Sunday, November 13, 2016

A Cesarean Birth Story

Seeing as my little hammy is almost 3 months old it seems really late to be posting this but can we forgive a mother of five for being super busy.  

I knew I was going to have to have a c-section from day one.  During the c-section I had previously with Cheetah when they couldn't get her out the doctor made  a t-incisions.  That means he started with a lateral cut (the way most c-sections are now performed) but because she had wedged herself up and he just didn't want to or couldn't spend the time to get her out he then made a transverse cut.  I will never know why he did that but when he did he told me then that if I had any more children I would have to do it via c-section.

My new OB knew this and had a conference with the other OBs in the office.  They consulted text books and current OBgyn recommendations.  They decided that not only did I have to have a c-section but because the risk of rupture with a previous T cut is almost 8% (the risk of rupture after a typical c-secion is .1% and the risk of rupture after the much more "dangerous" transverse c-section is 1%) and because Cheetah had come so early that I'd have to be on progesterone shots starting at 16 weeks and that they wanted to deliver at 36 weeks.  This was a big deal for OBs to decide.  There was a time when it was not uncommon for OBs to induce labor for convenience or mothers choice as early as 37 weeks, but evidence showing that was harmful to babies has now made it so that typically even in scheduled c-section they try to make it all the way to 39 weeks and in inductions they make most woman wait until due date.  To choose to birth at pre 37 weeks was a huge deal but looking at all my risk factors they decided that it was the safest choice for baby.  A possibility of a few days in the NICU was preferable to me going into preterm labor, having my uterus rupture and having the baby die due to the cord herniating out of the rupture before I could make it to the hospital.  It was a hard choice, one that my husband as a pediatrician felt extremely uncomfortable with but ultimately we decided it was the safest option.  To prepare I received two steroid shots to help his lungs develop and we scheduled the c-section. 

August 19th we sent our three oldest off to school and kissed our youngest who was staying with Grandma.  We stopped at Hobby Lobby on the way to pick up some number 4 pencils our son needed for art class.  We had chosen to deliver at the largest hospital in our area, the one that has the biggest NICU, but it meant we had to pass five hospitals on the way.  I was scheduled for noon so we arrived right around 10.  I wore my "This is my last one, seriously" t-shirt and insisted Dr. J take a picture of me outside the hospital.  The nurses found it hilarious. 

The next two hours were filled with surgery prep.  I had to give a pee sample which somehow I managed to catch only like three drops of.  My vitals were taken and I was gowned.  The nurse shaved my lady regions with what I can only assume was a piece of broken glass.  They insist in their pre surgery instructions you allow them to do it rather then do it yourself but because I followed that instruction I was left with three weeks of the worst razor burn ever.  I also had the indignity of hearing the doctors comment on it when I was on the table :)  The anesthesiologist came in and we chatted about my previous surgeries.  Then he and Dr. J started talking med school.  At some point during this Dr. J changed into scrubs and a little hat and I got an IV.  We have no pictures from this time because I took them on my phone and it died just a few days after this.  It also had every picture we had of Dr. J and Hammy after he was born a fact that even now I still morn.  My OB came in to chat and then she helped wheel me into the operating room.  

At this point I was starting to feel a little nervous.  Being cut open is not something I enjoy and I also was having a hard time shaking the fear and distress of Cheetah's previous birth and the bad outcome of my miscarriage two years before.  The staff helped me up so the anesthesiologist PA could start my spinal.  My OB came around and held my hands while I was bent forward.  At one point I cried out (having a giant needle shoved into your back even with topical isn't always pleasant) and my OB reached up with her hand and brushed my hair out of my face.  It was such a human gesture, so non medical that while it didn't remove all my fears I found it greatly calming and then I went numb.

They laid me back on the table and Dr. J came in.  Giving birth in a c-section is such a weird feeling, very surreal.  It is hard to feel connected when your body is so numb and so much of the talk around you is medical.  They cut through the layers of skin, fat, and connective tissue.  My previous OB had told me that my insides were ugly full of scar tissue.  He must have cleaned it out though because when Dr. Wallman got in there she said everything looked great.  

She came to my Jack O Lantern uterus and within probably a minute we had a crying baby.  I'd requested that they delay cutting the cord for a bit and milk it before they cut it so that Hammy could get as much blood as possible.  In those minutes though he was sitting on my belly I could neither see nor feel him.  Dr. J turned to me and with a chocking voice said, "He looks so good.  I don't know how much he weighs but it is well over 5lbs."  It was.  We had all been guessing he'd be 5 something but he came out at a whopping 6lbs 11.8 ounces.  A great weight for a 36 weeker.  The NICU team then had to check him over.  I wanted him with me as soon as possible but because he was under 37 weeks they had to give him a one over before he could be brought to me. 




 There is a picture of Dr. J just after a wrestling match in junior high that looks just like the above picture...well besides the giant glove and the nakedness but the face and hair, spot on!




 He got the ok, they threw a hat on him and brought him back over to me.  This moment was magic for me.  Sure it wasn't the beauty of pushing a child from your body and lifting him up onto your chest but after Cheetah's birth when she was almost immediately taken away and my only glimpse of her was through glass this was balm of gilead.  I could feel his warmth.  I could smell his skin.  I could talk to him and kiss him and gently pat him.

Eventually they would take him away from me again.  He was extremely grunty a potential sign that an infant is having some respiratory distress so they took him away to check his O2 stats and suction him out a little better.  Here he is hanging out on a warmer in recovery while they make sure his stats are high.  They were and so they eventually gave him back to me.  The staff had a quick discussion about whether or not to send him to NICU for observation.  It was heartbreaking news for me to hear because it was a minimum 8 hour sentence.  I kept my mouth shut though and just listened.  I will forever be grateful for the nurse who promised that she would keep an eye on him and kept reiterating that his O2 stats were great.  It was because of her that I got him back and was able to take him to my room with me.  They asked me if I wanted to try nursing and I said yes.  The nurses helped me up into a sitting position because I still couldn't feel my legs and wouldn't be able to until long into the night.  I was holding him and mentioning how I couldn't feel my toes when suddenly he jumped right on to nurse.  The kid had a perfect latch and knew exactly what to do.  Be forewarned that below are pictures of him nursing.  In our home we are very open about breast feeding but if topless pictures of me will disturbing you you might want to stop scrolling now.



 I feel for all my kids when they get to this right boob.  It is just so much bigger than the other one that I seriously worry that one day it is going to suffocate someone.  Haha,  I can't be the only person who has experienced this.  All of my kids have been breastfeed and they almost always know how to latch but that doesn't mean they do it right.  When Captain E was a baby he actually sucked almost all the skin off my nipples before my milk came in.  Peach always had a terrible latch and every time I breastfeed her for the next two year it was painful.  Hammy was an angel.  It never hurt, I never got chapped, and he just seemed to instinctively know what to do.  I mention it because while I'm a strong advocate of breastfeeding it isn't always easy and it doesn't always go this smoothly.  Sometimes you are going to need help and sometimes it is not going to be possible.  This isn't a failure by the mother it just sometimes comes down to luck.



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