Thursday, December 13, 2012

The first 6 weeks postpartum: some hard realities

I wanted to post about some of the harder realities of my transition to new motherhood. This time has been filled with many wonderous moments, grant you (please don't ever mistake that!), which I hope some of my previous posts have conveyed, but there have also been a number of difficult ones. Some of our lack of preparedness is because we couldn't really imagine we were having a baby until... well... we had the baby. I "knew" that we appeared to be having a living child, but emotionally, after six consecutive losses, it was a different story. Even up to the day of the induction, it felt dangerous to presume we were taking home a baby. That may sound strange, but we've had so much loss, it just felt perilous. And so my preparations - both  physically in terms of buying necessary baby things - and psychological - were a bit on the scanty side. Whatever your loss history, having a baby is a watershed experience. Somewhat of a "You don't know until you know." And everyone's experience is different. Add to that strong cultural mores that you are "supposed" to be only thrilled and happy.

If baby is healthy, then the rest doesn't matter. Right?


Well, I'd argue that if baby is not healthy, nothing else matters, but that it is ok to have feelings about the way things go down in your labor and delivery and postpartum. And I'm going to write about it, in case it is helpful to someone else:

Physical recovery after c-section: I had no idea about what to expect, because, well, I wasn't planning on having a c-section. In fact, I was naively certain I wouldn't need one (ha! ha!) because my provider has such a low c-section rate and I was so prepared to give birth (ha again!). But a c-section was needed (more on this when I share our birth story). So in addition to the emotional adjustment to the reality I found myself in, I was also very surprised to find that the initial few weeks after a c-section leave you pretty helpless physically. Initially, I was unable to roll over and had trouble getting up from a sitting position. I couldn't lift Magpie if she was in a bassinet beside the bed, which made it tough to room-in in the hospital unless Will or someone else was there at all times. All of this was magnified by the fact that Will's paternity leave was eradicated by Hurricane Sandy, as he was called into the hospital basically as soon as I was discharged home. Magpie and I were on our own. And we were physically not ready for it.

Emotional recovery after c-section: Also rough. I was sad about the way our labor and Magpie's arrival went. It felt chaotic and scary and I missed a number of things that I had looked forward to. I remember during the c-section, right before everything went to hell in a handbasket and the anesthesia failed, hearing a baby cry after they pulled her from my belly. And I thought, literally,

What is that sound? 
Oh, it's a baby. 
Why is there a baby crying in the operating room?
And then a few moments later...puzzled...Oh - that's our baby?!

It all felt so disconnected. I don't know her Apgars, I didn't get to see the placenta or umbilical cord (which I had wanted to), I never saw Magpie until she was all nicely cleaned and wrapped and hatted maybe 10 or 15 minutes later. I had moments of disbelief days later, this crazy idea that she had not actually come from inside of me. Maybe they had a room full of babies somewhere in labor and delivery and they'd just brought her into the OR to us from another room. Ludicrous, of course.

When one of a parade of lactation consultants came to the house and suggested I strip Magpie naked to weigh her before feeding, I stripped her to her diaper. When the woman commented to take off the diaper, I almost said, "But she came like this." The idea of my daughter naked felt odd for quite a while, as I hadn't seen her naked for days after her birth.

Talking to friends later, one asked, "Did you just have the most incredible high after giving birth?" The answer is no. I felt wrecked physically and emotionally. I'd been through 36 hours of labor and a rough c-section due to the anesthesia problem. When my friend asked that, it amplified some of the losses I was already processing from having had Magpie delivered in the way that she was.

I want to say that I don't think I was entitled to some wonderous type of birth experience, or that I expected my body to "know" how to give birth (which I've read people say), or anything of the sort. Obviously my body didn't "know" how to get pregnant, stay pregnant, get un-pregnant...and the list goes on. And thankfully, with medical technology, we've been able to overcome multiple hurdles along the way. But there was still a sense of loss with the way things went. I had strongly hoped to deliver vaginally, and I hadn't expected a c-section, if needed, to be so sudden and abrupt and without any of the human side of things as it was (in a non-emergency situation). I had thought there would still be some excitement: an announcement of "Here she is!" rather than no acknowledgement the doctors had her out and then hearing her faint disconnected and disembodied cry from across the room. I certainly didn't expect to have so much pain during the operation itself. I've moved on, mostly, and Magpie is certainly incredible however she got here, but there was an emotional loss.

