Going under the knife

Cloth diapers; baby wearing; breastfeeding; skin to skin contact; laboring in water.  "Back to nature" is very "in" right now when it comes to childbirth and baby care.  But nothing beats holy grail of good motherhood: natural birth*.  While no one doubts the necessity of medical intervention in some pregnancies - childbearing used to be a risky business - there's still a stigma attached to having a C-section - especially a planned one.  If you're not already familiar, a simple Google search will bring up all the issues behind the high C-section rate in the US and the various people and things that are blamed (lazy women, lazy doctors, evil insurance companies, etc.).  I'm not going to get into the various merits and demerits of these arguments, but all of these thing weighed on my mind when, in the later weeks of pregnancy, because Scott was breech and because of IUGR concerns, it became clear that the most likely scenario was that I would not go into labor at all but have a C-section to deliver him.

It wasn't what I wanted, and I was afraid of having the surgery (because who wants to have abdominal surgery?), but that was the way it was going to be.  Part of my fear stemmed from the fact that all of my girlfriends delivered their babies the old fashioned way, and I didn't know anyone (well) who had delivered via C-section since we partied like it was 1999.  Despite having one lucid dream about the operation, I really didn't know what it would be like.  Now, looking back on the event several weeks later, here are 5 things that surprised me about having a C-section.

1. It was worse than I thought it would be.  For the first 36 hours especially and then for about a week after that.  I thought the pain would be like a sports injury - that the affected part would hurt, but the rest of my body would feel totally fine.  Not so.  I was completely exhausted after the procedure and had no energy or appetite for about a week.  There were a few moments that were very painful (although the nurses did their best to prevent that from happening), and I felt completely helpless for the first 36 hours.  The second night I walked down part of the hospital corridor, and it was one of the most physically difficult things I'd ever done.

2. It was not as bad as I thought it would be.  I felt better pretty fast.  After about 10 days I was ready to start walking (like on the treadmill for exercise) again.  Even the night of the operation I was able to get up and go to the bathroom to wash my face and brush my teeth (actually going to the bathroom would have to wait another day).  Two days later I was ready to get OUT of the hospital.  Now at 5-weeks later, I don't think I'm in any worse shape than I'd have been if I'd had a normal delivery.

3. It was not as scary as I thought it would be.  Or maybe it was more scary.  I thought the idea of knowing I was being sliced open would make me freak out or pass out, but I was actually very calm during the procedure.  For one, the operating room is really cold so it's hard to faint.  Two, everything happens so fast that you don't have much time to think about what's going on.  Three, there are so many people in the room who are doing things to you in a business-like way, the natural inclination is to lay back and let it all just happen.  I was able to feel a little tugging at the top of my rib cage, but I don't remember feeling uncomfortable pressure or nausea.  Nothing that made me think, "OMG - my abdomen is sliced open right now."

4. Having the staples removed was not painful.  Seriously.  I was terrified that I was going to be able to feel them being yanked out one by one.  The staple remover was not like one of those mean things with fangs they sell at Office Depot.  It looked more like the thing they use to trim hang nails at the salon.  I barely felt a thing.  And my scar is small and not scary looking at all. It wouldn't even be visible in a bathing suit.

5. I didn't get to be the first person to hold my baby.  And it was okay.  In our modern times, at an uncomplicated natural birth, the baby is immediately placed on mom's chest while the doctors attend to the baby so the maximum amount of bonding can take place.  In my case, I had a glimpse of a very blue Scott being whisked away to be examined but then had to wait until he was all cleaned up and checked out before I got to hold him, and even then he was all wrapped up so I could only see his little eyes.

Does it freak you out to know that, at the moment this
picture was taken, my abdomen was being sown shut?

But the thing is, that's the only way I've ever given birth, so I don't know if I'm missing something by not having that initial time together.  I'm inclined to say no.  There's never been a moment in our relationship thus far when I said, "If only he hadn't spend the first 20 minutes of his life with the medical staff..."

Did anything surprise you about the childbirth process?  Or if you've never had a baby, is there something that you fear or wonder about giving birth?
 

*I'm not going to write about the whole "epidural vs. no epidural" debate because I don't have any actual experience with labor or labor pain.

