My Experience: Pregnancy & Gastroparesis
Before Getting Pregnant: Posted 10/27/11
I had an appointment with my motility specialist, Dr. Lacy, this week. It was a check-up, both for the gastroparesis and chronic constipation. Overall, I'm doing very well and together we identified a number of factors that have likely contributed to the improvement I've seen over the last couple of years:
The gastric neurostimulator: at this point, the device has decreased the nausea so significantly that I'm only using Zofran about twice a month. (Other than during flare ups.) Pretty amazing considering that used to be my main symptom.
Managing constipation: I've been taking a medication called prucalopride to treat the slow transit constipation. The results are quite dramatic. I'll spare you the details but suffice it to say I now take only 6 Ducolax per week instead of 24. As Dr. Lacy explained at my last appointment, chronic constipation not only exacerbates bloating, fullness, and nausea, it also further delays gastric emptying due to feedback mechanisms within the gut.
Time: Dr. Lacy believes that idiopathic GP can resolve over time, though it may happen very slowly. I believe this, too (I've seen it happen). His point, which I want to emphasize to all of you, is that the reason my body has been able to get even a little bit better over time is that I didn't have any "crazy surgeries." I get a lot of emails from people asking about various surgeries as a means to alleviate GP symptoms -- gastric bypass, the gastric sleeve, etc. In my opinion, removing or surgically altering an organ to treat a condition that you don't know the cause of and may resolve on its own over time doesn't make a lot of sense. (These surgeries have actually been the cause of GP in some cases!)
Self-care practices: I make careful dietary choices and pay attention to daily lifestyle choices, as well. I eat in a way that allows me to both manage my symptoms and maximize my nutrition. Right now, that means a lot of soups, smoothies, juices, and Orgain. I take appropriate vitamin/mineral supplements. I walk several miles every day and practice regular meditation. I try to manage stress (though that's something I still struggle with) and I take advantage of complementary therapies such as craniosacral therapy and biofeedback to augment my medical treatment. I also think my outlook on the situation plays a role.
With all of that out of the way, we moved on to the topic that I was most anxious to talk about. While the appointment was technically a check up, my primary intention was to ask about pregnancy and gastroparesis/chronic constipation. My husband and I have decided that we're ready to start a family but my health issues obviously complicate things. While this topic is a bit personal, I've decided to share it because I know there are many of you in the same boat.
In terms of the gastroparesis, plenty of women have gone through pregnancy after being diagnosed with GP and delivered healthy babies. It's not always easy symptom-wise and obviously nutrition is a big concern (there are supportive measures that can be taken, if necessary). I definitely think that my background in nutrition, the gastric neurostimulator, and the symptom management plan that I already have in place will be helpful in these areas. Plus, Dr. Lacy reiterated that some women actually get better during pregnancy. (Unfortunately it's impossible to determine in advance whether or not that will happen.)
In terms of the neurostimulator, Dr. Lacy has experience with patients who have gone through pregnancy with the device and he hasn't seen any complications. Though there is no official recommendation from Medtronic (the device has not been studied in pregnant women), there doesn't seem to be any concern about it harming the baby or otherwise impacting pregnancy, even when left on. I talked with my surgeon at the Mayo Clinic and he said that the wires are plenty long enough to stretch as the belly grows and he doesn't anticipate any issues.
The biggest concern, for me anyway, is the slow-transit constipation. Dr. Lacy is of the opinion that women should not take any medication during pregnancy, if at all possible -- especially not for the first three months. While there's no evidence that prucalopride causes birth defects, there's also no evidence that it's safe during pregnancy. The Ducolax also needs to be avoided since it could possibly cause contractions of the uterus. So I'd most likely have to navigate pregnancy without medication for the constipation.
Obviously given the severity of my constipation and the way it affects my GP symptoms, I'll likely be more symptomatic and probably quite uncomfortable, but Dr. Lacy is completely supportive of my desire to have a baby and doesn't see any reason why I shouldn't get pregnant. So we worked out a plan. Again, I'll spare you the details, but Dr. Lacy helped me figure out when I have to go off the medication in order to try to get pregnant and when I can go back on it if I am not pregnant. It's going to be a bit of work and I understand that my symptoms will likely flare up while we're trying and then for the duration of the pregnancy, but I'll do my best to manage it, knowing it's only temporary, and it will all be worth it in the end!
