Caitlyn’s 40 Week HBAC of Mono-Di Twins! 3


Shortly after having my now 3 year old daughter via cesarean birth due to failure to progress/CPD after an induction for post dates, I started planning my VBAC homebirth. Little did I know then that I would be carrying mono/di twins.

 The background:

When I was pregnant with my first, I strived for a natural birth. Although I left my OB for a midwife team that delivered at a fairly natural birth friendly hospital, took a Bradley birthing class, bought a birthing pool so that my husband and I could labor at home as long as possible, and I committed to a drug-free birth despite the nay-sayers, I was caught off guard when my so-called non-interventionist midwives started pressing for an induction at 39 weeks because the baby I was carrying was deemed too large for my body. They warned me about shoulder dystocia, and told me I was risking my baby’s life. They recommended a scheduled cesarean, and skipping the induction altogether based on an ACOG recommendation for suspected macrosomnia (newborn excessive weight). At 41 weeks the baby was estimated at 11.3 lbs via an in office ultrasound. (She ended up being 9.15) Although we passed the BPP’s and NST’s, we agreed to having my membranes stripped twice that week and scheduled a Pitocin induction at 42 weeks. I prayed to go into labor naturally before then, and I hired a doula at the last hour. I was scared. None of my care providers trusted my body, or my instincts that I could birth this baby. I knew as we walked in (late) to our induction at the hospital that I was making a mistake, but I was excited to meet my baby. I did not listen to my gut/intuition/myself. This became my biggest regret… not following my intuition, not listening to myself.

I felt awkward getting into the hospital gown after my perfectly healthy pregnancy… I wasn’t sick, yet I was being treated like I was. When the nurse came back to start the IV I started crying uncontrollably. I felt like I was betraying myself, but I was exhausted from fighting off this induction for two weeks, tired of telling people “no, I haven’t had that baby yet.” I felt like giving in, but felt like a failure for doing so.

After a long Pitocin induction, having my water broken against my wishes, begging for an epidural, and then running a low grade fever, I consented to a c/s 24 hours later. I’ve never felt like such a failure.

I was in a dark place, but not everyone knew or understood. My husband held me as I cried… for hours, days, and weeks. I learned quickly I couldn’t share with many people my feelings, because their responses made me feel even worse about myself. They said things like “at least you have a healthy baby,” which made me feel like I was ungrateful for this terrible experience I just went through, or as if I wasn’t happy about my healthy baby – of course I was. A few weeks after the birth I went to a local midwife’s mom’s meeting and I met someone who had walked in my shoes about 6 months prior. She actually had the same OB/Midwife team, and was told the same lines before her son’s birth. She told me it was ok to be sad. She told me my baby was not my birth. She told me about VBAC. She helped me believe in the power of following my intuition. I started attending ICAN meetings, studying VBAC medical studies, books and literature, living for VBAC birth stories, forums and blogs, picking my birth team, and recommitting to a birth not riddled with interventions.

The second pregnancy:

Almost exactly 3 years later, after a month or two of trying, I got the two pink lines! I thought it was a little early to test positive, and I started to experience morning sickness right away. I made an appointment with my dream midwife for 12 weeks. We had a prenatal that made my husband and I feel like we had known her forever, and we were over the moon happy to have a care provider that we trusted so much. We came back a month later for our 16 week appointment, and when our midwife palpitated my uterus, she started asking if my dates could be off… ‘By like a month or so.’ She and her student midwife smiled knowingly as they moved a Doppler around on my belly. My mind was preoccupied calculating dates, periods, and possibilities while considering I may have a baby in September and not October! Suddenly I came back to my senses when my midwife called my attention to the heartbeat. She hovered in one spot and said “one..” And then moved to the other side of my belly and said “two..” I looked at my husband who was smiling, back at the midwife who was smiling, and it clicked. I think I said “dammit.”

We scheduled an in-home ultrasound for the next day to confirm, that yes, we were having twins. When the tech left… I cried. I was THRILLED to have our family expanding by two beautiful babies, but knew the impact that this would have on my birth plans. Twin HBAC… My current midwife would have to refer me, since she did not deliver twins.

