Nursing after C-section -long - Mothering Forums

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Old 02-26-2004, 04:53 PM - Thread Starter
 
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Hello,
I am trying to find some information for my sister who is 36 weeks pregnant with baby #2.

History;
First baby was planned homebirth with midwife, she never went to a Dr.
Due to PPROM at 35weeks 3 days had to have a hospital birth with no other complications other than prematurity.

2nd time around she has seen a Dr throughout her pregnancy just as a back up in case she delivered early again otherwise she'd still like to have it at home.

At her 35 wk appointment an ultrasound showed that the baby is breech with the cord wrapped aroud the neck, baby shows no sign of distress and Dr. is letting her go another 2 weeks since the cord is long enough for baby to still turn naturally.

At 38weeks if the baby hasn't turned Dr will schedule to physically turn the baby. IF he is succesfull in turning the baby and she doesn't go into labor she can go home and if all goes well birth at home. If she goes into labor during the procedure or it is unsuccesfull and the baby is still breech then a c-section would be her only option.

Our main concern is what method should she choose if she has a choice in drugs for the operation. If the baby is fine she'd like to nurse imediatly after, what drugs would allow her to do that? What is best for the baby? I know no drugs are 'good' for babies and the GA is hardest to recover from, but which would be the quickest recovery for both her and the baby so she could nurse and not give the baby more drugs than neccesary.

On another note, to prevent nipple confusion and bonding issues we're hoping that if she has to have GA and is unable to nurse that I would nurse her baby for her. Is this un heard of? Has anyone ever had a back up nurser for their baby in the hospital? I've nursed her son throughout the later end of her pregnancy.

Sorry this is long but as you can see we're concerned about the best outcome if she has a choice in drugs for having a c-section.
Any advice would be greatly appreciated.

E & K (13yrs) and our flock of 6!

"Hey little one, why don't you go get cleaned up, you look like a country bumkin."
"Mum, I am a country bumkin"
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Old 02-26-2004, 05:05 PM
 
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Ok, I'm not sure but I think they only use GA if it is absolutely necessary. I'm not sure if they give it as an option.

With an epidural you are only numb fromt he bottom of your ribcage down. Nursing shouldn't be a problem in recovery. From what I hear it is the best option. Most won't let mom bf on the table. There shouldn't be a reason to not let her bf asap in recovery though. She may nee help with positioning if her meds give her the shakes (mine did with Tracy but not with Bryce...a difference in meds).

I had a epidural with both of my c/bs. So I'm not sure about the rest. Have her tell the anesthesiologist she doesn't want anything to cause her drowsiness. She would prefer to have all meds discussed before they are administered. Then she can ask questions about tis possible sideaffects on her and on her baby.

My pain guy was great in only giving things that i absolutely needed. Sometimes they pump you full of stuff that isnt necessay. Part of that is because a lot of women don't care. The more pain killer the better.

She also might want to tell them she wants the epi gone as soon as it possible. My hospital typically left it in 24 horus after birth bunless requested otherwise, which I did and mine was gone about 8 hous after surgery.

As for a backup nurser...never heard of it. But that doesn't mean much

I hope they are able to turn baby sucessfully and that she doens't have to think about all of this A c/b birth plan is a great idea. There are lots around just do a search for them

Single Mom to 2 amazing little men. T(7) and B(5)
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Old 02-26-2004, 07:15 PM
 
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You might want to post this question on the c-birth support thread to get more views from BTDT mamas.

I had spinal anesthesia all 3 times, and I have to say- I had no problem nursing this last time, my milk was in in less than 48 hours . The first 2 times I had problems, but I really think it was due to positioning problems, not anything to do with c-birth. I am sure things would be different with GA- and I think that you nursing the babe (if she has GA only, and with her pumping off) would be great!

