Post Partem, Part I

Since a few people have complained that the last few posts weren't gross enough...let's talk about postpartum issues.

Everyone tosses around the phrase "postpartum depression", but you rarely get the joy of hearing about the other stuff.  Perhaps because it's considered impolite?  Pardon me while I go off in a corner and laugh.  You know what's impolite?  Not telling the truth about the facts of life to those who are yet to experience some of them.

People have babies around just at the time they are least capable of handling them.  Consider the following:  Women spend months on end in discomfort, gaining weight and feeling exhausted, losing sleep and then, when pregnancy comes to a halt, there's labor and delivery and/or a C-section.  It's a grueling, painful, scarring, traumatic, and gory event.  When all that work is done, suddenly there's a cranky, crying little weasel of a thing demanding food about every two hours around the clock--for months on end!  And what's more, if the child accidentally oversleeps that two hour period (as long as 4 hours between feedings), the doctors say to wake them and feed them!  This little weasel also wants to be kept free from its own excrement, yet it insists on continually soiling itself.

And through all that, somehow Mom and Dad have to figure out how to care for themselves.  Mom is expected to try and remember to continue to nourish herself and get sufficient rest, and Dad is expected not to go insane while Mom is greatly incapacitated--and has comparatively paltry recourse for calming the child due to a lack of mammaries.

And Mom is sore.  Maybe she tore.  Maybe she was cut.  Maybe she had a large surgical incision made through her abdominal wall and has a belly full of stitches.  Walking is painful.  Sitting is painful.  Perhaps just moving at all is painful.  But that is secondary to the child because even more painful is listening to the sound of a crying baby.

And what's more:  the blood just never seems to stop flowing.  During pregnancy, Mom's blood supply increases by nearly half again what she had.  Well, she doesn't get to keep it all.  Sure, some goes with the baby, and some leaves at the birth, and some more leaves with the placenta and cord.  But there's more.  Lots more.  And it wants to come out as soon as possible.

Some wonderful people along the way designed some very long, hygienic, disposable pads for postpartum bleeding.  They are too small.  In order to be useful, they need to be chained so that one goes in front and overlaps somewhat a second that goes further toward the back.  If you are a particularly large woman, it's conceivable that you might need three at a time.  I'm not kidding.  At 5'8" (1.73m), I'm hardly what you'd call petite, but I'm not fat either, and to cover the span of gore, I needed this doubling.  Later, after 4 days or so, I was able to start substituting Poise and Serenity incontinence pads, which hold more fluid than the traditional feminine hygiene options.

And then there's the groin pain.  The hospital offered me pain killers.  I was allowed a strong dose of naproxen sodium (Aleve), and while it helped, it was more of a numbing than anything.  Same with the canister of pain-relief foam and the tube of hydrocortisone cream they gave me.  I was continually aware of the pain.  Thankfully, the hospital staff were also innovative.

Part of the pain in the groin is from swelling.  Anyone who knows much about first aid knows that ice helps to reduce swelling.  But who wants to put ice on their feminine delicacies?  Well, I did, though obviously doing so was tricky with all the red tsunami issues in the region.  The nurses did something very smart:  they took a disposable newborn diaper (which is, of course, absorbent and somewhat designed to prevent leaks) and found one end of the crotch region which was open like a pocket.  Ice was crammed into said pocket, and the diaper was introduced to my nethers.  Relief!

Now, another consideration.  We civilized folk understand that having blood all around is something of a health hazard.  And we aren't keen on handwashing a bunch of the stuff out after all that other work.  What does one wear?

While still at the hospital for recovery, I wore the Hospital Gown of Impossible Modesty again.  But obviously that wasn't going to hold my pads to the area of interest, nor was a newborn diaper going to fit around my thighs and hips.  Some genius whom I could kiss a thousand times over created some totally awesome underwear.  This underwear is purely a mesh of gentle elastic material.  It's lightweight and net-like, and super stretchy.  It's just strong enough to hold things together but sympathetic enough not to remind a new mom of her injuries.  I took home as many pairs as I could acquire and even managed to send them through the wash a few times and reuse them before finally donating them to a mom planning a home birth.  Part of me was tempted never to wear any other kind of underwear again...until I stopped needing pads.  Turns out the comfort level was dramatically reduced when mesh meets tender flesh.

The hospital staff gave me certain requirements before I could leave.  Immediately after I was done with the octopus and pony show, I met my first requirement:  peeing.  Owing to the extra hydration from the saline drip, I more than made quota there.  They also kept asking me if I had any gas.  Apparently you can't leave the hospital until you are farting properly.  Let me tell you, it's very strange to be regularly asked by strangers if you are passing wind.

One benefit that I experienced (and I'm not sure how common this is) was that I didn't have to have a bowel movement until 4 days postpartum, and it was relatively easy since I had stayed well hydrated.  Andrew and I drank an entire 24 pack of bottled water during our vacation at the hotel--er, I mean, our stay at the hospital.

Showering was tough, but I was not allowed to take a bath, nor did I want one given that I absolutely did not want to try getting back to a standing position afterward.  For the postpartum mom, I suggest disrobing (and rerobing) while in the bathtub.  I did not realize how keen gravity was to help me make a mess and ended up smearing blood on the floor in a vain attempt to clean up my drippings before more exited my person.  At least it wasn't my floor, so it was somebody else's problem in the end.

The Aristocrats.

