Here’s the short story, all of which is awesome: I had a vaginal, drug-free, di-di, vertex-vertex twin delivery, in a delivery suite rather than an OR, and with intermittent rather than continuous fetal monitoring. I was 9 hours shy of 38 weeks, and the girls were both in the six pound range (Clara being 5oz above, Phoebe 1oz below). Neither girl had any complications or saw the inside of a NICU. Both breastfed right away and have been relatively easy nursers since.
I had no tearing (new for me!). I didn’t poop on the delivery table (also, um, a first). I didn’t even get hemorrhoids. So basically I’m saying that, if the rest of this birth story reads like a rant against fetal monitoring and its evils and like I was deeply unsure about my decision to allow the Doc to rupture my membranes at 5cm+, I should probably be beaten with a sock and told to count my blessings, oh wait, I don’t have enough fingers.
But it’s impossible, IMPOSSIBLE, to write about the twins’ birth without some background.
When I got pregnant for the first time, with (just) one baby, my husband and I met with our local midwives to investigate home birth. My mother had four of her children at home (Unnecessary aside: Mine was the only hospital birth. I’m the oldest, and she never went back thanks in part to their enthusiastic routine episiotomy policy). My first pelvic exams as a teenager were with our family’s midwife, who had delivered two of my siblings at my home. I was there for my brother’s birth. In a way, having a homebirth with a midwife didn’t seem odd to me. It was an option, and I thought it was worth exploring.
A few things pulled me away from it. First, it really pushed my husband’s comfort level. I also learned that, in my state, homebirth midwives are prohibited from administering oxygen or Pitocin, either of which can be life-saving in an emergency (I later learned that many of them DO carry and will administer both, but they won’t admit to it if you ask them straight out, which I did). My insurance, also, was structured in such a way that I’d have had to pay double if I needed a transfer. Okay, I thought. Sure, fate. Whatever. I’ll do the best I can with this one, and then I’ll have my NEXT one at home. No prob.
My husband and I took an amazing, in depth birth class through the local midwife center. He went from being afraid he’d faint to strategizing with me about how we’d beat the birth system and hoping he’d be able to catch. We went into our oldest’s hospital birth empowered, powerful, lucky, optimistic. We stayed at home until my contractions were around 90 seconds apart, showed up, had a transcendental experience and a beautiful baby boy named Sam. We’d been planning a fight, but we didn’t need to – the nursing staff was on our side the whole time. I felt like a rock star. And I was sure I’d have no problem with a homebirth next time. I had the hips for it, apparently.
Fast-forward approximately 19 months. We had a rambunctious toddler, I was still nursing, and my husband and I were staring at two blue lines on a pregnancy test. WHOOPS. Because I was still figuring out what to do about a provider, we decided to spring for a private ultrasound to confirm the pregnancy. At less than 6 weeks pregnant, we learned that we had two babies in there. “Surprised” doesn’t begin to cover it. “Shocked” comes closer. “In shock” probably comes the closest.
Their pregnancy was…uncomfortable. It wasn’t horrid by any stretch of the imagination, and it was pretty much complication-free. But the constant nausea didn’t subside until week 18. I had an extremely brief second trimester, during which I could (and did!) eat, and then I had three solid months of zero appetite, choking down smoothies, and Jabba The Hut wallowing. I kept active, I counted liters of water and grams of protein, but physically? It was rather a lot.
It was hard mentally, too. I tried, but I did spend the early weeks worried about prematurity. My mother-in-law reminded me that I needed to research the local NICUs. Once I hit viability, I kept looking at pictures of babies born at 24 weeks, then 25, then 26 (and etc.) I decided against pursuing a homebirth fairly early, but I did end up switching to a provider recommended by the midwife who’d taught our class. The doctor, though male (which I didn’t like) said he’d pretty much do whatever I wanted. Cool, I thought. I basically hadn’t needed one the first time. Birth seemed easy – it was pregnancy that was hard. All I wanted was to make it another day, another week. Please babies, be okay. Please cervix, hold tight. Worry. Worry.
But something magical happened around 34 weeks. I was HUGE but damned if I couldn’t see the finish line. I started getting proud of this incredible thing my body was doing. I celebrated every passing week like it was a holiday. My confidence went up daily. I was also freed from any self-consciousness I’d had at the end of my son’s pregnancy (Yes WHYTHANKYOU I do happen to be massive! How sweet of you to notice!)
Maybe there’s no such thing as “a little pregnant,” but there sure is such a thing as very, extremely pregnant. I was just about the pregnant-est a person can get, and I was loving it.
