Pregnancy After a C-Section

Allow me to start by saying if you have the option of a scheduled C-section, be sure you research the risk factors, procedure, recovery, and subsequent pregnancies. If you have a "normal" pregnancy with zero to minimal complications, you will likely not need a C-section. We were presented the option based on my family medical history, current condition of my health and the size of my baby so we decided to have a scheduled C-section in October of 2011.  We made the best decision for the health of my baby and for myself and we have no regrets. It isn't the right choice for everyone but it was the right choice for us. ----

Well, I'm knocked up again! This is my second pregnancy after my C-section 20 months ago (You can read my birth story here and here). Last summer, my pregnancy sadly ended in a miscarriage. (You can read my story here.)

I am now 19 weeks along and it's going very well - except for the extreme nausea, cramping and pain. In the world of pregnancy, these are usually good signs of a healthy pregnancy. In the world of pregnancy after a C-section, these are all totally normal. Yaaaay?! When I chose to deliver my giant baby via Caesarian, I did hours of research. I neglected to research what would happen during subsequent pregnancies - I only looked at subsequent births.

Nausea is not new for me and I've been able to take prescription meds to keep it as controlled as possible. When it comes to the cramping and pain, I was surprised that it felt very similar to the recovery of my C-section. It feels like my incision is being stretched with my uterus - and that's exactly what is happening according to my doctor and the inter webs. Engaging my core and lifting 20+ pounds proves to be more difficult with each day. Standing or sitting for long periods of time makes me want to lay down on my back - but then laying down on my back makes me cramp like a severe menstrual cycle. The most comfortable thing to do is lay elevated on the couch and watch The West Wing on Netflix. Oh yeah, and I have a toddler.

Because my surgery was scheduled (at 40 weeks and 5 days), the doctors were able to take their time cutting horizontally along the "bikini line" and take their time stitching me back together. Some women with emergency C-sections or a vertical incision may not experience the same kind of discomfort because the weight isn't pulling down in one directional area. However, women with vertical incisions can sometimes acquire a "butt belly". Both incisions have their ups and downs (budum ching). Regardless of the incision, the recovery process sucks. Getting pregnant after a C-section is uncomfortable...and worth every moment.

So what are the options for pregnancies after a Caesarian? Knowing your limits, resting when possible, asking for help when its available, and lifting only when necessary. I have a medical belly brace to help with the weight distribution of my behbeh, but I personally don't feel much of a difference other than not being able to sit down. I can't babywear my toddler anymore so the stroller gets much more use now.  The many stairs in our townhouse require additional planning but its doable. Rest happens whenever my toddler naps. And a bonus tip from me: Stay as regular as possible when it comes to your stomach! Eat well and often - and be sure you "go" well and often. Constipation for an already stressed out stomach is awful.

On a semi-related note, a VBAC (Vaginal Birth After Caesarian) is a very real possibility for many women. Your doctor and midwife are the best people to speak with about the risks and benefits associated with the procedure. Personally, I'm going to try to have a VBAC if the baby is projected to be under 9lbs and if my blood pressure is better this time. If history repeats itself, we'll be doing another Caesarian.

So here's to 20 more weeks of a healthy growing baby and an expanding uterus!

A Rush of Love: My VBAC Birth Story

I love to read birth stories. I read online birth stories voraciously while I was pregnant, finding hope and strength in each woman's experience of bringing her child into the world. I read because I wanted to know what it was like to give birth vaginally.  My twins were born via c-section 5 years ago and I really wanted a VBAC (vaginal birth after cesarean) this time around.

I especially liked stories where the mom gave birth swiftly, serenely and without meds. Because that's the kind of birth I wanted.

This is not one of those birth stories.

But that's ok. I am proud to have it as my birth story.

Here it is: My 60 hour VBAC.

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I woke up on Monday morning, October 22nd, at 2am with a "different" contraction. Since I had been having strong Braxton Hicks contractions for weeks, I wondered if I would know the difference when real labor started. I did. The contraction hurt and the BH contractions were just "intense." I was so excited! I was 40 weeks 6 days pregnant and so ready for him to be here.

I got up and labored in the living room until sunrise. I walked around, swaying and breathing through the contractions. They came about every 5-7 minutes. I was sure that I would be holding my baby by that afternoon.

(Facebook updates in bold.) Oct 22nd. 8am: Silas decided that today will be his birthday! Will update when he is here!!

I called my doula and she came over around 10am. I was smiling and still so happy, laboring on the birth ball. My twins didn't have school that day (teacher service day), so we called a friend and had them go over and play for the day.

