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cesarean

Being her mother is amazing. Entering motherhood, not so much.

Entering this phase of my life in a whirlwind of pain, confusion, and abandonment hurt. At its worst, I felt like I was hanging on the lowest rung in a pit of despair, fighting desperately not to fall down completely. I begged my therapist for an appointment over Skype a few days after getting out of the hospital, while sitting in a Walgreens parking lot. We were buying formula for my skin-and-bones baby who was starving and screaming because I couldn’t make milk. Days after leaving the hospital, I had to return to have my incision reopened and an infection drained. I continued to go every few days for months. I had to hand her over to others while I sobbed uncontrollably over still being on disability, still being a patient, still packing an open wound three months after surgery. I had insomnia for almost five months because every single evening was spent replaying my labor and surgery, wondering why my midwife became distant and then disappeared, and trying to figure out how to dissipate unspent energy left behind when we stopped pushing and started cutting. I hid from my friends for three or four months because the staph infection I picked up at the hospital spread to my skin and a third of my face was covered. These last six months haven’t been kind.

Her half birthday is a special day for her, and for us as a family. We celebrated and reflected on the time she’s been with us and marveled at how much she’s changed and grown. It’s an anniversary too though – one that I recognize silently so as not to detract from this special little person’s day.

In between hugs and kisses, my mind raced back to laboring at home, going from excitement to urgency to transfer. And I tried to remember what happened after.

That’s the hardest part – not having memories. I don’t remember the sound of her crying in the operating room or the first time I saw her in recovery. I don’t remember much of the good stuff from the first two days at all. I remember alarms going off in recovery when my blood pressure dropped, going in and out of consciousness while waiting for them to bring her in, wondering if they’d even be able to if my blood pressure kept dropping, I remember the hospital midwife smirking as she pressed on my fundus so hard that I tried to scream but could barely manage a sound, doctors and nurses in and out of our postpartum room scrutinizing my erratic blood pressure and dark orange urine, I remember wanting desperately to go with her every time they took her to the nursery to do a check-up or draw more blood but I wasn’t allowed to stand up, I remember the intense and unusual feeling of sharp, stinging pain mixed with numbness all over my belly. Most of all though, I remember the unexpected and frightening feeling of the incision inside of me – the one on my uterus – the burning, stabbing, and piercing sensation migrating slowly down my abdomen as it shrank in the days following the birth.

Of all the physical feelings, that’s the one I’d most like to forget. I still have phantom pains. I had them all day on January 2nd. I have them sometimes when I lay awake at night questioning what I could have done differently or trying to put all of the pieces of the puzzle together to convince myself that I did everything that I could. “It’s not my fault, it’s not my fault…” replays as the phantom pain moves down my stomach. It’s worse than the pains of surgery that I felt when the final epidural failed. I feel those sometimes, too.

I can’t pretend it’s all negated by having the privilege of being a mom. I’ve been cut deeply. I hurt, physically and emotionally. I have to hold two spaces – mother, and me. I feel wounded and broken. I don’t have my strength back. My incision hurts still, every day. I have a lot of healing and forgiving to do. I’m also experiencing joy and love I never thought I’d know. It’s confusing, being a mom and being me. It’s hard to find the balance, hard to stop and find space for me, to treat myself kindly and tenderly, when all I want is to make it all go away so I can be strong and happy, so I can just be a mom and focus on her and stop worrying so much about me.

There’s so much going on when I’m Mama – so many things to distract me from the questions and memories (or lack thereof) and the lingering pain. I can be happy, whole, and present. And then in the quiet times, I crumble. Six months, crumbling and picking up the pieces. Over and over.

It’s getting better. Most of the time, I feel normal. Most nights, I sleep. I can reach my arms up high and not feel like I’m about to rip apart. I can laugh without bracing for pain. I can carry my baby without breaking a rule. I feel like I have so far to go though, and every day that goes by, every milestone reached, I wonder if I would have been a better mom and a happier me if I’d done something differently and done it “right”.

