Monday, March 31, 2014

Finally, an Update: My Birth Story, my Baby, and My Postpartum Life

My little one arrived at 38 weeks and 1 day, on February 20th, 2014. His name is Leo and he is a sweet, sweet little boy.
Leo, on day 4

Today he is already 5.5 weeks old. I know, I know- I have been really bad about updating this blog. I have multiple reasons for this.

First, his birth was really hard. I had been receiving care from a midwife practice throughout my pregnancy, and other than some spotting in the end of the first trimester/beginning of the second trimester, I'd had a really healthy, easy pregnancy. This all changed when I went in for my 38 week check up. I had missed my 37 week check up because it had snowed and the roads were too icy. Since I'd been so healthy, they said not to worry about it. But when I went in at 38 weeks, my blood pressure was high. I've always had borderline normal to high blood pressure, but I had crossed the line where they start to worry. I think it was around 138/95. Not awful, but not great. They did test my urine and I had no protein in it, which was good. But they told me to get some lunch, and then swing by the hospital for a quick blood draw and an ultrasound to check the fluid levels. Okay, no big deal. So I did that, and the bad news is that my blood pressure remained high. So they turned on the ultrasound and as it flickered on, the midwife let out a gasp and said, "That is NOT a head!"

Yup. Although I'd been told for weeks that my baby was head down, they had been WRONG. And the shitty thing is, I think I had always known this. I'd been feeling a really, really hard thing up under my ribs on the right side. The midwives had never done anything but a cursory feel, and proclaimed it to be a butt, but I was always skeptical, and then always brushed off my concerns. And then, sure enough, I had a breech baby.

So, with the blood pressure remaining high and the breech presentation, they called in the high risk OB and it was decided I should deliver my baby soon. The recommendation for high blood pressure is to deliver between 37 and 39 weeks, and I was right at 38. I asked if we could delay, but they really weren't excited about the risks. And after having seen the characters with preeclampsia in "Call the Midwife" and "Downton Abbey," I was scared too. I tearfully asked for one night to prepare, and they agreed. Also, the OB on call in the morning was skilled at doing external versions to try to flip breech babies, so the timing was good.

I went home, panicky and shocked, and we called our families to tell them what was happening. My mom said she'd drive down first thing the next morning. I told work that I would not be back again.

This was all a huge, horrible shock to me. I'd had such a healthy pregnancy. And although 38 weeks is full term, it's not ideal to deliver that soon. But I wanted a healthy baby, and this seemed to be what the doctors and midwives recommended.

I didn't sleep much that night.

In the morning, I remained a ball of dread and anxiety. Although some of me was excited to meet my baby, I was still in such shock at this sudden turn of events, and worried that he wouldn't be ready to come out or would need care. They told me it was unlikely but possible that he'd need help breathing, and I tried to focus on the unlikely part.

So this was the plan: get to the hospital at 7:30 am, and try the version to see if he'd flip. If he did, we'd immediately induce me and try for a vaginal birth. If he did not flip, we'd move into a c-section to get him out. If the version resulted in a problem such as a placental abruption (about a 2% risk, and terrifying), we'd have to have an emergency c-section, which was my biggest fear. I wanted desperately to be awake to meet my baby.

At the hospital, it was a lot of waiting around. Finally around 10:45, they moved me into the operating theater. I had been offered an epidural. It was just an option, because if the version worked, I would be trying a vaginal birth. Although I had always thought I'd try it unmedicated, I was such a ball of freak-out at this point that I said I wanted all the drugs they could offer. Also, the version is supposed to be very painful.

So I got an epidural and a spinal, with my husband out of the room. It was scary, but I was held by a nurse and remained pretty calm. I focused on meeting my baby.

The version took about 15 minutes, and was unsuccessful. I had not had high hopes and had already accepted the inevitable.

In a blink of an eye, I was prepped and the c-section began.

About 15 minutes in, I felt a tugging that became stronger and stronger, and then my son was lifted up and out of me, and held above the blue curtain. I cried and cried. He was perfect and healthy, and did not need a breathing tube. A few minutes later, he was brought to me and held to my chest. At which point, I decided I needed to throw up (thanks, epidural) and so my husband held him instead.

