Northern route vs. southern route

Given the choice of delivery method, I’d go with the stork every time. But limited to the more barbaric options of squeeze vs. scalpel, the lesser evil is less obvious. I didn’t have a choice, exactly, since my c-section was unplanned – nor do I have a basis for comparison since it was my first rodeo (although it more closely resembled a circus). I’ll do my best anyways to attempt to sort out the pros and cons of a c-section delivery and postpartum recovery.

Risks

Although C-sections are generally considered safe, they do carry additional risks compared with a vaginal birth. It is considered major surgery and requires an incision through the abdomen and uterus to deliver a baby when vaginal birth is considered too dangerous or difficult. The necessity in my case was documented as “failure to progress” because my jerkface cervix didn’t dilate past 7 cm and the baby was engaged in the pelvis (resulting in a disturbing cone-head) but essentially stuck there. Basically, a c-section carries the same risks of any surgery including severe bleeding, scarring, infections, reactions to anesthesia and longer-lasting pain, plus it can increase your chances of requiring a c-section for subsequent deliveries – should you be that kind of a masochist.

Recovery

C-section recovery is said to be longer and more difficult. I don’t know about the “more” part since I’ve never experienced a vaginal delivery, but I can firmly say that I wouldn’t describe my recovery as long or difficult. In fact, I keep saying that I feel like I got off easy. Within a couple hours of delivery I was back in my room and moving slowly but feeling pretty good. I had an extra night’s stay in the hospital along with a few added annoyances (a urinary catheter, continued IV fluids, compression cuffs on my legs, bi-hourly vitals checks).

Pain-wise, I’ve experienced worse. I’d say re-setting a broken bone trumps a c-section and both procedures come with a parting gift of far better narcotics (hello, Oxycodone) than you’d get with a vaginal delivery. That said, I never found I needed to take them every 4 hours as prescribed and after a few days I stopped taking them altogether and started hoarding the last 6 pills for a rainy day (jokes…sorta).

You can’t exercise for a full 6 weeks (not that you’d want to) but I’ve been quite active around the house and started going out for walks right away. Thanks to my trusty Fitbit, I know that since April 28 (3 days after delivery) I have walked no less than 5000 steps per day and have usually been clocking more like 7000-9000. I think that says something for how good I’ve felt. Right from the get-go my vitals have all been great and my incision has been healing perfectly – I barely even notice it’s there. Getting the staples out on day 4 was a cinch and the rest of the sutures will dissolve in 6 weeks.

Lastly, but certainly not leastly – I’d be remiss not to mention my unscathed nether regions. As my mom kept saying, “at least you can sit down!!” or, to put a finer point on it as my friend Bryan did, “hey, at least you didn’t blow out your vagina!!” There is definitely something to be said for this. Every day without tearing or stitches in your crotch is a good day in my books. And I haven’t had to deal with fear of that first post-baby poop or pain/stinging when peeing or bathing. With that, I can only assume it will also be easier to resume, shall we say, recreational activities, when I’m cleared for that.

Hassle 

For me, this would be the area where c-section loses some major points. For starters, you can’t drive for 6 weeks (!), nor can you lift anything heavier than your baby and you’re supposed to limit stair-climbing as much as possible. In other words, this would be a good time to have a chauffeur, maid and bungalow. Thanks to my parents living a block away from me, I have the first two pretty much covered since my mom walks over and drives me around for errands and appointments and has been picking up and dropping off my laundry (2 flights of stairs and a laundry basket would not be do-able for me).

Andrew helped me out by relocating all our shit to the main floor in the morning (bassinet, pump, pillows, diaper bag and a bag of personal stuff for me like my makeup, etc.) so that I can have everything on hand on one level of the house – and then trucking it all back upstairs for the night. Sure, it’s a bit of a fuck-around, but actually quite manageable once we got into the rhythm of it. Since we live close to where he works downtown he was also able to pop in at lunch sometimes to see if there was anything we needed. In this respect, I’m very lucky to have the support and resources that I do and I imagine most people would struggle more with the logistics of these post-operative recovery restrictions than I have.

