Postpartum: not for wusses

The boy is three weeks old.  Nobody gave him the memo on how breastfed newborns are supposed to gain weight more slowly than formula-fed babies. He is packing on insulation like nobody’s business. When he was born, he was eight pounds, and a long, skinnyish 21 inches. His elbows and knees had folds like saggy elephant skin, and his fingers looked long and wizened. Not anymore. He is a mass of dimples.

Ever since the blocked duct incident, left boob has been seriously overperforming. Right boob is totally normal, doesn’t get engorged, steady-as-she-goes…  but left boob almost fills up before the little guy can finish emptying it. Did it step up production because we nursed more from that side to get rid of the blockage?  I woke in the dark this morning and it was so painfully full I could see lumps on it where the ducts are, and little guy couldn’t get a grip on it. I sat in the bathroom and hand-expressed about a fourth of a cup of milk just to get things loosened up a little so I could feed him.Is there any way to get left boob to slow the heck down, or do I just wait for the little guy’s consumption to pick up and even things out naturally?

Postpartum is not for wusses. The first week, I could hardly bear to even wash around the stitches. Not because they were painful and swollen (which they were), but because the geography was so altered it was frightening to me.  Now at three weeks, I’ve got a better picture of it, and it’s still a bit frightening.  I have a Bartholin’s cyst. I dont’ know if it’s from the stitches or the swelling, but something has blocked the duct to the Bartholin’s gland on the left side, and it is swollen to the size of a chocolate truffle and feels like a rock under my skin. And it hurts. My pelvic floor muscles are still stretched out like old elastic. I’ve regained enough strength there that I’m not leaking urine when I sneeze, but once I sit down to pee, I can’t stop. I try, but no matter how hard I squeeze, I can no longer cut off the flow in midstream. I trust that’ll come back eventually, but I’m wondering how long it will take.  The biggest concern, though, is that I think I’m dealing with some organ prolapse. If you’ve read this far, I’m guessing the TMI is not a problem. And I really, really wish someone had told me about this stuff before I had the baby, so it wouldn’t feel so scary now. Lying down, everything feels relatively normal, but upright… things are bulging into my vagina that didn’t used to bulge there. If I had to guess I’d say it is my rectum in the back (which would explain the vengeful return of the constipation– things are just not the right shape in there) and my uterus in the front. These things register as a constant feeling of pressure on the pelvic floor whenever I am standing, and the front-side bulge (which could also be my bladder) is large and low enough that it “holds the door open” when I’m upright. It’s a strange and disturbing feeling.

I looked it up, and found that some 50% of women who have kids experience some degree of prolapse. The prognosis: It can improve over time, especially with good posture, but it never really goes away. Gulp.

Here’s what I don’t understand: when you are pregnant, and everyone and their sister is telling you all their horror stories about pregnancy and childbirth…  why is it that everyone tells you about the sleep deprivation and hemorrhoids, but not this? No mention of organ prolapse, when it happens to half of mothers? Is it too embarrassing because it’s a continuing problem? That’s one thing I would have liked to be a little more mentally prepared for!

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8 Days Later

Weird things happen after the baby is born. My blood sugars have gone hypo again, possibly due to breastfeeding. Certainly, this is better than high sugars, but it has required a change of strategy to manage it.

The boob fairy paid me a visit on the second night. I woke to find myself a 38D milk factory. I was hoping this was couple-of-days temporary. But my mother tells me, breezily “they’ll probably go back to a smaller size in a few months.” Now I’m glad she sent me those ridiculously large bras I thought would never in a million years fit me. They’re the right size now.

The first week was totally exhausting. And I was hardly getting out of bed. It’s hard to get used to napping when the baby naps, and he doesn’t sleep much at night. The last couple of days we have finally worked up the willpower to start putting him in his own bed to sleep. I would love to do the co-sleeping thing, but there are a couple of insurmountable problems with it:

A) Our bed isn’t safe, and we can’t get a new one or put the mattress on the floor.

B) Our bed really isn’t big enough for three of us: just a full, not a queen or anything.

C) Nighttime hot flashes. I had them during pregnancy some, and I’m having them a lot now. With a baby in the bed, here’s how that works out: 2am, nurse the baby half-asleep, put him down in the exact middle of the bed, sleeping sweetly, and scoot back to my own edge to sleep. 2:30am: baby has oozed over next to me to hug my boob in his sleep, and plaster his little body on my midsection. It’s adorable. 2:35am: suddenly it is hotter than a glass furnace in here, I am drenched in sweat, and here’s this little heat-seeking radiator child who wants to sleep glued to my side. AAAHHHHHH! Getoffme!  Too hot!

