Birth Photography credit: Megan Crown PhotographyI typed this up a while ago... but wanted to read through it. With it being so long and me not really having a lot of extra time on my hands, it has taken me two months to finally get it posted... oops. I read through it once.... but it probably could use another read through for grammatical errors, so this is my disclosure that it's probably not perfect. If there's any questions let me know, I tried to cover everything. I was going to post a shorter version on my blog and just keep the every-tiny-detail version for myself.... but that would require more time. Time which I just don't have :-P Here's an addition to the birth story post I added after I posted this.
At my 37 week appointment there wasn't much talk of induction just mentioned we could schedule for that Saturday if I wanted. Midwife Jess was supportive and understanding of my desires to not intervene medically. The OB she consulted with Dr. Cultrip had mentioned to her “well isn't she uncomfortable?” to which Jess replied “I believe she just wants to limit medical interventions as much as possible”. Many parts of becoming a mother or being a mother is uncomfortable…. doesn't mean I need to induce my children because I am uncomfortable. Which I wasn't at that point, physically I was great, emotionally I knew what lied ahead and that the world was going to affect my emotions about letting these babies be and letting nature take it’s toll even if the worldly ‘risks’ and ‘statistics’ said otherwise.
Two quotes that helped me through this agonizing waiting period were:
“You don’t make average babies” -Amanda P
“You make very patient babies” - Katie H
I had worked up some internal anxiety as I approached and went into my 38 week appointment. Knowing I was at that ‘recommended induction period’ which I had approached with Isaac, only at 42 weeks with a singleton. When I talked with the midwife Maggie, I asked if I needed to come in mid week or just follow up next week? She consulted with the OB Dr. Lupo who said, no, just come back next Monday and repeat NST and visit. Well that was easy they don’t seem the least bit concerned why all this talk about induction at 38 weeks? They were probably hopeful as well as I that I wouldn’t make it to then as i would go into Labor and the induction talk would be moot. I was sure they would come that weekend, on May 4th. We went to the Bryn Mawr garage sales and walked for four hours. I had acupuncture Thursday night, but even then I still wasn’t ready I was just hoping when I clicked over to 39 weeks I would be. I had a feeling these girls were hanging in for the long haul and I didn’t want to rush it. Just do what I could to nudge them if they needed it.
When we made it to 39 weeks, I knew I would need support so Kyle came with me. We saw midwife Jess who I was calmed with going into the appointment. But her first words to me were “Aren’t you concerned about stillbirth?”.... well yeah but I am also faithful these babies will come when they are ready and I am healthy, they are healthy I would need to see some proof for a reason to medically induce. She went to consult the OB and brought back into the room Dr. Nzarwarsky… who listened to my prior birth experience stating “this is starting to sound a lot like mine”. She then just went on to repeat the risks just as our midwife already has and stated “I recommend heading over today to get induced given your complications: the twins and the gestational diabetes however I know you are controlling with diet”. They checked me and I was 2 cm and “very soft” This was a super emotional visit, I was upset because here I was at this wall again. I knew my body and I know it takes longer to make babies but the medical side was also scarey I wanted them to get here, two healthy alive babies…. Kyle was also feeling the emotion in the form of rage as he felt the OB came in just to ambush us as she had no new information to give that the midwife didn’t. The thing with seeing the midwives was they worked as a team with the OBs. There were few midwives (only one other practice) in the Twin Cities that take twins and the reason the hospital did where I went was because they had a close working relationship with the OB team. We agreed to come back Thursday for a repeat NST and follow up visit. In the mean time I tried acupuncture again Tuesday night.
