Sunday, May 10, 2009

Update on Pregnancy and Previous Birth Trauma

(first part is copied from a post on the Solace for Mothers online community)

I'm 38 weeks pregnant and I've started feeling just awful pain in my belly, in the skin and tissues around my bellybutton. It got to such a point that I felt like I need to consult with a specialist to rule out anything particularly scary. So last night, I went to Labor and Delivery at the hospital where Willem was born.

I don't know whether I was really lucky or if the standard of care has changed there since Willem was born, but they were very respectful of my decision making power and very sensitive to my needs to be in control of the situation. Maybe I owe it all to the nurse who was attending to me because through our small talk, she learned that I had had a traumatic birth at that hospital and maybe she warned the resident and attending who was there.

I was so afraid going in. Afraid that I would be treated negatively for planning a homebirth, afraid that they wouldn't take my complaint seriously, afraid that they'd over-react and try to pressure me into an induction or c-section, afraid they try to bully me into transferring care to them...

None of those things happened.

And I think there may have been some good that came out of it. In talking to the nurse, she felt like she recalled my name from somewhere (probably from the Mothering dot Community forums. I think that's when I mentioned that I work with Solace and she felt like she recognized my name in connection with that. I gave her a couple of our business cards and told her about the two discussion boards. That's when I found out that one of her births was traumatic as well, and I was able to offer this board as a resource to her, as well as inviting her to participate in the advocates board since she's a L&D nurse who is sensitive to the topic of birth trauma.

Coming away from that experience, I'm really surprised, a little bit pleased and kind of confused. Surprised that what I expected to happen didn't.--I was really stressed out being there because my initial blood pressure was way high, as was the baby's heart rate.--I'm just so surprised that the attitude of the staff and providers last night was so different from the care I received when Willem was being born. And that's what confuses me: was it special consideration for the fact I had had a negative experience there previously? Or have things really changed there?

I'm kind of hoping (but I don't know how realistic it is) that after I complained to the hospital about the treatment that maybe there were efforts to better train staff in principles of informed consent and so every L&D patient is getting improved care. I would be so pleased if I knew that were the case. I was so upset after my experience that nothing would be done and the same things (and worse) would be happening to other women who were birthing their babies there. I know its standard practice not to inform people who have complaint that steps have been taken to prevent the same thing from happening to others (because that would be an admission of guilt, right?). But maybe, just maybe, there was some good that came out of my birth experience there, and things have changed for the better....I can only hope.

Or I got lucky with who was there last night...

In other news, I can tell more about the last couple of weeks in the pregnancy.

Everything was going great until about 36 weeks when I started feeling more tired than I had. I was feeling a lot of (self-driven) pressure to get things done while I still could so I started burning myself out on projects. I asked for help from my husband, and it took some effort and strong emotion to get him to understand what my needs at the particular time were. After we discussed and worked that out, I felt like I was getting much more support and understanding from him. So I thought things were going pretty good and that I'd just be enjoying the last few weeks of pregnancy without much stress.

Until Tuesday of last week, when I pulled the entire sheet of abdominal muscles on the right side of my belly. Something like it has happened when I was pregnant with Willem so I figured that a couple of days and some patience would resolve it. It was on Thursday that I realized that the muscle pain was gone but I had residual soreness around my bellybutton where it was sensitive to touch (especially if my 2 yr old bumped against it, or if the baby moved against the spot). The pain honestly was more intense than any discomfort I felt from Willem's 38 hour, lots of back labor birth. Never before had I experienced pain so sharp that I would cry out, tears would spring to my eyes and I would tense completely. The way I described my pain was like it felt like my bellybutton would going to rip apart from the inside out.

Of course, I wanted to understand what it could possibly be so I started internet searches for search terms like "bellybutton blowout" (just for fun, I wanted to see what would come up--not much), and "conditions of the bellybutton or umbilicus." The results that came up described an umbilical hernia which is known to happen in adults rarely but typically if the adult is obese or pregnant. I wanted to get that ruled out and then discuss with someone who knew about the condition what effects that might have on the end of my pregnancy, labor and birth, and if it would require some sort of treatment postpartum as well. I'd also like to know what sort of effects it might have on future pregnancies. So off to a specialist...

In some ways it has been a good experience because I've seen that I can trust health care professionals and turn to them in times of need in order to apply their knowledge and skill. (Of course the attending who saw me on Saturday didn't know much about what could be causing the pain, and couldn't necessarily rule out the umbilical hernia, but she was able to refer me to radiology where the technicians there would know what to be looking for in such a case).

I've also seen that complications in pregnancy can happen to me, even if its this really obscure one. This pain has definitely been a challenge because my mobility and ability to care for myself and family is very limited at this point. I remembered the priesthood blessing I received at the beginning of this pregnancy that warned me of challenges that I would face in this pregnancy. I would call this a challenge, with possibly more challenges to come as a consequence.

Tomorrow, I will go back to see the radiologist for an ultrasound of my umbilical region to rule out the hernia and possibly find an explanation for the pain I'm experiencing. Hopefully then, I will be able to consult with the various departments of medicine to figure out what the implications are for birthing this baby.

Prayers are appreciated because I am afraid of hearing that an induction or C-section is recommended or that this pain could make a non-medicated labor much more difficult. I do not want to be faced with the situation where I might need to choose between the gentle, non-interventive birth I believe is so important for my child and the hospital birth with epidural, induction or C-section. Based on my initial judgement, I'd take the more severely painful homebirth over the promise of reduced pain in a hospital if the risks of my discomfort is what is being weighed against the health of my baby. I know I am strong, I know I am capable and I have faith that I can labor and birth this baby on my own with this pain, even if its worse than I can imagine right now. Especially if I can give my baby the healthier, safer birth that I long to give her at home.

How does that affect my decision to UC? Depending on the amount of pain I'm experiencing and my need for support and comfort, I am more than willing to give up on the UC aspiration to have the midwives (plus additional assistants) there supporting and encouraging me.

Last night at the hospital, I had my husband, my friend (who was the doula at Willem's birth) and the nurse providing physical and emotional support during the exam where the resident palpated my bellybutton. I think that if I needed (and greatly appreciated!) that much support for that, I may have a much increased need for support during labor.

I suppose there is the possibility that the pain could resolve before labor begins (even though I've been experiencing sporadic contractions since Tuesday night) or that the pain in my bellybutton will not impair my ability to labor. I can hope for that.

1 comment:

Rixa said...

I'm so sorry to hear you're dealing with this debilitating pain. I had a similar (albeit much milder) pain in the exact same place, probably from the muscles and tissues separating. I hope you can get some answers at your next visit and most importantly, still birth in the way you feel is best for you and the baby. You can call me any time if you want to talk or vent or whatever.