And So It Is

So... I meant to write this in the two months I was on maternity leave, but obviously that didn't happen. Motherhood has truly taught me a lesson in prioritizing. Still, I wanted to write my story down so that my good memories aren't lost through time, and so I can flush the bad memories out of my system. My birth experience was a very positive one, and I'm excited to share that story. My postpartum recovery, however, was very rough and emotional, but I think it's important to share on the off chance that someone comes across it and knows that they're not alone.

This isn't a very graphic post, but there is a bit of TMI and mentions of mental illness (depression & anxiety). I'm putting it all under a cut mainly due to length. For those of you who do chose to read this, I hope you find it useful or, at the very least, interesting. I've tried to include linked definitions of things that most people don't know about until they're actually pregnant or in a relationship with a pregnant person, as well as links to helpful blog posts about other moms' personal experiences. 

Birth Story

My due date was August 24, 2011, a Wednesday. Because my maternity leave was unpaid and I only had enough saved sick and vacation time to cover so many days, I tried to work as close to my son's birth as possible to ensure lots of time spent with him afterwards. My goal was to at least work though the week if my son wasn't born on his due date, but you know how best laid plans go. On that Monday I went into work, but I was miserable. Pregnancy is different for everyone, but I think it's pretty universal to be extremely physically uncomfortable in the last month. On top of that, this was August in Austin, where we were experiencing a record-breaking number of days with triple-digit temperatures. I got as much done as possible that day and told everyone they wouldn't see me again until my leave was up. 

Tuesday I started experiencing early labor signs. What you see in the movies was not at all my experience. I wasn't going about business as usual, had water break, then popped out a baby in a couple of hours all while screaming and freaking out. There are a lot of signs that labor is about to happen, and they can start weeks before actual delivery. By Wednesday I started feeling very mild contractions. I called my doula collective about them because I wasn't really sure if I was about to go into active labor or not since this was my first pregnancy.¹ Cary, the doula I spoke to, assured me I probably wasn't going into labor right then but that it would be soon; she asked me to keep her and the other doulas updated on my progress. I would touch base with them a few times via email in the following days while they offered gentle words of encouragement. 

All that week we had friends and family with birthdays, and they kept hoping that our son would be their birthday present. My mom's birthday was his due date, but Wednesday came and went with no signs of an impending baby. I continued to have mild, sporadic contractions throughout the week, and on Friday I had my first post-due-date doctor's visit. My obstetrician, Dr. Sebestyen, found that I was still 4cm dilated - as I had been at my doctor's appointment the week before - and 90% effaced. I gave her the OK to sweep my membranes in the hopes of moving this whole delivery thing along. It really painful but fortunately didn't take long. Dr. Sebestyen predicted that I would go into labor 48 hours. That night, my husband Justin also did some acupressure on me to help speed things along. 

At 10:00am on Sunday morning, August 28, my active labor started. I had contractions that were much more intense than the ones I'd been experiencing all week, and I felt silly for ever thinking I had been in labor before; there was such a noticeable difference. After timing them at 10-minute intervals for an hour, I texted Justin at work that he might want to think about coming home. When he arrived and I was still having regular contractions, we called my doula collective. De'Andrea was the on-call doula that day, and she guided me through what I could expect. I was comfortable with my contractions, which just felt like really intense menstrual cramps,² so I held off on asking her to come over to our house. I just continued to take it easy and focus on my breathing while Justin made sure I was hydrated and the heat pack on my lower back stayed warm.

Sometime in the mid-afternoon, my contractions were at the 5-1-1 mark: five minutes apart, lasting for more than a minute, for more than an hour. This was the sign to call my doctor's office. Lisa was the midwife on duty that day, and she told me that since this was my first pregnancy, delivery probably wouldn't happen until 10:00pm that night at the very earliest. I told her I wanted an intervention-free birth,³ and she said that if I went to the hospital now, they would be more likely to push for intervention to speed up my labor. If I wanted to go to the hospital then, she would support me 100%, but she recommended waiting until my contractions were 3 minutes apart for an hour. I decided to wait since my contractions weren't bothering me, and I was happy laboring at home. We did call De'Andrea the doula, though, and asked her to come over. I had been touch with my mom all day, too, and at this point we told her to come on in to town since she was facing about a 3-hour drive to get to Austin.

