POSTPARTUM

They say you don't know what you have until it's gone.  That's especially true of abdominal muscles.  I certainly never had a six pack, but prior to surgery I was capable of all kinds of physical feats.  I could sit up.  I could sit down.  I could positively dazzle you with my ability to pee independently.  After the C-section however I needed lots of help.  Luckily, the postpartum wing of labor and delivery is filled with more help than anyone could ever want... or need.

***    

"Time for a feeding" said the night nurse, as she wheeled my son in from the nursery.

I fumbled sleepily for the control.  Eyes closed, I inclined my bed and unlatched the straps of my nursing bra.  Suddenly, I was jolted awake by the feeling of a cold hand on my breast.

"Oh!" I jumped.
"I'm just going to help you with the latch" explained the nurse, tweaking my right nipple.
"Oh, okay."

She showed me how to stack the pillows over my lap and laid Bobby down across them.

"Now we sandwich the nipple.  See?"
She squeezed my breast into Bobby's mouth and stroked his cheek to prompt suckling.
"You sandwich beautifully" she said.
"Thanks" I said, squinting up at her.

It took us a couple tries but Bobby eventually latched.  Of course when he came off my boob, we noticed he missed the nipple entirely and had been sucking my areola.      

"Yeah, that happens" said the nurse.  "You can just present the colostrum and finger feed him until you get the hang of it."  She proceeded to squeeze me like a tube of  toothpaste (err...titpaste?); collecting each droplet on the tip of her finger and shoving it between my son's lips.

After about twenty minutes of this, she disappeared into the night never to be seen again.

The next day my head was spinning.  So many people were inviting themselves into my room I couldn't keep track.

A nurse came in to administer my pain medication.

A different woman came in to ask about my rash.

A different woman still came in to inspect my incision.  "You can't eat solids until you fart" she said before leaving forever.

They'd flash their badges, introduce themselves, touch me and vanish.

Day 3 was the worst by far.  Bobby and I were getting much better at breast feeding but I was in immense pain.  The epidural wore off and the flesh around my incision was on fire.  That's not hyperbole.  Every time I moved the wrong way it felt like someone was burning my skin with a small torch.

I looked up at the time and realized my medication was thirty minutes late.  Lucky for me a new, a random doctor had just magically appeared.

"Hi!  I'm Dr. so-in-so.  I'm here to check your incision" she said displaying her ID.
 "Great!"  I sighed with relief.  "After that, do you think you could send in my medication?"
"Of course."

Ten minutes after her departure a new nurse came in.

"Do you have my medication?"  I asked.
"No - I'm here to help with the breastfeeding."
"Oh, okay"  I said, dizzy with pain.

Bobby was rooting for food, letting out short flustered cries as I struggled to force my nipple into his mouth.  His little, wiggly body pushed down on my surgical wound and sent sharp pains through my abdomen.

"Hmm... try this" the nurse would say grabbing my boob or adjusting my son or shifting my pillow.  With each jostle I could feel the frustration rise up inside me.

"Some babies have a hard time latching" she said.

That was it.  Each nurse seemed to contradict the previous one and I was tired of the mixed messages.

"He latches" I replied.
"I just meant..."
"He latches!"  I shot back.  "I can't tell how much food he's getting this way.  I haven't worked with the same lactation nurse twice and my son needs to eat!"  Warm tears threatened to push out through my eyes.

"Everything okay in here?" asked another nurse from the doorway.

"No" I sniffled.

"She needs her medication" said my husband sternly.  "She's been very patient; it's almost an hour late and she's in pain."
"Nobody called me about any medication" replied the nurse, seemingly dumbfounded.
"Called you?" my husband asked.
"Yes - you need to call in advance of every dose" she explained.

That was news to us!  Up until now, someone was always there with pills when I needed them.

I couldn't hold it in any longer.  Those first tears broke through and a waterfall followed.

"My son needs to eat!"  I sobbed.  

Everyone froze for a moment and then suddenly kicked into hyper drive. With comical speed, I was provided a breast pump and formula; I was assigned a new nurse and my medication was finally administered.

