The Baby Bean Blog

Thursday, September 29, 2005

Postpartum

A lot has happened in the last six weeks, not just with Ella, but with me too. I had a couple of scares where I was afraid that my incision was infected. Luckily, it never was--or at least not to the point where it needed to re-opened. I've had a urinary tract infection. And both Ella and I have fought a little battle with thrush. Did you know that a woman can get a yeast infection in her nipples? Neither did I. FYI: I don't recommend it. I've had a couple of yeast infections you-know-where, and nothing came of it except some itchiness. However, this nipple thing HURT LIKE HELL. Oh, and Ella's was (and continues to be) in her mouth. Apparently, it doesn't bother the babies, and she has certainly never seemed bothered by that white crap living on her tongue. So back to me: INTENSE NIPPLE PAIN. But even that (seems to be) resolved now.

So today I had my official 6 week postpartum check-up with the surgeon who did my c-section. Like I said, I've been there three times already in the past 6 weeks when I thought that the incision might be infected. Each time I've not had to take off my pants--just pull them down so that the nurse or doctor could see the incision site. Which is what I expected to happen today. But no. I was in for an internal exam too.

Okay, I don't know how you handle the preparation for internal exams, but I like to go into these occassions feeling clean. I'm not talking about a douche or anything (which I know you're not supposed to do because it messes up the balance of whatever is in one's coochie). But you know, I take a shower beforehand, do a little surface cleaning, that sort of thing. It gives me the confidence to spread my legs and have the spotlight on my "special place."

But I didn't think that would be happening, so I didn't take a shower this morning. In fact, I haven't had a shower in over 24 hours. Don't judge me. I've got other stuff going on. So you can imagine the joy I felt when I was presented with The Paper Sheet and told to undress from the waist down. My big fear is that there will be some little bits of toilet paper clinging to my pubic hairs. Which is why I shower, clean, and then make every effort NOT to use the bathroom between the time I step out of the shower and the time I spread my legs on the examing table. But I don't know what was going on down there today, and I suppose that's good: ignorance is bliss.

One thing I feel I should mention is that I experienced some red bleeding on Sunday. Not a lot, but enough that it looked like my period. But then there was nothing on Monday, so I thought, maybe it wasn't my period arriving. On Tuesday, I had some more bleeding. Then nothing yesterday. But I'm getting the feeling this is my period gearing up. NO FAIR. In case you didn't know, women who exclusively breastfeed generally DO NOT GET THEIR PERIODS. Why? Nature's way of spacing out pregnancies. I was SO LOOKING FOWARD to not having my period for the next six months or so. And I deserve it. Haven't I been through enough?

I asked the doctor about it today, and she told me that I could be having my period. (FYI: women who bottle feed tend to get their period about six weeks after giving birth, and yes, I'm six weeks out from the birth.) The doctor and I chit-chatted a bit, and then she asked me to spread my legs and she shone the light on. Then she says, "Your vagina looks a little atrophied." Excuse me?

Apparently, breastfeeding suppressed estrogen, which leads women to have menopausal like symptoms, which somehow include atrophied vaginas? What? This apparently means that my vagina is a little shrunk (I refuse to use the word "shriveled") and it's pale due to lack of blood flow.

Okay, boys and girls, if I have to have an atrophied vagina, it does not seem fair that I have to get my period! [Oz shakes fist at the sky.] Curse you, fertility gods!

The drama is now over. The whole atrophied vagina thing, well, it sounds worse than it is. I mean, it doesn't really mean anything to me one way or the other. It's not like I can feel a dry, shriveled clump of skin between my legs or anything. But just the fact that my vagina is "a little atrophied" must be commented on.

Anyway, the fact that my period is here means that I could already be ovulating. This is funny because the doctor told me that I should use birth control. I guess the expression on my face must have read something like, "Yeah, right," because she looked at me and asked, "What? Have you already without using protection?" I said, "Well, I'm gay." Then she said, "Oh, then go right ahead."

