Saturday, August 19, 2006

Let's Talk About C-sections- Therapy for All

I think I have mentioned, at least way back at the beginning, that insomnia is a big part of both the beginning and end of pregnancy for me. It's sort of how I knew I was pregnant before it was early enough to know. It's sort of part of the last six weeks for me as well. I have actually not been having too much of a problem with it since we have moved in. I have been taking Tylenol PM a lot. It's great for actually getting to sleep, avoiding bizarre dreams, and staying asleep, but it's tough to shake the next day. Last night, George and I were up late wasting away in front of cable that is left over from our friends who used to live here and I had no trouble falling asleep when we finally went to bed. So because I went down "undrugged," I have been wide awake this morning but also much of the night (needin' the Debbie Downer "wah waah" there again). I had a lot of dreams too, mostly revealing very clearly to me all of my anxieties about the coming changes. Anyway, it has all prompted me to write a little post about what I have been thinking about- you know to let all of you learn from my own experience.

Well, I guess the biggest thing is the C-section. The thing about C-sections, which everyone will tell you, is that doctors are far too eager to do them. In my case, it was truly an emergency the first time. I had gone into the hospital when my water broke. They gave me 13 hours to go into labor on my own. I never had any significant contractions and never dilated even a little, so they put me on pitocin. I was then on pitocin for 12 hours with very significant contractions, actually throwing up from the pain, and still never dilated. They did manage to get a heart monitor on Amabel, the single most painful and traumatic experience of my life (because, you see, I hadn't dilated)- and no, I am not forgetting that I nearly died in a head on collision where I broke several bones and had my forehead nearly gashed away. When Amabel's heart rate began to indicate that she was in distress and my water had broken 26 hours before, putting her also in danger of infection, there was nothing to do but get her out right away. I had been put on an epidural at the 22 hour mark and that had not helped me progress, but at least it made it easier to go ahead and do the surgery quickly. The only thing anyone has said in hindsight that may have helped is that they could've had me up and around instead of in a hospital bed hooked up to all kinds of monitors for that first 13 hours. But it seems that in the end the monitors as well as the C-section saved Amabel's life. I am confident that there are many cases where they are necessary and a wonderful providence, a gift God has given to our doctors to help save lives of many mothers and babies.

My doctor was the same with August. She had herself had a C-section the first time and then went on to deliver "normally" the next time. I felt like we were geared up together to keep me from having another C-section. She was somewhat skeptical as "failure to progress" is one of those things that she said is prone to happening again. I would also tend to think that for a doctor, failure to progress is really annoying- it messes up your day having to check on this patient again and again etc. A C-section is far more convenient for everyone involved because it makes the very unpredicatble birthing process both predictable and quick. I would never say that that was interfering with my doctor's doctoring abilities though. I went in two days before what would have been my scheduled induction date. I didn't schedule an induction because I actually preferred being cut open to going back on pitocin (or as I have come to think of it, the drug from hell- though I know it has also been great for a lot of people), so it was a scheduled C-section that she said I could back out of if I wanted to. But I didn't make it to that point because I went in one night after not feeling any movement from August all day. I knew I was being a little paranoid, but I really just wanted to hear that heartbeat and know everything was okay. Why do people think it is a good idea to share their horror stories of failed pregnancies with pregnant women? I don't know! Anyway, I heard that little heartbeat and felt much better. But they wouldn't let me go because I was having contractions four minutes apart. For weeks I had been having lots of contractions that seemed very regular that would even keep me up all night and then have them fizzle to nothing in the morning. This was exactly what happened in the hospital. They kept me there all night with contractions four minutes apart. In the morning, after ten hours, the contractions went away and I hadn't dilated at all. It was now just one day until when my surgery would have been scheduled. I was in the hospital. Someone was watching Amabel. My mom was on her way. I was exhausted. And it appeared that I was "failing to progress" all over again. The only thing was that my water hadn't broken, so I could've left. But we opted to go ahead and do the surgery. I sort of regretted it while still in the hospital. Had I just unnecessarily mangled my body? She said it should be no problem to have the four children we hope to have all by C-section. In fact, I hear often of one of the Kennedys who had nine.