Which leads us to…wait, this was supposed to be a birth story? Ah, distracted. Yes, Birth. Here we go.
The actual birth story really has to start with the “routine” non-stress test at 37 weeks, 5 days. Sure, my appointment that morning had told me that I was going to give birth any second (4cm, 80%), but so had LAST week’s appointment (3.5 cm, 80%). Sure, I was a touch on the large, uncomfortable side. Sure, my ankles and toes were swollen. But whatever. I could take this for another week, maybe even two! Bring it, full-term twins!
Even though I thought it was an unnecessary test, I waddled myself in there and plopped myself down for an easy twenty minutes of fetal monitoring. Babies A and B (as they were then known) were completely uncooperative. They wiggled and flipped and the nurse couldn’t get a good read on their heartbeats. Not that they didn’t have heartbeats, clearly they were actively kicking the monitors. They just didn’t stay still long enough to get a straight 20 minute read. The whole thing took about an hour and a half, during which one thing was consistent – the monitor on my uterus showed strong contractions the whole time, 2-3 minutes apart. Contractions that I could not feel.
The nurse wanted to admit me, and only let me go after a call to my doctor who, true to form, told the nurse to let me do whatever I wanted. “This is looking a lot like labor,” she said. “But I can’t feel anything,” I replied. I denied the cervical check (I’d already been checked that day so I knew I was at least 4cm. So yeah, back away from my cervix, lady.)
Anyway, home I went, but only after the nurse gave me a stern lecture about How Quickly Twins Can Come and What to Look For Before I Run (Don’t Walk) Back. The lecture made me a little nervous, honestly. Don’t get too mad at the nurse, though. It turns out she’s also pretty awesome in a pinch. She also looks exactly like Gwyneth Paltrow. You can imagine her as Gwyneth for the rest of the story, if you’d like.
Let’s fast-forward a few more hours. Basically, we went to bed early. I woke up at about 1am, and my belly was just a completely hard knot. It still didn’t hurt, but I could FEEL it, and I could time it. The contractions were 2-3 minutes apart, regular but not necessarily increasing in intensity.
Had I not gone to the non-stress test and/or gotten The Lecture, I’d probably have rolled over (figuratively, not literally; rolling over was an extremely difficult task at that point) and gone back to sleep. But I was on edge. So I woke up, puttered around, hand-wrote my birth plan, (I had an electric copy only and no printer ink) and timed these “contractions” I could barely feel, and finally woke up my husband. We then called my mom, who showed up at around 3:30 am, and hiked ourselves into the hospital.
The plan I’d worked out with my doctor was the following: They’d do everything in their power to allow me to stay mobile. I got a hep lock and agreed to intermittent, external fetal monitoring. He agreed to let me birth in the suite if things were going well (basically, he agreed to make the OR call on the day of). I’d have access to the pool, the shower, whatever I wanted. He also talked about how they had remote fetal monitors, which would allow me to stay more active. We also discussed the importance of babies on chest immediately after birth (actually a huge emphasis of the hospital where I gave birth; there are posters everywhere and they’ve sponsored a bunch of research on “kangaroo care,” or immediate skin-to-skin bonding, and do it most vaginal births and over a third of C-sections. Not perfect but still cool!)
Back to the story. I was admitted, had my dilation checked (still 4-5, 80%) and stuck back on those effing monitors by 5am. I never would have gone to the hospital at that point with my oldest, but I mean Oh Well? Cest La Vie? You live and you learn, I guess.
Because I was in early, rather than really active labor, it was boring stuff. They gave me a room at like 7am, and I started the lovely (horrible) intermittent monitoring schedule: 20 minutes on, 40 minutes off. I’d had to change into a gown for triage, but changed back into my clothes once I had a room, which made me feel less like a “patient”. I left my running shoes on, along with the same socks I’d worn when I had my son. My sister showed up, and soon, so did my mom (she brought my son to daycare).
But the contractions were still dilly-dallying about. Not particularly painful, very close together but a touch irregular. Not doing much. I spent my lovely 40 minutes of freedom walking the halls and doing the stairs, trying to get these babies on the road. But we were on the scenic route.
The problem with monitoring is that you can’t move. The problem with not moving is that it makes everything HURT. I know this is a cheesy analogy but it’s the best I can think of: laboring independently felt like I was a wild animal – powerful, primal. When I was stuck to the monitors, I felt like a caged animal. It sucked. Oh, and those remote/wireless monitors the doctor was talking about? Yes, the hospital has them, but apparently they don’t work very well so the nurses don’t like to use them. The docs don’t ever HAVE to use them, because they don’t really do labor care. Grumble.
