Wednesday, 26 July 2017

Wednesday September 7th, 36 weeks. I had just finished the bedtime routine for Wes and Clara. I come downstairs by around 9pm and the moment I’m not taking care of the big kids, I realize what’s been going on with my body. I notice wave like contractions that seem to be pretty frequent, at least 10 minutes apart. I go into the kitchen to tell Adam who is just finishing up his fantasy football draft (convenient timing.) His response was “Are you serious?” We had focused so much on making it to 37 weeks as our goal for our home birth. 36 weeks is considered “late pre-term” 37 weeks is considered “full term.” That would have given us the confidence that they wouldn’t need much or any support when born. But, here we were with contractions at 36 weeks. “Crap” I thought. I called Jill, our home birth midwife. She said she’d get her things together and would come over to check me. The contractions were still mild enough that I didn’t need to manage them, but they were frequent. I had a feeling we were officially in labor.

Jill arrived around 10pm. She checked me for dilation and said with a frown “Oh, Amy, you’re five centimeters.” “Crap” again. At that moment, my plan for another beautiful home birth went out the window. Once again, we all discussed the reasons for going into the hospital before 37 weeks and felt that it was the safest and smartest decision. Adam and I trust Jill completely and if her protocol is 37 weeks, then we were 100% on board with that. So, on my 3rd birth, I pack a hospital bag for the 1st time. Adam looked at my bag and didn’t think I had enough. I laughed because I wasn’t really concerned. This was all a new experience. I grabbed my toiletries and some of my Earth Mama Angel Baby products, a change of clothes for me and two sets of clothes for the babies and that was about it. Oh, and some snacks. I knew I’d need something to eat, even if I had to sneak it! I quickly grabbed some dates and crackers. We called my mom and told her labor had begun and we needed to make our way to the hospital. She was thrilled to hear she was going to meet her two newest grandbabies soon! Mom came over to stay with the older kids and we headed to the hospital.

I was having regular contractions while driving over and every little bump in the road felt magnified. Laboring in the car is far from comfortable. Adam put on the radio and I could not handle any music or added distraction at the moment so I turned it off. This was a big sign to me that things were definitely kicking into gear. We only live about 7 minutes from the hospital. When we arrived, it was very quiet. We had to search around the corner from the main lobby to find someone at a desk where we could check in. I got a wheelchair (another first) and they wheeled me back to triage where the nurse and doctor did an initial exam to establish where we were at.

