What made the second c-section birth better

I was really dreading having another c-section.  Mostly because the memory of the first one is fresh in my mind – how painful it was to sit up, much less walk for the first few days.  I remember feeling helpless in the hospital bed, unable to sit up enough to reach my son who was crying for a diaper change.  It was a terrible feeling – not just the pain, but the inability to move like I wanted to.  Afterward, I wasn’t looking forward to the restrictions – not being able to lift my son, or go up stairs too much, or even drive for a few weeks.  But without an option, I had to resign myself to the repeat surgery and its aftereffects.

I did have the option, though, in hospitals given that my doctors practice in three different area hospitals.  I chose (after discussion with the doctor who would be performing my surgery) the smaller, local community hospital that’s near my town.  With my son I went to a large city hospital with a full NICU unit, just in case there were any issues with my son and his size.  With my daughter, who was growing really well and above average on her weight, I felt less of a need to make sure I had a huge medical facility.  Neonatal care was available at that hospital if I needed it.  And now looking back, I enjoyed that hospital stay much more than I enjoyed the one at the larger hospital.  While I realize my experience is highly specific to these two hospitals, I thought I’d outline some of the distinctions that made my second visit a more pleasant one.

1. Convenience.  The community hospital is less than 10 minutes from my house, while the city hospital is 30 minutes on a good day.  With a little one at home, being so close was handy for my husband to run home and take a shower, and for my mother and sister who were helping to care for my son and who don’t know the area well.  For my 6am check-in appointment for surgery, it was nice to only leave 15 minutes early rather than more than half an hour.  And there was no charge for parking.

2. A smaller, quieter facility.  I was the only scheduled section the day I gave birth; and from what I could tell I was one of the only people in recovery for a while.  My recovery room was the furthest from the nurses’s station and entrance – the last one on the floor – so it was furthest from outside noise.  When there was a code red or blue in the hospital, it was difficult to hear from my room.  No one was wheeled past my door.  It was nice.

3. Nurses were friendlier… and they actually came when called.  In the large hospital it might have taken an hour for a nurse to come in when called.  In this case, if my nurse wasn’t available they sent someone else in – which was the case when I wanted to stand up for the first time.

4. Pain control was more of a priority.  Seriously, you should ask about this at any hospital you are considering.  In the bigger hospital, you had to call for your nurse to bring you pain medication – and as mentioned in the previous bullet, that could take an hour before they even showed up to see what you wanted.  This time around, the nurses and the lactation consultant stressed making my comfort a priority – if mom isn’t feeling good, she’s no use to anybody, especially the baby.  The nurses were always concerned about my pain level.  Yes, I did have to call for medications a few times, but they were prompt and sometimes scolded me for waiting so long to call (since I wanted to see if I did need them or not… and I really did).

5. I had more than 5 minutes with a lactation consultant.  Her office was two doors down from me, as a matter of fact.  She asked that I call for her at every feeding while she was on her shift.  She sat patiently with me, reassured me I was doing everything right, and told me how much further along with breastfeeding I was than people are usually.  She checked in before she left to teach a class.  I saw her a lot and I didn’t feel guilty about it one bit (unlike at the other hospital when I was told, “You know, people usually only see a lactation consultant once before they go” after I had seen her twice).

6. I felt listened to.  When I was concerned about my daughter’s weight loss, her constant crying, her constant nursing (to what felt like no avail to me), all of my nurses were patient and explained options to me.  When I described what happened with my son, they listened but reassured me each pregnancy is different.

7. Even the cafeteria workers took pride in their job, even if they realized the food they were delivering wasn’t so great.   They were very kind to me, always offering to make something off the menu if nothing sounded good.  (I never took them up on that offer).  One morning the woman had an extra food tray (like I said, I was at the end of the hall which usually meant I was the last to get food), and she gave it to my husband so he wouldn’t have to go to the cafeteria and pay $3 for yogurt.  Super nice.

8. Between my husband and I, we had a connection to at least two of the nurses who treated me throughout my stay – that we knew about.  One of my surgical nurses during the birth was connected to me through someone at work, and one of the head nurses requested to be my nurse because she knew my husband and his family from high school (she was the nurse there).  While sometimes people might find it annoying to know someone everywhere you go, I can tell you this much – I don’t mind knowing people at a hospital, since I think you’re bound to get better service because if you don’t, then everyone will know about it.

