Friday, June 7, 2019

Birth Story and the First 6 Months

So I posted about halfway through the pregnancy on the difference between the US and UK healthcare systems. It seemed like it was impossible not to constantly compare between our experience the first time and this time around. Generally, my thoughts then were that the UK system, which is a single-payer government-run system was driven by the need to keep costs down wherever possible, resulting in minimal care - while the US system was driven by the need to avoid lawsuits, resulting in excessive care. The further along in the pregnancy I got- the more convinced I became that this was the case.

Third Trimester
Once I reached my third trimester, my appointments started happening more often, though still much less often than the US. I also had to start visiting my general practitioner, in addition to the midwives that had handled all the appointments up until then. Every appointment was about the same though - I just had to leave a urine sample and get my blood pressure taken. They started measuring the size of my bump with a measuring tape (a seriously inaccurate measurement since every woman has a different abdomen and starting size), and then they would squish on my stomach to figure out which way he was facing. They would listen to his heart rate, but there weren't any more sonograms or anything to tell us how big he might be. No one ever weighed me.

I also had one more brief consultation with an ObGyn, which was one of only 2 appointments I ever had with one. It was actually the most helpful appointment I had - I explained that I was really concerned that I'd have another really rapid birth and wouldn't have a chance to get an epidural. She made a note in my book that I was to be admitted early and told me that if the hospital tried to turn me away I should be obstinate - or not go far in case the baby did come early - which just made me more worried that I'd have to argue my way into the hospital. She also ordered "membrane sweeps" for me starting a week before my due date - which basically means someone would squish my cervix to try to release some hormones that would help get labor started, in order to avoid another full induction like my first time around. The first sweep was painful but didn't work. The second one did.

just days to go

Early Labor
So just after the sweep, I started feeling what I thought might be contractions. About 24 hours later, I was sure they were definitely contractions and started timing them. First-time moms are told to go to the hospital when contractions are 5 minutes apart, but I was told to go when mine were 7-10 minutes apart, knowing that it could happen really rapidly after that. I wasn't super convinced anything was happening because it wasn't as painful as I expected - but when I got to 4 minutes apart, we decided it was time to go. Thankfully, it was around noon on a weekday, so we had no trouble getting an uber and getting to the hospital easily. We went to the maternity unit to check in, and found out I was only 1 cm dilated, not the 3 cm needed to be admitted. So we left to find some lunch and walk around a bit, when contractions really got more intense. We went back to the unit, but were told we couldn't be checked again for 4 hours - and would have to wait. Thankfully, after I made a bit of a scene in the waiting room, they found a spare room that seemed to be some sort of storage closet with a chair that we were allowed to wait in.

trying to go for a walk around the hospital grounds during contractions (not happy) 

After 4 hours in the room with contractions increasing to every 2-3 minutes and getting more and more painful, she checked me again, but I was still only 1 cm. She told us then that we really weren't supposed to be there and we should be at home, but we insisted on staying. She explained that she would need to kick us out if they got busy, which sent me into a total panic about whether we could have the baby at home ourselves - because I was sure I wouldn't be able to come back again. Spouso started looking up hotel options nearby, though that wasn't appealing either. I could hardly walk, and couldn't imagine wandering the streets in search of a hotel. She also explained that I didn't sound like I was in enough pain, so then I felt like I had to crank up the drama, but I also felt the need to be quiet so that she might forget we were there and let us stay longer. We waited another 4 miserable hours with the contractions coming basically constantly and getting extremely painful.  I was checked again and still a miserable 1 cm dilated. I remember pleading with the midwife - asking if there was anything we could do to move things along, to which she seemed rather shocked and said, "but that wouldn't be natural." Soon, the shifts changed and we got a new, much nicer woman who suggested that we take a break, go down and get dinner, and didn't say anything about kicking us out. So we did wander down to the cafeteria and found some sandwiches. I tried to eat between contractions, and we quickly got back upstairs to our little hideaway. Just as we were getting back to our room, my water broke.

