Monday, September 21, 2009

AfterBirth

(Okay, so, is that a great or a HORRIBLE name for a postpartum doula service? I've been brainstorming on it so long that I've lost all perspective. You can level with me!)

Anyhow. I had to write up a brief account of my own birth and postpartum experiences for my DONA registration, and I thought it apropos to include it here. I've already shared both my birth story and our extended breastfeeding adventure, but there's something about the immediate postpartum period that amounts to its own distinct experience for moms. It also discusses some details from my pregnancy that I haven't gone into here -yet; I do want to write about my experience with "parallel care" in a future post.
My first and so far only daughter, Lily, was born in April 2008 at home, under the care of two midwives and my best friend, who acted as informal doula. It was a water birth and a wonderful experience all around, especially after a somewhat difficult pregnancy which was shadowed by a complete, then partial, then marginal placenta previa that persisted all the way up to the 34th week. A vaginal birth was no guarantee, up until that final ultrasound, let alone a home birth. Due to the previa, I had been on pelvic rest and forbidden exercise from week 18 on, and partly as a result of that, I gained far too much weight.

On top of that, for the first 20 weeks, the threat of an ‘incompetent cervix’ has hanging over my head due to a cone biopsy I underwent 16 years ago, since the medical practice I sought parallel care from insisted upon digital exams every other week to determine whether a cerclage would be recommended. I also had some sciatic issues that were resolved by chiropractic care, some nasty carpal tunnel, which B vitamins helped, and finally the dreaded rash known as PUPPP, which nothing really relieved much at all. So the birth was a huge relief in every way, and will always be remembered as the most incredible day of my life.


My postpartum experience has much to do with wanting to do work as a postpartum doula; I saw firsthand how much support means to a mom, especially a new one, and even more especially in those crucial first days. The stress, the assorted fears, the physical healing, the engorgement, and the sleep deprivation alone affected me much more dramatically than I had anticipated. Add into that the formidable hormonal wallop that results by shifting from pregnant to not-pregnant, and then from not-lactating to lactating.

I don’t think there are more dramatic hormonal transitions in a woman’s life except for puberty and menopause, and both of those processes take place over years and years; these postnatal changes happen within days, or a handful of hours, even. And then add into it the most devastating part: extreme difficulty nursing. You’ve got yourself a recipe for some considerable feelings of despair and helplessness. Day three-into-four was the day of reckoning for me, where I truly felt I was staring into the abyss.

The story of Lily’s nursing struggles is far, FAR too complicated to go into here; I will summarize by saying that it took 5 months of constant work with an IBCLC plus regular craniosacral therapy for her to be able to latch on. We’re still going strong at 17 months, so it’s quite a happy ending, but those early days were nothing short of terrifying. I was very short on support at that time, which I absolutely will make sure changes for the next child (if there is one). The postpartum visits that I did get were so incredibly important to me. I could have used a lot more of it, for sure, but that was simply our situation at the time, and I’m grateful to have experienced it at all.

I saw firsthand just how valuable postpartum care can be, not just from my midwives' three visits and through my best friend, who came by about every three days for a while, but from the first in-home lactation consultant who visited me twice and checked in multiple times by phone. This was not the genius IBCLC that I later saw, and who truly got us breastfeeding after a very long struggle, but she was helpful in her own way; getting me started with finger feeding and the breast pump, advising on other postpartum issues, and even helping to change the sorely-overdue sheets. More than anything, the kindness and the simple human contact (mother to mother, too) made a difference, in itself. She was filling a bit of the role that a postpartum doula does. I consider it only right to return that service to others.
That's what I sent to DONA; all completely true, but without some of the messy details.

That third day. I still shudder to think about it. I had probably slept a total of 4 or 5 hours since the birth. A foreshadowing of the breastfeeding difficulty to come was a growing concern, as Lily showed no rooting reflex and seemed totally uninterested in nursing, and had not yet effectively latched on, so I was desperately pumping to ensure that my supply would still come in without Lily stimulating me, and to produce a few drops of colostrum which then would be cupfed to her. My hemorrhoids were positively frightening, making every position uncomfortable. I needed to take both my and Lily's temperature regularly, I needed to massage my fundus gently but regularly to help it shrink back down, keep replenishing my witch hazel and comfrey pads in the freezer to soothe my bottom, all tasks I could never seem to keep up with enough. I also had to put in the sun for a few minutes periodically to help with her mild jaundice, and at one point I was CONVINCED I had given my newborn a sunburn and was despondent.

