Friday, March 4, 2011

Home Birth of the Twins

As I blogged about before, I was put on bed rest at 35 weeks due to having a lot of steady contractions and cramping, etc.  I was on bed rest for 3 weeks (and just about went crazy).  When I was finally given the ok to get off of bed rest...I couldn't believe how winded I would get just walking from one room to the next, so most of my last few weeks were spent sitting/laying down.  Even when I was cleaning, I would have to vacuum part of a room and then sit and take a breather and then finish some more, breather, on and on.  It would, literally, take me a 1/2 hour to vacuum 2 rooms!

By the time I hit 39 weeks, I was ready to give birth.  I was huge, I was itching up a storm and just overall very uncomfortable and I was just ready.  At 39 weeks, my belly was measuring at 51.5cm.  I remember going to bed at night and willing the contractions to start.  The twins, however, decided that they would bake for another 10 days and those were the hardest 10 days of my pregnancy.  Wanting to have them right now, but wanting them to come on their own, I was in a constant battle of "naturally" inducing and waiting it out.  I started to take Blue and Black Cohosh, but then decided not to.  Same thing with a couple of other herbs/homeopathic "remedies".

There were several times during the last 10 days that I was sure labor was going to start.  My contractions would last all night and would get down to every 5-8 minutes...and then stop, like clockwork, at 7am.  Talk about annoying....those last few days before I really hit labor felt like I was living in "Groundhog Day".  I started crying one morning because I was so frustrated...being up all night laboring only to have it stop at 7am, just in time for my other kids to get up for the day.  It was not a fun week and I was worried that I would go into labor more sleep deprived than ever.

But, finally...on Sunday January 23, 2011, I felt a change (and it wasn't just because my belly was now measuring at 54cm).  I felt "different" and I knew that the twins would be arriving later that night or early Monday morning.  We had Joe's parents come and get the boys.  My daughter spent the day with my mom (and wanted to be at the birth) and I spent the rest of my day making sure I had everything I needed for my home birth.  I checked and re-checked everything and then I took a nice long nap.

I was very happy with the position of the twins, as they were both confirmed to be head down.  I knew that a breech baby could be safely born, but I felt better with both babies being head down.  And this was probably good because I was able to relax more throughout my labor.

I had some light contractions throughout the day, but nothing really steady or really strong.  The real contractions started, steadily, at around 12am.  I started this labor at 3cm dilation, already, so I knew it was going to move along pretty quickly.  My body has a habit of taking its time getting to 5cm and then within 20-30 minutes, I'll be fully dilated/effaced and the baby will be born.  I didn't think it would be any different in this case.

My midwife showed up at about 1:30am and her assistant arrived around 2:30am.  I spent the vast majority of this time walking, squatting, rocking.  I sat on the ball and did pelvic rocking.  Joe would rub my back and made sure to keep on top of me about continuing to drink water.  At about 4:30am, the contractions were about 4 minutes apart and lasting for almost 2 1/2 minutes.  I got into my tub and just relaxed into the water as my contractions came closer together and stronger.  My first bag broke in the tub at around 5:50am and I decided to get out of the tub.  I was out of the tub for 2 very strong contractions before I had the urge to push.  I had walked around the bedroom and upstairs hallway for those 2 contractions and then was back in the bathroom, standing next to the tub as I finally pushed.  Within 2 good pushes, Marina was born.  It was 6:05am and I was surprised at how fast it happened.  She ended up having a very short cord; too short for me to even pull her up to my belly.  We waited as long as we could, but once I started getting another strong contraction, we had to cut it before it fully stopped pulsing (to prepare for Ariana to be born since we did not have the "room" for both babies).

As everyone says with twins, if they are both head down, you should hold on to the 2nd twin to prevent them from flipping. Ariana was still head down as my next big contraction hit.  Just as she was moving to get engaged in the pelvis, she flipped transverse and then breech and before we had any time to try to flip her back, I had to push.  With the first push, the midwife announced that she was a footling breech...but she was also slightly posterior (a no-no for breech babies) and quickly turned her.  I had another big contraction and one more push and Ariana was born at 6:22am.

