SI and DD's Birth Story

October 1, 2009

I am happy to say that I am taking part in The Mom Pledge's Birth Story event!  Rather than simply write the girls' birth story as it stands alone, I have divided the tale into two parts- conception and birth.  In the first part, I revisited the sense of judgement that I experienced having used IVF while my husband underwent chemotherapy.  In this part I get down to what we all want to know... how DD and SI came into the world.






My pregnancy was anything but ideal.


I walked into my OB/GYN's office, happily pregnant, and informed the nurse that I was having twins.  My regular GYN already had a full list of pregnant patients, so she couldn't see me.  I was referred to her junior partner.  The junior partner was very, very excited.  She had never delivered twins.  She wanted to schedule my c-section that day.


I left and never looked back.


I went out and researched a local practice that specialized in multiples- every single doctor in the practice had multiples as a specialty.  It's just what they do there.  As a result, the office was a zoo of women like me- pregnant with multiples and trying to see the experts.  I never built anything like a personal relationship with the doctors there.  I was just pregnant lady with twins number eight or twenty seven of the day.


An early subchorrionic hematoma put me on bedrest, and the moment I finally stood up, the symphasis pubis dysfunction (SPD) took over.  It was excruciating.  My OB was completely unconcerned.  I was obviously fine, the babies were obviously fine, if I could do something for the pain, great... but if not, whatever.  Every other time I went in, she asked when I wanted to schedule a c-section.  I always told her I didn't, and she always said, "Great," and that was that.

But I was determined to have a natural delivery.

I started looking for alternatives.

A friend of mine offered to doula for me, and I bothered her nearly daily.  She gave me an impossible to follow diet (vegetarian Brewer diet for twins) that  I tried and tried to accommodate.  I just could not eat that much food.

I went to physical therapy and used moxibustion to help the babies get into position.

I learned to absolutely love acupuncture.

Through the intense rituals of creating familiarity between me and my babies, position wise, I became certain of who was who.  What they were like.  We began to develop a rapport.

But as the months wore on, my doula and my OB and even my chiropractor began trying to make me face facts- I was probably going to need a c-section.

Five months in...

My babies might be healthy and entertaining and awfully cute on ultrasound, but they were stubbornly transverse.

For those of you unfamiliar with the lingo associated with pregnancy and birth, "transverse" means that, rather than being head down (ready to exit as we all hope they will) or breech (butt or feet first), they were laying sideways, on top of each other.

No baby comes out sideways.

I tried.  Oh how I tried.  But I began to make peace with it.  I would have as "natural" a c-section as possible.  I wouldn't schedule one- I would wait to go into labor (probably early) and I would get an epidural, and I would at the very least be conscious for the birth of my children.  I wasn't thrilled, but I was beginning to make peace with it.

And still I tried.  Still I hung out upside down, shone flashlights into my lady bits, burned herbs next to my toes, spent hours and hours on my yoga ball.

I was so determined.  But I had changed my focus a little.

I stopped worrying quite so much about the c-section, and started worrying about pregnancy milestones.  How many weeks before the twins were viable.  How many weeks before the twins would experience no lifelong health issues if they were born prematurely.  How many weeks before they would be likely to just come home with us.

Every other week was a milestone, and  held up the next one in front of me- "Just stay pregnant another two weeks.  In another two weeks, they'll be so much better off..."

This was complicated by the fact that I started feeling that something was wrong.  Something seemed not quite right with DD, and I couldn't exactly put my finger on it.  I insisted on the OB checking it out, and as a result every few days we went in for an non-stress test (NST).  While these are only *supposed* to take an hour, they could never keep both babies on the monitor.  It was our twice-a-week-or-so seven hour long routine.  It was awful.  And every time the end result was that the babies were both fine, that there was nothing to worry about, and that I could continue being pregnant.

But I hated being pregnant.  Oh, how I hated it.  I was in so much pain, my gall bladder was shutting down, I had heartburn peeling enamel off my teeth, I couldn't sleep... I was ready to be done.

I started making really awful jokes about it.  I started shouting at my belly to GET OUT OF THERE!!!!!

And then, after one long evening of making incredibly tasteless jokes and complaining that my children could evacuate my womb any time thankyouverymuch, I went home and went to bed.  That was 11pm.

At 2am, I woke up feeling a gush of warm fluid between my legs.  I was about 99% certain that I hadn't just wet the bed, and I shook M awake.  "I think my water just broke!" I managed to get out.  He practically jumped out of bed in his haste to turn on the light.  I closed my eyes against the glare of it, and heard him say, "The bed is covered in blood..."

It was.  There was so. much. blood.