Aaron, Kate (my doula) and I spent the day laboring through the contractions. A hot bag of rice on my lower back became my best friend. We even took the rice bag on the two walks we took that day.  Kate would hold the rice bag on my back and Aaron would hold my hands. It was a beautiful fall day. (Aaron and Kate got a kick out of our neighbors and drivers rubberneck at me as I stopped and swayed through my contractions).

Oct 22nd. 2pm: 12 hours into labor. Still at home and working through contractions with my doula and Aaron. Doing well!

No baby by mid-afternoon, but I was sure that by dinnertime I would be holding my sweet Silas. My contractions were getting more intense as the day went on. I started using low "oh" noises as a labor technique. The contractions were getting anywhere from 3-5 min apart. My goal was to labor at home as long as possible and hopefully get to the hospital when I was 6cm or so, maybe even in transition.

Aaron was getting worried that I was going to squat and drop the baby at home so around 7pm we decided it was time to go to the hospital. Oy! Laboring in the car is a pain in the....butt? back? uterus? Not sure, but it sucked! Thankfully we are only about 10-15 min away but it was enough time for me to have 3 contractions on the way there.

We got to the room and the nurse wanted to check me. I absolutely hate internal exams and even wrote on my birth plan: "Wants minimum vaginal checks." I told her that she could check me as long as she was really gentle but I was sure that I was really far along. "After all," I told her, "I've been in labor since 2am this  morning."

"We'll see," she said. And checked. She was not gentle. And that wasn't even the worst part.

"It feels like you are about a 2, and 80% effaced."

I was in total and complete shock. Stunned. Horrified. How could this happen? How could I only be at a 2???? And I had had no further effacement since my doctor's appointment five days prior.

The nurse left (rather smugly, I thought) and I had my first emotional breakdown. How could I keep this up? It had been 18 hours already--could I even do this? I wanted the VBAC so badly!

We stayed at the hospital for another 4 hours, the contractions coming every 5 minutes. My doctor was on call that night and she checked me at 10:30.

"You're at a 3, 90% effaced. Do you want to go home? We could give you something to help you sleep."

After a few anguished glances at Aaron and Kate I decided that yes, I wanted to go home.

"Ok," my doctor said. "I'll write you a prescription for Ambian. Go home, take a hot bath and come back when your contractions are stronger and closer together."

So we left. Another car ride in labor.

Kate dropped me off at home and went to spend the night at a friend's house. Aaron went to get the prescription. My best friend, who was watching my boys for me, wished me luck and left too. Aaron called and said that the pharmacy was running really slowly and he wouldn't be home for about an hour and a half. I then realized that I didn't have any support at home.

I labored in a hot bath alone (had to fill it up twice). It was pretty awful. I prayed,  "Lord, give me strength, give me strength" through every contraction. I prayed Aaron would get home soon. Soon. Soon!

He finally got home around midnight and I took the Ambian (it was a tiny pill) and we laid down on the couch to sleep.

At 2:30am I woke up in crazy pain, convinced that Greek gods had come into my living room and were dictating the script for each contraction. For Athena's contraction, I had to labor like this! Dionysus  Do this! Note to self: do not take Ambian while in labor. It makes you a little cray-cray. The Greek gods left after about two hours but the rest of the night was kind of a blur to me.

Oct 23. 8am: Going on 30 hours of labor. Hospital sent me home because I was only at 3 at 10:30 last night. Please pray for strength and encouragement for me. Emtional stress is harder than pain right now.

Kate came back over around 8am and Aaron took the boys to school for the day. My contractions were sporadic through-out the morning, around 9-10 minutes apart. I was able to doze in between them on the couch for a few hours. We decided to go for another walk (more rubbernecking from car drivers) and then I got serious about re-hydrating  After that the contractions picked up to about 5-7 minutes apart. They were getting more intense but not getting closer together. I had a few crying jags throughout the day, but I finally got my head in gear. The 22nd may not have been his birthday but the 23rd was going to be!!!Kate had me do all kinds of positioning all afternoon on the 23rd. I did a hands and knees swaying pose (it was adorable. My huge ba-donk-a-donk swaying in the air as I rested on my elbows...) trying to get the baby to move into a better position. She try to manually move him over to the center of my belly because we thought he was posterior (sunny-side up). We tried manual manipulation. We tried ice on one side of my belly and a heat wrap on the other. He moved some, giving us hope but after 2-3 hours of positioning techniques and countless contractions, he seemed to settle right back into his previous position, on my right side, on his side/posterior.

