Friday 2 December 2011

My Caesarean Birth Story

I was feeling very anxious for an unknown reason in the run up to my EDD which was 4th August 2009.  I knew in my heart of hearts that I would not see that EDD, I was preparing for week 39. 
As it turned out, I gave birth via emergency caesarean section two weeks and one day early.  It was late on Sunday night and I had been asleep.  My mobile woke me. It was a phone call from my mother in law to say that my sister in law had given birth two hours previously to her first baby.  I remember hanging up the phone and smiling in the dark, delighted for the new parents and thinking how excited they must be feeling.  I was still smiling on my way to the bathroom and wondering should I go downstairs to inform Mister Husband that he was an uncle or wait till he came up to bed.  It was our seventh wedding anniversary and he was enjoying a drink, albeit solitary, downstairs.
 I didn’t get a chance to decide.  I finished my wee and immediately there was an audible “pop” followed by a steady release of fluid.  I was delighted with myself.  There go my waters I thought, fancy that.  What are the chances of two first cousins being born within hours of each other?  And two boys as well.  This is going to be great!  But hold on, surely I should be finished leaking at this stage.  I knew I was retaining a lot of water but this was ridiculous.  Then it stopped and I prepared to stand up.  It started again and this time I felt a large clot pass.  Straight away I knew this wasn’t right.   My waters hadn’t gone.  I was bleeding.  And heavily. 
I banged on the floor with my foot as hard as I could and heard Mister Husband run upstairs.  “Michelle and Ger have a baby boy,” I told him, “All’s well.  Don’t panic but I’m bleeding.”
“Shit, Gwen.  I’ve been drinking.”
I can still recall being as cool as a cucumber as I issued instructions for the phone.  I was going to ring my sister who would come down to stay with our sleeping sons and Mister Husband was to ring his father for a lift to the hospital.  As soon as my sister was on the way, I called the hospital and explained briefly what was happening to me.  I was told I could not wait the twenty minutes for my sister to arrive at our house and then travel another 40 minutes to the hospital.  I was haemorrhaging and needed to travel to the hospital via ambulance and Mister Husband could follow me.        
I grabbed my dressing gown, stuck three maternity pads in my pants, Mister Husband grabbed my hospital bag and within 10 minutes, the ambulance was outside our front door.  I could still feel the blood and knew from a previous haemorrhage that I could pass out.  I concentrated on my breathing as the lovely paramedic helped me into the ambulance, and took my details.  I could feel the beginnings of very mild cramps and despite the air of urgency, I was excited.  I was going to meet my baby!
We arrived at the hospital and I was put on a monitor straight away.  When Mister Husband arrived we asked our questions.  The bleeding wasn’t stopping and there was a strong possibility that I would give birth via caesarean section. It came as a shock as I had had two previous normal births and naturally enough, never entertained for a second that this would not be the case again.  My head was still dealing with all of this new information but I managed to convey that it was of the utmost importance, both to me and Mister Husband, that skin to skin contact should be immediate after delivery and breastfeeding should be initiated as soon as possible.  We were reassured that this would be the case in any event.  I couldn’t explain it, but I felt a strong need to repeat my wishes and stress that they be carried out.  In the event, of course, that I was going to be sectioned.  This still had not been clarified.   
After a short while, another doctor came in, removed the phone from the wall and informed theatre that they were to prepare for an emergency section. Mine. Then she looked at the nurse that had been taking care of me, and asked her for consent forms. 
This was really happening. 
I had to ask them to slow down.  Everything was moving so quickly and it all seemed to be taken out of my hands.  One minute I was being told that there was a possibility of a section and the next; I was shown the baby’s trace and told how he was not doing well.  There was talk of an epidural and how Mister Husband would be coming into theatre with me.   I believe less than hour had passed at this stage.
Obviously the severity of the situation dictated that a section was the only way to go and I signed the consent form, gave it a kiss, and handed it over.  At least, I thought, I would be awake and get to hold my baby immediately. 
On the way to theatre however, I was not looking forward to the inevitable sensation of a surgeons hands pulling and tugging my baby out of my belly and into the world.
Theatre is always a scary place.  It’s so sterile, shiny and bright.  And all those masked faces with smiley eyes.  The fact that you are lying on your back, in an extremely vulnerable position, does not help matters either.  Still though, me being me, I decided to help them and obligingly started to roll over, all the better for them to stab me in the back with their epidural needle.  I just wanted it over and to have my baby in my arms.
Suddenly the goal posts started to move again and this was before any drugs had been administered so it wasn’t blurry vision.
There was no need for me to roll over apparently as I was going to have a general anaesthetic.  My arm was being tightly secured in a tourniquet and the back of my hand smartly rapped as a voice without a body sternly informed me that my baby was in danger and had to be delivered immediately.  There was no time to administer an epidural and then wait up to twenty minutes to see if it would work.  Did I understand?  This was an emergency.  For the first time since I had been wheeled through the hospital doors, I heard the words “placenta abruption.”  It would be two days later before I heard them again, followed by two more, “medical catastrophe.”
What could I do?  Who was going to tell Mister Husband, who was waiting patiently outside the door, that he would not now be allowed into theatre?  I was nodding my head whilst clutching a gas mask as the same voice without a body was telling me to inhale deeply, that I would feel someone pressing on my throat, and just to relax.  Relax now. Relax.  Relaaaaaaxxxx…………….