After a few weeks of grieving that my easy, stress-free birth was not to be, and accepted that I had some obstacles in front of me. I was still determined to have a HBAC, I felt deep in my soul that it was still the right choice for me. A few things were perking my spirits; I knew that twins were term at 36 weeks, so I didn’t have to worry about being overdue again with induction talks. I also knew twins are usually smaller than singletons, and “no one has 9 lb twins,” right?!

I signed up for a ‘Birthing from within’ class that helped me do my emotional work. I decided that no matter the outcome of this birth (VBAC or CBAC) I would be ok as long as the decisions made were mine, and that I trusted my intuition/gut. I learned that I needed to surrender to the moment and have courage.

I started seeing a perinatologist, and consented to frequent ultrasounds watching for TTTS, and other complications. The perinatologist group was very supportive of me having a VBAC and even suggested that I never should have been induced with my first daughter. Risks of VBAC aren’t any higher for twin moms than they are for singleton VBAC moms. Knowing that if I got to term with no complications I would home birth, I hired my doula, and found a skilled midwife who was willing to assemble a team to attend my birth – as long as I made it to 36 weeks.

I made it my goal to learn about natural twin VBAC’s. I found some women from online communities who had done what I wanted to do. I read a few twin books. I researched preventing pre-term labor, and found that a solid diet heavy in protein and good calories was key. I gained the Dr. Luke recommended 24 pounds by 24 weeks, and for the first time in my life… gaining weight was work! I skipped the Dairy Queen that I visited weekly while pregnant with my daughter. Yet, I still managed to gain a whopping 75 lbs.

I stopped working at 32 weeks, because I elected to, not under doctors orders, although the perinatologist happily wrote my recommendation letter for work.

I had regular chiropractic appointments with someone who specializes in prenatal care, and who was extremely supportive of my VBAC. She encouraged me to wear supportive tennis shoes with everything, which although totally embarrassing sometimes, paid off. I had felt pelvic pain since the second trimester that was kept in control with those measures. I read about other multiples moms being almost immobile due to the pain. Considering my size, I was in fantastic shape. I slept in my bed, had virtually no swelling until the last month, and walked to Starbucks daily for my caffeine fix during the last month.

The last month:

Twins are considered full-term at 36 weeks, homebirth was ok’d if I made it to 36 weeks, and the perinatologist I was seeing wanted to see me deliver between 36-37 weeks. After worrying so much about pre-term labor I was sure that once hitting 36 weeks, labor would start. I had been having Braxton Hicks contractions steadily for months. My official due date was October 1st, and I was pretty sure I would have the babies in September.

September came, and I ordered my birth kit, had my home visit with my midwives and anxiously awaited labor to start.

The perinatologist office wanted to see us twice a week since 35 weeks for NST’s and BPP’s. It was a large group of doctors, we saw at least 7 different doctors, and there were only 3 doctors we saw more than once. Although there were a few who were ok with us being involved in our birth choices, there were a few who would instead question our motives, suggest we just do what they say without asking so many questions, and towards the end, really wanted us to schedule an induction. I was strong with my convictions in each office visit, but after I left, I would lose it. I would question myself…was I making the right choice? Was I risking my babies? Thank God I had a strong support team. My husband, doula, midwife, and friends would encourage me to do what I felt was best for my babies and myself, lifting me back up after each appointment. As hard as it was, when my body went into labor all by itself at over 40 weeks… I was vindicated. It gave me the trust in my body that I needed to labor and birth my babies. It knew what needed to happen.

The birth:

Labor started for me on Tuesday, October 2nd after feeling crampy and having a back ache on and off all day. I had a chiropractic adjustment and took a call from my mother in law on the way home. I found myself annoyed and distracted while talking to her, and then realized what I felt were contractions! We ate dinner at my parent’s house and told them they might need to come pick up our daughter that night. I was up until about midnight and then was finally able to drift off to sleep. When I woke up in the morning, everything had stopped.

I knew that this happened, and that I was closer than ever to the real thing. At the same time, thoughts like “what if my body doesn’t know how to do this?” Crossed my mind too frequently. As if that wasn’t enough, I had a couple people, both people I love, and both nurses suggest that maybe something was, in fact, wrong with my body. Maybe I just needed to accept that I was not meant to do this.

