I'm back!!! Tales from my pregnancy, delivery, recovery and return to work.

Hello!  I have returned from maternity leave and am back to work at Solstice Physical Therapy.  It is bittersweet, as I absolutely LOVED my time with my beautiful and sweet daughter, Emma, but I was also starting to get a bit stir crazy and missing work.  These 8 weeks off have really reinforced how much I love my work, my patients and the feeling that I get knowing that I am helping people to live their best lives.  I had my first afternoon back to work last week and felt completely energized afterwards.  I now feel like I have the best of both worlds – I am loving motherhood far more than I ever could have anticipated, and I still get to have a fulfilling career that allows me to change people’s lives for the better.  I feel very very blessed.
I wanted to share some of my experiences from my pregnancy, labor, delivery and recovery, as I think that some of them could be very helpful to others as they embark on the journey of motherhood.  There are many “old wives tales” and so many people voiced their opinions to me about my activity level, what I should anticipate, etc. that it made me quite nervous.  I would like to share my story so that other women can be inspired and know that pregnancy can feel good, the delivery can be beautiful, and recovery doesn’t have to mean sitting around and watching your body get more and more out-of-shape.

I was very nauseous in the first trimester and had about 8 weeks where I couldn’t really tolerate doing much of anything besides working and laying on the couch (this part was not the good part that I was describing earlier).  I tried to walk as much as I could to prevent completely wasting away, but it was still much less than I had been doing previously.  Thank goodness that for me it was so true what they say about the second trimester, at 14 weeks I started to feel amazing!!!  I returned to walking about 4 miles/day, doing yoga and my work load was increasing so I was getting quite a bit of manual activity throughout the day (I am a hands-on therapist, so my workday consists of a lot of standing, pushing, pulling and lifting of people’s bodies).   I had never felt better, especially with the knowledge that I was growing a human being inside of me!  From about the time I started to show (about 20 weeks) I had many people ask me when I was going to stop working, telling me that I should rest more and telling me that I was overdoing it.  From now on, I will advise everyone to “just listen to your body” because everyone is different and I definitely did not feel like slowing down.  By the time the 3rd trimester rolled around, if I overdid my exercises I would feel very fatigued for the next couple of days, so I adjusted my intensity levels accordingly and I felt amazing!  So don’t ever let anyone tell you that you should be slowing down, because I fully believe that my higher activity level led to a wonderful labor and delivery!  Also, no one could believe how “small” I was.  Part of this is due to the fact that I have a long torso, but I attribute much of it to my healthy diet and continuous activity, both through exercise and work.  For the most part, if someone has a healthy pregnancy, they can continue with their regular activity level and adjust as their body changes.

Another thing that I would strongly advise, both as a physical therapist and now as someone who has experienced pregnancy – MAINTAIN YOUR CORE STRENGTH!!!  This doesn’t just include your abdominals, this is referring to your gluts and upper legs as well.  Squat, squat, squat!  At around 12 weeks I started to have some pelvic pain around my sacroiliac joints.  I think that this was most likely due to the fact that for the last 8 weeks with morning sickness, I had been pretty sedentary compared to my normal activity levels and I had completely neglected my core.  As the fog of the first trimester started to clear up, I started working on my glut strength with exercises like clamshells, sidestepping with a resistance band, lunges and squats.  I also really focused on stretching, so I did prenatal yoga and a lot of pigeon stretching.  I also did abdominal exercises (avoiding exercises laying on my back) and engaged my transversus abdominus throughout the day.  My discomfort was gone except for times when I sat too long, but I believe that these exercises were the reason that I had such a great 2nd and 3rd trimesters.  When the relaxin hormone starts kicking in, it causes instability in the low back and pelvic area, which can lead to a lot of pain.  If women maintain their core and leg strength safely throughout pregnancy, they usually have much less discomfort.  It’s also amazing for labor and regaining your core strength after pregnancy!

Lisa 40 weeks

The morning of the day that I ended up giving birth to Miss Emma was just like any other day.  I was 4 days past my due date so I had been walking a lot, doing exercises on my ball, walking on uneven surfaces, squatting, eating spicy foods and pineapple, drinking a ton of Red Raspberry Leaf tea and using Evening Primrose Oil.  That morning I still had no idea that it would be “the day.“  It started off with a 2-3 mile walk with my mom – by that time I was having a ton of pain-free Braxton Hicks contractions (just tightening of my abdomen), so the walking was a bit slower than normal.  Then we needed to pick some stuff up at Lowes, we checked out a berry picking farm, and went to a bookstore to do some shopping for my parents.  By about 1pm I was tired after running the errands so we came back to the house, had a bit of lunch and my mom and I went out to the front patio to sit in the rocking chairs and enjoy the beautiful weather.  At 3pm I started to have some cramping sensations in my lower abdominal area and I figured that my body was starting to get ready to do something.  An hour later the cramps started to feel consistent so I started to time them – 4 1/2 minutes apart!  According to most things you’ll read and my midwives, you’re supposed to go to the hospital after your contractions are less than 5 minutes apart.  They were barely painful and had only started an hour before, so we decided to just sit it out for a bit.

