E3| Sarah Latulippe: Unplanned Cesarean, Midwife Hosptial Birth, Failed Epidural

Sarah lives outside of Barrie ON, she previously lived in Toronto for 10 years where she met her now husband Derek. She worked in Marketing before going back to school to become a sign language interpreter for the deaf, so now shes works in Universities and Colleges interpreting for students. Sarah and Derek have been together for 6 years after meeting on Tinder, and got married in January 2019 and conceived her first pregnancy quick after in January 2019 unexpectedly as she thought it would take a few months to become pregnant, but luckily it didn't take them long at all! Sarah didn't have any obvious early pregnancy signs so after texting back and forth with her sister she decided she would take a pregnancy test that came up a bold positive, Derek was down in the basement so Sarah went down to show him the test in excitement and they both could not believe how quickly they became pregnant and were thrilled to be expecting. Since this was Sarah's first time being pregnant she didn't know what to do next after a positive home pregnancy test and since Sarah had just recently moved to her new town she didn't have a family doctor close at the time and the one she did have had a long wait time so she went into the ER to get checked out and confirm pregnancy. While they were at the hospital Sarah met her lovely midwife who followed her through out her pregnancy and birth, the midwife explained the process of visits and care during pregnancy starting about 9-10 weeks. Around 5-6 weeks Sarah stared getting signs of pregnancy and she explains the one that sticks out the most is the terrible migraines she would get in the evening lasting through the night. -

"They were debilitating, I would stay home from work. It was throwing up all night long and unable to rest my head on anything".

Being pregnant she was limited in the pain management options, she was also on Diclectin to try and help with the migraines and nausea. Thankfully around 17 weeks the migraines stopped and she didn't have anymore after that. After taking with her midwife she said that if your have migraines before pregnancy that it can exacerbate then while you are pregnant. Sarah jokes by saying she would see other moms in the store and wonder how they managed with 2+ kids, but now that her son is born shes forgotten all about the struggles of pregnancy. After Sarah's 12 weeks ultrasound she was informed they saw some factors associated with Down Syndrome so around 14-15 weeks they went to Toronto to get testing done and meet with a genetic counselor and a week later thankfully the test showed a very low risk of Down Syndrome and they found out they were expecting a BOY!

"We would love the baby no matter what, you just want them to have all the health in the world."

Sarah went the midwife route and as a first time mom she had no set birth plan and had the "anything can happen" mindset. She didn't do any childbirth preparation classes but did learn a few things along the way, so she was planning dim lighting, a calm environment and soft voices from her support team with the hopes of a natural birth. Sarah had Braxton Hicks starting around 7 months that would sometimes make her wonder if baby was coming! At 40+3 she was past her dates and was starting to get a little inpatient so she explains she attempted the midwives brew that didn't result in labor and actually ended up scaring her due to all the conflicting advice about attempting this mixture, but thankfully everything was fine and she didn't have any of the scares people had warned her about.

Halloween night Sarah started to notice some "painful braxton hicks" but later realized it was the begging of true contractions. By morning Derek was wondering if he should stay home but Sarah knew labour can take a bit and by the time Derek go home from work that evening the contractions picked back up and continued through the night. During the night they watched some TV to try an take their mind off of the excitement and did some walking around the house and early morning the contractions really picked up and they made the call to their midwife. Around 3:30 am her midwife arrived, she preformed a Vaginal Exam to check dilation and she was 1 cm which wouldn't be enough for her to go to the hospital but because the contractions were coming so often and were quite strong her midwife suggested they go to hospital. They headed off to the hospital, and after being triaged the staff sent Sarah back home as she was still about 1 cm, so Sarah made the best of the situation and kept a positive attitude about heading home. Sarah's mother and sister drove 2.5 hours and met Sarah at her house to help support her though labour and delivery who she explains she was so thankful as they were great help to her, coaching her through her breathing and trying to help her relax her body. at about 10:30 in the morning Sarah called her midwife back who then came over to check Sarah again, this time she was about 1.5 - 2 cm and her midwife decided to have everyone head back to hospital which Sarah was a bit hesitant about just because she did not want to be sent home again and have to do the drive in labor for a 2nd time. Sarah decided to get the Epidural which she was nervous about because one of the side effects is chance of headache since at the beginning of pregnancy she had such a rough time with migraines but thankfully she didn't not have the side effect happen. 2 hours after the epidural was administered Sarah was starting to notice the pain returning, she was attempting to re administer more medicine using the push button but it didn't seem to be doing anything. Sarah had her headphones in listening to a podcast, then suddenly Sarah turns to her sister Abbie and asks her to take out her headphones and Sarah was having a troubles with her hearing and wasn't able to hear properly and her vision started to change grey a fuzzy; they noticed Sarah's blood pressure had gone down due to side effect of the epidural so they took her off the epidural, gave her some more fluid to help replenish her body and bring her blood pressure back to normal.

"Finally my blood pressure came back but it was so scary. Literally I was just worried about Henry the whole time obviously that his blood pressure was dropping or heart rate".

Once everything has settled the OB came in and checked Sarah, she explains after they check he said to her, "Uh how old are you" to which Sarah replies, "32". The OB then questions her and says,"and you want to do a vaginal birth?" and Sarah explains she has no preference just wants baby to come out healthy and the OB replies "I guess you deserve a fighting chance" which Sarah was a bit shocked hearing him say. Around 5 o'clock Sarah was working through the contractions when her OB offered her the option of getting put on a synthetic form of oxytocin (Pitocin) to help strengthen contractions due to their checks showing slow dilation. Sarah's mom inquires if they should just go ahead and preform a c section, and since both Sarah's mom and sister needed a c section they wondered if Sarah would need one too instead of starting the pitocin and it prolonging labour to end in c section anyways. The OB said no they like to start pitocin before resorting to a c section to give every attempt for a vaginal delivery, so Sarah agreed to being put on the pitocin drip which she explains resulted in very painful contractions. After 1 hour of very painful contractions and being 7 cm the OB came in and asked Sarah if she was "ready to give up" and have a section. Sarah was so shocked to hear him refer her next option of a c section as "giving up" but she agreed and had to wait for the surgeon staff to show up to hospital. With the epidural failing twice for Sarah there was a bit of concern that the spinal for the cesarean wouldn't take, luckily it did but Sarah did notice she could start to feel them stapling her up. When Henry came out it took him a bit to cry, so the team was spending a little extra time trying to get him to cry but everything was fine and said he was a really relaxed baby. ; once he was cleaned up they put Henry's head to Sarah's for a quick snuggle then Derek held onto Henry for the rest of the time since Sarah was unable to hold him. After 1.5 day stay at hospital Sarah, Derek and Henry headed home to start life as a brand new family of three. Sarah said the hardest part of her postpartum was the trauma of her birth, she explained she would get flashbacks of the nurse and doctors when he had asked her if she was "ready to give up", and it thinking of how labour and delivery went down and everything involved would bring her to tears. Physically she said she was in a fair amount of pain, thankfully she didn't have any issues with her incision healing up and after a few weeks she was able to start moving again. Her and Derek found the transition into parenthood pretty easy and they figured out a good method that works well for them so they aren't tip toeing around each other and how grew to become an excellent team.