Tuesday, May 21, 2013

Cesarean Section

Over the course of my pregnancy, I rarely thought about what the birth would be like or came up with a birth plan.  I was just to darn nervous that I would jinx something.  But starting around 28 weeks, my OBs would ask me how I planned to deliver and we would spend a little time discussing the merits of vaginal delivery vs cesarean section.  Most of my pregnancy I assumed that even if I did go into labor or have an induction there would still be a 50% chance of having a c-section (that was what my doctors quoted me for a twin pregnancy).  As the pregnancy progressed, I started to research vaginal delivery of twins especially since my daughter (Twin A) had been head down since like 24 weeks.  I almost went into labor spontaneously at 37 weeks, but when I didn't progress past 4 cm after 2 hours, we went home where my contractions immediately stopped (despite my best work on the exercise ball!!)  I pushed my doctors for an induction vs c-section at 38 weeks and so at 38 weeks, I arrived at the hospital for my induction.  As I was checking in, they asked me if I just wanted a c-section or try an induction.  An ultrasound revealed that my son (Twin B) had also turned head down, so we continued with my plan for induction.  I was very, VERY adamant that if at any time either of the babies showed any, ANY signs of distress that we would just go back for an immediate c-section.  My doctors were totally on-board with this plan.  When my labor stalled after 24 hours on pitocin for induction and magnesium for pre-eclampsia, after talking it over with CJ and my nurses and doctors, and after many tears, I asked for a c-section and within an hour, we were heading to the OR and 30 minutes later, I met my daughter and son.  I am beyond thankful to my OB for being very honest about that fact that I likely would not have progressed to fully dilated and even if I did my risk of tearing was incredibly high since I was so swollen.  I was kinda in a daze due to the magnesium, but my overall experience with the c-section was very positive and best of all my twins were here safe and sound.  The recovery was painful for the first week if I got behind on my pain medication and my milk didn't come in until postpartum day 5 (but that I might have been from the magnesium and it definitely wasn't from lack of nursing them!!), but after 2 weeks I was off all pain meds and I felt  great!!  Now, I have my c-section scar to remind me of how my twins entered the world and I think it is a beautiful reminder (which may sound weird, but I don't know exactly how best to explain it.)  So there you have my personal experience with a failed induction and c-section for the birth of my twins.

I come from a family of women who have had c-sections.  My mom had an emergency c-section with my twin sister and I with a classical incision and then had to have 2 repeat c-sections with my brother and sister. My twin sister had an urgent c-section with her first baby because on follow-up ultrasound her placenta looked awful at 36 weeks and her baby was breech.  She has since had 2 elective c-sections with my nephew and niece.  With each of her c-sections, her recovery time has gotten faster and pain less.  Seriously, after my nephew was born, my sister was up and walking around with us in the hospital and even went home a day early.  That about sums up my family's experience with c-sections.

As a doctor, I have experience with labor and delivery and have read some of the studies on c-section vs vaginal delivery.  Based on my personal experiences and my professional ones, I do not understand why people are so anti-cesarean.  I think we have cultivated this ideal of the natural childbirth has being the best and healthiest way to bring babies into the world and we have turned on cesarean deliveries as the evil twin with all these horrible side effects and dangers.  The reality seems to be (and the data seems to show) that cesarean deliveries under controlled situations are safe for mom and baby.  Vaginal deliveries also seem to be safe for mom and baby, but there are risks involved, serious risks, that I think we may forget about as we try to reach the ideal of a natural childbirth with a vaginal delivery.

I'm going to publish this post now for fear that I may not get back to it soon, but I'm going to do a literature search during my pumping breaks at work and try to come up with some data to support my ideas.  I'm not sure what the real reason for my post it, but I know how hard it can be to not reach that ideal of a vaginal delivery and the feelings of failure that are associated with it, but maybe, just maybe a cesarean section should not be thought of as the mom failing, but instead as mother bringing her baby or babies into the world in the safest way possible.

Friday, May 17, 2013

What's been going on...

Things have been crazy to say the least, so I will try to catch up quickly with bullet points.  I can't believe it has been 2 weeks since I last posted and we are already in the middle of May.

So, recently I've been working the night shift, which means that I get to hang out with the babies in the morning, but I miss putting them to bed at night.  CJ is doing a fantastic job, but it's hard not kissing the babies good night and putting them to bed or hanging out with CJ in the evenings.  I'm on nights this week and then evenings again the week after labor day and then it's back to days!!

We left the babies with my in-laws last weekend so that we could go to Atlanta and try to find a house for next year.  We were unsuccessful so far on the housing front, but we did stay in a 5-start hotel and really enjoy our one-on-one adult time aka sleeping in until 9am in the hotel!!  I actually spent my first mothers day sans babies looking for houses in Atlanta.  Come to think of it...I didn't even get a mother's day gift from "the babies."  I guess that's what I get for ditching them for the weekend.

