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.

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...

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.

Welcoming Will

Sorry, this has taken forever to write. But there was a lot to remember!

Will's birth story really begins on Friday, August 6, when my mom arrived for a quick weekend visit. From the moment she got here, we were working. I was a task master... we got my car washed and detailed, went shopping for postpartum clothes, installed the car seat, washed windows, weeded the garden, pruned bushes, hung artwork and cleaned the house. Looking back now, this was most certainly my last "burst of energy" before labor. I remember feeling a little tired, but I just wanted to keep working.

At 12:30 a.m. on Sunday, August 8, I woke up with what felt like mild menstrual cramps. I didn't think much of them, and went back to sleep.

By 3:30 a.m. the "cramps" were more intense. I couldn't lay down comfortably anymore, so I snuck out of bed and went downstairs to watch some TV. Since I was up and watching the clock, I realized the pains were coming about every 10 minutes. They didn't feel like what I imagined contractions would be like, so I still didn't believe I was in labor. I slept on and off on the couch, until about 7:30 a.m. when my mom and Ben got up.

We ate breakfast, and I continued to monitor the pains. At this point, I was pacing the living room during contractions. They weren't terribly painful if I was moving, but hurt like hell if I was sitting or laying down. We timed them for an hour or so, and then decided to take a walk and run to the grocery store.

By 12:30 the contractions hurt even when I was moving around. They were now coming every 5-7 minutes, lasting about 45 seconds in length. The nurse on call at our OB's office told me to keep monitoring the contractions for another hour or so. By the end of the hour, they were coming every 4-5 minutes, lasting about 60 seconds. The nurse suggested we head up to the hospital. It was 2:00 p.m.

Our bag was already packed, so we just had to grab it and go. As Ben was pulling the car out of the garage, I started crying as I hugged my mom goodbye. "My whole life is going to change." "Yes," she said, "But in the most amazing way possible."

I was so terrified that we'd get to the hospital and I would be barely dilated. I was in a fair amount of pain, and starting to doubt my ability to labor without drugs. I was so relieved when the nurse said I was 3 centimeters along. They moved us to our permanent room and hooked me up to monitor my contractions and the baby's heartbeat for 30 minutes.

We met Sally, our labor nurse, who was really supportive and excited about our natural birth plan. Since I was declining an epidural and everything looked good on the monitor, I was free to labor out of bed. Ben and I walked the halls of the labor and delivery ward, pausing to sway my hips when a contraction hit. After about an hour, I started to get really tired. It was 4:00 p.m., and I had been up for over 12 hours.

I laid down in bed and tried to rest in between contractions. After a little while, Sally came in and suggested I keep walking to move labor along. We got back out of bed and kept pacing the halls.

Around 5:00, the contractions were so intense that my knees buckled. I had so much pressure in my bottom. Sally checked me and I was already 9.5 centimeters. I had only been laboring at the hospital for 2 1/2 hours. Sally called the doctor and asked me if I felt like pushing. I didn't yet, but I was in a ton of pain. I couldn't find a comfortable position, and the contractions were constant. I was kneeling on all fours on my hospital bed when my water finally broke.

The doctor got to our room at 5:35 p.m., but I still had a small lip of my cervix remaining. I now had the urge to push, so the doctor pulled on my cervix to help me dilate the last little bit (this hurt like hell).

Since I didn't have an epidural, the doctor had my hold my own legs and curl my upper body around my belly. I remember thinking that I just wanted someone to help me hold my legs! I was exausted, but it was the most effective position to get the baby out.

Though pushing was tiring, there were breaks between contractions so I could rest. As I would start feeling the next contraction ramp up, I would almost start to cry. It was always hard to start pushing, but once I got going it wasn't so bad. Even without drugs, I couldn't feel the baby coming down, so I had no concept of the progress I was making. I remember thinking that the pushing wasn't doing anything. It just hurt.

The nurse and the doctor both said I was doing great, but I didn't believe them. It felt like I'd been pushing forever and it seemed like nothing was happening. Then I felt the "ring of fire", an intense burning and stretching as the baby crowns. Ben said he could see the baby's head... we were almost done! The doctor asked me if I wanted to touch the baby or use a mirror to see him coming out. Um, hell no. That was just one more step between the pain I was feeling and getting him out.

So I buckled down and pushed with everything I had. The burning got worse and worse. I thought it was never going to end, and then I felt a great release. As Will's head, shoulders and body emerged, all of my pain vanished. It was 6:02 p.m. Will was born after a mere 26 minutes of pushing (for the record, it felt like way longer).

Will started screaming immediately and the doctor put him on my chest. I couldn't believe I was holding my son. He was tiny, pink and perfect.

Ben and I had a few names we liked, but wanted to wait until he was born to pick one. As I was holding our tiny boy, Ben looked at me and said, "I think he looks like a William." And he did. It was who he was meant to be.

After a few minutes Ben cut the cord, and they took Will to the warmer to check his vitals. He had a 1 minute Apgar score of 9 and a 5 minute Apgar score of 10. As Ben and the nurses looked after Will, the doctor delivered the placenta and stitched up my small first-degree tear (with Will out, I happily took pain meds for this). I started thanking Sally and the doctor profusely. I couldn't believe it was over and that I had really done it.

Soon Will was returned to me to try nursing. He had little interest in breastfeeding right away, but snuggled up into my chest and fell asleep. It was amazing to feel his tiny chest rising and falling on my own. All seven pounds of him seemed to melt right back into me.

When I tell anyone that we delivered naturally, they always want to know if I'd do it again. And truthfully, I would. I felt so empowered by my delivery, and I'm really proud of my body.

That being said, I would have never been able to do a natural birth without our Bradley birth class. Labor and delivery is overwhelming and scary. Even with all our Bradley training, I had moments of fear and self-doubt. I can't imagine trying to do this without an informed birth partner and an implicit understanding of the stages of labor.

A million thanks to the team of people that helped us bring Will into the world. I feel very fortunate that we were given the opportunity to have the birth that we wanted. I'm far from an expert, but if I can answer any questions about my experience or give any encouragement to those seeking a natural birth, I'd love to.

Well, so much for that

Despite our best efforts, we are switching doctors and hospitals.

The insurance issues are just too complicated. So no more midwife care or water birth for me. Bummer.

We meet the new OB at our 32 week appointment. I'm sure she'll be fine and we'll receive excellent care. It's just hard to change this late in the game (we all know how I love the plan).

Our Bradley teacher is also a doula, so we're considering hiring her to help us at the birth. It would be nice to have her in labor and delivery as an advocate for us and our birth plan.

Say cheese!

According to the baby book, the baby starts smiling this week. Smiling. Isn't that crazy?

Speaking of baby books, I'd be remiss not to pass on my suggestions...

Loves It

"A Girlfriend's Guide to Pregnancy" (funny, honest and practical, but doesn't include any information on your baby's development week by week)

"The Pregnancy Bible" (Ben and I read this every Sunday for updates on how baby is growing; has great full color pictures and interesting facts)

"The Complete Organic Pregnancy" (good suggestions on how to be your healthiest while pregnant, without convincing you that everything around you is harming your unborn child)

Hates It

"What To Expect When You're Expecting" (comes off as preachy and condescending; I have no idea how it's the #1 selling baby book)

I'm just now venturing into the books on birthing. But contractions and cold packs are still really freaking me out, so I may give those books some time.