Things Get Serious
Once my water broke - things got moving very quickly. Contractions started getting super intense, still occurring basically constantly. I lasted for just a few minutes before getting checked again and finding out we'd reached the magic 3 cm and were allowed to be admitted. A wheelchair arrived and quickly whisked me down to a room. I don't remember most of this part very well. The contractions just got more and more painful, and were basically constant. At some point an anesthesiologist came in but said that it was too late for an epidural,  because I couldn't hold myself still enough. I remember being a bit angry about that, but not at all surprised. Instead of any pain relief drugs, they had a small tank of laughing gas that the midwife kept encouraging me to use - but it quickly made me really nauseous, so that was out too. After about an hour of really intense contractions, he finally popped out.

I remember with my first son that after came out, the nurse started squishing on my abdomen, which really hurt - and I begged her to stop. I don't think I realized that she was pushing the placenta out. The second time around, after the baby popped out, the contractions kept going, and I felt like I was going through labor again. It was awful - when I just wanted to be done, but my body just kept going. Eventually the placenta popped out, the baby got wiped off and dumped on my chest, I got stitched up, and eventually, after a quick shower, they dropped us in the recovery room to sleep.

here's a baby

and what do i do with you?

Recovery
In the US, with our first son, the recovery room was cozy, with just enough space for a couch for my husband to sleep on and barely enough room to have a couple visitors. We stayed there for 3 nights, which was long enough for me to be mostly recovered, while staff were constantly dropping in to check on him, check on me, help us with nursing, and talk through all of the next steps. Not so much here. I think we were moved into the recovery room around 3 am, and kicked back out by noon. A few people stopped by and mostly just gave me lots of paper to read when I got home, about what kinds of exercise I could do when, the schedule for doctor's appointments, etc. When it was clear that we needed to get out of the room, my husband asked for them to bring around the wheelchair - to which the midwife chortled, "If she needs a wheelchair, then she isn't ready to go home. But she needs to go home." So I very awkwardly navigated through the very busy hospital, leaning precariously on our wheeled suitcase, thinking that I hadn't even gotten out of bed by this time with my first. After a quick ride, we were back home in less than 24 hours since we'd left.

a room with a view

A few thoughts:
- Throughout the whole childbirth, there was this constant push towards it being as "natural" as possible. I asked the ObGyn about it, to which she replied that it was because I was mostly seeing midwives, while doctors have a different perspective. I just don't understand it at all. Why would I want it to be as natural as possible? It's natural for women to die in childbirth, as they did in great numbers until we started having medical interventions.
- This is my second childbirth now without drugs - it really pisses me off that I had specifically talked with my doctors about the possibility of not having time to get the epidural and discussed options to ensure I had the drugs I wanted - but those requests were ignored by a midwife who thought she knew better.
-Ironically, they kept trying to talk us into having drug-free birth, with the benefit that we would be in the nicer recovery wing that had a great view of parliament.  I thought it was ridiculous- who cares about the view? I want the best medical care I can get, so I was prepared for the bad wing. Well, because I didn't get any drugs, we earned the right to be in the nice wing, and I remember thinking, "Well, this is a nice view."
- In order to keep costs down, the hospital provided next to nothing for us. I didn't even get a gown until after the baby was born, and we had to bring our own diapers, blankets, and clothes for him. We even brought our own OTC pain meds because they didn't want to give us any. In the US, you're supplied with a whole tray of diapers and blankets for the baby, and lots of supplies for the new mom- which is great because you really don't want to take a whole pile of disgusting laundry back home with you.

The Next Few Weeks
Because the baby was born in early December, and my husband had a few weeks of paternity leave and then our oldest son's school was closed for the holidays - we ended up having close to a month with all four of us at home together. In some ways this was great - it was more time for me to heal up and rest up while my husband was there to help. But in other ways, of course it was more difficult because we also had to watch and entertain a toddler in addition to trying to figure out this new baby. At one point, we boldly ventured into town to see Christmas lights and stop by a restaurant for our first dinner out.
baby's first tube ride

first family selfie

While I was not happy with my brief hospital stay and labor experience, the next few weeks were actually pretty great for healthcare. In order to keep costs down, they kick you out of the hospital very quickly- but then followup with home visits by local midwives. This turned out to be really convenient, since we weren't leaving the house anyway we didn't mind having huge appointment windows. The midwives would check him, ask about me, and then be on their way. It was so much easier than in the US when we would have to drive to the doctor's office, wait in a waiting room full of sick kids, and then have a really brief appointment that didn't seem worth the trouble. I think we had 4 or 5 of these home visits before we were officially transferred off of the midwives.

