Ob Baby...We're Going To Have Kids!
Oh no! This can’t be right! I looked at the positive home pregnancy test again. Come on, make that color change some more. I sat still for a while and waited. Pregnancy was not on my list of things to do right now.
Nine months earlier I’d lost both legs above the knee and my right arm just below the shoulder in a train vs car accident. I learned to walk with prostheses using a quad cane and was planning to
move back to Los Angeles where I would live by myself and finish the last nine months of my Radiology residency. My thump-thud, toy-soldier walk was loud and looked funny but got me where I
needed to go. Doing things with one hand was becoming easier.
Timing Never Seems Right
When we thought the time was right, I told my parents we had a surprise for them. Imagine my confusion when my mother’s jaw dropped and she said, “You can’t be pregnant! How are you going to take care of a baby?”
“Well, we’ve thought about it a lot and we think we can do it.” There was a long silence. And then the truth came out.
“What are you going to do if Dave leaves you at some point in the future? You can’t take care of a child by yourself.”
Thankfully, on the other hand, Dave was elated. He’d always wanted to have two or three children and I was supposed to be the mom.
Being young (30 years old) and healthy, I knew the physiology of pregnancy would be the same for me as any other able-bodied woman my age. The challenges would be mechanical—walking with
bilateral AK prostheses while adjusting to a gradual weight gain, and then labor and delivery without knees, ankles and feet to help with pushing. I rubbed my flat tummy—it was one of the only
normal looking parts of me and I didn’t want to lose it. I envisioned the basketball-size belly I’d be carrying around. Or would it carry me? Once the baby was born, I’d figure out how to take
care of it with one hand. In my mind, the mobility issues of not having legs were separate from the issue of having only one hand. Two very different disabilities and sets of
challenges.
Prosthetic Considerations
The pregnancy occurred just about the time my prosthetist was getting ready to make my permanent suction sockets which I was anxious to get so I’d be rid of the thick, ugly straps that wrapped
around my pelvis. After explaining that I’d have a lot of soft tissue changes, he convinced me to continue wearing the temporary sockets. I ended up wearing them almost two years by the time I’d
delivered and then lost my pregnancy weight gain. Leaving my legs off and using a wheelchair whenever I was at home helped prevent skin breakdown, while wrapping my residual limbs in ACE wraps or
Jobst stockings in the evening and early morning minimized soft tissue expansion. It was a tricky dance.
Watch Your Weight
Weight was the most important factor I needed to control. My rehab after the accident was very intense and because I was healthy and physically in good shape, I’d been able to walk a mile in my prostheses four months after the accident. It didn’t take me very long to discover that eating salty foods, treating myself to desserts, or just eating to feel good, quickly translated into painful welts and blisters on my skin when my sockets got too tight. My husband reminded me that beer, wine and cocktails also pack on the calories—75% more in alcohol than in carbs or protein. You don’t have to chew to gain weight.
I suspect most amputees struggle with food issues. Pregnancy exacerbates these, so it’s really important to try and be at your ideal weight before getting pregnant. It is recommended that If you are normal weight you should gain between 25-35 pounds during pregnancy; if you are underweight, try to gain 28-40 pounds. Overweight women may need to gain only 15-25 pounds.
As the baby grew, my lordosis (normal curve in the lower back) became much more pronounced. From the side, I looked like a big fat letter “C”. Sitting relieved some of the stress on my back and since it takes a bilateral AK walker four times more energy to walk than a person with normal legs, I was still able to get enough exercise. The silver lining to this was that the gradual weight gain and continuing to walk every day made me appreciably stronger.
I was able to work full-time and live on my own until two weeks before my due date, when I went on maternity leave and moved back home with Dave. During the last few weeks I felt like a beach ball when trying to turn over in bed at night. I finally got to the point I’d tell Dave to just give me a shove and we’d giggle as my belly rolled over with me behind it. It helped to know that he thought I was the most beautiful thing he’d ever seen. How crazy was that!
Lobor And Delivery
Making a baby was easy. Getting it out was going to be a challenge. In 1981 we couldn’t run to the internet for YouTube videos on “how-to deliver a baby when the mom doesn’t have legs.” Even though I planned on delivering at the Naval Regional Medical Center in San Diego, (my husband was an active-duty Navy doctor there) where thousands of babies are delivered every year, they’d never seen a triple amputee mom-to-be. The burning question was—would I deliver with my artificial legs on or leave them off. It was hard to get any pushing leverage with only half a thigh on each side, but equally hard to figure out how to push with two prostheses on.
