Friday morning: the C-section
This was really just kind of surreal. For the first ten minutes or so, I had no clue what was going on -- there were two doctors working on me, plus I think a medical student. (Sharmi told me later that med students generally don't do much during surgery -- a typical job for them is holding the retractors, the clamps that keep the incision open, while the surgeons work. It's apparently a bit tiring. They also sometimes will cut the sutures after the surgeon ties off each knot. Very exciting. :-) The anesthesiologist was near me, but standing, and would often poke her head over the blue curtain to watch the surgery. Kevin could have done the same, but he elected to not watch -- I think if it were me, and I had the option to watch someone I knew being cut open, I would pass on that too. Too weird. (Generally hospitals won't let you videotape surgeries; even if they would have, we would have skipped it, I think.)The doctors chatted a lot, but I couldn't make out much of what they were saying; Kevin would occasionally relay stuff to me. The surgery seemed to be going relatively smoothly, if a little slower than normal, because they had to plan their route around the fibroids. There are two biggish ones -- 'biggish' according to my doctor, who says they're not actually particularly huge or anything. But apparently our anesthesiologist was a bit less experienced with fibroids, because she kept saying that they were huge! Which worried me a bit, but in the end, they did manage to get the baby out. Later reports told us that the legs and arms came out fine; they had to widen the uterine incision a bit to get baby's head out. I thought maybe this meant Kavya's head was too big, but I checked with my doctor this morning, and she said no, that it was just a fibroid in the way. Kavya's head is apparently perfectly normal-sized.
We did have some genuine cause for concern when she came out -- her initial Apgar score was only a 3. (Apgar scores measure five characteristics, on a scale of 0-2, so a 'perfect' score would be a 10. Anything under 5 is worrisome.) The neonatologist described her as limp and unresponsive. Eep. I wasn't really aware of any of this at the time, though. By the time I heard about it, they'd given her some oxygen and then done the second Apgar test (done at 5 minutes after birth), and her score went up to a beautiful 9. According to our Mayo Clinic book, doctors are not worrying so much about initial Apgar scores these days, because most babies with low initial scores do bounce back just fine and end up perfectly healthy. So I think we're okay on that front. Whew.
They let Kevin come and hold her after they cleaned her up a bit, and showed her to me. That was the first really great moment -- she looked so reassuringly normal. Just your typical, generic, healthy baby. I don't think I had any real sense that she was actually 'ours' at that point -- but I was just so relieved that she looked okay.
Then they took her away again, and a long tedious bit came next. Lots of pressure and them shoving things around, it felt like. No actual pain. This went on for half an hour, by which point, I suddenly got quite nauseous, and ended up throwing up some, which I can tell you, is not so much fun when you're tied down and all you can do is turn your head enough that it mostly goes into this little pink plastic tub someone is holding next to your mouth. And to add insult to injury, they made Kevin go away at this point. We're not quite sure, in retrospect, that they actually meant he had to leave, but he thought that was what they were saying. He went to see the baby again, and then went out to the recovery room to wait. I was feeling fairly miserable by then, and was not pleased that they'd taken him away. But they did reassure me that the throwing up was perfectly normal, and nothing to worry about -- just a result of them pressing down on some organ or other. (They even told me which one, but I can't remember the name.)
Not long after, they did finish up. My doctor came around to tell me it had all gone fine, and then they took down the blue curtain, unstrapped me, and shifted me onto a mobile bed. (That was kind of cool -- it was just like they do on the tv medical shows, where a bunch of hospital folk actually very quickly lift your prone body and sort of sling it from one bed to another. It felt smooth and efficient. I guess they do it a lot.) And then they wheeled it into the recovery room, where the baby and Kevin and my mom and sister were waiting.
The next bit was sadly not so much fun. I got very cold and clammy, and felt truly miserable and exhausted. The medical folks suggested after a bit that maybe my family should go on to mother-baby and wait for me there, so they headed out, and Kevin stayed with me. The attendants kept commenting on how cold I was -- apparently, my nose was icy. They piled me ridiculously high with blankets, and we just waited it out. After a few hours, I had mostly come back to a normal-to-the-touch temperature, and was feeling much less horrible. Just tired. Finally, at that point, they decided I was going to be okay. They had Kevin stay with the baby for a bit longer, and wheeled me up to mother-baby. I was lucky enough to get a private room (the hospital is converting all its maternity rooms to private rooms, but they haven't all made the transition yet), and before long, baby and Kevin and my folks were all there.
The ordeal was over, and as ordeals go, really not so bad. Uncomfortable, certainly, and a few painful bits here and there, but a few hours of discomfort is not so big a deal when you get a healthy baby at the end of it. Kavya was born at 11:30 a.m. on Friday, and by late afternoon, we were all ready to play with the baby. Or at least beam at her. And much photo-taking ensued. :-)
A low Apgar score after a C-section is pretty common. In a vaginal birth the contractions squeezes the fluid out of the baby’s lungs and generally prepares the baby for breathing and birth. In a C-section the baby is lying all comfy in the womb and then suddenly is removed so some babies just don’t get “oh I’m supposed to breathe now.”
I don’t think they give out 10’s just cos. Special K was 9 and 9. She came out kicking and screaming into the world. I wonder why my perfect baby didn’t get a 10 so I look around and
I read here http://www.marshfieldclinic.org/patients/?page=cattails_2006_marapr_apgar
“A score of 10 is extremely unusual as almost all newborns lose one point for bluish-gray coloring in their hands and feet before they have warmed up.”
Special K still gets blue lips when she’s cold and is still perfectly healthy (knock on wood)