Normalizing Twin Births; Twins Born Naturally in the Hospital

by Mrs. BWF on February 4, 2012

*A few parts of Jess’ birth footage were used in part 3 of More Business of Being Born, so if you’ve seen that, you’ll see her!

Nothing about my pregnancy went according to plan. After nearly 13 years of marriage and completion of my clinical social work graduate program, we decided it was finally time for us to start thinking about a family. It took us about 6 months of trying before I figured out there was a problem with the luteal phase of my cycle that was making conception more difficult than it should be. But after about 8 weeks of weekly acupuncture, yoga, chiropractic, and dietary changes, we got that plus sign we’d been waiting for. (The day after starting my new job, incidentally). Part of me always knew I’d have twins and so when I began dreaming of twins in the 5th week of my pregnancy, I had a feeling then that something magical was happening. And when I would talk to “baby” in my tummy, my whole body said, “That’s not right”, so I always talked to “babies” instead, just in case…

Each time we had a midwife appointment, Mitch would ask, “Can you tell if there are two in there?” (Mitch and I have been together 14 years – long enough for him to know that my intuition isn’t just a fluke.) My best friend was pregnant at the same time, due the same day, and I was consistently bigger than her, and MUCH sicker than her. I remember one day shopping for maternity clothes together – the two of us standing in the dressing room and seeing how much bigger I was, telling her, “Look at my belly compared to yours. I think there are two babies in there.” In retrospect, I also started feeling movement around 12 weeks – like little ping pong balls bouncing around my belly – what my midwife referred to as an “early quickening”. So there were lots of signs backing up my intuition.

By the time our first ultrasound came around at 20 weeks, I told Mitch I was pretty sure they would find two babies. But I didn’t completely believe it yet – my heart knew it, but my head had not quite caught on. The sonographer put the wand down on my belly and two perfect circles appeared on the screen. She immediately removed the wand, looked at us, and said, “So, …um, is this your first ultrasound?” Thinking this was a standard question, I told her that it was. “Ah,” she said. She put the wand back down and said, “Because here’s a head, and here’s baby number two’s head.” Mitch immediately started laughing and I screamed and said, “I knew it!” The only place my intuition was off was that I had dreamed of one boy and one girl. Instead, there were clearly two sweet identical little boys in there.

Our first glimpse of the babies! Two beautiful heads…

twins sonogram

This was the first of many changes to how I imagined my birth would go. I’d been planning a home birth or a birth center birth and had been getting my care through a local birth center. My midwife offered to do a home birth for us since they could not birth twins at the center due to their license. (No twins, no breech). I did some serious soul-searching and intuited that these babies were not meant to be born at home. So my midwife recommended an amazing OB in just over the border in Wisconsin. Kind of a drive, but totally worth it. Dr. H is more midwifey than many midwives I’ve met, and I felt totally calmed to be working with him. He had a lot of experience with twins and is regarded as a local expert on vaginal breech delivery – something that is fairly common with twins. “Breech is a perfectly valid way to come into the world,” he told me. I have never been afraid of a drug-free natural childbirth, but the idea of a hospital birth has always scared me. Dr. H and this small community hospital were as close to a birth center as I would get this time around, and I knew it was the right place to get my care.

We certainly experienced some major “twinshock” – I spent the day after our ultrasound alternately laughing hysterically and crying hysterically. But once the news sunk in, we began to realize what an amazing miracle was taking place. Feeling the boys grow and move in my belly over the next few months was something I’ll never forget. As the months went by, I got bigger and bigger. I was measuring 40 weeks by 28 weeks pregnant, so… fun.

One of my final belly pictures, at 34 weeks…

pregnant with twins

Fast-forward to 34 weeks: I’d been feeling restless the past few days. I’d gotten up at 2 in the morning and taken a shower one night because I just…had to. Mitch later told me that the late-night shower was when he started to think that the babies would be coming sooner than we thought – I’d never done anything like that. On a Thursday, I took a nap on the couch and woke up to a feeling that wasn’t quite right. Turns out I’d lost my mucus plug. I saw Dr. H the next day and he said not to worry – losing the mucus plug was a “nonspecific” sign. For the next few days, I started passing mucus regularly. Again, not necessarily anything to be concerned about. Still, we scheduled our second meeting with our doulas for that Monday just in case we were closer to the big show than we’d thought. Tuesday morning, I woke up with another feeling that a change had happened and found that I’d had some bloody show. We drove in to the L&D unit at our hospital and they put me on the fetal monitors, found that both babies looked good and saw that I was having some mild Braxton-Hicks contractions (which I’d been having since about 20 weeks). I was 80% effaced and just 1 cm dilated, (normal for twins) so they again weren’t worried.

