09/29/2004

P-Funk

No, not that P-Funk. In my case, the p stands for pregnancy. Also placenta previa. Panic. Prematurity. Please let us all make it through this.

The funk — well, I'm in one. I'm in a bad way. I cry a lot, and easily. During the day, I experience isolated fits of weeping. It's better, however, than the night, when I have long, vivid, literal dreams — in the one that recurs most frequently, I am at the hospital begging to be cared for. My request is refused by a doctor who tells me it's too early, that they couldn't save my baby even if I were admitted, that at this point they wouldn't even try.

Yeah, it's pretty bad.

I know that plenty of women have gone almost to term with placenta previa and delivered perfectly healthy babies via uncomplicated C-section. And plenty more have had a scare or two but ultimately went home with babies who have fourished. At the moment those facts are little consolation, since I can't forget that I've so often been the statistical outlier. Time and again, I beat the odds, in good ways first, then very bad. While I'm no more prone to a bad outcome than most women, I'm shellshocked enough not to be soothed very much by even the most encouraging statistics.

I wasn't entirely easy in this pregnancy to begin with. I'd had no reason to think there was anything wrong, but I worried nonetheless. It's just what we do — we worry for no good reason. We worry, and it's mostly for nothing.

Now I have something to worry about, something concrete and serious and documented by ultrasound. I could tell myself that nothing bad has happened yet, but it doesn't seem to help when I know that now it might.

12:02 PM in Jesus gay, I'm pregnant., Welcome to the bad place. Population: You | Permalink | Comments (70)

10/06/2004

Placenta previa primer

Introduction

Plenty of you have asked me, "Julie, what's placenta previa?"

Okay, no one has asked. Perhaps you already know. Perhaps you just couldn't care less. Or perhaps you have recently discovered an exciting new research tool called the Internet, much as I have. But since I cannot bear to keep this vast wealth of knowledge all to myself, I will explain.

Placenta previa describes the position of the placenta in relation to the cervix. In normal pregnancies, the placenta clings to the fundus, the upper part of the uterus. When instead it implants lower, closer to the cervix, you've got yourself a previa (fig. 1).

Placenta previa
Figure 1. You are so screwed.

There are three types: marginal, in which the placenta is located near the cervical opening; partial, in which the placenta partially covers the cervix; and total or complete, in which the cervix is entirely covered.


Incidence

True placenta previa persists in 1 in 200 live births, and 1 in 1,500 first-time mothers. Now, keeping my earlier lucky streak in mind, can any of the mathematicians among us crunch the numbers and figure out whether I should be buying a Powerball ticket?

Look, you can't win if you don't play.


Diagnosis

Low-lying placenta is often detected early in pregnancy via ultrasound. As the pregnancy progresses, however, it is common for the placenta to migrate (a misleading term, since the placenta does not actually fly south for the winter). With the growth of the uterus, the placenta is pulled safely away from the cervix in the vast majority of these cases. This suggests that early diagnosis is not an especially useful tool for predicting later complications.

The later the diagnosis of placenta previa, and the more complete the coverage of the cervical os, the more likely it is to persist until delivery. When a complete placenta previa is identified after 20 weeks or so, it is unlikely to resolve.

If placenta previa is undetected by ultrasound, it often remains undiagnosed until it manifests itself as bright red bleeding late in the pregnancy.


Causes

The causes of placenta previa are unknown, though some risk factors have been identified (fig. 2).

Risk factor Does it apply?
Smoking No
6 or more births Ahahahahahahahaha. Uh, no
Previous C-sections No
Cocaine use Not, um, [cough] in the last 10 years. [Clearing throat.]
Multiple pregnancy No
Previous uterine insult, including D&Cs Yes, but they totally weren't fun so they shouldn't count.
IVF Shit shit shit fuck piss
Figure 2. Totally screwed.

Symptoms

The hallmark of placenta previa is bright red bleeding in the second or third trimester. Only about 10% of women with placenta previa reach term without bleeding. The bleeding is generally caused by changes in the uterus and cervix as the body prepares for delivery, although it can also be incited by intercourse or vaginal examination.