For the record, even though I cumulatively spent hours strapped to the monitor, neither baby had one single sign of stress. I wanted time off for good behavior. I did not get it, but I did get intermittent monitoring the whole time (rare with twins) and maybe because of the monitoring (??) I got to deliver in the cushy delivery suite rather than the OR. Both of those were nice, and if I put it to myself like that, I can hate those monitors a little less. But only a little less.
My doctor suggested breaking my water at like 9 am. I was really hesitant – I wanted labor to progress on its own. I was also really concerned that one intervention might lead to another, that breaking my water would start a clock (he assured me that was antiquated medical practice). He also assured me that with him, it would NOT start a clock, and also dilated to a big 5, I wasn’t really risking much. It would just kick things into gear. I put him off for another two hours and hiked more stairs (and did more stupid monitoring.) I also knew that it would make things much more painful, and my body wouldn’t have the chance to make the endorphins to catch up to the pain.
I do not want to gloss over this fact: I felt pressure to just go ahead and let them rupture my membranes. It was not a particularly pressure-y pressure, everyone kept saying that it was up to me, they were here all day, whatever. But it was like sitting at a restaurant waiting for a friend to arrive – you don’t have to order. You don’t. But the waiter will keep refilling your water and you’ll feel like, well, a little pressure. I felt pressure, anyway.
Anyway, back to the question – rupture or not to rupture. I knew what it would do. And I was really worried about what it might do. But after a few hours of waiting, at like 10:45, at the top of the stairs on the tenth floor for the third time, I was like EFF it, Bring it, harder labor. Let’s get this shit over with.
The doc broke my water at 11:00 on the nose, and I was still at around 5cm. It did exactly what it was supposed to. My contractions regulated themselves, grew increasingly strong and productive, and started kicking my ass. The twins were born at almost exactly 3:00, and I’d describe the hours that followed this way:
- Hour One: More intense, but not terrible. I walked, bounced, and hated the 20 minutes of monitoring.
- Hour Two: Even more intense, really had to focus, lots of swaying and walking, and hated the 20 minutes of monitoring.
- Hour Three: I was in the shower for my freedom time, which was awesome, while my husband used the massager to put warm water on my contracting belly. But SHIT these were starting to hurt, and seriously? Monitoring already?
- Hour Four: G&!D%@$IT OUCH.
Every hour I climbed back off that bed and into my ginormous pad and mesh panties and kept moving. This made everything so so so much better. And every hour I had to climb BACK into bed and get strapped in by the most supportive, amazing, Gwyneth the nurse ever, who told me that yeah, you’re dilating more, and the babies look great.
I did go into the fog of labor – the crazy, swirling, calm, focused, extremely powerful and centered labor place where I was in charge, and I did not care whatsoever what was happening around me.
By around 2:30, I was starting to not be able to move through the contractions. I was walking less, and spending more time on the ball, leaning over the bed, asking for ice and pressure on my lower back. The contractions were also coming ON TOP of each other (More about son’s perfect birth – my contractions lasted 30-45 seconds and I had about 90 seconds in between. This is ideal for maintaining sanity and a positive outlook on life – I’d shoot for it if you have the option). Not these puppies. I had to really focus to make it through them, and then WTF? ANOTHER? Are you kidding me? Didn’t I just DO this? Gwyneth kept asking me if I felt like pushing. And I was really waiting for a real “urge” to push, which I did not feel exactly. But then at around 2:50, I figured I’d give a tiny push to see how it felt. “Wow,” I said to Gwyneth, “pushing really DOES feel better.”
Gwyneth jumped into action and got the doctor there. I started bracing myself for what I figured would be the next long slog part of labor, Pushing. People whirred around me, doing things and grabbing other things, all of which is a total blur. I was breathing really deeply, and mentally preparing myself to…have a baby RIGHT away.
First real pushing contraction, three pushes IN the contraction, and out popped Clara like a slithery octopus cork, born at 3:01. I said OW OW OW OW when she was being born, which is apparently a record for minimum swearing. They put her immediately on my chest, started rubbing her, and she started crying her pathetic little cry. She seemed so much smaller than my son had been, and she was completely covered in a very thick coating of vernix. She looked goopy and adorable. I kept kissing her, and thinking that I should think it was gross to be getting a mouth full of vernix, and then not caring. Kiss.
