Pregnancy Over 40: Two Month Retrospective

Seven Weeks Post Partum 

Successful VBAC 

Prior to delivery, one of my biggest hopes and wishes was for a successful VBAC - something I actually achieved!  I feel incredibly blessed by this fact.  Having had both a C-section and a long vaginal delivery, I can honestly say that they can be equally painful, exhausting, challenging and damaging.  With that said, the recovery from this VBAC is much faster.  I've been working out with weights since getting cleared at six weeks post delivery.  With my C-section, I didn't even think about working out until a year after my son was born.  Frankly, I'd like to see the dialogue around C-sections change to acknowledge it as the major abdominal surgery that it is.  As it stands, I think that because it seems "common," people don't really give it the credence it deserves.  Even my partner often refers to this surgery with the casual air people often reserve for really unpleasant root canals.  

The key to a successful VBAC?  This will be completely different for every woman.  Here is what helped me along:

First, my daughter's head was in the 35th percentile at birth, although she quickly made it up to the 50th percentile shortly thereafter.  So, even though she was technically bigger than my son (by 5 oz), I had a small advantage due to luck and physics. 

Second, I was in much better physical condition, despite being almost six years older than at my first delivery.  When I had my son at thirty-six, I was a very zen, walking-and-yoga kindof-girl.  This time?  I knew what I was in for and spent the years prior to conception (and pregnancy itself) lifting weights and doing cardio.  If I had not done this conditioning, there is no doubt in my mind that I would've tapped the mattress after about six hours. 

Third, I didn't go straight to the epidural, instead favoring morphine for a couple of hours.  In addition, prior to giving the epidural a green light, I agreed with my doctor that we would dial down the dosage so that I could have more body awareness during the pushing phase.  With the first delivery, I had zero feeling and never felt an urge to push.  I can absolutely see where a natural delivery would benefit someone pursuing a VBAC, but frankly, the long duration of my labor this second time around made that an impossibility.  

Fourth, I worked closely with my doulas to postpone my trip to the hospital until the right time.  Labor progresses differently for all women.  One of my friends gave birth a month before me and her labor was four hours.  For me, labor was taking a while, and had I gone to the hospital sooner, I believe I would have been a more likely candidate for another C-section.  Most hospitals expect things to progress a certain way once you are under their care, and it is challenging for them to resist the urge to "help" you along, whether by early interventions or simply a few well-timed statements encouraging you to have surgery.  When I went to the hospital, I could see the change in the nurses' faces when they realized or learned that I was attempting a VBAC.  They know instantly from a clinical perspective that you are more likely to end up with a second C-section, and this can lead to a lot of discouraging - albeit often unintentional - statements and actions from staff. 

Fifth, I hired a wonderful team of doulas.  You can see my prior post for more detail about this.  Suffice to say that I wish I had worked with them earlier in my pregnancy.  They simply bring the right energy to the room, even if you are otherwise having the most clinical of hospital deliveries.  

Sixth, I believed it was possible.  This requires a certain amount of self-awareness.  In my heart, I knew that it was possible to get through a VBAC, something I based on a certain amount of (flawed) logic ("It's a girl this time!  Surely, she'll be TINY!") and intuition (I just "saw" it happening when I visualized the process.)  At one point in delivery, I was just about done and said so.  Then, I looked across the room and saw the empty glass bassinet.  I somehow knew the minute I saw it that she was going to be fine, I was going to be fine and it was almost over.  It was as if she was saying "I'm going to be there in just a little while.  Hang in there, mama.  Be patient.  It's going to work out."  This was very different from my first delivery, where even at the beginning of the pushing phase, I just felt something was fundamentally "off."  

Newborn Care After Forty 

Women (and men) make all kinds of dismissive comments about newborn care after the age of forty.  Guess what?  It's about 100x easier this time around, even without the benefit of quite as much youth on my side.  Partly, this is because my expectations have adjusted accordingly.  I knew what I was in for, and I knew how transient it would be.  At the time I write this, Baby Girl is already well out of her newborn clothing and starting to think about dropping a night-time feeding.  My golden rule for child-rearing is basically to wait:  just when you think that you can't take another minute of whatever phase they are in, they move on to the next one!

Still, the biggest reason it is 100x easier this time is a simple one:  My partner is home full time with me during this period.  He is able to continue his education via online courses while I'm on maternity leave.  His presence allows me to gain extra rest and thus heal faster and take steps to restore my health. 

Behold the power of a decent paternity policy, Employers.  This two week standard is utter nonsense.  Most families I know do not have a bunch of grandparents and aunts and uncles and affordable babysitters surrounding them - many have only their partners and other children.  Giving men more substantial paternity leave allows them to support women, and supported women have lower incidences of post-partum depression, better health outcomes in general and - gasp - likely re-enter the workforce in a much more productive and expedient manner.  Two weeks is a joke, and hankers back to a time when men were primary breadwinners in all but a handful of families and interest rates for student loans were under 4%.