Though the lambs finally stopped screaming, I was still raw, unshowered and exhausted.  I quietly cried into my husband's shoulder when there was yet another knock at my door.

Now what? I thought.

A new woman emerged wheeling a cart packed with equipment.

"Is this a bad time?" she asked.
"That all depends..." I replied wiping my tears.
She chuckled.  "I'm a photographer and I'm here to offer some professional photos of your newborn today."

***

Utterly drained, I looked on as the woman wrapped Bobby in a hand-knit blanket from my aunt.  She posed him in the gentle light from our window; and with each click of her camera I could feel my body settle in.  The tears of tension turned to tears of joy as every small moment was skillfully captured.

I wasn't made up.  My hair was unwashed and unkempt.  My skin, still marred by an aggressive pregnancy rash was hardly photo-ready.  My limbs were swollen with water.  My eyes were puffy from the day's trauma.  Yet, I'd never been more happy to have my photo taken.

There's nothing easy about creation and these photos reflect that.  But every time I look at the beautiful truth in each frame I feel incredibly honored to have had this experience.  

C-SECTION

Still flailing from the labor shakes, I was wheeled into a sterile, white operating room.

"We're going to numb you a little more" explained the anesthesiologist.  "Patients sometimes say it feels like they can't breath - but it's just the medication."

"Okay." I nodded.

Slowly the feeling completely drained from my chest and abdomen.

"Can you feel this?" asked a nurse.
I couldn't.  I couldn't feel anything.

The room quickly filled with people:  my OB, a surgical assistant, a pediatrician and lots of nurses.

"We ready to go?" asked my OB.
"No - I need my husband.  Where's my husband?" I asked, trying to stay calm.
"Where's Dad?" yelled the OB.

A door opened and there he was, all scrubbed up.  He quickly took his place by my side as a nurse hoisted a blue sheet to block our view.

"We're going to get started." my doctor said.
"Please," I begged "don't give me a play-by-play - just get in and get out."
"You got it" my doctor chuckled.  "We'll be totally done in twenty minutes."

I squeezed Will's hand and looked into his eyes.
"I love you."  I whispered.
He smiled gently back at me.  "I love you, too."

Just then, I gasped desperately for air.
The nurse is right I thought.  It really feels like I can't breath.

I gasped again. "ItfeelslikeIcan'tbreathbutIknowIcan..." I blurted quickly on the exhale.
"Yup," confirmed the anesthesiologist "it's just the medication - your oxygen level is normal."

Shake, gasp, squeeze, apologize - rinse and repeat.  That's what was happening on my side of the blue divider.  Meanwhile my doctor and her assistant chatted politely as they peeled me open.

"Where did you go to school?" I heard my OB ask.
What is this, a cocktail party? I thought.  Focus, ladies...

Finally, I heard a collective "awww" from the group.

"He's nine pounds!" my doctor declared.  OH MY GOD. 
The nurses around me shook their heads in disbelief.
"A nine pound baby inside such a small woman" I heard one remark.

"He's stuck in your pelvic bone and the chord's wrapped around his neck" said the doctor.
"Is he okay?" I asked.
"Yup, we'll have him out in just a minute."

"Now, don't be worried if you don't hear him cry right away" a nurse came in close to whisper.  "It's totally normal."

"Okay" I nodded.

"Here he is!" shouted the doctor.

I heard one little coo and then nothing.
"Oh my God!" I smiled "Will, can you see him?!"  
"Yes - he's beautiful!" Will answered.

They whisked my baby to the pediatrician seated about ten feet behind me on the left.  The doctors were reassembling me layer by layer - but all I could focus on was Bobby.  I craned my neck trying desperately to catch a glimpse.

After roughly an eternity and a half, he was clean, swaddled and by my side.  He was the most beautiful child I'd ever seen in my whole life.  Blonde, pink and absolutely perfect.  Will held him up as a nurse snapped a picture.

"Because of the meconium" she said "he'll have to go to the NICU for monitoring - but I don't think he'll be in there long."

And just like that we were separated again.