I felt completely blissed out totally done. “Ahhh, that was nice,” I think to myself. “What a relief that’s over with.” My body relaxed, too, and the contractions took a breather. The NICU representative (or whoever she was, that was my impression) told me that I could continue to hold Baby A while I pushed out Baby B, if I thought I could do it (It turns out I couldn’t, FYI).
Baby B/Phoebe, meanwhile, with all the extra space, begins stretching out in her new home and being rather a nuisance. (I’m kinda guessing here, doing some patchwork – I’m not 100% sure what happened once I had Clara on my chest). The resident, there w/the US machine to make sure she didn’t flip breech, started having some kind of issue tracking her. Maybe they were worried about her heartbeat and maybe it was her position, but the doctor broke through my distracted reverie and says, “Maddie, I need you to push this baby out.” “But I’m not having a contraction,” I reasoned back with him. Then I tuned him out and go back to snorgle Clara. He said the same thing one more time: “Maddie, I need you to push this baby out.” I kinda sighed and decided to cooperate, and push, even though (as I mentioned) I wasn’t having a contraction. As soon as I did, my body started to contract and I asked my mom to hold Clara, so I could focus.
This was strangely different – all my contractions, both with Clara and Sam, had been my body’s doing. I was just surfing them, coping with them, letting them come and watching them go. With Phoebe, I pushed without a contraction, and then the contraction started and I was in CHARGE of it. This was a very strange and magical feeling. It sounds crazy, but I WAS the ocean, the power, and not the surfer. It felt incredible. Anyway, it didn’t last long. Within a few seconds, at 3:07, Phoebe was born.
One thing that my family thinks is absolutely hilarious is that I asked to cut Phoebe’s cord. It seemed like a fairly normal thing to ask, to me. My husband cut Clara’s and I thought it was my turn. My birth plan asked for delay until the cord had quit pulsing but I’m not sure they did it…but they may have. Again, kind of a blur. It was definitely not 10 minutes or anything, but I don’t remember seeing pulsing.
Anyway, I got Clara back from the NICU nurse (she’d actually had a little fluid suctioned out of her lungs in the meantime, apparently a risk of not being squeezed for long enough), and I got Phoebe and the four of us – including Mike – sat there and snuggled for a really long time. I actually, like with Sam, have absolutely no memory of how long or what we talked about. I do know that I got a bag of pitocin (an intervention that I’ve never had a problem with) and birthed the placentas (very hazy memories of that) and, since there was no need for any kind of stitches or anything, and since everyone was healthy, the room quickly emptied except for close family and Gwyneth the nurse, who continued to be awesome and helped get us all cleaned up, etc, afterwards. Eventually we transferred to a more permanent room.
In conclusion – no acid trip through orgasmic birth, perhaps, but DAMN the outcome was exactly what I was hoping for. The whole point of natural birth, to me, is a reduced risk of C-section, easier recovery, and no drugs for babies. This birth was harder and more painful than my first, I’d say, but the recovery was actually easier.
A few notes:
1.) The best advice on how to have an easy, natural birth is to avoid complications. The second best advice, if you’re heading for the hospital anyway, is to stay home until you no longer care whether or not you pack your hairbrush. Your mileage may vary, but those are what works for me (the second being the one I didn’t do this time).
2.) Did I write that whole thing and not mention the incredible support that my husband gave me the whole time? Seriously, amazing. And for making it through a hard contraction stuck on a hospital bed, may I recommend someone tracing circles on your belly with ice? Excellent.
3.) I’m not sure I could have done continuous monitoring w/o an epidural, though. I really am not. And I was really lucky to not get continuous monitoring – even my doc usually prefers it with twins. I had to be very clear about my desire to stay mobile (and I re-iterated it again and again, saying “I can do this as long as I can keep moving.”)
4.) The shower was very very nice. I didn’t have a tub, and I could have asked for one, but the shower, man. That felt very good. I kind of overheated after a while, though.
5.) Gwyneth the nurse later told me that she’d told the resident never to expect to see another twin delivery like that in her career. That made me feel pretty badass. Kinda sad, though.
6.) There were lots of people there, including a few that the doctor brought in because I was an unusual case – unmedicated twins. This didn’t bother me at all, and there were not as many as I’d been expecting. There was only one NICU person, for example (I think).
7.) The fact that breaking my water made things move so quickly makes me feel like I accelerated the girls’ birth by a few hours rather than a few days, something I can never know but really hope. They’re such tiny mites, I really hope I didn’t prematurely evict them. The doc said they were ready, the nurse said they were ready, and the labor progressed as if they were ready. I am almost sure they were ready. But it still nags a little.