It’s been 21 months since our living liver donor transplant and my cousin is living his best life hitting the gym, reading books, and posting hilarious nonsense on Facebook. Meanwhile, I am approaching 5 months postpartum and figured I should post an update. What was it like having a baby after a liver donation?

My Experience Is Distinctly Mine

Everyone’s body is different. If you’re a potential donor, keep that in mind. I’ve shared my donor journey here because I know I had questions before I donated. I know how difficult it was to find stories of other people’s experiences and long term recovery; especially stories that revealed the details I was curious about.

Therefore, my experience should not be taken as a description of what you could or should expect if you donate. This is just my personal experience.

Learning About My Body

While recovering from my first pregnancy, I learned that my body’s pelvic and abdominal strength was difficult to get back. I learned that I would struggle with constipation, ear and skin infections, and that the weight loss/ joint re-tightening took 4 or 5 months to kick in.

So it’s no surprise that after the transplant I experienced a lot of similar things. I knew to get in to see a Physical Therapist. I knew to take stool softeners. I had prescription ear drops to prevent ear infection, but I could not prevent that recurring skin rash situation on my abdomen. That stopped when I got pregnant, though. Not sure why. Hormone changes?

4.5 Month Old Baby at 21 Months Since Transplant

This was my second pregnancy and birth. So I was prepared for these same symptoms. I experienced them all again (but prevented most from getting really bad). Now, at 4.5 months out since I gave birth, I have my skin rash and poo situations under control. Yay!

I am still going to Physical Therapy because I need the accountability and motivation to actually do my exercises and get better. And it is getting better.

My 3 year old doing exercises with me! Haha.

I HIGHLY RECOMMEND physical therapy postpartum and after abdominal surgery. What I have learned about my body through these past few years has been incredible. The human body is capable of some amazing things.

Pregnancy Post Transplant

In the later stages, I had different aches and pains this time around. My ribs were one of the worst. It reminded me of the pain I felt after surgery where they had lifted my ribs up. However, I’ve also read it’s common for some women to have lower rib pain during pregnancy, especially when in certain positions (usually bad posture). Finding a comfortable position for sleep was easiest with the giant pregnancy pillow. So if you’re pregnant, invest and be blessed.

Occasionally my transplant scar tissue would feel kind of “catchy” as my stomach grew, but it wasn’t painful. I’d say uncomfortable. A little massaging would usually help and that was that.

I definitely wondered, a lot, if my body was going to be able to do and provide everything that baby needed. Was labor going to be more difficult? Was I not as strong as the first time? I won’t say I worried, but I had a few moments where I wondered uneasily.

Yet all my prenatal visits were just fine. Baby was healthy. I gained about the same amount of weight as I did with the first. There were a lot of minor differences between first and second kid, but that’s pretty normal. No pregnancy is ever exactly the same anyway.

Labor Post Transplant

Just like with our first, I had a spontaneous vaginal delivery. This time, though, baby came out faster. Which we were prepared for!

To be honest, the worst part was 1) I apparently had the flu but my symptoms hadn’t gotten bad yet and 2) the nurses couldn’t get my IV in or find the baby’s position with their ultrasound equipment. As far as my body’s ability to give birth…everything else went pretty much as expected.

T.M.I. ALERT

SKIP THIS NEXT PART IF YOU DON’T NEED THE DETAILS

SO, with Baby #1, we had no idea what we were doing. We got to the hospital with about an hour to go before delivery. It was about 5.75 hours from first contraction to baby #1 in my arms, when all was said and done.

With baby #2 we didn’t mess around. I got that first “This is different” contraction at 1:52 am. After the third, at 2:15, I got the husband up and we started getting everyone ready. We dropped the boys (our nephew who lives with us and our toddler) at a friend’s house at 3 am and headed for the hospital.

I was 5-6cm dilated when we arrived so they admitted me to a birthing suite. The contractions were painful but not jump-out-of-my-skin painful. I was walking myself around.

The nurses tried three times to get an IV. Blood was spilled down my arm. I won’t lie. I still get a little bit ‘o the heebie jeebies over the IV. I still remember the transplant hospitalization and all the things I was plugged into that made me feel claustrophobic.

Then the nurses tried to make sure baby’s head was down by digging into my pelvis with an ultrasound wand. I was having contractions this entire time, btw. They could not find him, they said. I was a tiny bit annoyed, especially when the doctor showed up and it took her all of 3 seconds to find him. Ah well.