I could never decide whether it was better to swaddle her or keep her skin-to-skin with me - whichever one I chose, I'd feel guilty that I wasn't doing the other. I had a gorgeous Maya Wrap ring sling* given to me at my shower, but for the life of my I couldn't figure out how to use it thanks to the incredibly confusing instructions on the DVD that came with it. I watched over and over and over again, and couldn't even get beyond the intro part of threading the damned thing.** Then her umbilical cord started to look seriously funky***, possibly gangrenous in my increasingly paranoid mind, and I had no idea what was normal.

More than anything, the sheer responsibility of it all was starting to really hit me. At one point I had her wrapped up and lying on a heating pad, and her diaper leaked, wetting the pad (I hadn't gotten the hang of using the waterproof covers yet). I decided that I had almost electrocuted my own daughter in my carelessness and itwasallmyfault and proceeded to sob hysterically, and I mean hysterically, over it for about a half an hour. My milk then came in and left me freakishly engorged with what felt like rocks in my boobs and armpits. Again, I had no clue what was normal, and rather than resting when Lily slept, I took to scouring the web for advice. I remember sitting at the computer on the MDC boards at 6 am with cabbage leaves stuffed into my bra, weeping and feeling like the most pitiful mother ever to barely-qualify for the title.

. . . Yeah, you could say I was a little overwhelmed.

Later that day, seeing how unhinged I was becoming, Aaron insisted that I take a walk, as I literally had not once set foot outside the house since I was about 6 hours into my labor. Lily was asleep, my list of tasks would wait for 5 minutes. I protested a bit and finally reluctantly agreed to walk out to the mailbox, at least. I put down my checklist and I ambled out the front door in a daze, and got about three steps before suddenly realizing I had walked out there with my shirt COMPLETELY unbuttoned and hanging open, the state I'd been walking around the house in. Thank goodness no neighbors were around to see, and it did give me the first laugh I'd had.

Hopefully, I'll be able to help mothers through the labyrinth with a little more grace than I.

*Wonderful product, but check out the videos on this page rather than the product's DVD.
** We love and use it constantly these days, as per below.
*** It was completely fine.


7 comments:

  1. Okay, Number 1.

    After Bertha - that's my doula's "Roller Derby Girl" name. LOVE IT! She's so rock n roll, and what a hilarious name to pay homage to her profession.

    Number 2.

    That. Baby. is. The. Cutest baby. I have seen. In a reallly. Reallyy long time.

    That baby is making me want to jump my husband right now so I can try for a third.

    *sigh* --- I want a baby girl.

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  2. I'm not so sure about the name but I don't think the average person knows what AfterBirth is, so it will probably be ok. I kind of wish we had hired a post-partum doula. First, my mom stayed for a week after the birth, and then my mother-in-law arrived the day my mom left and stayed for six more weeks or so. It was nice, but difficult to find my own space to be a mother. Wish they lived closer and could pop in rather than just live with me!

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  3. TfB - 1. AfterBertha is genius. GENIUS! Absolutely perfect for a roller derby doula. 2. Aww, shucks. We think she's pretty darned adorable ourselves. I hope you get a little girl, whenever the timing would be right for you guys!

    Fun Mama - That's a good ways of looking at the advantages of a doula offering care and support as opposed to a family member being there and in the same space full-time. Boundaries can get a little muddy, but when you hire someone, the work to be done and the roles are much more clearly defined.

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  4. AfterBirth, that is cute. :)
    I had PUPPS too! That was a nightmare! I would have actually signed up for a repeat cesarean at 37 weeks, if the other things I was trying didn't work. I still had it til birth, but it was manageable.

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  5. The name AfterBirth made me laugh really hard. That's probably a bad sign. :-)

    Truthfully, if I saw the name out in the community I'd be wondering if it was a quirky sense of humour or whether, by some chance, you actually didn't realize the meaning. Because you know that happens!

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  6. A late comment, but postpartum care is really so important. So thankful I live in Taiwan, where it is the practice to take a month after birth to recover. Many new moms go to their mother's or mother-in-law's for the month, but there are also postpartum care centers - I went to a postpartum center - basically like a hotel but with services: healthy meals delivered to my room, a fresh change of clothes daily, experienced nurses. It really helped me to get through the nursing problems I had with my son (he didn't latch on until week 3). I shudder to think how it would have been if I was home alone.

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  7. I LOVE the idea of a postpartum center! Something that should become standard over here.

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