The average gestational age at the start of bleeding is 32 weeks; with complete previa the onset of bleeding tends to be earlier. (The relationship between the onset of bleeding and neonatal complications is inversely proportional: The earlier the mother bleeds, the greater the risk of premature birth.)

The initial bleed is usually minor and tends to stop on its own. It is almost invariably followed by a later bleed of greater severity. The bleeding is usually unaccompanied by pain, although one in five women will experience symptoms of premature labor such as contractions.

Nearly 100% of women diagnosed with placenta previa will, at one time or another, freak the fuck right out.


Effects

The danger to the mother is minimal if she's getting proper care. The main risk is from hemorrhage, which can generally be treated with transfusions and fluid replacement as necessary. (And, no, "fluid replacement" does not mean "a succession of frosty-cold shots of Grey Goose." Try "large-bore IV," jackass.)

The risk to the baby is greater. The mortality rate for previa babies seems to hover somewhere near 10%, triple the neonatal mortality rate overall. 60% of these deaths occur from conditions related to premature birth. Premature delivery will occur in about two-thirds of previa cases.

Aside from complications of prematurity, previa babies also seem to experience a higher incidence of growth restriction and congenital physical anomalies.


Treatment

There is no treatment that can move the placenta out of harm's way, but feel free to think really hard about, you know, the slow inexorable progress of glaciers, the geological wonder of plate tectonics, et cetera.

In the absence of bleeding, expectant management is indicated. Patients may be advised to restrict their activities, eliminating exercise, lifting, strenuous movments, and especially sexual intercourse. Pelvic and rectal examinations are strictly contraindicated. Because the placenta could easily get nicked by careless noodling, nothing should be introduced into the vagina (fig. 3).

Itemsvagina_1
Figure 3. Wait, did I say you're screwed? No. You'd better not be.

If the patient remains asymptomatic, a scheduled C-section is performed once amniocentesis has established adequate fetal lung maturity.

If there's bleeding, on its first occurrence mother and baby will be evaluated. Upon cessation of bleeding, if their condition is stable, and if the mother can be counted on to be psychotically compliant, and if she lives close enough to a hospital to crawl there on her own in the dead of a midwinter night, tangled in her blood-soaked sweatpants and Steely Dan T-shirt, bed rest at home may be prescribed.

Upon subsequent and more serious bleeding episodes...

  • If the baby shows no signs of distress and the pregnancy is significantly pre-term, the mother may be given blood transfusions and medication to prevent premature labor. She may also be treated with steroids to hasten the maturation of the baby's lungs. Hospitalization until delivery is generally required. (Medical personnel are advised to be aware of the likelihood of a recurrence of the earlier freak-the-fuck-right-out, as later flare-ups are invariably more severe.)

  • If the pregnancy is close to term, and amniocentesis shows that the baby's lungs have sufficiently matured, a C-section may be performed. The baby will probably be fine.

  • If the pregnancy is not close to term, but the mother and/or baby are in significant distress, a C-section may be performed. The baby might not be fine.


Conclusion

Now aren't you glad you asked?


About the Author

Julie, who knows how to use Google, is currently working on a book proposal (working title: So You Have Placenta Previa, You Poor Sad Bastard: A Dry, Factual, and Not-At-All-Alarmist Guide). She is available upon request for thought-provoking lectures and reassuring patient consultations.

09:20 AM in I've learned a lot...but I'm not sure it's worth it., Jesus gay, I'm pregnant. | Permalink | Comments (88)

10/08/2004

Three more observations about my breasts

I don't look unquestionably pregnant when I'm clothed, thanks largely to my uncompromising foundation garment. Because of its unparallelled engineering, my breasts still appear to defy gravity, protruding much farther than my abdomen. I look dumpy, not pregnant, and my majestic prow precedes the rest of me into a room by an average of forty-five seconds.

...

I was cupping my breasts (or as much as would fit) in my hands the other day, feeling their heft and the strange texture of the stretch marks that now marble my skin. "My breasts," I called to Paul, who was in the shower, "will never be the same again."