“Gwen? Gwen?”
I opened my eyes five seconds later to see a tiny bundle dressed in white in Mister Husband’s arms.  Mister Husband was calling my name and handing our son to me for a kiss. 
I can remember smiling like an idiot, kissing both Mister Husband and the baby (our third boy!!!!) asking Mister Husband “how lucky are we?” and then closing my eyes again.
Oh, it was not five seconds later.  It was an hour and a half.  More on this later.
Shortly afterwards.
The next few recollections may not be in sequence.  I apologise.  Bear with me.
There is nothing worse than that “I’m going to throw up” feeling.  Except when you are on the flat of your back, unable to move, catheter in place and looking up at a stern faced nurse preparing a syringe.
I was starting to retch.  “I’m going to be sick.  Can you help me up?”  I asked.
“In a minute.” Stern Face continued with her syringe. 
I was visualising vomit on my face and in my hair.  “Can you help me up?  Please?”  I was starting to panic.
Again I was told, in a firmer tone of voice, “In a minute.”
I didn’t have a minute.  “Can you help me up, please?”  This time I was attempting to sit up myself.
“When I’m ready.”  Unbelievably Stern face was still playing with her needle.  But thankfully, she put it down to help me up. 
I learned the next day that Mister Husband had an incident with the same nurse.  Once our son was safely delivered, approximately ten minutes after I disappeared behind those theatre doors, Mister Husband was called in.    He was present all the while our baby was being checked over by a paediatrician who pronounced him hale and hearty.  He shook Mister Husbands hand and left the room.  Mister Husband was then told that I would be a further thirty minutes or so and he was asked to take a seat in the parenting room to wait.  Someone would be out to him shortly.  After an hour when people were coming and going, but nowhere near him, he decided to ask about me.  He met Stern Face who told him she didn’t know and had no way of contacting theatre, before continuing on her way.  At this stage he was beside himself. The thirty minutes had stretched into an hour and a half.  After another search for a nurse and some reassurance, he was finally told that I would be down in five minutes.  This is indeed what happened. 
Later on that same night, Stern Face put pressure on Mister Husband to have our son bottle fed.  He explained to her how important breastfeeding is to me and that I have previously fed two other children for 15 months each.  It was my wish that this baby be breastfed only and unless there was a medical emergency, this was to remain the case.  It was to be my decision and my decision only.   
Shortly afterwards again.
Trying to breastfeed.  If this sounds like I was out of it, it’s because I was.  Both of us were.  It’s like a dream to me that I managed to crawl, or maybe I was pulled, into a semi sitting position, to offer my breast to our son.  He half heartedly took it but it seemed, like me, all he wanted to do was sleep.
I wish I had been warned about the unbelievable tiredness that would come afterwards.

Shortly afterwards yet again.
Tea and toast time. Manna.  Absolute manna.
 Please sir?  Can I have some more?

Yet even later.
It was time to decide what to do.  The baby was still too sleepy to feed and I agreed for him to be cup fed in the nursery.  Those two nurses were fantastic.  They were understanding and supportive.  He took one ounce.  It was also time for Mister Husband to go home and tell the big brothers that their little brother had arrived.  We decided to call him Liam.

