This time it�s going to be different! I won�t have as much trouble with pain or a prolonged process. I have an appointment scheduled, so I�ll be fully prepared. Above all, I hope to avoid incontinence and prolapse problems later in my life. I�ve elected to have my baby by caesarean section.
Max was supposed to have been a seven-pound baby, but was actually nine pounds, eight ounces. His head and shoulders got stuck in the birth canal and he suffered fetal distress. Given my body habitus, he should have been delivered c-section, but I persevered and delivered vaginally.
Even elective c-section, with its measure of control, is not without risks. It is major surgery that has the potential to cause excessive blood loss, infection, deep vein thrombosis, bowel and bladder damage. The baby can experience respiratory distress syndrome if it is born too early. The recovery period for c-section can be longer than for vaginal delivery and there can be accompanying sexual dysfunction due to adhesions.
Note: Be aware that these are my personal opinions. If you are interested in c-section as an option for yourself, speak with your doctor.
I had my wonderful daughter, Isabelle Hadley, on February 11, 2003. She weighed 7 pounds 8 ounces and is 19 inches long. And I was happy to share those moments with you. The birth was broadcasted as part of the Discovery Health Channel's "Birth Day Live"�special.
If I ever have a third child, I will again select c-section. I just want you to know that in the last week of my pregnancy my only thought was that a scar on my belly cannot be as excruciating as the lower back pain I�ve had for weeks! I�m stopped thinking about the effects of surgery, I just wanted it all to be done!!
After the procedure:
A good place to start is an interview with Mary Alice Williams from Discovery Health Channel TV during the "Birthday Live" program in February, 2003. That interview took place just a few days after I gave birth. Here is a portion of it:
Mary Alice Williams: Why did you choose an elective C-section? Was it because of how arduous the first birth was?
Jennifer: Right, because of how arduous the first birth was. There were complications. It was difficult getting him out, and I also had a lot of problems with incontinence, leakage of urine, for upwards of about seven months afterwards. And with a goal of trying to protect my pelvic floor and vagina I chose to have an elective c-section. I knew there would be pain, but I didn't imagine it would be afterwards. During [the c-section] it was great, you know? It was a walk in the park. It was afterwards that [there was pain]. And not everyone, I guess, experiences that amount of pain, but I certainly did.
MAW: What are the signs of what is going to be chronic and particularly difficult postpartum?
Jennifer: Well, I think you are right in that it is a huge change to your body and to your life, so it's natural to be anxious and upset. But even in the first week women can become so depressed that they really are at risk for harming others or harming the baby. So even if it isn't the first week it isn't something that should be brushed off. Certainly if it lasts after several weeks after you've adjusted, after you've gotten the baby home, it is something that you really need to make sure that you tell your doctor about and that you get evaluated for even medication even.
MAW: For many women is it a chemical imbalance caused by the pregnancy? Hormone departure, so it self corrects?
Jennifer: Well, it doesn't necessarily always re-equilibrate, so that is the reason you sometimes need a little extra help.
MAW: Let me ask you this. It's a serious question. We have had so many generous and brave women tonight, total strangers to us, allow us to peer into this most intimate and special moment in their lives� Tell me how you decided to let us peak in?
Jennifer: From my personal perspective I think it is something that my daughter, Isabelle, would find to be a memento of her life. That's my perspective. But I also think it is really important for women to see and understand what it is really like. I thought it was important for women to see from my perspective going through it first hand, why I did it, what actually happens, and now I'm going to let you know, everybody, about the postpartum recovery. I think it is important for women to understand all of that and how it affects my sex life and my pelvic floor. When you're going through it for the first time it is really scary. My husband can tell you I was scared to death that A) I was going to die, B) it was going to hurt, so I think that if I can help other women and inform people that's what I wanted to do.
(This portion was written two months after the birth.)
The golden moment came two weeks after I had Isabelle. The pain, discomfort and swelling began to subside. I could walk around, move and even lay on my stomach. During the first two weeks I didn't have a recognizable body because of fluid buildup and bowel gas, so I still looked pregnant. I had to deal with quite a bit of pain and since I have a low threshold, it was excruciating at times.
But, at the two-week mark I was feeling well enough to even have sex ! At three weeks I went horse back riding and can resume driving and exercising. I'm currently trying to work out and adjust my diet to lose the weight I gained. It has been harder this time because I'm four years older, so my metabolism has changed a bit.
My mood has also improved since that interview. With my son, Max, I was very teary, emotional with a short fuse during pregnancy and for a few weeks afterward. I had virtually no short-term memory for six months afterward. During my current pregnancy, I felt I wanted to take some precautions, so I asked my doctor to prescribe an anti-depressant. The medication has helped me maintain my equilibrium. Any woman who is considering taking an antidepressant during pregnancy or while breast-feeding should discuss the options with her doctor. Some antidepressants are safer than others to use during pregnancy and breast-feeding. My energy, mood and mental capacity are back to normal.
The family has adjusted fairly well. Max has developed his own 12-step program of reacting to the new addition. At first, he was overwhelmed, quite and observing. That turned into an obsession that he, and only he, was permitted to hold Isabelle all the time. From there he became a little aggressive and needy; he interrupted breast-feeding time and would tap on Isabelle's head a bit harder than necessary. Now, he has graduated to complete indifference! All this behavior is normal, I hope!
Now I'm beginning to get back into my routine and working full time at my clinic at UCLA. I will continue to let you know how things are going, particularly how my sex life has changed, if at all! Oh, and thank you to the many who have sent best wishes. We all appreciated that.Dr. Jennifer's Cesarean Delivery
We then test the patient to make sure she is well anesthetized. Jennifer confirmed that she was feeling an appropriate amount of numbness and was comfortable. Then, I proceeded to make a small incision along her "bikini line" and successively entered the other tissue layers of the abdomen using heat. The muscles were gently separated and I entered the abdominal cavity.
At this point, the surgeon is able to see and feel the pregnant uterus. The bladder is then moved out of the way, and a transverse incision is made on the lower segment of the uterus, and extended upward on both sides.
There's the baby!
I reached in and cupped the baby's head with my hands, while an assistant put pressure on Jennifer's abdomen so that I could gently glide the infant through the incision. A beautiful baby girl was handed off to the awaiting pediatrician after the umbilical cord had been clamped and cut. The pediatrician immediately brought the new baby to Jennifer and husband so they have a first look at their baby. Because the anesthetized woman is not in a secure position to hold the infant, we wait until she has completely recovered to put the baby in her arms.
Still, Jennifer was able to kiss and welcome her daughter into the world. My attention was then focused on the removal of the placenta and sewing the uterus closed. All the layers of the abdomen that were cut were repaired and the skin was closed with sutures. The whole procedure only took about 20 minutes. The incision appeared as thin as a small cut.
Recovering is more difficult than recuperating from a vaginal delivery. It is, after all, major surgery. In addition to bleeding and discharge, constipation, fatigue and hormonal shifts, patients can expect incision pain, severe gas pain, and possible anemia.
Today, I am happy to report, Jennifer and baby are both doing beautifully!
Click a link below to view a video clip of the operation.