"It's okay," he called. "They'll still be attached to you."

...

The books all say you should expect your breasts to change during pregnancy. They will increase in size, of course, possibly creating stretch marks. Most likely your nipples and areolae will grow and darken as the weeks pass, making themselves a more obvious target for a hungry near-blind newborn.

Mine have done all of the above. Although I knew they would, I wasn't entirely prepared for how dramatic the changes would be. These are not my breasts — because someone would ask — but they are a fairly accurate representation of the before and after of my formidable rack.

03:45 PM in Jesus gay, I'm pregnant. | Permalink | Comments (56)

10/19/2004

24-week roundup

Doctor: New.
Sex: Male.
Attitude about placenta previa: Cavalier.

Baby: Present.
Heart rate: Normal.
Mood upon being prodded: Resentful.

Flavor of glucose drink for one-hour gestational diabetes test: Supersaturated Tang laced with a delicate whiff of rising gorge.
Results: Flunked, emphatically.
Eye-rolling: Lots, exasperated.

11:43 AM in Jesus gay, I'm pregnant. | Permalink | Comments (35)

10/25/2004

I'm ready to shut my pie hole now

dough boyLast week in the mail I received the instructions for my gestational diabetes test. I'd read a bit about the test and knew it involved fasting. That didn't concern me at all, since I knew I could depend on my formidable maternal stores for energy. (Come the apocalypse, everyone's invited over to my thighs for a snack. Don't worry, no shoving. There's plenty to go around.)

What I didn't know is that the test also requires the consumption of an entire bakery. In the three days prior to the test, I am to eat not only MY NORMAL MEALS AND SNACKS — underlined and bold in the instructions — but THREE SNACKS A DAY CHOSEN FROM THE LIST BELOW.

Said list includes items like a whole bagel. Two slices of bread. A cup of cooked pasta. A granola bar. A shitload of cooked rice (that's a third of a shitload uncooked, for ease of measuring). A brace of Twinkies, including licking the wrappers. Three tubes of Pringles, eaten in mouthfuls of five stacked chips or more. A big handful of brown sugar, neat.

Um, I made up those last three.

So to get back to the point, I am to consume all MY NORMAL MEALS AND SNACKS and ALSO about five additional pounds of FLUFFY WHITE FOOD per day. This might not be a problem if I weren't already consuming three cups of pasta a day, plus two slices of toast just to remind my pancreas who's boss. As it stands, it is 2:30 PM and I am now full to bursting after only one of MY NORMAL MEALS and one of the mandatory SNACKS.

Last night I had a real dilemma. I'd made a beauty of a pie, apple-ginger with a latticed crust. After dinner, I wanted pie, but I knew I still had ONE MOTHERFUCKING SNACK left on the menu.

Should I have the pie, I wondered, when I knew that pie plus a snack would leave me oozing a partially digested bready paste from every orifice as I lay down to sleep? (For future reference, mechanics of extrusion being what they are, bending in the middle only makes it worse.)

More troubling was the question of whether the pie should be considered a NORMAL SNACK. I have homemade baked goods in the house roughly half of the time, and if they're here, I eat them. Would the pie count, then, as part of my everyday diet, or as extra? How to classify the pie? NORMAL SNACK or NOT AT ALL OPTIONAL, CRAM IT IN, GIRLIE, COOL HAND LUKE-STYLE GLUTTONY?

Stumped, I ate the pie. Two pieces. And the toast. Two slices. With butter.

If I'm going down, I'm going down with all flags flying, all snacks pie-ing, and my poor sad pancreas whimpering in humiliating defeat.

02:52 PM in Jesus gay, I'm pregnant. | Permalink | Comments (38)

10/28/2004

My pie hole revisited

Remember that pie I made? Well, Paul gets to finish it.

I failed my gestational diabetes test, and I failed it with a vengeance. Out of four blood draws, my blood sugar levels exceeded the norm on three of them. And my numbers weren't even close.

