Labor, delivery, and postpartum recovery
Now that I am 6 (almost 7) weeks postpartum, I feel like I can accurately write about my experience. I have summed up my childbirth and postpartum experience here and will follow up with a few more related posts.
My pregnancy was fairly easy and low-risk until around 30 weeks when my OB discovered that I had a velamentous cord insertion. This means that the umbilical cord was attached to the edge of the placenta rather than the middle, making it more prone to rupture. I was put on weekly monitoring with a maternal and fetal medicine (MFM) specialist who would do an ultrasound to ensure that the baby was still receiving good blood flow from the cord.
By the 35-week mark, everything was good except for the fact that I began to experience a lot of swelling. I’m going to take a moment of vanity here and complain about what I know is a minor thing in the grand scheme of it all: pregnancy nose. I already have a huge honker, so to have my nose begin to expand so rapidly was awful. I frantically googled whether my nose would go back down to its original size. Thankfully, it did, and I saw results within the first week of giving birth. But at the end of my pregnancy, my face and nose had become very swollen and my skin was incredibly oily. I got a facial at 36 weeks pregnant, and the esthetician had to do so many extractions that she added a half hour to my session.
At the beginning of my 36th week, I went for my weekly MFM and OB appointments. For the first time, my blood pressure (BP) was high, around 145/85. They decided to have me rest and then re-take my BP, but it remained high. The OB asked me to come back at the end of the week so they could check it again, but it was higher when I returned. I was officially told that I had gestational hypertension, which explained my swelling. They decided to induce me at 37 weeks–the following Monday–to avoid development of pre-eclampsia.
Induction But Not Really
Since I knew that I would be giving birth in a few days, I spent that weekend making final preparations and relaxing. I finished (over)packing my hospital bags, got my hair and nails done, and ate all of the things. We had to get a rush order on some of our baby stuff, and I let my supervisor know that my maternity leave would be starting early.
The morning of December 16th, Billy and I showed up at my OBs office inside of the hospital. They wanted to do a quick assessment before sending me over to labor and delivery. My BP was still high–around 155/90–and the OB did a cervical check. That was when, to our surprise, we found out that I was 3 centimeters dilated. I had been dilated 1 cm throughout the pregnancy, so I knew that dilatation is not necessarily an indication of labor. But 3 centimeters was a good sign that induction may not take as long.
We were sent over to labor and delivery and got settled into the labor room by 11:30 am. I went through the check-in process with the nurse and she put an IV in which was awful because I have terrible veins. Thank goodness she got it in on the first try! I was asked different questions including about my birth plan. My plan was as follows:
- Don’t kill or maim me
- Don’t kill or maim my baby
- Try not to mess my junk up too badly
Some women have very precise birth plans and some don’t. It all depends on individual wants and needs. I didn’t feel the need to have a detailed plan for a few reasons, such as the fact that my OBs policies and procedures aligned with my wants (delayed cord clamping, golden hour, no routine episiotomy) and my husband is well aware of my desires in the case of different medical emergencies. I had also rotated among every OB in my practice, so I was happy to have whoever was on call deliver my baby. I’m lucky to have found doctors and a hospital system that were the perfect fit for me. But for women who need more support and information as well as an advocate for their health, a doula is an excellent option.
The nurse then asked me about pain management, and I expressed my desire to have an unmedicated birth. My reason for not wanting an epidural is that I am a control freak and the thought of not feeling my legs weirded me out. There is nothing wrong with an epidural, and logically, I knew it was fine. I’m just weird. But at the same time, I informed the nurse that I was not opposed to an epidural if the pain got too bad. She asked me what my pain would need to be on a scale of 1 to 10 for me to need an epidural. I told her 8. We decided that once my pain level hit a 6, we would re-visit the epidural conversation.
After all of the discussions about my birth plan and pain management, the nurse hooked me up to the external electronic fetal monitoring machine. The OB came in to discuss my induction and perform another cervical check. That was when she told me that I was 5 centimeters dilated and the nurse said I was having contractions about every 4 to 5 minutes. This was news to me because I couldn’t feel anything. So surprise! I had come in for an induction, but I was already in labor.
Around 12:30 pm, they started me on pitocin to get things moving along. If it were not for my high BP, we could have waited for my body to do what it was already doing naturally. But the risk of pre-eclampsia was still there, so the sooner the baby came out, the better off I would be. I had no issue with the decision to use pitocin, especially since I was there for an induction anyways.
Over the next few hours, I killed time by talking with my nurse and talking on the phone with my family. I would ask the nurse when my contractions were happening which she thought was pretty funny. They gradually increased to about 2 to 3 minutes apart. By 3:00 pm, the OB checked on me again, and I was 8 centimeters dilated and still not feeling any pain. She suggested that we break my water since I was doing fine, and I agreed. Breaking my water didn’t hurt at all, and the feeling of liquid gushing was odd. Billy said that he was shocked at how the water just kept coming and coming.