Birth plans

Last weekend we went to our final "getting ready for baby" class on labor and delivery, and I think it was the most helpful one that we took.  It was worth the commitment of almost an entire Saturday because I really do feel a lot more prepared for the whole childbirth thing.  I definitely have a better understanding about what is going to be happening to me physically and what will be going on at the hospital once I arrive.  Although I have read some books that cover childbirth, I thought the teacher did a great job making the whole process easy to understand and remember.  Here are a couple things I picked up from the class that I plan to do/start doing in the coming weeks.

• Dedicate a bag as the "going to the hospital" bag and start filling it up with stuff.  That way every time I think of something I want to bring, I can just throw it in the bag rather than having to try to remember as we're running out the door to the hospital.  We've been given several lists of things to bring, but some of the items I wouldn't have thought of are: 
• The breast pump in case there are issues with feeding
• Snacks for Daniel
• PJs to wear if I want something more modest than the hospital gown but don't want to put on my regular clothes just yet
• The iPAD and books/magazines in case we're there for awhile
• Write a birth plan.  I was reluctant to do this before the class because I don't want to be "one of those moms" or a difficult patient, but after yesterday I think it's absolutely the right thing to do.  It's not about trying to script the event, "I will labor for this long and have this medication at this time and I will absolutely not have a C-section" which is obnoxious because it isn't realistic, but it's about laying out your feelings about the birth experience on paper for a time in the future when you might not be able to articulate them yourself.  It would be one thing if I could just talk to my doctor about my wishes ahead of time, but there's no guarantee that she will be the one who delivers the baby.  In fact, because there are several doctors on the call schedule, it is likely that she won't.  Here's what I'm thinking about putting in the plan:
• If I'm having trouble coping with labor pain, I want to have suggested to me/ be reminded of different positions, breathing techniques, etc. first to see if those help.
• If I'm not getting enough relief from non-medical intervention and ask for an epidural, I want to have my progress checked to see how far along I am.  If I'm in transition or getting close, I want encouragement to keep going and to be reminded that it will take awhile to get the epidural and have it start working.
• If I get to a point in labor where I'm exhausted and distressed and delivery is not going to happen any time soon, I want to have an epidural so I can relax a bit and regroup to push later on.

Obviously all of that goes out the window if there's any concern about the baby's (or my) safety, but I think those are reasonable requests for a normal delivery... right?  Not too dictatorial or obnoxious?  

I actually really do want to try to deliver without medication, but I feel like it's just so hard to know what it will actually be like until I'm in the situation.  "They" say it's the worst pain of your life, and when I think of the worst pain I've experienced up to this point, it's probably being burned by the oven, but is having a baby like being burned by the oven for 24 hours straight?  I don't think so...  

Any moms want to chime in about things to bring to the hospital, birth plans, labor pain, etc?  

 

Baby Book Report - Easy Labor

[source]

The subtitle of this book is "Every Woman's Guide to Choosing Less Pain and More Joy During Child Birth" but really it should have been "Ha! Just kidding".  The thesis is that childbirth is the most incredibly, indescribably painful experience a woman will probably have in her entire life, that even experienced mothers forget how bad labor and delivery is, but that you should somehow prepare yourself for this unimaginable experience and come to the hospital relaxed.  Um... I'll get right on that.

The author is an obstetric anesthesiologist but he includes information gathered from other professionals involved in the birth process such as labor and delivery nurses, midwives, and doulas (which the spell-check desperately wants to change to "Douglass").  The rest of the book describes methods for controlling labor pain from the ubiquitous epidural to breathing techniques, to hypnosis to nitrous oxide (really... evidently it's all the rage in Great Britain).

All I can say is: bring on the epidural.  From what was written in the book and what I've heard from friends who have had children is that - because epidurals are much easier, safer, and less confining than in years past- you can have an un-medicated childbirth, but you have to really really really really really really want it.  In fact, a major reason that women choose to give birth at a birth center or at home is to avoid the "temptation" of medical pain relief.

I can tell you now that I have no such dedication.  With the new epidurals, you can move around and even walk around in some cases.  Friends say that you experience every contraction, it just doesn't HURT anymore.  And while I don't feel like I need to have it inserted before I have a single contraction, I don't feel like being in pain - especially being in screaming, swearing out of control in pain- will add anything to the birth experience.  Plus the idea of laboring for many hours without pain relief and then having an episiotomy* without pain relief is truly terrifying.

So in summary, labor = painful, not easy.  Epidural = good.

*Look it up (no gross pictures, but not for the faint of heart, either), then go look at your kitchen shears and tell me the thought of having that happen wouldn't keep you awake at night.