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The Fourth Trimester: Part 1

Jan 24, 2019

Hello there! Thanks for tuning in today. Today’s story is about the first half of the “fourth trimester” as they call it. Those precious/incredibly challenging 12 weeks post birth. Now if you’re good at math you’ll know that today I am sharing the tale of the first half of our fourth trimester aka the first 6 weeks. It might seem odd but if you’ve had a child you will understand how silly it is to measure time in weeks. These last 6 weeks are much more appropriately measured in hours. Because 1008 hours is exactly what it felt like. I’m not saying we have had a typical start to the fourth trimester certainly our story is unique. However, just like no two pregnancies are the same definitely no two babies are the same…and thus no two post partums are the same.

THIS IS MY STORY…

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Where did we last leave off? The birth? 7lbs 14oz? That was the EASY part, little did I know it at the time. I spent 9 months prepping for birth as if it was the challenge of a lifetime. I read the books, took the courses, practiced the breathing the meditation the mindfulness, hired the doula, visualized with my husband….we did it all. And guess what? It was over in 5 hours. Like right now….in 5 hours it will nearly be supper time….and on the day John was born I had a BABY in 5 hours. In retrospect birth was nothing to fear, I am glad I prepped for it but it almost seems silly how much emphasis I placed on that moment versus what comes afterwards.

Everyone says being a parent of a newborn is hard, and it is. Sleep deprivation is a killer. But for me, it wasn’t sleep deprivation that got me…it was Ecoli. Say what? Yes a lovely ecoli infection to compliment a rather intense labour and delivery. Let’s back up. Baby is born, 10 fingers 10 toes - awesome! They flop him onto my chest and wrap us in blankets and it’s literally the most amazing moment ever. Like a real live human baby just came out of me….and he’s MINE! I made him! So great. And if you are pregnant reading this I cannot WAIT for you to experience that moment for yourself.

BUT THEN…

I start getting shaky, I mean really shaky. Can’t stop convulsing. You know when you have the shivers like really bad and you just can’t control them? Something like that. Nurses say it’s pretty normal to be shaky post-anesthesia (I had an epidural remember). So ok, they just pile on more warm blankets and we are all too distracted by our lovely tiny human to really care.

WELL THOSE SHAKES NEVER REALLY STOPPED.

Once we left labour and delivery and got to our post-partum room I was feeling alright. They pump advil & tylenol into you every 2-4 hours for pain management so I wasn’t feeling too poorly. A couple hours later I finally stood up to go to the washroom….I’ll let you enjoy that experience on your own without spoiling it. The good part is, everyone cheers because it’s a really good sign when your urine output is high post birth. Might be the first and only time people cheer for you when you pee, enjoy it. That whole day we have family trickle in, mostly our parents and siblings. Everyone is ecstatic to meet baby and hear about our birth adventure. The first day goes by rather uneventfully, baby sleeps most of it. Don’t be fooled by this. Most babies will sleep their first 24 hours away, it doesn’t mean you’ve hit the sleeping baby lottery….wait until night two.

SPEAKING OF NIGHT TWO…

The day after baby is born it’s time to send Dad home for a nap. He doesn’t have Mom adrenaline so he is more or less a walking zombie at this point. My parents stick around so he can go home and get some rest. Well, didn’t everything fall apart just after hubby leaves. The shakes keep coming on, I am freezing at this point like cannot get warm. Doesn’t matter how many blankets they put on me. And yet, to the touch I feel steaming hot. Classic fever symptoms right? But the constant advil/tylenol combo I am taking for pain relief mask the fever and my temperature seems normal…..every so often the shakes would dissipate and I would get extremely warm, sweaty even. I would take a shower….and immediately slip back into the chills. Keep in mind at this point we are trying to figure out breastfeeding and also try to get as much sleep (see: any sleep) as possible. This is made extremely difficult by the constant interruptions by nurses taking baby’s vitals, my vitals and the barrage of tests/surveys/lactation visits etc. It seems the interruptions are timed perfectly for when either baby or me is asleep….frustrating.

HUSBAND COMES BACK AND I AM NOT DOING WELL.