We wouldn't be reunited until an hour into my recovery.  After 9 long months - the exhaustion, the mood swings, the aches, the weight gain, the worry, the rash, the induction, the labor and the surgery - there he was in my arms at last.

LABOR AND DELIVERY

A few months back, I asked my Facebook mommy friends to weigh in with their childbirth experiences.  A compulsive planner, the goal was to gather their collective knowledge and funnel it into my own birth plan.

But soon my simple query turned into a real conversation.  SO MANY amazing ladies responded; and as I eagerly absorbed their stories, I noticed some patterns.  It seemed the most disappointed women were those whose detailed birth plans were overruled by medical necessity.

So rather than attach ourselves to an unrealistic plan; spend money on classes we might not need and/or hire a potentially useless doula- Will and I decided the best plan was to wing it.

Yeah.  I know.  Me... wing it.  Crazy.

My only wishes were:

1. That my mom, sister and husband be allowed to coach me through early labor.
2. That I wait as long as possible to get the epidural.
3. That above all, we do whatever necessary to get our baby out safely.

As we drove to the hospital, I quietly prayed we made the right decision.

***

"Ohh..." said the on-call physician.

As she looked over my swollen, welt-covered body she conceded my case of PUPPS was in fact the worst she'd ever seen.

Moments later I was administered an invasive dose of Cervidil - a tiny tampon-like object covered in goo meant to soften my cervix.  I read that Cervidil could even kick my body into labor - but since the doctor's prediction for this induction was so confidently gloomy, I was prepared for massive disappointment.

As suspected there was no dilation when they checked me at 5 AM.

"So what now?"  I asked, sadly.  "Will I need to re-do the Cervidil tonight?"
"Hmm..." said the physician, inspecting my anatomy.  "I actually think an enema would help."
"An... enema?"  I trembled.

I was skeptical - not to mention scared for my tushie - but ultimately if it would get this kid out of me, I was game.

A couple hours after the interesting procedure, we received some good news:  I was 4 cm dilated and fully effaced!  Encouraged by my progress, the doctor agreed to break my water and get the show on the road.

Soon my mom and sister arrived.

"4 cm dilated!!"  I shouted as they walked through the door.  They screamed with excitement.  "The doctor just broke my water!"

They rushed over to lift my blanket and see for themselves.

"OH!" they simultaneously recoiled.
"Ali - that's the wrong color..." my sister said covering her mouth.
"What?  What do you mean?"  I asked.

The doctor came back and explained that there was meconium present in my amniotic fluid.  This meant Bobby had a bowel movement while inside me.

"So... I mean, is my baby going to be okay?" I asked.
"Yes - we'll have to monitor him very closely for stress;" explained the doctor  "and if he's ingested any of the contaminated fluid - he may need to spend some time in the NICU,"
I nodded sadly as I considered this possibility.
"Either way" she continued "time is of the essence.  I'll have them prep your delivery room and we can get going."

By the time transport arrived my contractions were in full swing.  The nurses helped me stand, at which point more of the discolored liquid came gushing out of me.  During the short, swampy walk to my wheelchair, I had to brace myself two separate times to breath through the surges - all the while trying to apologize for the mess I was making.

Once we settled into the snazzy new delivery room, I was free to concentrate on labor.  Will, Mom and Vic worked in shifts holding my hand and coaching my breathing.   Each time I felt a contraction coming on, I'd signal for help.  Whoever was 'on' would drop what they were doing and rush to my side.  Using this system, I found it easy to breath through the labor pain.  But after four hours when I still hadn't progressed, we started talking about pitocin.

Pitocin is a synthetic hormone administered by IV to strengthen contractions.  I labored for another two hours on pitocin and noticed the surges were coming on faster and more furiously.  Between bouts of tightening and intense breathing, the labor shakes took over my body - forcing me to flail wildly in bed.  I knew we were running out of time and I didn't want my pain threshold to hold me back.  So I told the doctor to order the epidural and crank the pitocin as much as possible without stressing the baby.  She agreed and soon the anesthesiologist was there with her giant needle.

***

Okay so here's my take on the epidural:

Why the hell would you NOT get the epidural???

Those contractions were OFF THE CHARTS and I literally - not kidding here - slept through them.

