Friday, February 25, 2011

C-Section: The Ugly Side

This post is long long long, but I left a lot of details out of Kermit's birth story, and I need to get them written down somewhere I can read them later. (But, I didn't want them integrated with his birth if they didn't have to be, because ick! let's focus on the cute baby for that one!) Details like, in what ways did it matter that I didn't give birth vaginally? How was the c-section? Did they put everything back where it goes, or is my bladder in a subtly different place than it was before?

The answers are: Lots of ways. It sucked. Things definitely feel a bit scrambled in there.

More details? Yes, I do have more details! If you insist.

First, I'll just mention that the nurses at my hospital are clearly not used to dealing with women who do not want a c-section, despite a non-trivial number of women attempting VBACs at this hospital on a regular basis. I can't possibly be the only woman they've ever dealt with who wanted a vaginal birth but didn't get one. And yet every nurse greeted me with something along the lines of, "You're here for your scheduled c-section! You must be very excited to be having surgery today instead of going through all the hassle of a vaginal birth!" When the first person said this, I didn't respond, because my eyes filled with tears and I didn't trust myself to speak. With the second person, I informed her that I actually would prefer the hassle, thankyouverymuch, but it didn't end up being feasible for me. I'm not sure how I expected her to respond to this... probably something like, "Oh, I'm sorry it didn't work out. We'll do our best to make this experience as positive for you as we can." That would have been reassuring. Instead, she tried to convince me that this way would be so much easier and more convenient for me. Which was exactly why I was upset, so it was exactly the wrong thing to say. Anyway, that nurse must have made a note in my file ("Crazy woman wanted VBAC instead of the nice convenient surgery") because every other nurse who came into my room, even ones who were just dropping off linens, gave me a speech that started with, "So I understand that you're a little reluctant about your c-section today" and then proceeded to tell me why surgery was oh so very convenient. In a voice that very much implied that only a naive little girl would be reluctant to give birth surgically.

Blech.

I'm definitely not a granola hippie type person, and I've always shrugged off people who believe that giving birth in a hospital automatically means that you'll be steamrolled by the uncaring medical establishment, blah blah blah. That whole outlook on hospital births was nothing like my experience giving birth to LL -- I had a doctor who listened to me, provided me with well-researched information, and ultimately let me call the shots about my own care; I had supportive nurses who asked how I wanted to be treated with regards to labor assistance, and then followed through on my wishes; the default behavior at the hospital is that all babies room in with their mothers; fathers are considered on equal footing with mothers, and are thus not considered "guests," which means that they can always spend the night if they want to; it is assumed that all mothers will breast feed, and formula is never offered unless it is explicitly requested by the parents. Basically, everything that the anti-hospital-birth people complain about... none of it matched with my experience with LL. But hearing nurse after nurse try to convince me of the virtues of a c-section, when I very obviously did not want it... um, yeah, I get it now.

Anyway, once everything was set for the c-section, I managed to get myself into a good mental place where I just wanted to meet little Kermit, regardless of how it happened. The c-section was, ultimately, medically necessary, so let's just go ahead and do it. And as I mentioned in Kermit's birth story, my hospital actually does a lot of things to make it easier on c-section moms, so that they don't miss out on as much of the post-birth stuff. A lot of these polices were actually new since LL was born, so I was pleasantly surprised. For example, when LL was born, he was immediately whisked off to the nursery. The nurse held him up next to me for 10 seconds so that I could get a quick glimpse and S could snap a quick picture of me with him, and then I didn't see him for nearly an hour, during which he was weighed and examined and bathed and dressed and everything else they do during those first precious minutes. I hate the one photo I have of me with LL immediately after his birth. The nurse was holding him at an angle to get us both in the photo, but that meant that I couldn't actually see him at all. In the photo, I'm trying to smile for the photo, but it looks like a horrible grimace because I'm really attempting to crane my neck to see his face, which is exceedingly difficult to do while you're unable to move and someone two feet away is still holding your uterus outside of your body. This time around, I got to see him as he was being born. He was cleaned up ever so slightly, the bare necessity of stuff was done (apgar scores and very little else) and then he was brought immediately to my side, where I got to touch him and hold him and stroke his face for as long as I wanted. They didn't do anything else to him until after my surgery was over, so that I could take part. Fantastic improvement over LL's birth.

