People say that going from one child to two is the hardest transition and that going from two to three isn’t that big of a deal. I went from one to three in the space of 1 hour and 5 minutes.
About a month before Punkin turned two my husband and I began having serious talks about having a second child. After all, Punkin was so “old” I mean he could TALK and everything! We began to miss the baby stage and I had the irresistible biological urge to be pregnant again. We’d bought a house almost 9 months earlier and felt it would be the perfect size for a family of four (a cape with 1 large, 1 small bedroom upstairs and a third bedroom–or office/playroom–on the first floor). So January 2nd, after about a second of deciding we were definitely going to try for another baby with a planned conception in about April/May/June because then I could work at least half the school year with a nice long break once the baby came and return the following school year we decided to attempt a practice run. We thought we’d try for a girl.
Voila! Pregnant with twin girls!
I am very lucky to be so fertile and we probably should have anticipated a quick conception but neither of us could have predicted what the next year had in store for us.
Pregnancy can be hard but I thought, after having such a nice pregnancy with Punkin, that my body just loved it and would have no trouble the second time around. Wow was I wrong! I had no “complications” but I was miserable. I found out I was pregnant seconds after implantation (I have always felt the cramping followed by nothing that indicates implantation) and was thrilled! I told my two best friends (at Olive Garden, the next time we went to that restaurant I announced I was pregnant with Peanut–we’ve agreed not to go there any more) and ate almost all the breadsticks before the basket was even on the table. My first pregnancy symptom was insatiable hunger and that didn’t ever ease up. At my first prenatal appointment I told the midwife I met with that this pregnancy was sooooo different from my first and his response was, “Well, all pregnancies are different.” But I knew something was wrong and very, very different. At first I just thought it was a girl but my misery was too acute, too all-consuming to just be that (and differences in pregnancies being attributed to the baby’s gender is really an old wives tale anyway, right?).
At my first appointment with a doctor she said, “We could do an early ultrasound to check dates if you want.” Completely medically unnecessary but I took her up on it. I needed to know what on earth was going on! So, at 9 weeks pregnant we went for an ultrasound. We looked around the waiting room at other new parents-to-be and smiled smugly, we were old hands at this.
In the ultrasound room we gazed up at the screen in anticipation of seeing a tiny flicker of a heartbeat my husband and I both almost threw up right there over the edge of the ultrasound table. Two round blobs with a small white peanut to one side of each… twins. Then my husband said, “We’re going to need a bigger car.” In retrospect this was a very Jaws-esque comment but I assure there was no clever humor in it at the time! Our small Toyota Corolla (that we’d just purchased) wasn’t going to cut it anymore.
Hey, I thought this was a post about your twin BIRTH experience, why are you including all this stuff about your pregnancy?
The main reason I’m writing this post is to lay the foundation for a comparison between my hospital births and my homebirth. I didn’t realize it at the time but the pregnancy itself would have been easier if I’d been planning a homebirth because my midwife and I developed a close relationship through the pregnancy and she would have been supportive of my emotional health as well as my physical health. The multiple doctors I saw in my OB practice could not because they did not know me–how could they in the 5-10 minutes I saw them once a month and almost never the same doctor twice!? So this pregnancy is very important to describe in order to later make a comprehensive comparison.
More than just our car situation changed that day. I had been thinking about having a homebirth since Punkin’s birth (my two younger sisters and I were born at home). The reasearch I’d been attempting to do about homebirth in Connecticut had yielded very limited results (I only found 2 midwives in this area and neither had any real information about themselves online). Homebirth didn’t seem “legit” and I didn’t want a lay midwife but didn’t realize that the midwives in CT are CPMs and are very well educated and qualified. So the idea of homebirth went out the window along with my desire to keep the gender a secret. I threw up my hands and gave in to the medicalized and risky birth I felt bound to have!