So, that's the update. The next several months are likely to be challenging, but I'm excited and optimistic.
My Pregnancy Announcement: 2/3/12
Pregnancy Updates
14 Weeks (First Trimester Update)
I'm now 14 weeks pregnant and officially into my second trimester! With the first trimester behind us, I'm looking forward to sharing more about my experience as a mama-to-be who also happens to have gastroparesis. This first post will be a bit long as I've waited to write it, but I'll be posting more regularly over the next six months.
The last three months flew by, between our pre-planned vacation and then packing, moving, and settling into our new house. Thankfully my pregnancy been pretty uneventful, aside from some "morning" sickness during the second month and a ruptured ovarian cyst a few weeks ago (scary and painful, but at least I got an extra ultrasound!).
I've been able to gain the recommended amount of weight (about 6 pounds, so far, even though I've eliminated all wheat from my diet) and have been giving my baby as much nutrition as possible via Orgain, fresh juice, smoothies, and purees. That's not all I eat, of course...just the most nutrient-rich things I eat.
That said, there have been a few challenges when it comes to balancing GP and pregnancy...but not necessarily in the ways I was expecting. Let's start with heartburn, something I haven't experienced since I weaned myself off of Nexium four years ago. Since I've been pregnant, I get heartburn quite frequently between meals and almost always at nighttime. I bought myself a Snoogle, which I fold in half so that my upper body is propped up while I sleep and that's helped (this thing is so comfy...and versatile!). On the upside, it's so nice to have a "normal" symptom. Almost all pregnant people get heartburn.
I've actually been less symptomatic gastroparesis-wise since I've been pregnant and I've been able to add some foods to my diet that, though GP-friendly, weren't Crystal-friendly before. Things like eggs and chicken. I've also been able to eat some things that aren't necessarily GP-friendly as long as I keep the portion small and the flavors fairly bland.
The "problem" with this, is that my stomach doesn't actually seem to be emptying any faster. In that way it's kind of like what I've experienced with the gastric neurostimulator (in fact, it seems like pregnancy has enhanced the effects of the stimulator). Feeling less symptomatic upon eating makes it more difficult to avoid eating "too much," which does trigger symptoms. This is further complicated by the fact that my appetite has definitely increased. Some days, I swear I never feel full or satisfied. Until the evening, that is, when the fullness finally hits, my belly gets huge, and my symptoms flare up with vengeance. It's almost like I can't feel the symptoms until my stomach is really full...which, given how I spent the first 5 or so years after my gastroparesis diagnosis, is really nothing to complain about! Just something that has required some special trial and error.
Other challenges have included finding a prenatal vitamin that I could tolerate over the long term. For this, I had to really take to heart the messages I repeat to my clients over and over -- "some is better than none" and "do what you can with where you are." There are some really good prenatal vitamins out there. But it doesn't matter how good a vitamin is if I can't take it day in and day out for nine-plus months without it exacerbating nausea, constipation, and/or stomach pain. A less-than-perfect daily prenatal vitamin every is probably better than a perfect prenatal vitamin here and there when I'm able to tolerate it. I currently alternate between VitaFusion Gummy Prenatals most days (which does not contain iron; probably why I tolerate it better than other formulas) and New Chapter Organics Perfect Prenatal a couple of times a week.
I discussed this decision with my OB/GYN, taking the vitamin bottles with me to an appointment before I even got pregnant, and she was on board with my decision. Since the need for iron increases in pregnancy but supplemental iron is hard on the GI tract -- especially slow GI tracts -- we decided that I would continue to supplement with blackstrap molasses. So far, it seems to be doing the job. If you're thinking about becoming pregnant in the near future, I highly encourage you to start experimenting with prenatal vitamins now. It might take some trial and error to find one that you tolerate and it's preferable to start taking them before you conceive to prevent early birth defects.
Another interesting experience that I've had just recently is the emergence of the "baby bump." It's exciting to see the changes in my body, but it's also slightly confusing. As someone who has struggled with bloating for the past eight years, sometimes so severe that I did look pregnant, it's hard not to immediately think "something's not right" when I see the belly sticking out. Granted, I've had quite an issue with constipation lately (which is true for many women during pregnancy, with or without a slow colon) and that's contributed to the belly bloat, but much of it is normal pregnancy growth. It's something I hadn't expected to have any trouble with, but it's been a little hard to wrap my head around.
