip squeezes, swaying with me, and anything else I asked. 
I wasn’t allowed to eat but I snuck some orange slices anyways. I thought I was sneaky, but then I threw up. It was very apparent I had eaten more than just “clear foods”. I threw up one more time during labour. When I felt the need to vomit coming on, I yelled for something to throw up into. The small kidney bowl was not enough. Mike ended up covered in vomit. As the nurses tracked him down a new pair of pants, I laughed and asked Mike to text my dad because he would be able to relate because my Mom threw up on him when she was in labour with me! I found out later that my dad immediately called my mom to discuss how similar their experiences were. 

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The contractions progressed and I started to feel a urge to push. Sonya caught that one as well. I kept going to the bathroom, with Mike in tow. She asked if I was feeling the urge to push and I admitted I was. They told me I couldn’t. Not pushing when your body wants nothing more than to push was torture. A nurse suggested that I push against Mike when I felt the urge. So while he ate his lunch I pushed against his back with both feet. 

We cycled through multiple positions and comfort measures. Not pushing continued to be the worst part. All I wanted to do was push. They checked my cervix and I was 9 cm dilated and fully effaced on one side. By the time
I was fully dilated but the one side had not changed. I was prepared to beg for them to let me push.
I asked Sonya to explain to me why I could not push. I reluctantly accepted her answer and continued to wait. And wait.

When they finally told me I could push I was elated. I realized for the first time I had not even considered asking for an epidural. I wondered briefly if they would give me one at that point. I was just so relieved that I could push. Sonya explained what pushing would be like and how the baby needs to travel. They explained that there would be additional doctors in the room in case the baby needs support because of the fentanyl. 

I pushed on my back and then on my side. I moved to my back again. I could feel my body getting tired. My arms were beginning to ache and feel weak from using them to leverage. I was no longer able to use the handles to help me push. I had Mike on my right side and our nurse on my left. As the baby got close to crowning Sonya helped me reach down and feel his head. 

As the baby crowned, my contraction ended. I yelled, “I want another contraction!” The nurses and doctors laughed. When the contraction finally came, they talked me through the push. I was ready for the sensation of his head leaving my body but the rest of the birth surprised me. I panicked and asked for someone to explain what I was feeling. Sonya quickly explained that what I was feeling was his shoulders, followed by his torso, and then his feet. And he was born. They placed Oliver on my stomach. I could feel him but could not see him clearly. I was immediately in awe of the small human laying on my stomach. 

Everything slowed down. There was plenty of movement and I am sure that the doctors and nurses where moving quickly but all I could focus on was that the human I have been waiting to see was here and Mike. We had made this tiny human. Mike cut the umbilical cord and they moved the baby up to my chest. I still couldn’t see him clearly but I could feel and hold him. I was in awe. 

We tried to get him to latch to start breastfeeding but my nipple wouldn’t cooperate. Sonya encouraged us and made suggestions but when it wasn’t working she made sure I felt that it was okay to stop and try again later. 

I was so full of questions. Did I tear? (Yes, first degree with a small second degree tear) Did I poop? (“I normally don’t tell but no.” However it is possible she was lying) Does he have two eyes? I have only seen one! (Yes) Does he look like he had Down syndrome? (He had markers for Down syndrome at our anatomy scan. No). 

We all guessed his weight. Sonya, the doctors and the nurses all guessed around 7lbs. I guessed 3. He was so tiny. How could he be any bigger than that? 7 lbs 10 ounces. 

We moved into the recovery room. We started making our phone calls to let our family know he was born. Because of Covid we knew no one would be able to meet him until we got home. Little did we know, the government would be prohibiting all gatherings the next day. While we broke the rules for our parents, his aunts and uncles still haven’t met him at 7 weeks old. 

The rest of our visit was a blur. We had a great experience at the Grey Nuns. I was extremely proud of myself for asking for help with nursing each time. We stayed an extra night to get more support with Oliver’s latch. The paediatrician had no concerns but the nurse that was discharging us seemed concerned about his colour.
We went home. We were so excited to settle into our new life! We had a lot of support lined up. Our doula was going to be there the next morning and my mom and stepdad were next door. I felt confident. 
The next day we had our appointment with the public health nurse. The nurse was concerned about jaundice and sent off a blood sample. She explained that if the numbers were as high as she thought they might be, he would need to be rehospitalized. I cried. We went home and waited to hear back. 

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About 4:00 she called and said he needed to be admitted back into the hospital. She said only one parent could stay with him and that since I am breastfeeding it would be ideal if it is me. I have been a mom for less than 72 hours and I am going to be alone in the hospital. I know many women experience this but it wasn’t what I had thought my experience was going to be. My heart was breaking and I was terrified. When we arrived at the hospital we were pleasantly surprised to find that Mike could stay with us. We weren’t in the NICU like I imagined but a postpartum room. We were together in a comfortable space. They even had dinner for one of us.
Breastfeeding while Oliver was treated for jaundice was different. I was told to time my breastfeeding and then pump after. Oliver was to eat formula. I felt like I had failed him. I couldn’t be enough. This started a whole new set of feelings and challenges. 
We spent two more nights at the hospital until his numbers were in the clear. While the doctor said he was healthy and in the clear, my confidence was shaken. The following week we saw a paediatrician and a lactation consultant. Both were not concerned about Oliver and I felt like we were ready to settle in. The lactation consultant suggested we get him weighed around two weeks. 
When Oliver was weighed at two weeks,  he was not back up to his birth weight. At his three week checkup he was still not there. He was not gaining weight as fast as he should be. I was devastated. I failed him yet again. We started combo feeding. It has been an adjustment that is stressful and disappointing but he is growing and healthy. I’m starting to trust my instincts again but it’s hard after feeling like I’ve dropped the ball so many times. After feeling like I have failed him so early on. I’m trying to settle in. I’m starting to trust myself. I’m starting to trust him to tell me what he needs. It was a bumpy start but we are okay. We are healthy. We are happy.

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