At the moment, I'm not sure what this means, aside from the fact that I'll have to alter my diet, do frequent finger-sticks, and continue to worry. I'm supposed to talk to a specialist in maternal fetal medicine and a nutritionist, but that consultation won't take place for a couple of weeks, so until then I'm a little bit lost. I've put in a call to a nurse to ask for some general guidelines to use while I wait for an individualized plan.

Only 15% of people who flunk the initial screening actually have gestational diabetes; it occurs in only 4-7% of pregnancies overall. I am starting to get tired of being so motherfucking lucky.

What frightens me more than the diabetes itself, which is generally manageable through diet and exercise alone, is my uneasy awareness that complications can snowball. For example, let's revisit my ill placed placenta — if it does, in fact, provoke a premature delivery, my baby is at greater risk for developing respiratory distress syndrome (RDS). But, wait, what's this? You say babies born to mothers with gestational diabetes are at risk of delayed lung maturity, and therefore also at higher risk for RDS?

Great! This calls for a goddamn donut. I told Paul he could have the last slice of pie. When I explained why, he said forlornly, "This wasn't how I wanted to have it...[long pause]...I kind of wanted to fight you for it."

02:14 PM in Jesus gay, I'm pregnant. | Permalink | Comments (57)

10/31/2004

Hitting the pelvic floor

happy fun pelvisYesterday I made the acquaintance of a stuffed pelvis.

You should not think it was your average warm and friendly stuffed animal, complete with googly eyes, plush fur, and perhaps a stimulating internal bell or rattle. No, this pelvis was a formidable thing, white canvas with brown spots, complete with forbidding projections that made it resemble nothing so much as a soft-sculpture horny toad.

I met this pelvis in passing at an antenatal class Paul and I attended. I had some reservations about going in the first place; since I am expecting to have a C-section, I wasn't convinced I'd find the information useful. Learning how to focus during labor pains is something I hope not to have to do — with placenta previa, going into labor is bad, and if I do, all the relaxation exercises in the world won't make a dent in my panic. But the childbirth educator said there would be information on breastfeeding and infant care, and I also hoped I might sit in a room full of pregnant women and enjoy pretending to be normal.

I learned a lot.

I learned what an actual placenta looks like. (This is helpful because if I ever meet mine in a dark alley I'll know which pulsing bloody disc to kick the bejesus out of.) I learned that pregnant women should never, ever wear white cotton leggings, no matter what. (I don't ever, no matter what, but the sight of one of my classmates squatting athwart a birthing ball was enough to make me feel a little light-headed.) And I learned that I am really, really sad.

I am not sad specifically to be missing out on labor and a vaginal delivery. During the riveting vulva-stretching scene in the obligatory video we were shown, Paul leaned over and whispered, without moving his lips, "If that placenta migrates after all, we're screwed." I readily concurred, because I easily got used to the idea of a C-section some time ago and feel no fear about it. No, I'm sad because almost everything women are now encouraged to believe about birth — that it's a natural process, that medical interventions are to be avoided, that our bodies can do this — seems, in my case, not to apply.

The educator talked for a while about early signs of impending labor. All I could think was, "If I get to that point, I'm in trouble." When your placenta is completely covering your cervix, the dropping of the baby or cervical effacement can throw a dangerous spanner in the works. "You'll recognize certain signs and you'll be excited," said the educator. Sure, I guess, if by "excited" you mean "bleeding like a murder victim." "Fear is natural," she pointed out, "but you're not injured, and the pain doesn't mean there's something wrong. It means there's something right." She forgot to add, "...Unless you're Julie, in which case it probably means the plague of locusts will be arriving forthwith."

And what to say about the idea that medical interventions are to be avoided, when at this point I eagerly embrace them? The last two and a half years have been nothing but a long parade of interventions — interventions for which I'm deeply grateful, even aside from ART. The intensive series of early ultrasounds, the methotrexate injection, the D&Cs each allowed me to face sadness and loss with some respite from fear, and some feeling of control, however illusory. I can understand and endorse the view that in an uncomplicated birth a woman's body is entirely capable of delivering a baby without intervention any more elaborate than someone gently mopping her brow, but in my case intervention is what could save my life and my baby's.

