Post-birth feelings

I am having a mix of feelings that really surprise me.

  • I am so happy that I have a daughter and a son.
  • I am proud that I survived an unmedicated birth.
  • I am happy that I seem to be recovering quickly.
  • I am happy and grateful to my body that I was able to conceive both babies and carry them to term.

But I have a lot of negative feelings too.

  • I feel a ton of guilt that I delivered early.  I see so many studies saying how important the last weeks in the womb are, and how babies born at 37 or 38 weeks have problems learning in second grade, etc. and the Apgar scores saying the baby is fine are misleading.  I’m afraid I did something wrong and that I might have damaged my baby for life.
  • I wonder if I followed the gestational diabetes diet and exercise regimen a little too strictly.  Maybe I cared more about myself than about the baby?  Maybe one year after the last baby was too soon to conceive again–though at my postpartum visit the OB told me that even six months would be fine.  I did not go in for a preconception physical since it had only been a year since the last pregnancy, which went perfectly.  In the year between pregnancies, I had planned to get fit again and lose weight, but my dad got cancer and the world collapsed.  The best laid plans…
  • I feel that my body broke down, and that this is kind of the beginning of the end for me. Part of this feeling is probably PTSD from both my parents’ cancer and the horrific loss of my father.  But all the literature out there about gestational diabetes is really scary.  My chances of developing into a Type II diabetic seem to be very high.
  • I feel humiliated.  I saw my medical records and the title is “elderly multigravida, maternal obesity syndrome,  gestational diabetes” and some other nasty things that I don’t feel like talking about.  I am married to a physician so I know that this is how records are kept, so that the doctor has the info about relevant conditions up front.  But it’s still embarrassing.
  • I’m embarrassed about taking two maternity leaves in two years.
  • I’m worried about the future of my career.
  • I’m worried what will happen when my husband goes back to work in two weeks, and when I go back to work in  ten weeks or so.  My husband was supposed to get six weeks of parental leave but his residency program cut it short.
  • I feel scared that after constant medical attention during the last weeks of pregnancy, suddenly there is nothing at all.

Well, hopefully putting all of this in writing will stop it from spinning around in my head.

I have been measuring my blood sugar occasionally even though the diabetes educator had said to just stop after delivery, and wait for the postpartum check.   One of the OB’s who rounded on me in the hospital told me it was particularly important for me to get checked because having GD with a second baby but not a first might mean that I had developed some sort of problem between pregnancies.  I am scared about the six week postpartum glucose challenge.  I just want to put all of this behind me, basically.  I’m not sure I will be able to.

In an odd coincidence my mom is in the process of being diagnosed as diabetic also.  It was found just as she was going in for cataract surgery.  She will have the surgery on my dad’s birthday.  He was supposed to have cataract surgery too–but between the eye exam and the surgery was when they found his brain tumor.  Bad memories all around.

I miss my dad a lot.  It’s coming up on a year.  I think maybe it is postpartum hormones but I am crying again, whereas I had stopped for a while.  He would have liked to meet my son.  In a moment of confusion very near the end of his life he had asked where my son was.  My mom said I had a daughter and he said he knew that–he was wondering where the second baby was–my son.  I hadn’t conceived my son yet–I would do so one or two months later, after his death.  I am an agnostic with little hope of anything beyond this world, but when the grief gets overwhelming I tell myself there were a couple of months after my dad died but before my son was conceived, so they might have met in whatever world is beyond this one.

I miss my dad, and my life before all these health crises and losses, and the end of my academic career, and things generally falling apart.  I guess though that if I could turn back time, I wouldn’t have my kids, so I am not sure what exactly to long for.

My (second) birth story

I gave birth four days ago (37w3d) at 10:48 a.m. I had begun working from home that week (37 weeks).  I normally work from home Monday and Friday anyway, so actually the extra days at home were Tuesday and Wednesday. I thought maybe I should go to work physically for our weekly meeting on Wednesday, but I was feeling very tired and I decided not to chance it.  I had been losing my mucus plug over the previous several days, and I wasn’t sure what it meant.

