We found out we were expecting twins at a six week dating scan. It was totally unexpected but we welcomed it as wonderful news, two little people would be joining our family! Having had a very positive midwife led pregnancy and birth prior to this pregnancy, I booked into the family birth centre at my local hospital, but a twin pregnancy put me in a 'high risk' category, so I was moved into obstetric care at a large, tertiary hospital.
At my initial booking in appointment the registrar asked what my thoughts were about delivery. A vaginal delivery made sense to me, I had a prior vaginal delivery, and the recovery while looking after newborn twins would be easier. She informed me that I would be "allowed" to birth vaginally, but that the pregnancy would not proceed beyond 38 weeks and I would have an epidural as there was a very high likelihood that the attending obstetrician would need to reach inside of me to manually extract twin 2 should it not descend immediately after twin 1. I went home with plenty to think about; my first birth had been induced at 40+11 and save for a small amount of gas and air it was completely unmedicated. I didn’t want another induced birth if I could avoid it, and I sure did not want to be flat on my back, feet up in stirrups with a doctor preforming a veterinary-like procedure on me! I realised how important it was that I have another unmedicated and active birth. I started researching extensively online, only to find that the birth explained to me at the hospital was standard procedure everywhere else. A multiple birth was something that apparently had to be closely managed and involve a high degree of intervention. I then went to a twins information session at my hospital. The senior obstetrician took us through the risks, scenarios and complications of a twin birth. He explained the use of an epidural for a twin birth, and at this point I put up my hand to ask why it was policy that we must have an epidural. He said “because it’s not nice to endure a manual extraction unmedicated, and if there’s a need for an emergency caesarean section then you will be able to remain conscious”. I asked if it was really necessary and his was response was that they strongly encourage the use of epidural but “if you don’t want an epidural then we can’t assault you”. Ah-ha, so if I didn’t give my consent for an epidural then, technically, it would be illegal to make me have an epidural. Right I thought…if it’s an issue of pain then I’m happy to endure it. I had given birth before and it was harrowing but I did it and I was happy I did it the way I did. Plus, there was always a chance twin 2 would descend nicely and there would be no need for a manual extraction. If there was an emergency and I needed a caesarean section then I would consent to a general anaesthetic. This would mean I would not be awake for the birth of my babies, and would mean I would also be unconscious for a few hours in recovery after the birth. It was a big thing to accept that this was a possibility, but again, I decided the possibility was small, and my desire to have an active birth big!
The wonders of the internet…..I watched a beautiful video I found online: and shortly afterwards discovered a group Birthing Multiples Naturally. Through this group I discovered many other women who were or had been in exactly the same predicament that I was. I got amazing support from them, read their birth stories, asked questions and discussed the ins and outs of a vaginal birth with multiples.
I was increasingly finding my hospital experience more and more difficult. I saw a different registrar at every appointment and knowing that I would not know the midwives or doctors at the time of delivery made me anxious, so I decided to enlist the help of a doula and found Gen, a lovely trainee doula with huge enthusiasm for a multiple pregnancy and birth. I met up with Gen a number of times over the pregnancy and would talk her ear off each time with the new facts I had found, my latest thoughts and my progress with the hospital. Soon after enlisted Gen’s help, a midwife at the hospital told me that there was a senior obstetrician on my clinic at the hospital who was experienced with twin births and was “a very nice man”. She told me that next time I book an appointment I should request to see him. At my first appointment with Dr E he enthusiastically told me I was an excellent candidate for a normal delivery, and he was positively beaming about my health and the health of my babies. It was so uplifting, finally a doctor who wasn’t trying on scare mongering tactics at every turn! From that point onwards I saw Dr E for every ante natal appointment. I finally worked up the courage to bring in my birth preferences document. He reviewed it carefully, and then for every point he said “yes, that should be fine”. I couldn’t believe it! Admittedly there was nothing particularly out of the ordinary about it – I wanted an active birth and no epidural – usually a given for singleton birth.
