labor

After getting pregnant, I experienced nine months of bizarre bodily functions and changes. Toward the end of the first trimester, I started shyly sharing some of these with women I know who’ve had kids. Time and time again, I got the same response from them: “Oh yeah that happened to me too and nobody told me!” Wha?! Why? Why are we keeping these things secret from one another?!

If you’ve been reading my blog, you know that I’m not one to hide the indecencies of pregnancy. I will never covertly say to you, “Oh that happened to me, too.” If we’re internet friends, you won’t need me to because you’ve probably already read about it on my Facebook or Twitter, whether it be tales of hemorrhoids or choking on excess saliva or my uncontrollable third trimester gas. Now that pregnancy is over, I will share with you the things that most people won’t tell you about recovery.

That weight? It might not come off the way that you expect it to.

You’re pregnant. You’re gaining weight. You want to know where it goes, so you google “pregnancy weight gain” and after reading sites like this one, you reassure yourself that all is well and you can go back for brownie number seven. You tell yourself that those 30lbs are nothing because you’ll probably lose 20lbs before you even leave the hospital! SCORE! Yeah, not so much. If you’re getting a lot of IV fluids, you may end up weighing more than you did when you got to the hospital. Don’t freak out. You’ll pee it all off in a week or so and one day, after avoiding the scale, you will step on with great trepidation and find that you lost 10, 15, or even 20lbs since coming home. Or maybe not. Maybe you had a 8lbs baby and you find after a week that you’re only down 10lbs. It’s ok. It took you 9 months to put the weight on – it might take awhile to get it off. And really, those seven brownies were worth it. The baby was kind of worth it, too.

You might get swollen. Very, very swollen.

Just because you made it to labor without ever getting huge hobbit feet doesn’t mean that you’re going home with the adorable feet you walked in on. In fact, you may not even be able to wear your own damn shoes out of the hospital. Seriously. Your capillaries get all leaky ‘n’ shit and you may or may not have gotten a lot of IV fluids and maybe you wake up in the recovery room to discover that your legs have been wrapped up in these strange, white, massaging leg…things…that are meant to decrease the inhuman swelling that happened sometime between pushing (or cutting) a baby out and getting set up in your recovery or postpartum room. Then maybe you push yourself a little too far and they swell up even more and you can actually see the tops of your feet jiggling because there’s so much fluid. You might have swell up to your knees. You might swell up to your goddamn hips. Fret not. You will pee it out. Drink a lot of water. A LOT. Elevate. Get your partner to massage your hideous Bilbo feet. Walk around. They will go down. If you had a c-section or a lot of IV fluids for other reasons though, don’t be surprised or embarrassed if you find yourself leaving the hospital in those hospital slipper socks with the grippy feet. It happens to the best of us, and it might take a little over a week (sorry) for you to be back in normal shoes.

There are things that hurt as bad as labor…after you’re done.

Ok so this doesn’t happen to everyone, apparently. But it does happen and I wish I had known. After you give birth and deliver the placenta, a doctor, nurse, or midwife may press down on the fundus to expel any blood clots. They might do it without telling you it is going to hurt like hell. You might yelp and cry and almost punch them. Apparently some women are offered fentanyl before that happens. I was not one of those women. I might be really fucking bitter about that. Maybe.

When you stand up for the first time, stuff might come out.

You bleed. A lot. When you stand up for the first time after delivering, a lot of that may spill out onto the floor. Don’t be embarrassed. The nurses know it’s going to happen and are prepared. If you can’t help but be a little shy or embarrassed about it, ask them to put down a Chux pad for you. It really doesn’t matter though – either way, they’re cleaning up your blood. But that’s what they do.

You will suddenly realize that pooping is scary.

This never crossed my mind until a nurse came in with a stool softener for me. She handed it over with a big jug of water and whispered, “Just relax and do your labor breathing and it won’t be too bad.” Um. WHAT? Labor breathing? For pooping?! I was so scared of that first poop after that. I couldn’t even do a tiny cough without bracing myself. How was I supposed to poop?! Well, I did on day 2 and it wasn’t a big deal. Drink a lot of water, eat your fruit and veggies, ask for colace AND senna, and order up some prune juice with your dinner. It’ll (most likely) be ok. There are pooping horror stories, but there are horror stories about everything if you look hard enough. I was apparently an “overachiever” and an “above average pooper” because I went easily 2x/day starting on day 2. I guess we all have to excel at something. Maybe you will also excel at pooping.

Peeing might be an issue.

