Monday, September 28, 2009

Aftermath (Fig's birth, part 4)

See Part 1 Part 2 and Part 3

After Will was born, everything was a blur.

He was crying but he wasn’t a good color—more purple than pink. They let him stay on me for a few minutes, and then they took him over to the baby warmer to pink him up.

I had requested that the cord not be clamped until it stopped pulsating, but I honestly have no idea if they honored this request or not. After Will came out, they pressed on my stomach a lot, and it was nearly as painful as transition. My doula coached me to breathe through this part just as I had during contractions.

Something felt very, very wrong. I could barely speak. I felt weak and sick. I felt like I’d been drugged, which was cruelly ironic, because I had refused pain medication during labor specifically to avoid feeling this way.

Someone mentioned again how much I had been throwing up throughout labor and Dr. T said something like, “Oh yes, the antibiotics she had for the GBS cause nausea and vomiting.” I wanted to throw something at her. They gave me another bag of fluids and electrolytes to try to replenish the last 10+ hours of vomiting.

Rob called both of our parents, but I don’t think I talked to them; I don’t think I could. I had been so terrified of what might happen during the labor that I hadn’t wanted to tell them anything. I didn’t want them to be celebrating what I thought might end up a mangled mess. But beyond that, I’d had this overwhelming, primal mammalian desire to burrow in a dark hole and give birth unscrutinized.

At some point the young nurse told me that Dr. T recommended giving me pitocin now to slow down the bleeding. Pitocin? Are you @#$%^&* kidding me? is what I wanted to say, but couldn’t. Besides, wasn’t nursing the baby supposed to reduce hemorrhaging? Where was the baby anyway? Was it that thing over there crying? Why wasn’t I nursing it? My doula was there and she told me she thought it would be a good idea to consent to the pitocin. Maybe I was bleeding a lot or something, I don’t know. But if my doula thought it was okay, then that was all I needed to hear. It was just so ironic to accept piticon now, since I’d fought tooth and nail throughout the whole labor to avoid it. Somehow, I just didn’t care anymore.

They did bring the baby back to me to nurse at some point. I was laying down, unable to move, and when he latched on, it hurt terribly. Like burning sandpaper. I didn’t care. The nurses said that his latch looked good, that the pain was just something I would have to get used to. I let him suck and suck and suck.

They took blood from Will. Not just a heel prick, they took vials of it from his tiny arm because of the damn GBS. They had been so slow to start me on my IV of antibiotics that even though I’d been in the hospital almost 12 hours before he was born, they didn’t have time to give me the second dose. So it was protocol to take blood from him to see if he’d gotten any infection (which he had not). He didn’t cry when they took the blood. He only cried when they bathed him, scrubbing off the vernix and blood.

By now, Rob had been up with me for over 24 hours, and he had collapsed into a sleep next to me in a horrifically uncomfortable looking cot. I had to pee really bad, but I still couldn’t move. The young nurse was there, and she helped me out of bed. The next thing I knew I was on the bathroom floor and she was waving an alcohol swab under my nose to wake me up.

It turned out my blood pressure had spiked at the end of labor. I heard them talking about “pre-eclampsia” and “pregnancy induced hypertension” and I kept trying to tell them I didn’t have those things. In my whole life, my blood pressure had probably never been higher than 90 over 60, and now here it was, 160 over 80. Was that why I felt so terrible?

They told me that sometimes pregnancy induced hypertension (PIH) could happen after the birth. That didn’t make any sense to me. Even in my stupor, I knew that the “cure” for PIH or pre-eclampsia was to get the baby out, so I still don’t know why this happened.

At some point it became morning. They moved us to a different room and Rob ordered us pancakes for breakfast. I’d had a few bites of Fig’s birthday cake at some point after delivery, but the last time I’d eaten anything substantial was on Monday afternoon. It was now Wednesday. In retrospect, I realize that that was a big part of why I felt so terrible. Once I ate the pancakes (and toast and fruit and juice), things started to feel a little bit more clear.

Both of our families came to visit us and some of our friends visited or called as well. Nurses came in every hour to check my blood pressure, which remained freakishly high, but nobody knew anything about the results from the tests they had done. With so much going on, it was hard to get any sleep. I was exhausted but I didn’t even want to sleep because that would mean I’d have to stop looking at Will. I couldn’t believe that he was really here, that I’d really given birth, and that I had managed to do it without drugs.