One hour from the start, I was sewn up and taken to recovery, with my perfect, healthy, small but not too small, 6.7 pound baby boy.

Just hatched!
First photo after birth

And this is where things got joyful and also really, really hard. The c-section was actually not very bad or very scary, but recovery was rough. I don't know WHY anyone would ever elect to have a section. I had a catheter in for 24 hours, I lost a lot of blood (enough to have a transfusion, though we decided against one because I was borderline), and the indignity is intense: I was wiped up between the legs on a regular basis by multiple nurses, and shaved in the operating room by a middle aged man named Diego or something, in front of at least 12 people. I couldn't get out of bed for a day or so, and I spent four nights in the hospital. Leo didn't latch on for eight hours, and I believe our breastfeeding troubles (more on this later) stem from either his early arrival or the c-section or both.

I don't want to go into the hospital stay too much, but suffice it to say I loved my baby, and hated everything else. It was impossible to get any sleep in the hospital, there were teams of people in my rooms at all time (a teaching hospital has it's drawbacks) and I was told there were multiple things wrong with my baby, none of which turned out to be true (heart murmur, failed hearing tests, and something much worse which I will also discuss later). But at the same time, I was in a fair amount of pain from the surgery, and I was having a horrible time with breastfeeding, and the hormonal swings were nearly incapacitating, so it was nice to be in a hospital with services available.

After four nights we returned home, and this was challenging too. One of the main problems was my unhelpful mother, who criticized our decision to bottle feed our baby. This was not our choice: he was not gaining weight from breastfeeding, and I was horribly engorged and needed to relieve the pressure with a pump, and I needed my baby to gain weight so we were using a combo of SNS, a syringe, and the breast. It was a nightmare, and he kept losing weight, and we saw so many lactation consultants... it is all a blur to me now, but it was a hard, dark time. I never understood postpartum depression, and this is an entry for another time, but it hit me hard, and I continue to struggle.

I mentioned earlier that we were told he might have a serious medical condition. It's still hard to talk about it, but the summary is that the peds teams said he might have a skull condition that would require surgery. Thank goodness, three weeks after he was born we met with a reconstructive surgeon and Leo was cleared as not having the condition. His head was just a little funny shaped because he was breech. It's already starting to get better as he grows up and his head re-forms. We have a follow-up with the specialist in three months.

The breastfeeding issue remains. We are not sure why he has such a lousy suck, but he lost about 12% of his weight, which is not good. So we had to try lots of different things, but ended up with me pumping my breastmilk and feeding him from bottles. Where I had a very ample supply to begin with, it's been reduced through his lack of sucking at the beginning and my bitter hatred of pumping. So now we give him about 60% breastmilk and about 40% formula. And I breastfeed on occasion, but I spend a vast chunk of time pumping and bottle feeding. I am struggling with what to do about this. I can't pump forever, and I don't believe formula is evil, but I feel a lot of guilt in my considering giving it up. I am still undecided.

His birth did not go as I had hoped or expected, and the feeding is very disappointing and stressful. But, there are shiny moments in all of this. I love, love, love to wear him close to my body in the Moby wrap, since I don't get the closeness from breastfeeding. It took me awhile to be okay with this, but I now sleep curled up around him, with his little head on my shoulder and his body pressed to mine. True, I have to sleep in the guest room because the bed is harder/safer than my cushy bed, and I now sleep separate from my husband so we all get a little more sleep, but sleeping with my baby is one of my favorite parts of the day. I always mean to get stuff done during the day, and I do, but I also spent long amounts of time just rocking him and staring into his tiny face. This is love, and despite my crying almost daily because of stress and sleep deprivation and sore breasts and being chained to the pump, this is my son, and this is why I endured all those years of infertility, tests, and heartbreak.

For all of you out there still struggling, I can't say it's been easy, but it's worth it. Though to be terribly honest, childbirth was not what I'd hoped, since really, I didn't experience it, just had a surgery. And I can't breastfeed as a primary nutrition source, so that's not working out how I hoped either. On my dark days, I wonder if adoption would have been an equally fulfilling road to parenthood.

But then I look into my son's face, and I can't imagine having anyone other than him.

As I said before, it's not easy, but for me, it's worth it.