That night, some friends came over for a visit. In retrospect, I was having a low “restless” backache, and some crampiness in my thighs, but I chalked it up to the fact that I’d been laying on that hospital bed all day. I was in denial that I would go anything less than 40 weeks, so why would I think that labor would begin any time soon?

1:45 am, Wednesday 1/12/11: I was asleep and heard/felt a slight “pop!” and felt what seemed like a tidal wave of amniotic fluid rush out. (Good thing we’d just put the waterproof mattress pad down). Our joke now is that Mitch and half our bedroom furniture went rushing down the hall on the gigantic wave of amniotic fluid. Mitch woke to me saying, “Oh shit oh shit oh shit oh shit.” There was no mistaking what had just happened and it was too early. Just as Mitch asked me what was wrong, he started getting drenched and realized what was going on.

Because I was 34 and 6/7 weeks, it meant we couldn’t have the delivery at our Wisconsin hospital that we’d wanted, but my wonderful OB could catch our babies at a local hospital in the Twin Cities (ha!) with a NICU attached. Already one of my biggest labor fears was being realized: I’d be delivering in the most medicalized possible environment. Quite the change from my initial dream of a water birth at home. But I knew it was best for my early boys.

We called one of our doulas, who told me to take a shower, have a little meal, and take some time to breathe and reflect on the fact that my babies were coming today. This really helped me calm down and feel more centered. I’m so glad I took that time.

Mitch printed out my birth plan, put my labor playlist on my iPod, and made me some oatmeal. I sat on the couch and cried some tears – both happy and scared, and listened to a favorite song from my labor playlist, Djorolen, by Bela Fleck and Oumou Sangare. I hummed quietly to my boys and connected with them, and let them know that it was okay that they decided to come earthside today. I didn’t remember it at the time but the translation of the lyrics to this song are, “The worried songbird cries out in the forest. Her thoughts go far away. For those of us who have no parents, her thoughts go to them.” Looking back, this was a spiritual moment. At that moment, I was that worried songbird whose thoughts were far away. I felt worried, lost, happy, excited, calm – all at the same time. But from that moment on, there was no fear. I knew somehow that it would all be okay, that I would push both these babies out of my vagina with little problem, that my body knew how to do what needed to be done that day.

About two hours from when my water broke, we were on our way to the hospital. By the time I got to there at 4 AM (on all fours in the backseat, which felt GREAT), I’d begun having some mild contractions – nothing worse than period cramps. Our doulas Sarah and Amber met us in our labor room and we met Lori, our nurse for the day. Much to my pleasant surprise, she was totally accommodating of my natural birth plan – not wanting pain meds, epidural, or continuous fetal monitoring, etc. It really was the luck of the draw because depending on the nurse, she could have required continuous fetal monitoring due to hospital twin policy. The nurse checked me and I was dilated to 4 cm. I couldn’t believe it – I’d barely felt a thing at that point.

I spent the morning in the early labor phase doing lots of hip circles on the birth ball, doing squats and lunges, and yoga led by Sarah. This was where I was sooooo glad I’d gone to prenatal yoga classes during my pregnancy. I felt so strong and powerful. I was able to moan through contractions and recover my sense of humor and ability to converse between contractions. Both my doulas and Mitch had their hands on me almost all the time, which was exactly what I wanted – I felt so supported. I had my labor play list playing which was also tremendously comforting – it helped the sterile hospital space feel more like home.

Sometime around 10 or 11am, a distinct shift in my labor occurred. We’d taken a class at the Childbirth Collective called “The Natural Rhythm of Labor” where the teacher, an experienced doula, acted out the stages of labor in a very realistic manner. This proved to be one of the most helpful things throughout my labor because I sort of knew based on how I was acting where I was in the labor, and that how I was behaving was normal. Once I felt this shift, I knew we’d moved to the next level. I was beginning to feel tremendous downward pressure in my bottom and a need to bear down. The contractions were intense and I could no longer talk between them. I was less able to be present with my low moaning and tensed up quite a bit. Again, my doulas and Mitch were amazing in helping me to relax as best I could. Because of the urge to bear down, my favorite place for the rest of my labor was on the toilet in the dark bathroom. I spent some time in the tub, but it wasn’t very deep and didn’t provide the relief I’d hoped it would. While I was in the tub, our nurse checked me again and even though I was sure I must be at about 28 centimeters at that point, I was at 6.

