A CS Geek's Reflections on Childbirth
11 days after the fact, I figured I'd jot down some quick thoughts and lessons-learned from the birth of our first child. These are probably not shocking or revelatory, and I'll admit now that I'm doing it partly to process things in public. And because a few people have mentioned that they're headed down this path and asked if I'd learned anything.
1. Make a plan, and plan to be flexible when you deviate from it.
Rationale: If you don't do the planning for the kind of birth you want to have, you probably won't have it. There are ways to stack the statistical deck in your favor, but there are still a lot of factors outside your control. As a successful, driven professional used to being able to exercise a high degree of control over everything in their life, this may be hard to accept. Sorry - accept it. As a friend recently pointed out, the WHO estimated that the "optimal" national c-section rate was around 10-15% While the US's is higher (about 30%), that means that even if you stack the deck, without knowing more information about your medical history, you're in the 1/10 - 1/5 range.
Personal: We ended up being part of that 15%, despite doing what we believe is nearly everything we could to avoid it. It's rough to have things not go the way you hoped, but knowing up-front that it's a possible (and optimal) outcome is important. A healthy mom and a healthy baby are the #1 goals, and sometimes this path yields the best outcome.
n.b. For someone without medical indications the idea of an elective c-section is baffling to me. It's major abdominal surgery. Internal organs yoinked out and exposed to the world. Don't go there. On the other hand, if your odds of having to have a c-section are known to be high in advance, I can say from observation that having a long and hard labor before your c-section will wipe you out and make your recovery longer. Still chewing on that one.
2. Hire a Doula to help you with labor. The doula will act as a clued-in additional support-person during labor, offering both experience, empathy, and a second set of hands/eyes/ears. There's also evidence that having a doula reduces your c-section risk and reduces the need for an epidural, if you're inclined to go without. (Other studies show that an untrained helper is less effective than a trained doula.) The cost is relatively low and the benefits are large.
Personal: We had a 45 hour labor ending in a c-section. I long ago lost the ability to stay awake for 45 hours straight and still be confident that I'm making good decisions. Our very awesome doula and I spelled each other for spots where each of us could take some cat-naps during labor, preserving both of our sanity and enabling me to remain conscious to support my wife when she needed it. As a first-time parent, it's also a huge relief to have someone else present who's familiar with the process and the system.
3. Find caregivers you trust.
This should probably be #1. As a researcher with enough biology background to be dangerous, I'm a huge fan of digging up information on pubmed, and my ego says I'm OK at it. BUT: Labor is a real-time event, and the decision tree expands rapidly. It's not too bad to do the research on your straight-line "envisioned" birth and figure out, e.g., your opinion on things like pitocin administration, but there's no way that you're going to be able to figure out all of possible variants and branches if things diverge from the plan. Which they're likely to. The people who are familiar with all of the branches are your doctors, midwives, and nurses. If things diverge, you'll find yourself needing to trust their recommendations.
Personal: Things diverge.
4. Be the most friendly, appreciative, and supportive patients you can - before and during the labor. Be engaged in your care, but respectful of your caregivers expertise. (Remember, you picked them because you trust them!) Unless you're in unique circumstances, your caregivers probably have to put up with a lot of shit from stressed-out, impatient, in pain, or otherwise understandably upset people. Your caregivers are human and will typically respond well to people who treat them with the respect and courtesy they deserve. This is an oblique way of saying that you'll probably get better care than the people who scream at them.
Personal: I have no data on this, but I've seen anecdotal evidence of this from when I used to volunteer in an emergency room as a college student. Human nature doesn't change much.
5. Identify the things you really care about, scribble them down, and be prepared to be gently assertive about them.
Personal: For us, this was having skin-to-skin time with the baby after birth. Because of the section, this didn't start until about an hour after delivery. Our hospital's policy was to provide an hour of this after birth before performing routine newborn procedures, but the roving nurse who did the post-birth baby care quite wanted the "hour" to begin at delivery, not when we actually got to our room (I think she was tired and was about to go off-shift and didn't want to deal with us). We had to push on this to get what we wanted. But it worked out in the end.
6. Pack your hospital bags early.
You don't want to be dealing with this on labor day. The probability distribution for this is high enough that you should give yourself a month or month and a half before the due date.
7. Get breastfeeding help. Find out the resources in advance. Take a class.
If your hospital doesn't provide (GOOD) lactation consultant help, within the first 24 hours, figure out the resources available to you. In Pittsburgh, the best option is the Breastfeeding Center. They're amazing. Your doula can also be very useful here. As can the nursing staff, ideally.