:Patty :fireman Catholic, intactalactivist, co-sleeping, GDing, HSing, no-vax Mama to .........................:..........hale:
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Old 02-26-2004, 08:17 PM
 
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Quote:
Originally posted by Katri'smama
Hello,
I am trying to find some information for my sister who is 36 weeks pregnant with baby #2.

History;
First baby was planned homebirth with midwife, she never went to a Dr.
Due to PPROM at 35weeks 3 days had to have a hospital birth with no other complications other than prematurity.

2nd time around she has seen a Dr throughout her pregnancy just as a back up in case she delivered early again otherwise she'd still like to have it at home.

At her 35 wk appointment an ultrasound showed that the baby is breech with the cord wrapped aroud the neck, baby shows no sign of distress and Dr. is letting her go another 2 weeks since the cord is long enough for baby to still turn naturally.

At 38weeks if the baby hasn't turned Dr will schedule to physically turn the baby. IF he is succesfull in turning the baby and she doesn't go into labor she can go home and if all goes well birth at home. If she goes into labor during the procedure or it is unsuccesfull and the baby is still breech then a c-section would be her only option.

Our main concern is what method should she choose if she has a choice in drugs for the operation. If the baby is fine she'd like to nurse imediatly after, what drugs would allow her to do that? What is best for the baby? I know no drugs are 'good' for babies and the GA is hardest to recover from, but which would be the quickest recovery for both her and the baby so she could nurse and not give the baby more drugs than neccesary.

On another note, to prevent nipple confusion and bonding issues we're hoping that if she has to have GA and is unable to nurse that I would nurse her baby for her. Is this un heard of? Has anyone ever had a back up nurser for their baby in the hospital? I've nursed her son throughout the later end of her pregnancy.

Sorry this is long but as you can see we're concerned about the best outcome if she has a choice in drugs for having a c-section.
Any advice would be greatly appreciated.
This is my advice and by the way my csection birthplan is on the FEB support thread.

I would not have a ECV by a doctor with the conditions you just described with the cord. Versions IMO are dangerous. They are painful, and if not done by a very skilled and successful OB can put the baby in serious distress. My version landed me in an emergency csection with a baby full of meconium, low heart tones, and bruised. What happened to me was a nightmare even beyond that. I would want to know what the OBs experience and success rate is when attempting a version. I would also advice it be done on L&D.
There are other methods of turning a baby. I am sure Pam the Midwife can tell you a few. The Websters Technique also. These methods are SAFER. I wish someone would have warned me. I am not trying to scare you but no one spelled out the risks to me with the ECV. Had they I would have just said cut me and be done with it.

I want to address some other things you wrote as well. The Version thing with already a breech baby with cord issues really bothered me and I had to get it out.

Epidurals and spinals are best for csections. None of these touched my infants. With the spinal my baby was out in less than 4-5 minutes. With my epidural 11. I am partial to epidurals with duramorph or PCAP pumps hooked into the catheter to offer long standing relief. It provides excellent pain relief the first 24 hours. Demerol is also good for pain relief during the recovery period and has little effect on the newborn. I was able to nurse both my infants, the last one with ease in recovery. I think you should really read the last two support threads because there is so much valuable information there that I think your sister can benefit from.

I hope your sister doesnt have to have GA. Its very risky but even if she does she can nurse her own baby. I think that will hurt her if you nurse her newborn before she does. There is no reason that once she wakes up that she cant nurse. They will not give the baby a bottle if she states no bottles and that the infant is breastfed. Csections, especialy first ones can be very emotional and I was hurt that with my first baby everyone got to hold her but me first. IF someone had nursed my baby, even if I oked then I would have wanted to die. My husband held my son but they laid him on my chest and I hugged him with my arms on the OR table. I also held and nursed him 15min after the surgery.

