The High Tech Way

C-section vs. VBAC -- it's all about the nursing

On Friday I returned to my OB for the first time since my post-partum Jack-pot appointments.  I am beginning to remember now that I got a lot of magazine reading done while pregnant the last time, due to waiting times in both the waiting room and then in the exam room.  There is no BusinessWeek or Time in the waiting room there, so I don't have to worry about doing serious reading.  I can read House Beautiful or Coastal Living with no guilt about how I should be working instead.

When my OB asked me whether I wanted to schedule a C-Section or try for a VBAC (vaginal birth after cesarean), I realized that all my thinking around this mostly has to do with breastfeeding and wanting it to be successful the next time around.  Exclusively Pumping was HARD. [Please check out this blog from an exclusive pumper who is doing it now with grace and little complaining. And she has a very cute baby too.]

It's not hard to do a pump session.  But when you are doing eight lengthy pump sessions every day, it becomes absolutely grueling!  Every time I gave up a pump session I was sad for about 10 minutes.  Then I would realize, OMG, I have more TIME!  I can sit down and rest for a few minutes!  I can do... whatever I want!

So there are some things that I want to change this time around about my hospital experience.  These things may or may not have contributed to our bad nursing experience.  But I need to give myself the best chance of success in terms of nursing the new baby.  I will Exclusively Pump again if I have to. But I DON'T WANT TO I DON'T WANT TO!  I want to have the baby fall asleep at the breast and be able to doze off myself and not have to put the baby down, grab the pump equipment and spend a half hour being milked when I could be cuddling my little boy.

Some things I think may have contributed to our problems:
1. I asked the nurse before my c-section: will you give me my baby to nurse after the procedure is over?  She said no.  And indeed, with the extra fluid that had not been squeezed out of Jack because he didn't travel down the birth canal, he spent a small amount of time in NICU having fluid sucked out of his respiratory system.  This delayed me getting him.

2. I asked the nurse to give him to me after we were in the hospital room.  They said no, his body temperature was too low. AND THEN THEY GAVE HIM A BATH INSTEAD!  This delayed me getting him again.

3. He was a sleepy baby -- always falling asleep before getting a full feeding -- and I am wondering if this is because of the drugs for the c-section and the narcotics for recovery that mom used.

4. Immediately after the c-section I wasn't able to get up to get him to nurse, so I was at the mercy of the nurses. Some of them were great and some of them were not.  I want more control next time.

 

And these things make me wonder if I should try for a VBAC.  I don't really want to personally. My c-section last time was easy, without complications, and healed very quickly. But if it would mean the difference in terms of successful nursing, a VBAC would be totally worth it.

Maternity leave

When you are getting four hours of sleep a day (and not in a row) your view of the world tends to get a little blurred.  That's what the first three months of Jack's life were like for me.

We had a tiny pack N play type bassinet downstairs in the living room where I would put him down to sleep after he'd passed out in my arms. Then I would run to try to make a dent in the never-ending pile of laundry or dishes. One day I discovered a trick to get him to sleep a little longer. Tivo had recorded this documentary about the Galapagos Islands. There was something hypnotic about the narrator's voice talking about sea turtles and blue-footed seabirds and ocean iguanas.  Jack slept the longest when it was playing. So I played it over and over and over again.

I remember a time, sitting in the glider chair in Jack's room during a rare foggy morning at the end of the summer with Jack in my arms, dozing after I'd fed him. David was still sleeping in bed. I thought, this is one of those moments that I want to remember forever, because I am truly happy. Thank you God for this moment and for this child.

As he approached six weeks old, Jack got more cranky. He had those dinner-hour episodes of inconsolable crying.  People who thought they had the magic touch with babies would come over and walk him around while he cried. And then they would give up and go home, Jack having beaten them down to the point where they were re-evaluating their purpose in life. It was really unbearable to hear him cry like that. While the crying episodes seemed to last for days at a time, really I think the longest it lasted was an hour or two.  And that was on a rare occasion. 

One time we went to a local chain store pharmacy. Jack decided he did not like it there and started to cry and cry and cry.  I was waiting for a prescription for him (I forget what it was. Eye drops I think, because he had a plugged tear duct that was a little infected.)  So we were stuck in the store waiting for the thing to be filled.

An older lady asked: "What is wrong with him."

I replied: "He has opinions."

She just stared at me.

When the prescription was finally ready 97 hours later, I started to wheel the stroller out of the store. I could swear Jack smirked at me as he stopped crying.

The pediatrician, who was a very even-handed, unflappable sort, told us, "Babies cry."  If he's been changed, he's been fed, he has no gas, and you've already tried everything, well, there's not a lot to do.

When Jack was having those crying episodes, I discovered that only one thing had the power to soothe him. That was sitting with me on the glider, with him facing out towards the room, and me singing the Beatles' "Hey Jude" (only I sang Hey Dude instead of Hey Jude). He would immediately stop crying.  I tried other songs too. They did not work. I began to suspect his favorite Beatle was Paul.