One thing I haven't kept up with during the past three months but I can't wait to get back to is my normal exercise routine. Partially because I was busy and partially because I was exhausted, I haven't been walking or practicing yoga regularly. Thankfully my energy level has increased in the past week or so and life is settling down, so I've dusted off my treadmill and I'm actually heading to my first prenatal yoga class tonight!
17 Weeks (Second Trimester)
After years of looking pregnant when I was actually just bloated, I'm proud to finally have a real baby belly! I'm 17 weeks along and things are going very well. The biggest challenge at this point is continuing to get enough nutrients as the baby grows.
My iron, sodium, magnesium, and calcium levels have all dropped slightly below normal, which isn't terribly surprising. When the diet doesn't contain adequate nutrients for mom and baby, they go to the baby first. And if the baby needs more, it'll take a little extra from what mom has stored in her body.
So, I'll have to work a little harder to enhance the nutrition in my diet. In part that means more blackstrap molasses, more NaturalCalm, and some extra Orgain. But it also means adding more variety to my diet...or, in other words, breaking out of my food rut.
Like most people with GP, I sometimes fall into a routine with my food, eating the same meals and snacks day in and day out. Orgain, MacroBars, potatoes, bananas, nut butters, tried-and-true smoothies and fresh juices...having nutrient-rich staples you can rely on is a good thing. Lack of variety is not.
For all of us with gastroparesis, pregnant or not, a varied diet is the key to getting all of the nutrients the body needs to function properly. The best way to enhance the variety in your diet is to eat GP-friendly foods in a rainbow of colors each day.
I'll be honest: this is not always easy. Even for me! Sometimes I worry that if I give myself an inch, I might take a mile. Never stop experimenting...never stop eating. Sometimes it happens. I overeat or try too many new things too quickly and end up more symptomatic. But I've found that most of the time, if I don't worry so much about what may or may not happen, I do just fine.
The other issue with venturing beyond your staples is that it takes extra thought and effort. Sometimes, especially when you're tired or low on energy, it's easier to stick to your staples than it is to actually think about what you're going to eat. Especially when you're fixing it just for you.
That's why I try to make preparing a variety of food as easy as possible:
I prepare big batches of recipes, like soups and purees, and freeze them in individual serving sizes.
I shop and cook when I have the energy, so that I have food ready for when I don't.
I try to make my meals something that my husband will also eat, even if I’m supplementing his with additional things.
Tonight I made Roasted Red Pepper Mashed Potatoes for dinner, a recipe which exemplifies ease, moderation, and "color." Potatoes are a staple for me, as they are for many following a gastroparesis-friendly diet. Though they're rich in potassium, they're lacking in color (phytonutrients). Adding roasted red peppers is a small change but a nutritionally significant one -- they're packed with vitamin C! As for making things easy, I made the potatoes in the slow cooker, pureed the peppers in my Vitamix, and fed it to my husband alongside his pork chops and peas. We both loved it!
The full recipe is featured in this month's newsletter. Definitely give it a try. But don't stop there. Keep experimenting, slowly and deliberately, with other GP-friendly ways to eat a rainbow of colors each day. Pregnant or not, food ruts aren't nutritionally sound or terribly satisfying. Taking small steps to incorporate more variety into your diet can go a long way toward improving your overall nutrition...and that's a big part of living (well!) with GP.
20 Weeks (Halfway There)
As of yesterday, I'm officially halfway through my pregnancy! A milestone that was marked by an ultrasound and a prenatal massage.
By the way, "pregnancy brain" is real! I just had to ask my husband what it's called when you reach an important point in your life. "Not a landmark, but a ....?!"
The massage was fantastic, but the ultrasound was of course the highlight of the day. To see my little baby on the screen -- heart beating, hands waving, feet kicking -- was unreal. We didn't find out the sex, but the technician did use the term "he" a couple of times. Hmm...
The last 20 weeks have presented some challenges, both general to pregnancy and specific to pregnancy with gastroparesis. Like figuring out how to deal with a raging appetite but a full stomach and how to manage the reflux that keeps getting worse as I get bigger. But the further along I get, the more I realize that this process is transforming my life in very positive and unexpected ways.
One thing that's changed is my relationship with my body. I spent many years being dissatisfied or angry with my body for not looking or working the way I wanted it to. I also spent many years not treating it very well, either in protest, punishment, or retaliation. Even after I started to take better care of my body, I felt very little -- if any -- gratitude towards it.