I am looking really sickly and feeling terrible. Nurses say my milk must be coming in! Totally normal to feel feverish. Ok cool, it’s the milk. Well it wasn’t the milk. They do blood work and a urine culture to make sure I am alright. Blood work comes back normal, urine takes 48h to culture so we won’t hear back for a while. The two days I spent in the hospital post birth were spent like this: extreme chills swinging into extreme sweats. Managed slightly by pain medication. I have my first bowel movement….if this is TMI don’t have a baby alright? All modesty goes out the window. Now, they give you a stool softener post birth for obvious reasons. Already been through enough trauma down there. My first bowel movement is loose, real loose. I think to myself, damn that softener works well…not sure I want to take another one. I also notice some abdominal cramping….ow that hurts. It’s your uterus shrinking back to size hun, I am told. I think to myself, oh ok, well shit with that intense of cramping it’ll probably snap back to size in a few hours! None of these symptoms flag the nurses…

FINALLY IT’S TIME TO GO HOME.

Shockingly they discharge me despite no real explanation for my symptoms. This is Friday afternoon. Feels so good to be going home even though I’m still not feeling well. By Saturday evening I am still quite unwell but thankfully my doctor calls with the results of the urine culture, you have a UTI! There was Ecoli in your urine so I will prescribe you antibiotics and you’ll feel better within 24-48h. Great. Well guess what? 48h later I had a fever of 40 degrees, was swinging between freezing cold chills and wicked hot sweats. For two days my husband, mom or dad would be mopping my forehead with a cold facecloth trying to keep me cool as I breastfed Johnny. He was tomato red (clearly ridiculously hot from my skin), poor baby probably getting steamed milk I was so hot. Everyone was really worried about me during those awful 48h at it had been nearly a week with the same symptoms…and no sign of improvement. The fever symptoms made it impossible to sleep. I was either freezing cold shaking like a leaf or burning up unable to cool down….so in 7 days I had slept a total of about three hours. Pretty gross. People love to say “get use to it” with a newborn but I knew this was a little extreme.

BY TUESDAY EVENING WITH A FEVER OF 40….WE DECIDED IT WAS TIME TO GO TO EMERGE.

Now this was a very difficult decision. There was no way in hell we were going to take Johnny to emerge and expose him to the viruses and bacteria lurking in every corner. He was one week old for goodness sake. So now we are talking about separating Mom and Baby….which broke my heart. I had already had my fair share of tears that week given how awful I felt but this was too much. How would I keep breastfeeding him if I went to emerge alone? What about my milk supply? Here is where my husband and mother in law save the day. Knowing the only solution was to get me to emerge and get this fever down ASAP they did whatever it took to make it happen. What it took was me pumping in emerge and Mike running milk back to the house so his mom could hand feed Johnny out of a cup with a syringe….drop by drop…can you imagine? She did this for 14 hours, didn’t sleep a wink. My Mother-in-Law is a life saver and literally tough as nails. Unfortunately you can imagine what being in emerge was like for my milk supply - it killed it. I couldn’t pump a drop. Stress I guess. At that time I was texting with one of my best friends letting her know what was going on. When I told her she immediately offered to drive over some of her frozen pumped milk. Because of her we were able to keep Johnny on breastmilk while I was gone. And you know what? My supply didn’t get better as soon as I was out of emerge (obviously) so she continued to give us frozen milk until we drained her whole freezer. Literally one of the most amazing women I know. So incredibly selfless and I will be forever grateful for her help. NOT that formula is the end of the world but in those early days there is a ton of benefit we would have missed out on from not being able to give Johnny breastmilk.

MEANWHILE IN EMERGE…

I get pumped with IV antibiotics that spike my fever to new heights. I wake up in a muck sweat after sleeping on literally a table in the emerge room. I am 7 days post partum….to say I was uncomfortable would be an understatement. The abdominal cramps were terrible to the point that they made me incontinent….that was probably the hardest part was feeling humiliated not being able to make it to the bathroom. A few hours later I started to feel better….that is my temperature felt normal. It felt too good to be true. I couldn’t remember the last time I wasn’t shaking or sweating…before labour started I suppose. You are probably thinking….sounds pretty crazy for a UTI and you’d be right. Although we never did find out what it really was…..we speculate an ecoli infection of my bowels but who knows. I was thoroughly examined and tested for all manor of things and it all came up negative. So 14 hours later I finally went home to see my baby and relieve my amazing mother in law from her heinous night shift.