Blood was dripping off the bed onto the rug on my side.  It was pooling between my legs.

I jumped up and called my OB's emergency after-hours number.  I got a call back two minutes later.  In those two minutes, I had run to the bathroom, and discovered something sticking out- something sort of fleshy but... wrong.  I couldn't feel any fetal movement.  I was desperately trying not to panic.

M was sopping up blood as I took the call, the OB told us to head straight to the hospital, to bypass triage, and that we were going to be admitted directly because they were now waiting for us.  The moment I hung up, the thing came out.  It was bloody and red and fleshy and about the size of my fist.  But it wasn't a baby, and it wasn't a baby part, and so I managed to calm myself enough to rinse the blood off my legs and throw on some clothes for the trip to the hospital.

What was normally a half hour drive took us closer to fifteen.  In that time, I had called my doula, who said would come as soon as she could.  I had called my parents, which was a disaster.  My mom was on ambien and had no idea what I was talking about and couldn't register the urgency in my voice- after all, I wasn't due for weeks.  I called my sister and left utterly panicked messages on her voicemail.  And I sat in the car, trying not to panic.

We got to the hospital and bypassed triage, just as we were supposed to.  But we still needed to wait for our room.  And because we had bypassed triage, they sat us down in the labor and delivery waiting room.

Where at 2:40 in the morning, there was a crowd of ecstatic grandparents, aunts, uncles, nieces and nephews to-be.  It was full of balloons, and flowers, and... happiness.

And we sat there for a few minutes.  Me, bleeding into a maxi pad, M holding me, trying to separate whatever was happening to us from the joy in that room.  Because we just didn't know what was happening, or what the outcome would be.

After about ten minutes, I couldn't take anymore.  I left the waiting room and demanded that we be allowed to wait somewhere else.  The lady at the L&D waiting room desk was less than helpful.  She eventually agreed we could just stand in front of her desk while we waited.  She wouldn't even offer me a chair.

Finally, we went into our room.  I was quickly hooked up to all sorts of monitors and an IV, and for the first time ever the nurses had no difficulty at all in locating both babies, and seeing that both of them were just fine.  Normal heart rates.  No signs of distress.

The OB (the one on call, not my regular OB) explained that they had no idea where the blood was coming from, but that as long as I wasn't having contractions (I wasn't) and the babies were fine, I would just be staying there.

...that it might be as long as a few weeks.

Me?  I had just had the most self controlled full blown panic attack of my life.  It had been six hours since I'd eaten.  My blood sugar was crashing.  In my relief and the expectation that I was now moving into the hospital, I asked if I could have something to eat.

They told me... no.

No, because I might have to have a c-section at any minute.

But, I thought, I might be here for weeks.  Am I not supposed to eat anything the entire time?

Eventually, once they knew what was going on, they said, I could eat.

Until then, no food.  No drinks.  Nothing.

So the waiting began.  Hours passed.  I was starving.  "Can I eat now?  Can I just have some orange juice?  Anything?"  I asked them over and over and over again.  Nothing.

As my blood sugar continued to plummet, I started having contractions.  Excruciating contractions.  Nothing like what I had anticipated, but that didn't matter.  When I'm having a blood sugar crash, everything is the worst that it has ever been.

I was desperate.  I knew that if I could just eat something I would be fine.  But they wouldn't let me.

I finally asked for something for the pain.  It was what they had been waiting for.

"If you're in that much pain, we need to get those babies out.  Now."

I wasn't ready.  They weren't ready.  I tried not to cry.  I was exactly 35 weeks pregnant.  I had one more week to go until I thought everything would be fine.

And then the OB dropped a bomb on me.  She explained because they didn't know why I was bleeding, they couldn't do an epidural.  I would have to be unconscious.

I freaked out.  I told her that there was nobody else in the hospital right then- almost true- and that they could RUSH the blood work.  That they could do something.  I don't know why, but it seemed to finally get through to her.  Maybe it was because this was a different doctor- she'd just changed emergency shifts with the OB who met me when I was admitted- and she actually understood how much terror I must be experiencing.  Maybe because she didn't know what was going on with the previous OB.  I have no idea.  But she said, "We'll try," and directed the nurses to get me ready for surgery.

M was moved to wait for me in the recovery room.  I was wheeled into surgery alone.

Anesthesia is bad for babies, so they don't give it to you until the last possible moment.  That meant that I was fully unsedated for all the pre-op nastiness.  The catheter, which HURT, the mail line insertion... all of it.  Finally, I was laying down, surrounded by doctors and nurses who informed me that as soon as my OB entered the room, we would begin.

Still numb, but holding my babies for the first time

She walked in and the first word out of her mouth was, "Wait."