Breastfeeding has not been a walk in the park.  The advocates are right, of course, that it’s best for all, but I now understand why so many opt out. There is a steep learning curve to it. The first few days were like nursing a shark. And he wants to nurse constantly.  After a whole week of frantic research and constant work on getting a good latch, I can finally say it’s getting better. Positioning made the latch less painful, and just today the babe seems to have had a breakthrough:  he found some better way of sucking tht gets him more milk for his effort. Now instead of sucksucksucksucksucksucksucksuckgulp, it’s sometimes suckgulpsuckgulp. Nursing sessions are still very, very frequent, and last anywhere from ten minutes to an hour. Sometimes the latch is great and everything’s peachy, but sometimes it’s still painful, and no matter how many times I un-latch him and try again, we can’t seem to get it quite right. But we’ll keep trying. Whatever we are doing is at least working: the boy has gained a whole pound in the last week!

Getting up in the night to feed and change the kid is hard. Really hard. Like, after the third time up, when you haven’t had a chance to go back to sleep since the second time, and the baby is making that squeaky noise that says “I’ll be ravenous in twenty seconds, come get me”…   someday you’ll roll your eyes and joke about this with other parents, but right now you’re saying “(*^%!!@ not again!”  And in those first few days, when I was still in a lot of pain– chafed nipples, swollen girly bits, pulling stitches, and hip bones that almost grind against each other every time I move– I admit I cried some.  No need to blame that on the hormones.  I’m still hurting, just not quite as badly now. Each day is a little improvement that I appreciate and look forward to.

One of the really nice things about being here, and about the particular midwife we signed up with, is that for my postpartum checkup today, the midwife/doctora came to our apartment– I didn’t have to get in a cab or ride the buses anywhere, which would have been horrible, given that I can’t sit in chairs yet.

The boy is gorgeous.  He gets just a little bit more awake-time each day. He makes little animal noises– kitten squeaks and bear growls and piggy grunts. He’s still trying to figure out how to hold up his head. He flails his arms in his sleep. He tends to look horrified when he poops, as though it wasn’t something he did, but rather something inexplicably done to him. When he has nursed his fill, and falls unconscious from the breast, he dreams. Sometimes it looks like his brain is running through a facial expressions test, firing the nerves for mouth, eyebrows, eyelids, cheeks…   sometimes he dreams about nursing: his chin bobs up and down three or four times, and then he grins broadly.

 

The Gory Details

So now that I have two hands free, here’s how it went down:

I got pretty much everything I wanted and planned for, and it was nothing like I expected. I mean, there’s only so much that reading can tell you. There are statistics and averages. We packed snacks in case we were laboring for the average 12 hours or more, and didn’t even dig them out of the bag until the morning after the birth. We didn’t have time to need them.

I had painless Braxton-Hicks contractions on and off for the better part of a week. I was trying not to get excited about them approaching our “due date” because I was a 43-week baby, and I figured 39 and a half weeks was too early to start hyperventilating. On Monday, I got up in the morning to use the toilet (for the fourth or fifth time in eight hours, sigh…) and plop!  The mucus plug fell out. It was this dark red gelatinous glob the size of a silver dollar. I told my husband, and tried not to read too much into it. After all, you can lose the mucus plug weeks before giving birth. You can even grow a new one and lose it again. But it can also come out a day or two before, or even during labor. So I cautiously took it as progress, and continued to pass little pink-tinged gooey bits for the rest of the day.

I spent the day having more on-and-off painless contractions which I basically ignored.  I ate cumin-drenched chicken hearts and chard for lunch, did all the usual chores and errands, made chicken soup for dinner, ate it, talked to family on Skype. Toward evening the contractions were still nothing I couldn’t ignore, but they seemed to be getting more frequent, so around 9pm or so we started timing them. They were running consistently 3-4 minutes from the start of one to the start of the next. I tried really hard to figure out the length of each contraction, but it was really hard to tell so we gave up on that pretty quickly– we kept coming up with times ranging from a minute and a half to over two minutes, which is not even in the guidebook’s range of possibilities. We looked at our numbers and said “well, they don’t seem that intense, but they’re every three minutes, and they’re at least forty seconds long– that’s two out of three.”  Plus, I’d had diarrhea for about two hours by then: this always happens with my period, and since I’d been constipated for pretty much nine months straight… this made me think it could be the real thing.