Towards the end
As I approached the 38 week mark I started to feel more and more like a time bomb, nearly every night visit to the toilet began with me thinking “is this it??”, and then….no, just need to pee. I tried as much as I could to shut out the expectation and, quite frankly, harassment from family, friends and well-wishers. I avoided going outside, my sheer size (especially on my small frame) was quite the spectacle. 38 weeks came and went; then 39 weeks came and went. At each hospital appointment Dr E and I agreed that my best chance of a natural birth would be to wait for a spontaneous labour. In the meantime I was kick counting every day, and going in for monitoring every one to two days. I was highly aware of where each baby was sitting and whether a jab was twin A’s foot, or twin B’s fist. Twin B was still comfortably breech, and was snuggled behind my anterior placenta which meant that I would often have to stop and wait until I got my next kick. Twin A was sitting right along my left side and every movement was discernable. I started employing all the tricks to get things moving, but to no avail. I had definite false labours that would go for a few hours, where I truly thought it was the beginning, but it would then peter off and I would still be pregnant. However I was in a pretty zen like state, and by the time I got to 40 weeks I declared that’s it, I was never going to have these babies and I’ve given up waiting! At my 40 week appointment Dr E and I discussed some options. I was pushing up towards my comfort zone with the pregnancy and was beginning to get a tad nervous about the babies. He performed a stretch and sweep at the appointment and declared that I was already 3 cms dilated and well effaced, I was ready to have these babies! Walking out of my appointment I had a little trickle of fluid come out. I confirmed it was amniotic fluid when I got home and that night figured surely something would start soon enough. I woke up the next day disappointed! That afternoon in fetal monitoring I mentioned to the midwife I’d had a leak and she said she’d have to get a doctor in. She then added that I probably should have not mentioned it as she was obliged to get a doctor and that they would likely want to induce me. A friendly registrar came up, sent me off for a scan, which revealed that fluid levels for both babies were getting low. I was booked in for an induction the following day and begged to go home for one last night before the big day, so they agreed not to admit me then and there.
The morning of my induction was a slow process, loads of waiting around! We were there at 7am and by about 8am saw the first doctor. She was really friendly, I discussed my birth plan with her and she quipped “yes, sure thing”. I was so relieved there wouldn’t be a fight! We started with breaking my waters which came out in a huge gush. The midwife was totally eager to get me all hooked up to a monitor which I wasn’t that keen for, but said it would just be for an hour or so to start with so I agreed. I bounced around on the fit ball and chatted to my husband Nick and Gen, making small talk and admiring the view from the birthing suite which was amazing. It was a really lovely day and I was feeling very at peace and relaxed. After about two hours not much at all was happening apart from the tsunami still gushing out (haha, low fluid? Didn’t feel like it!). I wasn’t even getting a contraction at all, so agreed to syntocin. I had the drip put in and Gen helped hook the TENS machine up. I looked at the clock – 10am, and declared I’d really love to see some babies by lunch time. Optimistic perhaps, but I just felt so ready for birth and was so excited to meet my babies. Some small contractions started up and I was managing well, still chatting and laughing through them. I was still bouncing around on the fitball and using my TENS machine, and trying not to devote too much energy to each contraction. As they increased in intensity I began to need to focus on each contraction more, so started letting the others do the talking. I began calling on my inner reserves a bit more, and began to get into my own zone, I remembered doing this in my first birth.
The monitor was starting to lose twin 1’s heartbeat (as it was too low down), so they requested to put an electrode into the baby’s head. I wasn’t too pleased with this idea, but they told me that this meant I could go on the wireless monitor and so could move around a bit more freely, so I agreed. As soon as it was put in it became apparent that the signal of the TENS machine was interfering with the wireless monitor, so I had to turn it off! I was not very happy about this at all, but by this stage was having trouble talking, even between contractions. The midwife said we weren’t too far away now and that a little gas and air would help without the TENS machine. I think she saw the disappointment on my face when she said in a slightly exasperated voice “so did you want to do this COMPLETELY drug free??” I was never opposed to some gas and air, I was just saving it for later on if I could, but I guessed that now was ‘later on’ and I should just take it. I hopped onto the bed and leaned over it. It was comfortable leaning over like that and I swayed and rode through each contraction with my gas and air and Nick next to me holding my hand. At one point he was trying to massage me, but I was just not enjoying being touched! However Gen had slightly cold hands and would very delicately rub them over my lower back and that was really nice. I had begun to relax a bit more and through each contraction would look at Nick and smile at him. I was in the full swing of labour, but it felt good! I was getting little niggling pushing sensations towards the end of each contraction.
