Skills learned for Childbirth work for Life
I recently had to have surgery on my shoulder for a torn rotator cuff and some other damage. Because of my sleep apnea and small mouth opening, the decision was made to do the surgery while I was awake with a nerve block numbing my arm. This was rather daunting since the position you have to be in for the surgery is a bit awkward and I realized I could become overwhelmed during surgery. I thought about things that might help me and realized that I needed to use a lot of the strategies and ways of thinking that I often teach in childbirth classes!
Many of the decisions I needed to make were for my comfort or to remain calm, but were not standard ways of doing things according to the medical staff. I decided that keeping my glasses on so things were in focus was important. So I told the anesthesiologist that I needed to keep my glasses on and why, which helped him in turn to advocate for me once he understood my thinking. That’s something a person birthing their baby via a cesarean might find helpful.
I had to have my right arm, with an IV, stretched out straight; I was on my side and my left arm was suspended from above and held that way throughout the surgery. I also had to be completely draped, including my head and face in order to keep a sterile field. I was somewhat apprehensive about this and having to lay still for over an hour in an awkward position. Having things over my face also triggered a kind of a claustrophobic feeling, so I asked them if they could at least move the drapes a few inches away from my face, which they were able to do.
I reached back to what I teach in my childbirth classes about advocating for yourself. I used a calm voice while using ‘I’ words such as, “I am finding this difficult; is there something else we can figure out that could keep the field sterile and me safe while not being right on my face?” I referred to us as a team working together and we quickly came up with a solution! They attached a piece of equipment to the side of the operating table that was a triangle shape and were able to put the drapes over it so it wasn’t right up against my face, which helped considerably. I have heard from clients that when the drape that separates them from the surgical field is put up, they often get the same feeling I did; in those situations it’s possible to ask beforehand or in the moment if the drape can be moved below the breast line. This gives mothers more space for skin to skin with baby and to be more comfortable during the surgery.
When I got to the operating room, the staff had a lot of cushions to put under my feet and knees and head so I was somewhat comfortable. Since my arm was numb from the tip of my fingers up into my neck and chest, I couldn’t feel my arm being suspended so it wasn’t painful per se, it was just an odd position. I also found breathing a little difficult because half my chest was numb. I had to really focus on deep slow breathing in and out, just like I teach in class for labor.
I also kept reminding myself that the doctors were monitoring me so I could assure myself that I was ok. This is also another fact that I remind my clients of when they are laboring and birthing and feeling anxious.
Once I was positioned, the surgery started and I needed to remain still so as not to inadvertently move my arm or shoulder. I thought back to when we talk about cesarean births and what you can hear and how to keep yourself calm. I used a lot of slow deep breathing to keep my body relaxed and loose. As noises increased, I worked to focus inward and I used some visualizations of the beach. I used some affirmations reminding myself that I was strong and I was capable of doing this and that it would soon be over. I could hear the surgeons talking, but it was very muffled because of the drapes over my head and covering my ear. I tried not to focus on that but to just focus on my breathing and staying relaxed, which turns out works well during labor and during surgery.
The anesthesiologist stayed where I could see him, which really helped. If I moved my fingers on the non surgical hand, it would get his attention and he would turn to get closer and check on me. So I kept reminding myself that he was there and I had an easy way to get his attention. I have often talked to clients about how they might think they want their partner and doula close, but might change their minds. Because of this we willingly back up, but having an easy signal to bring us closer would be so helpful. This is something I will be adding into my curriculum.
The nerve block that I had been given did not start to lose its effectiveness until the next morning, and as the pain came back, I continued to use my child birthing tools. This involved lots of deep breathing and trying to keep my arm and shoulder relaxed; tensing up makes pain worse. When the pain became out of control and the medication was not working, I thought about non medical things such as ice, music, distraction, and positioning to help, and again used my self advocacy to discuss with the doctors what I was feeling and what I needed. As barriers were presented of what medication was available to me, I again tried to keep my voice in control and ask questions to make sure we both understood each other and to talk about how we could come up with a solution together. There was a point that I was not calm and quiet, but continued to be very clear about what I was feeling and what I needed from the care provider.
Self advocating is not always an easy thing to do; it would’ve been nice if I had a doula who could help me come up with the words and talk to me about remaining calm. But it’s very hard to doula yourself! I just kept reminding myself to be clear about what I needed and not just give up. I have often found that people know how to self-advocate, they often just don’t think of it in those terms! This reminded me of the need to spend more time in class talking about times people might have unknowingly self-advocated, which boosts confidence when they realize they do indeed know how!
As I continue to recover, I find that I am still using the skills that I teach to pregnant couples to help me get through this difficult time. I often need to think of ways that I can make myself more comfortable, and look inwardly and see what it is I need and state that clearly. I remind myself, just as I tell my postpartum moms, that you need to take care of your body so your body can take care of you. I have had to learn to let other people do things for me, which is never easy, whether a person is recovering from surgery or from giving birth. But knowing our limitations in the moment and allowing other people to help us is so important.
This has been a good reminder that the skills and tools we learn as birthing people are skills that we can use throughout our lifetime in many situations that may come our way. Therefore the time spent learning these skills is never wasted time; it’s something that will benefit us forever.
How have you found yourself using the skills and the tools that you learned in childbirth classes? I would love to hear from you and reading your messages will give me something to do in the six weeks in which I’m not allowed to move my shoulder! I look forward to hearing from you.