Most women's bodies can do this. It doesn't look easy and it doesn't look trivial, but it's natural and normal and what our crankcases were meant to do. But what to do with the information that my body is giving me: that it didn't want to get pregnant in the first place, that it had a hard time putting an embryo where it customarily belongs, that it righteously rejects conventional bourgeois ideas about where a placenta should go, that you can take your apple pie and shove it where the sun don't shine?

I will frankly admit that one reason I looked forward to pregnancy, rather than pursuing adoption immediately, is that for a long time, between the endometriosis, the STDs, and the infertility, I'd felt my body was broken in some fundamental way. I hoped for the chance to disprove that suspicion, some way to validate the awesome power of my lady parts after all: Okay, it's hard to get pregnant, but once I'm there I'm gonna glow, goddamn it.

That hasn't been working so well.

I sat in the childbirth class and cried, not loudly or obviously, because I don't, but with slow and silent leakage of the occasional tear that I couldn't blink away.

And as I write this, I'm keenly conscious that some of you who read it will think to yourselves — because thinking to others is a big waste of time — I can't believe she's not grateful to be pregnant, that she's still complaining, that not even this can make her happy. At least she'll get a baby out of it.

And that is true; at this point it is probable that I will bring home a baby. But how I feel now goes against the grain everything I'd previously believed about that. The baby is the most important thing, of course. It's what we all want, above all: a tiny person to love and be loved by, and it's what I wake up thinking of in the quiet of the night, what makes me smile every time I feel an indignant thump from within.

But if the baby — the person, the love, the product — were the only thing, why would I have volunteered for this? Why would any of us who have undergone treatment? What I wanted was more than that baby, and I'm only realizing the enormity of those desires now that it's clear that they're lost to me.

10:20 AM in Jesus gay, I'm pregnant., Welcome to the bad place. Population: You | Permalink | Comments (79)

11/05/2004

Mama manifesto

As my pregnancy progresses, as we near that powerfully magical 28-week mark when most (most) babies survive their birth, I slowly edge closer to believing we'll soon have a child — a real live baby — in our arms and in our home.

I am bonding in my own twisted way. When the baby is kicking in an especially energetic manner, I sometimes urge Paul to put his hand against my abdomen so that he can feel it, too. Invariably, the kicking screeches to abrupt halt and Paul feels nothing. Either the baby is calmed by the pressure of Paul's hand, or he's fucking with us both. I hope it is the latter. That's what I mean by twisted.

I don't talk to the baby, not out loud. I figure if there's such a thing as telepathy, there is no more direct route than that between my brain and my baby's, via the cutting-edge fiber optic technology of my spinal column. So instead of talking I think to the baby.

I have begun making promises.

As foolish as it may be to attempt to cut deals with a creature who's still more gill than lung, I like to think we have an understanding. Here are some of the things I say:

I will not feed you Lunchables, as I believe it is unhealthy at worst and ill-mannered at best to eat sliced dead people. I may, at my sole discretion, cut funny shapes out of real food to encourage nourishment and delight, but then I already do that anyway.

I will be secretly amused when you call your seventh-grade math teacher a bitch, but you are gonna be so grounded for that.

Mostly I'll know when you're lying.

I will always take your side but it might not always look that way.

I will dress you in ridiculous getups as long as I possibly can. Coming from a woman who is currently clad in Polarfleece overalls with rainbow-striped knee socks, this is a promise you can depend on.

You will think I'm a dork but your friends will think I'm cool. Trust me on this.

The haircut you like is okay with me, as long as it's clean and out of your face. However, I cannot speak for your father.

I will turn an elaborately blind eye, much as my parents did, when you delve into Sidney Sheldon at age 10, as long as you have enough sense not to ask me what "fellatio" means. (Look, we have that OED for a reason, dig?)

I will buy funny Band-Aids.

