Nearly a Year Ago

My babies will be ONE tomorrow.  I can’t hardly believe it.  I never thought I’d be the type of woman who would say that the year just flew by or grieve the passing of such a special year, but I guess I am.  I take my babies for granted every day . . . and yet, every day they are a miracle to me.  I can hardly believe that after several years of heartache and pain, that I have two one year old girls and one five year old daughter.  I am blessed.

So why do I feel so crappy?  My mother in law is worried because I look pregnant.  No, I don’t think she’s rude for saying that . . . she said what I had been thinking, so I have to take it that much more seriously.  Why does my lower abdomen still hurt to be touched?  Why do I not EVER want to have sex?  And the constant spotting and cramping – I’m so tired of it.

Tonight I began researching the side effects of the Mirena IUD.  I tried to schedule an appointment with my OB/GYN, but he referred me to a GI person.  I’m going to cancel that appointment.  Perhaps I’m having GI trouble, but I really think it has something to do with the way Baby E was positioned, or the fact that my bladder was nicked during the cesarean, or a fibroid, or the reappearance of adenomyosis, or something.  I also suspect the Mirena.  It seems like there is an adjustment phase, an ok phase, and then a shit phase that continues to worsen.  I’m in the worsening shit phase, I’m sure.  So, I called and scheduled an appointment with my GP.  I’ll have her take it out and hopefully change my depression meds.  If that doesn’t work, Lord help me.

I have so much to be thankful for . . . why am I in so much mental and physical pain?

I am a winner?

I was shocked when I opened my e-mail today and discovered that my blog won an award!

Top Pregnancy and Childbirth Blog
Online Nursing Programs

Seriously, look at the impressive blogs that are on this list.  I am honored to be mentioned along side them.  This is the encouragement that someone like me needs every once in a while.  With everything that I have been through since that first cesarean (2004), especially since recurrent pregnancy loss struck me in 2007, I have struggled at times to stay connected to this vital community.  Or if all else fails . . . I can at least offer my own experience as example and encouragement for others who might see themselves on a similar path.  (If that’s the case, may God’s peace find you.)

I’m getting emotional . . . is it me or the glass of wine?

Cesarean Recovery, v.1

I am annoyed by my cesarean recovery.  I am more than 5 months post partum and still have pain and tenderness on the left side of my abdomen.  I’m sure I must have a number of adhesions that need to be broken down.  I did attend ICAN’s webinar about scar care and have been doing some massage.  I use a few drops of Young Living’s lavender oil – I recommend a therapeutic/medicinal grade essential oil – and massage it into my skin.  I have to massage all along the left side of the top layer of abdominal muscles (rectus abdominus), and it’s tender from pelvis to ribs.  Not good.

I am also annoyed that so many people are resigned to putting themselves, their babies, and their patients through this major abdominal surgery without a really really good reason.  Fetal distress, small pelvis, cephalo-pelvic disproportion, maternal demand, and previous cesarean are the usual suspects and are not necessarily indication for a cesarean.  <sigh>  I recovered easily enough from my first cesarean, but this time around it’s a different story.

I’ll end v.1 here.  To recap, I am not pleased with my recovery because I still have significant tenderness and pain more than 5 months after my surgery.  Does that sound like fun to you?

Positive Thoughts On the Cesarean Section

One of my ICAN friends posted this on Facebook today:

BirthCut Calling all C/S mothers! I am looking for positive cesarean birth stories! I am also looking for any tips about the actual surgery and/or recovery you may have for cesarean mothers. And, well, anything else you may have — art, videos, etc etc. Thanks!

Interesting thought.  Do I have anything positive to say about my cesareans?  Actually, I think I do:

DECEMBER 2004

I was exhausted from the flu – vomiting and pooping everywhere.  The illness forced my body into labor before we were ready.  Although I arrived at the hospital at 9cm dilated, my baby quickly got stuck.  I don’t know if I could have pushed her out.  I was so utterly exhausted.  I pushed with everything I had and it still wasn’t enough.  By the time I had the cesarean I was incredibly thankful for the “convenience” of modern medicine.

I did recover quickly physically.  I don’t recall feeling poorly for long.  And I still felt like superwoman . . . for a while, anyway.