I still felt so terrible—incredibly weak and sore all over from giving birth. My stomach felt like I had done a thousand sit-ups. I’m not sure if it was from labor or from vomiting for nearly 10 hours straight. Most infuriating to me was that I was still nauseated. As if 9 months of hyperemesis gravidarum wasn’t enough. It hadn’t gone away yet. My sister and even Dr. T had warned me that it would take a few days before the hormones left my system, but still, I’d been hoping that I wouldn’t feel so sick after the baby was born. No such luck.

At some point, I realized was time to get serious about nursing the baby. With some food in me and a few minutes of rest here and there, I struggled to think past the haze that had seemed to surround me since the moment my water had broken. It hurt so badly to nurse him that I knew something was wrong, and I had nurse after nurse come in and help me. They brought in a breastfeeding DVD for us to watch, and I realized that he was latching on wrong—that all of the nurses were continuing to help me latch him on wrong—but I couldn’t figure out how to get him to latch on properly.

At first I tried not to freak out about it, even though I knew that a bad latch could ruin breastfeeding from the get-go. I tried to keep calm by assuring myself that it would work out—this was, afterall, why I had been so hell bent on having an unmedicated, natural childbirth. Drugs and interventions used during labor can make breastfeeding really difficult, and that was the main reason why I had wanted to avoid all that.

Different nurses told us different things about how to feed him, how often to feed him, etc. When he was 24 hours old, they weighed him and I think they said he had lost 6% of his birth weight. Completely within the range of normal. But the nurse on duty then warned me that if he lost any more weight, the doctors on staff would tell me I had to feed him formula. She knew how dead-set against that I was, so she tried to help me avoid it. From then on, I fed him every 2 hours for 10 minutes on each side. It hurt like hell. One of the nurses suggested that I pump and we give him the pumped colostrum from a medicine dropper. So I pumped and pumped but nothing came out, and it hurt almost as bad as nursing him.

The baby was crying all the time. I still felt so terrible that I could barely even stand up, and Rob had to do everything. I couldn’t even get out of bed to change him. I started wearing down, fast. I cried every time I nursed the baby, and I cried in between nursing him because it still hurt so bad. I wasn’t sleeping at all. I hadn’t slept since Monday night and it became Thursday, then Friday.

I completely broke down about 3am on Friday—the morning of my 30th birthday. In addition to the lingering pain of giving birth, there was the unrelenting nausea and the burning, throbbing pain from nursing a baby with a bad latch and powerful suck. The night nurse, who was trying to be so helpful to me, asked if I wanted her to take the baby to the nursery so that I could sleep and she would give him “supplement” at his next feeding. I wouldn’t let her take him away. I hadn’t gone through an excruciating 23 hour labor with no drugs only to give up on breastfeeding because it hurt too bad.

At his weight check, Will was down 8% from his birth weight. Pretty low, but still within the range of normal. The nurse told me that the pediatrician would recommend giving him formula. She said that as a nurse, she had to tell me to follow doctors orders. But as a mother, she wouldn’t do it.

When the pediatrician came in, he was the rudest, most pompous jackass I had ever met. If you’re in Champaign-Urbana, email me and I’ll tell you who he is. He said I needed to give my baby formula because I was being discharged from the hospital on a Friday and would not be taking Will to the doctor until Monday. They didn’t want him to lose any more weight over the weekend. So because of the day of the week I gave birth, they were mandating that I give him formula. He told me that “the girls” (presumably the nurses?) would be in to show me what to do. He said there was very little chance that I would get into see the lactation consultant today because she was booked with other patients. At any rate, he assured us that she would say the same thing—that we should give him formula. I told him that if my baby’s weight loss was so severe that he needed formula, then this was an emergency and I needed to get in to see the lactation consultant right away. He rolled his eyes. I said fine, if I can’t get in to see the her, I will go to the free Carle Breastfeeding Clinic. He rolled his eyes again. Some women find that helpful, but they aren’t really going to show you how to breastfeed. They just use dolls.” Bullshit. I asked him if he had checked Will for tongue-tie—a fairly common condition that prevents babies from latching properly. He rolled his eyes again and told me that tongue-tie is rare and doesn’t cause problems latching. Bullshit. Seriously, if you live in the area, I will let you know who this jackass is so that you never ever ever take your children to see him.

After he left, I was a sobbing, hysterical, puddle on the floor. The nurse on duty tried to pull me back together by telling me kindly, “Honey, you don’t have to give your baby formula.” Thanks to her kindness and dedication, she got us an appointment with the lactation consultant for 1pm in the afternoon. It took forever to get discharged from the hospital, and during that time I couldn’t feed him because we were taking care of details and paperwork. We finally got out of the hospital and flew across town to our appointment. Will was screaming at the top of his lungs. It had been at least 4 hours since I’d been able to feed him, and nothing could calm him down. We sat in the waiting room with a bunch of sick people and our purple-faced-screaming, starving baby. I realized that this was the worst moment of my life. I asked the nurse at the reception if I could please go ahead and feed him even a little, but she told us we really needed to wait for the lactation consultant to work with us.