It was 10:30pm and the doctor came in and introduced herself, I’ll call her Doc 1. She checked dilation and determined we were at 6 cm. Then she did an ultrasound to see babies positions. As we knew, Baby A was head down on my left side. (Such a good little baby who was in that position for the final half of our pregnancy. I had meditated on that big time!) Baby B was breech and apparently laying on top of A also on the left side of my body. Not sure why B would choose this position when there was plenty of space on the right side! Throughout the pregnancy, B was either transverse or breech, never head down that I was aware. So, I wasn’t surprised that B was presenting breech right now. Doc 1 looked at me and very casually said, “Well, B is breech, so you’ll have to have a c-section.” We were shocked and all paused for a moment. In my head I was thinking “Seriously?!” Instead I replied, “But, there’s a chance that B could flip once A is out of the way. We have no emergency right now, I want to labor and give my body and my babies a chance at this.” The doctor seemed surprised. It was almost as if she had never considered the fact that B could possibly get in a better position for birth once A was born. I had hoped for a home birth, but even more than that, I had hoped and focused on and visualized a natural birth. I was determined to give this a shot. I deserved the right to at least try. After a little back and forth discussing the c-section, it almost seemed like the doctor was not going to let us try to labor. I was about to say “Then I’m going home. We’ll have our babies there.” Apparently, Jill was thinking the same thing. But finally, the doctor came in with a form for me to sign saying I was refusing the c-section at this point. Yes, I’ll gladly sign that. I just wanted to get up to my room so that I could labor comfortably and get this show on the road. I agreed to them putting a saline lock in (this was a port for them to have access to attach an IV if it was necessary.) I said I did not want to hooked up to anything at this point. Again, I had no emergency, I simply wanted to labor. The saline lock was put in and covered so that I could labor in the tub. I refused continuous fetal monitoring and said I wanted intermittent monitoring of the babies heart rates. I knew this greatly reduced my risk of a false reading creating unnecessary alarm which can result in cesarean. The doctor gave me a list of risks she felt were valid, but I have read that intermittent fetal monitoring is just safe if not safer. I told her that I understand that risks she’s presenting to me, but that I still insist on intermittent monitoring. She agreed and said that babies would need monitored every 15 minutes. I said that would be fine. Doc 1 told me that she would come in to check dilation every hour and that towards the end of my labor I would have to transfer to the operating room to finish laboring. I agreed with her request to check my dilation, but transferring to the O.R. to finish laboring? Umm, no, that did not sound appealing at all. *whew, deep breath* Again, I had to stand my ground. I said that I did not want to leave my room, as long as we had no emergency, I wanted to stay here and birth my babies. I don’t know of any laboring woman who is at the end of her labor, in a very emotional and vulnerable state, who would want to transfer to a sterile, stark operating room. The environment is so important for the birthing woman to feel safe, comfortable and relaxed. To have to shift gears and transfer to a new space in that moment would have taken me out of my zone and might have even slowed labor down. I had to refuse. I signed another form saying I was not going to transfer to finish my labor in the O.R. as long as we continued to have a normal labor. I reiterated to the staff at least 3 or 4 times, “I trust my body, I trust my babies. I deserve the right to try.” What I wanted to do was shout, “We have no emergency here! Why are you approaching this perfectly normal pregnancy and perfectly normal labor with so much fear? We’re here in the hospital IF something were to happen, then we address it. Not a laundry list of ‘what if’s’ and red flags when there are no red flags at the moment. I knew I’d have to stand my ground and fight for the chance to have a natural birth, so I was prepared for this. I’m so grateful that I’ve done my research and felt confident in each answer I gave the doctor.

After all of those logistics out of the way, Doc 1 finally let us labor. Our nurse from triage actually ended up coming to the room with us after Jill asked her to. She seemed to “get it” from the beginning that we were committed to a natural delivery and we felt she’d help be our voice. We head up to the room and you know what this home birther was surprised about, I had a beautiful labor experience in the hospital. We dimmed the lights and put on calming music (mostly Enya. I play her music for all my births) and it was really lovely.

At this point it was after 11pm. Lynn our other midwife arrived for labor support as well. I was thrilled to have Adam, Jill and Lynn by my side. I labored in the bed and as contractions came and went, I tried to get a little rest in between. Since they were manageable enough that I didn't have to move too much, I took advantage of that and rested while I could. Next, we filled up the jacuzzi tub so that I could labor there. It was quite comfortable in the tub. The warm water helped my body relax. It eased the ache in my low back and helped labor progress. Our nurse allowed Jill to hold one of the dopplers to help check babies heart rates. Thankfully they could even do this while I was in the tub. Each time, we got strong healthy heart rates responding. I continued to feel encouraged.

After laboring in the tub for awhile we decided to change things up. We asked the nurse for their birth ball. Jill draped a towel over the ball and I sat on it doing hip circles. I know how beneficial movement is to encourage baby to move down so I wanted to keep moving or swaying however I could. There was more monitoring of babies heart rates, still nice and strong. This kept me encouraged that the three of us were doing just fine.

Contractions began to pick up and become more intense. As each wave would come and go, I reminded all the muscles in my body to relax even more. I kept my face relaxed and would close my eyes through the rise and fall of the wave that moved through me. A few mantras that I continued to repeat in my head were, “Each contraction brings baby one step closer.” “My babies and I are a perfect team.” “I have no fear.” “I welcome each contraction.” “My body was made for this.” “We are perfectly safe.” And a slow and steady, “Relax…..” When I laid on the bed again, sometimes Adam would sit by my head, sometimes Jill. Lynn massaged my back. I was beginning to feel more intensity in my low back. I knew that was a good thing. Her massage felt wonderful. This was one of those moments in my labor where I felt like a goddess. I felt so supported by my team. I felt safe, I was cared for and I had the utmost confidence in my body.

