Saturday, March 25, 2017

The C-Section Birth Experience

My first c-section, due to breech presentation, occurred at around 4 a.m. Needless to say, I was a little tired and everything was a little rushed which didn't leave me a lot of time to take in the experience and everything was a bit of a blur when I looked back on it. With baby #2, I underwent a scheduled c-section delivery which was done at a much more leisurely pace. This left me more time to be nervous, but also more time to take in the details.

Here is my story...

My c-section was scheduled for March 12, which seems like it would be a perfect spring day for North Carolina. However, it snowed that morning. Luckily the temperature was still hovering around 33 degrees so nothing was sticking to the ground and we had an uneventful drive to the hospital. We arrived at 7 a.m. as instructed and waited about fifteen minutes before we were taken to our room. 

The hospital I delivered at has a very nice maternity center. Our room was a large "suite" which we stayed in for the duration of my hospitalization. Initially there was a lot of equipment in it...the fetal monitor to the left of the bed and a baby warmer to the right. I changed into a gown and was connected to the fetal monitor. 

Over the next two hours, I received a couple liters of fluids via my IV. They had a warmer for the fluids (something I definitely didn't get last time!) which was nice and it helped hydrate me because I was very thirsty after having nothing to drink for the past 8 hours.  I had my blood drawn and found out my hemoglobin was an excellent 15! The doctor and nurse anesthetist came in to say good morning and I signed a bunch of paperwork with the nurse.

At around 9 a.m., we were informed we were waiting on the anesthesiologist. Finally around 9:20, I was wheeled down the hall to the c-section room. (In this hospital, c-sections are performed within the maternity unit, not in the regular operating rooms.)

My husband was left outside the room, where he took a few selfies and waited...and waited...and waited... This was familiar to him from last time, but he has commented that this is quite the nerve racking time period when he is just waiting, unable to see what is going on inside the room. He said he could hear me chattering away so he knew I was nervous too.

Inside the room, I climbed out of my bed and hopped up on the operating table with the help of a step stool. The nurse anesthetist started hooking me up to monitors and switching over my IV to her pump. The anesthesiologist came in and introduced himself, as did the nurse manager. The manager attends c-sections when she has time and she was very nice. She was the one who stood in front of me when I hunched forward to get my spinal block.

The anesthesiologist placed the spinal block which hurt pretty bad. You can actually feel it running down inside your back. I'm not sure how this compares to an epidural. The main difference between a spinal block and an epidural is that the block is a single injection where as the epidural is the placement of a small catheter through which medication can then be injected over a longer period of time.

The block worked immediately, I was already loosing feeling in my feet when they helped me turn and lay down on the table. Then they place a foley catheter (to drain the bladder) and did the surgical prep of the skin. The last step of the prep is hanging up the drape. After the drape was in place, someone brought in my husband. 

He commented that he only got one picture of me before it seemed like the baby was out. This was pretty accurate, once the surgical prep was completed, everything moved very fast.

Lucas was born at 9:54 a.m. My husband has several pictures of him being pulled out and Lucas was wide-eyed and crying from the moment he entered the room.

After cord clamping, Lucas was handed off to the nurse to be wiped off, weighed (7 lbs and 14 oz), and have his vital signs checked. His APGAR scores were 9 and 10! They knew I used to a be a neonatal nurse, so this may be why they told me the scores. Then he was wrapped and handed to my husband to place on my chest.

My first baby snuggled nicely with me, but Lucas did not want to turn his head and was not pleased with his situation. It took a good fifteen minutes for me to be closed up as I also had a tubal ligation performed at that time. Then the staff transferred me and Lucas back to my bed and we were rolled back to our room.

Lucas started breastfeeding right away. I remember having difficulty positioning my first son, but Lucas just settled into the cradle position and started eating. We had trouble getting a picture of him which I was willing to send to family and friends because every time we moved him off my chest or tried to get a blanket in the way to cover me up, he would start fussing.

I had a lot more pain during this immediate post-operative period than with my first baby. They told me that with each birth, the contracting of the uterus gets more painful. My doctor had also given me Cytotec in the operating room. This is an oral medication which dissolves under your tongue and tastes like chalk. It is nasty and I did not have it with my first c-section. Cytotec is an additional medication which is used to prevent post-partum hemorrhage by promoting smooth muscle (uterus) contractions. So the combination of this being my second birth, the Cytotec in the OR, the pitocin infusion which is routinely given to prevent post-partum hemorrhage, and my son breastfeeding pretty much continuously led to quite painful contractions despite me still not being able to feel my legs or toes yet.

A few hours later, Lucas got his antibiotic eye ointment and Vitamin K shot and had his first bath. I used to bathe babies when I was a nursing assistant and I would have liked to have been able to bathe both my sons. But being post-operative from major abdominal surgery has its drawbacks and I allowed the nurse to handle it both times. (If you really want to be involved in your baby's bath, I'm sure the nurse could accommodate you, just ask!) Lucas wasn't too fond of his bath but he loved having his hair washed.

Feeling had come back by this point and I was starting to move around some. I had some water and jello and took some pain medication. I knew the nurses were changing shift, so I waited until the night nurse came in at 7:30 before getting out of bed. She took out my bladder catheter and I got up and walked to the bathroom without much difficulty. My husband and I ordered up some dinner.

Lucas slept with me and breastfed frequently overnight. He was having a lot of meconium stools which was another sign he was eating well. A benefit of being post-operative, my husband changed all those diapers! He also kept me supplied with yogurt (which I had brought), crackers (from the unit), and lots of ice water and juice. In the morning, I had my IV taken out and I took a shower. Lucas and I both got dressed.

His weight that morning was good! He was only down to 7 lbs 9 oz. Day one was mostly occupied by breastfeeding, paperwork, and a few naps. My son had his newborn screening (heel stick blood test) and hearing test done. The neonatologist came by and did an assessment on him (pediatricians did not see babies in the hospital at that time). We filled out our information for the birth certificate and social security number. My in-laws visited briefly to see the baby and reassured us that our toddler was doing very well at home!

Lucas mainly slept with me overnight again. Our first son had been happy to split his time sleeping with me and sleeping on my husband's chest which allowed me to get some extra sleep. Lucas was not as accommodating about sleeping with his daddy so I look pretty tired in the day two pictures.

Day two was just preparations for discharge. I could have stayed another night in the hospital, but I opted to go home. My son was eating well and, after that initial 6 hours of contraction pain, I had actually had much less pain than with my first c-section. 

The nurse midwife came by to discharge me and the neonatal nurse practitioner came by to discharge my son. 

We took a few quick family pictures in the hospital before discharge and then headed home!

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