Saturday, April 9, 2011

15 Things I've Learned After Giving Birth 4 Times

I learned a few things each time I have given birth, usually the hard way. I thought I'd share them just in case anyone else could learn anything useful a bit easier than I did.

1. Every pregnancy is different and when it comes to gender, the differences don't mean squat.

2. No matter how many times you've been pregnant, it is always possible for you to experience something you hadn't before.

3. Every labor is different.

4. Just because your water hasn't broken, (at least as far as you know), doesn't mean it isn't time to push. When your water breaks doesn't necessarily mean anything in terms of the progression of your labor or how soon your baby will be born. With my second and third labors, my water broke around transition or 8/9 cm. My fourth didn't break until it was time to push and then no one could even tell as she was so low she was blocking all the water. Other women I've known have had their water break much earlier in labor.

5. If you aren't sure if you have to go to the bathroom or not, tell the nurse. Maybe you do or maybe that is not something you should be in the bathroom for at all. :)

6. False labor doesn't hurt. Prodromal or pre-labor hurts but is fairly easily manageable. Labor, which actually does something, requires focus, relaxation and prayer.

7. The uterus is a sphincter muscle. Like any other sphincter muscle (if you don't know which ones, you can fairly easily look them up but I'm sure you know at least two even if you didn't realize they were said muscles) the muscle is naturally tense and it is by flexing or pushing the muscle that it naturally relaxes. Now, I don't have x-ray vision, but in my experience, gently pushing to, in effect, relax the uterine muscle aids the muscle while it contracts. The two labors I intentionally focused on doing this were Felicity's, where I made it to the hospital at 9cm dilated having already wanted to push for a half hour, and Teresa's, where I went from 2cm to giving birth in just over 2 1/2 hours. I don't know what a doctor would say about this, but so far my experience is that it helps. So, during an unmedicated labor, it is best to relax every part of you including your uterus but, unlike the vast majority of muscles, it is relaxed by a gentle pushing down. (I actually am just applying a tip given to me by a doctor regarding how to make getting a pap test less uncomfortable.) The opposite movement, think along the lines of a Kegel exercise, would make the poor hard-working uterus work even harder. Kegels are great to do during pregnancy, but not during labor. (I did such a reaction while on 66 en route to the hospital and thought I might split in half.)

8. A good coach is worth his weight in gold.

9. The first week after giving birth, you are going to feel strange, awkward and uncomfortable. It doesn't matter how many times you've done this. You're hormonal and you are adjusting almost as much as your baby is. Accept the fact that feeling strange, awkward and uncomfortable IS normal and will pass.

10. I have never experienced a c-section but I have given birth twice with an epidural and twice without any medical intervention. I definitely prefer giving birth without any medical intervention. First of all, having an epidural doesn't mean you might as well be lounging by the pool while the nurses and doctors do all the work. You may not feel the contractions (my epidurals worked such that I did not feel the contractions) but you might still feel significant pressure. With my second epidural I felt like my tailbone was going to break. You also cannot shift positions. When I had the epidurals, I felt pretty helpless and, indeed, even useless in the birth of my own child. If you have prepared to go without medication, and preparation definitely makes a big difference, I heartily recommend it. Epidurals can have advantages, but they are not free passes and do have a cost.

11. Consider carefully when you choose to go to a hospital. Hospitals and doctors are like ticking clocks. When you get there, they expect your labor to progress. If it doesn't, they want to intervene. And their intervention might move things along to their satisfaction or it might not. If it doesn't, what was a perfectly naturally progressing labor can easily start hearing whispers of a c-section simply due to time. With my first labor, I went to the hospital too early. I was 4cm, so they wouldn't send me home, but my labor stalled and it took me about 8 hours to progress 1 cm further, despite them breaking my water. I don't regret getting the epidural with my first labor as I was, quite literally, falling asleep between contractions I was so exhausted. My regret is getting to the hospital too early. Of course it is hard to judge your first labor, and I was so determined not to make the same mistake twice, I barely made it to the hospital in time for my second, but this is where a good coach can be very helpful in assisting in the decision on when to go to the hospital.

