Sunday, March 6, 2011
My First Birth - Part II - Four Days in the Hospital
Picking up where I left off in my previous post, I had just had what at the time seemed to be the relief of a c-section, which ended a 29-hour labor and produced a large, healthy baby boy. I had made clear my intention to breastfeed, and they said my son would be brought to me, and that they would send along a lactation consultant to help, once I was settled into my room on the maternity ward. I was wheeled back to the L&D room for recovery, where I had apparently been given morphine on my husband’s consent, and where we met back up with my mom. I was very groggy and exhausted, very weak, and really had no idea what was going on. I do remember telling my mom our son’s name.
Over an hour after the delivery, I was taken up to the maternity ward and into my room. A nursery nurse came to report that sometimes large babies have problems with maintaining their blood sugars, and if our son did, would it be okay to give him some formula? My husband and I had no idea, so we said, sure, if that’s what he needs, go ahead. Then she asked what kind. We also had no idea. We hadn’t “researched” formula (any more than we had researched breastfeeding, to be honest), so we just asked what they recommended, and they said many mothers liked Enfamil with Lipil. We said okay to that.
The baby had been taken to the nursery, where he was cleaned and given all the initial pokes and prodding. It turned out his blood sugar was fine, so they brought him to me to attempt breastfeeding. He was lethargic (as was I!), and it was difficult to get him to wake up to want to feed. The lactation consultant taught us about stripping him down to his diaper and tickling his feet to try to get him to awaken, and he did latch and begin to suck. He had a very good latch and a very strong suck reflex, and she said he should have no trouble nursing. I was tired and weak and in pain and having trouble so much as holding my 9-pounder, and we didn’t nurse for very long before they took him again.
I, however, was not doing as well as the baby. I was white as a sheet. It turned out I had lost a LOT of blood in the delivery. Not long after my abortive attempt at nursing, I began feeling sweaty and hot and very strange. Alarms started going off, and nurses rushed in, and they told me I was tachycardic (my heart rate had shot up to 160) and was going into shock. I had lost so much blood that my hemoglobin had dropped to 6.8. The normal range is 12 to 15, and I had been slightly anemic while in labor, with a hemoglobin count around 11.
They sent a crisis nurse to sit with me and help me calm down and took some readings with some kind of heart monitor (EKG machine, I guess?), which they only sort of knew how to hook me up to. In spite of the trauma of the whole matter, I was almost amused at how they couldn't get the leads to stick to my sweaty skin, and they weren’t exactly sure where they were supposed to go. It wasn’t exactly encouraging, but I guess they got the readings they needed.
It was determined I needed a blood transfusion to restore my blood count, and I was quickly typed (for the umpteenth time) and cross-checked and two units of blood were brought up from the blood bank and hooked into my IV. My veins were so sunken that they had to call in a special IV team even to get the IV started, and even she had trouble finding a vein! But eventually, I was recovering with someone else’s generously donated blood dripping slowly into my body.
I didn’t see my son much that day. He could really only be in the room if someone else was there with me, as I couldn't even get out of bed to tend to him. I was told that I probably wouldn't be able to start making milk until my blood supply was restored.
They told my husband to go home and sleep at night and kept the baby in the nursery, feeding him formula from a bottle when he needed it. They told us if we wanted, we could provide our Avent bottles for him to use, instead of the disposable rubber nipples they had in the hospital, in the hope of preserving his latch. So my husband brought some. I have no idea if it made a difference.
They had me stay in bed all of Monday as well. My husband stayed with me most of the day. He fed the baby, was taught how to change his diaper and swaddle him, and held him. I watched. I remember just being so tired and having absolutely no connection to this baby I had worked so hard to deliver. I did get to try nursing again, this time with a different lactation consultant who man-handled my breasts and tried to teach me two different ways to hold him. I felt clumsy, weak, and bullied. I was discouraged that he was so big and heavy and I was so weak and drained. Somehow, I thought it would be easier, or make more sense, or that I should instinctively know how to do this. Watching someone else open a bottle of ready-to-use formula and feed it to him was much easier than this craziness.
Monday night, I woke up crying in the middle of the night. The nurse on duty insisted it was because I was in pain, said I should tell them right away if I was in pain so they could give me more Dilaudid. I said that wasn’t it, and that I didn’t know why I was crying. No one had told me about the “baby blues,” the ebb and flow as pregnancy hormones suddenly stop and other hormones take their place. It wasn’t helped by my sheer exhaustion, pain, and trauma of the surgery.
Tuesday, I was finally starting to recover a bit. They let me get out of bed and take a shower, which was both scary and wonderful. They wheeled me to the “mandatory baby bath demonstration,” where a nurse, who was also one of the lactation consultants, bathed one of the other new babies to show us how to do it. (I still wonder that they had this mandatory baby bath demonstration where they went into excruciating detail on how to give your baby a sponge bath, which is hardly the most complicated baby-care task, yet there was almost no instruction whatsoever on breastfeeding!)
The lactation consultant came back up to my room with us and brought along a hospital-grade breast pump so she could show me how to pump. She told me I’d need to pump eight times a day – every two to three hours – to bring up my milk supply. I could save my colostrum and they would give it to the baby at his feedings so he could benefit from whatever I managed to extract. The idea of hooking myself up to this machine eight times a day seemed ridiculous. I had visitors, and nurses in and out, and most of the time had no idea what time it was. I think I pumped maybe three times that day, and nursed the baby once. This made no sense at all, but I took her word for it.
Tuesday night, I woke up in the middle of the night with my left hand extremely swollen. I had been on a saline IV to keep my hydrated, and apparently after 48 hours or so on an IV, the vein can just collapse, so saline was dripping into my hand. It wasn’t a big deal, health-wise, but it was scary and a little painful. They moved the IV site and gave me a warm compress to help bring down the swelling. They said the saline would just drain out. Still, I already looked like I had been hit by a bus, and now my left hand was swollen to twice its usual size.
Wednesday I was able to pump eight times, as instructed. I still didn’t have any milk, and I had no idea that this was perfectly normal after a first baby and c-section. It was discouraging, however, and exhausting, and I didn’t want to do it. Plus, washing all those pump parts so often? What a pain! I did try breastfeeding again, and still felt like a moron who couldn't manage this simple task of holding my baby to my breast and letting him suck. How complicated could this be?
The baby also started to show signs of jaundice, and he had to be on a bililight any time he wasn’t being fed or changed. This was… inconvenient, at best.
Thursday morning, my OB came to check on me and told me that I could go home that day if I felt ready. She said if I was still too weak, she could probably get me another day in the hospital, saying I wasn’t sufficiently ambulatory because of my anemia. But another of my OBs came later that morning and strongly suggested we go home. The nurses concurred. They said we weren’t doing ourselves any favors staying in the hospital longer.
I was told it would probably be a good idea to rent a hospital-grade pump, so I could continue pumping eight times day at home. I had purchased an Avent Isis double breast pump ($300) before the baby was born, assuming I’d need to pump when I went back to work, but they said it wouldn't be able to handle the amount of pumping I’d need to do in the early weeks to bring up my supply. I took their word for it. They had given me the name of a woman I could rent a breast pump from, and she came to bring me the pump, wheeling her sixth child in a stroller. She also sold me a hands-free pumping bra and some milk collection bags.
Then, Thursday afternoon around 2:30, we packed up, changed the baby into a “going home” outfit, put him in his car seat, and went home.
And if you think that’s the end of this saga, well, wait until Part III!