This also reminds me of how on my discharge papers from the hospital, it has this section where they tell you how long you have to wait to do things: 6 weeks for exercising, 4 weeks for swimming, 2 weeks for driving. Then there's a space for how long until you can have "sexual intercourse" and the nurse got to that section and then without missing a beat (to her credit) she said, "6 weeks until you can insert anything into your vagina." Which I've used on my partner every time she's gotten a little fresh with me. "Honey, just you wait, in two more weeks, something can be inserted into my vagina." Nothing sparks the mood like that sexy line, let me tell you.

So now I'm done with the surgeon, unless I want to continue to use that practice for my normal gynecological care. I meet with the midwife next week, and then I'm basically free and clear. Unless something comes up. And it probably will.

Thursday, September 22, 2005

Birth Story, Part 4

Well, kids, here's where I wrap it up. The birth was over in Part 3, but there's some details that seem more appropriate to go here than to fit into the next phase of this blog--assuming I'll have some time to devote to this blog on a regular basis, that is.

It's been so long now since it all happened, which is why I really should have written this earlier, but you know how it is with a newborn. Or if you don't, you'll just have to take my word on it. Whatever free time I have is devoted to 1) sleep or 2) trying to accomplish something like eating, taking care of the dogs, or basic household chores. (FYI, I am sacrificing the laundry to write this.)

So what happened? Why didn't little Ella slide out of my vagina like a nice baby should? Apparently, she was in my pelvis at an angle, and that's why she wouldn't fit. Basically, her head could not mold. You know about head molding, right? That's why babies who are born through vaginal births sometimes have cone heads. The plates of bones that make up the skull are not fused together so that when they come out through that narrow opening, their heads get pointy which makes it all possible. But their heads can only mold in one way: dead center. Since she was coming from an angle, her head could not mold, hence she couldn't fit through my cervix, hence the c-section.

I guess the most dramatic detail to follow the c-section is that I lost a lot of blood during the surgery. The reason for this was my long labor which exhausted my uterus and made it "spongy." A uterus is supposed to be "firm." Ah well. I ended up having to get two units of blood via a transfusion on Friday, three days after the c-section, because my red blood count was not rebounding. It was at a 6. Normal is 12. At 4 or 5, you don't have enough blood cells to provide oxygen to all of your organs. I was right on the edge.

Which, coincidentally, is a major reason I couldn't keep my eyes open after the c-section and for the days that followed. I thought it was the drugs, and they certainly contributed. But another part of the problem was that my brain kept shutting down to conserve oxygen. I have a friend who is going through chemotherapy, and she complains when her blood count is 10. 10! I laugh at her now. TRY 6, HONEY-PIE, AND GET BACK TO ME.

The one upside of having a c-section was that I got to have a catheter. Most people hate it. I don't know why. After getting up every hour--day or night--if not more frequently--to go to the bathroom, I didn't have to get up to pee FOR 24 HOURS. It was HEAVEN. I was so sad on Wednesday when they took that thing out. Of course, that also meant I had to get up and go to the bathroom with a searing pain in my stomach. It was almost as if someone had cut me in half and then sewn me back together. OH WAIT. THAT'S EXACTLY WHAT HAPPENED.

But at 5+ weeks out from all that, I'm doing much better. A lot has happened since then. I wish I had been writing about it. Not just for you, but for me to have a record of it, and for little Ella too, of course. I expect that she will be reading this one day. Although it won't be news to her. I'll be telling her at every opportunity how it took 48 hours to give birth to her, and THIS IS THE THANKS I GET? Oh little one, we're in for a long ride together.

Saturday, September 10, 2005

Birth Story, Part 3

The following events took place on Tuesday, August 16, 2005.

I woke up sometime after midnight, probably around 1:30 or 2am. The epidural was still in full effect. I could move my legs, but they felt numb. The midwife was there, and she did another internal check. I was at 9.5 centimeters--almost fully dilated. We waited another half an hour or so, and she checked me again. I was just shy of 10 centimeters. She did this thing where she stretched my cervix with her finger to get me that last little bit dilated. Then it was time to push.

I couldn't feel the contractions, but we could all see them coming on the monitor. When one started up, I began to push. Again, a little bit tricky because I couldn't really feel what I was doing. I could kind of feel that I was tensing some muscles, but it was hard to know if what I was doing was effective or not. I relied on the midwife to tell me if I had it right or not. According to her, I did.

