Anyone who has lived through what Dr. Karp refers to as the 4th trimester with a newborn, and particularly after having a c-section, can attest to the difficulties adjusting once home. It is not just the familial adjustment of adding another member to one’s family (and that is it’s own adjustment, believe me, especially for child #1), but there are real trials that will test a new mother and I have many to share. This is the bad and in some cases the downright ugly side of post partum.
- Hormone crash: While every woman experiences this to varying degrees, it happens to all women. Once the hormone rich placenta is removed, levels begin to decline and sometimes rapidly. In my case, during both my pregnancies, this crash coincided with our returning home. Not only do I feel emotionally raw and easily moved to tears (and I mean the ugly cry, more than once a day), but I can’t predict what is going to trigger me, how deep the spiral will be, and how long it will last. I have cried for long stints (over half an hour) both yesterday and today. It feels less scary than it did with my son and I attribute that to better pain meds (as pain medication can magnify one’s emotional reactions).
- Blisters: I am allergic to latex tape, something I often forget to mention. With this c-section, my MFM covered the incision with an adhesive pad. It was removed yesterday morning and I remember the skin feeling itchy. I scratched a little when I was in the bathroom and thought what is that wetness I feel? Turns out my scratching opened several blisters. I have large blisters (pinto bean size) all across my lower abdomen where the adhesive met my skin. I also noticed upon close examination of my incision, that blisters are forming under the steri-strips that were affixed over the sutures. Lovely. It was so uncomfortable tonight that I decided to lance them. I haven’t looked again, but I feel like they either re-filled or new ones have formed.
- Swelling: I experienced almost no pregnancy related edema. During a c-section, one receives a number of liters of fluids. I received 7 liters during my pregnancy with my son and asked for a reduction in that amount during this one. I’m not sure what the final tally was, but judging by my significantly swollen hips, thighs, calves, ankles, and feet, I’m gathering that I got about the same amount. The swelling has painfully stretched my skin and if I am on my feet too long, I literally can’t bend my ankles. It is quite a sight. It could take two weeks for my body to be able to process the fluid and, really, drinking fluids is the best way to move it along. Suffice it to say it is uncomfortable.
- Soreness: I am sore, internally, and the pain meds don’t completely take the pain away. I should mention that I consented to have a tubal ligation during my c-section. At several points during my surgery I heard my MFM discussing the state of adhesions in my abdomen with the doctor assisting her. During my c-section with my first son, I requested that the adhesions be removed (and because my bowel was attached to the back of my uterus with a finger like rope of scar tissue, this required a specialist be called in. No one wants to nick a patient’s bowel). At Kaiser, their preference is to leave them or to only remove them if it benefits the surgery in some way. At any rate, at one point Dr. F. began to explain that she could not perform the ligation because the round ligaments and my fallopian tubes were plastered in a tangle of adhesions to my uterus (and, we gatherws, was the source of my pain throughout this pregnancy). She marveled at just how she could not discern what was what. At one point she called it remarkable. She invited my husband to come around and take a look and to take pictures so that I could see if I wanted to. He did and I did. What grossed me out was the look of having all these structures attached to my uterus. At any rate, all that mess is causing additional internal soreness for me now.
- Hemorrhoids: I have never had one and thought I’d avoided them with this pregnancy. However, on the morning of my c-section, I did feel some swelling, attributed it to a pregnancy hemorrhoid and didn’t think much about it. Fast forward to today. TODAY as in 3 days post op when I was in the shower. I remember the solution they use to sterilize the back before inserting the spinal block dripping down to my butt so I decided to do a more thorough cleaning. I won’t give a detailed account but I felt something hard (and literally thought it must have been poop that somehow must have come out during surgery but never got cleaned) and the more I felt, the more freaked out I became when I felt THREE of them. A chain of hemorrhoids! OMG, I panicked for a minute because they were OUTSIDE my body. I did some research that said that people get a lot of relief by pushing them back in, but these are not going back (and, even if you do manage to get them back in, they will pop back out at your next BM, so the ‘fix’ is temporary). I can’t bear to actually take a mirror and look but I did Google “hemorrhoid” images and what I saw is what I felt. It is possible they will recede over time, but it is also possible that they’ll require surgery to repair. Loverly,
- Engorgement: As happened with my pregnancy with my first son has happened again: when my milk comes in it is fast and furiously, much more than can be expressed through nursing. And, we’ve been having a few hiccups in that department, too. My son is intermittently feeding at the breast. At first it was because he didn’t like the lanolin. Once I showered and fully cleaned it off, he was back to nursing again. My husband picked up something for me from Whole Foods that is lanolin free but apparently that also upsets baby boy’s delicate taste buds. Which leaves me to have to pump and pump and pump in an attempt to get some relief. But, here is the thing, I can’t get ahead of it. Even if I pump for 20 minutes on full speed, it only barely and temporarily eases the engorgement. And, I can’t really pump more than every 2 hours. So, my breasts are like hot
bouldersrocks. I am about to pump again now and will have to pump once or twice overnight. It is quite painful to pump engorged breasts. Trust me.
So, there you have it. Physically (and to a lesser extent, emotionally), I am a hot mess. I am uncomfortable, tender, sore, blistered and hemorroidal. Any one of these is bad enough on its own and would make one feel less than up to par. But, taken altogether, it is a lot and is overwhelming on top of acclimating to this newborn, to the sleep deprivation, and adjusting as a family of four.
If anyone has experience with any of the above and wants to share tips for resolution, I’m listening.
I managed to avoid getting stretch marks. Yay me!