Retained Placenta(s)

Childbirth is truly an amazing event.  I have been in the room, by my wife's side (so to speak, I was also the cameraman which put me at the foot of the bed at times) for the birth of all six of our children.  Except for my daughter Gabrielle (the stubborn little bugger was breach and she was born via c-section) all of our children were born naturally and 4 out of the 5 natural births were without pain medication or an epidural.  Again, except for Gabby, I have video of each of the births of my children (the doctor would not allow a video camera in the operating room for Gabby, although they did allow a still camera).  Each birth was absolutely unbelievable for a number of reasons, one of which is the manner in which my wife goes through and manages labor (more details on this for a subsequent post).  However, if birthing six babies isn't amazing enough, seeing a woman (my wife) birth two of our babies with no epidural or pain medication, then immediately following those births going through the removal of a retained placenta, should nominate her for Mom/Woman of the Decade.  

As many already know, following the birth of a child, there is the afterbirth where the doctor essentially "delivers" the placenta.  Typically a few minutes after the birth the placenta will, with only a few light pushes from the mother, come out relatively effortlessly, in one complete  piece.  However, in the case of my daughters Lily and Evangeline's birth, the placenta was very deeply implanted into my wife's uterus and it did not "release" properly and it needed to be manually extracted.  This is the process by which the doctor pulls on the umbilical cord, pushes aggressively on the mothers belly, uses their hands or a somewhat barbaric looking device called a curette (essentially a long scrapper) to manually remove the placenta, often times in bits or pieces amid an atmosphere of tension, pain, screaming and blood (at least that was our experience).  

I can tell you, writing the words "...manually remove the placenta..." and the actual experience are two VERY different things.  Being an observer I can only recount my feelings during the "extraction" and what my wife has told me regarding the experience, but I will do my best to paint an accurate picture. 

Immediately following the birth, an event that is full of excitement, joy and countless other emotions for both mommy and daddy and after which the mommy is truly exhausted, imagine the doctor, who is trying to deliver the placenta, begin to struggle with an inkling of surprise and concern on his face.  As he starts to pull a little harder on the cord to "ease" the placenta out, I can see Tiffany starting to feel very uncomfortable, letting out moans of pain as the doctor struggles to get the placenta to release.  The doctor then asks the exhausted mommy to lightly "push" as he is pulling, very aggressively now, on the umbilical cord to get the placenta to release.  The doctor is actually putting quite a bit of weight into his pulling, leaning back to exert as much pressure as possible without actually tearing the cord (that, as I understand it, would be very bad).  During the pulling, the screams of pain coming from my wife were unlike anything I had heard in any of our previous births and nothing like any noise I heard during the birth that just happened.  After a few more attempts like the above, the placenta begins to emerge but we are quickly aware that the entire placenta has not come out.  The placenta does not look like it did in our other births, typically a smooth looking reddish and purplish "bag" or "pouch".  The placenta looked raw around the edges; jagged. The placenta has torn while being removed and parts of it are still inside and attached to my wife's uterus.

What comes next can be described as nothing less than barbaric, a horror to watch your wife go through and probably the most painful experience that any one could endure outside of being physically tortured.  Realizing that the entire placenta has not come out, and after repeatedly assuring us that the last thing we wanted to do is have my wife go into surgery, the doctor resorts to two measures to try and remove the remaining bits and pieces of placenta.  In our first experience, with our daughter Lily, the doctor used his hand to reach inside my wife to remove the remaining stubborn pieces of placenta.  Through the screams of pain coming from Tiffany and the begging to go to the operating room to "knock her out", I could see that the doctor was literally "elbow deep" at times, pulling out little shredded pieces of placenta tissue.  In the most recent instance, with our daughter Evie, the doctor used his hands in addition to a long surgical steel curette to repeatedly scrape the inside of my wife's uterus.  Imagine seeing the doctor, with the long piece of surgical steel in his hand repeatedly  disappearing and then reappearing from inside your wife, the doctor doing so in what can only be described as a "stab-like motion".  The high pitched screams of pain, the tears flowing from my wife's eyes, her knuckles turing white as she grasps my hand with one hand, and the sheets of the bed with the other being the signs of the true pain she is experiencing.