This pregnancy has changed that. Maybe my body doesn't work perfectly. Maybe it hasn't functioned the way that I've wished it would for the past decade. But over the past 20 weeks, it has been doing the most important and amazing work of all...and it's been doing it well! My body has conceived and nurtured a healthy baby, while still keeping me healthy. Perfect? No. Iron is too low, asthma is worse, constipation...let's not even go there. But even still, despite what's it been through over the past eight years, here my body is doing something remarkable.
For the first time ever, I feel profoundly grateful for the work my body is doing. That itself is a transformative thought. And you don't have to be pregnant to make this shift.
When I think about it -- even aside from the pregnancy -- for the past eight years while I've struggled with and focused on gastroparesis, my heart has been beating day in and day out, my lungs have been taking in oxygen, my blood has been carrying that oxygen to every cell in my body. That's definitely worth a thank you.
What if instead of your body working against you, it's actually doing it's very best to work for you given the circumstances? What if when your blood work or test results come back normal, you take a minute and feel thankful for that? To realize that your body is actually doing a lot of things well. How different does that feel? How much more do you want to nourish your body and work with it instead of against it?
Just some food for thought from this mama-to-be. I can't wait for the day I meet my little one in person, but I'm trying to learn from and appreciate every step of the process along the way. I imagine the next 20 weeks will be full of more unexpected challenges and opportunities. Thanks for being a part of the journey!
24 Weeks (Pregnancy is Easy?)
Wait, don't throw anything at me! I'm kidding. But this week, week 24, I was reminded that my daily choices play a big role in how hard or easy the process feels (kind of like life, in general, huh?).
On Wednesday morning I had a prenatal massage (I get one every 3 weeks and its heaven; whether you're pregnant or not, treat yourself to a massage once in a while!). My massage therapist asked how I was doing, and I went on and on about how great I felt. Pregnancy is easy, I said, there's really nothing to complain about!
Mm hmm. By Thursday night I was whining to my husband about how much my left hip and leg hurt, how much worse my allergies are, how uncomfortable it is to sleep with all of those pillows, and how hard it is being the mama-to-beeeee...
What changed? I spent literally all day Thursday finishing up my Juicing & Blending eBook. I skipped my yoga class. I walked about 400 steps (mostly to and from the bathroom) instead of my usual 10,000+. I didn't take a nap even though I'd slept poorly the night before. I didn't take the time to juice (ironic, given what I was writing about all day). My water bottle sat empty on my desk for hours.
Yeah...that'll do it...
For the most part my pregnancy has gone very well and I am very grateful for that. When I found out I was pregnant, some of my family members and at least one of my doctors were quite concerned given the gastroparesis and other GI motility issues. But I really wasn't. I just knew it would be okay.
How? Because I've successfully dealt with big challenges before (living WELL with GP!) and I've learned a few things in the process. I know that attitude matters. I know that expectations matter. And I know that choices matter.
Sometimes I conveniently "forget" all of that, but it doesn't take long for life to remind me. So this morning, I'm writing to you as I walk on my treadmill. I'm sipping on my green juice and I have a full water bottle by my side. My allergies are still bad and my neck hurts from sleeping awkwardly on that mountain of pillows, but today there doesn't seem to be nearly as much worth complaining about.
No, pregnancy is not easy. Life most certainly isn't easy. We don't have control over everything. But we do have the power to make things a whole lot easier when we acknowledge that our daily choices really do matter.
30 Weeks (Q&A)
I can't believe it's been five months since I shared my pregnancy announcement with you! I also can't believe that in just 10 more weeks I'll finally get to see my little boy or girl's face for the first time. I could cry just thinking about it. (Okay, maybe I am crying...it happens a lot these days!)
Things have gotten back to "normal" (if there is such a thing) since my blood transfusion last month. I'm walking 10,000 steps a day, practicing prenatal yoga, and juicing and blending daily. Other than the typical pregnancy discomforts and a few extra GP-related challenges, I'm doing well and my little one is strong, active, and healthy. What more could a mama-to-be ask for?
I've received a number of questions lately about GP and pregnancy in general and my experience in particular, so I thought I'd answer some of the most common ones in this post.
Q: Have you been able to get adequate nutrition despite the gastroparesis?