Our plan going into the Thursday follow up was to have her sweep my membranes and return possibly Saturday (40 week due date) or Monday for an induction. Kyle came with me again (as well as Isaac but he always came with me). We had our NST, everything looked good, my blood pressure was good (a few weeks prior had been slightly elevated more so than that visit). Then we headed over to clinic to see the midwife: Mary. She was surprised we still hadn’t given birth as I’d seen her at my 36 week appointment. She wasn’t exactly pushy with an induction but seemed genuinely concerned and stated that “Everyone is gritting their teeth around here” Which I took as people were getting pissed I kept declining induction, but Kyle took it as we were just making them nervous that we were putting off induction. She commented that my blood pressure was elevated and there was protein in my urine (both of which had happened before and wasn’t any worse than it had been at times). She checked me and I was about 2cm and ‘very soft’ which was about what I was at week 36 (1cm and “VERY soft”). She did sweep my membranes but it felt different that it did when I had it done with Isaac and I had a feeling it wasn’t going to really do much. We agreed to come in later that day, we had Isaac to find child care for so we would go home and make it back in soon. Our Plan A for Isaac was heading out of town Thursday afternoon til Sunday afternoon and our Plan B was also heading out of town for the weekend on Friday…. so we called our plan C which is a neighbor with a boy the same age as Isaac’s and we knew he would be comfortable there. So thankfully they were available. We had a hospital bag packed but it was months ago, so it took us a while to get everything together. I remembered our friend mentioning she’d take Harpo, to which Kyle replied “Crap I forgot about Harpo” Luckily we just gave her our door code and she could come get him whenever it was convenient for her. After all this it was clear that we were NOT ready, lol. Had labor started on it’s own we would have been seriously scrounging around to get the remaining ducks in a row. Instead we were able to figure it out together. I felt somewhat numb, just ready to be done and mad that I had hit this wall yet again. We had somewhat of a breakdown at the house as Kyle was getting frustrated with Isaac, who was just needing a little more patience than usual and we were both on edge. Kyle got upset thinking this was the last time the three of us was going to be just that: a family of three. In my mind I was already at peace with this, as the night before I had a feeling so I suggested we eat at Five Guys (a burger joint) and have frozen yogurt afterwards. I had a feeling that could be our last ‘family of three’ outing and I was somewhat at terms with it. As we left the house we saw two of our tulips had bloomed. Two perfect, twin tulips. We took this as a sign and it was comforting. Tulips have not lasted in our yard, the rabbits get them or the wind knocks the blooms off… but these two tulips ended up lasting weeks after this moment. There was one that bloomed right beside these two and it only lasted a week.
We arrived at the hospital about 2:30pm Thursday afternoon, our doula also met us there. Got an IV placed when they drew blood and it hung out in a saline lock in the event we needed it later. Since I was carrying twins EVERYONE had pretty much been waiting on us. I was seeing the midwives but since it was twins I was to labor on the OB side as it was close to the OR which is where i would have to deliver. The midwives had a separate unit (right next to L&D) which we would go to after the births. We had a great midwife during our admission process, to whom we referred to as Kathrine Heigle because she looked like her, but her name was Dawn. They also did an ultrasound to confirm where the babies were before we got this show underway. To our surprise…. Baby B (Mary) was now first in line to exit and Baby A (Emma) had shifted up a bit and was further up my right side. So from the first ultrasound they had always been Baby A and Baby B, they knew it was the same from ultrasound to ultrasound due to the location of the placentas. But now that we were in labor and delivery the baby that was first to exit was Baby A… so this obviously made for some confusion because we’d have to think about it when talking about the Babies. As nurse Emily put it: “The baby formerly known as A” :-) I believe it was also nurse Emily who told us about the video clip Monty Python's The Meaning of Birth which was some great comic relief.
Given our previous birth experience with Isaac (long and drawn out: I went into labor at 41w6d after having my membranes swept, came into the hospital at a 5, labored for 17 hrs, had my water broken - didn’t progress, labored another 3 hours and then had an epidural placed - still didn’t progress, got pitocin and reached complete another 8 hrs later, only to labor Isaac down another 4 or so hours til it was time to push. Pushed for 45 min and he was born at 42w1d) we knew that we needed to be patient. I was in no rush to evict them but knew it was time and they needed a little nudge. So we knew that they weren’t going to come with the shift of workers currently on, they looked at us funny when we’d meet them and ask “When do you leave?” because we were looking at the shifts and knew we’d have a few shift changes at least one or two before the girls would arrive. We got the next two midwives names and the next nurse. and OB team. Since I was having twins, the midwives and OB worked as a team. The OBs were there to watch out for Baby B. We knew all this going into L&D. The chief OB, Dr. Lupo was on that evening (GREAT!) we have heard great things about her and she was all on board for a breech extraction if need be. Both babies were head down and it was unlikely we’d need any breech turning or extractions but anything could happen after Baby A comes out so I wanted an OB that was willing to breech deliveries (of baby B) which is the whole reason I moved to this practice/hospital at 20 weeks. The chief resident that evening was Dr. Priya G. I really liked her and she also was on board with the wishes in my birth plan (being I stay on the L&D bed, not move onto the surgical table, have my support team with me which included my husband, my doula Jess, and my birth photographer, Megan). But there was shift change at 8pm for the midwives/OB docs.
