What to expect when you're expecting (166 page)

Unplanned C-section.
An unplanned C-section is the other possible way your babies might enter the world. In this case, you may walk into your usual weekly prenatal appointment and find out that you’re going to meet your babies the same day. Best to be prepared, so in those later weeks of pregnancy, be sure to get your bag packed and ready to go. Reasons for a surprise cesarean delivery include such conditions as intrauterine growth restriction (where the babies run out of room to grow) or a sharp rise in your blood pressure (preeclampsia). Another unplanned C-section scenario may arise if you labor for a very long time and don’t progress at all. A uterus holding 10 or more pounds of babies may be too stretched to contract effectively, so a cesarean delivery might be the only way out.

Wondering if your triplets are destined to take the abdominal route out? Cesarean delivery is most often used for triplets—not only because it’s usually safest, but because C-sections are more common in high-risk deliveries (a category triplets always fall into) and because they’re more common among older moms (who give birth to the majority of triplets). But some doctors say that vaginal delivery can be an option if Triplet A (the one nearest the “exit”) is in a head-down presentation and there are no other complicating factors (such as preeclampsia in the mother or fetal distress in one or more of the babies). In some rare cases, the first baby or the first and second may be delivered vaginally, and the final one may require a cesarean delivery. Of course, more important than having all three of your babies exit vaginally is having all four of you leaving the delivery room in good condition—and any route to that outcome will be a successful one.

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ONGRATULATIONS! THE MOMENT
you’ve awaited for 40 (or so) weeks has finally arrived. You’ve put months of pregnancy and long hours of childbirth behind you, and you’re officially a mother, with a new bundle of joy in your arms instead of in your belly. But the transition from pregnancy to postpartum comes with more than just a baby. It also comes with a variety of new symptoms (good-bye pregnancy aches, pains, and discomforts, hello postpartum ones) and a variety of new questions (Why am I sweating so much? Why am I having contractions if I’ve already delivered? Will I ever be able to sit again? Why do I still look six months pregnant? Whose breasts are these anyway?). Hopefully, you’ll have a chance to read up on these and many more pertinent postpartum topics in advance. Once you’re on full-time mom duty, finding the time to read anything (never mind use the toilet) won’t be easy.

During the first week postpartum, depending on the type of delivery you had (easy or difficult, vaginal or cesarean) and other individual factors, you may experience all, or only some, of the following:

Physically

Vaginal bleeding (lochia) similar to your period

Abdominal cramps (afterpains) as your uterus contracts

Exhaustion

Perineal discomfort, pain, numbness, if you had a vaginal delivery (especially if you had stitches)

Some perineal discomfort if you had a C-section

Pain around the incision and, later, numbness in the area, if you had a C-section (especially a first one)

Discomfort sitting and walking if you had an episiotomy, a repair of a tear, or a cesarean delivery

Difficulty urinating for a day or two

Constipation; discomfort with bowel movements for the first few days

Hemorrhoids, continued from pregnancy, or new from pushing

All-over achiness, especially if you did a lot of pushing