9. I had two anesthetists with me during surgery.  In the large medical center, I had a nurse anesthetist.  She was great, sure.  I flinched during the spinal – actually, I tensed up pretty bad, which you’re not supposed to do – and later I realized it was because I was ticklish on that side on my back.  So the second time, I warned everyone who would listen that I was ticklish, and to please warn me when things were happening with the spinal.  And the second time, I had two people working on numbing me – a nurse anesthetist and the actual anesthesiologist.  They were both phenomenal, but it also added two more people to help talk me through the process and keeping watch over my vitals and state of mind.  It helped they both had a sense of humor and put me at ease.  Whereas the nurse hadn’t warned me during the birth of my son that lightheadedness, nausea, and a sense of panic are all side effects of the anesthesia, the anesthesiologist was very forward in asking how I felt and told me to tell him the minute I felt anything different.  I told him once I started feeling lightheaded, and he put a hand on my forehead and said, “Yep, you’re getting a little sweaty, a little clammy.  Don’t worry, perfectly normal.  We’re going to give you a little something to make you feel better.”  That. Was. Awesome.  I couldn’t have asked for a better team.

I hope you will be able to ask some tough questions and take a critical look at your birthing center, wherever it may be, and think about what’s important to you.  Privacy, quiet, pain control, accessible nurses…  You may think you know what you want – if you’re like me you think you don’t want a lot of pain medication, but then you do – so just keep an open mind, and I wish you the best of luck.

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“So, is this it?” and other awkward second-baby questions

The experiences of the infertilite in the fertilite world are often befuddling.  I have had such strange advice about having a second child, and even stranger questions, that I usually have to keep from cocking my head to the side and thinking out loud, “Is that really how normal people feel?”  Here is some of what I’ve had to contend with and, in some cases, explain in polite terms.

“I was a surprise, too, and I turned out okay.”  I didn’t hide the fact that I didn’t plan on getting pregnant so quickly after having my son.  But I didn’t plan on it because, as you know, I didn’t think I’d be able to beat the odds for a second time.  As in ever.  So yeah, surprise!  But how do you explain that to someone who doesn’t know the whole history or background, without getting into it and turning it into a weird and awkward conversation?  You don’t.  You just go with it and move on.

“You must have been in shock when you found out [that you were pregnant].”  A close friend asked me this about a month ago while we were having lunch.  And I admitted that yes, yes I was – for the reasons mentioned above.  “You have to remember,” I said to my friend, “I spent most of my maternity leave coming to terms with the fact that I’d have to be satisfied with one child.  That as much as I didn’t want my son to be alone and without siblings, the reality would be that he very likely would.  And that’s when I got pregnant.”  My friend’s eyes went wide as he threw down his sandwich and leaned back in his chair.  “Holy crap!” he said.  “I never even thought of that!”  Yeah, so that’s men for you.  He really didn’t have much to say after that.  I’m pretty sure he’s still processing that information.

“So, is this it?”  This from a nurse, her eyes darting between my 15-month old son and my ready-to-explode belly.  “God bless you,” she said, shaking her head and smiling, as if to say that she felt sorry for me and for the next two years of my life.  But I don’t know how to answer that question, “Is this it?”  I don’t even know how to answer that to my husband.  When one of the OBs in my practice asks me, “And are you having your tubes done, too?” and I say, “No,” even I have to wonder why that’s my answer.  And the best reasons I could think of are this: after years of struggle, heartache, rationalizing, hoping, hurting, and celebrating, it feels like the wrong answer to say “Yes, that’s it,” at this point.  It feels like a huge disrespect to my body, which has given me two incredible gifts after it seemed to have failed me for so long.  In theory, I really don’t want to be pregnant again.  In theory, there are lots of other ways to make sure that doesn’t happen that doesn’t involve further severing an already flawed organ.

Plus, it’s a little gauche to say, “Do I get a discount if I only have one tube tied?”

Bump-bump-bump…

This one is for the ladies with body issues; pregnancy wreaks havoc on your ability to accept your body both during and after baby.

I don’t have a pretty bump.  I didn’t the first time and I don’t the second.  Sure, it’s round and somewhat little – at 26 weeks people are just noticing that I’m pregnant at work – but man is it ugly in the wrong clothes.  And what makes it ugly?  To me, it’s that my belly button didn’t turn into an outie the first time and doesn’t look to be any closer to doing that the second time around.  The result: an unsightly jiggly flat and hollow spot at the belly button underneath stretchier shirts that makes you look more fat than pregnant.