12. If you want a natural drug-free labor, prepare for one. You'd prepare to run a marathon or participate in an athletic event. Labor and birth are hard work and preparation for them makes a world of difference.  Personally I am a big fan of the Bradley Method but regardless what method you want to use, preparation and practice are immensely helpful.

13. When you go to the hospital, bring what will make you comfortable. Personally, I find those hospital beds pretty hard so I always bring two pillows from home to help make it more comfortable. I like to bring my own pajamas and slippers. I also ask to leave after 1 night, provided baby and I are doing well. My insurance covers 2 nights but I am always eager to get home to my husband, my children, and my own delightfully comfortable bed.

14. Before you go to the hospital, try to make sure you eat something. Hospitals don't like to let you eat anything just in case you wind up with a c-section but labor takes energy and since you can't naturally sleep through real labor, your energy has to come from somewhere. It will be less draining on you if you have eaten. Although I do recommend keeping it something simple on the more bland side. Reflux and indigestion are not preferable when in labor. Also, make sure you keep drinking water. Those strong contractions will force you to breath through your mouth and it will dry you out. Keep drinking water and stay hydrated. You have enough to concern yourself with without getting dehydrated or feeling parched. Fortunately, in my experience, hospitals are decent about letting you have water or ice chips.

15. Night nurses are usually not as good as day nurses, and I've had doctors confirm the same to me in their experience. They can often not coordinate their visits waking you and baby at all hours. They can be brash, hurried, and insensitive. My best experience with night nurses was Elizabeth's birth when 12 women arrived in labor during the night and kept all the night nurses simply too busy to bother me. I wish I had some great advice for dealing with night nurses but so far the best I've been able to do is to be friendly, try to get them to do what they are supposed to do all at one time, keep the door closed and the lights off, and then countdown until the morning shift brings in the day nurses.

If I think of any others I will add them. Does anyone have anything they would add?

I have no experience with c-sections, so I leave any and all advice on that area to women who have had them.

8 comments:

  1. I love it. SO true. My first two labors (which were dangerous because I had frank and transverse breech babies) started the second my water broke. I had no labor with Will, scheduled c-section. I voiced loudly to my doctors with him, if we were scheduling our first c-section it had better be at 38 weeks 0 days since my water broke 38 weeks 6 days with my first two. My OBs were happy to oblige after two emergencies in the middle of the night! I would add to #13 make sure your coach and/or husband (as I know all husbands can't be coaches) bring their own pillows. Someone's husband, and I won't name whose (MINE) has refused to bring his own 3 pregnancies in a row now forcing the unnamed mother who brought some for herself (ME!) to give her pillows up. (Jeff broke his neck at 18, so it is very important for him to have the correct support, and I have always willingly given mine up because I need his support in so many other ways after a c-section).

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  2. Kristen, good point. I admit by the time I'm in labor, my coach's/husband's comfort isn't my primary focus so the coach should have his/her own comfort bag packed. I would also add some sort of snack bar or something because coaches get hungry too and, while they are allowed to eat, they might not want to leave you to go get something to eat. Good point!

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  3. I'd second the advice about going too early. That happened with my first two. Of course, my water broke very early with both and the docs say go as soon as it does. But I got to the hospital and things did not progress and I ended with two c-sections. Of course, the first was complicated by the fact that she was breech and the second by the fact that I'd had a prior c-section. But still, I wish I'd waited to go despite the fact that my water had broken.

    Interesting that you had a doctor confirm that about night nurses. That matches my experience too. The nurses I've had most problems with have always been night nurses. I always love the day nurses. (I wonder why that is?)

    Re c-sections. The worst is that you pretty much have to stay the four nights and that there's not much you can do to keep the nurses out of your hair even if you've given birth before because you're on pain medication and they have to monitor your vitals.