There are multiple ways in which peeing can be an issue. It might hurt to sit on the toilet. You might be incontinent. You might not have sensation in your bladder. I had all of these problems! Every time I stood up, I peed a little. Every time I sat down, I peed a lot. I couldn’t sit down on the toilet without pee leaking out the moment I started to bend my knees. Embarrassing! Part of my problem though was that I never had the sensation that I had to pee. With everything else going on, it took me awhile to realize I had no bladder sensation. If you find yourself piddling all over the damn place, take a moment to reflect on whether or not you can actually feel your bladder. If the answer is no, pee on a schedule. Every 1-2 hours. As soon as I did that, it took about 24 hours to stop peeing all over myself. That bladder sensation though? It took awhile to come back. I’m 5 weeks postpartum now and still sometimes don’t feel the urge to pee until it’s time to RUN to a bathroom. So, you know, keep that 1-2 hour schedule if things still aren’t feeling quite right. You don’t want to be incontinent and you don’t want a UTI. Especially when you can’t feel the places that might tip you off to said UTI.

While we’re on the topic of peeing…

Remember the good ol’ days of peeing in a downward stream into the water? No? You mean you never really thought about it? Yeah, well, you might be thinking about it now. That whole having-a-baby thing changed my pee stream, man. I will never scowl at people who’ve left little piddles on public bathroom seats. Ok, I will do that still because seriously people, it takes 5 seconds to check the seat and wipe it before you leave! But now I have more of an understanding of why that happens.

Alright. That’s all for now. I may or may not do a c-section specific “WTF? No one told me!” post when I have another spare half hour. But right now, I have to cuddle a baby and try not to pee myself.

Birth Story Part 3: The Arrival

August 2, 2012

baby, cesarean, doctors, home birth, labor

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In the OR, I got my third epidural. Well, sort of. The first two failed but I didn’t have to get it placed a third time, thankfully. It felt like a bandaid covering half my back had been ripped off when I had the first removed. I was happy to not go through that again. For the third try, they moved the catheter around to see if repositioning it would make the distribution more even and then hooked me up to a stronger drug. Relying on that after two failed attempts was terrifying. I imagined them cutting, and feeling it all. I expressed my concerns to the anesthesiologists (there were two for some reason) and they did multiple tests to show me how little I could feel and assured me all would be fine.

At 2am Monday morning, surgery started. The baby’s head was stuck in the birth canal. They had to make the incision longer and lower than they normally would. One doctor reached into the birth canal and pushed the baby’s head up while another doctor pulled the baby out through my uterus.

Shortly before they pulled the baby out, my third epidural failed and I regained feeling. I could feel them pushing and pulling the baby out and then moving and checking my organs – not the pushing, pulling, and pressure they told me I would feel. I felt a full range of sensations and pain but I was hallucinating and dissociated and couldn’t fully express what was happening. As soon as the cord was cut, I was given fentanyl and morphine but before they kicked in, I felt every stitch as they started sewing me up.

By the time the baby was out, I was uncontrollably shaking and disoriented. The Daddy and I had agreed that if we had to do a c-section, he’d go with the baby and do skin-to-skin while I was sewn up. I needed him though, so he stayed and the baby was taken away. I still feel guilty about the time she was away from both of her parents so early in her life. I feel fortunate that he was able to carry her over to me first. It wasn’t the moment we anticipated but we had our first moment as a family. The Daddy told me all about her as I looked on – her full head of hair and big, alert blue eyes darting around the room. I’m glad that he did – I was too disoriented to focus on those things myself. I wasn’t even aware that she’d been born. Without him there taking me through the experience, I would have completely missed seeing my newborn baby in front of me.

Our daughter was born at 2:28am on July 2nd. After all of the worry she caused during labor, she came out looking like nothing had ever happened. The doctors don’t know why she was having so much trouble. They suspect it might have been a cord issue – she had some red marks that made it look like she’d been wrapped in her cord kind of like a seat belt. The doctor thinks her cord may have been pulling back on her and tightening on every push. Since my water broke, there was no cushion and she may have pressed on it when I changed positions.

Now that I know her inside and outside of the womb, I think it’s simply a matter of her being a sensitive little person. She got hiccups when I drank cold water. She hated ultrasounds and dopplers and would spend exams squirming away, making it difficult to get her heart rate or get pictures needed for screening. She squirmed and kicked at loud noises. Now that she’s out, she always wants to be held and cuddled and is constantly alert to light and noise. She has busy little eyes and busy little hands, exploring the world around her. She’s my sensitive little girl, inside and out, and that made labor difficult for her. Ultimately the physical part of birth was about her, not me, and she taught me that in a very dramatic way.

Long story short: I had a baby, she is great, and now we’re home. Now on to the recovery.