As most of you know, I had complications with my incision. The right side felt hot to the touch while still in the hospital. I also felt a hard lump under that side. I mentioned it to doctors and nurses a few times but everyone told me not to worry, that it was most likely scar tissue. We went home without them doing much other than visually checking my incision.

A few days after we came home from the hospital, we realized it wasn’t scar tissue. My incision opened and started to drain in the warm spot with the lump.

The Daddy and I packed up baby and headed to triage. There, the resident stuck a very long cotton swab into my abdomen and swept it side-to-side to make a larger hole. You know what really hurts? Having a fresh incision opened up with a q-tip. The Daddy calmed me down by whispering in my ear and the attending physician held my hand and stroked my arm. Then they pressed on my abdomen to expel the contents of the abscess that had formed underneath my incision. Quite a bit of blood and pus drained out. The spot that had been sore and painful for a week felt better immediately.

Then they delivered the bad news – The Daddy would have to irrigate the wound morning and night, and then using one of the same long cotton swabs, he’d have to pack the hole in my incision with a special gauze tape that looks like a shoelace. This would need to be done until the wound closed. We’d need to irrigate so that infection didn’t pool in the open wound. The packing was to wick out the moisture, for the same reason. With irrigating and packing supplies and a 10-day script for Clindamycin, we were sent on our way.

For about a week, The Daddy did the irrigating and packing. I’m not a very good patient though – I freak out when I feel like I’m not self-sufficient – so I eventually took over. Below the cut is an explanation of the process, and some pictures.

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Tomorrow will be 12 weeks postpartum. My goal was to make one post a week. Considering I haven’t posted in a month…yeah. We’ll call that a fail. I’ve gotten into this bad habit of starting entries in Google Docs and then never returning because it’s either something requiring research/citations (PCOS Awareness Month post), something that ended up too long (c-section recovery post), something that requires more pictures/less modesty (post about recovery complications, incision scar, etc) or something that felt too personal in retrospect (PTSD to C-PTSD shift and body disassociation).

Anyway. Here’s a quick-y throwback to the State of the Uterus posts.

12 Week State of the…I don’t know. Mom? Family? Stuff.

First, the happy.

-The Daddy’s mostly back to work and I’m doing the stay-at-home-mom thing. Sometimes it’s overwhelming, sometimes it’s isolating. Mostly, I love seeing my baby all day, every day without worrying about childcare stuff, job hunting, missing her, etc.
-There are no longer pieces of suture randomly coming out of my vagina. Not gonna lie, that could also go in the “sad” section because it was fun-gross, like a really good nose blow or pimple.
-FSR is growing like a weed. Her lowest weight was 5lbs 11oz and now she’s 13lbs. Kid likes to eat.
-We’re doing that thing that people tend to do when they have kids – we’re entertaining the thought of leaving the city. I would like to stay here forever, but the desire to give my kid a yard with dirt to play in is much more important, and that’s not really an attainable thing in the city. I’m a little sad about the idea of leaving, but I think that if/when it happens, it will be good for us all.
-Tomorrow is mine and The Daddy’s seven year anniversary. Holy shit.
-FSR laughed! A big, real laugh on the 21st. I was tickling her under her chin. Ticklishness! That’s a thing that’s happening! Yesssss.
-It’s almost Halloween, which means ridiculous things like CUPCAKE COSTUMES are on sale. And I buy them. FSR is not sure what to think.

-Friends are having babies! Two this week and more on the way.

So. Yeah. There’s the good stuff. Motherhood and family life in general is great and I love my little girl so much. I would not trade it for the world. Not everything is sunshine and roses, though. Some things are hard. Real hard.