So we arrived, IV placed, ultrasound done, then they inserted cytotec at 4:45pm. This is a little pill that goes in next to my cervix to help it ripen. I was “Very Soft & squishy” but still long (about 50%) and somewhat closed (only being 2/3cm). I also had to be hooked up to the monitors. I had asked my midwives leading up to delivery about the wireless monitors and of course they said it could happen, but the nurses knew better. There were three receivers but only one baby one. So that wasn’t gonna work for twins. They needed one for each baby and one for fundal (contractions)... the third on the wireless was if there was a scalp probe on the babies head, not gonna work for external monitoring. These monitors are the same I had in my NST. Just a little pager type thing that sits on my belly and is strapped around my belly with an elastic band. Now this was very annoying because I had monitors on my belly and wires running from them. I was able to sit, lay, stand up but I couldn’t venture too far because of the wires. It was rather annoying and since my belly was just like a beach ball the monitors didn’t like to stay in place. The cytotec took off great and my body was making their own contractions. We were able to negotiate a walk around 8:00pm. The monitors wouldn’t give a good consistent reading if I was sitting on the ball or laying down, so we said if we get a good 20 min reading then we want a 15 min walk or so. It was so nice to get out and walk around the unit. There was a window we walked to.
After our walk I had part of my plug show up in the toilet (not the whole thing). They checked me about 8:45pm, the midwife said I was about 2.5cm then appeared freaked out when she felt what she thought was a hand and hurried away to grab the OB resident. The OB resident Dr. Erin Tracy said I was about 4cm and yes it was just the side of a hand which was no concern. Baby had it up by her head, which is normal. She actually tickled it and it moved in the time that she checked me. We also got another walk about 10 or so with our doula. (Doula Jess had left for dinner during our earlier walk I think) I was checked again (mainly because the midwife was so on edge) at 11:10pm and was 5cm and at a -2 station. I could somewhat feel the contractions but they weren’t in anyway uncomfortable. I wasn’t too concerned with my quick progress but the midwife on at 8pm sure was. I wasn’t surprised when my body stopped at 5cm. The midwife was pushy about an epidural and was stating that things were going to take off fast and they wanted it in place incase they needed to do any internal turning during actual delivery. I was aware of this and had stated in my birth plan that I would ask for one when ready. I didn’t want one placed until I was feeling active labor. The plan for Thursday night was to rest. Unfortunately midwife Jane was so high anxiety, rest was the last thing I got. Kyle rested in my bed, Jess rested on the chair and I sat in the rocking chair trying to rest. But everytime a baby would come off the monitor Jane would run in, so my goal was to try and get the babies back on the monitor before she came in as she would just come in and sit there and stare at us. I could tell from the start she was very nervous about the twins, not sure if she had delivered twins before and sure glad she didn’t with me. She was nice, just anxious. She was trying to read me because she seemed to think I would progress without her knowing it, but I was sure labor would start at some point before these babies came out.
Fast forward through the night of on and off sleep, we all got breakfast about 4:15am. A wonderful breakfast of hard toast and cold cereal, followed by the playing of eye of the tiger to get us in the mood for the next step. At some point Midwife Jane left and Midwife Kathy came on. She was very laid back, and talkative about her grandkids. She even brought in really good coffee for Kyle and Jess. We started pitocin at 5am at half (.5 milliU/min). They usually start at 2 and go up by 2 from there. I wanted to start very slow because I was nervous how it’d feel. So we started .5 went up to 1, then increased by 1 every 30 minutes. The monitors were showing contractions, but I wasn’t really feeling much. I had some contractions/cramps that started slowly about 6:25am.. Oh and since I was now on pitocin this meant no walks :-( I couldn’t be off the monitors because of the pitocin.
