Our twins are here!!! I can’t even believe it – our family truly feels complete and I can’t imagine it any other way.
If you like birth stories or are a twin mom to be yourself who is curious about a vaginal twin birth, sit back and relax because brevity isn’t my strong suit! Here’s my twin induction birth story!
At my 38 week appointment we’d scheduled a Cervidil induction to begin at 5 pm on Wednesday due to the fact that I was just 1/2 cm dilated at the time. My doctor wanted to see me the afternoon before I went in for a final check and that time I was 1 cm dilated, 50% effaced and both twins were still head down so we decided to move forward with the scheduled Cervidil induction. One perk of being induced (the only perk really) is that we were able to wrap up all loose ends, arrange childcare for Siena, and take an afternoon nap and show up to the hospital totally ready to go. It was extremely odd arriving and saying “We’re here to have some babies!” yet have no signs of labor.
My labor with my daughter 2.5 years ago with spontaneous (though it didn’t start until 41 weeks), long, and unmedicated. I labored at home for over a day and a half (about 20 hours of which was early labor and not very painful) before arriving to the hospital just before dawn. The contractions were so intense by then that I had to pause down the hallway on the way to get checked in. I labored for quite a long time in the dim hospital room where the nurses rarely bothered me except with the occasional intermittent monitoring. I was free to roam, shower, and labor however I pleased. I pushed for an exhausting 3.5 hours and my recovery was amazingly quick and easy. (You can read the entire birth story here.) It was the hardest thing I’ve ever done.
As I mentioned in a few of my final pregnancy updates, I really struggled with the idea of being induced. I was emotional in the week leading up to labor as I tried every induction technique known to man, with the exception of castor oil. I even used my breast pump several times over the course of the three days before induction day, which is one of the surest ways to start labor – but only if your body is ready. I did acupuncture and went to the chiropractor (which I wanted to do either way to ensure my pelvis was aligned and ready for the babies to easily move down into) as well. I tried eating 6 dates a day but after that appointment where I was 1/2 cm dilated gave them up as they were officially grossing me out by that point!
Despite my reluctance to be induced, I took my doctor’s advice and went for it at 39 weeks pregnant. Many doctors suggest induction with di/di twins at 38 weeks so I already felt like he’d “given me” another week. I struggled with this decision but was at peace with it when the day came.
We ate dinner just before arriving at the hospital which was a good idea because it took over 1.5 hours for me to even get checked in and the Cervidil inserted. Once it was inserted, I needed to be monitored constantly for 2 hours and then it would remain inside me for 12 hours total. After that, I was allowed to do intermittent monitoring, which meant that the nurses would be coming in to hook me up for 20 minutes of every hour. After the 2 hours of monitoring I did some walking around the room, bounced on the birth ball, did some blogging and then got hooked up again. Since I was going to try to sleep, I told her that I would just do continuous monitoring. However, it was SO much more uncomfortable than expected. Not only did the bands itch, but if I moved an inch one of the twins would fall off the monitor and a nurse would come back in to fix it. Though I turned the lights off shortly after 10, by midnight I was in tears of frustration because I didn’t think I’d ever be able to sleep and I was incredibly uncomfortable on the hard hospital bed. I told the nurse I just wanted to switch to intermittent monitoring so I could at least recline the bed back to a flat position and get 45 minutes of uninterrupted sleep. I’m pretty sure she let me go about an hour and a half or so because she woke me around 2 a.m. to do the monitoring again. She didn’t let me go as long this next time but between midnight and 6:30 AM I think I strung together about 4 hours of sleep.
The Cervidil is left in for 12 hours. Sometimes it sends people straight into labor without need for Pitcoin, which was my hope. I thought that would be my best chance of having the most natural induction possible. Unfortunately that wasn’t the case for me, although I did have some “real” feeling contractions in the night, it didn’t turn into a consistent labor pattern. When my doctor came to the hospital to check me at 6:45 he said I was about a 3 and was able to stretch me (as painful as it sounds) to a 4. I had to be off the monitors for a full hour after that so I was able to shower, get ready, drink my coffee and eat a full breakfast (the breakfast the hospital gave me was tiny and Mike got us breakfast burritos) before we started the Pitocin.