A: Yes! It has taken a good amount of experimentation and effort, but I'm eating a more varied, nutrient-rich diet now than at any other time since I was diagnosed with GP. This is in large part due to all of the juicing and blending that I do. Combined with the supplements that I take; both my baby and I are well-nourished.
The exception here, of course, is the iron deficiency. I was anemic prior to pregnancy and had very, very low iron stores. Since I had not been taking an iron supplement due to colonic inertia (see below), even the spinach smoothies and weekly servings of lean organic ground beef weren't enough to offset the increased need for iron. Since the blood transfusion, however, these dietary interventions seem to be helping to keep my blood count stable.
Q: Have you been able to gain weight? Was it difficult?
A: Oh, yes! I'll probably end up with a total weight gain of around 40 pounds. Though I gained 10 pounds after having the gastric neurostimulator implanted in 2010 and was within the normal BMI range when I got pregnant, I was still quite a bit underweight for me. My body has done a fantastic job of taking on what it needs in order to nourish me and my baby throughout pregnancy. I've made very deliberate dietary and nutritional choices, but I haven't had to try hard to gain weight.
(Please keep in mind that my dietary choices and improvements, would not be possible without the other aspects of my comprehensive management plan. I cannot emphasize this enough! It's HUGE.)
Q: Does the gastric neurostimulator affect pregnancy? Did you have your device turned off when you got pregnant?
A: No, my stimulator has been on the entire time. Prior to getting pregnant, I talked with my motility specialist, the surgeon who implanted the device, the VP at Medtronic, and my OB/GYN. All agreed that the device could remain on during pregnancy. While no studies have been conducted, I was told that many women have now given birth with the device implanted and there haven't been any reports of complications due to the device. Having the neurostimulator may have been why I experienced very little morning sickness!
As my belly has gotten bigger, I've had some discomfort around the site of the stimulator. The docs say it's from the scar tissue stretching. It hasn't been terribly painful, just annoying at times. The baby has also just started kicking the site of the device. Again, it doesn't hurt, but it's a little annoying.
Bottom line: having the device hasn't really impacted my pregnancy. If a C-section were to become necessary, the stimulator would obviously be an additional consideration. C-sections are performed very low on the abdomen, however, much lower than where the device is placed.
Q: Have the gastroparesis symptoms gotten worse?
A: Prior to pregnancy, I was told that there was no way to predict whether my symptoms would get better, worse, or stay the same. Thankfully, they've improved! Not the early fullness or the delay in emptying, but the variety of food that I can tolerate has definitely increased. .
Now in all honesty, I think this is partially due to pushing myself to step outside of my own comfort zone. Since being pregnant, I've tried things that I hadn't tried in many years (despite my advice to others!), and I've found that I do just fine in small portions. A result of the pregnancy itself? I don't know, but I plan to continue experimenting after the baby arrives to see.
I've talked with a number of other women who have gone through pregnancy with gastroparesis and most of them also noticed an improvement in their symptoms.
Q: Has the constipation gotten worse?
A: In addition to the GP, I also have motility issues in the colon and this is what most concerned my docs and my family when I was thinking about getting pregnant. We all knew that I'd most likely be able to manage the GP, even if it happened to get worse, with the comprehensive management plan and great team of docs that I have in place. The constipation was another story since I relied on high, frequent doses of stimulant laxatives and a prescription drug that couldn't be taken during pregnancy.
Thankfully (though counter-intuitively, since many women without GI issues become constipated during pregnancy), the constipation has actually been easier to manage. I now need only 2-3 stimulant laxative tablets every 4 days. This is a significant improvement. Please keep in mind that stimulant laxatives are not typically recommended during pregnancy, but this is why it's important to have a medical professional who looks at your situation individually and helps you to weigh the pros and cons, making the best decision possible.
Note: Colonic inertia is not the cause of constipation for most people who have gastroparesis. Please watch this video for more info about common causes and solutions.
This isn't to say that there haven't been challenges related to having GP while being pregnant. I have to be really, really diligent with my self-care and lifestyle, otherwise my symptoms flare quickly. The tenderness in the upper abdomen has increased as the baby has grown. The reflux has become a bigger issue. But just like everything else with GP (and life in general!) attitude and choices make all the difference.
I'm doing my best to make good choices, and I've never been as grateful for anything in my life as I am for this pregnancy. If you'd asked me 4 years ago, I'm not sure I would've thought it would even be possible. Yet here I am...10 weeks from welcoming my son or daughter into the world.
