January 25, 2015

Twin Time

When you are pregnant with twins, most of the people you meet tell you that twins are early and it seems that everyone knows someone whose twins were born so many weeks early. Even the doctors and medical books tell you that 38 weeks is considered full term for twins. And the numbers show that over half twins are born early. So, you can imagine that I pretty much took my due date, revised it two weeks earlier, and figured I was set. Surely I’d have the twins right around 38 weeks.

On Friday, January 9, at 37 weeks and 4 days, I started having regular, mild contractions over my IHOP breakfast with friends. I knew they were kind of giving me the hairy eyeball, so I tried to play it cool. When J and I got home though, they kept up and were 4 minutes apart. “Holy smokes!” I thought, “Is this it?!” My other labors had both begun at night, so this whole mid-morning thing was throwing me off. But it was enough that I called Josh home from work and my friend Stacy from her morning errands to watch J.

When the contractions started petering out on the way to the hospital I thought it was just because I was sitting. In triage at the birth center they looked unconvinced, as I was myself, that this was for real. The price of admission was a dilation check, which I don’t like to have done until I am seriously in labor. You can be a little bit dilated for a long time (like weeks) or not dilated at all and progress quickly, so for my personality that number is simply stressful. I was nervous about heading home without knowing if things would heat up, so I consented and, as I was dilated between 4 and 5cm, they kept me.

You know the ending. We did not have babies that night. We spent about 10 hours at the hospital as the contractions grew further apart and fainter. Finally, I admitted defeat, and we went home. Here I would like to say how thankful I am that my OB had no problem with my going home. It was the best decision for sure.

A little over a week later, with my sweet in-laws now in town, arriving early after our practice labor, I got ready for bed, resigning myself to having full term—as in 40, not 38 week—twins. But as I tried to get comfortable for sleep, I started having some crampy feelings (this was about 11:40pm). By midnight things started to get more intense, and I went to tell Josh to stop working on his paper because this might be it. I don’t have long labors, so it was only 15 minutes later or so when I decided to call my doctor. This was definitely not practice. She called right back and told us to come on in.

I did the Hypnobabies home study this time to help me stay relaxed in the hospital atmosphere. For me, personally, a hospital is not my first choice when it comes to birthing babies. To make matters worse, because I was having twins, the hospital required me to push in the operating room, just in case. The operating room is not the most welcoming room in the hospital. I was afraid that I would freak out and be unable to relax during my labor. The Hypnobabies program did help a lot with that. On the way to the hospital, I listened to my hypnosis track and actually did pretty well with the contractions, even though they were getting pretty intense, and I was having a lot of pressure in my back.  I remember as we made the last few turns thinking, “I just want to get in the tub. I just need to make it to the shower.”

We arrived at the birth center at 1am. Josh parked and came around to get me. Getting in the car had been no big deal, but faced with the prospect of climbing out of the Civic, I wasn’t sure I could do it. I waited out a contraction and forced myself to get out of the car. It was freezing cold, and Josh had my coat, but there was no way I could put it on just then. I walked into the birth center in my short-sleeved PJs. Thankfully I got a break halfway to the door, and I walked as I could to get in the door before another contraction started.

How they expect laboring moms to sign forms is beyond me. Josh took care of just about everything, and I scribbled something illegible between contractions. A smiling nurse showed up to wheel me to a room (no triage this time). I looked at the wheelchair and informed her there was no way I was getting in it. It took three contractions just to get from the lobby to the second floor.

Once we got to our room I was sort of surprised to find that it was crowded with Dr. Proverbs and nurses. Everyone was busy prepping something. They very kindly asked if I’d get on the bed so they could do a monitoring strip on the babies. I told them very tersely that I was getting in the shower and started stripping. Dr. Proverbs helped me in the shower, and we got the water going. The hot water was so soothing.

I was probably in there a few minutes, though it seemed like no time at all when Dr. Proverbs came and said, “The nurses are getting kind of nervous. Would it be ok to get out now and check on the babies and your dilation?” If left to my own devices, I would have stayed where I was, but I understood that the babies did need to be checked and slowly climbed out of the tub.

