Uwa Mom of the Week Manisha
Modernizing a system for better support
Were there any complications, expected/unexpected with your pregnancy?
My 2020 pregnancy was an absolute dream. I had minimal symptoms during the pregnancy and didn’t want it to end! My 2023 pregnancy was similarly quite lovely, although with a little more nausea, and I had placenta previa this time and that resulted in bleeding at 24 weeks requiring an overnight stay in a hospital for monitoring. After that, I was on serious activity restrictions and was understandably nervous of bleeding again, but the rest of the pregnancy was quite uneventful.
Did you feel supported or prepared for birth/postpartum while pregnant? In what ways yes or no?
I felt immensely supported by my husband, family, friends, and colleagues during both pregnancies. My husband especially ensured I felt extra pampered and well fed! After my bleeding incident in the 2nd pregnancy, all my neighbors volunteered to help out if any emergencies arose.
My employer (a major university hospital system) allowed for 2 half hour lactation breaks a day after my delivery until the baby turned one. Unfortunately they did not adjust for my productivity units (RVUs, used to track physicians’ ability to see a certain number of patients) and this affected my ability to apply for a promotion after that. I was able to fight for it by justifying my time spent with many research and teaching related projects, but realized that our system had to be modernized and more supportive. I submitted a proposal in 2023 to adjust for RVUs for lactating physicians until the baby turns one year old, allowing for 2 thirty minutes breaks a day, and this was approved for my department as soon as I returned from my second maternity leave. I shared my proposal with a colleague in the internal medicine department, who was able to submit the proposal to the university CEO cabinet and have it successfully approved, so now the policy is applicable to faculty from all departments of the entire university hospital as of June 2024!
Did you have a birth plan going into your delivery?
No, I did not have a birth plan. All I cared about was having a healthy delivery with a healthy baby! And I also knew I needed my husband with me at my deliveries. My first delivery was in December of 2020, when the covid pandemic was in full swing, and my hospital told me that if I happened to test positive upon admission I would have to labor and deliver by myself, without my husband. I could not accept this possibility, so I transferred hospitals at 37 weeks pregnant to one that said I would be allowed to deliver with my husband present no matter what, and I successfully did so at 40 weeks with him there the whole time.
How did reality compare with your expectations/preparations?
Delivery was as brutal as I imagined – I knew it was going to be a terrible experience for me and it was!
Were there any complications with your delivery? How did your medical team address the after effects?
The vaginal delivery in 2020 was by far more traumatic for me than my scheduled C section in 2023 (mandatory due to my placenta previa). However, my 2020 baby had a head circumference of 95th percentile, and I had retained placenta that required manual extraction for an hour with minimal anesthesia. It was very painful for me to walk even at 6 weeks and then the sutures came loose from my tear, requiring a cauterization. The 2023 delivery resulted in postpartum hemorrhage but it was well controlled with medications immediately and I did not require a transfusion. I recovered much better from the second delivery.
How far out postpartum are you currently?
16 months
What 3 words come to mind when you recall your postpartum experience(s)?
With the 2020 pregnancy, my post partum experience was miserable, exhausting, and painful! It was much worse than anyone ever told me it would be. I think this was because my delivery was so traumatic, and because breast feeding was extremely difficult for me in first 10 weeks. No one prepared me for that, so I was shocked how painful it was.
My 2023 pregnancy post partum experience was much more pleasant since my delivery was not as traumatic the second time, and breast feeding was also much easier the second time. In addition, my 2nd child slept a ton the whole first 4 weeks, which helped give me time to rest and recover.
How has your postpartum experience(s) compared with your expectations?
My post partum experience was very difficult the first time, and I was just grateful for modern medicine allowing me to survive the delivery, modern tools such as nipple shields allowing me to breastfeed (I needed these for 6 weeks for the first baby), and my mother for staying with me for the first few months to provide the support I needed.
What was the biggest challenge/surprise in your early postpartum experience(s)?
The biggest challenge for me in early post-partum period was breastfeeding. I felt that no one had warned me how difficult and exhausting it would be. It was excruciatingly painful for 10 weeks for me. I was glad I had a lactation consultant and also an online support forum to help me through it, and I ended up breast feeding each baby for a year.
What was the biggest challenge/surprise in your late postpartum experience(s)?
In later postpartum period, my biggest challenge was the continued and exhausting sleep deprivation.
How did your medical team/community help you navigate those challenges?
My medical team provided a lactation consultant which was instrumental in helping me through my breastfeeding challenges with the first baby.
What sort of support services did you seek out or wish you had sought out during your postpartum experience(s)?
I got the support I needed with the lactation consultant and my mom’s prolonged stay at my house. If my mom had not stayed with me, I would have definitely benefited from a night nurse. Perhaps pelvic floor therapy could have helped after my first baby as well, but interestingly things improved for me after my 2nd baby was born.
If you are also working outside of your home in any way, what has been your return to work experience?
I returned to work after about 3.5 months after each baby. It was not as hard to return to work as I expected. For me, I need time out of the house to be able to be my best. However with the 2nd baby, she had bottle refusal when I first went back to work, so I was incredibly sad to leave her starving and thirsty for the first couple days when she barely had a sip all day and had dry diapers – poor baby! She did learn how to drink from a bottle within a couple weeks fortunately.
What do you wish you had done sooner or differently during your postpartum?
After the first baby, I wish I had started venturing out of the house with the baby a little earlier. I need outings for my mental sanity! However, it was Jan to March of 2021 when covid was in full swing, so it was hard to leave the house with a newborn at that time, on top of the difficulties of recovering from my tough delivery, and the tough breastfeeding experience I had for the first 10 weeks. After my 2nd pregnancy, I wish I had joined a gym again sooner. I did start jogging again about 3 months after each baby, but going to group fitness classes is something that’s harder to make time for, and took me longer to get back into.
Is there anything else you would like to share? This could be words of encouragement to new moms, things you wish could have happened differently, tips, etc?
I would like to share with new moms that it’s okay to not feel like the delivery, postpartum, and newborn period are all rainbows and butterflies! Newsflash- they are not! While some lucky moms may feel they are, or have some type of protective amnesia for what they went through, some of the rest of us remember acutely how challenging it was to go through. Just make sure to accept all the help you can get from family and friends, make the effort to get out of the house every day, and don’t feel bad if you don’t love the newborn period. It’s so tough and such a massive adjustment, but things get better, and every delivery and baby are different.