I SLEPT THROUGH THEM, GUYS.            

Moral of the story:  GET THE EPIDURAL.

***

In any event - after twelve hours of labor my doctor arrived to make the final call.

"You're still only 4 - maybe 5 cm dilated" she said.  "There's A LOT of meconium and I don't want to wait too much longer before we discuss C-section."

Will and I looked at each other, took a deep breath and nodded.

"We tried." I said, the reality slowly setting in.  "Nobody can say we didn't."

After I legally consented to the procedure my family came back in to wish me luck.  I hugged them one-by-one, realizing with each embrace that I'd never, ever had major surgery before.

My Mom was the last up.

"Mommy" I said, a tear working its way to my eye "I'm scared."
She smiled gently.  "You're going to be fine.  And you're going to be a mother."        

NOBODY TELLS YOU THIS SH*T!

Last week was my best friend's wedding and as matron of honor, I had a few tasks.  Wearing a giant orange maternity dress was first among them; followed closely by speech writing, gown wrangling, standing for long periods of time and being on call for pretty much anything the bride needed.

This girl is my ride-or-die chick.  I love her like a sister.  SO despite my condition, I wanted to do absolutely everything I could to make her day special.  Still, I was nervous my size and symptoms would somehow interfere.

Happily, they did not!  My dress fit.  My speech went well.  I wrangled that gown like a BOSS!  And not for one second did exhaustion or soreness get the better of me.  The best part:  I got to be there for my amazing friend on the most important day of her life.

I had done it!  I accomplished everything I set out to do while carrying my precious boy.  Only a few days more and my near-perfect pregnancy would end in gentle coos and long-awaited cuddles.

At least --- that was my reality until the following morning.

I awoke to some skin irritation on my abdomen.  Thinking it was just stretch marks, I got more aggressive with my cocoa butter regimen and went on with my day.

By nightfall, the minor irritation had spread like a raised, red spider web covering my entire stomach and itching me to within an inch of my sanity.  I did some research and was shocked to learn there is actually a pregnancy rash called PUPPS.  The rash affects roughly one in every two-hundred pregnancies - usually first time moms who are carrying boys.

A rash caused by pregnancy?  I had no idea!  Nobody tells you this sh*t!

I wrote an email to my doctor asking if there was anything I could or should do.  She advised there is no known cause or cure for PUPPS.  She then instructed me to use some over-the-counter itch creams and take Benedryl at night.  But by the time my Friday doctor's appointment rolled around the rash had spread with a vengeance.

My hands, feet, thighs and breasts were now covered in RELENTLESSLY itchy bumps that no cream in my possession could appease.  I couldn't sleep - I just paced the floor trying desperately not to scratch my skin from my bones.  When I explained this to my physician, she said the best way to get rid of the rash was to deliver the baby.  Since I'd already reached the 40 week mark, she encouraged us to consider induction.  So together we decided to schedule a slot at the hospital for Monday.

In the meantime, my mom and sister came over to help Will with last minute preparations while I rested up.  We found some natural home-remedies that seemed to manage the pain for short periods of time.  Yesterday I took four lukewarm showers with Grandpa's Pine Tar Soap, drank two V-8's and lathered myself in A&D ointment.  All in all it was a good day but still the rash persisted.

I woke up this morning bloody from an apparent bout of sleep-scratching and found myself conquered by agonizing welts from temple to toe.

Horrified, I called my physician's office and spoke with the OB on call.  She seemed completely disinterested in my plight but begrudgingly agreed to call my doctor for instruction.  About a half hour later, I received a call back.

I was presented with two options - move up the induction to tonight or take one round of steroids.  When I opted for the former the on-call OB sighed.

"You know this induction won't work right?"
"What?" I responded in shock.
"I mean, you're not dilated, your baby hasn't dropped and if you weren't itchy we'd make you wait another week."

I couldn't believe what I was hearing.  I've been nothing but an excellent patient this entire pregnancy.  My doctor KNOWS I'm not a whiner and my only birth plan is to get the baby out safely.  I have no agenda other than to do what is medically wise for myself and my child - so to receive this response was incredibly disheartening.