Soon they became painful to the point that I was having to breath through them a little bit.  I’d heard too many stories of false labor and getting sent home from the hospital, so I decided to drink a bunch of water and try to lay down to see if they would subside – WRONG!  Laying down caused the worst pain yet and so I started timing them again and they were now less than 2 minutes apart.  I texted my doula to ask her when to go in, her exact reply was “now would be good.“  Haha!!  My husband was confused because we had discussed that we both prefer that I labor at home as long as possible, and it had only been a couple of hours.  We loaded up the car and once he saw that I couldn’t even get into the car because I had to wait for a very painful contraction to pass, he knew it was time.  I don’t remember much of the 30 minute drive, because by that time the contractions were sometimes right on top of each other.  I was holding onto the handle above the door and my husband kept reminding me to try not to rip off the handle.  =)  He dropped me off and it took me some time to get to the labor and delivery unit because I had to stop and breath through my contractions.  They didn’t even get me admitted to the hospital because they realized very quickly that I was in full blown labor – I was 5cm dilated and completely effaced.  My doula arrived the second that they got me into the triage room – her hands giving me counter-pressure on my pelvis was absolutely magical and helped me until I was able to get into the labor bathtub.  My doula and midwife were giving me advice on how to relax into the contractions and the tub felt amazing.  Everyone left for a while, most likely assuming that since it was my first baby that I would be awhile – they were incorrect in that assumption.  After 45 minutes I felt like I had to go to the bathroom and I was horrified to think about going to the bathroom in the tub.  The doula called my midwife and they came in to check my progress – the baby was crowning!!  They got me out of the tub as quickly as they could and toweled me off as I was having a contraction – the only thing that kept me upright was my doula supporting my whole weight, because my legs went out from under me from the pain.  They ran me across the hall to the room they had set up for me (it was my first time seeing my room), got me onto the bed on my side, and 8 minutes later I had pushed out my beautiful baby girl.  The entire process from start to finish was only 5 hours, and I was only in the hospital for 90 minutes before Emma arrived.  It was an incredible experience!  It was the most pain that I have ever endured, but the result was an absolute miracle and I also could not believe how fast and “easy” my labor had been.  I had no tearing and did not need any kind of intervention during or after the whole process.  Emma cried for about 10 minutes and then she started to root.  We were able to breastfeed and be “skin-to-skin” for 2 hours and it was the most amazing feeling.  I was completely awestruck that I had grown this perfectly formed little person inside of me and now, here she was!

Emma born

Here are my tips for labor – #1 – start perineal massage at 34 weeks.  I’m not going to elaborate on this, it can be googled.  I was taught this procedure in a pre/post natal physical therapy course that I took years ago and I was somewhat hesitant about it, but I’m sooooooooo glad that I did it!  My midwife was also extremely skilled at doing the same thing as the baby’s head was crowning and despite it being the most painful part of labor, it was very worth it.  I’m sure that it’s the reason that I did not tear.  Also, at 36 weeks I started using Evening Primrose Oil and drinking much more Red Raspberry Leaf Tea.  These are meant to soften the cervix and tone the uterus, and they very well could have been why I had such a quick labor.

Tip #2 – I learned “J breathing“ from YouTube.  I think that it’s a part of hypnobirthing, but I just watched a 5 minute video and it was very helpful to try to “relax” the pelvic floor and visualize the baby working it’s way down through the birth canal.  I’ve heard that tension in the pelvic floor, shoulders and jaw can really stall labor – so I made sure that I was very relaxed in my jaw, the midwife kept reminding me to relax my shoulders, and I focused on “breathing the baby down.“  This of course meant that I sounded like a bull elk throughout the more painful parts of my labor, but I definitely did not care at the time.

Tip #3 – do what feels good.  So of course, nothing actually “feels good” at the time, but there are certain positions, sounds, breathing, props, etc that can feel better to your body.  I’m sure that everyone is different, but I will tell you that for me, the warm water of the birthing tub was incredible!  I was able to be on my hands and knees during the contractions and allow my legs to open up and I pushed back into a kind of squat position (per my doula’s recommendation).  This allowed me to relax and open up my pelvic floor while also being soothed by the warm water.