Early in the morning on Thursday I woke up to some contractions, they continued to get closer together and a little more intense. I didn’t want to wake anyone at this hour knowing it was early. I did wake up my husband. I kept thinking that the contractions would stop again, similar to the way they did in the past…but they didn’t.

I labored in bed for a few hours, in and out of sleep while listening to relaxing music on my iPod until things got more intense. I moved to the shower, standing up and swaying and making a “mmmmm” sound through the contractions. My husband would touch my hand at the top of the shower from the other side and look at me through the glass. I would try to tell him when one was starting/stopping so that he could put the information into his IPhone application. I was waiting for 7am to roll around since that was when I could convince myself this was real, and text my doula to give her a heads up. I couldn’t wait until she arrived, so that I could zone out. I trust her immensely and knew she would take care of calling the rest of my birth team when the time was right. She did. She asked my husband the necessary questions without disturbing me. I could hear everything they were saying, and felt included, but was never required to think about timestamps or duration of contractions. It was amazing to labor with my guard down. To feel safe and protected really allowed me to labor and concentrate on my biggest job, staying in the moment.

An hour or so later, around 11:00am my midwife showed up. I was laboring in the birth pool. When she walked into our house, I felt such deep joy. I knew that this was actually happening. We weren’t hoping, or planning anymore. It was happening. I was having these babies today, vaginally, in my own home. This woman trusted my body, she trusted me as a mother, and she knew I could do this. She smiled knowingly as she walked up to me and embraced me. She asked me what she could do for me…I can’t remember what I said, but it doesn’t matter. Her question just reaffirmed that she was there to support me. She asked if I wanted her to check me, and I said yes. Although I knew that cervical checks don’t really mean much, I was praying that I was at least a 3-4. I had been working hard and wanted some proof of progress. When she told me I was a 6-7 with a bulging bag, my husband and I started crying. I was never this dilated with my daughter, and I was working much harder thanks to the Pitocin. Thinking back on this was the first time I realized that my husband was healing through this birthing experience too.

A few hours later, loving the birth pool, I was checked again, still a 6-7 with a bulging bag. Although I loved being in the birthing pool, I wasn’t making much progress, so I moved to standing up in the shower. For a few more hours I moved back and forth until laying on the bed for another check, and a with a tiny bit of help, my water broke. It actually felt good — a relief. I was a 9, but did not know that at the time. I got back in the tub. I remember being asked if I felt pushy… and I didn’t know. I gave a little practice push to see how it felt and I felt my body take over and make my little push a big push. I heard myself grunt deeply, and it surprised me because I didn’t intend to make any noise at all.

caitlyn1

I labored/pushed occasionally with contractions for about 40 minutes, and then my birth team said they could see a peek of my baby. I was told to reach down and feel my baby’s head, she was so close. I could feel her move down as I pushed and back up a bit when I didn’t. It felt right. I learned to push, and then hold a bit while waiting to push again. I did this until she was crowning, my hand touching her, connecting the internal feelings to the external. I remember my birth team encouraging me, and giving me tips, but I can’t remember what exactly was said. I remember her crowning, and waiting a bit…I remember hearing that her head was out, and then pushing for her body and just feeling a whooooosh as she slipped and twisted out of me. What an indescribable feeling…as she was lifted out of the water and laid on my chest, she looked at me. She looked me right in the eye. She seemed so all knowing and calm. I held her and could feel her cord still connecting us. I just kept saying “hi!, hi baby!” I knew that I had found what I had felt missing all this time. I was overwhelmed with joy, and felt a surge of love for this little being. I actually did not know she was a she until my husband and I looked at our baby. She was a girl, which meant I was having another girl soon!

caitlyn2

 

After the cord was cut, and we cuddled for a bit, and then I got out of the pool to lay on the bed so that we could check on baby b’s position.

I nursed her while the midwives palpitated my belly and checked my second baby’s heartbeat, which was always strong.

 

caitlyn3

 

After an hour or so, she was transverse still, and my midwife helped her move down with an external version. She easily flipped and engaged. I labored on the bed, but maybe because of hormones- it didn’t feel like labor. I felt myself pushing, but I didn’t feel painful contractions at all.

