31 March 2009

Things I've Learned - C-Sections

I was a breech baby, born by scheduled caesarean section. My dad, for years, kept forgetting my birthday because he thought they’d chosen the second of the two dates available for surgery. Back then in the dark ages of 1970, my mom was oblivious to the whole procedure, knocked out under a general anaesthetic. Modern anaesthesiology now allows mom to be awake and aware of the birth of her baby, a fact I am particularly grateful for, since I had an unexpected c-section myself.

After almost 30 hours of labour with my son, he hadn’t descended at all, and I had dilated a grand total of four centimetres.

Four stinking centimetres. Not even half way there, after water breaking at home, labouring for hours, two trips to the hospital, being sent home both times to labour in the comfort of my own home...

(Aside – who the hell uses the words labour and comfort in the same sentence?)

Then finally being admitted when contractions were less than two minutes apart and I couldn’t see straight in the midst of them. Gas. Epidural. Constant internal monitoring due to a low baseline fetal heartbeat, and ever increasing levels of oxytocin being administered.

All that for four measly centimetres. The Boy was staying put.

My GP and the resident on duty suggested that the baby might be too big for my pelvic bones to allow his passage. They told us we could continue trying for another four hours if we wished, but that they were going to bring in the on-call obstetrician to consult. While they were out of the room, my husband and I had a rare quiet moment alone and talked things over.

I was exhausted. The baby, although not in distress, kept doing worrying things with his heart rate. I was worried that if this went on too much longer, that I wouldn’t have energy left to push when the time came, or that the baby might become distressed and then we’d end up with much drama, and an emergency c-section.

We decided it was better to choose a c-section and deliver the baby safely than to risk complications for either one of us. If they suggested it, we wouldn’t fight it.

Twenty minutes later I was being rolled into the operating room.

We're all about the hats in this family

Last week, in fact a week ago today, my cousin had a baby girl. Like me, she had an unplanned c-section. Visiting her in the hospital with that beautiful tiny little baby, surrounded by friends and family, memories started to wash over me: things I didn’t realize I’d forgotten in the ten months since The Boy was born.

The Take-away:

Here is some of what I wrote in an email to my cousin and her husband that night:*
  1. You will feel like crying. This is normal, good and necessary. Let the tears flow. It's your body's way of dealing with its wild change in hormonal activity in the last 24 hours, and also of acknowledging the physical trauma of your surgery, not to mention the overwhelming emotions of becoming a parent. Think of the tears like a refreshing summer rain that scrubs the air clean and leaves everything revived. Let them wash away your insecurities and fears. Know that the tears will pass and you will feel better for having let them flow.
  2. Your abdomen will feel puffed full of air. This is because it is - for reasons unknown to me, this is a common result of a c-section. The only way to get rid of this air/discomfort is the indelicate reality of much flatulence. So embrace your inner frat boy and let them rip. (Re: frat boy: I don't suggest lighting your farts. Open flame + newborn = poor judgement call, and only so much can be forgiven because of hormones.)
  3. The hospital will likely give you stool softeners. TAKE THEM. The painkillers you're on can bung you up. You do not want this. Getting constipated (also common post childbirth whether c-section or vaginal delivery) is a whole deal you want to avoid at all costs, and it contributes to more discomfort in regard to item 2. Also, when you're able to, walk around. This helps get/keep things moving.
  4. Dried apricots. Send someone out to get you some, and eat them by the handful. They will help you with item 3. Also they're a healthy source of energy and iron. And they're yummy. Much better than what passes for food from a hospital kitchen.
  5. Sleep when you can. Feel no guilt whatsoever in asking people to leave when you need to rest. This is one of the hardest things to do, but girl, you need your sleep. You may feel an irrational compulsion to check on your baby every five minutes or so, to make sure she's breathing or just to gaze at her beautiful little face. This is normal. But let it go and sleep if you can.
  6. The first time you look at your incision, it will seem big and ugly and kind of scary. Within a few weeks, as the stitches dissolve and the steri-strips fall off, and as your abdomen starts to shrink, the incision will get smaller, and less angry looking. What started out for me as the Joker's ghoulish grin carved into the top of my pubic area is now a small scar only three inches long that is gradually fading to match my skin tone (ie pasty fish-belly white).
  7. Shower as soon as they tell you that you can. This will make you feel more like yourself. And make sure you shower every day, even if nothing else gets done. Including housework and thank you notes. (Anyone who gets their panties in a knot about not getting a prompt thank you note from a new mom can go piss in the wind. Seriously.) It is shocking how hard it is to manage something as simple as a daily shower.
  8. You will sweat a disconcerting amount. This continues for the first week or so, then eases off. I remember waking up in the middle of the night literally in a puddle of sweat. This is how your body gets rid of that extra water you've been carrying around. And being on the IV for the c-section fills you up with even more fluid than your body would produce naturally.
  9. Speaking of which, you may be really swollen for the first several days. Drink lots of water. And even though you may not be able to tell at first when it’s time to pee, go as often as possible. Know that one morning you will wake up, be able to see your ankle bones again, and feel like you’re Audrey freaking Hepburn.

Okay, what did I miss? Any other advice for a new mom with a c-section? Feel free to leave a comment, or you can reach me at alexishinde at gmail dot com. I look forward to hearing from you!


*Edited for clarity, typos, to take out names, and to make self seem more clever.


5 comments:

  1. This I can read all day...how did it go again? "well knock me over with a ball of my own____" -un-named yukon woman

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  2. Oh Preston, how I've missed you...

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  3. 1- Take the pain MEDS! Don't be a hero. take your meds when you;re supposed to, especially if you are BFing. If your body is too distracted by squelching your pain, it's not up to making milk (which is hard enough without the surgery) Baby will be fine, and YOU need to heal as fast as possible.

    2-the 2nd one is MUCH easier than the first (if your first C was unplanned) My story is very much like yours, except I had a textbook labor, did make it to 10cm and pushed for 3 hours and my 9 pounder did not budge a bit. Thus the unplanned C. But with #2, we went in at 39 weeks, and my overall recovery was so much faster and easier. Out of recovery faster, Out of bed and walking the same day, not sore for as long - since your body hasn't been through labor's trauma first.
    3- (this may differ in Canada, but in the US) the secret to getting out of recovery and into the room is to wiggle your toes asap, and the secret to getting off the liquid diet is to poop.

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  4. I agree with Izzy - I had a much easier recovery with the 2nd c-section, and probably easier still with the 3rd. But, you may want to ask the doctors to just install a zipper during your first...may make things even easier later on. ;-)

    Also, for the first little while after the surgery...if you have to blow your nose, it may help to put one foot up on something (toilet, side of the tub...) first and kind of bend over a bit to brace your tummy. Took me awhile to just be able to do that like a normal person again.

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  5. Good points, Izzy and Mommy Project!

    It never occurred to me that someone would choose not to take the pain meds. I was all about not suffering more than necessary.

    And I'd forgotten about the sneeze/cough/blow your nose stuff! Even laughing could tug at the incision. I think I spent most of my time for the first six weeks with my hand over my belly sort of holding everything together.

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