Just when we think that we have the babies figured out and we are getting more sleep, they throw us for a wrench.  This time, it was in the form of a very high fever 104+ for baby girl starting on Sunday through Wednesday with 2 trips to the pediatrician, lots of Tylenol, urine and blood cultures, lots and lots of tears, and very little sleep as well as very high fever 104+ for baby boy starting on Wednesday through today with lots of fussiness.  Baby girl went back to day care today and was feeling better, but baby boy still has the fever.  We are doing our best to keep them happy and hydrated, but I sure hope that they are healthy and sleeping again soon!!  I kind of broke down last night because I've been working crazy long hours and then I'm not getting much sleep and the babies are so sick and I just want to heal them or at least make them feel better.  Thankfully, today was a better day, but man, sick twins is rough!!

Alright that's all.  Only another 11.5 hours until my shift ends and I can go home to hubby and the babies!!

What fun plans do you have for the weekend?!?


Friday, May 3, 2013

Dropping my babies off...

Today, I dropped off my kids at day care.  Usually, CJ does this on his way to work even though the day care is right next to the hospital.  I didn't have to be at work until a little later and we were all running late today so I volunteered to take the kids so CJ could be at work almost on time and I would still be on time.  I do drop them off from time to time, but I really don't like it.  I love, love, love picking them up from day care.  I get so excited about it and then when I walk in there turn to look at me and are all smiles and it is the best feeling in the whole world.  Those first hugs and kisses and smiles after a day apart are so wonderful!!

Dropping them off is another story for me.  For the babies, it's a good thing.  They are very happy at school.  The teachers are awesome and take wonderful care of my babies and the babies get to do lots of fun and different activities then they would at home.  For me, it's hard.  I have to take them out of their car seats give them kisses and say goodbye.  I miss them with an aching, yearning kind of pain.  I guess that's what makes picking them up so special.

I always seem to have lots of thoughts about being a working mom spiraling around in my head.  I know that I not only want to continue to work, but I need to in order to pay off my loans and support my family (CJ is working too, but I am and will be the breadwinner in our family.)  That being said, my career is definitely not my priority.  I will always work really hard when I'm at work, but my priority is and will be my family.  The nice is that in a couple of years I may have the option to drop down to 95% or 80% which would allow me a lot more time at home.  The other really good thing that working does is it allows me to really enjoy and treasure the time that I do have at home with my family and it helps me to be more productive when I'm away from them or when the babies are sleeping so that I can maximize my time with them.  I love mornings with the babies!  Yes, the day does start out at 5am usually, but its filled with music (currently the babies like Philip Philips "Home," The Indigo Girls, Mumford and Sons, Zac Brown Band, and Taylor Swift, but sometimes I also let me husband picking out the morning Spotify station), lots of smiles, a big ole diaper change (they are in size 4's now,) getting them dressed (I pick out their outfits everyday,) nursing the twins, and playtime on the mat or in their jumpers.  It's so fun and the babies are so happy!!  It's great family time.  Then, I run out to work.  Evenings are also fun with walks or dinners out followed by bath time and my daughter nursing to sleep around 7-7:30 while my sons jumps and plays like crazy followed by my son nursing to sleep around 7:45-8:15.  The days pass by in a blink of an eye!

In conclusion, it is hard being a working mom, but I know that it is equally hard being a stay at home mom.  It's working for us right now.  I don't feel like I'm missing out on my kids growing up since I feel like I'm there for all the important stuff, but I do really, really miss them during the days.  I think it's something that I'm going to have to continue to re-evaluate and I like that I may have the option of working less in the future.

Those are just some of my rambling thoughts today.  Speaking of today, the babies turn 7 months old today. How did that happen??  I will try to update on their overall growth and development later!!  Maybe during my next pumping break.  See you then!!

Happy Friday!!

Thursday, May 2, 2013

Sometimes it's the big things!!

I was gonna try to talk about some of the little things this week, but I have some other big exciting news!!

The Little Eagles are registered for daycare in Atlanta for next year!!  YEA!!!!

This is such a huge relief.  I was losing tons of sleep and study time researching day cares, getting the twins on waiting lists, worrying about if they would get into a day care, worrying if we would be able to afford it, looking into hiring a nanny.  Then, I got an email from a friend of a friend who child attends this particular day care in Atlanta and loves it.  So, I emailed them and they have availability.  So, I called in the reinforcements by way of my twin sister who lives near Atlanta.  She headed over to the day care today and checked it out. She is a great judge of day cares and I think her criteria is even stronger than my own.  The end result...

They have availability for the twins.
We can afford it.
It's in a great location! I can walk there from one of the hospitals that I will be working at.  It's 0.3 miles away and an easy 7 minute walk.
My sister highly recommended it!!  She would send her own kids there and she was with me when we toured other day cares and she thought this was the best one.

The twins had the last 2 spots, so if we wanted them then my sister had to register them today, which she did!!

It's official the twins are in!!  It's actually a day school (not a day care) as their director informed me, so I guess the twins are going to school!!  I'm so happy...and relieved!!