Before having this c-section, Dr. M had assured me that a lot of things would be better than LL's birth. Since this was a scheduled c-section, instead of an "OMG, after 23 hours of labor the baby is stuck like a big round peg in a much smaller pelvic opening and he's turning purple we have to get him out now" c-section, the surgery itself would be much easier. None of that "push the baby back out of the birth canal so we can reach him" stuff that made my recovery the first time oh-so-fun. None of the body trauma from the long labor and several hours of pushing. Easier surgery. Easier recovery. He promised.

To summarize: that was not my experience.

This c-section was definitely completely different than what I remember with LL, but not in a good way. The birth itself was very similar, but once the baby was out, things diverge tremendously. I remember feeling very little during the 30 minutes it took to close me up last time; I mostly remember being rather bored and wanting to get out of there so that I could see my baby. This time around, I was consumed with the terrible tugging and pulling going on at my lower half. It felt awful. It's hard to describe the sensation of your body being tugged and pulled in a million different directions, internally, while you're unable to move. I can't use the word "painful" because the spinal does block pain down there, but it was intensely uncomfortable and unsettling. I also started feeling dizzy, and out of the corner of my eye, I watched my own stats on the monitor to see my blood pressure dropping down down down.

The anesthesiologist offered to give me something to make me sleep through the rest of the surgery, but I declined, because I wanted to be completely alert as soon as they were done, so that I could nurse. A few minutes later, I started to experience horrible chest pain that got worse and worse. I panicked a bit because, um, what happened to not feeling any pain? The anesthesiologist added some other type of pain killer, which dulled it a bit (he promised it was referred pain, and not a heart attack, which is what it felt like) but it also made me even more dizzy, and my blood pressure continued to drop. The tugging and rummaging seemed to go on and on, as I repeatedly asked how many more layers they had to go. It really sucked. Which surprised me, because I expected the recovery to suck, but not the actual procedure. Over and over in my head was the thought that thank goodness Kermit was here and healthy, but this whole surgery thing was clearly a mistake. I just desperately wanted to be out of there.

When I finally got to recovery, all I wanted to do was to sit up and nurse Kermit. When they took my stats, though, they discovered that my blood pressure was still very very low, and my temperature was also low and continuing to drop. They would let me sit up a little, I would get very dizzy, and they would immediately lie me back down. Thus, my first nursing experience with Kermit involved me lying flat on my back with hot towels wrapped around my head in an effort to bring up my core body temperature. (It didn't work; when I left the recovery room two hours later, my body temp was still hovering near 95, which is a bit insane, and my blood pressure was barely double digits. In retrospect, I'm not sure how I was even conscious.)

I was in that condition for the rest of the day. My L&D nurse asked me what one thing she could do for me that would make my life better, and I said, "I want to get up and walk around!" Nope, not gonna happen. "How about at least letting me sit up?" And she looked at my stats, and smiled apologetically, and asked if there was anything she could do for me that wouldn't make me faint. (Side note: I'm lying in a bed with rails. Why does it matter if I faint? It's not like I'm going to fall into anything or bump my head, and I'm sure I'd come around again eventually. I'm kidding, but only barely.)

Anyway, the surgery sucked. I'm not a squeamish person; I can watch my own blood being drawn, and I have no fear of surgery or anesthesia or any of the rest of it. Yet the last 30 minutes or so of Kermit's c-section ended up being one of the more terrifying things I've ever been through, as the chest pain consumed me and my abdomen was pummeled from within and I thought I was going to pass out and my blood pressure dropped lower and lower. And the rest of that day, as I struggled to sit up despite continuing low blood pressure and low temperatures, also sucked.

