Pain, apprehension, and joy
Tomorrow, baby Jean Marjorie Joy will be two weeks old. I am somewhat anxious about tomorrow; she has a follow-up visit with a pediatrician to do a weight-check and assess the possible need for clipping a tongue-tie and upper lip-tie.
It has been almost three years since my children have been to a pediatrician. Longer, in fact… We were in the care of a family doctor, a DO, but after we stopped vaxing, she dropped us. I was not eager to re-establish care with a medical doctor. I’m still a bit apprehensive about it… But, the particular pediatrician comes highly recommended by my midwife — which means a lot to me. As long as the parent is educated about vaccination choices, they do not give any guff about not vaccinating; if they were concerned about me declining Vitamin K or Hep B, it wasn’t apparent. They didn’t blink an eye about my baby being born at home. Or that she is my sixth child; the woman who did the initial assessment had five children, in fact.
Giving it some thought just now, I just realized that how I feel about pediatricians is the same way I feel about hospital birth, and why I chose to birth at home: I know my rights as a patient in a hospital. I’m well-educated as to the pitfalls of birthing the standard American way. I know what I want for my birth. I am confident in my ability to birth. While I truly try to be kind to those caring for me in a hospital, I am not afraid to put my foot down and refuse a certain kind of treatment, or sign AMA waivers, or what have you. But, with this birth, I didn’t want to do that. I didn’t want to be put in a position (perhaps literally!) where I had to endlessly justify my decisions and where I had to advocate for myself. I just wanted to relax and birth a baby in peace, without having to weather confrontation.
I felt the same about finding a new pediatrician, especially after the DO dropped us.
So, last week, going into baby Jean’s “72 hour” first check-up, which was really at one week, I was quite apprehensive about how the staff would treat my baby and me, especially since the actual doctor, the one recommended to me, was on vacation, and I’d be seeing the nurse practitioner.
However, it was an altogether successful visit. The only thing that made it difficult was that I was in physical pain…
I had some concerns (Lordy, this post is filled with apprehension and concerns!) about birthing a baby at 40, and the recovery from that. I am happy to say that the actual recovery has been amazing. Now thirteen days postpartum, I actually feel about 95% recovered. I think much of that is due to careful following of my midwife’s instructions — which has a heavy emphasis on chilling out — and the tender care of my husband, who took a week off of work, and served and fed me better than I would have for myself.
Despite baby Jean’s enormous size — 10 lb, 7 oz; 22″ long, 14.5″ head — and the fact that she had a nuchal hand (she was born with her hand next to her face… and since the midwife couldn’t push the hand back down, she pulled it out, so that baby was born arm-first), I sustained only a superficial 1st degree tear.
I have, however, had weird and painful OTHER things happen since her birth. First, I had to go to the emergency room when Jean was only three days. I have varicose veins — which I knew about — and one on the back of my leg had become puffy, red, hot to touch, and very painful. My midwife was concerned that, even though she couldn’t feel a thrombosis, that there might be a clot deeper in the tissue of my leg. After a phone call to her consulting physician, they both felt like I should go in, immediately, to the ER for an ultrasound of my leg. That was stressful. I think the most difficult part was actually bringing my baby to the germ-filled emergency room. My husband Martin came with me, and even though it was about 110° out, we decided that it was better to use the outside as a “waiting room”. The staff at the hospital was all unfailingly accommodating of me having a brand-new infant, and found us a private room almost immediately. Everyone was kind and attentive, and fairly rushed us through. We were in and out in just about two hours, and the better news was that a) no clot was found, and b) Jean doesn’t seem to have suffered any ill effects from our trip. The tentative diagnosis was “phlebitis” — irritated veins. Sitting for three days in bed is great for recovery from birth, but the staying stationary is less than helpful for varicose veins. In any case, the phlebitis, or whatever it was, seems to have resolved itself.
