One of our goals this time around was to get back home as soon as possible. We discussed this with both Laurence (our midwife) and Dr. Gravelle (our OB) and both were totally on board with getting us back home quickly as long as there were no complications.
It is worth noting that all of this was much easier this time around for one main reason. We knew what to expect and therefore could plan for it. With Elizabeth we had a lot of trouble and angst over breast feeding. As is quite normal for c-section patients Mary's milk did not come in right away with Elizabeth. This would not have been a big deal if she had not been so tiny. This time around Mary had only just stopped nursing Elizabeth about four months ago and was already producing some colostrum. We talked to Laurence about our concerns and she suggested expressing some and saving it in case we ran into issues. We also planned to get a pump immediately if things didn't appear to be going well. As it turns out my milk came in pretty much right away and this was a total non-issue which certainly made things much easier all around.
We learned last time that wards are not very restful. This time we requested a private room. Between changes in hospital procedure (only check vitals once a shift instead of every 3-4 hours) and the private room we did actually manage to get some sleep. But even so we were still woken multiple times and were surrounded by a bright and noisy environment. The nurses didn't seem to get the idea of light pollution and kept leaving the door ajar. Of course the hall is lit 24x7. While we were certainly very grateful for the excellent care and the relative peace and quiet it was not even close to being home. We had also learned that there were a number of items that the nursing staff look for in order to discharge you. You need to prove that your body is working as it should be in terms of input and output and the best way to manage this from the get go is to drink like there is no tomorrow. Mary duly drained the massive cup of water virtually non-stop, keeping Brendan busy walking back and forth to the water station. By the time day two rolled around the nurses were impressed enough to take out the catheter and the IV without too much coaxing and Mary was sitting in the chair nursing Matthew very early in the day.
The resident dropped by and talked to us about discharge and we communicated our desire to get out today. She seemed receptive but after consulting with the OB on call she told us that they would be more "comfortable" with us staying another night. We decided not to push the issue until we had a change to consult with Laurence. When Laurence dropped in a little later she was very impressed with Mary's and Matthew's progress. We asked that she plead our case with the OB / resident and she happily went off to do so. A short while later she reported back that she had not been able to talk to the OB since he or she was in the OR but that she had done her best to persuade the resident. The resident had apparently asked if all of Laurence's patients were so strong and she had responded that, no it was just Mary. She then gave Matthew a thorough once over and told us that she would sign the papers for his discharge so that we would be good to go if Mary got discharged. We thanked her for her efforts and sat back to wait and see what would happen. Around noon we got the news that as long as nothing came up before supper Mary would be discharged then. Our family checked in on us throughout the day and by supper everything was arranged for us to carefully and very slowly make our way back home.
After going to bed early and waking up at 11pm we both looked at each other and exclaimed that we had just gotten more rest than the entire previous night!
As a scheduled c-section patient we are not the typical midwife client but nonetheless we really can't stress enough how wonderful it is to have a midwife. Someone who knows you and you've had a chance to build a relationship with in advance. Someone who will help you develop a plan in advance no matter what the situation you find yourself going into. Someone who will advocate for you with the other medical professionals whom we've only just met. Someone who will come and help you out at home afterwards during those first few critical days. Honestly we really don't know how to say thank you enough to the team of midwives that we've dealt with and in particular to Jess and Laurence for their amazing help with Elizabeth and Matthew.