(Pro tip: Ask your doula in advance about what kind of support the hospital provides. She'll probably have seen them in action a lot.)
You're going to be spending a lot of time doing this. It's important for your kid's health and can save you time, money, pain, and reduces complications like jaundice if you get it working well from the outset. It's also surprisingly unintuitive and often requires work and help. Ask the nurses. Ask your lactation consultant. Ask your experienced friends. But spend time on this in advance, and it will pay off once you have a baby.
Second pro tip: If you have cracking and bleeding, Soothies glycerin pads are *awesome*. Better for healing than lanolin (lanolin is better for prevention; you'll probably want both).
8. If this is your first child, you probably don't understand how much help you'll need afterwards.
I certainly didn't. I thought I'd be tired and changing a lot of diapers, but the reality is that I've found the time to answer a few emails, put out two urgent work fires, write this blog post, and post one picture of our kid on Facebook/G+, and that's about it. In eleven days.
This may be the time of your life, other than major illness/accident/surgery, when you'll most need to depend on your support network. Again, as someone who's used to being extremely self-reliant and stubborn as hell (my mom tells me that my favorite phrase as a child was "I can do it myself!"), I'd urge you: Give yourself permission to do so. The few weeks post-birth aren't just about your health and mental well-being, they're also about your partner (either direction) and baby. I had to adjust to this a bit, and it would have been more optimal to have set up the infrastructure for this in advance instead of rallying more troops afterwords.
Recruit your parents, in-laws, friends, everything, to help you, not just to be social. Over-prepare - your awesome plan of being recovered within a week may turn into two weeks of post-operative care and newborn feeding. Or having premies that stay in the NICU for a while. Or, or, or. If someone offers help, take them up on it. You'll have plenty of time to repay the favors later.
Corollary: When your friends have a baby, offer to bring them dinner or go shopping for them. What seems like a relatively small thing for you (e.g., two of our friends just went to the store for vitamin D drops for the kidlet for us) can seem like an astounding boon to people who've only been getting three hours of sleep per night for a few days. :-) I get it now; I'm putting this on my future to-do list to try to repay some of the karma.
9. Amazon prime with next-day and saturday shipping. Plus amazon mom.
'nuff said. Set up prime in advance. The "mom" option gives you 365 day returns on most parenting items. Prime gives you $3.99 next-day shipping for "oh shit, I forgot" items, drastically reducing your need to head out to the drugstore.
1. Make a plan, and plan to be flexible when you deviate from it.
Rationale: If you don't do the planning for the kind of birth you want to have, you probably won't have it. There are ways to stack the statistical deck in your favor, but there are still a lot of factors outside your control. As a successful, driven professional used to being able to exercise a high degree of control over everything in their life, this may be hard to accept. Sorry - accept it. As a friend recently pointed out, the WHO estimated that the "optimal" national c-section rate was around 10-15% While the US's is higher (about 30%), that means that even if you stack the deck, without knowing more information about your medical history, you're in the 1/10 - 1/5 range.
Personal: We ended up being part of that 15%, despite doing what we believe is nearly everything we could to avoid it. It's rough to have things not go the way you hoped, but knowing up-front that it's a possible (and optimal) outcome is important. A healthy mom and a healthy baby are the #1 goals, and sometimes this path yields the best outcome.
n.b. For someone without medical indications the idea of an elective c-section is baffling to me. It's major abdominal surgery. Internal organs yoinked out and exposed to the world. Don't go there. On the other hand, if your odds of having to have a c-section are known to be high in advance, I can say from observation that having a long and hard labor before your c-section will wipe you out and make your recovery longer. Still chewing on that one.
2. Hire a Doula to help you with labor. The doula will act as a clued-in additional support-person during labor, offering both experience, empathy, and a second set of hands/eyes/ears. There's also evidence that having a doula reduces your c-section risk and reduces the need for an epidural, if you're inclined to go without. (Other studies show that an untrained helper is less effective than a trained doula.) The cost is relatively low and the benefits are large.
Personal: We had a 45 hour labor ending in a c-section. I long ago lost the ability to stay awake for 45 hours straight and still be confident that I'm making good decisions. Our very awesome doula and I spelled each other for spots where each of us could take some cat-naps during labor, preserving both of our sanity and enabling me to remain conscious to support my wife when she needed it. As a first-time parent, it's also a huge relief to have someone else present who's familiar with the process and the system.