One of my biggest concerns with a twin vaginal labor, induced or not, was the constant monitoring. I requested wireless monitoring and was told by multiple people beforehand that I could do it so I could freely roam the room and possibly even take it off to use the shower for a bit. But when they tried to hook me up and they realized that no, you cannot monitor twins wirelessly (apparently it’s not requested often). Suddenly I felt extremely trapped. One of the reasons why I opted for a natural delivery with Siena was that I wanted to be able to move around and didn’t like the idea of being confined to a bed. Now I had two IVs in me (one water/electrolytes, one Pitocin) and three monitor straps. I was able to move about 4 feet away from the monitors and at least I could sit on a birthing ball and pace in my little space. The tears started welling up as they were strapping me in and putting in the medicine. I felt trapped, overwhelmed, sad, scared, disappointed…. it was a rough moment. It didn’t help that I didn’t feel super comfortable with one of the nurses either as she clearly hadn’t read my birth plan and kept giving me unsolicited advice. Mike was able to console me and cheer me up a bit after the nurses left which helped. I also texted with a few friends who said encouraging words.
After that, I just tried to relax. When I had to go to the bathroom I’d have to unhook myself from the machine (keep the monitors on the belly though) and wheel my IV cart into the bathroom with me. I did some reading, starting writing my birth story, and scrolled social media for a bit. At 1 PM my doctor came in and said “Oh no, this is not labor!” or something to that effect. He came to break my water. I asked about the risks of doing so, and whether or not a clock would start if we did it (he said no) which could end up with c-section. He broke it and confirmed that I was still a 4, so the 5 hours of Pitocin hadn’t done much. He actually even said that I have a “cervix of steel.” Good for keeping twins in a long time, not so great for getting them out!
The water breaking sped things up quite a bit. Within 30 minutes the contractions were more painful and 2-3 minutes apart. We turned off our computers and put away the books and got to work. Mike did an incredible job over the next few hours as I worked through the contractions, which remained very close together and got increasingly intense (common with Pitocin, which is a big reason Pitocin and epidurals generalyl go hand in hand). The thing that helped me the most was listening to various relaxation meditations (Hypnobirthing and ones on YouTube) with my headphones in. We had dimmed the lights and started ignoring the nosy and annoying nurse.
Unfortunately the monitoring was a hinderance – when I tired to get into positions like bouncing on the ball and leaning over onto pillow on the bed to get through a contraction, one of the babies (usually A) would fall off the monitor. I’d literally be working through an incredibly intense contraction with a nurse moving the monitor over my belly. It was not fun. I felt like a caged animal or a lab rat, tied up and constantly being poked and prodded. With Siena, I was able to roam the room, get in the shower, and do anything else I needed to do to relieve my pain.This time, I was hooked up to so many things that when i had to go to the bathroom, which was frequently, I had to unhook and have Mike walk me there, making sure all the cords didn’t get tangled in the IV stand. I’d often do some stretching and walking around after using the restroom, taking advantage of my freedom as much as I could hooked up to the IV stand.
Going into this, I prepared for another unmedicated (as in no epidural) birth by listening and reading unmedicated twin birth stories, practicing my relaxation techniques, reading the Hypnobirthing book and reviewing my Bradley Method handbook. But I also went into it saying I’d play it by ear in terms of getting pain management. As I explained in my blog post about how a twin labor and delivery is different, I knew that I’d be continuously monitored and it would be much harder to get comfortable while in labor. But more importantly, if Baby B were to flip to breech during delivery, my doctor would have to manually try to rotate her by reaching inside me, which I’ve heard can be excruciatingly painful. If that didn’t work, she’d be delivered breech, which has additional risks. Also, it isn’t totally uncommon for Baby B to be in distress after Baby A is out and require an emergency C-seciton (the “double whammy”). Without an epidural, I’d need to be put under for the surgery and wouldn’t even be awake to meet my baby. In fact, this risk is serious enough that many OBs require an epidural for a vaginal twin birth, no matter how each baby is presenting at the start of labor. My OB did NOT require an epidural and said I could do it naturally, but I weighed all of these things in my mind in the months leading up to their birth. Once I knew I was going to be induced, I started leaning much toward the epidural over going through the more-intense pitocin contractions completely on my own.