36 Weeks (Learning to be Flexible)
Only four more weeks, give or take a couple, until my baby makes his or her way into the world. I can't wait to meet the little monkey who has been somersaulting around in there. He or she has already helped me grow in so many ways (aside from the obvious!) and our journey is only just beginning.
One thing I've had to really work on lately is flexibility. Not just physical flexibility in preparation for the birth, but also being flexible when it comes to my comprehensive management plan.
As I've mentioned before, most of my usual GI symptoms improved after I became pregnant (with the exception of heartburn, which has been akin to what I experienced when I weaned myself off of PPIs five years ago). This allowed me to expand my diet to include additional GP-friendly foods, such as chicken breast, eggs, and cheese. I started drinking larger quantities of fresh juice, diluting it less, adding more leafy greens. I was eating organic lean hamburgers a few times a week to keep my iron levels up. I had a piece of cake or a brownie here and there. I still had to watch portion sizes and overall volume carefully, but even if I did overeat the only real consequences was regurgitation of the "excess" food.
That was the first seven months. But in the last month or so, things have started to change. More nausea, more fullness, more pain. A lot more regurgitation. Hmm...
My first reaction was, "Nooo! My run of good luck is over. The gastroparesis is getting worse again!" Has that happened to you? You're doing really well and then things seem to take a turn and you immediately assume that that's the new direction you're going in long term? In actuality, it's perfectly normal at this stage in pregnancy for women without gastroparesis to experience increased fullness, heartburn, nausea and other GI symptoms as the stomach gets more and more squished in the abdomen. So, it makes sense. Just like most GP-flare ups, there's a reason. It doesn't mean that the gastroparesis has gotten worse in the past month or that things will keep getting worse over time. Those are just the stories a busy mind tells.
What it does mean is that for right now I have to change some things -- choices, actions, mindset -- to reflect the current reality. I have to be flexible, in other words. That means drinking less juice and using milder fruits and veggies. It means more potatoes and less lean beef. It means hubby and I are back to our nightly walks and I'm practicing more breathing exercises on my own. It also means being okay with these changes. Realizing that they don’t mean anything about the future.
There are always ups and downs. All things ebb and flow. Without the ability to be flexible, one of two things usually happens: we resist making any changes and therefore feel worse and worse, OR we give up completely and resign ourselves to "this is how it's going to be from now on." Neither is true and neither is terribly helpful. By taking one day at a time, we can more appropriately address our needs as they arise and find more consistency and better outcomes (physical and mental) overall.
This isn't the first time in my pregnancy that I've had to be flexible with my management plan. It wasn't easy to add new foods when I initially noticed my symptoms improving, for example. Ebbs and flows. Things will certainly change again after the baby is born -- and many, many times after that -- and I'll continue to practice being flexible knowing that it's a big part of living WELL!
Birth Announcement: It's a girl!
I woke up at 3:30 a.m. on September 16th with stomach cramps. After nearly two weeks of "practice" contractions, I didn't want to get my hopes up but these felt different. I took a shower and packed up my hospital bag...just in case.
At 4:30 a.m. I woke my husband, fairly confident at that point that it was the real thing. I labored at home for a bit, using what I'd learned in my prenatal yoga classes, the Hypnobabies program, and the childbirth classes we'd taken. My husband was amazing: calm, comforting, and supportive.
Things progressed quickly and an hour later we were on our way to the hospital. Because it was early on a Sunday morning, there was no traffic and the drive was oddly peaceful.
Once in triage, they did an initial examination and had me walk around the Labor & Delivery floor for a bit to see if labor progressed. I was worried they were going to send us home, but an hour later I was admitted, 5 centimeters dilated and clearly in labor. I remember looking at my husband with relief as I realized that we'd finally be meeting our baby soon.
Once in our birthing room, I labored just two more hours, first in the tub and then on my hands and knees, squatting over the hospital bed (wearing my pink Pretty Pusher). Throughout the labor and delivery I was surrounded by an amazingly supportive team -- my mom, my husband, our doula, my doctor (a family doctor specializing in maternity care and trained as a doula herself), and our labor nurse (who also happened to be a doula). Together they helped me give birth in the way I’d hope, without medication or intervention (no judgement for those who have a different plan!). It was truly a visceral experience and one of the most empowering things I have ever done.