This story is actually very hard for me to write because the way I felt and thought at the time is very different from the way I think and feel now. If I were to do go back in time I would make different choices right at the beginning of the pregnancy which would have led to a very different outcome. When we found out we were pregnant with twins, however, I felt scared at the increased risk associated with twin pregnancies. I was scared of delivering early (aren’t all twins delivered early?), I was scared of pre-eclampsia and gestational diabetes. I wanted to build a relationship with a provider in order to be able to comfortably share my worries. During the previous pregnancy I had seen a different doctor at every appointment. I asked and was told that I could not see the same person every time, the way this OBGYN group ran was for you to see every doctor because you never knew who was going to deliver you (that’s pretty standard for big OBGYN groups). Even when I said I didn’t care who delivered I just wanted to have someone follow me through the pregnancy they still said I couldn’t.
Overall the pregnancy was uneventful. I was miserable the majority of the time and I actually took some sick days in the first trimester because I couldn’t imagine dragging myself through my day. I was always hungry (starving!) but felt so sick I never wanted to eat. I called it Nature’s cruel joke. The school year ended when I was five and a half months pregnant and Punkin and I spent the summer lounging in my room in full-blast air conditioning but when the school year started I went back to work (36 weeks!). My substitute had not been hired yet so I called up some of my former students to help me unpack my classroom (my room had been moved) and set everything up since I couldn’t exactly lift boxes full of books! My induction was already scheduled for 38 weeks, two weeks into the school year and one week after my husband started his new job an hour away. We chose to induce for two main reasons: 1) to be able to plan and coordinate with our employers for time off and 2) to ensure that the babies were small enough that the doctors would be sure to allow a vaginal delivery.
The last two weeks of the pregnancy spent at work were actually the best two weeks! I dont’ know if it was because I was keeping busy, training my substitute and helping her get organized or if it was because the end was in sight but I felt GREAT! I had some hope of going into labor naturally before my induction date but by that point didn’t really expect anything. My body was just meant to carry twins (side note: I’d really like to see statistics on natural conception vs. medicalized conception and how it correlates to gestational age and fetal health, I hypothesize that the natural conceptions end with healthier/older babies compared with the medicalized conceptions). I said goodbye to my students on Friday and prepared for a trip to the hospital on Sunday.
The beginning of the induction was pretty boring. We waited around a few hours before the doctor came in to insert the cervical ripening medicine even though he’s the one who set our arrival time (apparently he wasn’t even at the hospital, why did he have us come in so early then?). Christian went home after the first few hours of the medication because nothing was happening and when I was induced with Punkin nothing happened until pitocin anyway. So Chris went home to be with Punkin (my mom was there too with my mother-in-law on call) and get a good nights sleep. The next morning Punkin went to daycare and my mom and Christian came to keep me company. The pitocin was administered and contractions started in earnest around noon. They were regular and were getting painful later in the afternoon but I waited for the epidural until after I saw Punkin (I didn’t want him to come while they were administering the epidural). With Punkin I didn’t want an epidural and even though it ended up being a good experience I didn’t relish the idea of getting an epidural this delivery either. However, I had gotten vibes from many of the doctors at the practice that they would be very nervous “letting” me deliver without one. The fear is, of course, that they will have to do an emergency c-section and because I wasn’t anesthetized already they would have to knock me out in order to operate. One of the doctors actually said he’d need me to deliver in the OR instead of a delivery room (they are about a minutes walk apart) just because it was twins. So I quickly made the concession to have an epidural. I didn’t really feel like I needed one when we finally decided it was time, the nurses even asked my sister if I knew I was having contractions as I chatted away to my mom. I explained I was just trying to ignore them but I certainly knew they were there. She was surprised because they were registering as “strong” on the fetal monitor. Ha! They were nothing compared to the pain before I got the epidural during Punkin’s labor!
An epidural is a tube inserted into the spine to deliver medication directly into the spinal fluid. The anesthesiologist threads a tube through a needle. You have to curl around your belly to spread your vertebrae. I had a blood pressure cuff on me that was automatically filling and emptying every two minutes or so at the EXACT same time I was experiencing contractions! I asked if they could take it off but they said no (I dont’ remember having one when I had an epidural with Punkin). I wasn’t ready when the anesthesiologist stuck me, I was having a VERY hard time curling around my ginormous belly! He didn’t quite get it in right at first and had to stick me twice. I still felt like he wasn’t letting me get ready and I was incredibly uncomfortable and kinda angry at the lack of communication.