My contractions gradually got more intense, but the pain continued to be manageable. I was able to breath through the rough ones and walk around or do whatever during the milder ones. When the doula arrived, she and Justin inflated her birth ball, which was fantastic for laboring. We placed it behind a chair in our living room, and while going through a contraction I would grab onto Justin, who was sitting in the chair, while De'Andrea would massage my lower back. We played my push mix and ordered a pizza. It was all pretty relaxed. De'Andrea even talked about my going to sleep, but when she found out I had started the weekend dilated at 4cm, she realized this baby was coming soon. At one point, we even thought my water broke. Not long after that, Lisa the midwife called to check in. I told her we thought my water might have broke, and she told me that if that were the case, I could start expecting the contractions to get really intense and I might want to think about going to the hospital. I told her I would wait a bit longer since I still felt comfortable but that we'd call as soon as we were leaving. 

And then, yeah, the contractions started getting way more intense. I could no longer talk through them and had to really focus on my breathing. I also started feeling all this pressure in my pelvis and kept running to the bathroom. A couple of times I even labored while sitting backwards on the toilet because I was worried about having an accident. And that's when I decided it was time to get to the hospital. At around 10:00pm, just as we finished calling the midwife and were packing up, my mom arrived and followed our doula to the hospital. As Justin and I were on our way at the door, I had one final contraction holding onto him in the kitchen. That was the last time it would just be the two of us at home.

On the way to the hospital, which was about a 5-10 minute drive, Justin called his mom, who lives in town, while I was doing some pretty heavy breathing and swearing. My contractions were really starting to hurt, and I was feeling the need to bear down. When we arrived at the hospital's delivery wing, it was very calm and quiet. There was no one in the downstairs lobby and few people in the upstairs lobby. I was really concentrating on not having the baby in the elevator. In triage, Justin went to park the car and get our hospital bags, while I got changed, strapped to a fetal monitor, and had my salin lock inserted.  I remember it being really cold and lonely in the triage room, even though I was alone for probably alone all of 5 minutes. Right after Justin got back, I told the triage nurse that I really wanted to push. She asked, "Like push out a baby?" Uh, yes. So she went to get Lisa the midwife, who found me dilated at 9cm. I gave her the OK to break my water, which was still in tact, and I was quickly taken to my delivery room. My mom, mother-in-law, and grandmother-in-law all came to say hello and offer their support before going back to the waiting room, leaving me with Justin, De'Andrea, and Joy the delivery nurse.

I was transitioning from 9 to 10cm, and this was by far the most painful experience of my life. I've passed several kidney stones -  2 of which required ER visits - and my doctors and nurses have all told me that it's supposed to be as painful as childbirth. On a whole, I'd say that's accurate - I'd actually rate passing kidney stones as more painful from start to finish - but nothing is as painful as transitioning. This is the one part of the pregnancy where I would have taken drugs, but I don't mean an epidural. I'm talking morphine. Thankfully, I had an amazing support group. I labored on all fours on the hospital bed, moaning into the head support while latching onto Justin during each contraction. He was so positive and had nothing but encouraging words for me. Between contractions, De'Andrea kept me hydrated and reminded me, "Let that contraction go." This was the best thing for me to hear because if I had focused on the pain of the previous contraction, I wouldn't have been able to handle the next one. I would have just tensed up. ("Let that one go." is pretty good life advice in general.)