Kim
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Old 02-26-2004, 10:23 PM
 
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I nursed all 3 of my girls in recovery, all were csec deliveries. 1 epidural, 2 spinals. No problems, no shakes, spinal headaches or anything. I would definitely talk to the anesthesiologist about exactly what meds they're giving in the IV though. I didn't get anything weird but after I was in my own room & especially on day 2 the nurses kept bringing me TONS of pain meds, both IV & pills. I was fine w/ the darvocet (sp?) but the IV motrin they gave in conjunction...ugh, what a bad combination. I was a zombie until I told them to take that away and leave me alone, LOL.

They will try to overmedicate csec moms post surgery, IME. The doc told me their reasoning was that you shouldn't get to the point where you NEED the meds, you should be comfortable/pain free. Except for me pain free meant unable to care for myself or the baby. It's a balancing act between zombie & hurting, you learn pretty quick. I have a very high pain tolerance, I come out of surgery ready to run a marathon, so that drugged feeling really was my only downside to my birth experiences.

Not sure if that's helpful at all but wanted to share.
Best of luck and hope your sis doesn't need a version or section.

OH--on the nursing for your sister...I'm pretty sure it won't be allowed. Sad because you've obviously got a great relationship w/ her but I bet the hospital will freak out and not allow 'unscreened/untested bodily fluid transfer'...You know how hospitals are...
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Old 02-27-2004, 03:11 AM
 
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An epidural uses a higher dose of medication than a spinal, but, because it doesn't go in as far as a spinal, there is less risk that you'll end up with an accidental misplacement and the attendant spinal headaches, etc. (That risk is extremely low.)

General is never necessary except for emergencies.
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Old 02-27-2004, 01:55 PM
 
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She really needs to do her homework. Find out what that particular hospital does routinely, and what rules they are willing to bend. She needs to have a birth plan that includes anything that might possibly happen, just so she's prepared for the unexpected and knows what she wants if something does happen. She needs to learn the risks of any procedure, and the risks of refusing them as well. The doctor won't give her the whole story, it's up to her to do the research.

I was not allowed to nurse my baby until after I left recovery! Yup, that meant the spinal had to wear completely off first, and it took four hours!! The spinal anasthesia left me paralyzed from my armpits down, but since time was of the essence, we couldn't take the time to wait for an epidural to take effect.

Most important would be for her to see if she can find a chiropractor who does the Webster Technique. It is safer and more effective than a manual version.

While I think it's very touching that you are willing to be a wet-nurse, baby doesn't need your milk. If it takes longer than a couple days for her milk to come in, it is ok to give baby some water to prevent dehydration and to help reduce jaundice. She should probably line up a lactation consultant ahead of time. If it were me, I'd go ahead and rent a really good pump just in case.
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Old 02-27-2004, 09:11 PM
 
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I had general anesthesia and would have had no trouble nursing if it had only been GA. I had an attempted epidural during labor and an attempted spinal just before surgery. They didn't work, so they put me under. I ended up with a spinal headache. It hurt so bad that I couldn't nurse and had DH give DD formula. We went on to nurse for 2+ years, so it worked out in the end. I wouldn't wish a spinal headache on anybody, though. Oh man, that hurt, much more than labor.
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Old 02-29-2004, 02:53 PM - Thread Starter
 
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Thank you everyone for your sharing your experiences.

If she does have a choice then an Epi sounds like the way to go. From our research it seems like the quickest recovery for both the mom and baby. The pain meds afterwards will be a tough one though, depending on her pain tollerance if she can live through with minimal/no drugs. The last thing we want is for her to be overmedicated.

Thanks Kim for the warnings on ECV.
Her OB has turned over 100 babies succesfully so we have high hopes that if it comes to that we'll be in good hands.
She has seen a chiropractor a few times through her pregnancy to get her back adjusted and she has asked about the Webster technique and he doesn't know anyone in our area that does it.
She has also seen an acupuncturist and talked to her about turning the baby using accupuncture but she refused to do it unless it's done in a hospital for fear of the baby's system crashing and causing delivery. However we have been using Moxa on her accupressure point (tip of baby toe) anyway with no ill results. So hopefully we can turn this baby without causing it distress.

