THE POSTPARTUM PERIOD

THE POSTPARTUM PERIOD: My experiences taking care of a baby after a cesarean and after a vaginal birth

By Heidi TrueArrow

Previously published in Birth Issues Winter 2010

Hello my name is Heidi; I am a pregnancy and birth junkie.

I love learning about all aspects of pregnancy, birth, postpartum, and parenting. I have had many different birth experiences; I have had 4 births of my own, attended births as a friend, and a doula. Watched a million births via video and still it never ceases to amaze me. I cannot believe that it actually happens. I still cry out in awe every time I witness a birth, even if it is a birth that I have watched a hundred times before. Really, it blows my mind, I feel even more connected to nature and to life when I am near or a part of the experience. These days I am really enjoying sharing my experiences in written form. This item I have written is about my personal experiences during the postpartum period after having a cesarean and then after having a vaginal birth.

In 1996, when I was pregnant with my first child, I had researched as much information as I could, about pregnancy, birth, breastfeeding, parenting… you name it! Alongside my wacky food cravings, I craved knowledge about what it would be like to give birth. I learned everything about pregnancy, labour and delivery.

I was pretty confident that I had the ability to birth without drugs and vaginally. I knew that there was a possibility to run into complications, but of course, none of those things would happen to me! So of course, like many other women, I didn’t pay too much attention to the chapters on cesarean or complications. I also skimmed over the whole postpartum section, which included the post-cesarean care, baby care and mom care. (What was I thinking?)

When I found myself with my first baby after going through labour and almost delivery and then ending in an emergency c-section, I felt like I had zero idea about how this would affect the plan I had to breastfeed, care for my newborn and myself. Aside from the disbelief and exhaustion I was feeling about the birth experience, I was pretty much in uncharted territory. But since I had no idea what I was doing anyway as a new mother, I didn’t know any different. I wasn’t too concerned. I thought, “Those darn books cannot prepare you for what it will be really like!”

My baby had some minor complications and was in the Neonatal Intensive Care (NICU) for about 6 days (that’s a whole story in itself). I found this time to be pretty unbearable. I was discharged as a patient after 3 days and the hospital gave me a room to stay in so I could breastfeed every 4 hours. At first this seemed like a wonderful idea but the room did not come with meals, laundry or support (from hospital staff)… and it had yellow walls, I used to think that yellow was a pretty nice colour, my favorite in fact, until the day that I walked out of that room! It was a scary time… I do remember having to walk quite a distance to the Neonatal Intensive Care Unit (NICU) from where I was and it was uncomfortable because of my incision (still new and healing).

Once we were finally at home, I found some things to be pretty annoying and uncomfortable because of the cesarean section, such as going to the bathroom, showering, coughing or sneezing, walking, carrying things, holding the baby, breastfeeding etc…pretty much everything that I was required to do in my daily life. I found breastfeeding after having a cesarean to be very difficult. I was physically uncomfortable due to the incision and breastfeeding isn’t easy and straightforward for some of us, even if we desire it. So the physical discomfort of the surgery and the physical demands were just more things that made breastfeeding complicated…I stopped breastfeeding after 11 days.

I wondered if all this was normal. I wondered if it was really supposed to be this complicated. I struggled through those first few weeks. I had my mom and my grandmother as support but no one in the community that I was able to turn to, neither professional nor personal, at least not that my doctor had spoken about. And I didn’t know about any mom support groups at the time. I really felt quite alone and I knew something was missing, I just didn’t know what that something was.

I struggled through the postpartum period not knowing any different, as best as I could. I was so new to all of the experiences that I was having I didn’t really have time to wonder if the birth could have been different. I did not feel cheated out of a natural birth, I felt like although the birth was incredibly hard, both physically and emotionally, I felt ok. It happened and then it was over, and it was time to move on to the next challenge, which was caring for a newborn. At the time my doctor told me that I would never have a vaginal birth, she said she thought I was too small. When she talked about probably having to have cesareans in future pregnancies, I was thinking I would never be doing that again anyway so, c’est la vie! I would live vicariously through other people’s births and get my fix that way! Little did I know…

Of course I would try it again, six years later (2001) with pregnancy number two. I didn’t really give much thought to those doctor’s words, it had been so long before, that likely things had changed and I’m not one to just do what I am told without all the information. It seemed pretty natural that I would just attempt to have a vaginal birth, and if it didn’t work out I would just have another cesarean section. I never thought of having a scheduled section. It just didn’t occur to me. I talk about those doctor’s words now because I now know what I would have missed if I had obeyed.