At around 5 PM I wanted to know how much I’d progressed. I needed to let go of some of my fears that I hadn’t dilated at all. Having such a long labor the first time (I was in active labor for nearly 24 hours and early labor for just under 24 hours) wasn’t helping calm my mind. I had a talk with Mike just before I asked to be checked and said that if I was around a 6, I’d probably get the epidural. If I was an 8, I’d highly consider pushing through as I was likely very close. Last time I was a 6 when I checked into the hospital at 6:30 AM and I didn’t end up starting to push until 4:00 PM. I pushed for 3.5 hours. The time between 7 a.m. and 7 p.m. when Siena was born was incredibly painful and long, and given how exhausted I was from the lack of sleep the night before and the emotional stress I’d been through, I just didn’t know if I had it in me to labor for another 8 hours, through the night. I was absolutely starving because they wouldn’t give me any real food after breakfast (although I’d been sneaking food). I was frustrated by the monitoring and it was hard to imagine going through transition hooked up the way I was. I was just ready for some relief or at least a sign that I was nearing the end.
The nurse checked me and actually seemed very impressed that I was a 6. I immediately made the decision to get the epidural. The anesthesiologist was available and came right in and the epidural was in place by 5:30 PM. The relief was almost immediate. The nurses set me up with the peanut ball between my legs to encourage baby A to descend into my pelvis. I could still feel some contractions on my right side so they had me lay on my side and increased the dose a little which helped. I could still wiggle my toes and feel sensation on my legs, but no more pain. It was wonderful! Suddenly Mike and I were talking and enjoying ourselves. I kept saying “The epidural is amazing!” The nurses told me to let them know if I started feeling nauseous, light headed, or felt pressure down below (like the urge to poop) and left us alone for a little bit. Since I didn’t get nauseous when I went through transition with Siena, I didn’t anticipate feeling sick again and was preparing to know when to push based on the pressure. Because I wasn’t moving around, the babies stayed nicely on the monitors and we got some peace from the nurses too.
Mike went and got some food from the community kitchen and they also delivered my dinner for Mike, saying “Do NOT let your wife eat this.” Well, remember how hungry I said I was? I ate some of his dinner – kind of a lot of it. I was starving! It didn’t even touch on the hunger I was feeling but it satisfied me at least a little. Mike and I sat and talked and enjoyed each other’s company. I couldn’t help but point out how incredibly different this labor was than my last – last time I had the hep lock but didn’t have a single thing attached to me the entire birth, with the exception of the intermittent monitoring. I now was hooked up to 8 different contraptions – Pitocin drip, antibiotics (I was GBS positive this time), IV fluids, 3 monitoring belts around my belly, an epidural, and a catheter. Yikes. This was the opposite of a natural birth. However, knowing I was going to be induced had allowed me to mourn the loss of my natural birth plan and just move forward and go with the flow. I was OK with it because the babies were behaving well and I was doing great and was able to rest. It was also pretty interesting experiencing both sides of labor.
Around 7:15-7:30, there was a shift change. I started feeling like I had to poop and told the new nurses this, who were busy working on the computer. They told me that if I was only feeling them during contractions that it didn’t mean anything and left. Now is the time to note that the hospital went through a new system change just days before I was admitted. All of the nurses at my NSTs warned me of the change and that it would have some hiccups. Throughout the entire process, we found that everything moved incredibly slowly as the nurses were trying to navigate the new system. They had also added additional staff so there were more people than usual in and out of our room.
About 15 minutes later, the nurse came in and said that Baby A’s heart rate pattern was showing signs that she was very low so she checked me. She immediately said, “You’re complete. Don’t sneeze or that baby is going to fall out!!!”
I was SO happy!!! One of my biggest fears about the epidural, besides the giant needle in my spine part, was that it would slow down labor and/or cause one of the baby’s distress which would ultimately end in c-section. Instead, I went from a 6-10 in 2-2.5 hours (or less, who knows when I actually got to 10). In retrospect I wonder if getting the epidural in my last labor may have actually helped me relax and open – or if the difference was mostly attributed to this being my second (and third) baby.