An obstetrician came in and asked to do an internal which found that I was six centimeters and the baby was posterior. I only heard them murmuring this and when I did I looked over at Gen and said “posterior? Six centimetes?” and she nodded yes with a very compassionate look on her face. I was not quite as far along as we thought, and a posterior baby was probably going to take some time. I continued to labour in the same spot for what felt like, and was…hours. Each contraction strong and steady, still smiling at my husband and holding his hand. Another internal later and I was 8 centimeters…..another internal later and I was 10 centimeters. My pushing urges were getting stronger, but were still not anywhere near the pushing urge I remembered with my first birth, it just didn’t feel right. The obstetrician told me there was still a lip of cervix that needed to move away for the head to descend. Yes – that was exactly what it felt like! At that point I hopped off the bed and stood up. I began to rotate my hips around; I was literally trying to squeeze the baby out! Gen gave me loads of encouragement, and I continued to move around and change positions. I knew exactly the pushing sensation I was looking for but it wasn’t coming. Another internal confirmed the cervix lip was still there. We went hour by hour, with each hour confirming that I was still 10 centimetres, but twin A’s head had still not descended. By 6pm the obstetrician came to have a chat. She said it was time to consider the possibility of a c-section. We could continue to go hour by hour, but the likelihood of the babies arriving soon was small. The labour was obstructed, and the safest option would be a surgical delivery. She said she would give us some time to make a decision, so she and all the staff cleared out of the room. For hours the labour did not feel ‘right’ to me, so I told Nick and Gen that I thought a c-section was the best idea. And then I added “but make it QUICK!!” Nick rushed out to say they should prep me for a c-section, and all of a sudden every single coping mechanism I had left me. I absolutely hollered through each contraction. The anaesthetist ran into the room and took me though everything in the kindest, most humane way possible (i.e. as quick as he could). Nick was rushed off to get changed and later told me he was a bit emotional in the waiting room as he never even got a chance to give me a kiss. Everything was a blur, there were people everywhere, and my previously dim room was lit up like a Christmas tree. I was wheeled, hollering, into the operating theatre, and that poor anaesthetist did everything he could do to get that spinal into me asap! If I wasn’t in so much pain I would have laughed when he asked me to roll over to my side and hunch over. My belly was so big there was absolutely no room to move! It felt like I had gone to heaven when that spinal started working. It was the first time in hours that I had been completely pain free (and the first time in months I was completely comfortable). I lay on the table in a blissful, dream like state while the hospital staff buzzed around me getting ready for surgery. I had the biggest smile on my face – I was about to meet my babies soon! Nick rushed in towards me and gave me a kiss and was amazed to see me beaming at him. By then it was 7pm and the staff were doing handover in the theartre, so we had twice the amount of staff in the room, it was definitely really busy, but I couldn’t care less.
My babies are born
When they lifted the first baby out the obstetrician said “you have a girl!”, and then lifted her above the screen so we could see her. In truth all I really saw was her bottom and ‘proof’ of her girlness, haha. She was a beautiful bright pink colour but she wasn’t breathing so she went straight to the resuscitation table. We hadn’t fully settled on names, but had a few I was happy with, so I had told Nick to decide. Then he said “That one will be called Emmeline”, which was the girl’s name I had chosen. As we knew they were both the same sex, he added “and the next one will be called Frances” which was the girls name he had chosen. It was perfect.
After some more grappling around we heard a loud cry, and they lifted up another little girl, our Frances, the obstetrician announced “Another girl, and this one has a perfect breech head!” Frances went off to the table to get weighed and at this point I realised I still had not heard Emmeline cry. I asked the anaesthetist how she was going, and he assured me all was ok. Not long afterwards we heard a cry from Emmeline and I breathed a sigh of relief and looked forward to both my girls being in my arms. First Frances arrived, looking all bleary eyed, but staring out at us intently, then Emmeline was handed to me, and I giggled a little as she felt quite a bit heavier, and had quite a bit more hair. The poor thing also had a squished nose, clearly having suffered a little from being the head down twin. We got a family photo taken and then I was whisked away to recovery while Nick and the babies went to the ward. I really wished I wasn’t separated from my babies but I was completely exhausted by that point, and used the time to doze off. Before I knew it a midwife came to get me saying “you have two VERY hungry girls up there, and a very besotted Dad”. I was wheeled up to the ward and the both babies were passed to me. Before I knew it I was tandem feeding them, and it felt incredible!
While it wasn’t necessarily the birth I had prepared for, it was the outcome I had prepared for – two beautiful, healthy babies. Throughout my pregnancy and labour I fought hard to give myself every opportunity to birth my babies naturally; I gave it my best shot, and for that I’m very happy and have no regrets.
My girls are one year old tomorrow and it’s been an incredible time as I have transposed my philosophies on birth to my philosophies on parenting twins. I love them dearly and we are having so much fun, in my more insane moments I think to myself I would like to do it all over again!
Edited by Alxeen, 03 April 2014 - 03:21 PM.