The next morning, my stats were still low, but no longer in the scary range, and I was allowed to sit up and eat a little and get out of bed. After LL's birth, this was when things were just starting to suck, because the recovery from labor + surgery was long and hard. But I'd been promised that recovery this time around would be much easier, so part of me actually started feeling like maybe the worst was behind me. Except that my recovery was worse than last time, too, for unknown reasons. It does seem to have been faster -- I wasn't able to move around normally until 8 weeks last time, which meant two full months of no driving and no lifting things and trouble standing up or getting out of bed. This time around, I felt like I reached 85% recovery by the one-month mark, and I kind of ignored that last 15% and just returned to my life, so that was definitely an improvement. But that first month was much worse than last time. It's almost as if my two months of pain from last time was just intensified and shoved into a shorter period of time. Is that better and easier? Um.... not sure. I was definitely in a lot more pain for that entire month. But maybe it's just an indication that, last time, I got off easy.

I had my six weeks post-partum appointment last week, and I know that I'm definitely better now than I was at six weeks post-partum with LL, so I guess that's something. And the remaining effects from the surgery (loss of nerve sensitivity for several inches around the incision; intense pain on my lower left side when I do anything more strenuous than walk from the living room to the bathroom; extremely weak ab muscles that give out when I carry Kermit for more than five minutes) are apparently completely normal, and can be expected to continue for another 4-6 weeks.

So, overall, while I'm thrilled that Kermit is here and healthy (recent hospitalization for respiratory distress aside), and that I will eventually be completely healthy as well, I can't say that things went as I expected. And while I'm grateful that c-sections are an option -- having a c-section certainly saved both my life and LL's life two years ago -- I'm left wondering why the hell anyone would choose a surgical birth voluntarily. S and I haven't decided yet whether we will someday want to try to have a third child, but I hate beyond measure that my birth experience with Kermit is inevitably going to color that decision for us.

5 comments:

  1. I don't think I can even begin to explain how connected to your experience I felt while reading this, or how grateful I am that you decided to write this post as I am struggling with to what extent I am willing to let D's birth color my desire to have child #2, let alone #3.

    My hospital experience was almost exactly the same as yours with LL. You already know about the similarities of the labor and delivery, but also what you described in this post about how supportive the staff and everyone was about nursing, rooming-in, Dad sleeping there overnight, etc.

    I was also told that if I did it again we could do VBAC, that the recovery and surgery would be easier, etc., etc.

    But I just feel so damn ROBBED of the birth experience! Even though I am grateful that it saved the lives of my son and I.

    I can honestly say that if I knew for a fact that I would be forced to have another c-section, I would not get pregnant again. Period.

    So many people are like "Really? But c-sections are so much EASIER, more CONVENIENT, etc." And I just want to flip them the bird and tell them to get out of my face.

    I think what kills me to is the certainty of uncertainty - you would have gone into labor eventually. Kermit was not guaranteed to get stuck again like LL did. But they say it's not worth the risk, etc. I don't know what I would do if they said "Nope, have to do the c-section again, sorry."

    But that's why reading your posts about this is so stirring to me - I feel like I'm down in these emotional trenches with you and we're both trying to figure out how to get the hell out of them while everyone around us tells us we're just imagining things and how could we possibly be upset by this?

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  2. I'm sorry you had such a bad experience. It sounds downright scary and I can't believe how insensitive the nurses were.

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  3. I have definitely encountered that attitude a lot - most people didn't understand why I wanted to even attempt a natural vaginal birth. I'm sorry the nurses weren't more supportive of you.

    That said - I think that this birth experience coloring your decision on Baby #3 would probably happen regardless of birthing "style". Some women who get to have a vaginal birth still have traumatic experiences...so...that's universal I think. Which might help thinking of it that way...

    Did you mention that your bladder felt like it was in a funny spot at your 6 week appt? Did the doc have any thoughts on that?

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  4. That really sucks. I'm sorry. And I think anyone who thinks major abdominal surgery is the easy way is seriously insane.

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  5. Wow. That sounds pretty awful. I am really impressed with how well you are able to share the rest of your birth story without having this tinge the love and happiness you had when you saw Kermit.

    On a personal note, I actually know a woman who just had a HBA3C! Yes, a HOMEBIRTH after 3 C-SECTIONS! None of the local hospitals were super supportive of her VBA3C, so she got a midwife and did it at home. I am in NO WAY saying that was a good idea, but a VBA2C is something that is possible.

    I am so sorry you didn't get the L&D you wanted. It sucks, and it doubly sucks that hospital staff just can't understand or comprehend how a mother could feel the way you did.

    ((hugs))

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