My doula texted me that she was going out of town Thursday through Sunday to see her mother in law, and was that okay with me?  I didn’t really know how to answer. Obviously with me being full term I wished she would stay, but it could be another three or four weeks and I could hardly hold her hostage that long.

I’d had my 36 week cervical check the previous Friday.  My normal doctor was on leave due to a death in the family.  The substitute doctor told me I was neither dilated nor effaced, just a bit soft, and that my cervix was very far back.  Basically, no sign of anything.  She gave me a GBS swab and I had a great deal of pain urinating the rest of the day.  I’m not sure how competent she was, and am glad I didn’t get her in labor.

I had an MFM appointment on Tuesday, which I had gone to with my mom.  I had a biophysical profile where I saw the baby on ultrasound and was scheduled for a growth scan the following week.  I told the doctor I was losing my plug, and she said “that’s OK.  You’re 37 weeks–you’re allowed to lose the plug.”  I asked her what it meant and she said “it might mean you are going into labor soon–or it might not.  We’ll make an appointment for next week and I’ll see you–maybe!”

On Wednesday, my doula texted me that she was back, which was a relief.  I tried very hard to finish all my work for work but I had a lot of phone meetings that took up much of the day, and I was feeling physically and mentally fatigued.   I took an hour walk on the treadmill and talked to my old PhD colleague.

That night, there was a lot more blood.  I woke my husband up at 11 p.m. warning him that something was up and I believed I was dilating quickly.  I was anxious and went to bed around 2 a.m.

Thursday I woke up around 5 a.m. with a stopped-up nose, needing to pee and feeling hungry. After trying my best to unblock my nose, I think I went downstairs and ate some cashews.  I began to feel really uncomfortable, like I was having bad menstrual cramps.  I woke my husband up and told him I was in pain. We called the doula around 6 a.m. or so.  She said she was on her way to work, but could leave work any time.  She also told me–inexplicably–that what I was having did not sound like real labor, and to call her back in four hours with an update.  That it sounded like Braxton-Hicks and false labor, that might progress into real labor or might stop.

My husband told her I was having contractions about 8 minutes apart, average length 35-40 seconds.  He was frustrated with me as he was trying to time the contractions and I was just in awful pain and didn’t care about the timing.  I sat down around 7:30 to send some final e-mails for work.  By this time I was in a ton of pain and starting to snap at my poor husband and swear a bit, which did not happen last time until I had been in labor for many, many hours.  The doula told me to hydrate a lot and eat lightly. I told her I was going to try a nap but it hurt too much and was moving fast.

My husband said he thought we should just call the doctor and I said go for it.  The nurse said to go to the hospital for a check.  I did not resist or disagree at all.  I guess I recognized by that point that I was in labor and that I was progressing quickly. At that point the doula told me she could not find backup at work, would be unable to come and check me, and suggested I call the doctor on call.  She would definitely come by tonight, she said.  I’d have a baby by tonight, I said to myself, and realized that I was going to go it alone without the doula. I tried taking a shower (I wanted to wash my hair and shave my legs so I wouldn’t be embarrassed when the entire world stuck their hands in me under bright light) but I also remembered from the birth class that water might make labor hurt less.  I found instead that the shower did not take the pain away and it was annoying to be wet.  I measured my blood glucose and got 105 instead of the 80’s it had been in lately.  This was unusual and was more confirmation for me that it was probably time.

My babysitter had arrived at 7:45 a.m.  She and the baby were downstairs.  I headed downstairs in a ton of pain, trying not to let my baby #1 see me groaning, and ate two eggs (stupid gestational diabetes).

Unlike with my last labor, I was feeling a bit of nausea. My husband stopped to drink his bowl of cereal with coffee in it (weird habit of his) and I snapped at him for going so slowly.  We went to pick my mom up but I was prepared for a five hours of pushing ordeal like last time, and I told her she might want to rest up and come later.  She said no, she was coming now.

