1 Mother 2 Another

(This is part two of a four-part Friday series on c-sections; click here  for the first installment.)

When my daughter was discovered to be stubbornly breech, my OB talked through our options with us. Many doctors will automatically schedule a c-section for a breech baby; they worry about he head and neck being damaged during delivery; the chin can get hung up on your pelvis, the doctor can pull too hard . . . and brain damage results.

My doctor was willing to allow me to try a vaginal delivery if I went into labor naturally, provided the baby didn’t get too big and nothing seemed to be wrong with the situation. After much discussion and research, we decided to try it. My OB warned that she would have final veto power, and if I went into labor and anything even “smelled funny”, she’d whisk me into the operating room for a c-section. She also said she reserved the right to insist on a c-section if it got too close to my due date and I didn’t go into labor.

Baby girl didn’t turn, and I didn’t go into labor, and the c-section was scheduled. I was very nervous – not about the surgery itself, since I implicitly trusted my doctor and her track record. This just wasn’t how I’d envisioned the birth experience, and I didn’t want to spend my first important bonding weeks with my daughter on pain medication and distracted by the whole recovery process. I couldn’t find anyone who had had a c-section to tell me what to expect, how much it hurt, what “they” don’t tell you.

So in the event you need a c-section, here’s what to expect, how much it hurts, and what “they” don’t tell you. 

As a qualifier, please note that I had a scheduled c-section. That means that we had plenty of advance notice and the doctor was able to take her leisurely time making a pretty incision. If you have an emergency c-section, seconds are precious and you may have a different type of entry than I did. I had a small, horizontal incision right around my bikini line. Emergency c-sections may have a larger, vertical incision running down the middle of your stomach. This may take more time to recover from and have different ramifications for future pregnancies, so listen to your doctor over my anecdotal (though charming) information.

The night before baby girl was born I was asked not to eat at all; it’s the whole “anesthesia on an empty stomach” thing. I showed up at the hospital several hours before the surgery to take care of paperwork, pre-surgery monitoring, etc. I’d encourage you to try to schedule your surgery in the early part of the day, so you have a better chance of being on time and not being bumped for an emergency operation.

As far as what to bring, a ton of books cover that stuff, so I’ll only add a couple things. Bring a nursing pillow of some kind, like a boppy. It will make holding the baby for nursings much less painful on your new incision. Bring a couple pillows from home to make yourself (and your husband if he’s rooming in) much more comfortable. And as far as what to wear home from the hospital, choose your pants carefully. You’ll look about six months pregnant still, so you’ll need maternity pants. A lot of maternity pants these days are the low-slung ones, and this will put the most pressure at the exact spot of your incision. So choose a pair of comfy pants that come up high and loosely over your belly. Don’t wear a dress; it’s difficult access-wise for nursing and you’ll be stressed enough when you hear your newborn cry without adding the whole having-to-get-undressed-to-feed-her thing to the mix.

Once the paperwork was finished I was put on monitors and started with an IV drip. They fill you up with fluid; I can’t remember why but it’ll come back the next day as grossly swollen feet. And then comes Painful Moment Number One (there are three in all): a nurse will shave you for the surgery.

Without shaving cream.

Yep, it’s surprisingly painful. If you ever get a bikini wax regularly, I encourage you to talk it over with your OB in advance. I’m not sure how far ahead of time you need to schedule the wax; it may be 24-48 hours for possible infection reasons. But I’d STRONGLY encourage you to get the wax rather than the hacking-away-with-a-dry-Gillette job that I had done. They are not allowed to use shaving cream since it would create too close of a shave (!!!) and could encourage a nick or cut, which then might become infected, etc. etc. So there you go.

When you finally get to surgery time you’ll waddle your way into the operating room and hop up on the table yourself (or at least I did). My doctor permitted my husband to be in there with me; most places allow that as long as it’s not an emergency c-section. He’ll have to suit up in surgical blues and look a bit like a smurf, but you’ll be incredibly happy to have him there holding your hand. He gets to sit up by your head and say wonderful things to you. He can probably bring the still camera with him; the doctor will tell him when he can take a picture, and the anesthesiologist or some assistant may offer to take a few pictures for you. Video cameras are most likely out, though, for liability reasons.

The spinal block will numb you completely from the rib cage down. Don’t stress about the long needle going into your spine; they use a local anesthetic that’s sprayed on so it’s a little pinchy feeling but better than, say, a shot in your arm. Then you’ll lie down quickly before you go numb and fall over, and you’ll feel the numbness spread slowly down your body. It’s kinda cool. And don’t worry; the doctor will test you and make sure you’re numb before picking up the scalpel!