AUGUST 2009

Pregnant with twins which meant that I was “risked out” of homebirth and birth center birth.  By 37 weeks both twins were breech.  When my Baby A broke her water in the middle of the night, I knew she did it with her feet.  I was so disappointed because the LAST THING I WANTED was to go through major abdominal surgery again.  I had learned so much about my body . . . I learned that my miscarriages were likely influenced by the presence of adenomyosis (caused by the first cesarean in 2004) . . . I knew that if I were to get pregnant again that a VBAC after 2 cesareans would be nearly impossible unless I wanted to try it alone . . . I know that these abdominal surgeries are risky in my line of work (I’m an opera singer).

I had considered bucking the system since breech is a variation of normal, depending on who you ask.  I thank God for guiding me elsewhere, because my precious Baby A would not have likely survived a vaginal birth.  She was entangled in her cord, and the cord was wrapped around her legs.  Both girls presented double footling breech.

Although I am still in pain 5 months later, and have yet another scar, and have yet another saggy somewhat sensation-less flap of skin above my scar, and have found my singing to be anything but stellar due to my weakened core, I am thankful that a cesarean was available to me.

I don’t recommend a cesarean unless it is really REALLY necessary . . . sad that probably half of the cesareans that are performed in the United States are likely not necessary.  A cesarean is considered a morbidity because of its seriousness – it’s a MAJOR abdominal surgery.  However, there are situations where a cesarean may be prudent or necessary.  When the technology is used appropriately, it is indeed a blessing.  To learn more about c-sections, visit Childbirth Connection and ICAN.

Cesarean Scar Care Webinar

I just attended the Cesarean Scar Care Webinar with Isa Herrera via the International Cesarean Awareness Network (ICAN).  What a terrific benefit for subscribers (it was free), a great introduction to ICAN for folks who aren’t subs, and a great cost ($15) for non subscribers.

Herrera is the author of Ending Female Pain and performs physical therapy in New York City.  I was excited to attend this webinar because 5 months post cesarean, I still have a LOT of pain and tenderness, especially on the left side.  I imagine this has a lot to do with E’s position in utero.  Herrera said that an uncomfortable lie can cause more adhesions, so obviously I have a lot of work to do to break up those adhesions and get to healing!

Herrera states:

“Women coming to me are often not getting the tools and advice they need . . .” to recover from cesareans.

Sad but not surprising.

Something I previously misunderstood:  according to Herrera the abdominal muscles (the recti) are not cut during surgery.  Instead, they are pushed to the side.

Something else I didn’t know:  during a cesarean 8 layers of fascia and connective tissue are cut.  From what I previously learned, it’s the damage to the fascia and connective tissues that compromise the uterus the most.

Something of which I am skeptical:  Herrera hypothesizes that regularizing and rehabilitating the scar tissue and adhesions may reduce the risk of uterine rupture in future pregnancies and labors.  The reason that I am skeptical is that from what I know about scar formation and healing, scar tissue NEVER approximates undamaged tissue.  Scar tissue organizes differently from undamaged tissue.  On the other hand, it is possible that with Body Talk or acupuncture or other healing modalities that damaged tissue can be restored.  And it’s not like my arm splits open every time I use it, and I have a large gnarly scar on it!

Herrera talked us through a number of exercises and stretches that should help break up adhesions and encourage healing.  The ones that I plan to start using immediately are “long strokes,” “longitudinal stretches,” and kegels while drawing in my abs.  I’ve also started using my Wii Fit and have found that the exercises there have woken up my core a bit.  I am also massaging lavender oil, purchased from Young Living because of the medicinal-grade quality, into the “damaged” areas.

For more information on cesarean scar care, purchase Herrera’s book.  Also, check out the websites http://www.apta.org and http://www.pelvicrehab.com.

Heads Up On Infant Mortality

A Notice from the International Center for Traditional Childbearing (ICTC)

ICTC is observing September’s Infant Mortality Awareness Month; JOIN ICTC IN THE “HEADS UP” ON INFANT MORTALITY AWARENESS CAMPAIGN” AND KNIT AND CROCHET HATS TO REFLECT THE INFANT MORTALITY RATE FOR VA, OR, FL, PA, CA, NM AND D.C.