Last time I was scared to go to the hospital in case it was fake labor.  This time I knew it was real but I dreaded being in pain and having to sit in the waiting room.  That is exactly what happened; the paperwork and all took forever.  There was a not-too-pregnant lady there on a stretcher who had just been in a car accident.  She was there with two EMTs who were looking at me sympathetically.  There was another African-American lady there with her mom.  Her mom said she’d been having contractions since the previous day, but she didn’t seem in any pain and seemed sort of dazed.

As soon as the admission paperwork was complete (I had preregistered but they make you do some paperwork anyway) I went to the farthest corner of the waiting room. Finally a lovely motherly tech  (probably the same one as last time) came with a wheelchair and took both me and the quiet lady to triage.  The other woman was able to walk, but I tried and had to stop.  I ended up in the wheelchair.  The nurse tried to tell me her name and I had a contraction and didn’t hear.  She told me to sit on the exam table and I told her it was hard to sit due to the pressure.  She said that was all the more reason I needed a check.  I was moaning a lot and the “rooms” were separated only by curtains–I’m sure I scared some women!  She did the cervical check and announced that I was 8 cm.  I said “Oh God.”  I knew I was dilated but I’d expected 6 like last time.  She asked me if I wanted an epidural and I asked how much worse it was going to get.  “You’re in the thick of it now,” she said.  I think there was a second nurse now.  She tried to introduce herself and I didn’t pay attention and the two nurses laughed knowingly and said “she’s like, whatever” or something.  It was weird and annoying to hear myself talked about in the third person and I also didn’t like that they thought it was normal and/or funny that I was in so much pain.

I knew labor was almost over at this point but I said I wanted drugs anyway, because I was afraid of how much longer things would last, how the pushing would feel, and I was afraid not to have any doula support or know Lamaze.  I felt very disappointed in myself for giving in.  I think at that point the nurse said they would try to give me an epidural but there might not be time.  She asked if I could walk and I said no, so they wheeled the whole bed to the delivery room.  My husband said that he helped–I guess they were really short on staff.  My husband tried calling my mom in the waiting room outside (only one person is allowed in triage) but her ringer was off.  He went to get her.

The nurses told me they had no staff to do a bed to bed transfer so I’d have to get up.  I got up and got on the L&D bed.  For whatever reason, they put up the side rails.  I laid there and moaned and screamed.  I remember saying “help me.”  I think then my mom and husband arrived.   The nurse asked me when my contractions had started and I said/yelped 5 a.m.  Someone radioed the hospital OB to be prepared, since s/he was on the premises and it was possible that my OB would not make it in time.  Talk about being scared–I had no doula, I was in labor weeks before I had expected to be, I had no anesthesia, and now my doctor might or might not show up.  They started an IV and mercifully used the blood from the needle stick to check my blood glucose, so that I never actually had a finger stick.  They told me my glucose was slightly elevated but nothing terrible.

To add yet another fun wrinkle, I was told that I was GBS positive, which had my OB’s office bothered to call and tell me, I would have gotten to the hospital even faster than I did.  Being GBS+ meant that ideally I was supposed to receive an antibiotic drip for four hours before delivery, but it was going to be more like four minutes.  I was told that baby would have some extra blood work afterwards to be sure he was not infected.  The nurses were all talking like I was about to deliver (which I was) and things were barreling ahead like a runaway truck–it scared me that there were no brakes on this thing, there would be no break, this was really it.

My husband asked them to give me ice chips, and they did.

I laid there screaming, writhing, and doing whatever, with an increasing feeling that I was going to pee myself–and then BOOM my water broke with an audible explosion.  The warm bath was a welcome relief.  I remember someone saying “rupture.”  My mom tells me the doctor had arrived at this point.  I just remember looking between my legs and seeing him and being relieved.  The nurse cleaned me off. I think I yelled “I need to push.” At that point I had another cervical check and I screamed bloody murder.  The nurse took her sweet time, ignored my screaming, and felt up my cervix very well before saying something about I was 10 cm with something-or-other lip and reporting that I was ready to push.