Apparently my bag of waters was extremely bulgy, and once it went, I was moved to the birth stool. I was immediately very uncomfortable! I was finding it hard to push in a different way than I had learned earlier… This was the most challenging part of my labor. Every time I pushed I would think to myself “I am strong. I am strong. I am strong.” I didn’t feel like I was making much progress, I could not feel the same moving downward feelings that I could with her twin sister. I kept glancing over at my husband holding my new baby skin to skin, and I was anxious for us to all be in bed together. I heard my midwife announce that our baby b was breech. We had all prepared ourselves for this possibility while I was pregnant, since its not an uncommon presentation for twins. I looked in the little mirror my midwife had, and I could see a little butt coming through. I pushed for almost the exact same amount of time as I did with my first twin, but it felt like I was more eager to get her out. Her body came through and I was coached to quickly push out her head, again my midwife caught her and handed her to me.

She had vernix covering the top of her head like a little hat. Her cord was on the shorter side and so I couldn’t lift her up too high until her cord was cut. She was beautiful, bright and alert. I felt such a relief that she was so content and healthy. I was done, I did it. I was sobbing and smiling. I looked at my husband who was holding our other baby in the rocking chair and he smiled with tears in his eyes too. He was so proud of me. I lay in bed cuddling my new family, and I was blissfully happy and utterly exhausted. While I was laboring my sweet neighbor brought a fruit basket, cookies, and some quinoa soup. My doula spoon fed me soup, and we all ate her delicious cookies.  The girls weighed in at 8lbs 4 ozs, and 8lbs 2 ozs. I knew then that my body made perfectly healthy big babies, that I was perfectly capable of birthing.

 

caitlyn4

 

I wish this is where my story ended, but we had a little bump in the road.

The transfer:

The midwives checked out my tears. I had a first degree vaginal tear, and a second degree perineal tear. They mentioned stitches or possibly just glue for repairs. They told me whenever I felt the urge to push, that I could deliver my placenta. The last thing I needed to do. I never felt the urge. After a bit, they had me push even though I didn’t have an urge… And nothing happened. After a while longer of pushing, uterine massage, pushing with cord traction, some medications and herbs to help the uterus contract, I still hadn’t delivered the placenta. It was still attached way at the top of my uterus. I always knew I had a fundal placenta. As we waited I started to bleed more heavily and it was concerning my midwives. I could tell by the way they were looking at me that they had bad news. They wanted me to transfer to the hospital. I could feel the disappointment in the room as the call was made. I’m not sure if it was the awesome birth hormones, or because I have always advocated for home birth by saying that the hospital is just down the street if you really need it. I felt totally comfortable with heading in. It reaffirmed that as a home birther, I don’t hate hospitals. This is what hospitals are for.

I had my placenta manually removed by a doctor upon arriving at the hospital, while being scolded and shushed for yelling in pain. Although they could wait for an ultrasound machine, apparently they could not wait for any pain relief. It was the single most painful experience of my life. They had my husband wait just outside the door to the L&D room with the babies in the hallway. My father was with him. When they were finished, he came in and helped me nurse the babies again. I was then taken to the OR and given a spinal block for stitches and a more thorough exam. We stayed that night in a postpartum room on the L&D floor, with the babies, and went home the next evening.

I had a few people comment that I ‘ended up in the same place we would have had I chosen to deliver in the hospital’ instead of home. I know in my heart, I made the right choice. I followed my intuition, I listened to myself, and trusted myself. I knew that we could do this (the babies and I). Had I birthed in the hospital I believe it is likely I would have had a cesarean birth. In which case, I definitely wouldn’t have been in the same place physically as I recovered from a surgery. I would not be in the same place emotionally, as it would not have been the healing experience I just had. My babies would not be in the same place, because they would not have had a drug and medicine free labor and birth that they were given. No, I can say that this was not the same place at all.


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3 thoughts on “Caitlyn’s 40 Week HBAC of Mono-Di Twins!

  • Cassandra

    This gives me such hope! I just found out that we will be having mono di twins in November, and am terrified that the new doctor I am being referred to will insist on a cesarean section.
    With my first child, my dr was so fantastic and knew that I wanted a natural birth, so didn’t even offer anything, but I haven’t met the new dr. and am worried because there are a few in our city who prefer them, one even has the nickname the butcher!
    Hearing how you were so strong and kept to what you wanted is inspiring!