Sternly, I replied "my doctor and I are on the same page, thank you... and I opt for induction.  See you at four." 

With that, my friends and family - it's showtime.  One more pine tar shower stands between me and my party of three.  And whether this induction takes or ends in C-section, I'm more than confident I'm doing the right thing.

Thank you all for the readership and support leading up to this moment.

I love you all.

THE GIRL WHO CRIED BABY

Pregnancy teaches you a lot about yourself.  Something I’ve learned this trimester is that I am NOT the girl who cried baby.  In other words, the many symptoms that parade as labor pain have not driven me into a tizzy.  Constipation, gas and even the occasional contraction have been met with self-control – if not complete denial.

Yesterday however, I was tested in a way I’d never been before.  After my weekly internal exam I went to work as I plan to everyday until this kid pops out.  Toward the end of the day, I noticed I was a bit wet.  It wasn’t a big gush like you see in the movies, but I wondered if it could be amniotic fluid that somehow leaked throughout the day. 

Then the contractions came.  Crampy pain began gathering in my lower abdomen, traveling up until my whole stomach was tight to the touch.  They weren’t incredibly painful – but then again I have a high threshold.  They weren’t exactly timeable, but then again, I kept second guessing myself – rationalizing that every other surge was in my head.  Since I work only a few blocks from the hospital, I had Will come to my office so we could decide what to do together. 

Though I was fairly sure it was a false alarm, the doctor on call felt I should have the fluid tested.  “If you’ve ruptured” she said “you could risk infection.”  That’s all we had to hear.

The contractions continued as we walked through the hospital door. 

“Need a wheelchair?” asked a kind man in the vestibule. 

“No thank you.” I said politely. 

“I’m not THAT girl.” I whispered to Will.  Why would I take a wheelchair from a real pregnant lady; one who was having real contractions unlike the phantom ones I was sure I was experiencing?

Up to labor and delivery we went.  For a moment, Will and I looked at each other with excitement.  No matter the outcome, within the next few weeks – this WOULD be real, and we WOULD be leaving with a baby!  It was all incredibly surreal.

Our sassy nurse Francis greeted us at the desk.  “I’ve been waitin’ for you, baby!” she exclaimed.

Before I knew it I was in a robe, strapped with monitors and having a q-tip shoved… well… up there. 

“Now we put this in here” sassy Fran explained pointing to a vile of clear liquid “and wait to see if it tests positive for amniotic fluid.” 

Simple enough.

In the meantime, I watched the monitor scroll by. 

“What do those lines mean?” I asked.

“That means you’re having a contraction.” Sassy Fran answered. 

AHA! I silently rejoiced.  I’m not going crazy, those ARE contractions.  I felt so validated.

Throughout the hour I was there, I had roughly six contractions.  They varied wildly in interval and severity.  The biggest one ranked about a 5 on a scale of 1-10.

“Okay.” Sassy Fran said re-entering the room.  “You’re not leaking fluid, BUT you are having contractions so I think we need to examine you.”  Will and I looked at each other in disbelief. 

“Oh, really?” I asked. 

“Yup, just want to make sure you’re not dilated.”

And for the second time that day, I was to a medical professional as a dummy is to a ventriloquist.  Sassy Fran and I may have only just met, but we sure got to know each other in a hurry!

She lingered a while, squinting with thought as she checked and rechecked my cervix. 

“Hmm,” she said, seeming surprised “nothing happening.”

I was released with a good education.  The first lesson I learned is that Will and I are a pretty great team.  The whole trip, we remained calm, playful and excited.  Never once was there a tense moment or a miscommunication. 

Number two, I learned I have to trust myself more.  Why should I be so worried about overreacting anyway?  This is my first time at bat, so of course there’s a learning curve.  Even if I had taken every class in the world, nothing can teach you what sort of physical sensations you’ll experience during labor.

Last but not least, I learned that false labor = a night off from the evening chores:

“Will, would you feed the dog when we get home?” I asked.

“Yes.  Since Sassy Fran put her entire hand inside you, I think I can manage that.”