We went back to the labor room and this was when I was beginning to tell my support team, “You guys, I don’t think I can do this anymore.” Again, I remembered from the Childbirth Collective class that this was a good sign because it meant I was getting closer to the end. “You ARE doing this!”, my support team reminded me. Eventually I began begging for an epidural – supposedly another sign that things were progressing. Sarah, Amber, and Mitch knew I didn’t want the epidural so they helped me through more contractions. All the while, I was begging and saying I couldn’t do this anymore. I was so exhausted – I couldn’t understand why they wouldn’t just let me lay down in the bed! It was hard not to tense up so much, but Amber helped me do a low roar through my contractions. I also threw up several times at this point – I again remembered from our Lamaze class that this was a “good sign”. Even deep in laborland, I was somehow able to remember that barfing was often an indicator of transition.

Amber and Mitch, helping me through a contraction…

husband and doula

The nurse checked me again because I was doing so much grunting in my contractions that she felt sure I was ready to push. She discovered that I was still at 6 cm, had a slight fever, and that my cervix was beginning to swell from all the downward pressure over the hours. Sarah and Amber had me switch my breathing technique so that I wouldn’t bear down so much, but it was nearly impossible not to. The nurse said, “Okay, I know you don’t want an epidural, but I think we need to do something to take the swelling out of your cervix.” There was part of me that wanted to look at my labor support team and say, “See!? I won! Epidural!” Even though I didn’t want it, the idea of relieving the intense pressure of the contractions had taken over. The anesthesiologist came in and as he was prepping me, he said, “I see you have some acne on your back. That can increase the potential for infection which can lead to paralysis and death.” I was like, “Yep, paralysis, death, got it. Sounds good. Let’s get that epidural now, please!”

After the epidural was placed, it took only about 10 minutes to realize that I was one of the small percentage of women the anesthesiologist mentioned for whom epidurals don’t work. The intensity of the contractions had only increased and I had full feeling and movement from the tips of my toes to the top of my head. I could have stood up and tap-danced, no problem. (If I knew how to tap-dance). Sarah and Amber sent Mitch to go get something to eat thinking that we’d have some time now that the epidural was in. Wrong – nurse checked me again since I was still bearing down and clearly feeling the increasing intensity of each contraction. In retrospect, this was the final part of transition.

25 minutes after my non-functioning epidural was placed, I had gone from 6 cm to 10 cm! Sarah called Mitch and told him to get back upstairs quickly. The nurse got scrubs for everyone (Twins automatically have to be delivered in the OR at most hospitals. Lame.). And even though I was in a deep internal place, I knew we were at the end and the birth was near. I have never felt so fully in my body in my life – it was the most profound physical experience I’ll ever have. Sarah told me it would be okay if I started doing some little pushes when my body felt like it. My OB was on his way from Wisconsin (at about 4pm – rush hour!) and I could tell the nurse was beginning to get a little nervous that she was going to have to catch these babies. Luckily, we rolled past Dr. H as they were wheeling me to the OR. Seeing him smile was very reassuring.

There were about 15 people in the OR – a team of NICU nurses for each baby plus the NICU resuscitation team, and some nurses for me. Mitch was at one side, my nurse at the other, and Sarah was at my head. Amber was videotaping. Side note: I’m SO glad my delivery was videotaped. I tell everyone to video their birth if possible. It was very healing for me to be able to watch what I did during the birth of my sons. It was tremendously empowering to be able to see the whole experience from a different vantage point. In the time since the birth, I’ve watched the video literally 50 times, and I will show it to anyone who will watch it so they know the amazing things I am capable of. UPS guy? Thanks for the package, want to watch when I pushed two babies out of my vagina without the aid of any pain medication?

So anyway, pushing. I didn’t realize how much pushing a baby out feels like the exact same sensation as pooping. My pushing wasn’t super productive at first, but once Sarah started telling me to push into my bottom, it made all the difference. No wonder I’d wanted to sit on the toilet for the last several hours. At one point, I reached down and felt my little baby A’s head as I was pushing. That really helped me focus as well – there really and truly was a baby coming out of me! All this pushing wasn’t for nothing!

I was in such a deep internal place – a place I’ve never been before. Most everything just melted away and I had a singular focus that I wasn’t in control of. It was as if my body was pushing, rather than me pushing. I was aware of Sarah at my ear. I was aware of Dr. H’s gentle encouragement. I was certainly aware of the intensity of the physical sensation. What I was most aware of, though, was my sweet Mitch at my left side. With each push I could hear his words of excitement, telling me I was amazing and telling me how each push got us a little closer to the end. I could hear the smile in his voice. I could tell he could see the progress I was making – the first baby’s head making more and more of an appearance with each push. I didn’t hear a trace of worry in his voice – only joy and amazement, and that more than anything got me through.