Breaking The Water

We’d been at the hospital for about an hour when I was fully dilated and effaced. Just waiting for the water to break. So they offered to make that happen so we could get this show on the road. I gave the go ahead. Then the longest poker needle thing I’ve ever seen in my life was handed to my doctor so she could break my water. I wish I hadn’t seen that needle.

At 4:07 the doctor broke my water.
With Baby #1, I remember my pain as definitely getting to a 10 out of 10. The contractions I was feeling with Baby #2 felt like a 7, comparatively. I felt fully in control and able to be present through the pain.

At 4:21 our little guy was born!
Seriously, just a few contractions later and it was all over. One contraction helped me remember how to push productively. Two contractions to crown. Three contractions for his head to come out and I still had enough time to push out his body. Boom. Done. It was crazy.

So Labor Was Weird Fast.

You know that feeling when you get something WAY better than what you were expecting and wonder if you’re going to get ‘caught’? So you’re kind of unsure if you should start celebrating because what if fate suddenly realizes that no, you weren’t supposed to have it that good, and corrects the error? You ever have that feeling?

That’s what I felt after he was born. He was 7 lbs, 18.5 inches.

It was 2.5 hours from start to finish. It wasn’t as painful as I was expecting. He was healthy and perfect. I got some pitocin, as pre-planned, to help reduce the bleeding.

Well, the other shoe did eventually drop.

Kind of. Later that afternoon, I was feeling like my immune system was crashing. So they decided to test me for the flu. Positive. Guess I wasn’t the first woman to give birth with the flu recently.

This is me trying not to spread the flu to my newborn. He’s gonna think his mother has no nose or mouth. My symptoms are pretty much gone but it’s not even been a week yet so I’d rather stay cautious. Meanwhile the other #postpartum side effects are kicking in. I’m so thankful this little guy is letting us get some sleep by being chill in his crib. Back up to his birth weight too!

They started me on Tamiflu and I had to wear a face mask for the first two weeks when I held and nursed the baby. We also had to get the rest of the family on Tamiflu and wearing masks if they held him, just in case. I’m pretty sure our baby thought his family didn’t have a nose or mouth. Thankfully he won’t remember any of that.

Postpartum Abdominal Stuff

Like I said in the beginning, I knew to expect the “typical” (for me) recovery issues: constipation, ear infection, skin rash, etc. There was also the typical postpartum feels: contractions when nursing as my uterus shrunk, thankfulness for the peri bottle, etcetera.

What about that scar and the recovery of my previously cut open and now thoroughly stretched abdomen?

So, my pregnancy linea nigra showed me that my transplant stomach-stitch-up wasn’t perfectly centered! See where it is above and below the scar? My stomach looks like a weird balancing sculpture.

In the first month or so, right around my incision, the skin/scar tissue certainly felt sticky and uncomfortable in a few spots. So I’d massage it as I had been doing. At this point I don’t feel that anymore. I will say, I still don’t have full skin sensation around my scar and belly button maybe never will. I’m used to it though.

On the right side of my abdomen, below the scar, I occasionally get the feeling that the tissue or maybe even muscle is burn-y or cramp-y. It’s hard to describe. It rarely happens. When it does I’m always like…hmm, this is still happening? Neither my doctor or PT seems concerned. As my organs and nerves and muscle and tissue settle back into non-pregnancy configuration, it seems likely some things would feel odd now and again.

I got pregnant about 8 months after the liver donation. Now we have this guy!

My primary concerns now are rebuilding pelvic floor strength (although I don’t have the leaking issues like I did after pregnancy #1) and making sure my entire core gets back to supporting my upper body like it should.

My lumbar spine isn’t flexing normally. When I bend forward, my lower back doesn’t flex as far as it should, causing some pain and limiting my range of motion. This happened after pregnancy #1 also. So far, it doesn’t seem like the transplant surgery has made that any worse. I just need to be good about my PT exercises and my posture.

In some ways it is easier to understand how the liver transplant worked than how pregnancy and birth work. I’m so thankful for this body of mine. I have two little boys and one full grown cousin that I cannot imagine life without.

Any questions?

I’ve heard from a few potential donors who are curious about the pregnancy and birth after transplant. Please feel free to send me a message if you have specific questions I didn’t address here.

I know that transplant centers are gathering data on living donors who go on to have children. Turns out, a good amount of living donors are women of child-bearing age. So there should be some better and more official data on that in the future. Ask your transplant coordinator if they have updated info.

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