I don’t know why I happen to have this particular shape bump and so many others don’t.  But it makes me look at other pregnant women with envy at the their perfectly shaped bumps, that kind without any flat spots.  I don’t know if it has anything to do with your fitness level, the amount of jelly already on your belly, how stretchy your skin is, the kind of cocoa butter or oil you use on your belly, or even genetics.  I don’t know if it’s because people have bigger than average babies versus those of us struggling to put on literal baby weight.  At the end of the second trimester (when the belly button is supposed to have popped) it’s not like I can do anything about it anyway.  I guess I’d just like for there to be an honest discussion about different bump shapes… like how shorter women’s bumps tend to go out further because of a short torso, versus taller women with more room to stretch.  Or how one bump can be low and the other can be high and it means absolutely nothing at all.  Or how it’s okay that your bump isn’t a perfect half-circle.

Nevermind the fact that your bump tends to be a little bit bigger earlier with subsequent pregnancies.  So here I am feeling like a beached whale with three more months to go, bumping into things, hitting my bump with the car door, and starting to get uncomfortable bending over to paint my toenails and put on shoes.  I don’t seem to remember this happening so early, but maybe the mind is forgetful.  Someone I know told me the “pregnancy brain” forgetting effect is there to help you forget how uncomfortable you are during pregnancy so that, to ensure survival of the species, you’ll willingly do it again.  I’m beginning to think he was right.  He’s got a flat gut that sticks out, too.

Oops, I did it again

At my two-month checkup after giving birth earlier this year, my OB/GYN told me I could get pregnant again before I even got my period back.  I kind of rolled my eyes at her and said, “Are you serious?  Yeah, I don’t think that will be happening.”

“You’d be surprised,” she said.  I countered by reminding her it had taken me two years to finally get a pregnancy to stick.  “You never know,” she said.  I dismissed her advice.  Given the fact that I had beaten the odds with my son at every turn, as I’ve detailed throughout my early pregnancy, I really didn’t think I’d have the luck to beat the odds again.

I spent the first few months as a new mother panicking about the idea of raising an only child.  I worried that he would be spoiled, unable to socialize with others, not having any playmates growing up.  I worried that in old age he would be solely responsible for my husband and I, that he would have no one else to confide in.  I thought about my relationship with my sister, and my husband’s with his siblings, and I wanted those same bonds to exist for my son.  And I dismissed my feelings and resigned myself to being a great mom even if that meant only being a mom of one.

Well, here I am, 12 weeks pregnant, against all odds.  I am still holding my breath, as if none of it seems real.  And knowing what lies at the end of the road, I’m a little more nervous about another c-section.  Sometimes ignorance is bliss.  My OB/GYN group this time around is taking a wait-and-see approach to my care; “It’s possible you just make small babies,” one doctor said.  “That’s just how your body works.”  At this point I feel utterly clueless about how my body works.  Why now and not four years ago?  What about my body is so different?  It’s older now; I thought you were supposed to be more fertile when you’re young?

I’m already fielding questions, again somewhat unexpected, that seem somewhat insensitive to the infertilite journey.  “Well, I heard your body is more fertile after being pregnant,” said one nurse.  This doesn’t seem like a statement of fact to me; and she’s a nurse.  “Are you still considered high risk even though you’ve already been stretched out?” said another person.  And my answer: “Yes, I am,” because the uterus returns to its usual size after pregnancy, which for me is the shape of a deflated balloon.  A little deflated banana balloon.

Here we go again!  I will be tracking both responses to my pregnancy as well as observations going through this for a second time.  For me it is all about getting through one day at a time, and being thankful for the family I’ve been blessed with.  And my wish for you is to give you Hope, that though it seems preposterous, though it seems far-fetched, though it’s something you might roll your eyes at, it’ll happen for you and sometimes when you least expect it.

The woman I’ve warned you about is me

I’ve had lots of curious recent discoveries into the world of infertilite mommyhood that I thought I would have been able to avoid, given my own story and situation.  But as I stared into the face of my sister-in-law as we walked through a children’s consignment sale during her 7th month of pregnancy, I realized that I had become my own worst nightmare.  I was the woman with the horror stories about giving birth.  I was the woman who thought it was better to give you the reality check than the comforting words you need to hear.  And I thought I was doing it all for the right reasons.