On to the sad/bad:

-PCOS is back full-swing. Oh hello, adult acne! Has it been a year since you left already?! I’m having the worst breakout since…I don’t know when. I literally have zits on top of zits, and cystic acne. It hurts so bad, I want to claw my face off. Hopefully birth control will knock that shit out ASAP.
-SPD, still a thing.
-Baby weight, also still a thing. I decided that 2.5 months of legit disability means that the “9 months on, 9 months off” thing doesn’t apply. I get 11.5 months. May as well round that up to a year. This is bumming me out not because of a number on a scale or size on my pants but because I don’t feel like myself. My body shape changed. My old clothes that fit look different now. I have to re-learn my body, and that’s hard. So. Favorite jeans? I will see you next September. Maybe. I might not see you again at all and if that’s the case, hopefully I will be ok with that over time.
-I feel generally unwell/unhealthy because I’ve been more inactive than I have ever been in my life because of limitations brought on by recovery and complications. It’s seriously so bad, I gave up my initial goal of joining a boxing class and instead have actually been looking into mall walking because air conditioned walking on a flat surface is seriously the only thing that doesn’t sound horribly painful. Oh, god.
-Hole in my abdomen? Still got it.

There you go, folks. That’s where we are right now. I really do want to get on some of those other posts soon, but…yeah. Parenthood. Time constraints. Brain fog. We’ll see how it goes.

Until then, I’ll be over here…doing this.

First things first: I’m REALLY sorry for that title. Really.

A little backstory: I was released from the hospital 5 days after FSR was born (more back story: the baby’s nickname is Flopsy Space Rocket aka FSR). I had a very difficult recovery in part because of the loooong labor before the cesarean. After returning home, I had complications with my incision. It appeared to be healing beautifully from the outside, but there was a large, painful lump on the right side. A couple of days after we got home, the reason for that large, painful lump made itself known when my incision opened and started draining blood and pus. We went back to Labor & Delivery where they opened the incision back up to allow the abscess underneath to drain. Lump and pain, gone! Unfortunately it wasn’t as simple as that though – that was the beginning of irrigating and packing my wound with gauze tape two times a day, and returning to the hospital one to three times a week. The hospital visits continued until 2 weeks ago and I am still irrigating and packing two times a day.

I had my postpartum check-up yesterday at just over 7 weeks postpartum. Those of you familiar with the postpartum checkup know that it’s supposed to be done at 6 weeks. When you’re returning to the hospital anywhere from one to three times a week, they’re not really sticklers for you doing that checkup on time. Ha.

I was looking forward to this visit. This is the Big One. It’s when you get released for normal people stuff like sex, exercise, and lifting more than ten pounds. It’s when they say, “Ok! Go back to work! Go live life! Be normal!” Since I seem to excel at doing everything the hard way, I have four more weeks of disability and only lifting ten pounds. Four. More. Weeks. I’m only cleared for sex and “normal daily activity” but not work. The sex part is out though, as I still have a hole in my abdomen leaking blood and other fluids. Yeah, no. No sex.

I was also diagnosed with Symphysis Pubis Dysfunction, or SPD. SPD is fancy-talk that means my pelvis and hips are all loose and janky and moving about in bad ways resulting in instability and misalignment of my pubic bone, hips, lower back, and SI joints. Sometimes it feels like things are floating around and getting ready to pop out of place. Sometimes my pubic bone feels like it’s grinding together at the pubic symphysis. On a normal day, my back hurts so much that it spasms. On an active day, I get so sore that it takes me days to recover. The first day that I pushed myself, I had to waddle/limp out of Target. Getting up hurts. Sitting down hurts. Walking upstairs hurts. When I lay on my side, it feels like my bones are moving. Basically, life kind of sucks now when it requires movement…and my very particular baby really likes when I move. End result: my back is always tight and sometimes spasming, my pelvis feels like it’s being pried apart by a crowbar, and my sacrum and coccyx feel permanently and deeply bruised.

Instead of making room for the treadmill and re-inflating my reflex bag, I’m shopping for a brace to relieve my pelvic girdle pain. The SPD pain has been going on for awhile. It seems to be getting worse as I get more active, so I’m trying to slow down again. Friends, this is a large part of why I’ve been turning down invitations lately or why I’ve been wishy-washy about doing things. I want to do things. I feel bad saying no, because I don’t want to say no and because I feel like my friends are starting to get frustrated and impatient with me. I want to feel like a normal person again and take time away from my family to be with my friends. I want to take my baby to the park for walks and picnics and fresh air. I can’t though, because it hurts really bad and it sets me back too much.