Hormones/Mood: All I can say is Wow. This has all straightened itself out now but those first few weeks. Oh. My. I felt like some kind of combo animal-child. So emotional that I would burst into tears talking to Will. Not always unhappy, sometimes just moved, literally, to tears, but really, really intense emotions all around. I am someone who feels things very deeply but tends to keep a good lid on it. And in addition to deep emotions, I am strongly rational, and I tend to lead with the rational (or try to). For me, immediately postpartum, that went out the window.  I was a ball o' emotion. I felt needy and shaky, and...almost primitive. It didn't last that long (a little over a week?), but it was something I did not expect and haven't experienced before.

Bonding: I had realistic expectations on this I psychologist friends warned me - you will be thrilled Magpie is here, but you will not immediately love her. And I didn't. She was exquisite and lovely, and I felt very protective of her, but I did not instantly love her or feel that I "knew" her. This has grown. I now look at her and can't help smiling. I look at her and am incredulous at her perfectness. At her presence. I feel a growing bond each day. But it wasn't instantaneous. Not by a long shot. I'm glad I'd been warned about this so I didn't beat myself up about it. I look at her now and am just suffused with affection for her. But it wasn't instantaneous.

Breastfeeding: I envisioned Magpie suckling at my breast, milk dripping down from the sides of her mouth. Her content, me content. I imagined myself rolling over to her co-sleeper at night and the two of us doing dream feeds. Ah bliss.

Well, not so much. Magpie never could latch on properly in the hospital. She she lost 13% of her birthweight while we were there and they mandated that I introduce formula using a supplemental nursing system (SNS) to stem her weight loss. Within a few days at home, my milk came in, I started a crazy pumping schedule, and was able to forego the formula and feed her breast milk through the tube.

But breastfeeding itself wasn't happening. Magpie's tongue was severely tied. We ended up having three procedures with an ENT to help free it up. She just plain couldn't get her mouth open enough or her tongue in the right position to eat. We limped along with the SNS for a while - a cumbersome tube taped to my breast, my nipples cracked and bleeding. Each feed took over an hour. It was brutal. But even with the SNS, she still couldn't get enough milk and wasn't gaining weight. She dropped 20 percentile points on the growth chart. I grew increasingly despairing. Finally, we introduced the Haberman feeder, a bottle made for babies with feeding issues. It's been a life saver.

But now Magpie isn't so interested in the breast. And I am fighting recurrent blocked ducts and repeated bouts of mastitis. We are still working on it. I haven't given up, but for now it's an exclusive pumping relationship. And although I am incredibly grateful to be able to provide milk for her from my body, it is not at all what I imagined...

Isolation: I am a person who loves being alone. So when I thought about my maternity leave, I looked forward to it. I did not imagine feeling so cut off from others, almost as though I am under house arrest. Some of this, no doubt, is due to the fact that my family lives across the country. But the other part is that I am really stuck in a way I hadn't anticipated. It is hard to get out - especially as an exclusive pumper (for now, at least) with our relentless every two hour feeding schedule followed by pumping. Magpie takes about an hour to eat, and then my pumping takes a good 30-40 minutes (long, I know). And then with a diaper change and some burping, it is time to eat again. The heavy hospital grade pump is not transportable. And while it is wonderful and has made giving her breast milk possible, the hospital pump means that I have to be home every three hours minimum to pump during the day.

Fatigue: This one is a no-brainer, I suppose. And it was not unexpected. I am tired. Bone tired. I knew I would be. What I didn't realize is that I would be so bad at sleep deprivation. You hear people say all the time: sleep when the baby sleeps. Well, when Magpie is sleeping, yours truly is usually pumping. There's no sleeping here. And then at night, same drill, feeding followed by pumping. There is some sleep then, but very interrupted. Something like 1 or 2 hours of sleep followed by usually about 2 hours of is not enough sleep for a geriatric mom like myself. So still trying to come up with a better plan for this, or a better way to handle this. Not sure how long it will be until it gets a bit better, because with the pumping I'm not seeing how I could sleep through the night, even if Magpie did. And right now, I wake her to feed over night a few times because her weight gain has been so problematic. But hopefully would be so nice.

So these are some of the tougher parts of new parenthood. Some expected, some not as much. Some of these things may seem trivial, and they are. I would go through anything to be able to parent Ms. Magpie. No questions even asked. But I wanted to be honest about the tough parts in addition to all the joys. In case it is helpful to someone else heading down the same paths.


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Wednesday, December 5, 2012

Long-term prognosis

In early November 2007, we miscarried our first pregnancy after our first IVF due to a double aneuploidy. We were completely blindsided by the loss, which happened after several strong heartbeats and a graduation to the obstetrician. A few weeks later, my husband Will received an email from our reproductive endocrinologist.