It is hard because you make a decision, one that is "the point of no return" without really having all the information you need. I say that because the recovery for the first C-section is obviously going to be easier than recovery from a second one. But you only have your recovery experience with the first one to factor in. And carrying a baby after one C-section is infinitely more comfortable than carrying a baby after two C-sections, but you only have the second pregnancy to factor in. I can only judge now that I have had to recover from a second surgery and carry a third baby to term that the recovery for this third C-section is going to be pretty bad. Added to that, there is the problem of having to be in the hospital for a lot longer while leaving two kids who need to be cared for at home. My mother is always generous with her time and gives us all a week to help us out after we have a new baby. With a four day stay in the hospital, her time is almost up before I even get home with the baby. To give me maximum help when I get home, we are actually going to hire a babysitter to watch the kids while I am in the hospital and let my mom come later on. We have been looking forward to George's paid paternity leave from the bank for a while thinking that he will be a huge help. What a great benefit! Unfortunately, now he has another job and school will be starting, so it seems like there may not be a whole lot of "leave" to speak of.

All of this to say, I am pretty terrified of having another C-section. I am pretty terrified of how to care for three children while recovering from this third major surgerey (or otherwise). I am sharing this because I think some people are strangely comforted by other women having multiple C-sections. I think this may have a lot to do with with the big advocates of natural childbirth making us feel really judged for having them. Believe me, I understand that. I understand feeling very defensive about having them because people say such nasty things about having them, when you know that you just did what you thought was best for yourself and your baby- and that often times, as with Amabel, you didn't even have a choice. I just want to say to anyone who has had one, who may have the choice about having a second, be determined not to. If you have to have one, I am sure it will be fine, just as I am sure I will be fine and I was fine after having August. But do what you can to make carrying your third and fourth children etc. easier. And do what you can to make your recovery easier. I will be sure to let y'all know how the recovery goes. I anticipate a lot of pain just because I have a fair amount even now. It just seems unfortunate that some doctors (not mine) tend to be flippant about the idea of having multiple C-sections and consequently some women might tend to make a hasty or flippant decision themselves. On the other hand, sometimes it can't be helped and people need to quit making people feel like they have done wrong or even just worse to have had them.

That's my two cents- or actually much more than two cents. But I feel like I can say something on the matter because I have been there. People who have never found themselves in a situation where they fear for their child's life if they don't have a C-section really shouldn't have much to say on the matter. And maybe that includes doctors too. How can you encourage or recommend one that is not absolutely necessary, especially if you're a man and have no idea what you are asking your patient to endure? On the other hand, how can you condemn having one if you also have no idea what sort of labor or agony someone endured before having one?

This is a pretty emotionally charged subject matter for me. I have actually been pretty unkind to my children while writing this and need to go apologize. But I just hate that I have gotten the feeling from some people that I somehow gave the impression that C-sections are no big deal. They are a big deal. On the other hand, I really don't want to be one of those people that is anything but gracious to someone who has them. I am afterall, one of the ones who has them. I think birth is so mysterious. Even with all the medical advances we have, it is still such an uncontrollable experience. To try to control it with unnecessary procedures is not good. To insist (or even imply/ lean toward) that all surgical procedures are unecessary or due to lack of competance on the doctor's, mother's, or hospital's part is equally not good. And in the end, maybe all discussion on the matter should be done with careful consideration of the mother, the one who feels the weight and sensitivity of caring for the life of her child and her own health in the situation, as opposed to just batting around an idea think tank or debate style.

6 comments:

Anonymous said...

Okay, Abby, you must put me down on the helper list. Seriously, anything that I can do to help you.

I had a c-section with James and was really fearful that I would have to have one with Nathan. My OB actually told me that he was almost positive that I would have one. I remember sitting outside at Gulf and squalling about that one to anyone who would listen. But I was blessed to have him vbac. My main fear about the whole thing was the recovery that I would have to do -- along with mothering a 20 month old. So I really do empathize with you. So, put me on the "bring several meals list" and put me on the "come pick up the kids and take care of them for most of the day list", okay?

-annie

mj said...

First, I can't help as much as I might have been able to in months past, but I can bring a meal or two. I'll also suggest that you try to get some free help with the kids while you're in the hospital. There are plenty of people at church who would be happy to help.