It was 7pm again, 24 hours since we first went to the hospital. I was over this. I needed to know what was going on, even though the contractions were still 7 minutes apart. I texted my mom and said, "Going to the hospital again. Not coming home without the baby." Enter car ride 3 from hell.We had an awesome nurse this time with a great sense of humor. She checked me."You are 3cm, 90% effaced."Yep. Same as 24 hours ago.

My doctor was on call again that night. She came in and said, "You are in what we call "Dysfunctional Labor".

Me: "Ya think?!"

And that is when my birth plan went out the window. I had wanted a low intervention, med-free labor. I didn't want an epidural or have to be confined to the bed.

But in that moment, I didn't care. It wasn't just that I believed that "all that matters is a healthy baby!" That phrase annoyed me so much during my pregnancy. Yes, I did want a healthy baby (and his stats were awesome the whole labor!), but what I wanted mattered too! I DID want my ideal labor and birth experience.

But, I had given it a good try. I had labored over 40 hours without any type of intervention. And nothing was happening. So, we moved on to plan B, C, and D.

And that was ok.

Oct 23. 8pm: 42 hours of labor at home. Went to the hospital again and had not progressed in dilation in 24 hours. Doctor said I was in dysfunctional labor. Currently have epidural to let me sleep and pitocin to help me dilate.

Cue emotional breakdown 5 (6? 7?) while I got the epidural. Everything I was "losing" hit me in that moment, coupled with my phobia of needles. Thankfully Aaron and the nurse helped keep me from hyperventilating. With the epidural in, I started to relax. My doctor really wanted me to sleep. I was so keyed up that I couldn't really fall asleep, but I was able to doze. Doctor came in at 2am. I was at 4cm and she broke my water (another thing on my birth plan that I didn't want to happen, but hey...whatever!)Oct 24. 10am: Going on 54 hours. At 8. Epidural is helping me cope.We were now in day 3. I was only dilating about 1cm every two hours. It was slow going. And the epidural was starting to wear off. I requested two "boosters" of pain relief. Sweet bliss...but they didn't last for long: one hour for the first and about 30 minutes for the second. Pretty soon all my pain relief was gone and my contractions were moving into the pushing stage.In all those birth stories I read, this is when those birthing women said "things got intense."

Um...yes. "Intense" would be "a" word to use. A nice word. A word that doesn't really describe what it means to be in that stage of labor.

One of my greatest fears about labor was that I would feel out of control, whether that meant I felt like people were "doing things to me" or that I would feel like I couldn't handle the labor itself. (Yes, I know, I am a control freak).

I felt like I was flirting with that out-of-control crazy feeling. Not quite Greek gods crazy but just a little bit...out of control.

I alternative prayed silently "God, help me! Give me strength, give me strength!" in the 1-2 minute respite I had in between contractions or repeated out loud "I can do this. I can do this. Damn-it-I-can-do-this!"

The praying and swearing seemed to work pretty well.

I started pushing at hour 59. During that final hour, my husband, doula and two nurses kept telling me I was doing great. All I could think was, "Am I doing anything??? Is it ever going to end?? Oh, God, it has to end!!"

I slipped over into the out-of-control. I had my final emotional breakdown. But it was almost over. Through my tears and two gut-wrenching screams, when I thought I had no strength left, I pushed my baby into the world (and the nurse who told me to stop screaming? I kinda wanted to punch her in the face).

Oct 24. 1:52pm: Silas is here!!! Brit and baby are well. Thanks for all the prayers and encouragement. Silas came in at 8-3.

I said and felt so many things in those first moments. My first thought when I saw my son when the doctor held him up?

"He has a little butt!"Ok, let me explain this weird, first thought. My twins were so tiny when they were born (3 lbs 13 oz and 4 lbs 12 oz) and they were so skinny that they had no fat, no butt cheeks. They were so frail and weak.But Silas had cheeks.I got to hold him on my chest right after he was born. And in that moment, I realized that this is what I wanted out of my birth. Not the low-intervention, labor-in-the-tub, no-epidural, push-the-way-I-want-to-push, whatever. I wanted to feel that instant rush of love and connection that I missed when my twins were born via c-section and rushed away to the NICU without even a kiss from their terrified new mother.

But this time, the rush was there. Through tears and exclamations of "Precious baby! Happy Birthday! I am so freakin' glad that is over!" I fell in love with my son.

Oct. 24. 3pm: Got to have Silas skin to skin for an hour after he was born and he nursed wonderfully. Filled with love. However, I feel like I got hit by a semi....three times.

My labor didn't go the way I wanted it to. I didn't get my birth plan.

But I got my moment. My rush of love.

After 60 hours of labor, I got to meet my precious, wonderful son, Silas Edward Meng.