I will try not to treat you as an experiment, no matter how adorable I think you'd look in a Skinner box. Any studies I do conduct will be performed before you are old enough to remember them. (Note to self: Test efficacy of Ministry's "Stigmata" as lullaby sooner rather than later.)

I will not display any photo of you that showcases your full frontal nudity, no matter how gloriously proud I am of your elephantine genitalia.

Most of the time I'll be laughing with you. Oh, sure, sometimes I'll be laughing at you, but I will not make it obvious.

Yes, you may join the Girl Scouts. No, you may not join the Boy Scouts. I do not feel this is inconsistent, and I'll be happy to tell you why.

I will mess with you. A lot. I will blow in your face to watch that bewildered squinty look that babies get when they feel that single surprising puff. When you cry, I will gently and rhythmically tap my hand over your mouth, so that you make that "bah-uhbah-uhbah-uhbahbahbahbahbah" noise, perhaps surprising you out of your wailing but at the very least entertaining myself enough to endure it.

I will try not to tell stories about you that embarrass you, but you have to let me know I'm doing it. Deal?

No, we will not get rid of the cat if he scratches you. Do you think it was a good idea to pull his tail? I wonder if you'll do it again.

I will surely annoy you by singing made-up words to songs. I do it on purpose. If you can't beat me — and on this, my dear, you cannot — I surely hope you'll join me.

As an addendum to the above, I am well aware that I sound nothing like Joan Armatrading. I will sing along nevertheless. To any complaints, I shall say, "Hard cheese."

I will hold your hand in public as long as you'll allow it.

I will try to remember not to say no unless it matters.

I will try really fucking hard not to swear in front of you. Or at least not quite as much.

Okay, look. I know I'm supposed to pledge that I'll protect this tiny creature born into our care. I'm supposed to give a solemn oath to help shape his young life into one of beauty and meaning. I'm supposed to vow to nurture and to encourage, to cherish and to love, unconditionally, without limit, beyond the bounds of reason.

But, jeez, I just said I would, didn't I?

04:44 PM in Jesus gay, I'm pregnant. | Permalink | Comments (47)

11/09/2004

Flipping out

Yesterday, to reassure my loved ones about the congenital anomalies scan, I sent out an update:

This is apparently routine for patients with gestational diabetes, and really the only thing scary about this is the name. It's merely a very detailed scan, complete with measures like length of femur, appropriate flapping of heart valves, counting of kidneys, presence of nose, etc. The name is scary, but the procedure isn't, and I am relieved to report that all is well.

We have exactly enough kidneys, some interesting-looking pieces of brain, two legs, two feet, two hands, and one arm. (Okay, we probably have two arms, since we do, in fact, have two hands, but Batman was obstinately keeping his left arm hidden, with only the hand peeping out for counting purposes.) The presence of the nose was confirmed, and it appears to be centrally located for style and convenience.

I also sent a picture.

My aunt called this morning to tell me she'd liked the picture. "Your baby's cute...!" she said.

"Thanks," I said.

"...But his hand looks sort of like a flipper."

As God is my witness, she said that.

I put it to you, gentle readers, and I fully expect you to be as speechless with indignation as I was. You be the judge: does the baby's hand look flipperlike in the least?

09:25 PM in Jesus gay, I'm pregnant. | Permalink | Comments (69)

11/14/2004

Put. That. Back.

Yesterday's childbirth class saw us shifting our focus. Our discussions of validation — "I can't do it." "I can see how hard you're working, honey...but the baby wants to do it." — and comfort measures — cold packs, massage, groaning like the hydraulics on a 1936 International Harvester — seem to have ended. This time we went high-tech: we talked about pain relief and C-sections.

The first thing the educator did was pass around a sheet with a pain scale on it, one that encompassed every attitude from -10 ("wants no medication whatever, even for a C-section") to +10 ("wants to feel absolutely nothing, wants anesthesia before labor begins"). The educator instructed us to find ourselves on the scale. Since the sheet sternly admonished us that +10 was "an impossible extreme," I settled for a +9 ("scared of pain, dependence on staff for pain relief"). But then I admit that my circumstances are unusual; unlike most women about to be presented with a newborn, if I feel pain it means something's bad wrong. Damn skippy, I'm scared.