Finally, transition ended, and I was fully dilated. I switched to a squatting position in the bed and started pushing. Pushing was painful but not as much as transition and nothing I couldn't handle. But each time I pushed the muscle in my left thigh would cramp and that was driving me nuts. I would have a contraction, try to push, my leg would cramp, I'd get mad and swear, and we'd get no where. Everyone suggested different positions, but nothing worked or I was too worried about pain to try them. Nurse Joy finally laid down some tough love; she told me I had to just push through the pain and try laboring on my back, slightly sitting up, with my feet in stirrups. I had been fighting this but it turned out to be the perfect position for me, especially with the squat bar still attached for me to hold on to and with Justin and De'Andrew pushing against my feet with each contraction to mimic a squatting position. My leg stopped cramping, and with Justin's encouragement, I was able to really push. He kept asking me to give him one more push during each contraction - like when you're exercising, and you tell yourself to go just one more minute or do just a few more reps. He was also just so excited and joyful about seeing our son's head (it's amazing how many things that gross you out before labor become no big deal during).⁴ When Joy was able to see about a quarter-sized amount of his head, she went to get Lisa. De'Andrea had told me that when the baby started to get out of the birth canal, I would need to switch to gentle pushes so I could avoid a perineal tear. But my son and I were both too impatient, and Lisa got there just in time to catch Bixby as he slipped out.

Everyone says that as soon as your child is born, you forget about all you went through to bring him or her into this world, and it is so true. I had kept my eyes closed all during the pushing stage, so that when Bixby came out crying and I opened them, it was like waking from a dream. They immediately put Bixby on my stomach, where I started to breastfeed while they covered us with a blanket, and I was so unbelievably happy. I was so calm and elated holding him. In fact, I was so thrilled to have my little man out safe and sound that I was pretty oblivious to everything, including the huge tear I had from the final push. Later I would find out that I had hemorrhaged enough to have required a blood transfusion, partly due to the fact that the right sutures were not in my room (something Lisa the midwife was not happy about). While still in stirrups, I was being sown up, which took a long time. But I had Bixby to dote on, so I didn't notice. 

Once Lisa was done stitching me up, we went through the usual postpartum experience: Bixby was measured (weight: 7lbs, 5 oz; length: 19 ¾"), our families met him, Justin oversaw his first bath, we both rested a bit, and we moved to the room we'd call home for the next 2 days. Despite a lack of sleep, a high heart rate, and the repeated need for a saline infusion, I was overall feeling pretty good. Bixby was doing a good job of latching, we were seeing our first visitors, and I was managing to sneak in some naps between nurse checks. 

Then around 6:00 that evening it started to go downhill. Bixby was being really fussy, even though he'd just eaten and everything else seemed fine. Visitors held and rocked him, but after everyone left, I couldn't console him. He was only happy when he was nursing, and he'd cry inconsolably and almost in pain when he wasn't. I spent the entire night awake, trying everything to calm him and constantly nursing him. I was on the verge of a breakdown, when a nurse finally came in and declared that I wasn't producing milk. Bixby was starving. So she started us on the supplemental nursing system (SNS), which allows a mother to still nurse while getting formula to her baby. I talked to a lactation consultant later that day, but she seemed sure that there was a latching problem not a production one. Still, I would continue to use the SNS during our hospital stay, and I'd pump constantly in the hopes of upping my production. 

Things improved once we found a surefire way to feed Bixby, but I was still dealing with the effects of my hemorrhage. I had spells where I would get intense, fever-like chills due to exhaustion, and at one point I had to have an iron infusion which ended with my saline lock dislodging. All this on top of the usual postpartum one-two punch of taking care of a newborn (which is SO HARD) and recovering from a vaginal delivery. The latter makes you feel like an old man - you're in constant dull pain, you can't walk or sit or use the bathroom normally, and you're wearing really ridiculous underwear. It didn't help that Justin was starting to get that weird sickness that comes from being in a hospital for too long. Thankfully we had a wonderful nursing stuff and have great moms who all took really good care of us. 

