Vaginal Prolapse

As I explained in her birth story, Charlotte's delivery was very intense. In the midwife's words, she pretty much came "crashing" out of me. Her exceptionally fast delivery, coupled with the fact that she was extremely low during my last few weeks of pregnancy, means she basically trashed my pelvic floor. As a result, I have what's called a vaginal prolapse. Specifically, a cystocele, which means part of my bladder is sagging into my vaginal canal.

Anatomy diagram, because this shit is hard to explain

Your pelvic floor runs along your vaginal canal and is basically responsible for holding up your internal organs, including the bladder, uterus and rectum (see healthy pelvic floor on the left). When the pelvic floor is weakened or damaged from child birth, the muscles can no longer hold your organs up, which means your organs can sag into your vaginal opening (see damaged pelvic floor on the right).

Many women have a minor vaginal prolapse following child birth, but it's so small that it can't be seen or felt (stage 1). As you heal after child birth, the pelvic floor strengthens and your organs slowly pull back into place.

I have a moderate cystocele (stage 2-3) which means I can both see and feel the prolapse. I'm fortunate that mine is relatively small (the size of a nickel), and doesn't cause any pain. More severe prolapses can be extremely uncomfortable, cause incontinence, and require surgery. Although my prolapse may never completely go away, my midwife is optimistic that we can get it to stage 1 with enough rest and physical therapy.

I noticed my prolapse about three days postpartum. I had been complaining to Ben that I had a lot of pressure in my bottom following Charlotte's birth... something I don't remembering feeling when I was recovering from Will's delivery. As it turns out, this pressure was my organs sagging through my pelvic floor. A quick inspection with a hand mirror revealed a small mass at the opening of my vagina. It totally freaked me out, and I made an appointment to see the midwife the next day. A vaginal exam confirmed the prolapse, which I had already self-diagnosed with Dr. Google.

We'll have a more thorough conversation about my recovery and treatment plan at my six week postpartum appointment, but I do have some lifestyle modifications in the meantime, including limited physical activity (light walking only), a 10 lb. lifting restriction, and a daily regimen of Kegel exercises. The lifting restriction has been the most challenging, as I can't lift Will or Charlotte's car seat. But we're making do.

Even with physical therapy, my prolapse will never completely go away. As a result, my midwife has advised that we not have any more children. Another pregnancy and delivery (even c-section) would significantly stress my already weakened pelvic floor. I would likely need surgery to repair the damage from another pregnancy, and would risk dealing with a moderate to severe prolapse for the rest of my life.

Although Ben and I were seriously considering only having two kids, it was really upsetting to hear that we shouldn't have any more children. It was a decision I wanted to make for myself, not a decision I wanted to be forced in to. But we have our two sweet, healthy babies, and we're reminding ourselves to count our blessings.

Birthing Charlotte

Since having my own children, I love hearing birth stories. Love, love, love. Birth is so incredible, and I love hearing every woman's experience, whether it was a natural birth, medicated birth, c-section or adoption. How you welcome your child into your lives is a monumental experience.

Fair warning: This gets a little TMI. Right from the get-go. So if you don't want to hear about my reproductive organs and all the nitty gritty details of labor, I advise you stop reading right now.

Also, if you're so inclined, you can revisit Will's birth story.

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Charlotte's birth story really begins the day before she was born. At my 38 week OB appointment that Monday, our midwife recommended sex to help induce labor. Although I wasn't yet overdue, I had carried Charlotte almost a week longer than I had carried Will. I was exhausted, huge and ready to meet our little girl.

On Tuesday, I decided I'd had enough. Although I was gigantic, and the thought of sex at 9 months pregnant wasn't super appealing, it sounded better than being pregnant any longer. So we gave it a shot. Honestly, I was skeptical that it would do anything. Little did we know, it would take less than 7 hours for labor to begin.