As it turns out, my advice is probably best suited for only other infertilites.  Although I was aware that my SIL had been told by her doctor she’d never be able to have kids, I didn’t know why and I never asked.  I knew she was devastated at the time, and as such, was (presumably) really psyched to actually be pregnant given her infertilite status.  She’s a very go-with-the-flow kind of free spirit, so I let her lead the way with questions for most of her pregnancy and I avoided mothering her too much.  I was proud of myself for having gotten this far, knowing that along her pregnancy she had some complications of her own – too much amniotic fluid, the baby grew very large, and she kept getting dehydrated.  So when it came time for some SIL-bonding at the sale, I took the opportunity to make sure she was more prepared than I was for the time of the birth.

This was an unfortunate mistake, however.  Because as it turns out, the advice that I have for someone who is pregnant isn’t really relevant for the majority of moms-to-be.  I had biweekly non-stress tests.  The doctors and midwives joked my baby would glow in the dark I had so many ultrasounds, because he didn’t grow to average size.  And I had a baby in the breech position with no chance of even squeezing out a natural birth.  Add in to the equation a few other factors, like the small size of my baby, my passing out hours after the c-section, my lack of labor pains (and them being back labor pains when I did have them all of two times), and my difficulty with breastfeeding, and you’ve got yourself a nightmare for a new mom-to-be.  Yikes!

So, yes, I told her all of these things…  mostly because she asked and was curious, and wanted to know what all of it was like.  But nearly every statement I said had to be qualified or dismissed with something like, “But that’s just because he was breech,” or “That’s just me, that’s not the normal experience.”  And with every piece of advice I could give, other than stocking up on sanitary pads, I became increasingly aware of how awful I must sound and how unhelpful it really was.  She really had no chance of having half the difficulties I did, so why bother scaring her with them?

Now that she’s had the baby, who was born a week after her due date, she’s remained just as relaxed about motherhood as you could imagine a free spirit being.  She’s had no troubles breastfeeding, her baby was a whopping 9 pounds, and she had to be induced.  After 24 hours of labor that went nowhere, the doctors gave her the option for a c-section and she took it.  Realizing how exhausting it had been for me to recover from that surgery – and mine was blissfully scheduled and relaxed, not preceded by a day of labor – my husband and I waited two full days before visiting in the hospital (unlike the rest of the family).  I don’t see a trace of shell-shock in her face, as I imagine mine was full of, and I keep my mouth shut about the aftermath of giving birth.  I nod as I listen because the first few weeks with a newborn are a universal period of unconditional love and personal sacrifice, and we all can relate to that.

In the meantime, I’ll be keeping my stories to myself until the day comes when someone who truly needs to know, for her own health, asks.  And, of course, to all of you – because you wouldn’t be reading my blog unless you hadn’t already wondered.

Maybe I should play the lottery

It doesn’t matter that I had a baby.  Every time I see a pregnant woman it’s as if I had never been pregnant.  The same internal dialogue races through my mind, even in the day care parking lot as I’m carrying my son in to school.

It must have been so easy for her.

Look at her, she’s working on number three.

Lucky!

I should know better.  I was aware of my own belly bearing those same reminders to other women, to the point that I was sometimes embarrassed I was pregnant.  Spending the better part of 2012 pregnant did nothing to stem the jealousy that I still feel.  Maybe I feel this way because I spent my whole pregnancy walking on eggshells, hoping to make it to the next week, the next month, the next trimester.  I am still in disbelief that I made it to full term, much less almost to 40 full weeks.  I know how the odds were stacked against me at every turn, and still I beat them, and no one would have known that by looking at me.

(Well, if they had looked closely at my stomach in the last trimester, they would have seen the lopsided effect of the unicornuate uterus keeping the baby on the left side…  But who really knows that you can have half a uterus unless you’re the one facing that diagnosis anyway?)

It’s a weird feeling, trying to rectify the absolute miracle that happened to me – from beating the odds of having a spontaneous pregnancy, to beating the odds of complications likes placenta previa, to beating the odds of having a miscarriage, to beating the odds of pre-term labor and incompetent cervix – to making it full-term.  About the only thing I couldn’t beat was the intrauterine growth restriction, try as I might with the amount of protein I ate every day, and the breech position.  I have friends who had completely normal pregnancies, completely normal uteruses, but delivered early for one reason or another.  They were never on bedrest, were never asked not to exercise, weren’t going for twice-weekly non-stress tests like I was.  One of my midwives had said he expected my baby to come out “glowing” from all the surveillance he was on.

