A few days after finding out I was having twins, I began mourning the loss of my birth experience. Dramatic? Probably. But as a Doula and at the time, prospective, Childbirth Educator, and someone who’s frankly quite terrified of needles, I knew that medication, needles, scalpels and augmentation were not for me.
Coming to terms with the possibility that my birth was most likely going to be filled with things I didn’t want was very difficult. I agonized, cried and had panic attacks over it for weeks. After seeking the advice of other doulas and doing some serious soul searching, I finally started to feel peace about the possible ways I would birth these babies. However, I was very prepared to make informed decisions and fight for what I wanted and needed during my birth experience.
I knew that in order to have a birth that somewhat resembled the ideal I had envisioned, I would need to have a doctor who was ok and on board with at least some of my desires. Home birth was not an option for me so I chose a practice I was familiar with through both personal experience, and experience as a doula, who I knew would give me the best chance at a vaginal birth of twins in the area. That being said, out of the four doctors in the practice, only two were ok with the fact that I didn’t want an epidural or even want the catheter placed but only one of those two was ok with doing a breech extraction if needed, should baby B turn breech after baby A was born. While I knew I could make the decision to refuse any procedure, I also knew it was probably going to be an uphill journey and one I wasn’t sure I was strong enough to climb.
On the day I went into labor (around 34/35 weeks gestation), the doctor who didn’t mind if I refused the epidural but wouldn’t deliver a breech baby B was on call, but I felt at ease. We arrived at the hospital when I was 5 cm and 100% effaced. Within an hour, I had progressed to 6 cm and was hardly uncomfortable, despite the air conditioner in L&D being broken, and it being 82 degrees in my room. The rest of the labor progressed quickly, with minimal discomfort, and without any mention of pain meds, or epidurals from the nurses and the doctor.
At 9cm I was not feeling the typical transition-like contractions I had felt with my previous 2 labors and wasn’t quite sure what was happening with my body. I had prepared for something so much more intense! I had also prepared to defend my choices with the medical staff every step of the way, but none of that was necessary as they were in awe that I was completely in control of my contractions and pain management, and was willing to listen to and think about the choices I was presented with and decisions I had to make.
There were a few things I did agree to and ask for after making conscious and educated decisions, but they were MY decisions. I did ask for a bag of fluids when I arrived at the hospital, so I had an IV and I did ask for pitocin to be turned on during pushing if it was needed. Staying in the labor room to birth my babies was not an option because of hospital policy, but I was ok with that and we did move to the operating room at 9cm. Though it wasn’t a climate controlled, dimmed room, I was able to maintain my focus and feel at peace with being there.
Immediately after being checked and found “complete” I felt the urge to push, and 5 pound 13 ounce Baby A was born after a few pushes, 5 hours after arriving at the hospital. Not one nurse counted or yelled or told me how to push, which was exactly what I had asked for.
When Baby A was born I remember thinking she was tiny and had a great cry, but I didn’t get to actually see her face. She was passed to my nurse who started checking her over, who then had to passed her to the NICU nurses because the doctor needed her help. Baby B had flipped transverse as soon as her sister was born and she did it fast too.
Everything I had read about twin births said that the worst pain you would ever feel would take place if you had to have a version during labor without an epidural. And there I was, facing a version without an epidural. When I made the decision not to have an epidural I was very much aware of the possibility of the pain but I figured I would rather endure 5-10 minutes of intense pain than all of the risks and side effects associated with an epidural through a labor.
Somewhere between both the doctor and me “talking” to Baby B and begging her to turn and the doctor and nurses beginning the version, I went into a trance like state. I didn’t feel pain, just a lot of pressure. I spent the last minutes of labor fully aware of everything that was happening, but It felt like it was happening to someone else and I was just watching.
During the version there were about 5 hands on my belly, some holding the space where baby A had been, others turning baby B. They were able to turn her to be head down, but she then turned transverse again and her heart rate became rocky. The doctor decided it was best to do an internal version to try to get her into position to be born. He was holding the ultrasound transducer with one hand and internally moving the baby while trying to keep her cord from prolapsing with the other. He was able to move baby B into position to be born but then she moved her hands above her head. So we sat, and waited. Waited for her to move, waited for something, anything that would allow me to push for her birth. And we waited while the doctor still was holding her cord and her in place, internally.
After roughly 13 minutes of waiting, her heart rate plummeted and wasn’t showing any signs of recovering. She needed to be born right then, but that wasn’t going to be possible to do vaginally. I will never forget the look in the doctor’s eyes when he looked at me and told me he had to do a c-section. He knew how much I didn’t want one and how hard I had fought for this birth. I knew that he didn’t want to do a cesarean and had tried everything possible to get Baby B to be born vaginally. There just weren’t any other options.
Because I had chosen not to get an epidural I was going to go under general anesthesia, which I had never been under before. The anesthesiologist who was standing by quickly started preparing the anesthesia while the nurses were racing to put sensors on my chest. The pitocin was turned off, and the room was switched from a birthing room to a fully functioning operating room in less than 45 seconds.
Right before I was put under general anesthesia, the doctor saw on the ultrasound screen that Baby B had moved her hands, and yelled for me to push. And in the confusion and haste of the OR, I pushed twice and our feisty 5 pound 8 ounce Baby B while the doctor guided her into the world, just 17 minutes after her sister was born.
I will forever be grateful to my doctor for trying so hard to give me the birth I wanted and what I needed. He respected me and my knowledge and trusted me and my body to do what it needed to do to birth these babies. Never once did he look down on or question my choices, he never made me feel like naive or pressured into anything. He went well outside his comfort zone and fought for me and fought for birth and in those 17 minutes, admittingly learned a lot.
Four years later the birth of my twins serves as a reminder of strength and courage that I hold within. If I can get through a nearly 15 minute internal version without pain medication, I can handle almost anything. I look back on that day with peace and a sound mind, knowing it went exactly the way it was supposed to go, with nothing to regret.