She leaned over me and said, "I just got your blood work back- we can do the epidural.  They'll go get your husband scrubbed in right now- and then we'll begin."

The next two minutes were a blur.  The epidural was inserted, and I went completely numb from the chest down.  M came in, looking both terrified and relieved.  He stayed next to me with his hands on my shoulder while the procedure began, and then...

...they invited him to look over the curtain for the birth of our babies.


I'll never forget the sound of his voice.  It was high and cracked, he sounded like he might faint.  "Oh my god, I see her.  I can see head now..." and then I heard her cry.

SI

I don't know what the doctor said.  I just wanted M to tell me everything- what did she look like?  Was she okay?

A few moments later, the next baby was out.

They took the girls away from M and me to clean them up, get their Apgar scores, weigh them... while they did that, they stitched me up.  M got to hold them first.  I couldn't quite register what I was seeing.

8:34am, SI- 4lbs 6oz.  8:36am, DD- 4lbs 14oz.

Once they had finished cleaning me up, I was propped up a bit and handed my children.

DD

It was bliss.  It was overwhelming.  I looked at them both and thought, "How can I love you so much?  Who the hell are you?"

Surprise surprise, their blood sugar was low.

I agreed to giving them bottles of basically sugar water to see if that would help.  SI got hers first.  As a result, when they checked her blood sugar again, it was perfect.  DD's wasn't, so they insisted on sending her to the NICU.  By the time she made the trip via elevator and had her blood sugar checked again, it was perfect.  They started telling me that any time now I would have her back.

It would be almost nine hours before I finally did.

In that time, my doula, and then my parents arrived.

As soon as DD was back with me, life was perfect.

I had my daughters, they were healthy.  They were tiny, but they were healthy.

Reunited

I don't know if it was the rush of oxytocin, or the morphine, but I was the happiest I had ever been in my life.  We spent five days in the hospital, during which friends and family came to visit, I snapped picture after picture after picture of them, and I ate all the oatmeal and hard boiled eggs I could possibly want- brought to me in bed.  I would stay up in bed while M desperately tried to sleep on the cot/bench/thing in the room, watching the girls sleep and singing them lullabyes.  I knew how crazy it was- soon enough I would be desperate for a few hours sleep and they wouldn't let me have it... but I was too enamored of them.  I just wanted to take in every single detail for as long as I could.

I still look back on those days as one of the best vacations of my life.

Recovery from the c-section was not what I had expected.  I wasn't in as much pain as I thought I would be, but the muscles in my abdomen never fully recovered.

"I missed you."

And I still feel like I was right about my body- that if they had let me just get my blood sugar up, I could have stayed pregnant a while longer.  Long enough to already have my doula and my parents with me, long enough to be calmer and more prepared.  At least a little.

It turned out that I had a partial placental abruption, caused most likely by the blood clot that was responsible for my subchorrionic hematoma during my first trimester.  That's what had passed in the wee hours of October 1, 2009.  It was DD's placenta.

I learned that my instincts are good.  I was probably right about my blood sugar, but I was definitely right about DD.  There was something wrong.  Not wrong enough for it to cause her any damage, but enough that I knew.

I have felt judged by other moms for having a c-section.  Judged enough that I always say emergency c-section, to make it clear that it wasn't my choice- that it wasn't my idea.

DD and SI

But the judgement over my c-section has never bothered me as much as that over IVF.  Possibly because I can't imagine anyone reacting very differently when they wake up in the middle of the night soaked in blood.  Possibly because I don't have the baggage of M's cancer and treatment attached to the process.  Partially because I feel so justified in my own knowledge of my body, regardless of having a c-section.  Mostly because I simply can't complain about the outcome.

My daughters?  They're as perfect as children come.

When Baby X is ready to arrive, I will have the confidence to assert myself, to say, "I know me better than you, I know this baby better than you, and these are the facts.  Now give me some damn orange juice."

This time, I'm going to try again for that natural delivery, but not for me so much as for DD and SI.  I don't want to spend five days having an awesome hospital vacation.  I want to have my family together.  I don't want to spend nearly a week separated from my twins, I don't want to spend over a month unable to hold them because of the sutures in my stomach.

First night at home with the girls

I want that natural delivery because I believe it's what will make us a whole, happy family fastest.  And maybe best.

But if I have to have another c-section?  If it turns out that my uterus is only comfortable to transverse babies, or that there is some sort of fetal distress...

I'll have that c-section without more than a moment's hesitation.  Because what matters is that all of us get through this okay.  Not that I do it with my hippie ideals perfectly intact.

And I promise, In another month and a half... I'll tell you all about it.