In all, the entire ordeal (in both cases) lasted about 30 to 45 minutes. The pain of labor and delivery pales in comparison to what my wife just experienced (and she would agree). The pile of tissue where the intact placenta "should have been" was indiscernible.  My wife, finally having been administered some pain medication was now able to hold our new baby while the doctor gave her a few shots of novocain prior to stitching up the tearing that occurred during the ordeal (that's right, it is still not over for her yet, at least she is numbed up for this).  In the case of the birth of our daughter Evie, the doctor ordered an ultrasound too make sure that he was able to remove all the bits and pieces of the placenta.  

Interestingly enough, in talking to my wife the other day, discussing the very events above, she said something truly unbelievable, and it is a testament to her love of the labor and birthing process (yes, her LOVE of the process).  Had she known that she would have to undergo the events described above prior to her labor and delivery, she still would not take an epidural and would still opt (assuming she even had a choice) to perform the procedure outside of the operating room.  The birth experience, absent any medication or an epidural, is something that my wife, even after six babies and two retained placentas, would not pass up.  

Love Languages

My wife and I recently finished a book (for the second time) called "The Five Love Languages" (www.5lovelanguages.com). The premise of the book is that each of us communicate love in different ways (the author, Gary Chapman, has broken this down into 5 main love languages) and the key to a fulfilling, happy marriage is to make sure you are speaking your spouses love language.  Each of us has a "love tank", and when our spouse is showing us love by speaking our primary love language, then our tank fills up.  If love is not being communicated in the right language, our tanks remain empty, and as a result, we become unhappy, withdrawn, or worse.  Unfortunately, we usually tend to speak the love language that fills our own tank, the one that would be most meaningful to us, regardless of whether or not it is the language that fills our spouse's tank.  This is why a man, who thinks he is showing his wife that he loves her by mowing the lawn, painting the hallway, unloading the dishwasher, washing the car, etc... (the love language Acts of Service) is surprised when she tells him she does not feel loved (her love tank is on empty), that he never spends any time with her (Quality Time) or he never brings her flowers unannounced (Receiving Gifts).  The man was not speaking her primary love language.  
The five love languages that the author describes are as follows:
1.  Acts of Service - such as making dinner, washing the dishes, doing the laundry, cleaning the house, paying the bills, etc...
2.  Words of Affirmation - saying thank you, saying how appreciative you are for things your spouse has done or is doing, compliment their appearance, provide encouragement, praise, etc...
3.  Receiving Gifts - gifts for no reason such as flowers, a love note, a small trinket, the gift of time, etc...there is no need for it to be expensive.
4.  Quality Time - spending one on one time together, focussed attention on each other, even if for only 10 minutes, talking a walk, going to the movies, going out to dinner, etc...
5.  Physical Touch - holding hands, a touch on the small of the back, a kiss, a massage, a foot rub and yes, cause I know what I thought of the first time I read the book, other "extra curricular" bedroom activities.

Perhaps the most interesting, and maybe the most surprising premise of the book is the assertion that love is not a feeling, it is actually a choice, an ability that is demonstrated by choosing to love our spouse in a way that fills up their "love tank" by speaking their love language.  It is a choice that we make every day, a choice that allows for personal growth and for us to affect the growth of another individual.  Alternatively, being "in-love" is a feeling, a feeling that does not contribute to personal growth or the growth of another individual such as our spouse.  Being in-love gives us the false sense, the illusion if you will, that we have no further to grow,that we have arrived.  

We have all experienced the in-love feeling, think back to when you first met your spouse.  Think about the flutters in your stomach, the undeniable feeling that you have met "the one", that you have met the person you were going to marry, the excitement and nervousness before a date, the anticipation felt prior to seeing him or her.  When in-love, we often times overlook or just cannot see some of differences we might have with our significant other.  Our sight is clouded by the in-love experience.  However, as most of us have probably experienced, the in-love emotion is usually temporary.  It is superficial, it wears off as the trials and tribulations of life unfold, as life's responsibilities take over in the form of children, work, a mortgage, bills, etc...  

However, in successful marriages, in flourishing relationships,  what replaces the in-love experience is better.  It is a deeper emotional connection with another human being that the in-love experience cannot even begin to touch.  This book provides a roadmap to finding that place, and the key is being able to identify what your spouses primary love language is, and then make the commitment to speak it.