When my daughter was born (35 wks 3 days due to PROM) after only an hour of nursing they poked her foot to test for blood sugars then determined her levels weren't high enough. They insisted on taking her away to the nursery were they gavauge fed her sugar water to up her levels. My husband acompanied her the whole way but didn't know if he could refuse the tubal feeding or not. I was extremely upset to find that out later. This was also a planned home birth gone early. IF they'd given me more time to nurse her before testing I'm sure the levels would have been fine. We later fed her harmless homeopathic tablets as advised by my midwife with the lactose n.f (milk sugar) base and needless to say she didn't have to get 'fed' again!
That is the main reason we have a back-up nurser just in case my sister is unable to, because at our hospital this is standard procedure to test the baby then supply if needed without consulting and if we say no formula then they gavauge feed instead which causes the baby great discomfort.

We will check with them though and if they're poo poo then we'll just have to lock the door! :LOL

E & K (13yrs) and our flock of 6!

"Hey little one, why don't you go get cleaned up, you look like a country bumkin."
"Mum, I am a country bumkin"
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Old 02-29-2004, 11:24 PM
 
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Your sister can have duramorph put in her epidural line or have a pcapump that delivers meds right into her spinal column, this will give her excellent pain relief, limited mobility, and will not go to her head. I had this the last time with my epidural and had the epi line removed 17-18 hours post op. I felt great. Morphine I would stay away from. Avoid phenegran and request zofran for nausea during the surgery.

I will be happy to give you any info I can about the drugs. You have to tell them no pre-op drugs or they will give them to her. This is standard proceedure. I refused all post op drugs as well, except what was in my epi line hooked to the pcap. I did not have phenegran or zofran on the table. I did get nauseated from low bp but was given ephedrine, which made me high, to bring it back up and it went away. I had three doses of this, twice in the OR and once out. Low BP is common with epidurals. Eohedrine will not hurt the baby, they are usually out by the time it gets into the system good.

I had a bad experience with a spinal but others here have not. Mine didnt take the way it was supposed to, went in my chest instead of lower and I felt the whole thing. I also had to lay flat on my back for 24 hours. No fun.

Kim
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Old 03-03-2004, 12:04 PM
 
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Good luck on getting baby to turn. No experience there, so I can't offer advice, but I do have some thoughts about nursing.

Has she considered trying to pump some colostrum in advance? Babies don't really need much the first couple of days, so volume is not essential. It's only by comparison to formula fed babies has there become an issue about amounts of fluids taken on the first few days. Heck, in the fifties, babies were NPO (nothing by mouth) for the first 24 hours. But, you mention that you had low blood sugar issues with a baby. This is unlikely to happen to your sister or her baby, BUT if this is something she's concerned about, if she had some colostrum stored ahead of time, she'd know that baby was getting *her* milk, and it's the perfect first food to help seal a baby's gut. I actually plan to attempt this with my August baby, just in case my GD returns. Didn't have an issue with my DD but I want to play it safe.

Good luck! Hope all goes well for your sis. How lucky she is to have someone looking out for her like this.

Caroline
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Old 03-03-2004, 06:37 PM
 
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It sounds like this is the kind of hospital that might give you hassels about using back-up boobs. Which is entirely lame, but there ya go. I think the prepumping of colostrum is a great idea. Most likely, if a section is necessary, your sis will have an epidural or spinal meds and she should be able to nurse as soon as they close her incision. If she's shaky, her dh or you can help her with positioning. I nursed my son within 90 minutes of my section-- it would have been sooner if my blood pressure hadn't crashed.
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Old 03-04-2004, 12:02 AM - Thread Starter
 
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She's got a pump and is ready to start pumping beforehand to get colostrum if it's needed. I'm glad to hear so many moms that nursed shortly after surgery. This has been such a tramatic experience going from a planned home birth to a planned section but that does give her some comfort knowing she should have no problem nursing after. After researching in this message board we've gotten alot less scared about the whole situation.