I woke up about 5:00 AM on Wednesday morning with a contraction. It wasn't severe, but it was there. I was about to drift back asleep, when I felt another one just a few minutes later. Then another. I grabbed Ben's iPad and started timing my contractions with this awesome contraction counter. After about 15 minutes of timing, I realized I was having very regular contractions every 4-5 minutes, each lasting 30-40 seconds in length. This got my attention. Excited, I hopped out of bed and started walking around the house. It was about 6:00 AM.

We had been expecting a winter storm overnight, which delivered lots of rain, snow and sleet. As the sun came up, I realized that everything was covered in about 1/4" of ice. My contractions were getting a bit closer together (3-4 minutes) and longer (40-60 seconds). Not knowing how the roads were, we decided to phone the on-call nurse at 6:30 AM. She agreed that given my fast labor with Will and the questionable road conditions, we should probably come in. I had intended to labor at home longer, but we didn't want to risk it with the weather. We called Ben's mom to come up and watch Will, and prepared to go to the hospital.

Grandma arrived at our house around 7:30 AM. We kissed Will, grabbed the hospital bag and headed out the door. Luckily, the roads weren't awful, but we got detoured due to standing water and street flooding. After some creative driving, we got to the hospital a little before 8:00 AM.

We got checked in and met our nurses. A cervical check revealed that I was three, nearly four centimeters dilated. I had to be on the monitor for 30 minutes, so I got settled in bed and watched The Today Show. My contractions weren't terribly painful yet, but I was beginning to use relaxation breathing to get through them.

Once my time on the monitor was up (around 9:00 AM), Ben and I started walking the halls. The birth ward is one huge rectangle, so we paced around and around and around, stopping to sway and breathe through contractions. Every few laps, the nurse had me come back into the room to check the baby's heart rate. Luckily I didn't have to get in bed for these checks, as my contractions were getting really uncomfortable unless I was standing and swaying. It was nice to have so much freedom to move. The nurses were really accommodating of our birth plan and birth wishes.

Our midwife checked in with us throughout the morning, often walking the halls right alongside us. This is probably the greatest difference between Charlotte's birth and Will's birth... our midwife was so present. When Will was born, the on-call doctor came in at the last possible moment, caught Will, stitched me up and left. But our midwife was more like a partner in the birth. She was with us virtually all day.

Around 12:00 PM, I got really tired and nauseous. We went back to our room so I could lay down and listen to music. After about 20-30 minutes, I made myself get back and keep moving, as I knew that would help move labor along. We made a few laps around the birth ward, but the contractions were getting really intense. I had some pressure in my bottom, but I wasn't yet experiencing the urge to push. I didn't want to be walking anymore, so we headed back to the room.

Back in the room I just couldn't get comfortable, so our midwife set up the birthing bar for me to lean on and work through some of the pain. I had my arms resting on the bar with my bottom out, swaying my hips to try and drop the baby down. It was about 1:00 PM at this point, and the contractions felt like they were coming non-stop. There was no relief. It seemed like my body was being pushed to the limit.

Although I still didn't feel the overwhelming urge to push, I needed to do something to keep labor moving. The pressure in my bottom was getting more intense, so I got on my back and grabbed my legs for a few contractions. Although this is how I pushed Will out, it felt all wrong this time. I couldn't articulate what I needed or how I wanted to labor. All I knew was that this wasn't right.

Our midwife suggested that I use the birthing bar to labor in a squatting position. The baby still had to clear the turn around my pubic bone, so the midwife coached me to stand and squat with the contractions to allow gravity to help us along. I never would have initiated this, but it was the perfect position for this labor and this baby. It actually felt good to push in this position, and I could feel myself making progress.

At this point my water still hadn't broken, and we were starting to think the baby might be born with the bag intact (how cool would that be?!?). But suddenly my water broke, splashing Ben and the midwife and scaring the shit out of me. It made a audible "pop," relieving a ton of pressure. All of a sudden, I felt the baby drop very low, very quickly.

My contractions had been pretty brutal for several hours, but after my water broke they started to feel unbearable. In fact, the contractions were so cripplingly painful that I felt like I couldn't push during them. However, I suddenly had the overwhelming urge to push between contractions. So my body would push then I would push. It was basically like laboring non-stop.