The babies were doing just great the entire time. Shift change happened again Friday morning about 8am. Another cervical check at 9am, was about 6cm and at zero station, however at a later check she was back to a -1 station and 80% effaced. Another check at 11am and I was the same. Our doula left just before 1:00pm on Friday to go home and get some rest, take a shower, and eat some food. At this point we were at about 14 or 15 on the pitocin and it was clear it wasn’t doing much. I did lose my mucus plug in the toilet about 2:30pm, so this was a good sign, some cervical change was happening even though I wasn’t feeling much.
They checked me about 3:45pm Friday evening and there was no change: still “very soft and stretchy”. They said she was about a -1, -2 and the midwife ‘stirred things up’ to try and help. Once we got to 20 (the max) about 5pm it was time for a new plan. We negotiated a break!!! The OBs gave us a 4 hour break to get off the monitors, go eat, even have a walk outside on the cafeteria patio. They were contemplating an overnight break, but at this point we were committed and we didn’t want to draw this out any longer. We went down to the cafeteria and there really wasn’t anything good, so we actually left the hospital completely and went a block to a restaurant and got a real meal. We then walked the halls of the whole hospital. I started out much faster and quickly became a waddle, which was a good thing. I was getting crampy and was hoping for the walk to help with some progress. We went back to our room for a shower and a nap before our return time of 9pm. I wanted to go for a quick unit walk before we started again so we set an alarm for just before 9 and walked to our window one last time.
At 9:30pm Friday night we started the pitocin up again at 1mill. Dr. Pryia was back on duty and came in and did an ultrasound about 10:45pm to make sure they were still in position. By about 11:15pm I was having contractions every 5 min or so but still not really feeling them. Midwife Karlyn was going to break my water at 11pm, but the OB team was tied up in the OR so she didn’t want to break my water until they were ready. Kyle and I were able to rest a bit in this time, Doula Jess was still at home but we were in touch, also in touch with our birth photographer the entire time. In this time I asked my nurse what the news was and they had just gotten another women in needing close monitoring like myself so they were waiting to get her done before they broke my water. At this point they knew I wasn’t going anywhere so we were kinda on hold, which I was okay with because as I mentioned the entire time we need to be patient with these babies we are on their clock.
Once all that cleared way they came in to break my water, first doing another ultrasound at 2:05am and I was still 5cm and at a -1 station. Again they asked in a pushy short of way about the epidural wanting it in place before my water broke. I again stated that I will ask for it when ready and that I wanted to actually be in labor before getting the epidural placed. If the second midwife had her way I would have had one placed Thursday evening and would have been stuck in bed for 40 hours. They would just not drop the epidural push. I said to go ahead and start the fluids when they break my water, since I’d need an hour of fluids before they place the epi. They broke my water at 2:25am. I called my doula and chatted with her. I didn’t want her to come all the way in if I was just going to be sitting there. I didn’t have confidence that breaking my water would do anything since it didn’t with Isaac. So I figured we’d break my water, nothing would happen then I’d get the epidural, crank the pitocin and get them out “Isaac style”. Since that’s what eventually worked with Isaac after my labor stalled. Jess told me to give it an hour and see what happens. About 3 or 3:15 my nurse asked if I was ready for the epidural at that moment because if I wasn’t she was going to turn off the fluids so they weren’t just running for no reason. Pretty much an hour on the dot (3:30am) I got a different feeling contraction, one I actually needed to breath through and rehearse hypnobabies in my head. After three good contractions, I said go ahead and get the epidural underway, this was about 4am. We also had Jess come in at this point because I was afraid she would ‘miss the good part’ thinking the epi was coming then we’d just be sitting around again. Jess was on her way in and they checked me at 4:20am and she was at a zero station and I was 6cm. At some point I remember contractions being one on top of the other so I asked that they turn the pitocin down (it was at an 18 if I remember right) I wasn’t getting a break between them. Contractions were lasting about a minute and my break was only about 30 seconds. Jess arrived just before anesthesia came in to place the epidural. The epidural was placed about 5:00am but I was still feeling the contractions and able to move my feet. She said to give it a few contractions, so I did. I could feel the outer part of my right thigh getting numb and a tiny area on the outer side of my left hip, but no where else. All the pressure they put on me to get the epidural and then when I finally do it doesn't even work! Erg.