Healthy Babies Are Everyone’s Business and I know that you care.

In 2008, over 27, 600 infant died before age one, most of the deaths were preventable. Monroe, president and founder of ICTC said, “factors that contribute to the higher rates of infant deaths include: premature births, low-birth weight, poverty, mis-education about proper food choices, poor pre-conception health, late prenatal care (beginning prenatal care late in the 2nd trimester,) less than 5 prenatal visits, high blood pressure (causing restricted blood flow to the placenta) and hypertension formally referred to as pre-eclampsia, SIDS, failure to thrive syndrome and accidents”.

booker1[In Montana, 70 babies die before the age of one.]

ICTC is asking every able body to join us in knitting or crocheting at least ten infant hats and sending them to the ICTC State Representative in your state by September 15th. The ICTC State Representatives are listed on WWW.ICTCMIDWIVES.ORG, or you can send them to the national at ICTC PO Box 11923, Portland, OR 97211.

The hats will be displayed at an infant mortality awareness rally in the week of September 26th. At the end of the public awareness project the hats will be given to infants as “Going Home” gifts when they leave the local NICU units. What a comforting gift to an ill baby and support to worried parents. By participating in the “Heads Up” Campaign, we can increase awareness about the causes of infant mortality and then create the solutions to reduce infant deaths.

The International Center for Traditional Childbearing (ICTC) is an international organization established in 1991, and head quartered in Portland, Oregon. It is an infant mortality prevention, breastfeeding promotion and midwife training organization. The mission is to increase the number black midwives, doulas, and healers, to empower families, in order to reduce maternal and infant mortality. ICTC educates on the causes of infant mortality and provides solutions through education, direct services and training midwives and Full Circle Doula Birth Companion Training.

This campaign is being co-sponsored by Birthing Hands of DC and other supporters.

To learn more visit http://www.ICTCMIDWIVES.ORG or call 503.460.9324

I didn’t actually find more info about this via the ICTC website.  However, Birthing Hands of DC has info on their site as well as links to easier patterns that you can knit and crochet, even a 10-minute preemie hat.

And I know that you have 10 minutes to make a hat for this wonderful cause!!!

Hospital VBAC: The Don’t Forget List

[NB: Most of what I’ve written below applies specifically to the hospital venue.]

We all know the books to read when preparing for a VBAC or the videos that will help us gain confidence in our ability to give birth vaginally.  We all know to pack our hospital bags, including our mental focus recordings, and bring a copy of our birth plans.  We all know that we need a doula with us, one who is experienced supporting VBACing women. 

Many of us even know that we need to talk powerfully about our upcoming VBACs.  “I’m trying for a VBAC” is not nearly strong enough.  Replace that with “I’m planning a VBAC.”  Did you birth the first time with “I’m gonna try to give birth vaginally” going through your brains?  Probably not.  I myself never doubted my ability to give birth naturally.

Anyway, I digress.  In addition to constructing a clear but concise birth plan, you need to also do the following:

  1. obtain a copy of the hospital’s VBAC consent form; review it and make changes as you see fit; give a copy to your care provider and bring a copy with you to the hospital
  2. obtain a copy of the hospital’s cesarean consent form; review it and make changes as you see fit; give a copy to your care provider and bring a copy with you to the hospital.  My hospital doesn’t have a cesarean consent form.  They have you sign their generic “invasive procedure” form which I find unacceptable.
  3. discuss the modifications you’ve made to the above forms with your care provider(s)
  4. especially if you’re NOT married, make sure your will is in order
  5. make sure you bring a medical power of attorney in case medical decisions need to be made and you are incapacitated

Bruce Flamm’s VBAC consent form appears everywhere on the internet.  I personally didn’t find it sufficient, but it is a place to start.  Here’s a great post - an actual cesarean consent form with some added commentary from the blogger.  I’ve taken this form and modified it so that (1) consent is not given for elective cesarean; (2) consent is withheld until the situation would arise for an emergent cesarean; (3) my husband is named as having power of attorney in the case of an emergency where I was unable to make my wishes known.  I also added some things that were missed on the form.

Please ask questions or offer your own suggestions!