They got both babies on monitors, and checked my dilation while also putting in a hep lock. It was a busy moment. Dr. Proverbs announced I was at 9cm. Given how fast I was progressing, we decided it was prudent to go to the OR. Thankfully, they wheeled the whole bed down the hall; there was no way I could have walked so far.

We started pushing shortly after we got in the OR. My water hadn’t broken yet and the bag started to bulge out pretty quickly. Dr. Proverbs told me to keep pushing and expect a big pop. I actually felt the bag bulging out, which was both cool and weird. Another push or two and it exploded out. Josh said the nurses actually jumped back out of the way. Once that was gone, it was down to the real deal.

It took a few pushes to find a good rhythm. My doctor was doing perineal massage during every push and that really helped give me something to focus on. Everyone was really encouraging and supportive. At 2:53am, when M was born, Dr. Proverbs told me, “Jamie! Open your eyes!” and there he was. They gave him to me right away, and I cried with joy and relief. I did wish that the nurse vigorously rubbing him would go away. I didn’t want anyone messing with my perfect babe. Because the boys shared a placenta, they cut M’s cord pretty much immediately, which was disappointing. There was some concern that odd things could happen with the blood flow between the boys with one on the outside and one on the inside, but I still wished he could have gotten more of the cord blood.

Josh took M, and the nurses took his measurements and wrapped him up and gave him to Josh. Dr. Proverbs was telling me what a great job I’d done. She said M had been born posterior, or sunny-side up. That was why my back had hurt, and it had made him more challenging to push out. We hoped that little J would be better positioned. A few minutes later the show was back on. I thought my water broke on one of the pushes, but afterwards Josh told me Dr. Proverbs broke it. Either way, he was heads down and coming out, if a bit sideways. He didn’t take as long to be born; I think that was probably because his brother had stretched things out for him and also because I had a better handle on pushing. His contractions were really intense though with a crazy tail on them where I didn’t feel like I could push, but I was still contracting. A few of those were really hard to deal with.

At 3:17am, 24 minutes after his brother, little J was born. He was also placed on my chest and he got to stay. They let his cord pulse for several minutes before they clamped it and Josh cut it. Then they took him over for measurements as well.

I had been a bit nervous about the third stage. In both my previous labors it had taken a good 45 minutes for the placenta to detach. I knew that hospitals were not too patient with waiting on a placenta, so I feared I might have to tap dance a bit to keep them from trying to go in after it. Thankfully, this time it came free within just a few minutes. I was bleeding a fair bit, but nothing too crazy, so they let me be for the moment.

Later, in recovery, I ended up with Pitocin to get my uterus to contract down. I was still bleeding on the borderline of a hemorrhage, so they were being careful. I had the choice of Pitocin, Cytotec, or uterine massage. I don’t know if you’ve ever had your post-baby uterus massaged, but believe me when I tell you that it is extremely unpleasant. After enduring that several times, we tried the Pitocin, which was actually much gentler (I had been afraid that it would also cause really painful contractions), and stemmed the bleed. Once that was under control, they took us to a recovery room.

I was very leery of going to a hospital to have my babies. For twins, it was the best decision, as we do not live anywhere near a really good hospital. The hospital we went to was 45 minutes from our house, much too far if we’d run into any real problems. The staff though, was amazing. It helped that our labor nurses were actually the same ones we’d had the week before. They were thrilled to see us back and excited to be part of a natural twin birth. We had nothing but supportive, kind nurses who respected our decisions. It was such a relief. I was afraid that they would wake us up all night even more than the babies would, but we had the same night nurse both nights and she just peeked at us and pretty much let us be, which was great.

A week out, I’m finally used to there being two babies. Those first few hours and days I’d just look from one boy to the other and say in wide-eyed wonder, “There are two of them!” I had seen them on ultrasound, I had felt their individual wiggles and kicks, but to see their beautiful faces side by side was a revelation. I feel that they are a fulfillment of a promise. And they are so much more than I ever could have asked for.

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