Your doctor will probably narrate the surgery while it’s happening; you can listen or not if it skeeves you out. It’s a pretty fast thing; your baby will most likely be out within 30 minutes of starting the process. You have a vertical surgery blue screen under your boobs so you can’t see what’s going on even if you lift your head, which is probably a good thing. But I was totally alert and talking the whole time; no grogginess or anything. I’d heard rumors that they tie your arms down, which they definitely did NOT do. I did have an IV in one hand, but that was it. I even kept my glasses on the whole time! My OB said I might feel a faint “tugging or pulling” during her removal, like someone was rummaging around. I didn’t feel that at all.

Once the baby is out the doctor will lift your newborn up to show you over the screen. It was so weird to me that she was there, and I felt exactly the same! My husband and I cried, and we took pictures.

If this had been a vaginal birth, at this point in the proceeding I would have had definite preferences. I wanted to hold her immediately and keep her in my arms for a few minutes before the doctor examined her. I wanted them to wait on the eye smear thing and give us some bonding time. Unfortunately, the rules are a bit different for a c-section.

For one thing, the pediatrician is hovering right there, ready to take the baby. She needs to examine your newborn right away to make sure he wasn’t distressed at all by the surgery. So don’t fight it, and say “thank you” for taking care of your child. After a brief examination they’ll happily hand the baby over to your husband to hold. Our doctor slipped the goop in Maddie’s eyes while we weren’t looking so we had no control over that, but Brian was holding her within probably five minutes of her birth.

You, unfortunately, won’t be holding her for a while. Have your husband bring her up to your cheek, shower her with kisses, nuzzle her and stroke her cheek. But know that you just can’t hold her right now. And it’s okay. You’ll have the rest of her life to do that.

After some time in the OR with you, the baby will be taken to the nursery. Your husband can stay with you or head on up with the baby. Don’t argue with them and fight to keep her with you; there are strict hospital rules, and you are in no condition to try to check up on her every few minutes in her bassinet.

Your doctor will take longer closing you up than he did getting the baby out, and when you look at the neat stitches later you will thank him. It will take maybe 45 minutes for the second half, and you’ll then head to recovery where the spinal will wear off and the morphine will kick in, hopefully overlapping each other. All I know is that the longer I spent in recovery, the foggier my brain got. Brian split his time between running up (different floor – genius design) to the nursery and videotaping her, and running down to me and showing me the video. I had family and friends visit in recovery and learned there how to use the self-administered morphine button. And don’t worry – you can’t overdose on it; the machine won’t let you administer a dose more than every 15 minutes or so, and they monitor how much medicine you’ve given yourself fairly frequently.

And let me say here – don’t be a hero. There’s no need to let the pain in just to see “how much you can take”. The good news is that it’s a morphine drip, so it will hit your system almost instantaneously. That means that you don’t have to keep administering it even if you’re not in pain, just to stay ahead of it. But don’t wait until it’s unbearable before pushing the button. No one’s keeping score. I tried to ride with a bit of – not pain, but awareness – because I didn’t like being so doped up I couldn’t talk. But I definitely was not in pain.

Unless you had complications during surgery, they’ll probably bring your baby to you and allow you to try and breastfeed. Don’t freak out if you don’t feel that instant bond looking at your child, or if your baby doesn’t take to nursing right away. First, you are stoned, and second, lots of infants don’t nurse like a pro first thing; it’s not just c-section babies. It doesn’t mean it won’t work soon. If you are too out of it to hold your baby, don’t be afraid to say so; no one wants you to drop your infant just to prove you love her. And again, you most likely won’t be allowed to keep the baby with you while you’re in recovery; they simply don’t have the staff to watch you and your baby both. So don’t argue if she needs to head back to the nursery. It’s not for long!

When you are deemed stable and there’s a room available, you’ll move to the recovery section, into your new home for the next couple of days. If you want the baby in the room with you, the only way it will be allowed is if you’re in a private room and your husband is staying with you. Realize that you are on a catheter and IV, heavily bandaged, and unable to stand up. You will not be able to change your baby, pick her up, go see what’s wrong, and so on. So you’ll only be allowed to have the baby room in if someone else is there. If you choose or need to have your baby in the nursery, make sure you make your feeding preferences clear so they don’t give her a bottle without your permission, and they bring her to you for nursing periodically.

Next week – we’ll talk about recovering from this thing.