No, my baby didn’t come early.  He was content to wait even in cramped quarters until the scheduled C-section.  He was healthy enough to room-in with me – another miracle.  And yet, in speaking with my friends who had the early or pre-term babies, for as much as having a pre-term baby is a heartbreaking, scary experience, it meant they didn’t go through the same discomforts that I went through in the last month of pregnancy.  They didn’t gain weight rapidly or get so uncomfortable in any position they couldn’t sleep.  And once they had their baby, they could recover – and sleep! – in their hospital room because their baby was not with them. 

I look at other “normal” women and think they are lucky without having any clue as to how long it might have taken them to get pregnant, just because every minute I was pregnant was a victory for me.  But a newly-pregnant first-time mom might know I had my baby skin-to-skin immediately after birth and rooming-in with me during recovery, and think dreamily how that is the perfect, ideal scenario, and how lucky I was for that to happen.  And then I talk with my pre-term friends who hear my story about the guilt of sending the baby to the nursery just to get some sleep for a few hours, about never getting any sleep longer than two hours because the baby wakes up, and how that hinders your ability to recover.  And every single one of them has said, “You know, although it was really scary at the time, we were so lucky to have had the baby being taken care of in the NICU.”  

Imagine that. 

No one wishes the NICU on anybody.  But every pregnancy, from start to finish, is different, complex, and scary – even the so-called “normal” ones.  So when you think someone else is lucky because their situation might be more ideal than yours, remember that person might be looking at you and thinking you’re the lucky one.  Count your blessings each and every day, especially the blessings in disguise.

My green shower

The fall was so jam-packed with events, between holidays and nesting, that I didn’t really get a chance to talk about the awesome baby shower I had.  And it was awesome not because of the games that were played, or the food and cake (which were both really awesome), or the cute items I got that I wasn’t expecting.  It was awesome because it was exactly what I wanted – relaxed, laid back, and green enough to make me feel like I wasn’t killing the environment.

As Americans, we throw out on average 4 pounds of trash a day.  That’s 1460 pounds – or three-quarters of a TON of garbage annually – on average!  With an average life expectancy in the 80s…  you’d throw out 124,100 pounds of trash if you lived until 85.  That’s 62 tons, or roughly the equivalent of one of the heaviest tanks in the US military.

M1 Abrams Tank

Since the fourth grade I’ve wanted to save the environment, recycle and reuse things, buy from consignment shops, and generally respect the planet.  So when wedding season and then baby season came along in the last decade, I shuddered at nearly every shower at the amount of garbage thrown out just in the ribbons and wrapping alone.  At one shower there were three or four bags of trash just in the wrapping!  It made me slightly nauseated, especially to know that there was still boxes and other wrappings still to be thrown out once the bride or mom to be opened up the package to use.  I resolved to have my baby shower be green, because that was one small thing I could do to eliminate the facade of the shower.  So when the time came, I asked my sister (and anyone else who might have had a hand in planning to shower) to ask guests not to wrap any of the gifts.  My husband disagreed and thought I was being rude telling guests how to (not) wrap their gifts; I persisted and won.  I even consulted Dear Abby; she didn’t reply.

There were other reasons to ask guests not to wrap gifts.  I hate the feeling of everyone watching me unwrap gifts.  It’s painful.  And the audience gets quiet, especially after they get over the initial hour of “Awwws!”  It’s just painful.  And now with electronic registries as ubiquitous as they are, things aren’t much of a surprise for anyone.  Is it really a surprise if you open a gift you pre-picked out for yourself?  No.

All that being said, the younger attendees of my shower totally got it and appreciated not having to spend an extra $5-10 on a gift bag or wrapping paper.  The older – really old – people didn’t understand it, but I didn’t really expect them to.  Only one person wrapped gifts, who apparently had purchased all the gifts and wrapped them before she got the invitation… props to her for being super organized.  And there were other benefits to this tactic that were unintended but pleasantly surprising:

  • I spent more time mingling with family and friends, especially family that I don’t see often, than I did opening gifts
  • If people had to leave early, they didn’t feel bad about it because everyone had lots of time to see all the gifts on display, including me
  • People got really, really creative about presentation
  • The shower was over in three hours, food buffet and dessert included

It was one afternoon.  Now here I am and since my son was born I’ve probably contributed some 1500 disposable diapers to landfills.  And we’re only getting started…