Wednesday, 8 April 2015

10 Things You Should Know About Having a C-Section

You'll have to forgive the overflow of baby-related posts for the next while. That's pretty much all I can think about, and considering the number of times I've Googled looking for these kinds of posts, I reckon it may come in handy for someone else in future.

One of the really contentious things about pregnancy right now, is how these moms-to-be choose to deliver their babies into the world. The serious arguments I have heard regarding natural vs. C-section births could leave any mother very confused, and often, misinformed. It's easy enough to read the physiology about what happens, but often, the real story as experienced by the average Jane, is not heard. This is particularly true, I find, of C-section deliveries. So, not that I consider myself any kind of expert on this topic, and only based on having been in labour and having had a C-section, let me share ten things I found people forgot to mention regarding having a C-section delivery.

1. You'll be shaved.
This may seem like an obvious thing, but I feel the need to mention (probably for vanity's sake more than anything else) that unless you do it properly, yourself, beforehand, this is not going to be a spa-standard experience. Understandably the place where the incision will be made needs to be hair free. I thought I would save the nurses some time and effort and clean things up myself. However, there are a few problems with that, starting with the fact that, definitely by the time you are preparing for deliver, you can't see a darn thing down there. (Just as a side note: I would not recommend you ask your husband/partner to assist you here. This is not the same as shaving your head with a Wahl.)
In addition to this, as it turns out, no matter how much clean space you make for your incision, the hospital won't think it's enough, and so they'll do a 'proper' job - soapless with a Minora blade - and leave you with pretty much nothing. But don't worry: once you finally get the dressing removed, and if you survive the itchy regrowth, it'll be back to normal eventually.

2. You'll have some serious shakes.
The anesthetic is not optional. Obviously. But for your sake, I hope that you do not have to have it after an epidural. (When this happens, there is a chance that it won't take and you'll end up getting numbed from the neck down. Not fun. Much more pleasant is the good ol' regular spinal - numb from the waist down.) Still, whatever anesthetic you get, there is one universal side effect. The shakes.
It's unavoidable. You can clench your teeth until your jaw hurts, you will still have this involuntary, full-body shiver session that you cannot stop. You don't feel cold (that's a different side effect altogether), you just can't keep your body still. It's particularly scary when you are holding your newborn (your husband/partner will be sick of you asking if they're holding baby tight enough), but it passes pretty soon after delivery.

3. Your pics will be graphic.
Perhaps you don't want birth pics. That's ok. I, on the other hand, am a scientist in the field of the human body. I live for these pictures. And yet even I was a little surprise by all the detail - the gaping wound, layers of adipose tissue, blood and somewhere in between, a baby. The point I'm trying to make is that this is seriously invasive surgery. If your husband/partner is a little queasy, I suggest you make arrangements for them to sit to the side, somewhere close to your head, and just look up when the doctor announces your baby has arrived.

4. Your bladder will take strain.
The bladder is precariously close to the uterus, and given that you'll have a catheter (inserted under anesthesia, thank goodness, but unfortunately removed without), post operatively there will be some collateral damage. Mostly it just becomes a little difficult to pass urine, but this passes in a day or two. Interestingly though, UTI is the second most common infection following a C-section, so ensure that you drink litres and litres of water, and that you go to the toilet regularly so not to place any additional pressure on your bladder.

5. You'll have gas.
If I didn't put this on this list, you'd be sitting there post operatively feeling very embarrassed by something that is completely normal. After all the pulling and prodding done during surgery, your digestive system will be very sluggish, and coupled with the effects of your painkillers and anti-inflammatory medication, you will feel a little constipated and very gassy. This is meant to pass in a couple of days, but in case you want to help the process along, the answer is peppermint tea! That, and getting moving around will help improve circulation and speed up digestion, and you should be (almost) good as new.

6. You'll still bleed. A lot.
Regardless of how your baby comes out, the fact that both the baby and placenta are removed means that there's a bit of cleaning out that needs to be done in your uterus. This means that you will bleed (heavily at first, and then less and less until it's just discharge). This can last up to six weeks, but given that it tapers off, it's not nearly as bad as it sounds. What you do need to be prepared for are the humongous pads and granny panties. The pads are not the most flattering or convenient, but the granny-pants are super comfy and support your belly!

7. You will need help.
When you're tied up to a drip and a catheter for at least a day after surgery, you're going to be bed bound. This means that when these are removed, and you're finally allowed to roam free, you're going to feel like a new-born Bambi trying to walk for the first time. Do not try it alone. Also, you have stitches in your abdomen, so you're unlikely to even be able to stand up straight. Make sure you have someone on hand to help steady you before you hobble off on your own. The more you walk around, the easier it'll get, but take it slow!