THAT WAS THE END OF THE FEVER BUT THE BEGINNING OF THE FEEDING CHALLENGES.

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Now it’s not clear if I would have had great milk supply before the infection but I certainly didn’t afterwards. My son also has a high arched palate making it difficult for his tongue to reach the roof of his mouth. These two things combined made for difficult breastfeeding. We were dependent on donor milk from the get go not that his anatomy made it any easier. So without him breastfeeding well, I had to keep pumping to keep my supply up. Thus began our breastfeeding journey. Over the next 5 weeks we would see: lactation consultants at the hospital (5x), a private lactation consultant (2x), a paediatric dentist (3x), an osteopath (2x), my family physician (4x), a urologist (2x), a paediatrician (1x), an ENT (1x), pelvic floor physio (1x for me) = 21 appointments in 42 days since he was born….basically one every other day. Johnny had his tongue and lip tie released, his airway assessed by an ENT over concerns about his noisy breathing and numerous LCs about feeding difficulties. We have seen amazing improvements in his anatomy after the tongue tie release (tongue can stick out of his mouth and reach roof of his mouth, his jaw has come forward etc.) however it hasn’t translated into improvements in feeding…yet. I am still somewhat optimistic however our current routine is to pump what I can to bottle feed him and top up with formula. It’s not ideal but it’s working. Baby is over 10lbs now! Up nearly 3lbs from birth. Because baby is thriving and I am managing well we aren’t too concerned with getting back to the breast right away, we may never.

THE PRESSURE TO BREASTFEED IS REAL.

I think I will dig into this in a separate post because it’s a bigger conversation we need to have. It has taken me 6 weeks to come close to making peace with the fact I may never breastfeed. I think of my pregnant friends and the ones who haven’t had kids yet and I would never want them to feel what I felt. REGARDLESS of what you decide or are capable of doing, you must know you are not alone. We are all struggling. And those people who look like they have everything figured out…they are just better at hiding it. FED IS BEST. Say that to yourself like a mantra. Breastmilk is great, breastfeeding is great but so is bonding with your baby and feeling confident as a mother. Your mental health matters too. I will save the rest for another post. In the meantime if YOU are struggling with breastfeeding and need someone to talk to, count on me to be there. I have been through the ringer trying just about everything there is to try to make it work. And even if you choose not to breastfeed, I will still be there for you. We all need to lean on each other for support.

SO HERE WE ARE AT THE 6 WEEK MARK, HALFWAY THROUGH THE ‘FOURTH TRIMESTER’

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It’s been an incredibly challenging six weeks mostly mixed up in anxieties and guilt over breastfeeding difficulties, and more appointments than I would ever choose to go to this soon post partum. I can count on one hand the number of days we have had at home just being together bonding and getting to know one another. We are FINALLY through all appointments and can just look forward to days at home, days with friends, and fun outings. THAT is the post partum life I am looking forward to. Whether breastfeeding is a part of that picture isn’t clear yet but I’m ok with that. I am practicing more self-compassion these days. Lord knows I need it.

I am looking forward to getting back to ‘me’ things. Like working out! I am working closely with my pelvic floor physiotherapist to make sure my return to activity is safe. An ounce of prevention is worth a pound of cure. So although I want to ‘jump back in’ I am being conservative and taking it slow. I know it will pay dividends later. Today I did my first set of bodyweight squats and lunges while out for a walk with Johnny. I felt alive! Looking forward to more days like this.

I will leave it there for now. More on breastfeeding and the fourth trimester to come. Excited to share with you my post partum workouts as I get myself into shape. Can’t wait to see what this body is capable of. It won’t be what it was but it might be something better, because I am better…stronger..than I ever imagined I could be. I am owning the “Mama” title, I f*ckin earned it (pardon my french).

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I AM MAMA BEAR…HEAR ME ROAR!! (OR GRRRRR! ….IS THAT WHAT BEARS DO?)

That’s all for now. Sending love to all the current, future, and potential mamas out there.

Coach P.

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