They called my doctor, who lives about 7 minutes away, and told me no to push or sneeze. Shortly after, I started feeling sick. I didn’t get nauseous in transition last time so I didn’t expect it. I told the nurses and they handed me a barf bag. Less than a minute later, up came all that food I’d eaten. It was almost comical – the nurse said “WHAT DID YOU EAT?” in a funny, joking way (I liked this new nurse a lot more). Later she said “There was mac and cheese in there!” Oops, I got caught red handed!
I felt better immediately after vomiting and the nurse gave me some mouth wash. I was able to clean myself up a bit before they started wheeling me to the OR. All twin births must be held in the operating room due to the risk of emergency c-section. I had mentally prepared for this. I’d read a lot of twin birth stories where the mom had to deliver on the cold, narrow operating table, but my doctor assured me I could deliver in the delivery bed.
When we got the OR, they set me up in the middle of the bright room, legs spread open, with about 12 people in the room with us. There was a NICU team for each baby, my doctor, the anesthesiologist, and my nurses as well. I was a little shy at first until we got down to business. My doctor did a great job of guiding my pushing by pressing down on the area that I was supposed to focus my effort on. Mike was holding one of my legs and encouraging me. The nurses were giving me compliments and telling me how great I was doing. The shyness I’d briefly had when we first got into the room was completely gone and I felt pretty badass in the middle of the room with my legs wide open, birthing two babies!
Given I’d pushed for 3.5 hours with Siena, I was a little nervous it was going to take a while, but after 3 contractions and probably 8 pushes, Scarlett was out! The mood in the room shifted a bit because the cord was wrapped around her neck. They cut it off and put her on my chest and the nurses aggressively patted her to get her breathing. She didn’t cry at first and they took her off of me and brought her over to the warmer. Within a few seconds, which felt like minutes, she was crying. Her APGAR score was an 8 even despite that scare. Mike was able to cut the cord. They put her back on me and let us do skin to skin while we waited for little Rowan to make her grand entrance. In nearly all the twin birth stories I’d read, the doctor would break baby B’s water and kind of force them out as soon as possible. However, my doctor believes that baby B should be born on her own terms, something I agree with. We waited for the contractions to start up again and for her to move her way down into the birth canal. I got about 5 minutes of skin to skin with Scarlett during this time which was wonderful. One baby on my chest and one still in my stomach -what a unique and incredible experience!!! A nurse took our photo while we waited and I cried tears of joy!
Once it was time to push again, Mike took Scarlett and a nurse took over holding my legs for pushing. My doctor cued me and I pushed and her head began to crown immediately. The doctor warned everyone that her bag of waters was very tight and that it was about to become Splash Mountain in here. One or two pushes later, her bag of water exploded all over everyone (who had covered themselves up a little in anticipation). We all laughed and joked about it, the mood in the room was really fun. My doctor reached inside and tried to get Rowan’s hand off of her head (I was thankful to have the epidural). One more contraction and a couple pushes later and Rowan was born, with her hand on her head. By some miracle, I didn’t need any stitches despite this extra obstacle.
They immediately placed Rowan on my chest and we got skin to skin time. She was assessed right there and we got another photo. Mike came over and cut the cord after it stopped pulsating and apparently the placentas came out at some point but I was so preoccupied with my babies to notice. Eventually I had BOTH my healthy babies on my chest and was wheeled out back to my room. I felt so triumphant on that ride back to my room – I had my two healthy full term babies on my chest. My time pushing in the OR was one of the best of my life – the vibe was light hearted and fun and it was a life changing moment that I’ll never forget.
Both babies had started rooting even in the OR and I was able to immediately breastfeed them. Without any help from the nurses somehow I got them to tandem feed right away, reclined in the bed with them lying on my chest. It was absolutely beautiful and we spent our golden hour just staring in disbelief about these incredible humans we made and recapping the birth story from both our perspectives.
So here they are: Introducing Scarlett Eliza, 6 pounds 4 oz, born at 8:23 PM on April 12, 2018 and Rowan Avery, 6 pounds 11 oz, born at 8:45 PM on April 12, 2018.
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