After what felt like an eternity, but what was actually less than 40 minutes, Oskar Jeffrey was born at 5:09 pm. O had a tough time at first – he was gray and floppy and did not cry for quite some time. They whisked him off to the NICU team as soon as Mitch cut the cord. Mitch went to Oskar and Sarah told me to talk to him so he could hear my voice. He had to be incubated because he was having trouble breathing on his own. But Sarah told me, “Jess, if they were really worried about him, they’d have taken him out of here by now. He’s going to be okay.” I don’t know if that was true, but it calmed me down. Even as she was saying that, I could see that he was pinking up, much to my relief.

No sooner had she said that than I began to feel the urge to push again. I’d sort of forgotten that I had another baby in me. I heard Dr. H say, “There’s another bag of waters” and as he was saying that, my second bag of waters broke. When that happened, I heard him say, “And there’s a head!” Those were some of the sweetest words I’ve ever heard. My second little boy, who’d been breech the whole time in utero, had somehow managed to turn after his brother was born. I was honestly thinking, “I don’t know how I’m going to do this a second time.” But one contraction and about 3 pushes later, Henry Christopher entered the world at 5:13pm, wriggling and crying. I barely felt him come out. They were able to put him on my chest for about 15 seconds and it was amazing – the biggest high of my life. I cried out, “Baby, baby, baby, baby, sweet baby! I’m your mom!” I felt an almost primal urge to lick him, and I wanted to kiss him nonstop. But he had to be intubated as well, so he was taken off pretty quickly also. I didn’t even notice delivering the enormous placenta that my boys had shared over the last nine months.

Meanwhile they’d stabilized the boys and were able to bring them to me briefly before transporting them to the NICU. I couldn’t believe how much I loved them. It was scary seeing them with their ventilators in, but I had the feeling that everything would be alright. I knew they were in good hands. Something in me knew they would be okay.

I was on such a high after the delivery. They wheeled me back to my room and right away I asked for the room service menu. I ordered grilled cheese and chocolate pudding and nothing ever tasted so good. Mitch was shocked to hear me say, “You know, that wasn’t so bad. I’m really already starting to forget how much that hurt!” About an hour after that, I started to feel like I’d been put through the ringer, and was so so anxious to go see my boys. It was such a strange and empty feeling to have given birth so triumphantly but to be without my babies.

The first picture of the four of us, in the NICU at Children’s…

twin boys

When it was all said and done, even though almost nothing went according to plan, it worked out exactly like it was supposed to. I had what can only be described as an amazing, magical labor and delivery. Because of my experience, I also feel strongly that beautiful, sacred, soulful birth can happen anywhere: I have had two truly transcendent experiences in my life, and one of them occurred in a brightly lit, sterile OR, on my back, in stirrups, with a literal crowd of people looking on. I felt every second of each passing sensation and now I wouldn’t have wanted it any other way. I ended up getting my natural childbirth after all, and I’m really glad now that the epidural didn’t work.

In the difficult days after the birth when my boys spent a few weeks growing and getting stronger in the NICU, I thought over and over about how strong and amazing and powerful I was during their birth. If I was capable of that, I am capable of anything. One of my best friends told me later, “You’ll never get tired of telling that story as long as you live. It’s an amazing thing that you did and you should never forget that.” We are now approaching my boys’ first birthday and hardly a day has gone by that I don’t think about the day that I gave birth to them. I’ve often heard the saying that when a baby is born, so is a mother. This has held true for me – I feel like when my boys were born, I was reborn. I’ve spent most of my life feeling like I was not a strong person, but after birthing my babies I know that I have strength I never knew I had. I’ve since become a doula and I always tell my mamas, “You have no idea how strong you are.”

So to whoever reads this, please know that twin birth can be just as normal as singleton birth. It’s a bummer that as twin mamas we have to fight that much harder for our births, but we can still have the birth we envision for ourselves and our babies. My advice from my experience is to hire a doula (or two!), and find a care provider who is experienced with both twins and breech vaginal deliveries. If you have a good birthing team in place, you can focus on birthing those beautiful babies without all the extra worry. If you are expecting twins you are not automatically a high-risk ticking time bomb. Twin birth is just a variation on normal birth, period.

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