Finally, the lactation consultant saw us. She was amazing. She put him on me the right way and despite the fact that I was completely raw, it didn’t hurt at all. She said breastfeeding wasn't supposed to hurt and that anybody who told you otherwise was wrong. I was so overjoyed I couldn’t believe it. My milk was starting to come in, so he finally had more than just a few precious drops of colostrum to swallow. He sucked ravenously. They weighed him before and after the feeding and he gained 3 ounces. Contrary to what the pediatrician had assured me, the lactation consultant never once said I would have to give him formula.

We left to go home. Everything was in disarray—exactly as we had left it. My parents came and my mom stayed with us for a few days. Thank god for that, I don’t think I would have made it otherwise. She cooked and cleaned and cleaned and cleaned. The house had never been so clean. I will never be able to tell her how much this meant to me. Suddenly after becoming a mother myself, I needed my own mother more than I ever had before.

Nursing never really went well. He latched on great in the lactation consultant’s office, but I couldn’t do it the same way by myself at home. As the weekend progressed, he latched worse and worse, and it hurt just as bad as it had in the hospital.

As if all of this weren’t enough, Rob got sick. I had been afraid something like this would happen. Rob was carrying so much on his shoulders because I had basically been a hysterical mess ever since my water had broken. He’d had to be the calm one, to constantly reassure me, to constantly tell me everything would be okay and to constantly remain positive. I had been so afraid that he would crack under all this stress. During those difficult days, my mom took care of all three of us. I don’t know how she did it, but I’m so glad she did.

Aftermath of the aftermath

We saw the lactation consultant at least once or twice every week after Will was born. I was still in a lot of pain and still had trouble getting him to latch properly on my own. The lactation consultant gave me a nipple shield to use while I was still healing. In retrospect, this was a double-edged sword. It allowed me to nurse him without pain, which was miraculous. But it prevented him from properly draining out the milk. This led to my having repeated bouts of plugged ducts. My god that hurt. Plus, milk production is a supply and demand issue. If the baby doesn’t drain the breast—especially at the beginning—your body thinks you don’t need to produce so much milk. You end up with a low milk supply and a hungry baby. This is what happened to me. I don’t think it is completely a result of the nipple shields, but they definitely contributed to it.

For a while everybody tried to be supportive and convince me that Will wasn’t hungry—that he had gas or needed to poo or was bored or simply that babies just cry. These things might have been true for some of his crying bouts, but he was my baby, and I knew those endless purple-faced screams meant he was hungry. One week he only gained around half the amount of weight he was supposed to, and during the feeding at that appointment, he only drank one ounce (based on his pre-and post-feeding weight). That's when the lactation consultant said I had a low milk supply.

Dealing with this has been the most difficult thing I have ever faced in my entire life. I plan on writing an entry about all of the efforts we’ve gone to to increase my milk supply and keep Will growing, and I hope to write it in retrospective, with a happy ending. At the moment I’m still going through it though, and I’m not sure yet how it turns out.

Thanks for reading.


Anonymous said...

you made me cry.... I'm always in your corner, only a phone call away!!!!! you will get thru these difficult days,,,,,,, being a mother is one of the toughest jobs and MOST REWARDING jobs you will EVER have!!!!!( no matter the age of your baby.. whether it is 1 week or 30!!!!! WILL is YOUR baby , and the MOTHER LION in you, will always be ready to ROAR!!!! you and rob are wonderful parents, and are doing a great job. just don't be sooo hard on yourself.......... luv you all, mama--

Tracy said...

wow! Thanks for sharing...I'm sure you will help many moms with this. Will be adding this link to my website. Keep are so good at it!

amypfan said...

I have said it before and I will say it again--you are Will's mommy, and you know what is best for him. I'm so proud of you for making it through all of this.

gutzville said...

Glad everyone got home happy and healthy and that Will is packing on the oz. We started the uphill climb on Monday, but look forward to the adventure. We'll have to have dinner sometime

Rixa said...

I've been reading through your Cloth Mother blog, your breastfeeding adventures, and finally your birth story. Thanks so much for writing this down! I am so sorry you had such problems nursing and with a colicky baby. Anyway your clothmother blog is on my google reader. I always love finding other academic mothers! (If I can call myself one if I have a PhD but am not currently teaching...)

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