What I'm Holding Ahead of My C-Section

Giving birth in Texas, and bringing two daughters into an uncertain world.

Photo by Ritesh Tamrakar on Unsplash

Hi folks,

Today I’m writing about a week and a half out from my scheduled C-section on July 14th, and my mind is a mix of so many thoughts. Most of them are half-formed, and they are not at all linear. But, if you don’t mind, I’m going to use this space to put them out into the universe and ask for your help holding them.

• I wrote on Instagram a few weeks ago about my fear of dying during childbirth. I’ve long had this fear, and living in Texas doesn’t help!

  

  
  A rant (skip if this isn't for you!): I had a long talk with my OB, who will do my C-section, about my fears related to dying during childbirth. She is very matter-of-fact, and I love that about her. The good news is that she feels like her OB group has always been very supportive of her doing whatever is needed to keep mom alive. The biggest risk to mortality during C-section is hemorrhage, and she told me if we need to do a hysterectomy, we do it. (Of course, that is not the ideal situation, but her emphasis is we do what we have to do when mom’s life is on the line). I said I have no need for a uterus anymore after these babies (lol, this is for sure my last pregnancy). Again, hopefully all of this is moot, but it's good to know we are on the same page. I reiterated that I'd like something for anxiety after the babies come out, because last time I had such bad shakes and I hated how it felt when they were putting me back together. And she said that would be no problem.

  
  And I guess here is the rant part: Giving birth is, for most women, the most physically risky thing you will do in your entire life. I know there is so much desire and interest in home births these days but, for me, I will just say that I trust and respect modern medicine.
  
  I want to be typed and crossed. I want the IV. I want my anesthesiologist in the room and trauma surgery on call and in-house. I want the neonatologist in the OR and the NICU next door. I want all of that standing by, just in case. Birth, especially high-risk births, are not something to mess around with. And when we see bad outcomes in home births related to delaying care, it guts me. Because so often it was preventable.

• I read

  Sarah Kendzior
  ’s recent piece on the recent election in NYC and the defeat of Cuomo, and that someone younger, more hopeful, and not a cog in the Democratic machine will have an opportunity to make his mark. This isn’t a political newsletter, and as I embark on the immensity of bringing two girls into the world, I did feel a spark of hope in this outcome. I don’t know if Zohran will deliver what he promises if he gets elected in November — but I do know that it is time (it’s been time) for a changing of the guard in the Democratic Party.

Heat Exhaustion

• I’m having some feelings for and about my son K, who just turned three, and whose life is about to turn upside down in about a week. He is excited to be a “helper” and a big brother. And I know our relationship will be forever changed, and I’m nervous and scared and sad for that. He knows we are having twins and but — he’s three — so there’s only so much he can really grasp until they are here. What I see with my patients is that typically, when a second baby comes, the more challenging thing to manage is actually the first child’s emotions. Not sure if that holds true for twins or not. TBD!

  

  Me and K on his 3rd birthday last month.

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• One thing keeping me sane right now is that fact that we hired a night nurse (actually two night nurses who will be switching off nights). I made this decision because, as a perinatal psychiatrist, I know how important sleep is for prevention of PMADS. I’ve also stayed on my Zoloft (went up on the dose during pregnancy). Knowing that we will be covered at night for five nights a week for almost three months is a huge, huge weight off of me. It’s definitely a privilege, and I know not everyone can afford it (will say it’s more affordable here in Austin than it would have been in Washington DC where we lived prior). From day 1 of becoming parents 3 years ago, we made the conscious decision to spend all of our money (joking, kind of) on childcare because we don’t have grandparents local, and Justin and I both work full time. It’s made me much less resentful or burdened as a mother, which in turn supports my mental health. I share this with you because I want to be transparent about how I make all the things happen — and I also want you to know that if you have the means, and if you are weighing budget decisions around getting support — please remember that caring for your needs pays off in the long run. I sometimes have patients who will remodel their bathroom before they will pay for a doula or childcare. We get to decide where and how we spend our resources.

AMA: Pregnant with twins edition

Next week you’ll be getting a fantastic guest essay from

Jillian Anthony

. I hope that everyone has a nice long weekend and stays cool. Next time you hear from me, I will be on the other side!

xo,
Pooja

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