Wednesday, April 27, 2011

Five Things that Shocked Me about Cesarean Recovery

I've said before that my cesarean was not a planned one, so to say that I had no idea of what I was getting myself into is an understatement. My learning curve after having my son was steep. Here are some of the "surprises" I encountered in both my son and my recovery that I had never read about prior to and that I don't see mentioned very often anywhere.

1. Unexpected Digestive Issues

It seems very clear to me that my son was fated to have digestive issues. He had really bad reflux until he was about six months old. He has struggled a very underdeveloped digestive system (although it has improved greatly over the past few months) and has a very acute dairy allergy. These natural digestive issues were further complicated by his cesarean birth. One of the first issues he encountered was excessive gas and spitting up developing within hours of his birth. The nurse assigned to us the first day assured me that babies born through c-section often have gas and spitting up issues the first day because when the baby is born through c-section, they are often frightened by the sudden action of the doctor pulling them out. This causes them to cry and to swallow large amounts of amniotic fluid as they are being pulled out. (Conversely, babies born vaginally often do not because of the pressure exerted when they are pushed out.) I don't know if this is true from any other sources, but as the nurse was a twenty year nursing veteran, I had no reason to doubt her expertise. I can attest, the my son was a burping/clear fluids puking machine his first twelve hours or so.

Babies born through cesareans also lack exposure to the helpful bacteria of their mother's birth canal. This bacteria is the same bacteria that should be found in any healthy digestive system, but are missing from most cesarean birthed babies. (Cesarean birthed babies have, instead, been found to have bacteria found on the skin in their digestive systems.) This lack of helpful bacteria can make foods (even breastmilk) harder for those babies to digest.

2. Extreme Cluster Feeding

It is my understanding that most babies clusterfeed to some extent especially during growth spurts or during times when there are supply issues. Cesarean birthed babies take this to the extreme with clusterfeeding sessions lasting hours on end. This happens most often on the third through fifth day after birth. I've read that this may be the babies' reaction to a slowness in the mother's milk coming in (another common side effect of a c-section is that the milk is often delayed in coming in). In my case, my milk came in only two days after my son's birth, but my son still extreme cluster fed on both the third and the fourth day after birth. The third day (the day we came home from the hospital), he fed for almost eleven hours straight from 4 in the afternoon to 3 in the morning. He slept only in four ten minute stretches that entire time. Panicked, we trolled in internet and found descriptions of this behavior and even called the hospital ward we had just left. We were assured by both sources that this is not uncommon for cesarean birthed babies. (The following night, he cluster fed for 9 hours straight; the night after that, he fed for five hours . . .after that, he stuck to two hours or less.)

3. Physical Recovery takes a lot longer than Six Weeks

Before I had my c-section, I thought that when books said there was a six week recovery time that at the end of the six weeks you would be fully recovered from your surgery. I was so wrong. Six weeks is the MINIMUM recovery time. It is basically the time your body needs to recover enough so that the incision site will not likely reopen. It takes months for your body to fully recover (at least nine months for the muscles alone to heal). It is not uncommon for the incision site to remain tender and for the muscles to ache long after those six weeks are up. Some parts of it never heal. (I have permanent numb spots along my incision site.) Most resources I have read say that to insure your body is completely healed from your surgery and give you your best chance at a VBAC, you need to wait at least TWO YEARS before conceiving another baby. Even if you do wait that long your muscles and the skin of your incision site is forever altered and my not be as elastic or as comfortable as it was during your pre-cesarean birth pregnancy. (Kayce has been very candid about some of the experiences she has had in her post cesarean pregnancies.)

4. Mental Recovery Can Take Even Longer

Some women have cesareans (expected or unexpected) and feel perfectly content with both the procedure and its aftermath. Some women are devastated by it and even suffer PTSD. Others are somewhere in between. It's impossible to know where on the spectrum you might land. Prior to going into labor, I would have told you that although I was planning a natural birth, I would be fine with a necessary cesarean. However, after my labor, I learned that wasn't true. Even though I really do think that my cesarean was necessary, it has been a huge emotional hurdle for me to recover from.

In the beginning, it was really hard to struggle with my emotions because it didn't seem like anyone around me really understood why I was struggling. I think all new mothers struggle with a version of this. Taking care of a newborn is mentally and physically exhausting and sleep deprivation is far crueler than most of us realize until we experience it firsthand. Meanwhile, it seems that everyone around you keeps cajoling you to "cherish every minute." You can start to feel you are a terrible mother just because you are crying because your breasts ache and you haven't had a two hour stretch of sleep in three weeks. For mothers who have just had cesarean surgery, you are dealing with post-partum emotions, physical demands and recovery from your labor, and intense physical recovery from a surgery. Unlike most other emergency surgeries which would result in other people tenderly attempting to take care of you, a c-section is treated almost as if it didn't happen by a lot of people because the focus is on the healthiness of the baby not the mother. Of course, every mother is delighted that her baby is healthy, but it is also perfectly normal (even healthy) for her to be aware of her own discomfort and recovery. It's also natural to go through highs and lows in your emotional recovery.