The Next Day
Monday was a wash out.  Immediately on waking up, I thought of my two boys at home and I began to cry.  I was missing them already.  There was a morphine drip in the back of my hand for my convenience which was a major contributing factor to the incredible tiredness I was feeling.  I even found it hard to talk.  I refused food.  I watched, completely redundant, as Mister Husband and the nurses changed Liam’s nappy and lifted him in and out of the cot in order for me to feed him.  He had to have another top up that day.   If I felt like crap, he must have felt worse.  I wish someone had told me that Diaphene and Ponstan were an alternative to morphine.  In my case, a much better alternative. 
My catheter was removed that afternoon and I was helped out of bed.  To say I felt like a ninety year old woman with severe arthritis, is an understatement.  The sexy white support stockings did nothing for my self esteem either.  I told myself I bore a striking resemblance to Nicole in Home and Away but had more than a sneaking suspicion I was more like poor old Colleen when she goes to Bingo!
I remember hobbling down the corridor clutching the arm of a nurse.  I walked from my ward to the next ward and had to turn around.  I was exhausted.  Never before had I wanted a hot shower as much as I did that evening, but I knew it wasn’t going to happen.  I just was not up to it.  Plus, it was time to get breastfeeding established.  I had to call the nurses when I wanted to feed Liam and although he still wasn’t very interested, I was delighted to discover that it was indeed possible to feed sitting up.  The fact that I still had a nice round belly helped.  I was able to prop him up on that and all the extra padding, protected my wound.
After the first day, things began to get clearer.  I was able to have my shower, but needed a chair to sit on for fear of becoming dizzy.  One nurse told me not to do this alone but another led me into the bathroom and showed me where the alarm was if I needed it.  I was left to my own devices after that.
Thankfully all my fears about breastfeeding post caesarean proved to be unfounded.  Liam was feeding well once we got down to business.  He was still sleepy but was actually feeding so I was happy and his nappies were an excellent indication that he was doing ok. And my milk came in at about the same time as it did on our second son, which was day three.     
What I was not prepared for nor advised about was the havoc a section would wreak on my innards.  Oh my god.  I didn’t have a bowel movement until day three and the night before I had to call the night nurse and plead for some kind of relief.  I knew what I was feeling was not “after pains” although I was experiencing these too.  I was full of wind, gaseous, my tummy was so distended it was rock hard and feeding Liam that night was extremely difficult.  It was like being pregnant with twins who were having a rave inside me.  My stomach rocked and rolled, popped and gurgled and hissed until I was given a peppermint capsule.  I was extremely sceptical as I swallowed it down but within ten minutes, I was releasing wind for Ireland.  The relief was extreme.
The scar itself was not a problem.  It was the maelstrom of emotions after the operation that took me by surprise.  Nobody tells you about this.  I hated the fact that other people had to look after my baby for the first couple of days until I was in a position to.  I felt completely redundant.  I was also ambushed by feelings of guilt over my other children being at home without their mother.  I felt bereft and when I spoke to Mister Husband and the boys briefly each morning, I was in floods of tears afterwards.  Tears because I missed them so much and although, I was the first thing they mentioned when they woke up, I was quickly forgotten as they went about their daily business.  There was also, a very, very brief, scary moment that maybe this was not my baby sleeping peacefully in his cot at my bedside.  After all, I was unconscious when he made his dramatic entrance into the world.  Too late, though, I had already bonded and no-one was going to take this child away from me, be he mine or someone else’s.  Mister Husband later reassured me that he was our flesh and blood.  If I needed further proof, I only had to read the many emails that were pouring in from family and friends proclaiming that he was the spit of our oldest child and announcing that Liam “has his Daddy’s head on him.”  Another thing that I had heard about, and indeed, experienced the second time I gave birth were the fabled after pains everyone talked about.  But these were different this time round.  Much, much different.  They were so sharp, so vicious they literally took my breath away.  It felt like there was a fist taking hold of my entrails, twisting hard and yanking downwards with great force, so much so that I was woken up at times with my fist stuffed in my mouth in an attempt to stifle a cry of pain. 
Because I had haemorrhaged at home and lost more blood as a result of the operation, I was severely anaemic.  A healthy haemoglobin count is 13. The day before I was discharged, I was 7.5.  I was given an iron transfusion and warned that it would take up to five days to “kick in” but almost 5 weeks again before I would feel the full benefit of it.  
In the days after being discharged from hospital, I parked myself on the couch in the front room out of sheer necessity.  It was truly an enforced maternity leave.  The after pains were still coming as brutally as before and I was slightly worried about my blood loss.  Breastfeeding can mean that blood loss is minimal but I had stopped bleeding on the day I left the hospital.  The PHN seemed to think I should be bleeding more and a doctor advised that unless I was bleeding heavily, there was nothing to worry about. But I wasn’t bleeding at all.  There was also a huge build up of pressure in my pelvis.  That, coupled with unbearable cramping at times, made me very fearful of an infection or another haemorrhage. 
