Breathing through the contractions. One coming stronger than the next, right on top of the other with no time in-between to rest. There was no time for an epidural, even if I wanted one. It was happening fast - faster than anyone expected for a first baby. I was feeling every bit of my body stretch and adjust to get her here safely. It was excruciating, but powerful at the same time.
She was coming fast and furiously. I could feel her move through me inch by inch. I was minutes away from finally meeting the baby I had fought so hard for. My body took over and in 3 pushes I felt the dreaded ring of fire and her head was out. It was then that chaos erupted with the shout of "SHOULDER!"
You've probably never heard of it before. I know I didn't, until it happened to me. Shoulder Dystocia - the terrifying emergency that happens in less than 1% of births and can lead to catastrophic consequences. in 2016, the year before Nora's birth, my local hospital had only 6 shoulder dystocia births. My own OB said she's only witnessed it happen a handful of times, and it's every OB's nightmare.
So when I heard that loud "SHOULDER" scream, I had no idea what was happening, but everyone around me knew. My contractions suddenly stopped. My body knew too. The next few seconds, which felt like minutes was like a choreographed routine. The next I knew, I was flat on my back, with two people (nurses maybe?) holding my knees to my ears, someone pushing hard on my pubic bone. My OB was holding her head and on the count of 3 we all worked together - my OB pulling, me pushing as hard as I can, and the nursing staff pushing down on my pubic bone. I pushed so hard the blood vessels in my eyes and on my face popped. I have a permanent mark on my forehead to remind me.
I felt her explode out of me. It was an audible pop with the amount of pressure being forced on me to get her out. My husband, who was pushed aside, said the 4 students flanking the OB like the Mighty Ducks flying V all took a step back in shock - and probably to dodge some of the lovely birthday juice.
She was taken away immediately to the other side of the room where a whole team of people was waiting for her. I never saw them enter the room. Suddenly they were just there, front row to the show. I couldn't see her through all the bodies. I wanted to will everyone to shut up so I could listen for her cry, but I couldn't stop screaming myself. Then I heard a tiny cry. Tom turned to me and we locked eyes. "Did you hear that?!?!" he said. That memory is so vivid in my mind.
Then they took her away to the NICU. My doula managed to snap a photo of her in the incubator so that I could at least have that.
Shoulder dystocia happens when one or both of baby's shoulders do not enter the pelvis during birth as they should, and baby essentially gets stuck.
This can lead to:
Damage to the Brachial Plexus Nerves, which travel from the spinal cord in the neck down the arm.
Fractures to the collarbone and arm
Lack of oxygen, and in extreme cases can cause brain damage or death.
In the mother, this can result in:
Injury during delivery
Nora came out grey and floppy. I wasn't sure if she was alive and nobody would tell me one way or another. One thing I found out later was that her cord was wrapped pretty tightly around her neck, which isn't dangerous in itself, but my OB decided to cut it before she was delivered. Her reason why, I'll never know. Unfortunately, she cut me in the process (accidentally) and that's the only stitches I needed.
When we were able to go to the NICU to see her, all of the nursing staff stopped and was watching me. Tom said he heard some nurses say "is it her?" They all knew about it. Everyone knew my body failed her. Everybody was watching. We were a walking sideshow.
Nora was so bruised. The poor thing had gone through such a ride to get here. Her left arm lay limp by her side. The doctors and nursing staff couldn't tell me if she'd ever re-gain movement or if she would be paralyzed forever. Not exactly the words any new mother wants to hear.
In the moment, and for months afterwards I beat myself up a lot over not knowing or unwillingly causing damage to myself and my newborn. Then I started to take control. I joined support groups, I did my own research. I talked to other momma's who have experience this, and I started talking about it online. Suddenly I wasn't so alone.
Risk factors for shoulder dystocia include:
Fetal macrosomia (born over 8 lbs, 13 oz)
Mothers who have diabetes and/or are significantly overweight
Mothers with previous shoulder dystocia births
advanced gestational age
Mother's who are petite
Twins or multiples pregnancies
Poor fetal positioning
So you can see it's not just one thing that sets off alarms. But also, it's just something that happens. Nora was 8 lbs, 7 oz, so not abnormally large. There was no way of knowing this was going to happen to us.
Two years later we found ourselves back in the NICU when the twins were born prematurely, and some of the nurses remembered us. One told me Nora's case was the worst she's ever seen, and I'm so thankful she didn't tell us that at the time. Bringing Nora back in to visit her sisters and to show off how far she's come to the the nursing staff that kept her alive was one of my proudest moments.
If you didn't know this story, you'd never know anything was ever wrong with Nora now. She's one of the lucky ones. It took a full year of physiotherapy for her to regain full function of her left arm and shoulder, and I plan to write more about that process since that's what I'm asked about most.
For me, however, I'm still recovering physically, emotionally and mentally. I suffer from constant hip pain and tailbone pain. Mentally I believe I have some PTSD. Recently there was a story in the news with Kara Keough Bosworth from the Real Housewives series also having a Shoulder Dystocia birth and unfortunately her son McCoy passed away from the injuries he received. The flood of memories came back and although Nora will be 4 years old next month, it still hits me like a ton of bricks. I count my lucky stars that we're both okay.