Thanks mamas for all your great support, she's not technically due until April so we really hope the baby turns before then!

E & K (13yrs) and our flock of 6!

"Hey little one, why don't you go get cleaned up, you look like a country bumkin."
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Old 03-06-2004, 06:07 PM
 
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I am just curious if this baby has turned or about an update.

I would also say there is a homeopathic remedy for breech babies that might be worth a try, I am not sure of the name though I think it has been mentioned on the boards before.

Stephanie

Stephanie married to Jerry  partners.gif  mama to  modifiedartist.gif (10) and superhero.gif(7) and 3rdtri.gif
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Old 03-06-2004, 07:16 PM - Thread Starter
 
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*Update*
An ultrasound last Wednesday showed the baby still breech with the cord wrapped around the neck (no change).
From here she is sheduled on March 9th to try and turn the baby.
We're not sure if her OB will do the procedure if the cord is still wrapped, he didn't say anything about not being able to but wouldn't that be a little scary? I realize quite a few babies get wrapped up in the cord and still come out just fine, it's just a little different when their breech...

She bought the "breech baby" homepathic kit and has been trying several different remedies, so far nothing has changed.

She did get to make a belly cast for this baby, in her last pregnancy she didn't get a chance to because he was unexpectedly early. This has been some joy in this otherwise 'afraid of the unknown' pregnancy.

I'll update as soon as we know anything.

Thanks for caring Stephanie.

E & K (13yrs) and our flock of 6!

"Hey little one, why don't you go get cleaned up, you look like a country bumkin."
"Mum, I am a country bumkin"
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Old 03-08-2004, 06:37 PM
 
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Just to jump on the bandwagon with DS I nursed him an hour or so after his c/b, DD I didn't nurse until 2 1/2 days later because she was in the special care nursery due to fluid in her lungs, BUT the hosipital knew she was bf only so she was on sugar water and I pumped for her (although I didn't do my 1st pumping until almost a day later ) We have been successfully bfing now and she has never had formula
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Old 03-08-2004, 09:32 PM
 
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I think that is so awesome of you to offer to nurse her baby for her if needed. I'm sure it would be allowed but maybe need to be explained ahead of time to the hospital staff, I mean it would be you acting as a wet nurse right?

I just had an unexpected augmentation and c-section last Thursday with an epidural and all the standard pre-op drugs. my baby is nursing great so far. I always thought drugs of any sort would effect nursing and this was something I was really concerned about and I asked my midwives and lactation consultant as well as every nurse I came in contact with about this at the hospital. They all told me it shouldn't effect it at all (not sure if that's just the standard answer or is true but my experience has been good so far) I started nursing immedietly in recovery (even though my BP did crash) I think he was still on the breast withing 15-20 min. the hospital I was at has an EXCELLENT lactation program and I saw a consultant about every 3-4 hours for 3 days which really helped me get started. My milk is just coming in now and things have been good so far, alot easier than I ever thought they would be in any case (even with a natural birth)..

Blissful Mama to DD-(5), DS-(6) and someone new due in November!
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Old 03-08-2004, 09:42 PM
 
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She should try moxibustion to get the baby to turn -- it has a 70 - 80% success rate. There are also some great methods to get a baby to turn in "The Natural Pregnancy Book" by Aviva Jill Romm.
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Old 03-09-2004, 10:06 PM - Thread Starter
 
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6 am monitoring of the baby for an hour before her OB did an ultrasound. Baby's heart tones were great and the placenta is nice and healthy. Baby is in a transversed (sp?) position or 'wedged sidways'. Nothing real scary just very unlikely to be able to turn by its self. Cord is still wrapped so Dr couldn't turn physically. Her water level is lower than we'd like (another reason for not being able to turn possibly) and if it's gotten any lower by Friday then he'll plan the section early next week. If her water level stays steady and doesn't fall then he'll let her wait till closer to her due date before the section. Sigh..... Well, all hopes of a 'home birth' have now been demolished. She's taking it rather well, though not real happy out any of it she wants what is best for the baby.

