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.

Things I've Learned - Labour

This post was prompted by a conversation I had today with my cousin, who's due in March. We talked about many things: prenatal classes, visitors in the hospital and at home, nursing pads, bottles, breast pumps... There is so much to think about as you enter your final weeks of pregnancy, but looming large above everything else, is labour. Capital L Labour.

When I first discovered I was pregnant, I immediately read everything I could get my hands on. I tore through What to Expect and devoured Your Over 35 Week by Week Guide to Pregnancy. I bought my husband The Expectant Father and read it in an afternoon. (Of course he never even scanned the table of contents, but that's a rant for another day.) I read and read and read, and looked at websites, and lurked on forums, and asked friends. I was informed. With a vengeance.

Except that I realized, as our due date approached, that in addition to skipping the bits about c-sections and formula feeding, I had somehow glossed over all the information in my many pregnancy books about labour.

My husband is from a medical family. Dinner conversations as he was growing up were often icky, and graphically so, as his parents (both doctors) and his sister (studying medicine) discussed their day. As a result, he can handle just about anything, and laughs at my complete inability to deal. When I'm flipping through TV channels and chance upon surgery in progress on one of the learning channels, I practically break a finger I'm in such a hurry to get the channel changed. So as I read my pregnancy books, I would make one passing glance at a diagram of the baby in the birth canal, convulse with squeamishness, and turn the page. At the prenatal class I was the person saying, "Really? Do we have to have another diagram? Do we really need to know what that looks like?"

As the last couple of weeks of my pregnancy were upon us, and it became clear that I could, technically, go into labour at any moment, I finally knuckled down and read about it.

And then I put it out of my mind.

I dealt with the idea of labour by not thinking about it too much. I figured my body would do what it needed to do whether I was freaking out about it or not, and would probably do it better if I wasn't freaking out. As my friend Christa, a nurse who's worked a lot in obstetrics, once said to me,

"Listen to your monkey. It knows what to do."

I let that be my mantra, and stashed the (to me) unsavoury details in a dimly lit, cobwebby, rarely used corner of my mental library.

Our birth plan was simple:
Help me, and support my partner in helping me, to safely deliver a healthy baby.

Which is exactly what happened.

Except it wasn't at all what I expected or thought it would be.

And here's something that's true: none of that matters.

The Takeaway:

1. Every woman's labour is different. Your expectations, your philosophy, and your choices will inform your experience, and comparing yourself to the woman you know who had her baby easily after three hours of labour will make you a crazy person. (Unless you are that woman, in which case don't step out in front of my car. I'm just sayin'.)
   
2. Don't browbeat yourself with words like "natural". As I told my friend Stephanie who was concerned about being induced and that it wouldn't be a natural process "baby's born = natural". The rest is details.
   
3. Within weeks of giving birth, the details of labour and delivery will start to become fuzzy. If we remembered every detail forever, a lot less women would go through it more than once.
4. Labour is to parenting as wedding is to marriage. Labour is over quickly. (For some, more quickly than others, yes, but I'm talking about within the context of your entire lifetime.) Parenting is the part that matters.