I was so glad to be getting out of hospital, I had neglected to ask what I should be aware of in the event of an infection.  Typically of me, I thought of the questions to ask after the fact.  Again, too late when I was home, it occurred to me that I hadn’t received any after care advice either.  I’d had various people at different times visit my bed side with leaflets on contraception, sterilising bottles, post natal depression, pelvic floor exercises and a how-to register your baby pamphlet.  Bearing in mind that this was my third child, I considered myself to be fairly well versed in those matters already, but was pretty clueless in the caesarean section area.  Which is exactly why five days after discharge, I went back to the hospital presenting with the above symptoms.  Only to be told that they were all perfectly normal and to be expected.  At the same time, I was put on a preventative course of antibiotics.  Just to be on the safe side.  I also replenished my supply of pain killers and Arnica.
Your stomach is your fulcrum, your prop, your support and it is only when you have what is considered to be major abdominal surgery, you discover just how often you use your stomach muscles.  For everything.  Coughing.  Sneezing. Laughing.  Even brushing your hair.
There is a six week recovery period post section and during this time you are advised not to drive, to refrain from hoovering and carrying out any heavy housework duties, anything, in fact, that requires a pushing and shoving movement.  Carrying and lifting anything heavier than your baby is also very much advised against. What they don’t tell you, is how you’re supposed to carry on about your daily business without doing any of these things.  How do you ignore your toddler who has his arms outstretched for a hug, to be lifted and comforted after he has had a tumble?  What do you do when you’re down to your last drop of milk and cannot drive to the shops for more.  You can’t even walk there and back.
Mister Husband and I are blessed with very supportive families who rallied round in our time of need.  But I was still struck by how useless I felt.  There were days, especially in the first couple of weeks, where I was literally unable to get out of bed.  I suffered from sensory overload. I can recall one morning in particular.  I had overdone it the day before by having a family breakfast in town and then pushing the buggy around for a half an hour.  I was so exhausted the next morning, the sounds of our boys were like shards of glass piercing my brain. Mentally and physically over whelmed, I was reduced to tears. 
One of the little luxuries I was looking forward to after I gave birth, was being able to roll over in my sleep without having to get out of the bed to do so.  Three weeks after the section and I am no closer to this indulgence.  I may not have to leave my bed in order to change sides but I am still cuddling up to a pillow to take the pressure off my scar and I still have to be careful getting in and out of the bed. 
I realise I am only midway, at the very least, through the recovery process.  It is not going to happen overnight.  If some of what I’ve been reading of late is to be believed, the complete recovery time is a year at the most. I have read my fair share of pregnancy books and there is always a chapter concerning caesarean sections and a little piece at the beginning, imploring the reader not to skip.  And they are all the same.  They cover what it is like to have a section; the prep before theatre, what happens in theatre, tips for the mothers partner in theatre, tips for the mother in theatre, where to look, where not to look etc. etc.
I have yet to read a segment, any segment, on the recovery process.  Nobody mentions how in the early days the scar can become red and raised, often with a burning sensation at one end.   I never knew that numbness is very common.  That this can last for a year or more, indeed some women never regain full sensitivity.  Other women have complained of a breath taking pain in their shoulder.  This is deferred pain from the section and not the beginnings of a heart attack.  Another side effect is adhesions caused by scar tissue often needing more surgery to repair which in turn, can cause even more scar tissue.   There is also a one in one hundred chance that a section scar can rupture with a subsequent labour.   The difficulties of going to the bathroom are ongoing.  Haemorroids are a distressing pain in the proverbial.  But the hardest reality of a section, I am finding, is the knock it can have on your confidence to bear another child.  I am discovering that my family dynamic might have been changed forever.  At this very moment in time I am nervous, scared even, at the thought of becoming pregnant again.  I used to think that four or five children would be great.  Our family was going to be finished by the time I was forty.  But that has all changed now.  It’s something I’m not completely comfortable talking to Mister Husband about as he has already said that his family is not finished yet.  I can only hope that whatever decision we make will not have a detrimental effect on our relationship. For me, this last pregnancy was going to be a practice run for our fourth baby, one which I was hoping to have at home.  The fact that I had an abruption of the placenta could render me an unsuitable candidate for a home birth.
Certainly the odds are slightly raised that I could haemorrhage again.  All of these things, and more, have, at some stage, run through my head after the section and whereas I firmly believe that it is up to the individual to do their own research and have an arsenal of questions, at the same time, it would be so much nicer if a brief beforehand or immediately afterwards, was given.


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