There was a lot of the nurses telling me how well I was doing, which seemed weird as I wasn’t doing much of anything; my body was doing its thing and I was just along for the scary ride.  I remember my hair being sweaty and lying on my left side in the fetal position, hanging onto the bed rails. They did something to the bed and said “grab your legs” and I said “I can’t” and the doctor said “there’s no can’t now.” The nurse told me “we have your legs–just push.”  She had one leg and my husband had the other.  My mom said she was rubbing my leg but I have no memory.  I screamed that I needed a break and couldn’t push yet but they told me no, I had to push on the next contraction.  The contraction began and I started moaning hysterically.  I was panic breathing and they told me to breathe in my nose and out my mouth, but my nose was sort of clogged up so I couldn’t breathe that well.  On the first push I couldn’t keep my legs open well and the nurse told me sternly that I was closing my pelvis off and needed to let my leg drop.  The nurse was pretty awful and told me “X, open your eyes!  Look at me.  Focus.  You can have this baby out in one (?) push but you need to focus.” I pushed.  It burned badly and I guess that was the ring of fire–I’d felt it last time too, despite my epidural.  They told me the head was delivered.  The doctor said something about the cord (turns out it was a nuchal cord) and told me to stop pushing, which I did.  My husband said the aggressive nurse yelled “CORD!”

The OB did something (my husband tells me he pulled on the cord a little and used the slack to unwind it) and then told me to give a little push.  I did.  The baby’s shoulders were out.  Third push and that was it.  The baby was wiped down and put skin to skin with me.  The feeling of a warm squealing baby on one’s chest–I’ll always remember it. Baby was out after the third push and put on my stomach.  He seemed smaller than my last as he was earlier, though really they were the same weight and almost the same height.

It seemed a long time before the OB cut the cord, asking my husband if it were OK with him (yes).  OB asked if he wanted to take a photo.  There was a little wait and then I think he tugged on the cord (yuck) and I delivered the placenta, which was a non-event.  The OB told me I had a borderline first/second degree tear and that we’d call it a second.  He warned me there was a needle coming (Lidocaine) and that it would hurt.  It did but wasn’t too bad.  After giving the Lidocaine some time to kick in he sewed for a long time, and I asked him how many stitches.  He said it was one long stitch, kind of like a shoelace; there was only one thread.  I think the needle went in about ten times though.  He did not wear a face shield.

There was blood everywhere and it had somehow gotten on my arm (I saw in the video that they accidentally brushed me with bloody clothes).  The doctor said he’d try to keep the needle in the numbed region, but at least once I felt the full stitch and it hurt.  The OB asked my husband “you aren’t videotaping this, are you?”  My husband said “no–taking a photo of the placenta” (gross, but as part of his job he dissects them on a daily basis.) That was that–the OB reassured my husband  that he had only ever known two GBS infected babies and that strangely, they were not born to infected moms.  We said we were glad he made it to the birth and he laughed and said there were probably some angry women in the office right now (which doesn’t make a great deal of sense as he was on call–though come to think of it, with my last birth the OB also called in the office at the last minute to say she would not make her 8:30 appointment).  He said he’d leave now and give us privacy to do whatever we wanted.

After lots of screaming during the delivery, I was quiet in the aftermath.   My mom said I looked great, but I could see on the video later that I was still frightened and upset.  The nurse did my charts, which she said she didn’t have time to do beforehand since I delivered so quickly.  I asked her if I had a precipitous labor and she said no–if I started at 5 a.m. and delivered at 10:48 that it wasn’t quite fast enough to be called precipitous.  I was disappointed and relieved.  They weighed and measured the baby.  I was given an unmemorable meal which as I remember included mashed butternut squash, milk, and some carrots.

They kept me in the delivery room for two hours before it was time to move.  The IVs were all still in me, including the antibiotics I think.  My husband asked if they were still necessary and if not if they could be turned off–I’m not sure whether they were.  I was given two bags of Pitocin which lasted for hours and hours until long after I had moved rooms.  I think it caused me to swell up a lot–when I came home from the hospital I had only lost the baby weight whereas I should also have lost the weight of the placenta, amniotic fluid, etc.  It definitely caused some very painful postpartum contractions.