I had a c-section with Calvin for the "failure to progress" reason plus, he was a big baby. I had several hours of labor before that decision was made. I had very successful VBACS with Nevin and Evangeline, and then an emergency C-section complete with general anasthaesia with Charis. I agree that the whole C-section experience is hard to understand if you haven't had one. I'll be praying for you to get all the rest you need during those extra days in the hospital and that you'll recover very quickly when you come home and have to care for two toddlers and a newborn.

the good, the bad & the ugly said...

Abby,
I am very thankful for c-sections. Although I have not experienced one first hand, I can think of many children and even mothers who may not have survived with out one. I don't know if I am in denial or just busy from moving into a new house and throwing birthday parties, etc., but I have not really thought through the stress of three kids. That would probably be a wise thing to do before Lydia Joy arrives. I keep thinking since the boys will be 6 and 4 that this baby will be an easier adjustment. Maybe I will just stick to that philosophy and stay in denial! Just for encouragement, my best friend had three c-sections and her last one seemed to be the easiest to recover from. She did really well and paced herself. I hope somehow you will find that to be true, too!

Abby said...

All of you, thank you. I never expected such encouraging comments. I appreciate your offers to help, your sympathies and success stories. Who knew so many people had similar experiences? Jennifer, as I recall, your story with Charris beats all though!! What a nightmare that was for you!

I have kind of spent the day still wrestling through this fear of surgery and recovery. Our babysitter is a friend of mine from highschool that the kids love, and my mom offered to pay for it, so don't feel too sorry for me about that- it's more the organizing it that causes my anxiety. I already feel pretty helpless, already not cooking a whole lot or feeling like I'm getting much done (but isn't moving just one of these things that takes forever no matter what?!!) so I feel worried that I will not be able to manage- especially when you girls with four kids of your own are offering to bring meals way across town to me!!! I can't imagine being able to do even most of what y'all do!!

As for you, Miss Good, you and I are just cut from different cloth. I don't have the sweetness in my whole body that you have in your pinkie finger! You are such the amazing lady! I don't think you are in denial; I doubt you will be overwhelmed. If the move or the birthday party didn't get ya, I can't imagine Lydia Joy will be anything but pure joy for you. I look forward to hearing about it too. The Eeyores of the world, like me, definitely need people like you to spur us on!

Hey Annie, did ya catch that I was blaming you for our free cable?! Really, we have always been nightowls, we're just watching more interesting programming at midnight these days :)

the good, the bad & the ugly said...

Abby,

You have no idea how wicked my heart really is! Referring to yourself as Eeyore made me laugh really loud out loud. I think I'm a Pooh, senseless and gullible just floating around. I am currently waiting on your big sis to stop by on her way to Nashville. I can't believe I'm actually going to see her today! I hope I can see you in the flesh, too, sometime soon...when we both get settled in our new homes and with our new additions. Take care!

Katherine said...

hey abby! i have to say, i went thru several hours of labor, the doctors did all they could and (i still have to laugh at this) my baby was still too big to come out, so they did an emergency c-section. however, they had to knock me out for reasons i will spare others. i have to say a scheduled c-section has to be less traumatic than the emergency ones (it HAS to be, else i am doomed), though i'm not sure your blog implies that. and afterwards, realizing my baby would not have come out except for modern medicine, i was immensely thankful for not having to go thru what women went thru hundreds of years ago (probably not even that long ago), and losing their life & the baby's. it is very reassuring to me when i hear people say they've had several c-sections, since, abby, my husband & i happen to want 4 kids too. and i would love a vbac with the next one, but i think i would rather avoid a traumatic situation more. unless they can magically weigh the child in the womb (which they definitely miscalculated by almost 2 lbs with lucas and are notorious for being off), i don't know that i have the confidence to know whether or not i can push out a 7 lb, 8 lb baby. lucas was 9 lbs 11 oz. i know there are kids much larger than him, but apparently my body was not built to push his size out!

and i read your next blog - don't worry about being too vulnerable (or maybe we're so much more alike than i even had guessed so i don't know the difference). i could identify with at least 3/4 of what you said and the rest was just different details of the experience.

and here's a thought - giving birth in different ways with different challenges is probably just another opportunity to see and know God, trust that He is good, and continue to be molded by Him. i most definitely am a different person not just in having lucas, but in the process of giving birth to him.

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