I pushed. And I pushed. And I pushed. I was told that I was doing a good job, but we didn't seem to be getting anywhere. I did what I could. I did the best that I could. I lost track of time, as I had done ever since I arrived at the birth center on Sunday. Eventually three hours past. The baby's head was still in the same spot it had been when I started pushing. She wasn't coming out.

After three hours of pushing, I was in a daze. Actually, after everything that had happened, I was in a daze. They told me to stop and that they were going to talk to a surgeon. This wasn't shocking to me. At some point, I'd started to realize that I was going to have a c-section. It wasn't what I'd wanted, but I was too tired and too confused and too everything to feel anything but numb about it. It was like the epidural was spreading to my heart and my head.

The surgeon came in and looked at the print-out of the baby's heartbeat and my contractions. The baby was still doing great, after all this. Everyone was still amazed at how well she was responding. Knowing that I was a birth center client and knowing that birth center clients strongly preferred vaginal births, she made a suggestion.

She said that we should let the baby "seep." Basically, I would stop pushing for an hour, during which the contractions would continue. Sometimes, babies would right their position in the uterus, and then when the woman began pushing again, the baby would finally be able to come out. The surgeon and midwife suggested this to me. It was the last little bit of hope being extended to me. Lethargically, I said yes, we should do it. I didn't really have any hope that it would work.

I catnapped again for the hour of "seeping." Then the nurse who had been with me since midnight (by this time, I had been through three shift changes) came and said that it was time to start pushing again. My midwife was sleeping, and the nurse wanted to let her sleep a bit longer. I was very comfortable with this nurse, so I was fine moving forward with her. She had a slightly different strategy for pushing, which she said was because she was used to helping women who had epidurals. I followed her lead. Again, she said I was pushing really well...but the baby still wasn't coming out any further.

After another hour of pushing, I said to the nurse, "I don't see much point in this." She looked at me and nodded. It was time to call the surgeon again. The midwife came and I told her that I was ready to go forward with a c-section. And then things swung into action.

The midwife explained to me and my partner what would happen as various people moved in and out of the room, getting everything ready for me to go. Basically, I would be given a spinal, a more powerful anesthesia that would completely numb my lower body. This would be administered through the epidural catheter that was already in place. Once I was numb, my partner would come into the operating room and she could sit with me at my head. When the baby was born, she would be looked over by a special team of doctors who were there just for her. After they had checked her out, my partner could hold her and bring her over to where my head was. That was the plan.

The anesthesiologist came in and had me sign some papers. He told me the same things that the midwife had told me about the spinal. He also mentioned that if the spinal didn't work for some reason, I would be put under general anesthesia where I would be asleep.

My partner was handed some scrubs to put over her clothes, and I was wheeled away to the operating room. My midwife came with me, and I was happy about that because she was the only one who paid much attention to me. The other doctors and nurses around my bed on wheels were chatting with each other, over me, around me, I felt almost like I didn't exist.

In the operating room, I was strapped down onto the operating table. My arms were stretched straight out and strapped down too. I felt like Jesus being laid on the cross. I hadn't had much time to get scared or nervous, but that got the ball rolling.

The only doctor to really talk to me was the anesthesiologist. His masked face would appear above me from time to time as he told me what he was doing. He put a shot of something into my epidural. Oh, I should mention here that my epidural had been losing its strength during my last bought of pushing. I felt much less numb than I had before.

So he pushes something through the epidural line. A minute or so went by and then I felt a pinch on my stomach. Not a pinch with someone's fingers. It felt more like my skin had been grabbed by some metal tweezers. "Ouch!" I said, confused. Then I realized that had been a test to see if I was numb. Even though the nurse or doctor, beyond the blue drape that blocked my view past my breasts, had pinched me, when I spoke, neither looked in my direction. Just to be clear with them that they shouldn't start operating, I said, "I could feel that."