It read, in part:
"See you guys soon and have a nice Tgiving. Hang in there. 
Mo's long-term prognosis here is fabulous. Remind her of this for me."

We printed the email and saved it. It ended up filed as part of my ever accumulating infertility-related medical records. Files that I am piecing through and paring down today.

I've thought of this email many times in the past five years and my reaction to it has varied.

At first, I was so moved that the RE took the time to be sympathetic and encouraging to us. I clung to his words as I grieved our loss: Our long-term prognosis is fabulous. I formed the words again and again in my mouth. Words that meant everything would be ok. We would be parents soon!

I returned to his words after our second miscarriage and took comfort in them.

And after our third miscarriage.

By the fourth, fifth, and sixth miscarriages, I had become increasingly bitter about the email. What kind of freaking fabulous prognosis was this?! Seriously? This was fabulous? Because our reality seemed dismal and our future prospects increasingly hopeless to me. It felt like false hope had been offered. The words now felt extra cruel because I had fiercely wanted to believe them for so long, although I knew the email had been written with the best of intentions.

Will and I even began wryly alluding to the email with each other in a dark-humored, angry kind of way. We needed this "fabulous prognosis" like we needed holes in our heads.

And then pregnancy number seven. Which somehow...kept...continuing. Even when we couldn't imagine that it would. All the way to a delivery. All the way to Magpie.

And now she is here.

She is sleeping in the other room. I tear up just realizing the incredibleness of it. Of her.

And so it turns out that our long-term prognosis was fabulous after all. What I had failed to appreciate was the word "long-term." I would never have imagined how long-term it would be.

But five years later here we are.

What a difficult journey it has been.

Amazing. Unexpected. She is here.


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Monday, December 3, 2012

Almost 6 weeks update on Magpie

Time keeps passing so quickly - the day a constant whir of feeding and burping and pumping and soothing - all as it should be, but not leaving much time to even think about posting. I will try to get in at least little posts rather than have so much time pass.

So, to begin with: Ms. Magpie. She is delicious. She will be six weeks old on Tuesday at 11:39pm. Hard to believe. She is making lots of eye contact now and debuted her social smile last week, becoming more and more practiced at it as the days go by. We don't have any pictures of her smiling yet, but I'll post one as soon as we capture one. She is also starting to track objects. Just this morning she looked at a toy overhead and both followed it with her eyes and turned her head toward it. I know, I'm the mom, so I'm biased, but I was very impressed!

So far, Magpie is a petite girl. We have had significant feeding issues since her birth that merit their own multiple posts, but basically, she still is not able to get much milk directly from the breast, although she enjoys hanging out there (which I appreciate!). She also was not able to suck sufficiently to get enough milk from the supplemental nursing system that was introduced to us by lactation consultants (a tube that I tape to my breast so she can nurse and get additional milk at the same time). She would try and then would fall asleep. I would wake her and we would try to continue...the whole thing would take over an hour. She was exhausted; I was exhausted. And for a few weeks there, she was not gaining much weight.

Finally, the pediatrician called a halt to the madness (I think she was sick of seeing us week after week). And then, based on the ped's call, the lactation consultant we've been working with recommended we try the Haberman bottle. It's a bottle made for babies with significant feeding issues. And it still requires her to suck to get the milk...but she is able to drink it successfully now. We've also made the amount she has to drink smaller (60 ml) and are giving it to her more often (every 2 hours during her 16 hour "day"; then 2 feeds 4 hours apart overnight). This seems to be working. It takes her about 45 minutes to drink the 60 ml, but she can do it. And for the first time, she gained what the pediatrician says is acceptable.

So at a day shy of 6 weeks, Little Miss Petite now weighs 8 pounds 15 ounces...up from her birth weight of 8.1 pounds.

It's hard to say what her temperament will be like because she's so little, but so far she seems to be a very easygoing and mellow little girl. She doesn't cry very much (hopefully I'm not cursing myself by writing that!). She loooovvveeeesss to sleep, especially when it's time to eat (the doctor thinks this is partly because eating is so exhausting for her). She also loves to look around and take in everything around her. She likes tummy time, she loves to nurse (even if it is just for comfort), and she loves to look into people's eyes. She hasn't really noticed Moxie yet...still waiting for that to happen!


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Thursday, November 22, 2012

Gratitude, in pictures

This year, we have much to be thankful for. A thousand moments already in the past month.

We are so thankful

for this

and this

in Grandma's arms

and this moment.


First bath


First bath, looking at Daddy

So grateful.

Sleeping in Mommy's arms

For her.


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Monday, November 12, 2012

Newborn pics

Here is Ms. Magpie, still in the hospital at three days old. We think she is beautiful.