More time passed and Jill suggested I might want to try laboring in the shower. I hadn’t done that with either of my other babies. Of course I was willing to give it a shot. I tried sitting on the stool that was in the shower but it wasn’t very comfortable. So I stood and held onto the support bars when the contractions came and went. Then Jill brought in the birth ball. She propped that on the stool so that I could lean on it and sway my hips. That felt great. The warm water was hitting my low back and my upper body was draped over the ball. I remember the contractions feeling pretty intense here. After enjoying the warmth of the shower for awhile, I needed to get off my legs.

I dried off, and came back to the room. I draped my arms around Adam’s shoulders and let my body weight hang into his arms. I swayed my hips and we did this “slow dance” for a bit. I was trying all of the techniques I could remember to try and get this baby moving down. The nurse continued to check babies heart rates frequently, but the doctor only came in once to check dilation. She said she would come in every hour, but she didn’t. I realized how nice this was actually. We were pretty much left uninterrupted to simply labor. It was really lovely. The doctor was communicating with our nurse as to how I was doing. Our nurse relayed that we were fine and labor was progressing. Doc. 1 asked her if she thought I wanted anything to speed things up. At this point our nurse knew well enough to answer for me. No, I did not. She told me this and I chuckled. I was doing just fine. At around 5 am, Doc. 1 checked me and I was at 8 cm. I had hoped this labor might move along faster than my others, but I guess my body just labors slowly. I wasn’t discouraged though. I continued to trust my body and my babies.

I was feeling pretty tired at this point so I laid in bed to attempt to rest in between contractions. Surprisingly, I did doze off here and there. This little bit of rest felt good. Time continued to slowly tick away… Another vivid memory I have of our labor experience was opening my eyes as I lay on the bed and looking at Adam reclined on a chair and Jill and Lynn sitting patiently and quietly on the couch. Our music was still playing and the lights were still dim. The room felt sacred and beautiful. I had this overwhelming feeling of gratitude. I was so grateful I had the support of these three people around me throughout my labor. I could not imagine doing this with just Adam (sorry, honey) I was pleasantly surprised at how comfortable, safe and peaceful my labor felt. Days later I told Jill I felt like a goddess. I wanted her to know how grateful I was for her and Lynn’s support and patience in our labor process. Little did I know our beautiful labor scene was about to be very much “interrupted.”

At 7 a.m. we all noted that the new shift of doctors and nurses would be arriving soon. No one had arrived yet to introduce themselves, but we knew Doc. 1 who allowed us to labor very privately through the night was about to leave. I was feeling a little discouraged because I had anticipated labor progressing a little faster this time around. Slow and steady for me, I guess… I asked Jill if she had a suggestion for a new position or technique. She asked if I wanted to get back in the tub. I agreed and they filled the tub with fresh, warm water. As I made my way in, Lynn suggested I try getting into a squatting position in the tub during a contraction. Wow! Well, that certainly felt different! I could definitely feel a shift in baby’s positioning while squatting through contractions. It was a lot more intense and a little scary, but I continued to relax my muscles, repeat my mantras and trust. This squat suggestion from Lynn was her final gift to me to help move baby down.