I’m also still anemic, though not nearly as anemic as I was. I have elevated something or other, too – something dealing with liver function – so now I have to follow up with my primary care doctor for a physical and more labs.

My vagina, on the other hand, seems to be made of rainbows and magic. It tore while I was pushing but the doctor said that it healed so well that you’d never know the baby almost came out of there. So, hooray to my vagina I guess? If only the rest of me healed that well!

So, yeah. That’s where things are right now. Here’s to hoping things get better, quickly. Except my vagina. ’cause it’s already the best.

In the OR, I got my third epidural. Well, sort of. The first two failed but I didn’t have to get it placed a third time, thankfully. It felt like a bandaid covering half my back had been ripped off when I had the first removed. I was happy to not go through that again. For the third try, they moved the catheter around to see if repositioning it would make the distribution more even and then hooked me up to a stronger drug. Relying on that after two failed attempts was terrifying. I imagined them cutting, and feeling it all. I expressed my concerns to the anesthesiologists (there were two for some reason) and they did multiple tests to show me how little I could feel and assured me all would be fine.

At 2am Monday morning, surgery started. The baby’s head was stuck in the birth canal. They had to make the incision longer and lower than they normally would. One doctor reached into the birth canal and pushed the baby’s head up while another doctor pulled the baby out through my uterus.

Shortly before they pulled the baby out, my third epidural failed and I regained feeling. I could feel them pushing and pulling the baby out and then moving and checking my organs – not the pushing, pulling, and pressure they told me I would feel. I felt a full range of sensations and pain but I was hallucinating and dissociated and couldn’t fully express what was happening. As soon as the cord was cut, I was given fentanyl and morphine but before they kicked in, I felt every stitch as they started sewing me up.

By the time the baby was out, I was uncontrollably shaking and disoriented. The Daddy and I had agreed that if we had to do a c-section, he’d go with the baby and do skin-to-skin while I was sewn up. I needed him though, so he stayed and the baby was taken away. I still feel guilty about the time she was away from both of her parents so early in her life. I feel fortunate that he was able to carry her over to me first. It wasn’t the moment we anticipated but we had our first moment as a family. The Daddy told me all about her as I looked on – her full head of hair and big, alert blue eyes darting around the room. I’m glad that he did – I was too disoriented to focus on those things myself. I wasn’t even aware that she’d been born. Without him there taking me through the experience, I would have completely missed seeing my newborn baby in front of me.

Our daughter was born at 2:28am on July 2nd. After all of the worry she caused during labor, she came out looking like nothing had ever happened. The doctors don’t know why she was having so much trouble. They suspect it might have been a cord issue – she had some red marks that made it look like she’d been wrapped in her cord kind of like a seat belt. The doctor thinks her cord may have been pulling back on her and tightening on every push. Since my water broke, there was no cushion and she may have pressed on it when I changed positions.

Now that I know her inside and outside of the womb, I think it’s simply a matter of her being a sensitive little person. She got hiccups when I drank cold water. She hated ultrasounds and dopplers and would spend exams squirming away, making it difficult to get her heart rate or get pictures needed for screening. She squirmed and kicked at loud noises. Now that she’s out, she always wants to be held and cuddled and is constantly alert to light and noise. She has busy little eyes and busy little hands, exploring the world around her. She’s my sensitive little girl, inside and out, and that made labor difficult for her. Ultimately the physical part of birth was about her, not me, and she taught me that in a very dramatic way.

Long story short: I had a baby, she is great, and now we’re home. Now on to the recovery.

We pulled up to the hospital at 6:30am Sunday morning. The Daddy threw a “WOMAN IN LABOR” sign on the dash and ran for a wheelchair. We made our way up to the fifteenth floor. Contractions in the hallway, contractions in the elevator. At least the hospital was mostly empty at that hour.

He wheeled me to the nurses station and as he was checking us in, I had a powerful contraction. I was still feeling it mostly in my back and rectum and sitting in the wheelchair was too painful. I didn’t wait to get checked in – I leapt out of the wheelchair toward waiting nurses and growled, “Get me in a room and give me drugs” and stormed down the hall, blood and fluid running down my legs, in the direction of open doors. The nurses raced ahead, led me to the delivery room and called the anesthesiologist.

