Ok, so before I get to the birth story I'm going to explain a little about my twin pregnancy... My boys were diamniotic/monochorionic (di/mo) twins. This means that they shared a placenta but within the placenta they had their own separate amniotic sacks (thank you Lord..a shared sack is INCREDIBLY risky. ). When twins share a placenta, they are always identical (fertilized egg split into two zygotes/embryos or whatever, lol, and essentially the same DNA) It is often riskier than when each twin is in his or her own placenta. About 10-15% of di/mo twins develop TTTS, twin to twin transfusion, where blood vessels open in the placenta and one twin essentially gives the other a blood transfusion. This can be very dangerous and fatal to one or both. Other risks are IUGR (inter uterine growth restriction), unequal share of placenta, and other things.
Delivering twins is also riskier than delivering just one baby. Many twin moms choose an elective c-sec (or have to have one because of baby A's position, among other reasons). Both of my boys were in PERFECT position (head down) from about 24 weeks on so I decided that I would avoid a c-section if I could. There are risks with both. One of the risks with a vaginal birth that my doctor discussed with me was a prolapsed cord for baby B. This can occur after baby A is born, before baby B's head is engaged. The cord can enter the birth canal and be pinched, effectively cutting off all oxygen to the baby. This can be life threatening and can mean an emergency c-section for baby B. I was praying that I wouldn't have to recover from both a vaginal and c-section delivery!
During my pregnancy, I was aware of these risks but very calm...maybe the hormones?! Or naive? Or God's peace?! :) I was monitored obsessively throughout my pregnancy... Ultrasounds every other week starting about 1/2 way through, appointments every week for the last few months, non-stress tests, fetal EKG, I missed a lot of work. Everything was picture perfect, everything! At 35 1/2 weeks I had an ultrasound that showed that there was a sudden and significant weight discrepancy between the boys (aka discordant growth). This can be a sign of TTTS and other conditions.
I remember the evening of that ultrasound, sitting on the couch at my parents house. I was doing phone parent-teacher conferences because I was way too pregnant to do them in person. (Only a fellow teacher can understand how exhausting conferences are!) My contractions were also coming and going as they had been for weeks! My OB, Dr. Bollin-Richards, called me herself and said "I think it is time for the boys to come out! How does Valentine's day sound?"
The night before my induction, Brandon and I went on our last date pre-babies. I made him run in to see if we could get in right away because getting out of the car and walking into the restaurant was quite the effort for me! When I walked in the hostess showed us to our table...then paused and said, "um, maybe we should find a different table." Ha! She was right! It was all crammed in the corner, I never would have fit in there. We found an empty booth and we pushed the table toward Brandon so I would be able to fit. We got quite a bit of attention....The restaurant's manager bought Brandon a beer and me a dessert. I remember walking through the restaurant (um, to the bathroom, or course) and just watching all the heads turn to watch me (aka a belly with legs) walk by.
The following morning I think I got up at 4 am. My induction was scheduled for 6 am. We walked into the ER together, Brandon carrying a suitcase, back pack, and a birthing ball! And me carrying nothing...well, just twins. :) By 8am I was hooked up to a million different things: contraction monitor, a heart monitor for each baby, and an IV with pitocin to induce contractions.
Ugh, I was so bored. I just sat in bed all strapped up waiting for something to start happening! ALL morning, I stayed at 2cm and my contractions stayed about 2 minutes apart but barely noticeable. This was not very different from what I had been experiencing for a few weeks already. The nurse periodically came in and upped my pitocin levels. Lunchtime came and went...and I wasn't allowed to eat (don't get me started...). Mid afternoon my contractions were not much different, only slightly stronger. Just barely uncomfortable. I was so bored and so hungry!
Finally at around 5pm my doctor decided to try and get things moving a little faster. (Stop reading if female anatomy freaks you out.) She decided to use a foley bulb, a long balloon-like thingy that is inserted past the cervix and inflated to put pressure on the cervix (which helps it to dilate). The resident doctor inflated it to 4cm saying that it should increase my contractions and fall out once I reached 4cm dilated. They said it might take about 2 hours or more.