The anesthesiologist pushed some more stuff through my epidural catheter. Another minute went by and I felt another pinch. "I could feel that, too!" I said. As I concentrated on my body, I realized that my legs weren't particularly numb anymore. Shouldn't they be? "And I can feel my legs, too!" I said. "I can move them!" which I did a little bit as proof.

Again, neither the doctor or nurse looked at me or responded to me. The anesthesiologist's masked face appeared above me again, and he said, "We're going to put you to sleep now, okay?"

I looked from him to the midwife. One of them explained to me that they couldn't give me anymore medicine through the epidural catheter. I wasn't responding to it, and this was the only way. What could I do? I nodded my head, and a mask was placed over my nose and mouth. I felt tears start to leak out of my eyes, and I'm not even sure why. I guess I was scared. Not much seemed to be going my way. The midwife put her hand on my forehead and said, "I'm so sorry." Then I heard the anesthesiologist say that I might feel some stinging or burning in my face. Shortly after he said that, I felt what he described, and that was the last thing I remembered.

I woke up in the recovery room. The midwife was on one side of me and my partner was on the other side, holding the baby. I couldn't see very well. Everything was in double vision. I looked at my partner and I asked, "Is it a boy or a girl?" She said, "It's a girl." I wanted to hold her, but I knew I was too drugged to be trusted to hold my baby. "Let me see her," I said. She turned the baby around so that I could get a look. Two babies floated slightly apart from one another. "I see two of her," I said. Everyone in the recovery room laughed. At least I still had my sense of humor.

Seeing her made me want to hold her even more. I looked down at my body and saw this air-inflated sheet of cylinders laying over me. I pushed at it with my hands and asked, "What is this?" I was told that it was a heated air blanket. Although I already knew the answer, I said, "I want to hold my baby, but I can't, can I?" My midwife shook her head.

I was going in and out of consciousness. I would feel my eyes close, and no matter if I tried to fight it, they closed anyway. Then I'd open them again. Somewhere in all of this, I insisted that the baby was hungry and that I must breastfeed her immediately. I don't remember this, but there are pictures to prove that it happened. The midwife tried to explain to me that the baby wasn't hungry, but logic was most elusive to me at this point. I kept insisting, so eventually, the midwife picked up the baby, elicted her "rooting" instinct, and put her on my breast, where she latched on a sucked like a champ. This made me feel better from what they tell me.

Eventually, I stopped seeing two of people and I got to hold my little Ella. I don't remember much of it except the feeling of warmth in my arms and struggling not to let my eyelids close. Here was my baby. I wanted to hold her forever and protect her from everything. Then a nurse came in and said that they needed to take the baby to do something or other to her. I said to my partner, "Go with the baby. I'll be fine." She wasn't surprised. We'd talked about this before the c-section. I wanted her with the baby the entire time since I couldn't be. They left and I fell back onto the bed and into unconsciousness.

Saturday, September 03, 2005

Birth Story, Part 2

The following events took place on Monday, August 15.

It had been 24 hours since the aminotic fluid had begun to leak, and I was still at the birth center. I think part of the reason for that was because it was so busy with all those other women actually giving birth to their babies that the midwife didn't have time to worry about me. In the early hours of the morning, she came to check on me and asked if it was okay to do an internal exam to see if I was progressing. I was 5 centimeters dilated. Yippee! I finally had some hope that things would work out and I would have the birth I wanted after all that had happened so far. My contractions were still a little farther apart than one might want: 5-7 minutes. But 5 centimeters was pretty good. (FYI, 10 centimeters is completely dilated.)

Because I was so far along, I was given permission to get into the jacuzzi. I'd been looking forward to that ever since I got pregnant, basically. As you may know, pregnant women are not supposed to get into hot tubs. Normally, I'm not confronted with hot tubs very often. However, since I joined a gym a few months ago, I've been forced to walk by a wonderful jacuzzi hot tub several times a week. all the time knowing that I can't get in. Very sad. But alas, I climbed into the jacuzzi at the birth center and prepared to labor there.

Naturally, after about 20 minutes, my contractions slowed down to 10 minutes apart and I had to leave the jacuzzi.