Tip #4 – this is probably the most important one of all – HIRE A DOULA!!!  I loved my midwives and I would highly suggest that someone utilize a midwife if they want a much more laid-back approach with minimal medical intervention.  They were all incredible and made me feel so comfortable throughout my entire pregnancy.  Midwives are known as being very hands-on and present for your labor, but it was not guaranteed and they could have had more than one patient at a time (in the hospital setting I was in).  For this reason, I decided to hire a personal doula so that I could have complete one-on-one support throughout my labor.  This was the best decision that we made, both for my comfort but even more so for the support of my husband.  Because he knew that I was well-taken care of, my husband was able to relax throughout the experience.  He said from the get-go that he wasn’t sure how he would react to me being in so much pain and him being powerless to do anything about it.  By having the support of a very experienced doula, he was able to sit back and let her take the reigns.  Before we got to the hospital he tried to help me a couple of times by rubbing my back and pushing on my hips, but because he wasn’t quite sure what to do, it didn’t feel good and I ended up yelling at him to stop.  Once we were at the hospital, my doula knew exactly where to push, pull, support, etc and my husband was able to sit back and just say encouraging things to me.  He did stand at the head of the bed and I gripped onto his forearm during the pushing phase – I felt a great connection with him during this most vulnerable part of labor.  I was glad that he didn’t have to be helpless and possibly endure my painful outbursts during the other parts of my labor.

Recovery was very quick for me.  I barely had time to get fatigued during labor, so I actually felt great.  The other thing is that Emma had great timing and we never missed a night of sleep (she arrived at 8pm and we were able to get to bed by about 11:30pm).  Sleeping at the hospital was difficult – the bed was very uncomfortable for me, there were always lights on, nurses came in to check vitals every few hours, and I felt the need to ensure that Emma was breathing about every 30 minutes!  I started getting very stir-crazy and was able to walk the halls of the hospital the next day with my mom, and that felt great!  Once we were home, I started walking outside again.  It was very slow to begin with, but I really made sure that I listened to my body and I was back to 3-4 miles in 2 weeks (for the first 2 weeks I used a post-partum abdominal binder which was very helpful for support and for helping my muscles to pull back together).  I truly feel that staying active, walking, working at my manual job, and doing prenatal yoga were they keys to my quick recovery.  My husband is also VERY supportive and we were able to work out a schedule that allowed me to get some rest despite breastfeeding every 2-3 hours.

Emma is now my little buddy – she goes almost everywhere with me (except now she’s at daycare while I work) and she is absolutely the light of my life.  She wakes up smiling every morning and it melts my heart over and over again – it’s like the best groundhog day ever!  We still walk at least 4 days a week (it’s much more difficult on the 3 days a week that I’m working) and I’ve been able to get back into a few yoga classes on You Tube.  Sometimes I do exercises with her while she’s laying on her playmat or doing tummy time – I’ve got to get it in somewhere!  =)

Returning to work was so great for me!  I’ve worked very hard and have been blessed to be able to own my own practice and treat my patients in the way that I feel is best.  I no longer consider what I do as work, it is my true passion and I gain so much from working with my patients to improve their quality of life.  By the 7th week of being at home for maternity leave, I was getting a little stir-crazy.  The entire 7 weeks I made sure that I got out almost every day and either ran errands, scheduled social get-togethers or at least took a long walk, but it wasn’t as fulfilling for me as being a physical therapist.  At week 8, my parents and aunt came to stay for the week and they were able to take care of Emma while I returned to work for a few hours.  It was amazing!!!  I felt so comfortable knowing that they were with Emma and I had a renewed energy after seeing some of my favorite patients and being able to work with my hands and problem-solve.  It was the best transition back to work and I thank my parents and aunt for being able to provide Emma and I with that comfort.  Daycare has been wonderful and she’s already building her little immune system by getting a cold and giving it to me in the first week!  =)  I’m so lucky to have found a great place with wonderful caregivers and I’m sure that Emma is going to learn so much while she is there.

Looking back on the entire process of pregnancy, labor, delivery and recovery, I would have to say that the ultimate suggestion would be to WALK!  It’s so easy on the joints, you work your core muscles (if you’re walking briskly), you get fresh air, it’s free and I truly feel that it was one of the biggest reasons that everything went so well for me.  I have enjoyed this entire process more than I ever thought possible and feel so blessed that I have been able to experience it in my lifetime.  The outcome of having my beautiful, sweet, laid-back little girl is the best thing that I never knew that I was missing.

Emma walk