The head games

I spent a while second-guessing the series of decisions that resulted in the c-section in the first place. Did I need to induce when I did? Did I need the epidural so early and did that stall my labour? Could I have tried harder? The size of the baby, the fact that she was cone-headed from trying so hard to get into the birth canal for so long and the impression my operating OB-GYN gave me afterwards all pointed to the fact that this particular baby was not keen on exiting through the gift shop, and the outcome probably would have been the same no matter what I did or didn’t do. But you wonder. It was a bummer that I was in such a daze immediately after she was born, but it is what it is. I did feel a little bit like I missed out on a part of the whole birthing experience (pushing is sort of key in the whole deal) but really it’s more that I traded one experience for another. Ultimately, there is no easy way to bring a baby into the world and we are very lucky that both she and I have had no complications or issues since leaving the operating room.

She’s perfect. And I’m getting there 😉

 

 

And then came baby

As a big believer in Murphy’s Law, I knew all along that I shouldn’t have bothered writing a birth plan. But it’s what you’re supposed to do, according to the prenatal classes…and with Andrew egging me on too, I finally caved and banged out a simple bullet list. But I put “plan” in quotation marks to make sure the powers that be (both physical and metaphysical) would know that I know how very little control I have over such divine acts of modern medicine and nature.

Nonetheless, by the time we had our baby girl in our arms, the “plan” had become a running joke around the L & D wards of not one, but two hospitals. It all started on a Saturday in a hospital not too far away…

Saturday, April 23

Since I was overdue with no signs of imminent labour, and a cervical sweep hadn’t moved any mountains (or babies) I was scheduled to start induction on this date. This was my choice – as my other option was to schedule an ultrasound to check if baby was thriving (or not) and wait for labour to start spontaneously, provided all was well on the ultrasound. My maternity clinic had no preference on which choice to make, and since they only let you go 10 days over anyways, I thought I may as well schedule induction and hope for labour to kick in naturally before then. I thought that, like her mom, baby might rise to meet a hard deadline.

She didn’t.

So I was 40 weeks and 6 days when I went to the hospital I was assigned to deliver at (FMC) to get a cervical ripening balloon (CRB) inserted around 4 pm. It actually involves the insertion of two saline-filled balloons into your cervix to start the dilation (widening) and effacement (thinning) process required to achieve the 10 cm necessary for vaginal delivery. The CRB insertion sounds kind of awful, but is actually no big deal. No pain; just weird to go home for the evening with two tubes hanging out of your body, taped to your inner thigh. Ideally, you will start having contractions and/or your water will break and/or the balloon will fall out (because the cervix dilates larger than the saline balloons and releases it). Failing all of the above, you phone in at 8 am the next morning to schedule a time to have the CRB removed and begin chemical induction (synthetic oxytocin).

That evening, we ate pizza and cupcakes and watched Netflix. I had some mild, period-type cramps and lower backache–but no real action.

Sunday, April 24

At 8 am we called FMC to report, well, nothing – and they told us to eat breakfast and come on in. By the time we got there, FMC had turned into a zoo of women in active labour. So, after a couple hours of uneventful fetal monitoring, they sent me home and said they expected to have room to accommodate me around 3pm and would call me then – if they didn’t, I was to call them.

At 4 pm they still hadn’t called, so I called them and was asked to come in at 5pm. When I got there they had suddenly gotten crazy busy again and once again couldn’t handle me. Their best suggestion was to call around and try to get me into another hospital (I asked if just getting the CRB out and going home was an option and they said no – it had to come out after 24 hours max and besides, they preferred to keep going with induction once they had started). Two other hospitals had no room for me either. Finally, SHC – a hospital clear across town – called and accepted me.

So I ended up at SHC around 7 pm (tranquil, sparkly new, freaking amazing facilities, a room service menu, 24 hour unlimited friends & family visitation). When they checked me there I was 4 cm and still unaware I was having contractions. Naturally, I assumed things were going to keeping going along swimmingly (ahahahahaha. No.)