I started hyperventilating and telling the nurses that I couldn't feel my hands. They had to coach me to slow down my breathing. I don't remember much from this stage, except that I felt very out of control. It was as if the labor was happening independent of me, and all I could do was surrender to it.

After my water broke, things moved very fast. Once she made the turn around my pubic bone, she was born in just a few pushes. The midwife said she pretty much "crashed" out of me.

Ben wanted to catch the baby, so as she started crowning, he moved to the bottom of the bed to assist the midwife. Even though Charlotte born born with her hands by her face, crowning wasn't as painful this time around. I distinctly felt the "ring of fire" when Will was born, but this time it felt more like intense pressure. The midwife said I tore in almost the exact same place as with Will, so I suppose the skin was already stretched to accommodate.

Knowing we were almost done, I gave it everything I had. Every last ounce of strength I could muster. I heard the midwife say her head was out, and she asked me to stop pushing so she could check the baby's neck for the cord. Then I gave it one last push to clear her shoulders. I felt her slip out of me and instantly all the pain went away. It's an incredible thing to go from the most pain you've ever felt to the most joy in a matter of seconds.

She was wailing as they put her on my chest. Her little face was purple and bruised from her fast delivery. I marveled at all of her dark hair. Her tiny, long fingers. She was absolutely perfect.

This time we were able to wait until the cord stop pulsating before it was clamped and cut (this wish was ignored by the on-call doctor during Will's birth). I enjoyed cuddles with Charlotte as the midwife waited for my placenta to deliver. She started rooting for the breast and latched just a few minutes after she was born.

After delivery, I started hemorrhaging pretty severely, so the midwife gave me a shot of Pitocin and then a Cytotec suppository to help control the bleeding. I also needed a few stitches to repair a small tear.

Charlotte's birth was much harder than Will's... very intense right from the get-go. Although I felt very empowered after Will was born, I vowed to never give birth again in the minutes after Charlotte was born. As it turns out, that decision may have been made for me... I've since developed a delivery complication that may prevent us from having more children. But that's for another post.

Above anything else, we're so thrilled our sweet Charlotte is here. Her arrival was dramatic (to say the least), but she couldn't be more mello and content. We're loving this time with our sweet, cuddly little girl.

Naming Charlotte

For weeks, Ben and I were at an impasse on what to name the baby. He loved the name Charlotte. I loved the name Norah. Neither of us was willing to budge.

I was fully planning to play the labor and delivery card for my name choice, but I started coming around to the name Charlotte in the weeks before her birth. However, the moment that put me over the edge was this email from a friend...

"I just want to point out that if you have a Charlotte and call her Charlie (which, just so we are clear, I'm going to do behind your back even if you tell me not to), then your family will be Ben, Sam, Will, and Charlie. Two beautiful and stealthy women masquerading in a family of male names.  If you don't do this I'm totally going to try to pay another family to do so."

Two beautiful and stealthy women masquerading in a family of male names. 
I was sold.

When she arrived, we took one look at her and knew: she was our sweet Charlotte. It suits her, and I can't imagine her as anyone else.

One Week Old

Charlotte Louise - 1 Week

Dear Charlotte,

My sweet girl, today you are one week old.

I can't believe you've only been here for seven days. You've settled quite easily into our lives, and in some ways, it feels like you've been here forever. Or at least that you were always meant to be a part of our family.

You are the sweetest baby. Very content and mello. You really only cry when you're hungry or chilly, and even then, we've only gotten a "mad" cry out of you a few times. Daddy and I jokingly call you our "victory" baby... our reward for making it through those challenging early months with your brother.

Breastfeeding is going well, although we had some latch issues early on. I'm still a little sore (especially on the left side), but the lactation consultant says you're now latching correctly and things will get more comfortable in the coming days/weeks. You took to breastfeeding very easily, and you are a ferocious eater. You take both breasts for most feedings and audibly gulp down my milk.