very excited big brother



Maternity Leave/Being Home All Day with a Baby
Once the holidays were over, the kiddo was back to school, spouso was back to work - and I settled into a new routine with the new guy. After dropping off our firstborn at nursery school, we would come home, clean something, start some of the endless laundry, have some tummy time, take a walk, and share a nap. In some ways it was much easier than the first time around - I made a concerted effort to leave the house every day, usually talking a walk in the park and always stopping by daycare - which got me out of the house, gave me a bit of exercise, and just a dab of social interaction. The biggest improvement was that my husband was teleworking 2 days per week, which gave me a lot more social interaction as well as the opportunity to leave the baby at home and escape for a quick break and time to myself. We even tried to squeeze a quick happy hour into the short break after he finished working and before we needed to get the big kid. In some ways, it was much harder - having to take care of our oldest son meant that I couldn't just sleep in in the mornings, and sometimes I had to take care of them both at the same time. I felt torn between needing to take care of the baby and wanting to spend time with him, when he was clearly feeling ditched.

tummy time

a typical happy half hour

our first of many walks in the park

Health Visitors and GPs
Children receive their shots and any medical treatment through the family's GP, but the regular checkups and measurements are taken by a team of nurses known as "health visitors". So once we were done with the prenatal midwife team, we were transferred to the health visitors for all of our regular weighing and checkups. Just like my pregnancy, I find this system really frustrating - you have to visit the nurses/midwives for regular measurements, but if you have any basic questions, then you need to go visit the doctors, which are completely separate and much harder to get in to see. Whereas in the US we would have a single appointment in which he was weighed, the doctor gave him a quick checkup, we asked whatever questions had come up, and then the nurse would administer whatever shots were needed -- here in the UK, that would be three separate appointments that all need to be scheduled separately. There are also plenty of questions that I would ask our pediatrician in the US that I would never bother to schedule a separate appointment for here - things like, "what sunscreen do you recommend?"Anyway - after a few rounds of shots and checkups with the GP, we finally finished all of the back to back appointments, and are just supposed to go to the health visitors periodically to weigh him - which I rarely do, because it takes all morning, and I can do it myself from home.







Breastfeeding
It's a bit odd that my first maternity leave ended with me having to travel by myself to attend the funeral of my grandparents, and then 2 months after this baby was born, my grandfather passed away, forcing me to again travel to a funeral by myself after just having a baby. The first time we decided not to travel with the baby because we were overly cautious new parents, but this time we didn't even have the option because his passport hadn't arrived yet. Both times were pretty awful because I had been breastfeeding - which meant it was physically very painful to be away from the baby, despite trying to pump constantly. After the first time, I returned home and immediately went back to work, which ended up resulting in the baby just refusing to breastfeed and us switching over to bottles. I was worried the same thing would happen this time, but it didn't, and we went back to exclusively breastfeeding. Now we're in a situation where the baby actually refuses to take a bottle, so I can't be away from him for more than 2 hours without problems.

Sleeping
Our first son was sleeping through the night at 2 months, which was critical since I needed to go back to work. This guy is still not sleeping through the night at 6 months and doesn't seem to be in any hurry to change that.



Projects
In addition to keeping the house clean and constantly fighting the laundry - I worked on a few projects to keep myself busy. I went room by room through the entire house, sorting through every drawer and closet to get rid of anything we didn't need anymore - generating 40 bags for charity. I completely overhauled the back and front yards, which is exciting because things I planted last year seem to be doing well now and are starting to flower. I finally bought a real sewing machine and made new curtains for the baby's room and some new baby blankets. But generally, I'm running out of projects and getting a bit bored.

my hydrangeas are blooming!

Job Hunting
One thing that definitely made this time around a lot harder was knowing that I didn't have a job to go back to. I somehow thought it would be easy to job-hunt while watching a baby, which of course, turns out to be impossible.  I found a career development program that offered seminars to expats trying to find work in the UK, which I had hoped would help me explore other jobs that I've never even considered - but didn't quite live up to my expectations. It did however help me improve my CV and linked in profile, and got me thinking more about what I wanted in my next position. I applied for more things and had an interview, but still haven't found a new position. I'm hoping I'm getting closer and will be back to work soon.


Anyway- obviously that's a lot for a single post. Now that we've gotten past the hardest months, things are settling out - we're finally getting out again and beginning to travel. More on that shortly...

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