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Tuesday, November 6, 2012

Two weeks postpartum: an update

Baby girl Magpie is two weeks old today, as of twenty minutes to midnight tonight. She is sleeping beside me right now, and will hopefully rest long enough for me to get a quick post in. I haven't decided whether I will post her name on this blog or not, so stay tuned as I figure it out. But rest assured, she is here, she is adorable.

The past two weeks have been a whirlwind. I will post her birth story in a separate post, but just the bullet point version gives you an idea:
  • 36 hour induced labor
  • contractions two minutes apart, lasting 1.5 minutes peak to peak (omg)
  • then vomiting with each contraction commences!!
  • Mo waves white flag after 6 hours, asks for epidural
  • maternal fever
  • fetal tachycardia
  • dilate to 6 cm, then cervix starts swelling shut, down to 4 cm
  • c-section called
  • anesthesia fails during surgery (OMG never heard of this. Don't recommend it)
Magpie was born at 11:39 PM on October 23rd. What I didn't realize until later is that those twenty minutes counted as her and my first full day in the hospital. We had feeding issues from the get go, with Ms. Magpie unable to  latch properly, and me bleeding from both nipples.  That plus our accelerated time table meant that Magpie was deemed to have weight loss issues almost from the start. We saw many lactation consultants in the hospital and finally cajoled an ENT to come to our bedside once she had lost 13% of her birth weight. He performed Magpie's first frenulectomy because it turned out she was tongue-tied.

We got discharged Saturday night and told we must supplement with a supplemental feeding system (basically a small tube) with formula, since my milk hadn't come in ... all this just in time for Hurricane Sandy. We fared well compared to so many others in our region. I grew up in an area beset by hurricanes and so underestimated how serious Sandy would be. Category 1 just didn't seem so spectacular, and yet, wow, so much devastation around here. It's mindblowing. 

So we were unscathed, and so fortunate, during the hurricane. Our only issues were that we ran out of formula and couldn't find more during the height of the storm. One of my dear friends lost power and brought her frozen milk to our house rather than have it spoil, so for one day, Magpie drank that...and then blessedly, my milk came in enough that I could pump and supplement her with my milk through the tube. Will got called in all week post-hurricane because our hospital was swamped with patients due to all the other hospitals in NYC closing, and had a simultaneous staff shortage because of the storm, power outages, no public transportation, and the three-passenger rule for commuters trying to come in, which made it difficult for physicians to make it into the city to work unless they could find passengers.

So me and Magpie were on our own much quicker than expected. We've been trying to learn the ropes of breastfeeding, but she has a lot of trouble sucking, which has meant I feed her with the tube and the breast, which takes 1.5 hours or so, then I pump using a hospital grade pump, and then we do the whole thing again every 2 to 3 hours (from the beginning of one feed to the next). It's an almost continual process, and hasn't gelled well with recovering from the labor and major surgery. 

Magpie was still having such problems we took her to a second ENT yesterday who performed an upper and additional lower frenulectomy. So we are hopeful she will be able to feed a little bit better. Poor little one. Because of the weight issues, we've been at the pediatrician's office every other day or so. But she's hanging in there and gaining some. And I'm hanging in there and healing and trying to rest when I can. And Will is back at work, his week of vacation gone due to the hurricane and not replaceable apparently (bah humbug!!)

The other fascinating thing is the wild hormonal ride I am on. I am drenched with night sweats several times a night. Soaking, soaking wet. My mood, is well, a bit labile - although better than it was. 

This is all very interesting. Feels so primal much of it. And I feel often like I am just trying to surface for a breath of air when I can and then just hanging on for the breastfeeding, night sweating, exhaustion ride of it all.

So all normal stuff, but all new normal stuff for us. 

And Ms. Magpie. Wow. She is lovely.She is delicious. I don't know that it has sunk in that she is here to stay with us. That she is ours.

Unimaginable. All of it.


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Wednesday, October 24, 2012

She is here!

Ms. Magpie has arrived!

She came via c-section last night at 11:39, after a long trial of labor (36 hours from when they inserted the cervidil).

Will and I are both pretty tired but also over the moon.

More soon.


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Monday, October 22, 2012

Today is the day

Heading in now for the induction. I feel scared. I feel excited. I feel humbled. 

My husband Will is meeting me at the hospital.

For now, 

"I dream of the one yet to be born. The one still curled in my womb. The one who will open like a star."  -Carole Maso, The Art Lover
(thanks to Gwinne for introducing this quote to me) 

But soon,

maybe tomorrow? Maybe the next day? 

She will be here.

She will be born.

I can hardly even dare to imagine it.


photo credit:

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