My contractions immediately picked up to the point of being very uncomfortable. Right away, I couldn't talk through them. I just stayed in bed and flinched through every contraction...I want to go back and tell myself to stand up and relax! I would have been so much more comfortable! lol. Brandon tried to encourage me to try some of the techniques we had discussed. I refused them all, I just didn't want to move. I was strapped up to so many machines, it was so cumbersome.
About 45 minutes to an hour later (around 6pm), I went to pee...and the foley bulb came out! YAY! I remember yelling in excitement to Brandon from inside the bathroom. IMMEDIATELY my contractions became VERY strong. Oh man, I was not prepared. After a few contractions I said..."ok...I think I want the epidural!"
My memory of the contractions with Owen and Carter's labor is so much different than my memory of the contractions with Clara's. I don't know if it was because it was an induction vs. natural labor, or if I was just much more prepared for Clara's labor. I don't remember having a break between contractions at all at this point with Owen and Carter.
After I asked for the epidural, the nurse asked me if I wanted Stadol (a narcotic pain killer used in labor) to take the edge off the pain. Previously, I had made the decision NOT to have Stadol. Because I was in a lot of pain and did not have the support I needed (Brandon wasn't prepared either) I said OK. I'm perfectly at peace with every part of their labor and delivery except this part. I REALLY regret it. It did NOT remove the pain and was not worth and "edge" it took off. I felt drunk and woozy and like I was not as present as I wanted to be for the remainder of my labor and delivery. I hated it. It can also cause the following effects in babies:
Central nervous system depression
Respiratory depression
Impaired early breastfeeding
Altered neurological behavior
Decreased ability to regulate body temperature
My boys experienced at least two of these symptoms and were highly susceptible to the others even WITHOUT the use of Stadol being that they were born 4 weeks early. I don't know if the Stadol played a roll in this, but I am angry that I was not fully informed...and that it is used so routinely in labor!
Laboring while under the effect of Stadol was just cloudy. I remember the pain and everything else around me was a blur. I was floppy and lethargic. The anesthesiologist came in after a while, sometime around 7 or 7:30. I remember being sat up by the nurses and them undressing me for the epidural. I felt like a rag doll. The contractions were incredibly painful and all-consuming. I have no memory of any pain from the epidural being placed, only from the contractions.
After a few minutes, the epidural started to take effect. Ahhh....it was so nice! The Stadol was also starting to wear off a little, though I still felt tipsy. I was exhausted and settled in to take a nap. Not 30 seconds after I had closed my eyes, I felt a warm gush between my legs. "Um, I'm pretty sure my water just broke!"
The resident doctor was called in and checked my cervix. 7 cm! What?! I couldn't believe it! It wasn't even 8pm yet. At 6 I had only been 4 cm! I was also starting to tremble and shake at this point, which at the time I had not known was a sign of transition.
Suddenly, Owen's heart rate dropped dramatically. The doctor was suddenly concerned, and I felt a jolt of panic through my heart. The doctor checked my cervix immediately and with a shocked expression said, "You're 10 centimeters!" (this was literally less than 2 minutes after he had said 7cm.)
I remember turning my head to look at Brandon, totally ecstatic! Owen's heart rate returned to normal shortly after, the resident explaining that sudden dilation can cause a baby's heart rate to drop.
The next little while was full of preparations. My doctor was called (she was at home!) and the room began to fill with nurses and doctors. I had so many people in the room! It definitely felt weird and awkward...with all these strangers milling about while I was being put in the stirrups. I was so tired and still felt odd from the stadol.
At around 8:45 my doctor came running (literally) in! She was out of breath and had a huge grin on her face! She told me that she had rushed to the hospital and run up the stairs! She had not expected me to progress so quickly.
I began pushing just shortly after she arrived (no way could I have waited without that epi). I. Was. So. Tired. I could feel each contraction tightening and would push through them then lay back and rest. I remember Brandon and my nurse were on my left, a med school student at my right, my doctor and a resident (his first vaginal twin birth :) down below, a nurse for each baby by the infant beds and a NICU nurse for each baby in case it was necessary. So many people!! I remember the med school student introducing herself to my nurse and thinking "this is so weird! I'm having twins right now and these people are just having another day on the job." I also remember thinking "who are those people?!" About the nicu nurses as I was pushing. Maybe would have been nice to have been introduced!