7:30 a.m. Doc. 2 arrives and introduces himself. I’m laboring in the tub, Jill is sitting on the side of the tub next to me, Lynn is sitting on the couch and Adam in the chair. Doc. 2 asks how we’re doing, and probably says a few other things, but my exact recollection of this is a little hazy since I’m extremely close to pushing, even though I’m unaware of it at this point. This is what I vividly remember. Doc. 2 says he’s heard that Baby B was presenting breech. He continues to inform me that we must deliver B via cesarean if the baby remains breech. We will not be allowed to attempt a vaginal breech delivery. He says this very sternly with no room for discussion. I am shocked and heartbroken. We were under the impression that as long as Baby A was head down and came out first, we’d have a chance to deliver B vaginally. I had planned, the entire pregnancy, for the possibility of B being breech and was confident in Jill’s experience catching breech babies that we’d be ok. I knew that it would be a gamble as to which doctor we’d get whether or not we’d even be allowed to try. Well, apprarently, Doc. 2 was not the one. I took a moment and replied, “But what if I don’t agree to a cesarean.” To which he replied, “Then I will have to get a court order.” Stunned. We were all stunned. I put my head down and rested it on my arms as another contraction came and went. Part of me hoped that if I just ignored him, this wasn’t actually happening. I asked the doctor, “So you’re telling me that even if I do not agree to a cesarean, you will force me to have one?” He stood there with his arms crossed and replied, “Yes.” I could tell that he was uneasy relaying this news. It was almost as if he was the unlucky one who drew the short straw and had to come into the room to tell us this. Lynn asked very calmly and respectfully if he would explain his reasons why we couldn’t try for a vaginal breech delivery of B, after A had already “paved the way.” He replied saying that he felt it was just as dangerous as a singleton breech birth. I didn’t even know how to respond. I had read numerous birth stories of B being breech and sliding right out. I understand there are risks to breech birth, and I know that my home birth midwife does not have the privileges to catch my baby in the hospital, but I wanted to say, “No, I will not have a cesarean, Jill will catch my breech baby then.” She had experience in this and I trusted her just as much as she trusted me. Unfortunately, that would not work, especially not now as the tone in this morning crew had definitely changed. So, I cried. I had labored beautifully through the night, trusted my body, trusted the process and in the room walks fear, doubt and control from this person. I was so upset. I knew crying was a good release, so I allowed myself to feel it and let it move through me. Maybe it would help Baby A arrive soon.

I remained in the tub, continuing to move through contractions, continuing to attempt to ignore the fact that we were just threatened with a court order. Doc. 2 made it seem that this was hospital policy since we had no choice in the matter. I felt defeated and yet, still hopeful that just maybe, Baby B would flip head down. After this unpleasant meeting with Doc. 2, a representative from administration entered the room. She introduced herself and then very briskly said we are only allowed to have 2 people in the room with me, so someone had to leave immediately. Even though Doc. 1 allowed us to have 3 in the room all night with no issues what so ever. The representative continued by saying that I would have to move to the operating room for the remainder of my labor. I thought in my head, “You’ve got to be kidding me.” They escorted Lynn out of the room. Jill, Adam and I were in disbelief. The entire tone had changed from a trust filled, peaceful labor experience, to absolute fear from the doctors. I felt that they were grasping at everything they could to control this situation. Yet, I continued to have normal contractions, we had no issues with heart rates, everything was moving as smoothly as it could. We had absolutely no emergency and no cause for alarm. We were being completely respectful and reasonable and were not sure why the change in tenor. (*side note* I called the hospital weeks later and spoke to a different representative to ask if these were hospital policies. I was told there are not written hospital policies regarding a Baby B breech delivery and there is not a hospital policy for moving a laboring woman to the O.R. to complete her labor and birth. So why all the drama and threats? It felt like bullying.)

I think this was the last boost I needed. There were so many people in the room buzzing about, talking, deciding things without my consent. Then I got the sign I was waiting for, the urge to push. “YES!” I screamed silently in my head. After all of the fear that they were projecting, and the demands thrown at me, I knew without a doubt that I was not getting out of this tub, even if it was against hospital policy. I gave my first push, no one noticed except Jill. She looked at me and whispered quietly, “Are you breathing?” I nodded my head and through gritted teeth whispered back, “I’m pushing.” Jill simply laid her hand on my shoulder. With this first push, my water broke. I felt the little “pop” and thought, alright, we’re doing this! I waited for another urge to push and held the bars in the tub. I was kneeling and bearing down. This time the nurse noticed me and came over. She asked “Are you ok? Are you having the baby?” I nodded my head but kept my grip firm on the tub handles. She quickly and gently says, “Ok, we need to get you out of the tub. Very slowly and carefully, let’s get you out of the tub.” I shook my head and told her there was no way I could move. I reached down to see if I could feel a head, but I didn’t. “Crap! Come on, baby!!!” I thought. I gave a third push. In my head, I was cheering so loudly, “Come on, baby! Come on, baby! We can do this!” I was determined more than ever to birth my baby in my way. Push number 4 arrives, I grip the handles, and in one great and beautiful surge, Baby A slides out and into the water! That experience is one of the most incredible feelings in the world. I felt like a total warrior!