3. Find caregivers you trust.
This should probably be #1. As a researcher with enough biology background to be dangerous, I'm a huge fan of digging up information on pubmed, and my ego says I'm OK at it. BUT: Labor is a real-time event, and the decision tree expands rapidly. It's not too bad to do the research on your straight-line "envisioned" birth and figure out, e.g., your opinion on things like pitocin administration, but there's no way that you're going to be able to figure out all of possible variants and branches if things diverge from the plan. Which they're likely to. The people who are familiar with all of the branches are your doctors, midwives, and nurses. If things diverge, you'll find yourself needing to trust their recommendations.
Personal: Things diverge.
4. Be the most friendly, appreciative, and supportive patients you can - before and during the labor. Be engaged in your care, but respectful of your caregivers expertise. (Remember, you picked them because you trust them!) Unless you're in unique circumstances, your caregivers probably have to put up with a lot of shit from stressed-out, impatient, in pain, or otherwise understandably upset people. Your caregivers are human and will typically respond well to people who treat them with the respect and courtesy they deserve. This is an oblique way of saying that you'll probably get better care than the people who scream at them.
Personal: I have no data on this, but I've seen anecdotal evidence of this from when I used to volunteer in an emergency room as a college student. Human nature doesn't change much.
5. Identify the things you really care about, scribble them down, and be prepared to be gently assertive about them.
Personal: For us, this was having skin-to-skin time with the baby after birth. Because of the section, this didn't start until about an hour after delivery. Our hospital's policy was to provide an hour of this after birth before performing routine newborn procedures, but the roving nurse who did the post-birth baby care quite wanted the "hour" to begin at delivery, not when we actually got to our room (I think she was tired and was about to go off-shift and didn't want to deal with us). We had to push on this to get what we wanted. But it worked out in the end.
6. Pack your hospital bags early.
You don't want to be dealing with this on labor day. The probability distribution for this is high enough that you should give yourself a month or month and a half before the due date.
7. Get breastfeeding help. Find out the resources in advance. Take a class.
If your hospital doesn't provide (GOOD) lactation consultant help, within the first 24 hours, figure out the resources available to you. In Pittsburgh, the best option is the Breastfeeding Center. They're amazing. Your doula can also be very useful here. As can the nursing staff, ideally.
(Pro tip: Ask your doula in advance about what kind of support the hospital provides. She'll probably have seen them in action a lot.)
You're going to be spending a lot of time doing this. It's important for your kid's health and can save you time, money, pain, and reduces complications like jaundice if you get it working well from the outset. It's also surprisingly unintuitive and often requires work and help. Ask the nurses. Ask your lactation consultant. Ask your experienced friends. But spend time on this in advance, and it will pay off once you have a baby.
Second pro tip: If you have cracking and bleeding, Soothies glycerin pads are *awesome*. Better for healing than lanolin (lanolin is better for prevention; you'll probably want both).
8. If this is your first child, you probably don't understand how much help you'll need afterwards.
I certainly didn't. I thought I'd be tired and changing a lot of diapers, but the reality is that I've found the time to answer a few emails, put out two urgent work fires, write this blog post, and post one picture of our kid on Facebook/G+, and that's about it. In eleven days.
This may be the time of your life, other than major illness/accident/surgery, when you'll most need to depend on your support network. Again, as someone who's used to being extremely self-reliant and stubborn as hell (my mom tells me that my favorite phrase as a child was "I can do it myself!"), I'd urge you: Give yourself permission to do so. The few weeks post-birth aren't just about your health and mental well-being, they're also about your partner (either direction) and baby. I had to adjust to this a bit, and it would have been more optimal to have set up the infrastructure for this in advance instead of rallying more troops afterwords.
Recruit your parents, in-laws, friends, everything, to help you, not just to be social. Over-prepare - your awesome plan of being recovered within a week may turn into two weeks of post-operative care and newborn feeding. Or having premies that stay in the NICU for a while. Or, or, or. If someone offers help, take them up on it. You'll have plenty of time to repay the favors later.
Corollary: When your friends have a baby, offer to bring them dinner or go shopping for them. What seems like a relatively small thing for you (e.g., two of our friends just went to the store for vitamin D drops for the kidlet for us) can seem like an astounding boon to people who've only been getting three hours of sleep per night for a few days. :-) I get it now; I'm putting this on my future to-do list to try to repay some of the karma.
9. Amazon prime with next-day and saturday shipping. Plus amazon mom.
'nuff said. Set up prime in advance. The "mom" option gives you 365 day returns on most parenting items. Prime gives you $3.99 next-day shipping for "oh shit, I forgot" items, drastically reducing your need to head out to the drugstore.
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