When they broke my water there was meconium (baby’s first poop) in it, so they didn’t give me very long to labour on my own (maybe 2 hours? I dunno. Time ceased to exist) before starting the oxytocin drip which – I won’t lie – fucking sucked. My contractions, which noticeably kicked in when my water broke, went from manageable to out of control with barely any breaks, very quickly. I hadn’t wanted an epidural…and I tried the laughing gas…but shortly after midnight I got an epidural (courtesy of one Dr. Cheeseman – I can’t make this shit up) which favored my left side, resulting in a totally dead left leg (dead as in, it fell off the bed and somebody literally had to pick it up for me) and still some pain (like maybe 30%) on my right side. Go figure. Whatever – it was 100% heaven compared to no epidural.

Note: the physician group that works out of SHC always insists on an ultrasound before CRB and/or induction (as opposed to the physician group from my clinic who gave me the option of either booking induction or having the ultrasound and waiting out spontaneous labour,not doing both). So when I was transferred to SHC with no recent ultrasound, they were not happy about that and insisted on continuous fetal monitoring and starting an IV on me. Being all hooked up like that seriously hindered my mobility and ability to cope with the labour – I’ll stop short of saying that I know I could have done it au naturel without the oxytocin…but it certainly felt at the time like that was what broke me. And fast. Well…if 24 hours is fast.

They kept cranking up the oxytocin at what felt to me like insanely frequent intervals and I slooooowly got to 7 cm and that’s where I stalled.

Monday, April 25

At 9 am Monday morning I was at 7 cm and at 3 pm when I was still stuck there we were given the choice to max out the oxytocin drip and give it another 2 to 3 hours before going to a C-section. Or go for the c-section then and there. The OB GYN was comfortable with either course of action, although we both got the impression that she was leaning towards “let’s get this over with”. Se decided to go for it. I didn’t feel like another hour or two would help and I was exhausted. I felt like I’d been in labour for days…and I kind of had.

I wasn’t overly worried about the procedure, although the only thing I remember thinking over and over was “I just want her to be okay”. Luckily, the surgeon distracted me by asking if I had any musical requests and I asked for classic rock, as you do when you’re on fentanyl.

Sloane was born very quickly at 6:05 pm, weighing 8 lbs 2 oz and 19.5 inches. It’s all a blur and all I remember are various unidentifiable people saying that she was a girl after all (we knew this, but I was actually doubting it going into the OR), that she was peeing on me (ha!), and that she had hair. After that, I was so out of it (shaking, puking, super stoned from the fentanyl and epidural top-up) that Andrew had to do the skin to skin contact (literally took off his shirt) and she was given a bottle. But about an hour or two later we were back in our room (suite really, these hospital rooms are all private, huge, big bathroom with a shower and a little curtained off bedroom area for your partner to sleep in and you do labour, delivery and postpartum in the same room…it was so awesome, I keep accidentally calling it our “hotel room”…and everything was fine. Plus I had a fine selection of birth photos courtesy of a nurse who took my phone and documented it from the other side of the curtain.

Literally every single thing I had on my very simple birth plan did not happen the way I wanted it to. I didn’t want continuous fetal monitoring, I wanted to do early labour at home and remain mobile throughout my labour at the hospital, I wanted to be allowed to drink water and clear fluids, I didn’t want an epidural, I wanted to do skin-to-skin and breastfeed right away, I didn’t want to be induced with oxytocin and on and on…I still go back and forth between being fine with this and being unhappy/emotional about some of it. Knowing what I know now, I wish I had opted first for the ultrasound and gone from there so that even if everything else went exactly the same way it did, I would have at least had more information about Sloane’s status in utero and more options (like avoiding the continuous monitoring) at SHC.

Hindsight, right?

But at the end of the day, everything they say is true. Once the baby is there nothing else matters. Except maybe catheters…and IVs that fall out…and 7000 blood pressure checks…

And for the curious, this is the song that was playing when Sloane was born. She coulda done worse.