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 III

We've all seen movies where the woman is laboring in the hospital bed, looking pathetic or screaming in pain.  When I was brought to the L&D room, I was pleased to find it exactly as I remembered from the walk-through our birth education class had done:  a well-designed bed with all sorts of configurable, Transformer-like parts to facilitate labor and delivery, a rocking chair, a comfy couch, a private bathroom with a Jacuzzi bathtub, and other little touches here and there that really made it seem more like a hotel with easily cleaned floors.  The lights were kept appreciably dimmed, particularly given that by now it was after 11pm.

My contractions (which almost completely ignored the standard durations and frequencies they lie about in prenatal education) relented slightly so that I felt brave enough to try a little food and drink.  I knew I had a ways to go to get to 10cm dilated before my beast of burden would be experiencing the New World, and I wanted to be sure I was sufficiently hydrated and calorically stable.  I downed a bottle of water and some small snack foods.

Now, they say that women don't remember the pain of labor or that they forget the experience afterward.  I felt that I had a very clear memory of the flow of events, though my ability to estimate duration was admittedly impaired due to more pressing matters occupying my everything.  When I initially set to writing down the story of my labor and delivery a matter of weeks after the fact, I had somehow forgotten entirely (until reminded) about this next development as my segue into the Jacuzzi bathtub.

For the first time in nearly 5 months, I vomited.  It was not expected.  It was not pretty.  It was ALL OVER my Hospital Gown of Impossible Modesty and the Transformer bed's sheets.  Well, I didn't like the gown anyway, and I wasn't keen on laboring in the bed either, so off came the hospital gown and, naked as the day I was born, I climbed into the tub to rinse off and continued to labor there a while.

By this point, I no longer cared who saw me naked, so long as they weren't taking pictures.  I was ginormously pregnant and in pain and trying to maintain focus on the task at hand.  Sabrina, the Fabulous Doula, had brought a small kit of battery-operated tea light candles, and we turned the lights down low in the bathroom.  She and my husband Andrew traded turns providing counter pressure on (i.e. pushing a fist hard against) my lower back while I writhed about in the water.  Sabrina occasionally had to escape to relieve her stomach of its contents (morning sickness knows no time/place boundaries), and Andrew often had to trade out because his knees dislike him and kneeling on the tile floor by the tub was not helping them to like him more.

They also tried as best as possible to obey my commands and to take them seriously--despite that I was undoubtedly difficult to interpret.  Sabrina was able to discern my gestures (mostly a lot of grunting, vague hand motions, and attempts to speak through gritted teeth) with considerably better accuracy than Andrew, who is most definitely not a multi-tasker, despite how appreciably calm he seemed to remain throughout the process.  Besides being made to kneel beside the tub and essentially maintain a fist pressed against my low back, my labor assistants were also tasked with two other annoying efforts.

One, the Jacuzzi tub had problems.  The tub had 2 jets on either side, which were both weak and irrationally placed, but still they were better on than off.  An unfortunate side effect of the jets was a perplexing inability for the tub to retain water.  Many various measures were attempted to keep as much as possible from draining; however, despite all valiant efforts, frequent refills were still required, which were made all the more obviously necessary by the horrendous cacophony of the jet intake when the level dropped too low.  This helped me, in a way, as a distractionary technique, despite being a somewhat aggravating development.  

The other major task I imposed on Sabrina and Andrew was to continually restart a musical pullstring teddy bear.  The entire time I was laboring at the hospital, this bear needed to be played for me to listen to the soothing sounds of Rock a Bye Baby.

Occasionally, I was forced to leave the tub and get checked for my "progress" on the bed.  Still I managed to get most of my monitoring done in the tub.  For those not in the know, during labor the hospital staff put these elastic bands around your belly with measuring instruments attached to them.  One is for measuring the baby's heart rate, and the other is for (mysteriously) tracking the mother's contractions.  During this eternal and hazy period of labor, I was grateful for the lack of a clock in sight.  All I could do to track time was to tolerate the occasional 15 minute bouts during which the staff insisted I don the elastic bands--and with only moderate petitioning, they let me use the waterproof ones (boxed region) so I could stay in the tub!

So, looking like some horrible science experiment, I writhed naked in the bubbling, cacophonous tub while wireless electronics were strapped to my insanely swollen midsection and teeth-grindingly painful contractions wracked my body.  Good times.  I once hinted at the idea that I might need painkillers after all, but Andrew quickly reminded me that I did not want them and sternly indicated that I should not ask again.  I didn't.  And I thank him for it, though I know if I were more insistent, he would have relented.

At 7cm I had still been lucid but my communication skills were rapidly diminishing again.  By 9 cm I could scarcely say "bear" to indicate that my focus needed restarting.  My nurse had a shift change, and a new crew came on.  These women flowed into my room and took up positions all around me.  Shana (remember my midwife?) had been hanging by the sidelines most of the time, often whispering inaudibly with the nursing staff (which I later learned was to show amazement at how I was laboring).  Now she informed me that I could no longer leave the bed.

Lying naked in a roomful of strangers would ordinarily be unnerving, but I had some scant coverings on my lower half, and anyway, I reasoned, these people see this sort of thing all the time.  I made up my mind that I did not care:  there were more important things imminent.

The time to start pushing had nearly arrived.