Initial drama aside, the home-to-hospital transfer was flawless. Our midwife beat us there and was waiting with our records. I was in a room before The Daddy finished checking in and I had fentanyl administered and an epidural on the way within ten minutes.

The anesthesiologist came right away but we had to wait out two contractions before the epidural was placed. I bit down so hard during the second that I started wondering if it’s possible to shatter your own teeth. I hoped that the fentanyl would take the edge off while waiting for the epidural but its most notable effect was making me hear voices every time I closed my eyes. Luckily after two contractions, there was a long enough break to get the epidural placed with no problems. Relief!

With pain controlled, reality set in – I was in a hospital over 30 hours after my water had broken. Would they rush me into a c-section? Treat me poorly because we were a home birth transfer? I questioned our decision and wondered if I should’ve stayed home and found a way to deal with the excruciating pain. Logic gave way to fear and for a moment, I forgot about the other reason we transferred – the baby didn’t seem to be handling labor well. Those thoughts were interrupted by our nurse asking about our birth plan and someone checking my cervix.

My cervix wasn’t swollen. I was dilating again. Contractions had slowed and the baby seemed ok. My midwife acted as doula and the hospital staff were accepting of her being there – she had my prenatal charts, a labor flow chart, and was helpful in relaying our birth plan. A nurse quickly jotted down our birth plan and didn’t bat an eye at us declining all but one newborn procedure. The doctors were wonderful. They accepted everything we wanted and didn’t push us. They supported our vaginal birth goal and did everything they could to facilitate that. It was a shock and relief.

Pitocin was started to try and get regular contractions going again. I dilated quickly, the swelling was gone, and I started pushing. After a few pushes, the contractions spaced out and I fell asleep. I woke up a little while later to alarms and people rushing into the room. The baby’s heart rate dropped like it had at home, but it hadn’t recovered. A nurse shot terbutaline into my thigh to stop contractions and then flipped me on all fours (literally – the epidural made my left leg completely numb and I couldn’t move it at all) and rushed me to the OR for emergency surgery.

The Daddy was in the bathroom and had no idea what was happening when he walked out and they were wheeling me away. I was taken into the room alone, getting bits and pieces of what might be happening on our way down the hall. I was concerned for The Daddy and wondering if anyone had stayed behind to tell him what was going on. As soon as we got into the OR and they prepared to put me under, her heart rate went back up. Back to the delivery room, to try again.

Pitocin was restarted when the terbutaline wore off. The baby tolerated labor and pushing for awhile. Pushing was a relief; the pain went away and I felt like I was finally doing something productive. I pushed for four hours. I pushed her from -1 to +3, The Daddy saw her head and reported that she had tons of hair. We thought we were going to make it (apparently I was an “excellent pusher”). She was distressed again. Her heart rate took a very long time to recover. I don’t remember a lot of what followed. I know I got two more shots of terbutaline because the baby’s heart rate fell and didn’t come back up. I know they fiddled with my dose of pitocin. An alarm went off again. At some point, my epidural failed and I had to have another one put in. The second one failed, too. By this point, Sunday was ending. I was exhausted and scared for the baby and didn’t feel like I could go on. The hospital birth team came in. We talked options.

We were given three choices:
-Keep pushing with the understanding that another decel would mean emergency surgery where I’d be put under and The Daddy would not be allowed in the room.
-Try forceps and risk vaginal tearing, injury to the baby, and the possibility of it not working and needing a cesarean anyway.
-Have a c-section right away.

The hospital team left us to talk. I asked the midwife her opinion and if she thought forceps or surgery were warranted. She suspected a cord issue and thought it’d be best to get baby out quickly. After discussing with her and The Daddy, we decided forceps were worth a try and told the rest of the team.