I was encouraged to try to get some sleep. With my contractions now coming 10 minutes apart or so, I actually did manage to catnap between them for a couple of hours. As the light of dawn came through the window, the midwife came back to check on me again. I had only managed to dilate half a centimeter in all the hours that had passed. With my contractions spaced further apart, I went ahead and said what was on her mind: "I guess I have to go to the hospital." She nodded her head and said that she thought that was the best thing to do at this point.

My mom had joined us the evening before, and my partner and I sent her out to the McDonald's to pick us up some breakfast. I knew that once I was at the hospital, I wouldn't be allowed to eat. We ate while we waited for another midwife to show up. As it turned out, the woman who was in the family room was also being transferred to the hospital. She had been pushing for three hours with no luck. The midwife who had been on duty for the past 24 hours was accompanying her to the hospital, and the midwife coming on duty would go with me.

The hospital was only across the street. My partner loaded our stuff into the car and we drove over. I was checked in and put into a room. The midwife who came with me was actually only on for four hours. She was covering those hours for the midwife whose day it really was--she was coming back from Florida and couldn't be there until noon.

The nurse at the hospital put an IV in my arm and hooked me up with fluids and...pitocin. They started the pitocin out at the lowest level: 2. The goal was to get me to have contractions that were about 4 minutes apart. They also strapped the fetal monitor to my stomach and another monitor which tracked my contractions. We watched the lines on the screen to see the baby's heartrate. It accelerated with the contractions, and this was good. A baby that responded to contractions was a healthy baby. Babies who did not respond or whose heartrates decelerated were cause for concern.

The midwife who came on at noon was actually the midwife who I'd had my very first prenatal appointment with at 10 weeks. It was sort of like coming full circle.

By the time she got there, the pitocin was up to an 8 or so. The contractions were coming 4 minutes apart, like they wanted. I found them pretty tolerable. I didn't feel like I needed pain medication to deal with them. I grabbed my partner by her shirt when I felt them coming on, but all in all, it really wasn't that bad.

I'd been quite afraid of pitocin-induced contractions because I had heard how much more intense they were than regular contractions. I'd wanted to avoid pitocin in general just because I wanted to do things on my own. But I have to admit that I was excited to think that I would be having my baby soon, and after already being involved in the process of laboring for more than 24 hours, I'd made my peace with this artificial drug.

Besides that, as I mentioned before, my baby's heartrate was doing great. In fact, practically everyone who came into the room commented on the print out of her heartrate. And as time wore on, words like "amazing" could be heard. She was really doing exceptionally well for such a long labor. (Of course, we didn't know the baby was a "she" at the time.)

Some time in the early evening, the midwife did another internal exam and found that I was 7 centimeters dilated. At that point, a woman generally enters the "transition" phase of labor, which lasts from 7 to 8 centimeters. This is the most intense part of labor with contractions coming strong and fast. It's also the shortest phase, usually lasting about 20 minutes. After "transition," there tends to be a lull in contractions and then a woman dilates pretty quickly to 10 centimeters and feels a strong urge to push. In other words, when you hit transition, the end should be near.

During the internal exam, the midwife also noticed that there was a lot of my bag of waters that was still in tact. She asked if I would be okay if she broke it, to which I said, "Yes!" I'd heard that once the bag of water was broken, contractions usually picked up intensity, thereby hurrying up the process of labor. Now at 30 hours of labor, I was ready to speed things up by whatever means necessary.

The midwife broke my water, and it felt like tons and tons of water came flowing out of me. In case you're confused about my water breaking early Sunday morning and then again now, basically, what had happened on Sunday morning was a "high leak," not the dramatic gush that I was now experiencing. Also, a pregnant women is constantly producing animotic fluid, so even though I was leaking fluid, I was also replacing it. Now, however, all bets were off as a bunch of fluid gushed out of me.

This allowed the baby's head to press firmly on my cervix, which is what intensifies the contractions and hurries things along. And boy did it ever. Contractions which had previously been completely manageable quickly became more painful than anything I could imagine. I clung to my partner with a death grip. The contractions came fast and hard, lasting for a minute at a time. I felt them intensely in my lower back, which was odd because the baby was not positioned in such a way that I should have been experiencing "back labor." The midwife simply said that different women feel pain in different places, and I must isolate pain in my lower back. Well, that explains A LOT, but this is just about the birth, so I'll save that discussion for another day.