You seem to have your days and nights mixed up, as you will sleep for much longer stretches during the day and be alert for longer stretches at night. I often have to wake you during the day to nurse. But even when we're up at night you are so peaceful. You're absolutely content just to snuggle on my chest or gaze around.

Perhaps the most surprising thing about bringing you home is that we're now bedsharing. You will only sleep for a 40-50 minute stretch alone in your bassinet, but when you're laying next to me in bed, you'll snooze for 2-3 hours. Given the fact that we both need to sleep, bedsharing soon became a no-brainer. Having you in our bed made me nervous at first, but now I absolutely love it. I adore snuggling next to you as we're falling asleep, and waking up to you breathing peacefully beside me. We'll need to transition you to your own bed eventually, but for now, I'm enjoying the extra newborn snuggles.

We're absolutely in love with you, sweet girl.

Love,

Mama

She's Here!

Family of four

Charlotte Louise arrived on Wednesday, April 10, 2013 at 1:41 PM. She weighed 7 pounds, 7 ounces and measured 20 inches.

Labor was intense, but we did it all naturally again. Ben was an awesome birth partner (the nurses even commented on it), and Charlotte is absolutely perfect. We're feeling so blessed.

More photos and birth story to follow...

Nursery Preview

As promised, here's a peek at BG's nursery...

Despite my complete and utter fear of birds, we went with a bird theme. It felt very whimsical to me, without being overly girly.

In planning the nursery, I knew I wanted to do something in yellow and gray, but the pieces I chose initially weren't cohesive enough. It just felt very boring and blah, until I found this gorgeous bird mobile...

It really only takes one piece to inspire a space. After I found the mobile, the rest of the room just fell into place.

We elected to introduce a few more colors from the mobile, most notably the aqua/mint and red/pink. The extra color really helped the room "pop" more. The yellow and gray is pretty, but very neutral.

I think the closet may be my favorite part of the room. I love the extra color and it's so organized!

My mom made the valance and the curtains for the closet, as well as the baby quilt pictured on the crib in the first photo.

I'm debating adding something over the changing table. I feel like that space needs to be anchored somehow, but I don't want it to look too cluttered. I like this look of this frame collage.

I'm also in love with this glider makeover. I hate how boring and neutral our glider is. All of our nursery furniture is recycled from Will, but if I had a do-over, I'd invest in a much comfier (and prettier) chair.

A few amusing anecdotes

I can't form any cohesive thoughts to write a formal blog post, so here are some snippets from our life in the past week:

1. We all had the stomach flu (gastroenteritis) last week. It started with Will, who showed no signs of being sick, until he started vomiting all over the OB's office while in the middle of my 38 week check. Seriously... I'm on the exam table, doppler gel on my belly, maternity pants pulled down around my waist. And Will starts barfing. Everywhere. It was horrifying at the time, but pretty damn comical looking back now.
2. I ripped my maternity pants, which is probably a new personal low.
3. Will has started declaring that he can't do things (like brush his teeth or put away his toys) because "my belly is just too big, Mama." 
4. Will started sobbing at the grocery store today because I put ice cream in the cart. WTF? He kept begging me to put it back, tears streaming down his face. I probably should have just put it back and avoided the episode (and the extra calories), but at 9 months pregnant, food is my only friend. (Mother of the year, right?)

Bump Watch 2.0

BG - 38 Weeks

Sigh. Here we are... 38 weeks.

I've never been this pregnant before. Will was born at 37 weeks and 6 days. But this little lady is completely content to hang out for a while longer. Not even the slightest signal of labor.

My parents are coming this weekend, so I'm hoping that it might happen then. It would be really convenient if we could go to the hospital with live-in babysitters present. Plus, my mom was randomly here the weekend Will was born, so that would be very serendipitous.

I feel like I've dropped from two weeks ago, so I'm choosing to believe that's a good sign. I'd love her here sooner than later.

In the meantime, we wait.