Although it was nice to have a round-the-clock team to help with baby duty, Justin and I were both so grateful to finally go home. He had a week off, and my mom stayed with us for a few days. This really helped, but I was still struggling. The afternoon we got home, I was having chills so severe that I couldn't hold Bixby. That's when we introduced him to a bottle. I was heart-broken over this. I had prepared myself for the fact that my labor plan might have to change, but I didn't prepare myself for the idea that my child-rearing plans might do the same. ⁵ I already felt so guilty about not giving Bixby a diet of only breastmilk, and I was even more sullen about him possibly having nipple confusion. The hospital lactation consultant, our pediatrician, and our friends had all given tips on increasing milk supply, and I tried everything despite how exhausting it all was.⁶ But one thing Justin asked my midwife during the checkout process was if my hemorrhage had affected my milk supply, and she said that was very likely the case. In light of that, all my nursing and pumping and taking supplements felt fruitless. It didn't help that I couldn't find much information about nursing while recovering from anemia, nor that people just assumed I was breastfeeding full-time. And of course, all my hippy dippy parenting resources just talked about how breast is best. It made me feel like such a failure and a bad mom. ⁷

In hindsight, I know that I was also dealing with postpartum depression (PPD) and anxiety. Which shouldn't have been a surprise considering that, in hindsight, I know that I also had prenatal depression and anxiety. In the last month or so of pregnancy, I was having panic attacks and constant crying jags. This continued in the weeks following his birth. What pushed me to finally get help was when we took Bixby in for his 2-week check-up, and our peditrician asked me if I felt weepy all the time... since I very obviously spent that entire doctor's visit on the verge of tears for no reason. He suggested I visit my obstetrician's office. I made an appointment for that week, and it made such a difference. Lisa the midwife listened to all my troubles, gave me a prescription for Zoloft, and told me point-blank, "I give you permission to stop breastfeeding." At the same time, Justin reassured me that he was perfectly OK with us formula-feeding Bixby and that I shouldn't feel pressure to do anything else. It was like having a weight lifted. 

Around this time, we realized Bixby had colic, but being on anti-anxiety medication and not having to constantly stress about milk production made it so much easier to deal with. It also helped that Bixby was only colicky during the day and was a champ at sleeping through the night. Funny enough, about 4 weeks after his birth, my milk finally came in. It still wasn't enough to feed Bixby exclusively, but at that point, I was over the many steps and supplies it takes to increase production. I breastfed when I could, and we formula-fed the rest of the time. 

Then Bixby turned 2 months old, which was a big turning point for me. I went back to work, and I felt a lot better not being tied to the house and not wearing pajamas everyday. Bixby's colic subsided, and he started being able to go longer between feedings. I was getting more sleep. Bixby was exploring his world and developing his personality. 

Bixby's now 6 months old. Things are still rough sometimes - right now all 3 of us are getting over respiratory illnesses, Bixby's teething, and I'm always working to keep my general anxiety in check - but the hardships of the first few months seem so far away. We all sleep pretty well, we've got our routines, going out with Bixby isn't a big production. I think Justin and I have both become better and stronger people who are almost obsessively in love with our son. The little man himself is such a smiley, happy baby full of love and curiosity. It is a true joy to have him in our lives.

One Last Thing

It may seem like overkill, but one of the best things we - well, really Justin - did is create a Facebook fan page for Bixby. Not only is it a very convenient way to keep family and friends updated with photos and his development without spamming our News Feeds, but it has really given me a sense of community. So many of our mom friends have shared great advice, support, words of encouragement, and their own experiences. It's been such a reassurance throughout all my moments of doubt and worry, and is an example of the good technology can do to bring people together.

♥
Sarah

1 Here is a good explanation of what a doula is and does.

2 When not on hormonal birth control, my periods cause severe cramping and a host of other horrible symptoms, so I'm pretty pain tolerant when it comes to uterus stuff. 

3 The Business of Being Born pretty much explains all my reasons for wanting an intervention-free birth. And that's all I'm going to say about birthing choices.

4 Like poop.

5 I definitely know better now. 

6 Here is a great article about someone's own struggles with milk production, and how disheartening it can be. 

7 I now realize that this is just what society does - makes all moms feel bad for every single parenting decision they make. Yay!