At 5:30am I was feeling the urge to push, saying “I need to poop!” At this point the nurse had brought in the bunny suits for Jess and Kyle as we were going to be heading to the OR when it was time to deliver. I told the nurse to bring in one more for Megan (my photographer) which at this point Kyle had texted her saying “Come now, she’s a 9” as soon as they checked me. I just thought I needed to poop because my body had cleaned out my system gradually on Friday, then we had a nice big meal on Friday evening during our break so I was afraid it was just that needing to work it’s way out. When they checked me, it was not poop I was needing to push out but a baby. So things got rather crazy, I didn’t see much of it as I was pushing in bed. Jess helped me to try not to push by saying “pa-pa-pa” They wheeled me out of the room and through a few doors to the OR, JUST like the scene in Monty Python's video clip (that I mentioned previously) haha, where it was filled with lots of people that I didn’t pay any attention to. Within two pushes Baby Mary was out and brought up to me. It actually felt good to push her out, despite being able to feel everything. Perhaps it was that there was another baby helping push her down and out. But heck if the second birth was going to be this easy than birthing twins is the easiest thing ever... too bad number two wasn't as quick. Mary's cord wasn’t very long and she rested about head on my rib cage. A staff person went to cut the cord when I heard a few others say “No, dad is going to!” Birth plans are amazing for this as everyone had read it and were great advocates for what I had written in my three page plan. Kyle cut the cord and Mary was brought up to me, skin to skin.
Mary’s birth 5:50am
Karlyn Peterson, midwife
Dr. Pria G resident
Dr. Doty staff OB
She weighed 7 lbs; 20.5 inches long and a head circumference of 13 inches
For a split moment all was still and I was joyful to be holding my baby…. then realizing I wasn’t finished yet. “Gotta get another baby out” I could feel the contractions that I had strongly felt were dwindling. Dr. Pria reached in right away and held on to Baby B (A)’s head. (My photographer didn't make it in time for Mary's birth, but arrived in the OR about 15 minutes after. Luckily Kyle and my doula grabbed our point and shoot and got a few captures of Mary's arrival)
Her bag of waters was intact and she was still pretty high up at a -2 station. I had closed to about 8cm. She made sure the head was in place, moving the cord over out of the way then broke her bag of waters to assure she was engaged. At this point she removed her hands and Dr. Doty stated “Well looks like you’re all good here, you can head back to the room if you’d like. At this point you’re just laboring a singleton and we are not needed”. My midwife was on the same brain thought as I because I didn’t want to move back to the room, I just wanted to get this second baby out. For fear that if she stayed in too long they would cut her out. So we stayed in the OR but everyone else left. Everyone but my immediate midwife team (probably a few nurses, my support team and my midwife).
We labored… and we labored… I asked about the pitocin making sure it was getting turned up as the contractions had slowed. And to also note, Mary's cord was still just hanging out of me this entire time, with a big set of clamps on it. Not the most comfortable thing to have dangling between my legs. Mary had latched and nurse for a little bit in hopes to get contractions going, but it was hard to labor with her on my chest so for the most part Kyle held onto her while my doula was at my side. I was watching the clock as I knew twins were typically born within an hour of each other, I thought maybe she was waiting til 6:50am... I pushed with some contractions, I breathed through some contractions, they brought in the bar and we utilized gravity to squat through contractions…
then two hours passed and the OB team came back in to check on us. Fear rose up in me again as I wanted to have two vaginal deliveries not just one, fear they would talk about a c-section. Of course when they come in they talk all quiet as I’m trying to figure out what they’re saying. I can’t remember if I asked or if the words just got clear, but I heard her say “You’ve been laboring for 2 hours, if it was active pushing for 2 hours that would be a different story, but since it’s just the labor stage you don’t really need to be in here anymore you can go back to your room” At this point my midwife agreed (and I was fine with it too) so we headed back to our labor & delivery room. This was encouraging and relieving as they wouldn’t be sending me back if they were contemplating a c-section…. but then it meant the game was on, we were laboring this baby out and boy was I ready to be done. We headed back to the room about 8am and it was time for shift change.
We got to the room and Kyle was holding Mary, we all look over and he is passed out, asleep. I asked them to poke him to make sure he was alive, he was just exhausted. At this point I was just in active labor, laboring one baby having just birthed one a few hours previous. I asked them to get anesthesia back in, hoping to get the epidural fixed so we could crank the pitocin and I could ride it out and get her labored down. They came and pushed some more drug, but still no effect. So I gave up hope on the epidural and just needed to plow through.