    My first c-section was the hardest. After that it got much, much, much easier. With the first one I was afraid to move and everything hurt so much and seemed so overwhelming. After that I knew that just pushing through the pain and moving as much as I could as soon as I could was the best thing. And I really think it just hurts less on subsequent times.

    I'd suggest that staying hydrated after the surgery is a big, big thing you want to watch. Especially if you're breastfeeding. And don't let anyone try to tell you you can't nurse a baby after a c-section. I've successfully nursed 4. And no the pain medications in your system don't hurt a newborn. I drink lots and lots of juice and water. Every time a nurse comes in I make her bring me one of the really big cups full of water plus more juice. My second baby ended up dehydrated and in special care nursery on an IV because it took my milk too long to come in (also in part because of a hemorrhage; but my own hydration was critical to nursing success.)

    I've also learned that you need to be firm with the nurses and that you can tell them no sometimes or ask them to come back later. Also, this time the hospital didn't allow children under 12 except siblings to visit and I was kind of grateful not to have to entertain my nieces and nephews.

    One other specifically Catholic thing... did you know you can request Anointing of the Sick before giving birth? I've done it before my last two c-sections. There are special prayers for an expectant mother. It was such a huge comfort to me to have those sacramental graces when I was on the operating table.

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  4. Melanie, thank you so much for all the advice on c-sections. I never would have imagined anyone would say a c-section would mean anyone couldn't nurse. I wonder if hydration effects how quickly one's milk comes in?

    I've never asked for Anointing of the Sick before giving birth. I have had priests give me a blessing beforehand, but not the sacrament. I don't know if that says more about me or about the priests at my parish but it is a shame I haven't.

    Re: night nurses. The doctor I spoke with said that because the night shift pays more and, generally, the mothers in post-partum are not sick patients, there is a tendency to get nurses who are there for the money and relatively easy work (since the moms aren't generally sick patients) rather than love of the job. So unfortunately, there tend to be more night nurses who just want to do what they need to do without as much regard for the patient.

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  5. These days it's less common to have women told a c-section means they can't nurse; but I know that myth is out there. My mother-in-law didn't nurse any of her kids because she'd had c-sections with all of them. Also, when Sophie was in the Special Care Nursery there was a mom with a premie who was refusing to pump milk for her baby because she'd taken some codeine or something the day before and she couldn't be sure it was out of her system. (Mind you, all the doctors were trying to convince her to give the baby breastmilk.) And there I was with feet the size of cantaloupes hauling myself across the hospital to nurse Sophie as much as I could while I was on major pain killers after my surgery. I wanted to shake the woman for refusing her child the best possible nourishment.

    I think hydration definitely affects milk flow and I suspect being dehydrated will delay it coming in.

    I know the priests I've asked for anointing seemed a bit surprised to be asked but were eager to comply. I suspect that if I'd asked for a blessing they probably wouldn't have offered to give me anointing.

    That makes sense about the nurses. The day nurses also all seemed much younger and more in love with babies.

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  6. It never would have dawned on me anyone would think a c-section would make any difference when it comes to nursing. I've always been a bit on the naive side of things but I don't see why the baby coming out differently would make any difference to the milk supply. It is a shame such a falsity could mislead women, especially when they are just post-partum and extra emotional.

    Teresa's was the longest it ever took my milk to come in. Usually it is less than 36 hours but for her it took 48-72. By the time I got to the hospital I was parched, so I am very curious if dehydration played a part in the delay.

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  7. These are all spot on! I share your philosophy on natural birth; actually my first was in a hospital and my next two were homebirths. I can't say enough good things about homebirth. I know it's not for everyone, and I'm very blessed to have never had a breech presentation or any other complications. Being able to go to sleep in your own bed after giving birth is the most wonderful feeling, and a close second is being able to introduce your new family member to the other kids right away.

    I agree wholeheartedly on the value of a good coach. Having my husband and mother as active participants in my births has strengthened my relationships with them in a profound and permanent way.

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  8. great advice- and I just have to say- I LOVE your daughters' names

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