“Hey, tell that lady to get those boots off!” yelled the charge nurse as I held Dave’s arm and trudged down the hall of the Labor and Delivery Deck. At the Naval Hospital you don’t go to the L&D room, you go to the Labor and Delivery Deck, as if you are on a ship. Pretending we couldn’t hear, I grinned at Dave and said, “Wait till she sees what’s really happening.”
It didn’t take long to realize that it’s advantageous to have real-live knees that bend, and heels that fit into stirrups so you can push effectively. The nurses draped my prostheses to the top of the sockets so we didn’t have any problems with soiling them, and then we settled in to the rhythm of early labor. My fake legs looked good but couldn’t transmit any force with the knees flexed in the “get-ready-to have-a-baby” position. We ended up with the OB doc hugging one knee and my husband hugging the other. On every push, they leaned a shoulder up against their assigned knee and pushed toward me while I held my thigh, leaned up and pushed toward them. I’ll guarantee you it was one of the shortest labors ever, because these two men had to push every time I did.
Second Time
Three years after our daughter was born, I was pregnant again. This time the entire process seemed easier because we’d been through it before. Plus, there seemed to be much more humor this time around. I was in my third trimester the morning Michelle, our housekeeper, sat down on the floor to help pull my legs on. This was back in the days when I needed someone pull the stump socks off and screw the valves into my sockets.
“Wow, Linda,” she said. “Your ankles are starting to swell.”
“Pardon me,” I said, thinking I’d heard wrong.
“I can finally tell you’re pregnant because your ankles are swollen.”
Not knowing what to say I just blurted out, “Michelle…what are we doing? Aren’t we putting on my artificial legs?” Her face turned beet-red and we both laughed until we cried.
The day he was born I got home from work at 6 pm. Fifteen minutes later I told Dave we should go back to the hospital where our son was born three hours later. My fondest memory is the sight of Dave leaving the hospital with my legs draped over his shoulders. With my jeans pulled up over the top of the sockets, it looked for all the world like he was taking half a person home.
After the accident, it was hard to imagine life would ever be normal for us. For many reasons, pregnancy seemed out of the question. Getting pregnant and having children was the best thing we did
to make us whole again and live a normal life.
Remember
- Consult with your obstetrician and prosthetist before or at the beginning of your pregnancy.
- Try to have your pre-pregnancy weight at a desirable level.
- Hold to the weight gain recommended by your OB doctor. Count calories every day if you need to.
- Keep your residual limb/s wrapped when prosthesis is off to minimize swelling
- Get plenty of exercise.
Guest post by Linda K. Olson. At age twenty-nine, Linda Olson lost both her legs above the knee and her right arm in a train vs. car accident in Germany. You can learn more about her and her very active lifestyle on Linda's blog.
Further Reading
Having kids after an amputation
This week it’s all about being an amputee parent. Even without a limb difference, the idea of suddenly being responsible for a child can be daunting. Immense joy is regularly mixed with feelings of fear and being completely overwhelmed. Often even more so if you are an amputee. So throughout the course of this week we hear from four amputees, learning about their thoughts on parenthood. Jasmin, a young women from Germany with an above knee amputation - and a regular contributor to The Active Amputee - kicks-off our Spring Special. read more
Amputee pregnancy
Joanna lost her leg in a mountaineering accident. She has what is called a Chopart amputation. That means that she has retained a load- bearing heel bone and heel pad. However, due to a needed shortening her amputation presents as a Symes (which is an amputation through the heel bone). Joanna can walk short distances without a prosthesis. Only a few years after her accident, Joanna is expecting her first child. In this personal article she shares her experience of being pregnant while still getting used to her new life as an amputee. read more
Some assembly required
"Monday May 26, 2014. That was the day I truly knew, I was capable of living the life ahead of me-whatever I wanted that to be. It was the day I was fitted with my first prosthetic leg. It was the day I took my first steps on the leg. It was the day I got back into a pool. It was the day I took time to wear make up again. Needless to say, it was a busy day." This is how the amazing story of Monique Murphy began. And what a story it has been ever since. read more