Then… from about day 2 until day 7, we were treating what we thought was a clogged milk duct. The protocol for that is soaking in hot water, using a heating pad, massage, and nursing on the clogged side as much as possible, using a variety of odd nursing positions, all to help clear out the clog and to ensure that it doesn’t turn into mastitis: a breast infection. Well, nothing seemed to help. I cannot describe the pain. It was, I do believe, the worst in my life, and I include birth in that list.
On Tuesday early morning, a week ago, I was massaging my “clogged duct” and to my absolute horror, saw the side of my nipple gape open. Hidden at the base of the nipple in the wrinkly and folded skin, what had presented as a clogged duct was actually my nipple, detaching. It was entirely sliced through, from about 6:30 – 11:00, a good 3/8 of my nipple, completely cut through. It looked like someone had actually sliced it. Someone had, in fact: my darling newborn, with her powerful but inefficient, tongue- and lip-tied suck.
My salvation was a Medela nipple shield. I am old-fashioned. There just seems to be something wrong with putting a piece of silicone between baby and mama. Historically, I haven’t been a fan of nipple shields. However, it was about my only hope for nursing on that side… With literal shaking and tears from fear of pain, I put it on and attached little Jean Marjorie. Not only did she latch on with no difficulty, but the pain was reduced a good 97%. The pain was still present, but completely tolerable.
So, for five days, I nursed using the shield. It was an annoyance but a blessing.
This morning, she nursed successfully without the shield, and there was virtually no pain and no further damage.
I can tell that she is still not latching on quite correctly. Also, she nurses for a good hour at a time, yet doesn’t seem to ever fully empty the milk from my breasts. She is perpetually hungry. She is wetting an adequate number of diapers; I don’t think her life is in danger from malnutrition. However, for all that I am spending 1/3 to 1/2 of my time nursing my baby, I don’t think she is gaining any weight, and may, in fact, be losing weight. We’ll find out tomorrow.
Theoretically, I don’t mind spending so much time nursing my baby. It is a precious, precious time. But logistically, at some point, I need to be more available to my family, and my baby would benefit from being able to adequately get the milk she needs in a much shorter amount of time. She is spending so much time nursing that I don’t think she’s getting quite enough sleep. Her need for sleep and her need for mama’s milk are in conflict with each other… I can tell she is both exhausted and hungry. Poor sweetie.
So, while I don’t relish the thought of anything getting clipped on her — for all everyone’s assurances that it barely hurts and that she’ll heal very quickly with no disruption of nursing — it does seem that it would be best for both her and me to get the procedure(s) done.
Other worries that were a waste of time:
- Homebirth itself. It was, despite some challenges in the birth itself, absolutely perfect. My husband is a new convert to the benefits of homebirth. Better late than never. :)
- Too many people in the room. We had my midwife, the midwife’s assistant (who is nearly a licensed midwife herself), a student midwife, and a friend who was acting as doula… No one was intrusive, everyone cared for me magnificently, everyone had their place.
- The children. My husband was more concerned about this than I was. Our boys just kind of checked on me periodically, and the girls were present for most of the birth — exiting on their own when things got too intense — and it was just right.
- Our family adapting to #8 in the home. This has been so smooth. So very smooth. My husband is abundantly smitten with baby Jean. The girls are wonderfully gentle and attentive big sisters. The boys slightly less so, but no less loving, and what they lack for in personal attentiveness, they make up for in their general service to our family and to me and baby in particular: they are definitely picking up the slack.
Anyway… now that I’m no longer in continual pain and that there is hope on the horizon, I’m much… happier. Not that having a baby is all about my personal happiness. But, with the difficulty of the birth (difficult for me, that is), I felt more relief than joy at her birth. Then, when the nursing issues started on the second day, the leg vein issues on the third day, etc., I feel like I’ve been somewhat on edge and not able to fully participate in the JOY of a newborn. There have been moments I relish, and my heart is absolutely filled with love and ZERO regrets; I can’t imagine life without Jean Marjorie Joy. But, I’m looking forward to the coming weeks even more.