I reached down and lifted my baby out of the water myself (another life changing feeling!) and exclaimed, “The baby’s here!!!!” Immediately, at least 3 different people picked up a phone or other radio device and said urgently, “Baby in the tub!” “A baby was born in the tub!” It was as if, in the history of humankind a baby had never been born in the water, geesh! As I lifted my baby out, I didn’t even notice the sex. My husband came over and announced, “It’s a BOY!” I had a moment to hold my boy, then he cut the cord. Once they took baby over to examine him, they asked if I was able to carefully move to the bed. I knew we still had work to do. We needed Baby B in a much better position.

Labor 3 meeting GWith help, I slowly made my way to the bed. Doc. 2 did an ultrasound and Doc. 3 enters the room and introduces himself. From the ultrasound, it looks as if Baby B has slid down to a transverse (laying sideways) position. Not so good. “Damn” I thought, ok, let’s get this baby to flip. I asked what I could do. We tried a kneeling position and they raised the back of the bed so that I could rest my arms on that. Jill was behind me trying to gently coax baby into a better position. I was in this position for only a few minutes. During this time I glanced over and saw the nurses caring for my little Baby A. I asked how he was doing and they reassured me he was wonderful, 5 pounds 15 ounces and healthy. I was really proud of that birth weight! Then I brought my focus back to Baby B. I was praying over and over in my head, “Come on, B, you can do this. Head down. Head down.” Honestly, even if B flipped breech at this point, I was going to find some way to birth that baby vaginally. After trying for a few minutes, heart tones were checked and strong as can be (good job, little baby.) We decide to do another ultrasound. Still transverse, shoot. Now the Doc’s 2 & 3 ask me if they’d like me to have them try an external version, where they attempt to get baby to turn into a more desirable position. I quickly agreed, knowing there’s no possible way to vaginally birth a transverse baby. Doc 3, does an internal exam while Doc. 2 gently guides his hands on my belly. They’re working together and I feel like (finally) we’re all a team in this. They explain that they must be very careful not to disrupt the placenta. Doc. 3 tells me that he feels a hand and foot presenting first, like a pike position. That’s not good. After another few minutes at this, more heart tones are checked and my little baby’s heart rate is still rockin. But now, I communicate to the Doc’s that I feel contractions return. In my head I’m thinking, this is not a good thing. Very shortly after contractions return, I tell them that I’m feeling urges to push now. We all know this is not helpful for baby attempting to turn. The doctors look at me and kindly but strongly suggest that now would be the time for cesarean. Adam and Jill both look at me with fairly wide eyes and both nod their head saying, “Yes, we agree, Amy.” I felt that yes, now is the time to make this decision. Not 9 hours ago, with hypotheticals being thrown all around. I looked at the docs and agreed. “Yes, I accept this recommendation for cesarean now.” Even though, this was not what I had planned or hoped for, in the moment, this was the right decision. I felt like I was given the proper information and was a part of the decision making process versus, threatened into it. This was key and very important to me (as it should be to all laboring women.) As I look back on this process, I was very grateful that even though we did not see eye to eye in the beginning, once this baby flipped transverse and we needed to act, everyone was a team player. I never got the sense that the doctors were giving me any “I told you so” vibe. I truly believe that they wanted this baby to turn for me, but little B had other plans.

They began prepping for transfer to the operating room. I was able to see and hold my sweet Baby A. Adam asked if I wanted to name him yet, but I wanted to wait to meet his sibling. We were pretty sure these two were identical and we’d have another boy on the way soon, but I wanted to be sure. As they were getting things ready, I was holding back urges to push. That is a pretty uncomfortable sensation. Just before they wheeled me out, I asked if it would be possible to check baby’s position once more. The doctor very kind obliged. Still transverse (little bugger.) Ok, let’s do this….