So we called the midwife around maybe 10pm. Or tried to. My husband’s cell phone was not cooperating, so he went to ask the neighbors to use theirs. It worked, but ran out of minutes in the middle of the call, so another neighbor’s phone was enlisted. Our apartment building being what it is, by that time news had whisked through the whole place. The landlady came over to check on me and make sure we’d packed our toothbrushes. One of the older gentlemen– I think it was the owner of the first cell phone– walked up the street and got a cab for us. Once the cab arrived, it had to wait a few minutes for me to get out of the bathroom, and the neighbors escorted us and our backpacks out to the cab, after making sure we wouldn’t get gouged on the fare. The cab driver got confused about where exactly we were going, so the ride ended up longer than usual– five contractions in the cab, I counted. By this time they were really unpleasant, at least partly because they were in a cab. Still not as bad as my ordinary period cramps, though. Then again, my ordinary cramps are hellish.

We reached the birth center at 11:05. The doctora let us in. I drank some water, we went upstairs and put our bags down, and she checked my dilation. I had not had a pelvic exam for the entire pregnancy, which was nice. This one exam was really uncomfortable. She didn’t give me a number, which was good, because I would have obsessed over it. She just said I was “at the beginning” and we should all get some rest. I said I was feeling nauseous and a bucket was procured. I promptly spewed my entire lunch and dinner into it.  She told my husband to come get her if we needed anything and went downstairs to take a nap. I brushed my teeth.  We crawled into bed and tried to nap.  My husband actually managed to snooze between contractions, but getting horizontal made the cramping go all into my lower back. Ouch!  Still, we were both really tired and up past our bedtime, so I alternated between lying down with husband pressing on my lower back during contractions, which helped tremendously, and sitting on the toilet, since my intestines were still busy emptying themselves and sitting there with my feet up on a stool and my head stretched back was marginally more comfortable than being in bed.

I was not keeping track of the time, but it didn’t seem like much had passed before I was feeling nauseous again. I tottered to the bathroom to throw up, leaned over the bucket, and heaved. But instead of vomiting, my water broke with a great slosh all over the floor and I grunted involuntarily. I climbed into the empty bathtub to keep from making an even bigger mess, called for my husband to go get the doctora, and felt myself convulse and let out a long and unflattering “UUUuuuuungh!” sound.

I got down onto hands and knees (fortunately, it was a huge bathtub).  And in a couple more grunts the doctora and my husband were there. We ran the water– not to fill the tub, but because the sound was nice and I liked the feel of it on my feet. At the doctora’s suggestion, husband climbed in behind me and I sort of squatted and leaned back on him, and hung by the armpits from his knees, which was comforting, and also made the pushing urge stronger.  Here I alternated maybe twice between just leaning on my husband and hanging onto a hammock that dangled from an overhead beam. When my arms got too tired for the hammock, I leaned– here and there letting out a long grunt over which I had no voluntary control. It all seemed to happen very fast. The doctora asked if I wanted to feel the baby’s head, but I declined because I thought it might freak me out a little. Maybe three more pushes and my son gushed out into the bathtub, looking a little purple in the moment, but he pinked up almost instantly, squeaked, gurgled a little, coughed, opened his eyes, and peed on me. I am pretty sure his head and the rest of his body came out all in the same push, but I was pretty out of it at that point, and can’t say for sure. The doctora handed him to me, checked the umbilical cord and asked if we wanted to feel it– it was still pulsing and felt more like a rubber hose than anything biological.

My husband, who had been a rock the whole time, now admitted to feeling rather woozy– probably some combination of the hour, me pressing the air out of his lungs while I pushed, and his much-clearer-than-mine view of the crazy amount of blood in the bottom of the tub (mixed somewhat with the running water, which made it look like even more)– so we crabwalked our way around to the other side of the tub where he could sit/breathe more comfortably and still hold me, while I held the baby, who was still attached. My son (somewhere in there, I had checked to see) was already making nursey-faces– nosing from side to side, open-mouthed, sticking out his tongue– so I held him up to a breast and he latched right on. The doctora told me to give another good push, so I did, and the placenta flopped out. I had no idea how large a placenta was!

Once the cord had gone all white, the doctora tied it off with what looked like green dental floss, and I cut it. We handed the baby off to his father so I could rinse off. The doctora checked me out and said I’d torn superficially. She recommended stitches, but said if I chose not to, I didn’t have to. I’d torn superficially– one tear on each side. I agreed to the stitches, and we established that I could put that off until daylight, so I was tucked into bed with baby, husband, a gigantic maxi pad, a couple of towels, and a big chux sheet, and we dozed until the sun came up. The baby was awake and alert for the first hour or so, which was cool. I nursed him, and he fell asleep hugging my boob. He smelled like cumin.