As my maternity leave wore on I started to realize that I was deluding myself by thinking I could hire a mother's helper-type to take care of Jack when I went back to my job. You see, even though David telecommutes all the time and I do it a lot of the time, we both still worked full time, with lots of time on the phone. And Jack was a very active boy who needed undivided attention when he was awake.

I'd spent such a long long time and gone through so much pain to get him into my life that it was breaking my heart to think of sending him away to daycare -- away from me for many long hours every day. Jack was the light of our lives. He made it all worth it.

But I made too much money to quit my job and too little money for a nanny. I was screwed.

One day at the breastfeeding support group I heard another mom talking about a particular daycare. It was less than a mile from our house, it had web-cams (so you could look at your little sweetie during the day from your computer), and the program sounded like the kind of place I would want my boy to be. (It was a Montessori preschool with an infant program.)

When my mom came to visit we took a tour of it. Even though I did no comparison shopping, I knew this was the place for us. The caregiver to infant ratio was 1 to 3, and they all loved loved loved the babies. It just felt really right.

Nonetheless, I cried when I dropped Jack off there for the first time. And for the second time. And for the whole first week. I became a clock watcher at work, waiting for the earliest possible moment when I could make a break for the door and go get my boy and cover him in kisses. Twelve weeks of maternity leave was not nearly enough. Not nearly. And I started to get a little angry about that.

Evicting Tarzan, the birth experience

When we took the birth class and got the tour of the maternity wing of the hospital, I was really impressed. I was expecting some kind of communal ward full of women in pain.  But there were many many birth rooms, ensuring that each woman had her privacy if she wanted it (or could invite the whole clan in if that was her choice).

There was television, mood lighting, a private bathroom with a tub and some with Jacuzzis, comfy chairs, drapes. If you didn't look at the floor, for a moment you almost might forget it was a hospital room.  Also, except for the big giant light that came out of a trap door in the ceiling to illuminate the important areas when the doctor was ready for that. (The big light at the end of the tunnel...)

But it looked different when I checked in that night. My nerves were rattled, and listening to other women screaming in pain rattled them even more. I was not at all dilated or effaced and yet I wanted to turn back.  My mom and David dropped me off and got me settled.  I got no food in case a c-section was in my future.

After mom and David left, the nurse came in to insert the Cervidil, a tampon like object that had medicine in it to soften up the cervix and get things moving.  It really hurt.

They hooked me up to a bunch of fetal monitors (around the belly), and left me to watch TV and sleep. They would check on my progress in the morning. 

Like most pregnant women I got up to pee about 10 times that night. Each time I had to unhook myself from the monitors and carry my various wires into the bathroom.  Not very relaxing, and pretty darn cumbersome.  At one point when I got back from the bathroom a nurse was in my room waiting for me. She said the baby's heart rate had dropped significantly right before I unplugged. But we plugged back in and all was fine.

In the morning they rechecked my cervix, which looked exactly the same as it had the night before.  No action whatsoever. They gave us the option of either trying to continue with an induction or go straight to the c-section. They wouldn't let me go home because of the drop in the Tarzan's heart rate during the night.

They were not optimistic about the chances of getting things going with the induction.  After going back and forth and debating this with David and my mother, we opted for the c-section.  (I know, I know, many brave women before me have gone the other route.)  It was a tough call. But after listening to all those women screaming all night long, and thinking that my induction could last days, not hours, it seemed to be the least unpleasant path.

In retrospect I think it was the right decision because (a) my OB said the baby's head was canted off to the side, so it wasn't pressing properly on the cervix, and (b) she said that the amniotic fluid was very very low.

All along I really didn't care which way Tarzan came out, as long as he came out healthy.

So my water was taken away from me and I was wheeled away from the very pleasant birthing room to the surgical suite.  Yikes.  By this point I was totally freaked out. I had never been checked into the hospital before, you see. I was very much disliking the lack of control.  I did not like people who I just met poking needles into my spine.  I found this to be very very scary. 

When the very nice anesthesiologist was doing the spinal block, I was in tears, and so freaked out that they broke protocol and let David come in and be with me for that part.

It is very weird to not be able to feel the lower part of your body anymore.  And then have that part be pretty much exposed under lights. But, whatever. 

The procedure was finished in minutes. One of the nurses captured lots of bloody c-section pictures with David's camera.  (David used to be a professional photographer, so he has a nice camera, and the nurse was a photo buff and had been looking to buy that particular model...)

I could hear the boy crying and they showed him to me for an instant and then he was whisked away and David followed. 

Then the longest part of the experience -- getting sewn up by the docs.  I learned that the doc who was assisting my OB was from my home town, and we talked about baseball and how our team was in town this weekend and we were missing the game.  Kind of surreal.

The boy went to NICU for a little while while they sucked some fluid out of his respiratory system. Apparently it's common for c-section babies because they don't get it all squeezed out of them on their way out the way vaginally-birthed babies do. But he was totally fine.

They brought him to me in recovery and I held him.  It was amazing. And then my mom held him too. Later I saw the pictures of David holding him right after he was born. 

We named him Jack.