As they wheeled my bed down the hall, I closed and covered my eyes. Everything felt bright and loud. Especially as we entered the O.R. I felt the need to even shade my eyes. I was mentally preparing and doing my best to accept this new turn of events. Things moved seamlessly here though. Each person on the team from anesthesiology to the nurses to the doctors took time to explain to me how things were going to go and what they were about to do. Again, I felt respected here and very cared for. I hunched forward, the epidural was placed in. In only a few seconds, my legs became numb and heavy. Such a crazy sensation. The team of nurses give a “one, two, three” and hoist me onto the operating table. They continue their preparation and Adam comes in to stand beside me. The nurses were so kind and checked in regularly to ask how I was feeling. Then they asked if I would like Baby A placed by my head? “Absolutely!” This helped calm my nerves. I breathed in my little boy, then looked at the ceiling as I continued to try and focus. Relax. Trust. I found a small screw that held a piece of ceiling tile in. That became my focal point. Just like in yoga, you can be in an extremely challenging pose, your gaze is focused and your breath is steady, then you realize you’ve been staring at a tiny speck on the floor. Nothing significant, but it held a great deal of power and strength for you. This little screw on the ceiling was my drishti, where I held my gaze.

Doc. 3 performed the surgery and Doc. 1 stayed late after her shift to assist. As Doc. 3 communicated that he was going to begin, I surrendered to our birth and began to feel the tugging sensation he described. Thankfully, I felt nothing more than tugging and pressure, nothing painful. The process took longer than I expected. I’m not sure exactly how much time went by. I snuggled Baby A, asked Adam how things were looking, stared at the screw in the ceiling. I told the nurse when I was feeling nauseous, she brought over something for me to inhale. I took some slow and steady breaths and that eased the nausea. Then, minutes later, I hear Adam announce, “I see a penis!” Haha, thanks, Daddy! Doc. 1 brings Baby B up. I’m still staring at the screw in the ceiling. She lifts the flap on the screen they place between my head and belly, it’s like a plastic window now. Doc. 1 asks, “Do you want to give your son a kiss?” She brings Baby B to her side of the window and I kiss the other side. He’s crying and perfect.

Labor 4 birth of RAs I’m laying on the table, unable to move, I allow myself to cry. I was relieved my babies were here. Grateful they were both safe. Proud of myself for bringing A into the world on my own and proud of myself for birthing B with some help from the doctors and nurses. I cried because I was sad that my 4th and final baby was a cesarean, but had to trust that he needed to be born that way. I cried because birth is beautiful and powerful in all ways.

The nurses are checking Baby B and he is doing great. They announce that he’s a sturdy 6 pounds 8 ounces. Wow! I was impressed with A’s birth weight and I was pretty shocked to hear B was even heavier! I grew some super strong babies and could not have been prouder. We agreed that Baby A would be named George Brian and Baby B would be Rory John. Once surgery was complete, they brought me back to my labor and delivery room for about an hour of recovery before moving upstairs. I enjoyed skin to skin time with my angels. We tried nursing a little but they were mostly sleepy. Jill and Lynn both came in, at different times, to meet the boys. I thanked them for all of their support. Words can’t express my true gratitude for them. At 36 weeks and 1 day, both boys were developed enough that they did not need any time in the NICU. More gratitude!

labor 5 post birthThe weeks after the birth of my twins were filled with a great deal of emotions. I allowed myself to feel each one. I celebrated my body for all it went through to birth my babies, but I also mourned the fact that we did not get to experience the home birth I had so focused on and hoped for. One of the mantras I held onto throughout my pregnancy is “I accept and receive the path that is meant for me.” I continued to gently remind myself that this was our path. Instead of fighting it, I chose to accept it. That mantra gradually helped me heal emotionally from our birth.

Our path has brought 4 beautiful children into our lives. And now, with confidence and contentment, our family is complete.

4 kiddos

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