Tuesday, November 22, 2011

Laboring medication free: part 2

I hadn't intended to write this in two parts, but as I started writing last time, I realized I had more to say about why, than a one-liner. Here's part 1. It's also given me a lot of time to think about whether I want to make this public or not. But, I realized that there is very little discussion about labor/deliver/recovery, and other soon-to-be moms might find this very useful. So here we are at the nitty-gritty.


After arriving at the hospital, I pulled out my birth-plan to give a copy to the nurse. It was a short list of my preferences, but it could have been summed up in two phrases:

1. I prefer no interventions unless medically necessary.
2. I want to nurse the baby as soon as safely possible.

I am definitely happy that we have made so many advances in medicine, and would never refuse intervention if there was any concern whatsoever for my health or the health of the baby. To me, it isn't worth risking my baby's life or mine for some notion that "I can do it on my own". That said, it is my personality to want to minimize the risk of adverse reactions.

I had already tested negative for group B strep, and wasn't high risk, so my OB was comfortable with me declining an IV unless it became necessary.

Labor, for me, was near-constant intensity. After weeks (months?) of wondering how it would be, and planning all sorts of different techniques to pass the time while the intensity built up, it all went out the window. Labor hit me like a truck. It seemed like one second I was sitting on the couch, the next, my contractions started and quickly escalated to severely painful. There was no gradual buildup, in length or intensity. They were, pretty constantly, about 90 second contractions with about 30 seconds in between for about 9 hours. I didn't have time to do much other just focus inward during each contraction. I didn't want any distractions, and could hardly respond when questions were asked. The 30 second intervals seemed to pass in a flash.

Scott was great because I would get very hot and start sweating during the contractions, and want the blanket off of me, then would cool down rapidly and have chills/shakes in between and want it back. I could barely respond to him, and so I think he thought I was upset, when I was really just focused on the process and didn't have the energy to devote to being polite (Thanks for being so understanding, Scott.).

Given the intensity, if I had had longer breaks between contractions, I might have seriously considered medication, but as it was there was no time.

All my plans for laboring on the ball, or pacing the halls, or all the fancy positions dried up. I did get in the warm shower (and would have stayed there much longer if they'd let me), but then it was all I could do to control myself, and spent most of my labor in different positions in the bed. If I could have drug myself out of bed, perhaps labor would have gone faster, but the thought wasn't a possibility at the time.

Finally, and you'll know when it really hits, I felt the undying urge to push, push, push! Similar to my first thoughts that I was in labor, I had experienced a couple times during labor where I thought I was ready to push. When it is really time, it isn't a thought, it's a need. I need to push. Now. Before that, however, it's probably best not to waste your energy or stress, and wait until the need overcomes you.

Everything was quickly put in place, ready for the baby. The doctor even said he expected the baby to be out in just a couple pushes. The pain of delivering a baby is so much different than labor. In a way it is more intense, but it is also much easier because you know the baby is going to be there any second (instead of the seemingly endless wait of labor). It really does feel like a ring of fire, but it's also a little numbing. My brain was strangely focused during the pushing/delivery stage.

So, I pushed. And the baby moved down. I pushed again, and her head was 1/3 out. I pushed again. And she didn't move. I pushed and pushed and pushed. For nearly an hour I pushed, and everyone (the doctor, my husband, the nurse, my dad) kept saying, "just one more", "she's so close", "push just a little harder". I pushed until I had nothing left to give. Push, push, push, fight, fight, fight. Then, she turned blue. Blue. Very blue. Scott's face lost it's color and the doctor said (as he started the process) that he was going to do an episiotomy. He then told me to push (as soon as the scalpel was out of the way), and pop! Baby girl slid out without any problems.

I was always nervous about routine episiotomies, and how everyone says they take longer to heal than natural tears (which they do), but man, in this case it made all the difference in the world. If I knew that it would have saved me an hour of pushing, a giant egg on my little girl's head, and nearly suffocating her, I would have asked for it from the get-go. That said, research shows that in most cases episiotomies may not make much of a difference.

I ended up with three natural tears that required stitches, in addition to the episiotomy, and a beautiful baby girl (with a big bump on her head). Also, I  felt great after delivery. Really great. Wonderful. I got up and showered (with a little help - but it was so, so nice to rinse off). Claire nursed right away, and although I was still learning how to breastfeed, she did a great job latching on (one BIG benefit of babies born closer to 40 weeks, rather than earlier is they have enough fat in their cheeks to facilitate good nursing).


I don't think a lot of people discuss recovery for the mom. Also, I am not a medical professional (not "that" kind of doctor), so please discuss everything with your health care provider first. These things were really great for my situation (vaginal birth with stitches) for promoting healing and limiting discomfort, but there are likely many other things (please share in the comments):

1. The hospital has something called "super cream" that you may be able request (a nurse offered it to me the last day in the hospital, and I wish someone would have mentioned it sooner). It's a salve that helps take away the pain/burning around the tears/stitches/labor-induced hemorrhoids, but is only used for a few days.
2. Ice diapers or ice packs for swelling
3. Sitz baths (the ones at the hospital look like this) to promote blood flow
4. Dermoplast spray for pain (I thought it was less helpful than other things, but a good option to have)
5. Witch hazel for cooling relief

And, more practically, when you go home:
1. Take several pairs of the throw-away underwear from the hospital, it's so nice not to have to worry about this.
2. Take the squirt bottle. It's quite hard to keep everything clean, and the squirt bottle (esp with warm water) is very soothing.
3. Find an old washcloth to pat yourself dry after using the restroom and rinsing with the warm water (instead of toilet paper that can leave little pieces, especially getting caught on the stitches)
4. Take a few minutes each time you go to the restroom to really just focus on yourself and on healing. It's worth it to take the sitz bath, even if you're exhausted, to help encourage blood flow and healing.
5. Ask your partner to help you remember to keep up on any meds you are taking for swelling/pain. Even just tylenol/advil. It is so easy to forget, so having an extra person and staying on top of the pain can really work out in the long run.
6. Have your partner help with bringing you food and -especially if you're nursing - making sure you always have fluids near. There will be a lot of swelling, and believe it or not, drinking more fluids can actually help to reduce traumatic swelling.

This is my small contribution to helping new moms with some of the topics that get lost in the excitement of the the new baby (at least in my experience). Good luck and happy labor!

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