The nurse did my charts, which she told me she didn’t have time to do beforehand since I delivered so quickly.  I had to sign a bunch of forms which made no sense after having delivered, like one agreeing to a blood transfusion if necessary and one stating that I would not videotape the delivery.

The nurse who had been a drill sergeant during my delivery was now all nice and smiley. They weighed and measured the baby.  I was given an unmemorable meal which as I remember included mashed butternut squash, milk, and some carrots.  I wasn’t sure I should eat normally after so many weeks on a gestational diabetes diet.  They kept me in the delivery room for two hours before it was time to move.  I sent my  mom to go eat lunch before the cafeteria closed. After my two hours were up I was able to get up and get in a wheelchair.  They wheeled me into Room 3B17 and I got up and got into bed.  The nurse helped me use the bathroom.  The next two days of postpartum were a blur of nurses, heel sticks for the baby, etc.  Baby’s glucose was pretty good despite my GD and we did not have to give him formula or send him to the NICU. We came home two days later.  I am proud to have survived an unmedicated birth.  I made it without our doula or any training in breathing.

The joy of having a son has indeed erased some of the pain of not having a father.  My dad would have said something jokingly about the circle of life.  I miss him, and life goes on.

PS–The doula met with me postpartum just to say hello.  She gave me a full refund, which was very kind of her.  I guess I didn’t really need her at the birth, and I am happy to have made a friend.

37 weeks

So tired…just want to sleep.  Feel like I am on a treadmill at work.

I am a bit unnerved that ACOG changed the definition of “full term.”  I understand that I shouldn’t request (or be given) an induction today just because I feel crummy, but am I supposed to be worried even if I go into labor naturally?

DH remarked that we have done no preparation for this baby.  But honestly I can’t think of much to prepare because we have everything we need from the last go 21 months ago…still haven’t put most of it away yet!

36 weeks

I am 36 weeks today.  It seems like I should be nearing the end, but I guess in principle I still have a month to go.  I don’t think it will be that long.  I am glad I’ve made it this far.  Last night I thought I might be in labor, but it seems I just have a really bad reaction to eating too much broccoli.  I have read online that gestational diabetes gets easier to control after 36 weeks and also that it gets harder.  I am not sure which it will be for me.  I have an MFM appointment tomorrow for my first biophysical profile, and then Friday will be the regular OB for GBS and a cervical check.

We have been cleaning the house a bit.  There is a lot of junk and detritus left over from the first few weeks postpartum of my last baby.  Cleaning it up brought back a lot of sad memories of my father suddenly, since those were the last few weeks before his symptoms began.  I put away my ironing board and remembered how he had always ironed all of our clothes, and I remembered the night before his funeral ironing my own, and how horrible and surreal it all was.   Going to the hospital too I will notice the big hole as he was with us last time…it was mom, dad, and my husband.  This time it will be just mom and husband (and a doula).

I worry about my mom too.  I wish she were a little less stubborn–but you can’t change people, and I am stretched thin.

My husband is a PGY-2 now (second year of residency).  I thought his becoming more senior meant life would become easier, but instead he tells me no–it’s just more responsibility.  This is frustrating.  You think there’s a light at the end of the tunnel, but then there isn’t.  Or maybe it’s a train!  People say life will be easier in a few years when our kids are school-aged, when DH has a real job.  But we’ll be 40 then.  I am already starting to have health problems.  For the last couple of years all I’ve seen around me is illness and death and begun to experience it myself.

We picked a baby name, but everyone in the family hates it as it is “too common.”  I don’t care.  It’s me carrying the baby around and me who pricks my finger 4x a day, and I don’t really want anyone else’s input.

My brother-in-law’s dad died.  I was the first in my husband’s extended family to lose a parent.  He is the second.  Of course, BIL is way older than me and has three siblings.  So I still just got really unlucky.

I am increasingly immobile and feeling tired.