Lilianna made her way into the world at 10:33 a.m. weighing 7 pounds 14 ounces. I cried when my husband announced, "It's a girl!" We didn't know the sex in advance, but almost everyone thought it was going to be a boy. A little girl was a beautiful surprise.
I immediately held Lily skin-to-skin, so full of love and gratitude. Just a couple of years ago we weren't even sure I'd be able to get pregnant, let alone carry and deliver a healthy baby. But here I was, holding a perfect little newborn in my arms. (Appropriately, it was three years to the day after my gastric neurostimulator implanted!)
My After-the-Birth Story
Unfortunately, the day went downhill from there. About half an hour after Lilianna was born, I started to feel lightheaded and nauseous. I handed Lily over to my hubby, just to be safe, and asked for some juice thinking that my blood sugar might be low.
I then noticed increasing pain in the pelvic region. Initially, I was told it was normal but as the pain continued to get more intense, I insisted that something wasn't right. My nurse had been with me throughout Lily's birth and when I told her that the pain was worse than anything I'd just experienced, she grabbed a doctor.
The pain was so intense by that point that I couldn't even roll over so they could remove my gown. I asked them to cut it off instead. The doctor examined me and determined that I had a hematoma. (I was bleeding and the blood was collecting internally, putting pressure on the tissues and causing an immense amount of pain.) She then said it required surgery. Somehow I'd gone from a perfect birth to emergency surgery in less than an hour!
Once we were in the operating room, they did a spinal and the pain went away almost immediately. It was such a relief that I blurted out, "I love you all!" which got a laugh from everyone in the room. (All of the doctors and nurses were wonderful; I couldn't have asked for a more caring, competent group of professionals in this situation.)
After the surgery, I was taken to the recovery room. I was glad that it was over and I was anxious to see my baby. As I waited for my husband to bring her in, my nurse, looking at the monitors, asked me if my heart felt like it was beating fast. It did, so she called in one of the surgeons. My heart rate was well over 200 and I was starting to feel really bad. I then noticed that the pain in the pelvic region was returning. When they examined me, they found that I was bleeding again and the hematoma had re-filled. At that point my doctor realized that my current symptoms were being caused by blood loss (on top of the pre-existing anemia).
They took me back to the OR where they quickly did a second spinal, transfused two units of blood, and started a second surgery. Because the hematoma was far more extensive than they initially thought, they brought in additional surgeons to assist. They also called a specialist at another hospital and were on the phone with him throughout the surgery, asking for feedback each step of the way. If I hadn't been so out of it from all of the medication and blood loss, this probably would've scared me even more. This was anything but a routine surgery.
While the surgeons were working, the anesthesiologist asked me if I felt itchy. He'd noticed that I had hives all over my body and my eyelids were swelling. The best guess was that I was having an allergic reaction to the blood I'd been given, which had been transfused very quickly. This brought up another set of fears from my previous allergic reaction, but I was given Benedryl and assured that it wouldn't cause the anaphylaxis that I'd experienced before.
Once back in the recovery room, I finally got to see my husband, my parents, my brother and his fiancee. It was a relief to be with my family, as I'd felt so scared and alone in the OR. I still hadn't seen Lily since early that morning, and I cried when I realized I hadn't been there to feed her in nearly 10 hours (she'd been given a bottle in the nursery and was doing fine). I was exhausted physically and emotionally, and all I wanted was to hold my little girl. An hour later, I was finally able to do just that and I held her all night long. I couldn't bear to put her down, even to sleep.
The next day I received four more units of blood to replace what I'd lost and I was monitored carefully over the next several days to ensure that the bleeding had stopped. I was finally allowed to get out of bed for the first time on Wednesday and that afternoon we were released from the hospital.
Walking through our front door with Lily in my arms was one of the most joyful moments of my life. I couldn't stop crying. I cried a lot those first few days -- more from emotional overwhelm than from pain, though the pain was still significant. So much had happened, good and bad, but I hadn't really processed any of it.
It's been nearly three weeks now and I'm healing physically and feeling much better emotionally. I am so in love with this little girl and so grateful for the lessons she has already taught me. I've realized that "now" is not "forever"... things can and do change. I've learned that immense joy can exist even in the midst of great pain...and we can choose which one we embrace as our story. Most of all, I've discovered that I'm stronger and more resilient than I ever imagined I could be.