My research took a different curve the second time around; I was looking for successful VBAC stories, and statistics etc. I had come across so much information and by accident stumbled onto a movement to bring birth back to women and their families. I started to feel empowered as a woman and a birther. I wanted to find that something that I had missed the first time around. I learned about homebirths, doulas, and midwives. I began to feel honoured to be able to give birth.

I attended my first prenatal appointment with a new doctor who was open to attempting a vaginal birth, and saw really no reason not to try it! When I choked out my question about a home VBAC with a midwife, he gave me the name of a few and said if it doesn’t work out with the midwives, feel free to come back! So there we were my husband and I, meeting with midwives, planning a home birth, all totally normal. We interviewed a few and it became very clear that this was the way we wanted it to be. It seemed to fit so well into my consciousness that I was even inspired to pursue a career in midwifery (still trying to figure that part out). Once we were settled into the rhythm of the pregnancy and the birth drew nearer I felt like I was prepared for it, I felt like it was going to happen. I didn’t have any reason to doubt it…my body was built to do it.

When labour began, it seemed to be so smooth, I didn’t have to do anything I didn’t want to, I didn’t have to move rooms, unless I wanted to. I didn’t have to restrict food or drink, I was really involved in the contractions, and I was free to get down to the hard work of birth. When it came time to push, I can remember thinking “I don’t want to go to the hospital,” yet I felt the baby was not coming out (I feel like this about 10 minutes into the pushing stage of every birth by the way). I trusted the midwives with my life and my baby’s, they assured me that everything was going well. Baby sounded good. I was doing well. Things were working out. I just kept pushing, 45 minutes of pushing (I thought that was long)…and there she was! The attempted home birth after a cesarean became a successful home birth after a cesarean. It was “uneventful” like they write on your hospital records after a normal birth with no complications.

I said over and over and over, “I can’t believe that she came out!” I just couldn’t believe it. I also could not understand how she was a full pound bigger than my first baby yet she had entered the world via my birth canal! We could do it after all. Having a vaginal birth at home for me was an incredible experience, I felt amazing, I felt empowered, I trusted my body in its ability to excel in what it was meant to do!

I noticed a difference right away after the birth, during the postpartum period. I was up very soon after the birth and feeling well. I wasn’t under the influence of any medication, I was alert and elated. I could walk around much better; I was feeling almost back to normal after a week or so. It wasn’t as complicated compared to my first experience. I guess there are many factors that were involved. In retrospect the recovery period after the vaginal birth was much easier than after the cesarean section.

I had a different kind of support system the second time around, which came naturally from having the midwives that I did (I loved them and wanted to marry them into my family, somehow). It was a different kind of care than my first experience. Since my older child was almost 6, I didn’t really have to chase her around, but having a faster recovery period was definitely helpful in caring for her. As a matter of fact, baby 2 was only about 24 hours old, when we ventured out on our first outing, (to buy a vacuum).

I also noticed in the months following the natural birth, that I shed the pregnancy weight faster and easier and felt emotionally better too. With the support that I had, I managed to breastfeed quite successfully for 17 months. I am very proud of that!

In my experience, I never felt like I couldn’t have a Vaginal Birth after Cesarean (VBAC), it seemed straight forward to me. That’s where babies came from, unless there are complications or there are medical reasons to have a cesarean section, for me, I would just try it out. I made it through the very hard physical birth of my first and if I could make it through that and have things turn out ok…then even better if I could do it the traditional way! I wouldn’t have known any different if I had continued to have cesareans with my other children, (which was an option). I wouldn’t have had the experience of having both, and I wouldn’t have been able to form a balanced opinion about it.

I know that having a cesarean can and will work out in its own way, most of the time; it’s the same with a vaginal birth. I cherish the experience of my first birth equally as much as I cherish all the births I have been fortunate enough to experience. In each experience I learned something new about pregnancy, about birth, about babies, about myself and my capabilities, about life. I have had 1 cesarean section, 2 home births after a cesarean, and one hospital birth after a cesarean.

Heidi TrueArrow is the mother of four, 3 girls and 1 boy. She is a birth and postpartum doula. She currently works at the YWCA Edmonton. She enjoys spending time with her boyfriend Alex, hip hop dancing, painting pictures, and just recently got into motorcycling.