We talked about different medications we might be offered. I entertained myself by making anagrams. (Stadol: Sad lot. Tad S.O.L. Do last. Demerol: Led more. Med role. Sorry, what were you saying?) The educator showed us a helpful poster of a large and bulbous woman being administered an epidural. The woman was squatting calmly, balanced on her tiptoes, holding on to nothing, quite a feat when there's a long needle about to be introduced into your spinal column, for which you must remain...perfectly...still. I was keen to learn exactly which narcotic had been administered, because I want some before my upcoming audition for Cirque du Soleil.

And then we talked about C-sections. Another helpful poster made its appearance on the easel: Reasons for Performing a C-Section. Fetal distress. Placental Problems. Wack-Ass Presentation. Good-Christ-Almighty-No-Way-Is-That-Head-Gonna-Fit-Through-That-Pelvis.

The educator gave us a bare moment to absorb this information, then whipped us into a participatory frenzy by wheeling in a gurney and setting up a role-playing exercise. One of the men was selected to be the expectant mother, while the rest of us were given various jobs around the operating room — surgeon, scrub nurse, pediatrician, anesthesiologist, etc. I wanted to man the placenta bucket so that I might sneak in a good old-fashioned ass kicking while everyone else was cooing, stitching, or fitting the newborn with a fetching chapeau, but instead I was appointed pediatric nurse, and immediately took to menacing everyone nearby with the bulb syringe.

She walked us through what happens in a C-section. Do you know? I do, now. Here is a brief outline:

  1. Prep: shaving, scrubbing, draping, IV, anesthesia, etc. Draping includes erecting a barrier of cloth between the mother's chin and her abdomen to serve as a sort of sneeze guard. I am of the opinion that they should use one made of Plexiglass like at a salad bar, for easy viewing.
  2. Incisions: cuts made through whatever happens to be making it inconvenient to lift a baby out.
  3. Retraction: pulling the edges of the incisions wide to form a large enough opening for...
  4. Grabbing: seizing the slippery prize and wrenching it MacDuff-style into an ice-cold operating room.
  5. Whisking: hurrying the newly delivered baby out of the operating room away from the mother. Yes, away from the mother, who does not get to touch or feed the baby until...well, sometime later.
  6. Inspecting: checking to make sure the mother's uterus is still in good shape. Do you know how they do this? They pull it out of the abdominal cavity. Oh, sure, it's still connected (by God knows what mechanism, though I hope mine has a security device on it to discourage theft), but they pull it out to play with it. This is the single most upsetting thing I've heard since the class began, and makes me reconsider my desire for a clear splatter shield. In fact, I may ask for a blindfold, just to be sure I don't see Scottie Pippen, M.D., twirling my ute as if he were a Harlem Globetrotter, preparing to move outside the key for an easy 3. Dude! Put. It. Back!
  7. Closing: the mother is stitched up, swabbed down, and wheeled, still high as a kite, out of the OR. I assume she's still high as a kite, because the educator didn't have us role-play the part where the mother is shrieking for more opiates, now. I may have to practice that part at home just in case.
And that is how you get a baby via C-section.

I asked with some trepidation whether I'd be able to breastfeed right away, and the educator looked shocked. "You'll just have had major abdominal surgery!" (Oh, silly me, I thought that part where they pull out your uterus for show-and-tell was just a motherfucking trifle.) I am disappointed that I won't get to do this, because babies born to mothers with gestational diabetes can have low blood sugar, and it's thought to beneficial to put them to the breast right away. Sorry, Batman, you'll have to make do with a Big Gulp and a bendy straw. Sprite or Cherry Coke?

The only part of this whole affair that didn't freak me out was the part where the educator warned us in the "operating room" not to touch anything: "You're all sterile!"

Please. We prefer "subfertile."

10:18 AM in Jesus gay, I'm pregnant. | Permalink | Comments (64)