Premature birth: the story of Phélicia
Sometimes my job is to do pressure points, massages, compressions on the pelvis for 12 hours. No time to eat or sleep for hours, we put our lives on silent and we lose track of time. A premature birth is often a different story.
Sometimes my job is to talk gossip, find first names, hold the hand and stroke the hair of a mother who can do nothing but wait and hope. Simply.
You never know what kind of birth is going to happen when you are on your way to the birthplace. It's always a few days later that I understand what I've learned and the real work I've done.
Phélicia had a placental abruption at 34 weeks pregnant. When the placenta begins to detach from the uterus, there is small or severe bleeding. If the baby seems to be affected, we should induce delivery or go for a cesarean section.
Le placenta de Phélicia played tricks on him, sometimes bleeding, sometimes calming down. So when she started bleeding at the beautician, she didn't think she would give birth that night. It was not the first time that she had visited the hospital only to come out a few hours or days later.
Because her placenta threatened to come off completely at any time, the Caesarean is always near. The medical team of St-Justine asked to put in from the start, the catheter for the epidural in case we had to go for an emergency cesarean.
When I arrived, the anesthetist was giving the shot. Eventually, Phélicia opted to receive the first bolus of the epidural, but not the infusion. That is to say, during the initial bite, she was injected with a first dose of medication which relieved her.
Then there are the subsequent doses, but she didn't want them. The effects of the epidural wore off quickly and the sensations of the contractions came back quietly. Finally the moment when it was impossible for her to continue, she took the doses. Since she absolutely couldn't move because of her placenta, the contractions were hard to handle.
The sensations that the contractions bring on are intense, but much easier to manage if we can move around and put ourselves in the most comfortable position for us.
A touching story from the start
Phélicia and Rivu, her partner, hired me because the father had to leave for 2 months, exactly around the expected date of delivery. It was impossible to change the dates or cancel. The 23-year-old would therefore have to give birth without her lover. He had only been gone a few days when I got the call.
I was immediately touched by their story and by the resilience of this woman. When she called me to tell me that they should induce delivery that evening, I knew it would not be a simple delivery. I was happy to be available for her, even though I was not yet on call for her delivery.
Vanessa, Phélicia's sister, mother of 4, was with us from start to finish. It wasn't planned, but she was with Phélicia when the bleeding started. She did not want to leave her bedside, even to go and breastfeed her own 4 month old daughter. The bond between the two women was so beautiful. They understood each other well, they were accomplices. Vanessa was always taken by the emotion during the new developments.
Between calls to Bangladesh to let dad know, naps and frequent bleeding examinations, night has set in. Then the early morning came and finally the sun was up when the baby started to show signs of exhaustion.
A second complication
The problem was, the baby couldn't do its job and squeeze into the pelvis. The umbilical cord was in his way! As soon as the baby descended into the basin, it cut off its own oxygen supply.
Have you ever sat on a bomb? It is a little the sensation that Phélicia must have felt. You should not cause more bleeding, you should not rupture the membranes of the amniotic sac, so as not to have a cord that falls into the vagina ... In short, a cocktail of hormones not the most relaxing.
Sometimes my job is to hold hands and stroke the hair of a mom who is going for a cesarean when waking up from her nap.
A little confused and exhausted by the major blood loss of the last few hours, small tears came silently running down Phélicia's cheeks.
Even if we understand the logistics, if we know that there are no other options, that it is for the best ... to go to the operating room always a little scary. This is the unknown and it was not expected.
Sometimes my job is to let moms go beyond the door that I can't go through. It is having to wait for long minutes, in a waiting room or in a recovery room, without news. It's finally being able to close your eyes, without being able to sleep.
After a moment that seemed interminable, Phélicia came to join me in the recovery room. Her sister had left with the baby in neonatology. He was fine, but considering his age he had to be under surveillance. 34 weeks and 5 days is not that small, but it is premature nonetheless.
The big lessons
It was not what the parents had imagined the birth, but Phélicia gave birth to a healthy son, in the safest way given the situation.
Sometimes my job is to offer alternatives to modern hospital medicine. But sometimes, I'm really happy to live in a country where all this is offered to us. The St-Justine medical team was there when we needed them and everything was done with gentleness and attention.
You learn something new with every childbirth and this time it was an exercise in patience for me. I could not offer physical help as I am used to, I could only be by his side, valiantly and patiently.
That's all my job to doula. And I'm so happy to be able to understand it better every day.