When we woke up in the morning, he had passed a tremendous amount of meconium on my arm, and it had squelched its way onto everything– sheets, pillow, baby, me, and the towels. We were in an awkward bind. The doctora was still asleep, and we were loath to wake her so early just because we didn’t know where to find appropriate rags for the cleanup. I staggered into the bathroom and rinsed myself off, but it was a bit chilly to be washing the baby in cold water. We waited a bit, and then my husband went to wake the doctora. She used it as an instructional opportunity on how to wash the baby in a bucket. We got everything cleaned up. I nursed the baby again, we did all the weighing and measuring and checking (8 pounds, 21 inches, perfect in every way).  I got a proper shower and then got stitched up (ow ow ow!). Somewhere late morning or noonish, we packed up and got a cab home.

A lot of birth stories talk about it as a deep spiritual experience, and I believe them, but mine wasn’t like that. It happened way too fast for that. Everything before transition was like having a period without the naproxen, except not as bad– because with menstrual cramps there’s no break between. Part of me now thinks women who can’t bear the contractions without drugs are just wusses. I have to remind myself that A) it’s probably not equally painful for all women, and B) most women don’t have periods as bad as mine to condition them. Anyway, the birth of my first child: not a deep spiritual chant-fest. More like getting run over by a freight train without warning. We arrived at the birth center at 11pm, barely dilated, and a little after 2am, my water broke and suddenly I was pushing. My son was born at about 2:45am.The entire second stage, maybe thirty or forty minutes… in my own experience, it felt like five minutes. Totally out of control, everything happening at once, and there he was!  People have been telling me how lucky I am to have had such a short labor, but I really wish things had gone slower so I’d have had a chance at avoiding the tearing and stitches– those are still quite painful.

I expected to bring home a squishy purple baby with a cone-shaped head, because that’s what all newborns look like…  except they don’t. When he was born, my son had little Klingon-like ridges on his head where the bones overlapped, but no molding, and he wasn’t squishy or purple looking. After only a few hours the ridges had smoothed out considerably, and now they’re barely there. Not completely ironed out yet– he doesn’t seem to have a fontanel in the front so I guess things are still aligning.

I did get what I wanted: A natural birth. No drugs, no IVs, no inductions or surgery, no strangers…   just me, my husband, and the same doctora I’ve been seeing for all my checkups. Nobody snipped the cord and whisked my son away to APGAR him. Nobody sucked the snot out of his throat or washed him and bundled him up before I could hold him.

We had sort of planned to fill up the tub so I could hang out in the water during labor and possibly for the birth, but in the end, there wasn’t time for it. And that was ok: you can’t plan everything. If I had it to do over again, though, I’d probably put a diaper on the kid before going to sleep. At the time, I was too doped up on my own hormones to think of anything so practical.

No Longer Embarazada!

In the wee hours this morning, at the birth center, after an uncomplicated and surprisingly short labor, the kid made his exit.

He turns out to be a boy, which shows my subconscious dream life knows nothing.

He is gorgeous, of course, from his robust nose to his long froggy legs.  We are totally thrilled and totally exhausted. And I feel like I have been run over by five trucks. It was hard to move before– but right now it is damn near impossible. My wonderful husband has been feeding me steak. In bed.

And since the baby is sleeping, I should be, too.

Lost mucus plug… progress?

Yes, it must be progress. I’m not in labor or anything, and once again trying really hard not to get overly excited about it, but… typically labor starts within a couple of days of this happening, right?  Then again, for some ladies it doesn’t start for weeks yet, the plug re-forms, and can fall out more than once. That must be crazy-making.

Just another indication that maybe I won’t be pregnant forever.

Practice

We’ve settled into a pattern.  I have a couple of contractions during the day. They get more frequent in the evening– by the time we’re ready for bed I’m convinced this is the real thing, because they’re coming every few minutes and starting to feel a little more serious. Then we go to bed, and everything stops.

It’s frustrating, but at the same time, I know even the “practice” contractions are helping to dilate the cervix, so it’s not like they’re wasted effort or anything. I just have to be patient, and when things are ready, the contractions won’t stop just because we turn out the lights and go to bed.

But I hope it happens soon. I am abominably tired.

The Big Fake-Out

Yesterday I had a good series of contractions going. All afternoon, all evening. They even got closer together– probably every five or six minutes by the end of the day– though they never got really intense, and probably didn’t last long enough to qualify as real contractions. Still…  I was really hoping they’d turn into actual labor at some point. They didn’t. Stopped almost as soon as I went to bed. Had one really good one that woke me up in the night, and then nothing. Back to waiting.