I may have to cry “BABY!” more often.  

AN UPDATE

It’s been over a month since I’ve written and the explanation is simple:  I’m in full-on nesting mode.

All of Bobby’s clothes and linens are washed; the diaper bag is packed and ready; and the nursery is nearly complete.  We’ve taken the hospital tour and filled out all of the intake paperwork.  We tracked down a breast pump and researched a couple pediatricians.  

Yet, the “if my water breaks today” list is still uncomfortably long.  Before my feet even hit our bedroom floor, I find myself repeating the unchecked items like a mantra:  Ready the vehicles, install the car seats, pack the ‘bug-out-bag,’ freeze some meals, watch the shaken baby video, purchase cradle sheets…etc.  Additionally, we’re tying loose ends at work, saving every available penny and trying desperately to keep up with all the other chores.     

In the midst of this mania, I’m still a human going through a gigantic transition.  There have been emotional highs and lows, physical obstacles and external challenges the likes of which I’ve never personally known. 

Truth time:  If I stop long enough to think about some of these underlying anxieties, I cry. 

Many of these challenges involve other people and are thus unblogable; but happily I do have an alternative outlet:  music.  Throughout my life, the gift of song has rescued me from many a spiritual valley.  Now more than ever, I’m inspired to turn all of my joy and pain into honest lyrics.  I’ve been collaborating with a good friend since June and (spoilers, guys) it’s really friggin good.  Easily my best work to date.  I will be very proud to present it to you all when it’s done.

Until then, the catharsis of creation, the promise of Bobby’s smile and my INCREDIBLE husband have been getting me through. 

Of course when all else fails, I can always throw myself into the to-do list.

THE SHOWER

Waddling into the bright room adorned with safari animals and soft blue wrapping paper, I let out a sigh of relief.  The busy morning was behind me; I was here and ready to celebrate our little boy.

***

Only 18 hours prior, our friends arrived from Virginia.  I tell ya, nothing makes you feel like more of a grown-up than your first houseguests!  Conversely, nothing makes you feel like less of a grown-up than your houseguests’ children. 

I was confident our home was clean and safe.  Naturally our friends’ adorable toddler shot that delusion to hell. 

He bee-lined for a glass heirloom before tugging on a metal shelf stacked with kitchen appliances.  “That’s not bolted down!” I warned, imagining disaster at every turn.  This was all before he fell backwards down our ungated staircase.  Will caught him in a feat of INCREDIBLE Dad-to-be heroism – but man was that close! 

I could just see the headlines: 

“Prospective parents lure innocent family into death trap.” 

“CPS demands immediate surrender of unborn child; report cites ‘sharp edges.’” 

The words “would you bring your kids HERE???”  printed over a picture of our perilous living room.

Happily, our friends handled it with cool and grace.  They joked with us about taking notes for our own child and only had to tell their kids once what not to touch.  I was incredibly impressed by their behavior; everyone lived and a great time was had by all.

The next morning, I awoke early to make coffee and grab bagels from a local deli.  Once everything was laid out on the table, I handed the hosting reigns to Will and set out to make myself pretty. 

Now, it had been quite a while since I cared about my appearance.  Pregnancy exhaustion has a way of striking unnecessary primping from the itinerary.  People were coming from all over to see me however and I was determined to look halfway decent.  A little hairspray and a lot of shellac later, I was faced with the ever-daunting selection of shoes.  It had been at least three months since I tried to wear heels.     

Why not?  I thought.

Of course, before we even left the driveway, my feet were swelling like overly yeasted cake batter.

Right.  That’s why not.  I was reminded.

***

No matter – I had arrived.  The room quickly filled with smiling faces and big gifts.  My Mom and sister did a wonderful job organizing every last detail.  The food was amazing, the décor was adorable, the games were HILARIOUS and the company was outstanding.

I opened the beautiful gifts (barefoot) with the help of some girlfriends.

We now have everything we need to prepare for our little prince.  Once we trash every breakable, cover every outlet, and bolt every piece of furniture to a load-bearing wall – we’ll be all set!!!

A special thanks to everyone who made our day so special.  <3