My own emotional recovery has also been impeded by what I refer to as "The Mt. Everest Syndrome." Prior to my labor, when I heard about people who made it almost to the top of Mt. Everest, but had to turn around for technical, weather, or health reasons, I never really understood why they became obsessed with trying it again. Wasn't it enough that they almost made it to the top? They made it further than most of us ever will. Why do they need to risk it again? Now, I understand perfectly well where their obsession comes from. I labored for 26 hours without pain killers. I have learned that I am a woman warrior and that I have the mental and spiritual strength to birth a child. I know what I am capable of. However, because my son got stuck, I have yet to be able to show the rest of the world what I now know about myself and that drives me mad. I have often described my c-section as "defeat snatched from the jaws of victory." I feel like an Olympic athlete whose shoelace broke causing me to trip inches from the finish line. I long to roar my child into being and to claim that victory as my own. I want to be one of those women who say with pride "I birthed my baby and now I can do anything."

5. C-Sections Introduce Troubling Doubt

The most nefarious, by far, of all the surprises I have encountered during my cesarean recovery is the introduction of doubt into all thoughts of future births. Many women who have experienced cesareans (maybe especially the women who experienced necessary ones) feel self-doubt as to whether or not their bodies will be reliable in future labors. Having been failed by your body once, it's hard to have complete faith that your body will not fail you again.

Complicating this self-doubt further is the doubt of everyone around you. A woman who is planning her first birth is told "when you go into labor" and "when you birth your child." A woman planning a VBAC is told she will have a "trial of labor" and "if you birth your child." Even those who believed in her the most during her first labor or in her labors prior to her cesarean now have cause to doubt her and her ability to birth. That can make future labor feel like an uphill battle already. In an attempt to realistically acknowledge what has been proven to be a birth possibility, support team members often feel they need to develop the repeat cesarean birthing plan alongside the VBAC trial plan. It's a little like training to run a marathon while your cheering section is gassing up the car to pick you up when you collapse. (A necessary evil, but still a gut checking one!) During my first labor, when I hit a wall during transition and said aloud that I couldn't go on, that I didn't have the strength, I was immediately assured by those around me that I could go on and that I did have strength. Now, I live in fear that if I am not in the right environment for birth, I will be believed if I utter those words again and will end up with another c-section which is something that I most assuredly do NOT want for myself or my child unless it is necessary.


Rachael said... [Reply to comment]

I believe in you. And your body.

Shawna said... [Reply to comment]

You are the best, Rachael!

Kayce Pearson said... [Reply to comment]

Love this post.

Your body does know what to do. And just as a reference, we have moms that HBAC just under 2 years from their cesarean. Most times if mom gets pregnant before a year has passed (though it depends on length of that too) we will talk to her in depth, but again, it is the woman's decision.

Your body does work. But, trusting it again after an experience like yours is a very rough road.

Huge hugs!

Shawna said... [Reply to comment]

Thanks, Kayce! I probably should have mentioned that many women have successful VBACs sooner than two years . .. I was just thinking of what I'd read. I believe that I will be able to do it. I just hope I can surround myself in an environment of people who feel the same!

Nena said... [Reply to comment]

Thank you so much! Numbers 4 and 5 were the hardest for me! I'm not sure if I will ever forgive myself for giving permission for the doctors to do what I feel could have been a preventable "emergency" C-section

Shawna said... [Reply to comment]

@Nena: Thank you for reading! I sometimes wonder if I made all the "right" choices, too, but the important thing to remember is that we can only go forward. I wish you luck and love going forward and I am with you in your struggle!

Kelli said... [Reply to comment]

Though i cannot speak to the first four points as my child nor myself have had those issues in correspondence to our c-section, i do deal with point number five. I often wonder if my body is capable of giving birth without the help of intervention. My first child was born vaginally, but only after 36 hours (24 of which were natural) of labor. I did have an epidural after 24 hours and she was still born with the aid of suction. My second daughter, i labored at home for 24 hours and she wasn't moving down appropriately. We went to the hospital and though the dr. Encouraged us to keep at it (he was confident i could deliver vaginally it was just going to take longer) i had had enough. I was mentally, physically and emotionally spent. I opted for a c-section only after the doubt had set in that i don't have easy or short labors. I have not regretted this decision at all, despite setting out to have a much different birth by choosing home birth. The two are worlds apart, but now i can see both sides of the spectrum and i think we as women and mothers don't give ourselves enough credit for what we do have to endure during childbirth...regardless of the shape that takes.

Shawna said... [Reply to comment]

@Kelli: Thank you for sharing your experience. I'm hoping that I can one day get to the point where no matter what outcomes I may have, I am okay with them, too!

Jessica said... [Reply to comment]

Fantastic post, I had such a similar experience! This is so true! My boy had bad cluster feedings which all the LC's had me thinking I was nuts for thinking his CF's were abnormally long. Who was I to think otherwise being a new mom and all...I still have numbness and tingling/slight pain around the incision and it's been over 1yr. And I can totally relate to the PTSD, I lost the battle thinking. I was and still am devastated that I failed at having a natural birth. Now I am struggling with fears of a new pregnancy. I no longer trust my internal birthing abilities and I fear a repeat c-section ;(

Shawna said... [Reply to comment]

@JessicaOh, Jessica! I just saw your comment! I know where you are at, but I believe in you. I know you can do it. Just trust yourself!

Post a Comment