As the waves of intense pain washed over me, I told myself that it was only going to be about 20 minutes, and I could take it. Me, my partner, and the midwife all huddled together and made low, gutteral "ooooooh" noises, which was supposed to help. I don't know if it did or not, but I guess it was a distraction.

As time wore on, I started to become afraid during the brief breaks between the contractions. I knew that horrible pain was just around the corner again. I had no concept of time at this point, so I asked the midwife how much time had passed so I could know when this 20 minutes of hell would be over. When she told me that I had been going through this for an hour, I felt the wind fall out of my sails. An hour.

She suggested that she do another internal exam to see how I was progressing, and I readily agreed. If I'd made it to 8 or 9 centimeters, I guess it would be worth it and I could go on. When she told me that, after an hour of this, I was only at 7.5 centimeters, I felt a wave of depression hit me. The midwife left the room for some reason, and I looked at my partner and said, "I can't do this anymore. I need some sort of pain medication." She had been just as into the idea of an unmedicated childbirth as I had been, but after seeing the agony I had been through for the past hour, she readily agreed with me. When the midwife returned, I told her that I needed something for the pain.

The midwife also agreed and suggested that I get an epidural. I said okay without a second thought. She left again to get the anesthesiologist. I sat close to my partner and in complete silence, I turned my mind to a new task: stopping the contractions. People might be surprised to hear this. Maybe you won't believe me. But I couldn't take the pain anymore, and I put my mind to a single focus of preventing the contractions from returning. No, they didn't stop completely, but they slowed down dramatically. Rather than coming every 3 minutes, they came every 5-7 minutes. Rather than lasting upwards of a minute at a time, they lasted about 20 seconds. Rather than completely robbing me of anything except the sensation of pain, they became manageable once more. It took all the powers of concentration that I had, but it was worth it.

I was completely drained at this point, and when the midwife came back and told me that it would be another 10-20 minutes before the anesthesiologist could come and give me the epidural (he was in the middle of a c-section), I felt my grip on social control slipping from me. I maintained my mental focus on stopping the pain of the contractions, and that was all that I had the energy for. I was sitting on a chair, leaning forward against my partner, and I was scared. Scared of the pain. In my fear, I felt the urge to pee. I could have gone through the process of getting up and relocating to the "commode," but I didn't want to do that. Instead, I peed where I was sitting on the chair. (The chair did have a waterproof pad on it.) I didn't mention this to anyone.

When the anesthesiologist finally came in, I was relocated to the bed where I sat and hunched over the way I was supposed to so that my back was flexed and he could insert the epidural catheter. I had to remain perfectly still during this time, even if I felt a contraction. Obviously, I didn't want to mess up the anesthesiologist when he was sticking something into my spinal column.

I was scared. Scared of what was happening to me. I was also dealing with the fact that this was really the final blow to my plans for childbirth. I wasn't at the birth center. I was at a hopital. I wasn't untethered. I was hooked up to machines. I wasn't in labor on my own. I was on pitocin. I wasn't going to be able to feel my child being born. I was having an epidural.

As I sat on the bed, I felt the desire to pee again and again, and again and again, I let go and peed as I sat there. (Once more, I was sitting on a waterproof pad which the nurse would remove once the anesthesiologist was done.) The anesthesiologist, thankfully, gave me the quickest epidural the midwife had ever seen performed. I laid down on the bed and quickly felt the pain receding until I felt nothing.

I laid on the bed and shook uncontrollably every 20 seconds or so. I had been awake for 40 hours. I had been laboring for over 30 hours. I hadn't eaten anything for almost 12 hours. I was at the end of my rope. They told me that now I could just go to sleep and let the drugs do the work. Before I did fall asleep, I watched at the nurse came in and upped the pitocin level about every ten minutes.

Before midnight, I was sleeping. My body was laboring even though I couldn't feel it. And that's how Monday ended.