8. You need all six weeks to fully recover.
A C-section is serious abdominal surgery. There is skin, tissue, organ and muscle damage that is no joke to repair. The reason the recommended rest period is six weeks is because that's the amount of time needed (the uterine scar itself doesn't heal completely for 12 months after surgery). Don't think you can accelerate that too much. While it's important that you do get walking around, there are very strict guidelines as to how much you can exert yourself. Included in the list of things not to do without doctor's clearance is: drive, lift anything heavier than your baby, housework, exercise (including climbing stairs and nooky). Even laughing, coughing and sneezing will be uncomfortable (even painful) and require additional support. There are some pretty nasty things that can happen when your body doesn't heal properly - it's just not worth the risk.

9. You may be judged. Quite possibly by yourself as well.
This is a sad truth. Whether your C-section was elected, suggested, or an emergency, there are going to be people (usually who haven't had a C-section themselves) who are going to have a lot to say about it. Try not to let it get to you. This can be difficult as, very often, we judge ourselves too. One of the most resentful things about the C-section is the long recovery, and in the midst of the frustration of it, it's easy to wish that things had not happened the way they had. Try to remember the grace that brings each child into the world, and the miracle you are holding as a result. In the greater scheme of things, six weeks is only a drop in the ocean of a lifetime of weeks you'll share with your children. Years later, the only reminder you'll have is a small, faded scar above your bikini line.

10. You will still have a very beautiful birth experience.
Despite all the things I've told you, this is still a precious, extremely personal and (dare I say) pleasant birth option. It's pain free (in the moment, anyway) and allows you to be fully present while your child is being delivered. You can still see them, hold them, immediately nurse them, and practise kangaroo care - all while you get stitched up. Your heart will still swell when you catch the first glimpse of your miracle. Your breath will still catch in your throat when they open their lungs and cry a sound that you will be able to identify amidst dozens of others as your baby's cry. You will still dote on them in awe and wonder, and forget every moment of pain and discomfort you ever felt while birthing them. You will not care how or why you brought them into the world the way you did, and just be grateful for the gift that they are.

A Promise Fulfilled

Last Monday, 30th March 2015, was a significant day. It was a long day, with a very early start - 04h30, to be exact. It had been preceded by a restless night - and if I'm to be perfectly honest, rather anxious night -  in which I got no more than three hours of broken sleep, and waited and planned for, for weeks. It marked the start of the next chapter in the current miracle situation in our lives (if you don't know the background, you can read it here): it was the day that the baby we were told we wouldn't be able to have was born.

I would by lying if I said that not once during this pregnancy did I doubt or question God's faithfulness. Somehow, being in the midst of a miracle does not make you immune to these human things. It was particularly trying the last few weeks. After having some serious labour symptoms from 32 weeks, it had become the norm for me to bargain with God, pleading that He let me last just until Button was full term at 37 weeks. He did. During that time I also had two cases of chickenpox at my school (potentially very dangerous depending on how long after exposure you go into labour) including one student in my class. And finally: low and leaking amniotic fluid, which I suspect eventually led to Button's birth. Thank goodness for friends and family who regularly reminded me of God's plan for Button - even though we don't know the details of it all, we know that it's to prosper and not to harm him.

So after nine months of waiting (it's funny how that feels shorter the second time around), on Monday morning at 08h07 at the sound of a newborn baby's cry - my newborn baby's cry - my heart burst open and doubled in size. It was amazing. I think Andel and I saw him at the same time, and almost simultaneously said "he looks just like Zac". He was beautiful and small in his pale, wrinkled skin, exercising some serious lung power for a 3.2kg, 52cm newborn, and surprised us with his immediate latch and impressive suction.

Choosing a name is always such a consequential thing for us. Before we had kids, we had a list of names we loved. Then other people used some of the names for their kids. Or we met a child - or adult - that turned us off one of two of the names. Or, when we finally were pregnant, it just didn't seem right anymore. Zac was a bit of a last minute choice, albeit deliberate and significant, and at the time we had no idea how it would influence names thereafter. Suddenly this time we had to find something that went with Zac - also short and sweet (or at least cute), also significant, also meaningful. And so, after countless names narrowed down to eight, and then three, we settled on Sam Blake Klaasen. Sam like the prophet Samuel whose name means "God has heard", and in memory of a cousin we never got to know. And Blake after a family that is so much more than family to us.

Since Sam's birth we have had a pretty fiery baptism into this new normal as a family of four. The first night home from hospital was particularly trying. But, despite the occasional battle between tag-teaming children and equally exhausted parents, we are finding our rhythm. And Zac adores Sam - constantly wanting to kiss and hold and feed and change and play with him - which is the most any parent can hope for.

Welcome to the world, sweet Sam Blake Klaasen. Oh, the plans God must have for you... We eagerly await its unfolding.