The contractions were probably about 5 minutes apart and did not feel very productive, so a lot of the time I was pushing with the contractions. I felt I had to milk them for all they were worth and make the most of each one manually. The first birth was much easier as far as my active participation. I tried different positions in the L&D room, I got up on my knees facing the head of the bed, we raised the head of the bed so I could lean on it with my arms.
My midwife Kathy would check me often and she could feel a lip of my cervix on Baby ‘B’s’ head, so with a few contractions I would push and she would push the lip in effort to get baby’s head past it and to a complete stage. This felt like forever, I kept waiting for them to say “one more good push and she’ll be out” but that didn’t come. They would cheer me on and say “good push, almost there, doing good, etc” but not the light at the tunnel I had hoped for. They started to get stuff set up so this told me we were close. Kyle put on some more Eye of the Tiger about 10:20 to get us pumped. Then Kathy put on her birthing gown… yes closer! But still a ways away. Finally (with what maybe an hour left of laboring) they removed the big kelly clamp that was attached to Mary's cord and replaced it with a smaller one, I remember hearing someone say "Oh we don't need that big clamp on there, lets put a smaller one on", kinda late now but whatever. At some point we brought the bar back onto the bed for me to grab on and pull while I pushed. They had held my legs up at a point and I remember my right calf getting horrible cramps. I could lift them up (no thanks to the epidural) but it was helpful for them to hold them as I worked to get any leverage I could to push her out. OB had come in just before this as they were concerned with hemoraging so they wanted to be prepared and present when it was time for the birth. My doula suggested getting a sheet out. For one contraction she held on to the end of the sheet, for the remaining we wrapped it around the bar for me to leverage off of and this seemed to be very helpful, I could definately get more bang for my buck out of the pushes.
After one of the pushes Kathy hollared “get the OB team in here” Yes! I thought, NOW we are finally close!! The actually ‘pushing’ phase lasted about 45 minutes, however to my body and mind it was 5 hours. Finally Emma was out and handed up to me, her cord was even shorter and she didn’t reach the whole way. I looked down and Emma was COVERED in vernix, I couldn’t believe it. Mary didn’t have a drop on her (like Isaac) but Emma was completely white. I was so happy she was in my arms! She was what we were waiting on. I don’t know if it’s true but I’ve always thought that early babies have more vernix and the more you get term or over term they lose the vernix, so I knew that Emma was the hold up. Heck her sister even pushed her out of the way to exit first. I knew all along Emma was on her own clock and needed the most patience. She was second to turn from breech causing me lots of stress but showing me I just needed to be patient.
Emma’s birth 11:10am
Kathy Furey, midwife
Dr. Maggie Hildabrand, resident
Dr. Nezworski staff OB
She weighed 7 lbs 4 oz; 20 inches long and a head circumference of 13.75 inches
Once she was out, Kyle got to cut the cord again and as I held her so happy to be finished laboring, the medical team worked fast to do whatever they were doing down there. They had a cytotec pill they put in my butt which was to help with hemorrhaging and they gave me some fentyl because I was done participating in this labor and wanted to enjoy my babies not all the tugging and prodding they were doing down there. They got the placentas delivered and had said “I don’t even think you tore”, which they did evenutally end up putting one small criss-cross stitch in on the side. Later Kathy shared that she really thinks the fact that we took everything so slow and had a nice long break Friday evening was the reason I didn’t bleed/hemmorage after deliveries. I was thinking maybe it was the five hours in between that my uterus had to contract down on one baby that helped.
Two placentas connected via membrane. This amazes me
When we first got to the hospital everyone was “wanting to be there for the twin delivery” when in fact the only people that got to see BOTH babies born was myself, Kyle, and Doula Jess…. they each had their own birth team/staff, own labor stories, and even own birth locations (OR and L&D room). Pretty amazing how it ended, not my ‘ideal envisioned birth story’ but even more perfect than I could ever imagine. I have heard a lot of “is that even normal for there to be that much space between deliveries” I just respond “I do not have normal labors, average time between vaginal deliveries is 17 minutes… we blew that out of the water”