Sigh of relief. There wasn’t much to do after that but wait. Laying on my back in the hospital bed with my sister, mother and husband chatting around me I just tried to relax. I put my feet together and let me knees hang open because I felt like I was at least doing something to help my babies move down. We were having a good time (seriously, we enjoy waiting for babies). I began to feel like I needed to poop (I’d already peed ALL OVER the doctor when she was checking me, everyone thought it was my water breaking!). I mentioned this to my mom and asked her to get a nurse, her response was, “Oh just do it, no one cares!” She did go get the nurse because I really wanted someone to be there to clean it up! The nurse came in to check me and BUMP there was the first baby’s head! I saw her expression and she scampered out to get the doctor ASAP. I could have had the baby out before she got back but I waited patiently. Three pushes later my little Twinkle Toes was born, 6lbs 11oz, 19 inches long. I snuggled her on my chest for a moment before handing her over to my husband and sister who proceeded to fool around with her making her “talk” and probably traumatizing her for life.
Meanwhile, about 10 people had filled the room with equipment and bodies (thank goodness it was a big room!). An ultrasound machine was brought over so we could check the position of Baby B. I could feel where she was, her sister had been born and I think she got scared. She was curled up tight under my right breast, far away from the exit and breech! A second (older) doctor was brought in to assist in the attempt to turn the baby around. The older doctor had one hand on the ultrasound wand and one hand on my belly, my doctor had one hand up inside me (thank you epidural!) and the other on my belly. Together they worked for about 15 minutes, unsuccessfully, to turn her. Then came the most crucial and memorable moment of this entire birth story: My doctor looked at me from her position between my knees and gave me my options. “We can go ahead and attempt to deliver the baby breech or–” I interrupted her, “I do not want a c-section,” I said firmly. Her reply, “Okay then.”
Later on I realized how incredibly lucky I was to have that particular doctor on call at the time of my delivery. A few hours earlier or a day later and things could have gone VERY differently for me. Most doctors never even SEE a vaginal breech delivery let alone take the time to get the extra training needed (at my 6-week appt I thanked her for “allowing” me to deliver that way and she in turn thanked me for acknowledging it because she did take the time to get extra training for it). But luck was on my side that night so we prepared for a breech delivery. We waited for about 30 more minutes for contractions to pick up and for the baby to move down (contractions slow down after the first twin is born, probably natures way of giving mom a break and time to nurse and bond with her first baby). I can vividly remember my view, looking down across my somewhat deflated belly, watching the doctor who was calmly staring at my vagina! More than once during this time a nurse came in to urgently tell her something and she dismissed them calmly. She was 100% with ME. Again, I am reminded of how lucky I was to have her as my doctor that night. After about a half hour it was time to push. This was not as easy as I’d hoped. Twinkle Toes had basically fallen out of me but Pinky was doing things her own way, and her own way was not going to be easy for me! I pushed and I pushed HARD but getting a butt and folded knees out is a lot more difficult than a head attached to a body curling up and out. I pushed for less than 20 minutes total but those moments seemed interminable at the time. I remember looking up at one point and seeing my husband and mother take a sudden step back. Apparently Baby B’s amniotic sack was still unbroken and bulging out as I pushed. They didn’t want to get splashed! I remember saying, “I CAN’T DO THIS” as I pushed because the nurse kept saying, “Yes, you can!” in response. It was annoying me so much I changed my chant to, “GET OUT!!!” And finally she did.
My recollection is that she shot out of me and the doctor was lucky to catch her, although I’m pretty sure it wasn’t quite that dramatic. The doctor did say, “Did the placenta come out?” only to glance down and say, “Oh, there it is!” I only caught a glimpse of it but it was huge and beautifully bright red. I remember thinking how HUGE it was (it was actually two separate placentas fused together). They cleaned her off, my full-head-of-hair Pinky, 6lbs 9oz, 19.5 inches long, I sat up with my cool twin nursing pillow and prepared to breastfeed them for the first time. I had been looking forward to that moment since Punkin weaned almost two years earlier. I felt so powerful and proud at that moment. Not only had I delivered twins vaginally but one of them had been breech. I felt like I could jump up and run around the entire hospital– I felt invincible!