Okay, just kidding, but seriously, the whole experience was full of all sorts of nastification.  Still, there were bright spots.  I was up and walking around immediately after giving birth.  I was able to take pictures of Jackson napping on Andrew for the first time, just a couple hours afterward.

My mother-in-law (MIL) and then, shortly thereafter, my own mother traversed their separate drives (each in excess of 2 hours) and gladly snuggled with their new grandson.  My mom had already been made a grandmother twice over via my sister's reproductive habits.  My MIL had not, as Andrew was an only child, and she dubbed herself Nana.

Nana and I had not had a great deal of time to get to know one another in the less than a year's time we had known one another, but she soon got more than her fair share of time with her only daughter-in-law as she stayed the next 10 days to help us adjust to our own new roles as Mama and Dada.

Next up, a review of nursing and postpartum doulas, and (I promise) an end to the postpartum grotesquerie.  We'll start a new kind soon enough.

Labor & Delivery, Part V

***Potentially gross photo alert below.  If you aren't digestively stable, don't scroll down!***

Hurray, I had given birth to my little baby Jackson!  But the fun doesn't stop there.  You know the old saying about a woman's work never being done?  While there are arguable feminist issues to be made with that statement, it seems true when it comes to Labor and Delivery...and even more so in the time following when there is suddenly a child who needs constant care and attention.

So, after I got to hold my crying little purple octopus, Jackson was conveyed to a special table with purple lights and had all sorts of poking, prodding, measuring, and cleaning perpetrated on him by the staff.  As far as he was concerned, he had been abducted by perverted aliens (or was being recruited by the military).

Andrew and Sabrina got to go over to the table then and ogle the cute little thing I had made while I was stuck on the Transformer bed still.  This gave the staff time to inject something into my IV without asking me or any of that informed consent "nonsense" that hospitals are supposed to employ.  I noticed and asked as coherently as I could what was being put into my bloodstream and was informed that I had just been dosed with pitocin.

Apparently the staff was impatient?  I don't know why they didn't ask me or at least tell me (or my husband, or my doula, or...) beforehand that this was something they might do.  Since pitocin helps stimulate uterine contractions (which, I'm fairly certain, were still doing just fine at that point), I can only assume they were doing it to expedite delivery of the placenta.

Before this whole experience, I had wondered how aggravating it would be to be stuck waiting for the placenta to come out, and now...I have no idea what the standard duration post-baby-delivery would be.  (Is it sufficiently obvious that I'm irritated by being drugged with pitocin?  Okay, good.)  Suffice it to say that I did not have to wait very long, and I barely felt anything when the placenta and cord were born.

I say "born" because I was surprised to find myself somewhat emotionally attached to these inanimate organs.  As part of my attempts to assuage my

 desire not to waste anything, we had already

 planned to donate the cord blood, which was done by a needle being inserted into the umbilical cord and draining the awesome, stem-cell-rich blood into containers.

Because the placenta was so large, we had well more than the standard quantity available for donation and were later thanked in person by a representative from the cord blood bank.  In fact, the placenta was so big that the nursing staff all crowded around to gaze at it.  Though with a nearly 10lb child, it was hardly surprising that his source of nourishment should scale up so much above the norm as well.

The size of it was something of a blessing for me, too, as it meant that much more of my 50lbs (about 22.6kg) gained during pregnancy was already gone!  But...emotionally, however, I felt a strong sense of guilt about the placenta itself going to waste.  For a long time afterward, and occasionally even now, 16 months after the fact, I felt as though I had had another life in that placenta that had just been treated like so much garbage, just another piece of "hazardous waste" for the hospital to handle.  My guess would be that if I were from a very primitive culture and had just endured labor and delivery on my own, I probably would have been pleased to find a nice big hunk of nourishing food made available until I was recuperated.

But in this day and age, and living in the United States, I'd feel like some kind of pervert for making a meal out of my own placenta though if I look for a reason, a valid and incontrovertible reason, I cannot see what problems there would be other than: how do I cook this? and How does one season a placenta?

Alas, however, the placental delivery was not the end of the journey.  I needed stitches.  Andrew had returned to my side for the final part of my additional organ ejection and was now enjoying his new son some more.  (Note my leg in the background as Andrew held his son for the first time--also the first time he ever held a baby!)

Shana was calm and focused, carefully sewing my perineal tear before I got too much more sensation back in the area.  I cannot remember if she used any anesthetic, though I know it hurt somewhat.  Andrew was curious but I forbade him to watch her sewing my flesh because the expressions on his face were making me feel uneasy.  More than ever, I was vowing to be better at doing my Kegel exercises if ever I should find myself impregnated again.

As for Jackson, life wasn't a great deal better.  He was naked.  His cord had been cut and clamped.  His limbs were no longer cozily squished into a very small container and (if I had a guess), he probably had some serious "pins and needles" going on in them.  Because his color at birth was something akin to what you would expect to see on a choking victim, he failed one of the points on the APGAR test, but otherwise he passed with flying colors.

Our pediatrician, Dr. Judy Banks, had come into the room.  (Why not?  It was a party, right?  Never mind the naked woman spread-eagle with the needle and thread hanging out her privates.)  She gave a very thorough examination of Jackson's abilities to make sure there was nothing of concern.  I was somewhat busy at the time, so most of what I have to go on are the photos that Sabrina the Fabulous Doula had taken.

And Labor and Delivery was done.  The postpartum period was beginning, and I was very shortly given the opportunity to nurse my very own child for the first time ever.  Stay tuned next week for some postpartum fun!