Birth Story

 Gather 'round folks, it's time for a birth story.

When I last left you, I had seen my OB for my 36-week appointment and scheduled my 38 week induction, even though the OB didn't think I'd last 2 more weeks. At this appointment, I learned that all twins are moved to the OR for delivery at 7-8 cm and I could only have 1 support person in the OR with me. This was a huge bummer because I had really hoped to have my husband and both IFs in the delivery room with me, but I understood because of the higher risk factors.

I went back to work and started tying up loose ends "just in case." I'm an Architect and project manager; the other PMs at my firm are certainly qualified to take over my projects for me, but there's a lot of project-specific information that only I knew so I felt the pressure to leave things in good shape in case someone had to step in for me. I went home for an uneventful evening of TV watching and eating leftover Indian food.

At 8:45 pm Thursday night, still sitting on the couch, I felt 3 gushes that saturated my undies and pants. I was gun shy to declare my water had broken after the first false alarm, but my husband was certain that's what had happened. I obviously wasn't peeing myself and the gushing just wouldn't stop, so I called my Doctor's answering service. While we waited for the midwife to call us back, I climbed into the empty tub, called my IFs, and told them to start their 2.5 hour drive to the hospital. Around this time my mom arrived to stay with the kids - we're so lucky she lives close by. I had put together a little "birthday" gift for the babies but hadn't wrapped it yet, so Mom wrapped that while we waited. After speaking with the on-call midwife we got the official green light to head to the hospital. 

Sitting in an empty tub on a Friday night, nothing weird here.

We arrived just after 10:00 pm and went to a triage room. I wasn't having any noticeable contractions, but they quickly confirmed that my water had broken and was continuing to leak, checked the babies on the monitors, then moved me to a labor room. At this point, I was 4 cm dilated and still 70% effaced. My contractions picked up at 10:30 and progressed slow and steady. I had a chat with my midwife and labor nurse about labor goals (I've learned by now that there can be no birth plans, only goals) and I was still committed to vaginal delivery, no epidural.

IFs arrived at 1:00 am and I was so glad to see them! We agreed on a delivery rotation - my husband would be in the OR with me as I finished laboring, IF 1 would step in for me to deliver Jack, then IF 2 would take his place for me to deliver Marsha* - following the 1 person at a time rule but allowing all the guys to participate. By 1:30 am my labor was progressing slowly enough that we all agreed to try to sleep. Fortunately, the labor wing wasn't fully occupied so the IFs were given their own room to sleep in. 
*I had nicknamed the babies Jack and Marsha and called them that until the IFs formally shared their names via a birth announcement. I knew the babies' names already but that wasn't my good news to share.

It was hard to sleep with all the machines beeping constantly but I got a few hours sleep until the contractions woke me up at 5:15 am. The midwife had me try several different positions, both to encourage contractions and to try to get Marsha to turn head down. By 10:00 am I was 90% effaced but still only 5-6 cm dilated. Considering I was 4 cm when I was admitted, the limited progress was disappointing. Dr S, the on-call OB, came in at the same time and we discussed options. He still thought a vaginal delivery for Jack was possible, but Marsha was still sideways and would need to be manually manipulated into position after Jack came out. This would be intense and painful for me, with Dr S having to reach up into my uterus, so he recommended an epidural. Additionally, if Marsha ended up needing a last-minute c-section, there might not be time to give me a spinal block and they would have to put me under - another reason for him to recommend an epidural. I really didn't want one, but that seemed like the best option for vaginally delivering both babies so I agreed. Unfortunately, from this point forward I was very sleep-deprived (and hungry and thirsty) so I don't have a solid timeline for everything.

I got the epidural placed (around noon?) and it was awful. I really don't do well with needles and getting that put in is one of the worst things I have ever experienced in terms of pain and discomfort. After I was numbed I continued to slowly progress, with the midwife helping me into different positions. I eventually made it to 7 cm / 90% effaced and hit a plateau. The midwife wanted to give me a small dose of Pitocin to get me up to 8 cm and into the OR but Dr S was opposed because Pitocin is not recommended for laboring women with a previous c-section scar. Another hour of contractions and still no real progress. 

At 4:00 pm Dr S came back to discuss a c-section. His reasons were if Jack were going to fully engage with my pelvis and dilate me to 10, he would have by now. Further, Marsha was still sideways and still wasn't likely to turn on her own. Even though I didn't like the topic at hand, I felt very comforted that we were discussing it as a whole birthing team - me, my husband, the IFs, Dr S, the midwife, and the labor nurse - and I didn't feel pressured or forced about anything. My initial reaction was to labor for one more hour and see what happened, but the more we discussed it, it seemed like foregoing vaginal delivery and setting up for a c-section for both babies was our best choice. I could labor for several more hours and still not be dilated enough to push. I could deliver Jack vaginally and still need a c-section for Marsha, and I really didn't want to recover from 2 types of delivery. And there was also the small, but catastrophic, chance of a uterine rupture if my body didn't respond well to Pitocin or pushing. On top of that, I was running on very little sleep and wasn't sure I had the energy to labor much longer. The medical staff stepped out and the "family" agreed to a c-section. I realized that my preference for vaginal delivery was just that - my preference - but this wasn't about me and a c-section seemed to be the safest way to get these babies delivered. I consented to the c-section at 4:30 pm so we just had to wait for an OR to become available. We also agreed that my husband would be in the OR with me and both IFs would wait just outside in a staging area with babies taken to them right after delivery.

Even though I knew what to expect I spent the waiting period getting nervous. I remembered how hard the recovery was last time and I was sad the IFs wouldn't be in the room as their babies came into the world. Throughout my entire stay, I wasn't allowed to eat or drink anything but ice chips, and my last meal was 8:00 pm the night before. Even worse, the hospital air was dry which made my thirst even worse.

Could all these Dads be any cuter?

At 6:15 all the guys suited up and we headed to the OR. As they put me on the table the anesthesiologist upped my epidural... and he was "generous." I felt numb up to my chin, I had to constantly wiggle and squeeze my fingers to make sure I didn't entirely lose feeling in my hands, and it felt like a weight was sitting on my chest. I also felt tired and light-headed so the nurses literally had to remind me to breathe. Being flat on my back and congested didn't help matters either, so I was breathing through my mouth which only made me even thirstier. I remember asking for water over and over.

So glad I was able to have my husband in the OR for support and picture taking. 

As Dr S started the incisions he commented that my uterus was paper-thin, so we definitely made the right call not to give Pitocin or try to push. He easily delivered Jack (4 lb 12 oz) at 6:51 pm with Marsha (5 lb 10 oz) following at 6:52 pm. Wouldn't you know it, she flipped head down as soon as Jack was out of the way - what a rascal! After she was born, Dr S said she had 2 knots in her cord and had her cord wrapped around her neck! Neither of those things were causing her distress in the womb but could have quickly turned dangerous had I tried to deliver her vaginally. I'm not a big believer in fate or destiny, but the universe certainly knew what it was doing when we decided on a c-section.

Jack (left) and Marsha (right) in their birthday suits

I got to hear the first cries and see each baby above the drape as they were delivered, and my husband was allowed to take photos, then they were quickly taken to their waiting Dads in the staging area for their clean-up and vitals check. Despite being born at 36 weeks 1 day, they were very healthy.

The second half of the surgery seemed to take forever and all I wanted was to drink some water and have the epidural wear off. Everyone went back to my labor room for a quick visit then we were moved to 2 recovery rooms to get some much-needed rest.

Next up, recover and some final thoughts on surrogacy.