Up until this point, I had been getting up to empty my bladder about every 15 minutes. My childbirth instructor recommended going to the bathroom often during labor because an empty bladder helps the baby descend, and a full bladder can make contractions more painful. But once they broke my water, it was best for me to stay and labor in bed. The position that was most comfortable for me was on my side with a peanut ball between my legs and Billy massaging my lower back. By 3:30 pm, I was finally starting to feel contractions and my pain was at a 6. I told the nurse that I was still fine not having an epidural and used my breathing techniques to get through each contraction. It was all moving along very fast, and by 4:00 pm, I felt the need to push.
Pushing took just under an hour, and it went by pretty quickly. Having my playlist going definitely helped as a distraction, especially when that ring of fire hit. After guiding me through the first two contractions, my OB let me lead the way, letting them know when I felt a contraction starting and needed to push. I won’t lie, this hurt a lot, but it wasn’t a constant pain so it was bearable.
After one more big push, Booker Lee Houston was born to the tune of “Clout” by Offset and Cardi B playing on my phone. He was 5 lbs 9 oz and 18 inches of cute baby covered in vernix. I can’t describe the shock that I felt when I saw my baby laying on my chest. I was in disbelief that I had just given birth. I was focused on the baby and didn’t really notice the placenta coming out (that darn velamentous cord snapped right off) or the lidocaine injections used (a few stitches for a small, superficial labial tear). All pain seemed to disappear, and I was incredibly happy to have my baby in my arms.
I was admitted in the hospital for 3 nights, and those were the most difficult. My stitches stung a bit, and the postpartum bleeding was heavy. But overall, it wasn’t bad. I used ice pads for the first 12 hours, but then I ditched them because they were annoying more than anything. But the sitz bath that the hospital provided and the can of Dermoplast became my best friends. Even without perineal tearing, there was a lot of swelling and these two things gave some much needed relief.
When it was time to go home, I was still waddling like I did when I was pregnant. I wore a Mamastrut postpartum support belt which helped quite a bit. The next two weeks involved a lot of cramping and lounging around in my postpartum underwear (Always brand for the win). Breastfeeding was difficult during this time as we navigated latch issues, formula supplementation, nipple confusion, and pumping to build up my milk supply. Thankfully, Booker’s pediatrician has a lactation consultant available who helped me, and a friend kindly informed me about the wonders of nipple shields. I managed to be able to breastfeed, although I still pump and give the occasional bottle to help prepare for when I return to work. We still use formula sometimes, too. At the end of the day, fed is best.
At my 6-week check up this week, the OB cleared me, and I got a prescription for birth control (team one and done). She explained that since my milk supply is good that going back on the combo pill is fine. However, if I notice a drop in my supply, I need to make an appointment so we can explore other contraceptive options. After my appointment, the OB said they will see me next year for my pap, and that was it. After months of constant monitoring, it feels weird that I won’t see my doctor again for so long.
One of the most important parts of my postpartum care has been for my mental health. I found a great telehealth option that allows me to video chat with my therapist on a regular basis. I knew going into pregnancy that I would likely develop postpartum anxiety (PPA) because of the hormones plus my dealing with grief and loss plus the winter depression that hits me every season. I wanted to get ahead of the problem and scheduled a therapy appointment for two weeks after Booker was born. It has been a big help in keeping me grounded and giving me the tools I need to navigate anxiety and grief in the wake of new motherhood.
Lots of Changes
Now that the hard part is over (lol j/k), the rest of my maternity leave will be used for as much relaxation and family bonding as possible. I took 16 weeks of leave, which is absolutely a blessing here in the US where parental leave is abysmal. Childcare isn’t any better, especially here in DC where the average daycare will cost you around $2,000/month. So my wonderful husband, being the amazing man that he is, is now a stay-at-home dad for our son. Billy is pretty excited for this next chapter, and so am I.
During the first few weeks of parenthood, it quickly became apparent that having one car was going to be difficult, especially with my little Honda Civic. We decided to get a second car and went with a new-to-us 2014 Honda CR-V. I refuse to go the minivan route, and this smallish SUV is a good compromise between my little car and a big mom van. People actually have enough leg room to sit in the seat in front of the carseat (man those things take up space!) and the stroller doesn’t take up the entire trunk.
The other big change is that we are moving out of our apartment at the end of February. We still aren’t ready to commit and buy a house, but thanks to a friend, we found a beautiful rental just minutes away that actually has a driveway for two cars (a rare find in the DC metro area) and a yard for Booker to play in. I’m kind of sad to say goodbye to Booker’s nursery before he could even really use it, but I’ll have fun putting the new one together.
I’m writing two more health posts on this same topic: one with a list of pregnancy, postpartum, and baby care products that I found particularly helpful and another involving prenatal genetic testing. I plan to write a grief post as well that discusses grieving during a major life change. Baby-related topics aside, I’m excited to share some new career stuff, too.
Becoming a parent is weird, exciting, and scary all at once. I don’t know where my path will lead me, but I look forward to finding out.