After pushing for almost an hour, Owen Alexander was born at 9:45pm! Right away, he was placed on my stomach. My immediate reaction was shock and fear. He looked impossibly tiny! I had never seen such a small baby. I gasped and said, "He's so tiny!" He was so cute! He didn't have much fat on him so he had lots of wrinkles. I was kind of in shock and touched him gently. I couldn't believe my baby A was here! He was on my belly for a few minutes until it was time to deliver Carter.
The doctor instructed to me to push through a contraction, and suddenly Carter's water broke. My doctor's tone and facial expression became suddenly serious. The resident doctor tried to help with cleaning up my water, but my doctor snapped at him, telling him to leave it. Brandon and I became very nervous and my doctor informed us that Carter's cord had prolapsed, that she had pushed it back in, but that he had to come out NOW so she would be using the vacuum extractor. I pushed continuously during and between the contractions for only 2-3 minutes, when finally Carter came out! Brandon and I were both praying out loud We looked down and Carter was completely purple and floppy as a rag doll. He looked lifeless. I stared and stared and stared at him. Apparently I couldn't hear anything going on, which I suppose is a good thing, because Brandon later told me that my doctor said urgently, "Get him to the NICU!" (My doctor still remembers this birth well, and talks about what a scare he gave us all!)
After maybe 20-30 seconds, Carter took a deep breath and let out a wail. Oh we were all so relieved! By 1 minute old, he received an APGAR of 7 and was perfectly fine. He was so adorable! At a pound bigger than Owen, he looked SO much different! They looked nothing alike. Hard to believe if you see them today!
A little while after the placenta had been delivered, the nurse was checking my belly to make sure all was well, when I began to hemorrhage. My doctor was called and I got a little nervous when I heard the nurse, upon being told that my doctor was busy, say, "No, she needs to come right now!" The bleeding stopped pretty quickly, but shortly after I became very nauseous and incredibly shaky. It was such an uncomfortable feeling! (I was so thankful that I didn't experience any of that with Clara's birth.) I was quite anemic for a while, and pretty pale!
I didn't nurse my boys for about an hour and a half, due to feeling so hazy, losing blood, becoming nauseous and vomiting, and shaking very uncomfortably. I remember nursing them, but I felt very numb and utterly exhausted. I remember holding both my tiny babes, one in each arm, as they wheeled me to my recovery room. A couple we passed said, "aww! twins!" Thinking back, I grieve the fact that I did not have that time right after birth to hold my brand new babies skin-to-skin on my chest, to just hold them and talk to them and nurse them. My time in the hospital was uncertain and overwhelming. It was not how I had imagined and looking back it was a much more difficult recovery, physically and emotionally, than what I think is normal.
Ultimately, Owen and Carter were (and are) so healthy, especially for being born at 36 weeks. They weighed 4lbs 13oz and 5lbs 12oz, respectively. They spent no time in the NICU at all and were home with us 48 hours after they were born. They were so tiny and sooo sleepy all the time. The first few weeks with them were incredibly challenging. (I think having 2 preemies is about 5 times harder than having 1 full-term!) It took us about 1 1/2 hours to feed them both, then we had a little over an hour before we had to start the whole process over again. And in that hour we were washing pump parts, changing diapers, changing spit-up clothes, and hopefully feeding ourselves as well! Since the boys were early, they were not able to just nurse and get what they needed, so they were nursing and taking bottles of breastmilk. Brandon and I got 3-4 broken hours of sleep a night! (Maybe I should do another post Brandon's nighttime antics during those weeks: sleep talking, sleep walking, and sleep diaper changing.) After a long 6 weeks, we finally started settling in with the boys! They became wonderful nursers and I was thankfully able to breastfeed them for 19 months. :)
I can't believe our big four year olds used to be those tiny little buddies! It has been the most amazing experience to be their mommy. I'm so blessed and I thank God for them every single day!
Owen, left Carter, right
Owen, Left Carter, Right
Carter, left Owen, Right
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