Our hospital only performs sections with the Spinal drug. They said it's the quickest recovery though it differs from all that I've heard, hopefully it wil be so. They did say that as soon as she leaves the OR she gets to have the baby so that was a little good news.

Her OB says we (my sister and I) will probably be reported in medical history of being two sisters that each had frank-breech babies. Except mine was itty-bitty (35 wks) and came out naturally.


We've tried Moxibustion but due to the position of the baby it seems to be imposible to move.

Thanks again for all your help and support through our situation. We really appreciate all the experience you've shared.

If any of you feel like sending my sister your thoughts and best wishes you can e-mail her at

[email protected]

this is a really tough time for her and it would make her smile.

Thanks again!

E & K (13yrs) and our flock of 6!

"Hey little one, why don't you go get cleaned up, you look like a country bumkin."
"Mum, I am a country bumkin"
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Old 03-10-2004, 07:48 AM
 
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just to chime in as well!

i had no problems nursing after my c/b last november - i was still woozy in recovery when the nurse and my husband helped ruby to nurse...i haven't a clue what they put in the epidural, but i refused the morphine drip and the nurses wouldn't give me pain meds unless i requested them - we found out at the end of the first day (I was in utter PAIN!) that they (the nurses) thought I wanted no meds since I was a homebirth transfer...

sheesh! i took percoset and vistaril and toradol? while in the hospital, dropped the toradol after day one...they all assured me it was fine for the baby and by the time my milk came in on the third day, i wasn't taking as much percoset and no vistaril...

good luck - she'll get through just fine - the sun will start to shine again at about 8 weeks post and get brighter from there...
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Old 03-11-2004, 04:46 AM
 
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Can't do a long post, but I wanted to share with you -

I've had 2 cbs - one with an epi (july 02) and the most recent (2 wks ago) with a spinal.

I liked the spinal A LOT better than the epi. The block was more complete (though I could feel sensation, no pain), and I wasn't woozy afterwards.

No complications from either.

interestingly enough, the same team administered the drugs for both of my births - pretty remarkable since our hosiptal delivers about 11000 babies a year!

Good luck to your sister.

Oops, gotta run.
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Old 03-19-2004, 11:41 PM - Thread Starter
 
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oops


E & K (13yrs) and our flock of 6!

"Hey little one, why don't you go get cleaned up, you look like a country bumkin."
"Mum, I am a country bumkin"
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Old 03-20-2004, 01:16 AM
 
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Great News! Great Name! I'm glad she was able to get to the breast so soon.
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Old 03-20-2004, 05:07 PM
 
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Quote:
Originally posted by Katri'smama
Hello Everyone!
We have a little Girl!

Lorenna Edith, 7lbs 3oz.

Lorenna was born via c-section within 6 minutes of the actual incision and is very healthy. After suctioning, a good rub down and Apgar testing she was placed back on Lindy's (my sis) chest and nursed through the whole suturing process (45 minutes).
Lindy's uterus is heart shape which resulted in trapping the baby's head in the upper lobe.
Lindy's been a little nauseated and her temp has been lower then wanted (95.6) due to the left over anesthesia, but is gradually rising and she's doing good.

Thanks again for all your help and support.


My uterus is heart shaped too, its bicornuate. That is why my daughter was in a weird transverse position and never would go head down. I am so glad that your sister had what seems to be a fairly good csection. I am so glad htey allowed the baby on her chest that entire time. for a 45 min suturing, they must have sewn her up really well!
I hope she has a wonderful baby moon and glad she was able to be with her baby right away.

Kim
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