My wife had a long labour. We had been enthusiastic labour parents, taking to the role and its expectations with duty and excitement. We walked the block in the early stages of labour, ate well, relaxed when possible and stayed home as long as seemingly possible.
I was told by a tired midwife over the phone to not come to the hospital until my wife’s contractions were less than 4 minutes apart, not to get too excited, but to call back if her water broke.
The clinical and apathetic mood of our conversation was mildly deflating, the midwife almost annoyed that I had rung. I understand night-duty and its pressure, its lethargy and its sleep deprivation – but I was having a baby! Well, my wife was anyway – some excitement or encouragement could have been in order!
We waited and waited. My wife’s water had broken while she’d gone for a nap and her contractions were under the 3 minute mark. Surely things were looking good. We headed up to the hospital in an eerie calm, driving slowly to not cause discomfort; excited but fully aware this was the start of the journey – not the end. While I was completely aware of how unrealistic Hollywood birth scenes really are, yet it still seemed anti-climactic driving in a calm and restrained manner through the quiet streets to the hospital.
Our arrival to hospital led to us being ushered in to a sterile examination room and the midwife “had a look” at how things were progressing. Anyone familiar with this area would know that midwives don’t look with their eyes. There was some confusion and deliberation before the first midwife made off for reinforcements to also “have a look”; leaving my wife sitting on an examination bench, with slightly less dignity and a lot more KY jelly than when we entered.
Eventually everyone was happy having “had a look” and we were ushered to the birthing suite to have some rest and prepare for the day ahead. Through this process I was pushed to the side and out of the way, my involvement seeming unnecessary.
Labour went as smoothly as possible until after the 30 hour mark, my wife’s dilation slowed and things became more complicated. A foetal heart rate monitor was connected and my wife was administered syntocinon intravenously. The midwives had been fantastic as they had made every effort to explain things to my wife about what was happening. As the effects of the synthetic-hormone began, the heart rate monitor began to display our baby’s heart rate dramatically slowing with each strong contraction, before rising back up to normal limits.
Patients are often connected to various forms of technology and devices that monitor and assess homeostasis to varying degrees, often alarming and beeping due to changes in blood pressure or heart rate, alterations in oxygen saturation or occasionally a dropped lead or sudden movement.
The alarms often create anxiety and confusion in patients and visitors, worried that a Hollywood-style resuscitation attempt would ensue following an alarm. I often tell people – “don’t start worrying until I look worried”. Our midwife was doing her best to look unworried – but a little experience could see that she was concerned. That and the notes she was writing all over the print-out; outlining that she was still awaiting the doctor’s review, despite having paged him earlier.
To the layman, the midwife jotting notes on the printouts may not raise any alarms, but this had me concerned. In a day and age when documentation is paramount in ensuring professional protection, I know you only start documenting things that carefully as they happen in times when things start going wrong.
Nothing was mentioned of the dipping numbers on the monitor. My wife was focused on her contractions and I was attempting to remain focused on helping her through them; all the while knowing my baby’s heart rate was dipping below acceptable levels and nothing was being said about it.
Our obstetrician finally arrived. He was an affable and seemingly well-read fellow open to our wants and needs; including our intentions to have as natural a birth as possible, attempting to avoid a caesarean section if able, and with minimal drug therapy. He offered his suggestions and explanations of what was happening in clear and understandable language.
There was little medical (or obstetric) jargon as he explained that mother and baby were now quite “tired” and that the baby was having some difficulties maintaining its heart rate and was in some distress. He offered us a plan of attack that would seem him attempt to deliver the baby without surgical intervention. His calmness was strongly juxtaposed by the goings on around us midwives milling around in preparation as we all tried to ignore the heart rate monitor, beeps dipping in the background.
The delivery of his information in such a casual and straightforward manner was comforting for me. It was personal, sensitive and reasonable – panic is not an emotion you wish to see on anyone’s face in times like these and his ability to diffuse our increasing anxiety was welcome.
What followed was a delivery that was later described by our obstetrician as “agricultural”. My wife had been in more pain than I had seen any patient before in my professional duties and the analgesia that had been administered to her had been administered incorrectly. I was torn as I noticed what had happened; as to what my boundaries and roles were. An average father-to-be wouldn’t have noticed that there was a problem, but I’d seen the drug not fully clear the intravenous line.
Professionals were at work in a highly stressful environment and my primary concern was supporting my wife. This role dilemma continued to place me in a difficult situation after our son was born; he was blue and unresponsive, the umbilical cord having been around his neck. Part of me was panicked to hear the familiar sounds of an infant resuscitation effort being performed just near me. Part of me wanted to be involved, or even to see him. To be honest, in the rush of baby being delivered; I had not seen he was a boy – I’d just seen this blue, contorted baby being pulled as swiftly as possible from my wife’s body, covered in amniotic fluid, vernix and blood and handed to the awaiting Paediatrician.
The fears of any complications due to asphyxiation, a failed resuscitation or other complications were very real in my mind. There was no ceremonial cutting of the cord, quick gentle cuddle or time to rejoice; our son needed medical attention and my wife was still in pain. I was helpless and unable to influence any of these situations – something I am very much not used to and it was not welcome.
The confusion on what to do and where to be is intense, all the while midwives, nurses and doctors are attending to the needs of my wife and baby, helping them as best they can. Communication at this time was understandably minimal. The paediatrician and nursing staff were working on our baby, the obstetrician and midwives focussed on my wife’s pain and birthing of the placenta.
Time went by and the severity of the situation subsided; we got our cuddles, then our son was whisked away for observation and we were left to it. What was my role now? I had a wife to help, still connected to an intravenous line that had eventually delivered the pain relief after the birth of the baby, failing to take away any labour pain, but now successfully making her drowsy and giddy – on top of the usual post-partum issues.
My newly born son lay under a heating lamp, connected to monitors; still mildly cyanotic, alone and asleep. Our families were interstate, as our wish – but were desperate for news after such a long labour. The doctors and midwives had moved on to the next problem, next birth and the next duty. I was left somewhere in the middle – emotionally and physically drained, still confused on what went wrong towards the end of the labour, and still confused as what my role now was, still uncertain on how I fit into the plan of care or delivery of services.
I was capable of caring for my wife as any husband is and also capable of caring for sick or injured patients requiring assistance with mobility and showering – which my wife now was. However, was this MY role? I knew better than most that hospitals run on people knowing and understanding the roles within the organisation and fulfilling them – but where did I fit in? The past few hours had been so chaotic that I was unsure what to take on as my role and what to leave for the staff.
I still had adrenaline pumping from the excitement, but also from fear. My wife had been in incredible amounts of pain and I had been unable to help her. The medical model of care had failed her in the very important task of pain management, which aside from being incredible unpleasant has also been shown to directly affect the birthing process (Wong, Perry, & Hockenberry, 2002).
Communications throughout the labour process had been fantastically clear and appropriate – but now there was no communication or support – the initial problem of a baby needing to be born had been effectively and efficiently dealt with. Our new requirements for support and explanations did not fall into the priorities of medical staff at this time.