Then I felt something else…
A knot of pain started at the nape of my neck. It was a dull ache and I asked my sister to massage it. The twins were nursing so I tried to ignore it, I thought I’d just pulled something during labor. The girls were great nursers already (yay!) and after a few minutes were done (babies don’t nurse for long stretches of time at first when they are getting colostrum, once the milk comes in that changes). We lowered the bed and I eased myself back down onto my back when suddenly I realized the pain was gone. I knew immediately what had happened. I had a spinal headache. Fuck.
My biggest fear about having an epidural was getting a spinal headache where the spinal fluid leaks out of a puncture in your spinal column (caused by the epidural needle) causing the brain to sit directly on the skull instead of suspended in a bath of fluid. After having a great epidural experience with Punkin I wasn’t really worried for a second epidural… but it was so horrendous I’m having a hard time even writing about it two years later. The next few days were a pain-filled blur. The twins were born at 9 and 10 at night and the next morning I was officially diagnosed with a spinal headache. The solution was to do a spinal patch which is a large vial of your own blood drawn and immediately injected into the spinal column. The blood then clots, sealing the hole, allowing the spinal fluid to regenerate without leaking away. That was the worst experience. The pain of just moving onto my side so they could access my back was excruciating. I cried while they drew my blood and injected it, I couldn’t even open my eyes to look into the eyes of the nurse who was holding my hand and telling me I’d be okay. I ended up having really painful tingling all up and down the right side of my body for the remainder of the day which the anesthesiologist who came to see me said he’d never heard of before. I cried then too because I began imagining my entire life spent in this searing pain. The anesthesiologist was not very sympathetic, in fact he was a twin and he told me how much he hated it (and it brother). Gee, thanks.
The pain did finally ease and that night I spent virtually pain-free. The next day, Wednesday, we waited until late afternoon waiting to see if Twinkle Toes would be discharged (her bilirubin numbers were high, even though she’d spent some time under the bili lights). We were able to go home with orders to return the next morning for a bili check. That night I struggled to get myself comfortable in my own bed, sitting up with my back against the headboard to nurse the girls. As I scooted backwards I thought I felt a pop but I was so tired I dismissed it as my imagination. The next morning I knew what it was, my spinal clot had popped out and my spinal fluid was again leaking out. I don’t remember anyone ever telling me to be careful to avoid things like sneezing or sudden moves… My spinal headache was back again, full force. Thursday Christian brought Twinkle Toes back to the hospital by himself (I nursed her right before he left) to get her blood work done while I lay horizontal on the couch with Pinky. It turned out that Twinkle Toes needed to go back to the hospital to spend a night under the lights.
The timeline is a little fuzzy here but we ended up back at the hospital for a day and a night. They told me they could leave her in the nursery and sit in the chair with her… and I looked at them like they were insane. I couldnt’ remain vertical and function because of the pain and I refused to leave her. “I’m nursing her and her twin sister,” I told them. If I was going to keep her at the hospital then they were going to have to find a way to get me a bed too. They ended up putting us in a former closet that was going to be converted to a family visit room (for parents of babies in the NICU) but was just a painted closet with no ventilation. They wheeled in a bed for me, an isolette for Pinky and a bili-box for Twinkle Toes. They eventually brought us a fan we put in the doorway and a divider we placed in the hall that gave us some air and semblance of privacy. We went home more than 24 hours later with instructions to come back again for more bloodwork. Thankfully the girls were given the all clear by Sunday morning. That same day I spoke with a very kind anesthesiologist about my headache. He told me that he’d almost never heard of a headache lasting more than a week and got me on the right medication (oh, I forgot to mention the “cure” for the headache is caffeine so I was feeding my brand new twin babies caffeine their entire first week of life!) and told me that if I was his wife or sister he’d advise me to just wait it out rather than go back for another spinal patch. About 24 hours after that (at almost a week to the hour) the headache started to fade.
At this point, of course, my husband had to return to work and the real challenge of caring for these two beautiful (and needy!) babies on my own began! (visit my other blog for stories about the insanity in the first year!)