Give me drugs! Birth Story: Part 2

July 27, 2012

baby, cesarean, doctors, home birth, labor

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We pulled up to the hospital at 6:30am Sunday morning. The Daddy threw a “WOMAN IN LABOR” sign on the dash and ran for a wheelchair. We made our way up to the fifteenth floor. Contractions in the hallway, contractions in the elevator. At least the hospital was mostly empty at that hour.

He wheeled me to the nurses station and as he was checking us in, I had a powerful contraction. I was still feeling it mostly in my back and rectum and sitting in the wheelchair was too painful. I didn’t wait to get checked in – I leapt out of the wheelchair toward waiting nurses and growled, “Get me in a room and give me drugs” and stormed down the hall, blood and fluid running down my legs, in the direction of open doors. The nurses raced ahead, led me to the delivery room and called the anesthesiologist.

Initial drama aside, the home-to-hospital transfer was flawless. Our midwife beat us there and was waiting with our records. I was in a room before The Daddy finished checking in and I had fentanyl administered and an epidural on the way within ten minutes.

The anesthesiologist came right away but we had to wait out two contractions before the epidural was placed. I bit down so hard during the second that I started wondering if it’s possible to shatter your own teeth. I hoped that the fentanyl would take the edge off while waiting for the epidural but its most notable effect was making me hear voices every time I closed my eyes. Luckily after two contractions, there was a long enough break to get the epidural placed with no problems. Relief!

With pain controlled, reality set in – I was in a hospital over 30 hours after my water had broken. Would they rush me into a c-section? Treat me poorly because we were a home birth transfer? I questioned our decision and wondered if I should’ve stayed home and found a way to deal with the excruciating pain. Logic gave way to fear and for a moment, I forgot about the other reason we transferred – the baby didn’t seem to be handling labor well. Those thoughts were interrupted by our nurse asking about our birth plan and someone checking my cervix.

My cervix wasn’t swollen. I was dilating again. Contractions had slowed and the baby seemed ok. My midwife acted as doula and the hospital staff were accepting of her being there – she had my prenatal charts, a labor flow chart, and was helpful in relaying our birth plan. A nurse quickly jotted down our birth plan and didn’t bat an eye at us declining all but one newborn procedure. The doctors were wonderful. They accepted everything we wanted and didn’t push us. They supported our vaginal birth goal and did everything they could to facilitate that. It was a shock and relief.

Pitocin was started to try and get regular contractions going again. I dilated quickly, the swelling was gone, and I started pushing. After a few pushes, the contractions spaced out and I fell asleep. I woke up a little while later to alarms and people rushing into the room. The baby’s heart rate dropped like it had at home, but it hadn’t recovered. A nurse shot terbutaline into my thigh to stop contractions and then flipped me on all fours (literally – the epidural made my left leg completely numb and I couldn’t move it at all) and rushed me to the OR for emergency surgery.

The Daddy was in the bathroom and had no idea what was happening when he walked out and they were wheeling me away. I was taken into the room alone, getting bits and pieces of what might be happening on our way down the hall. I was concerned for The Daddy and wondering if anyone had stayed behind to tell him what was going on. As soon as we got into the OR and they prepared to put me under, her heart rate went back up. Back to the delivery room, to try again.

Pitocin was restarted when the terbutaline wore off. The baby tolerated labor and pushing for awhile. Pushing was a relief; the pain went away and I felt like I was finally doing something productive. I pushed for four hours. I pushed her from -1 to +3, The Daddy saw her head and reported that she had tons of hair. We thought we were going to make it (apparently I was an “excellent pusher”). She was distressed again. Her heart rate took a very long time to recover. I don’t remember a lot of what followed. I know I got two more shots of terbutaline because the baby’s heart rate fell and didn’t come back up. I know they fiddled with my dose of pitocin. An alarm went off again. At some point, my epidural failed and I had to have another one put in. The second one failed, too. By this point, Sunday was ending. I was exhausted and scared for the baby and didn’t feel like I could go on. The hospital birth team came in. We talked options.

We were given three choices:
-Keep pushing with the understanding that another decel would mean emergency surgery where I’d be put under and The Daddy would not be allowed in the room.
-Try forceps and risk vaginal tearing, injury to the baby, and the possibility of it not working and needing a cesarean anyway.
-Have a c-section right away.

The hospital team left us to talk. I asked the midwife her opinion and if she thought forceps or surgery were warranted. She suspected a cord issue and thought it’d be best to get baby out quickly. After discussing with her and The Daddy, we decided forceps were worth a try and told the rest of the team.

The attending physician did a vaginal check and said there was no room for forceps. Our options were keep pushing or head to the OR. The hospital staff left the room again so we could talk. We decided to have the surgery. And with that, they wheeled me to the OR while The Daddy left to get scrubbed and changed so we could begin phase three.