The attending physician did a vaginal check and said there was no room for forceps. Our options were keep pushing or head to the OR.  The hospital staff left the room again so we could talk. We decided to have the surgery. And with that, they wheeled me to the OR while The Daddy left to get scrubbed and changed so we could begin phase three.

I need to preface this by saying it might not be 100% accurate. It’s all a blur. There are parts I don’t remember because of trauma, exhaustion, or drugs. I’m breaking the story down into three parts: home, delivery room, and surgery.

The one thing we heard over and over again in childbirth classes was how boring childbirth was compared to birth in the movies – there are no big gushes of water, no screaming, no mad rushes to the hospital, no alarms going off…

Ha.

My water broke with a gush just before midnight on June 29th. I was almost asleep when I felt a pop. I stood up and found a puddle at my feet. I waddled to the bathroom, pants soaked to my toes, leaving a trail behind me which my cat licked up. Cats are disgusting. After waking The Daddy, hugging each other excitedly (“this is it!”), and cleaning up, I had two hours of rest before regular contractions started.

We labored at home for over 30 hours. The first 26 or so were amazing. The Daddy filled the birth pool, we called our birth team, everyone was excited! The house was full of love and anticipation. We talked, laughed, ordered pizza, and when I had difficult contractions, the mood effortlessly  switched to calm and supportive. My doula and midwife joked that I was like the women in the birth videos and that I made it look easy. I felt proud and empowered. At one point, I sneezed at the peak of a contraction. It was excruciating – I pulled a muscle and my side spasmed during contractions for hours – but we laughed, because really, sneezing during a contraction is kind of absurd.

In the final hours, we were shaken. I was passing out in the pool between contractions. My cervix stalled at six centimeters for what felt like hours (it may have been; I don’t know) and there were stretches of time when contractions were three on top of each other with a thirty second break and then three more. They went from having a slow climb with one peak to happening quickly with two peaks – one hard slam in my rectum followed by one stab to my cervix a few seconds later. My cervix swelled. My midwife massaged it during contractions to break up the scar tissue that neither of us knew I’d had. Breathing through contractions didn’t work for that level of pain. The only relief was screaming – LOUD – like I was being attacked. The faces around me started to change; even through the pain and altered state, I saw it and tried to reassure them during the brief moments between contractions that it was ok, that screaming helped me through. Blood sprayed on the walls and dresser. Things were wrong and that was starting to sink in.

Baby had enough. Her heart rate dropped drastically when I changed to the one position that made labor bearable and took pressure off of my cervix. My midwife said the words I didn’t know I’d been waiting to hear: “You know we don’t have to stay here.”

Labor started at 11:45 Friday evening. At 6am Sunday morning, we transferred to the hospital. The Daddy and our doula packed a bag, I got dressed between contractions. Our midwife’s assistant, who’d been absent until that moment, helped pack their supplies and stayed at the house to get the bedroom in order for our eventual return home. Our midwife tried to keep things calm as urgency and anxiety grew with the realization that things were about to change.

I decided only the midwife would come with us. She needed to hand over our prenatal and labor records but what I really wanted was to be alone in a room with The Daddy and a doctor so it all could be over. My birth team was great – I loved what they all had to offer us at home – but things were changing and I was having trouble grasping that change. Divorcing myself from the hours at home felt necessary. Nonetheless, getting into the car and leaving half of the birth team behind to be replaced with doctors and nurses was hard.

The drive to the hospital was surreal. It was still dark as we raced to the hospital in the fog, hazard lights on, sailing past traffic lights and stop signs. We made it there safely and in record time, and we began phase two…

It’s been a little over a month. A lot has happened since then.

We’ve gone from this:

9-month belly

 

…to this:

Timing contractions during our planned home birth

…to this.

Cesarean Section

After a 50-hour labor followed by a 2-hour cesarean section, we have a beautiful and healthy baby girl. I’m still recovering physically and emotionally. The labor process was not what we had expected at all, though I suppose it never really is. I hope to update more in the future – I’d like to do a couple of posts about the labor and delivery process, the aftermath, and a post about getting and being pregnant with PCOS. It’s hard though, juggling being a new mother and a patient, so it’ll probably be awhile.