Marina weighed in at 7.3 pounds and 20 inches long.  Ariana weighed in at 6.9 pounds and 19.25 inches.  Both were very pink, very healthy and being doted on by their big sister, Makayla, who was overjoyed to have baby sisters.

All in all, the girls' births went perfectly smooth and very quickly and pretty "pain free".  I am so happy with the safe delivery of the girls.  I couldn't have asked for easier and issue free births.

I got about 5 minutes to nurse both babies and cuddle them before the second placenta (Ariana's) was birthed.  I noticed, immediately, however, that there were some large blood clots that came with the placenta (the first placenta had not been birthed, yet).  That concerned me greatly...and although the midwife reassured me that all was fine (I mentioned it repeatedly that I was concerned about the blood clots) but she immediately started giving me herbal tinctures to help with contractions and stop bleeding.  I didn't think much of it at the time.  I was just focused on getting the first placenta delivered (and worrying about the blood clots).

However, as I pushed, I would feel gushes of blood.  Since I had hemorrhaged before with the birth of my second child (Adrian), I knew the signs all too well.  I had mentioned the bleeding to the midwife and she was still reassuring me that all was fine.  She had me changing positions (standing, squatting, sitting, etc) and pushing.  Nothing was happening.  Nursing the babies didn't help, nipple stimulation didn't help.  I asked several times about the clotting and the bleeding and stated, "I'm hemorrhaging" and she reassured me that all was going along fine.  I got to the point where I felt like I needed to lay down (I was still in the bathroom).  My husband helped me to the bed where I laid down and pushed a few more times.  I remember feeling like my energy was slipping away.  I felt weak, I felt cold and I wanted to say something and I couldn't say a word.  I looked over in to the bathroom and was shocked at the amount of blood that was on the floor, the towels and the chux pads.  I tried to say something to the midwife about the blood, but I couldn't get the words out (I knew this was bad) that point, she put the oxygen mask on me.

I remember my mom asking the midwife if she was going to call the ambulance.  I remember the midwife was sitting at the end of the bed and said, "I haven't decided, yet."  At that point, my husband grabbed his cell phone and called the paramedics.  My husband called for the ambulance at 7:05am.  Almost 35 minutes after I first noticed the blood clots.  As soon as the paramedics were called, the midwife and her assistant grabbed all of the bloody towels and put them in a garbage bag, mopped up the floor quickly, and threw away all of the chux pads.  The midwife even changed the chux pad that was under me, and full of blood.

When the EMTs arrived, I had a little blood on the chux pad.  My husband had told them I had hemorrhaged and was losing a lot of blood.  I remember seeing 2 of the paramedics look at me (and the not very bloody chux pad under me) and look in the bathroom and not move any faster.  There was no urgency.

After what felt like an eternity (they asked me if I was having problems with the last placenta, and the midwife mentioned I had been up for 30 hours--which was a total lie) they took my blood pressure (which was very high) and strapped me to the gurney, got me into a (very) cold ambulance.  The last thing I really remember in the ambulance is getting the IV inserted...and the one female EMT saying, "I think she lost a lot more blood than we saw..."

When I was finally on the Labor and Delivery floor, we waited for the doctor to arrive.  Once she got there, I was given Cytotec (to increase the contractions--and it did this very effectively) and some pain killers (the contractions were that bad--and I could not imagine being induced with Cytotec, which is dangerous, anyways).  The placenta was delivered within a few pushes and I laid down on the bed.  After an hour or so, I wanted to get up to go to the bathroom (couldn't stand the thought of a bedpan) so the nurses helped me--reluctantly because they wanted me to use the bedpan--and I almost immediately passed out.  That is the last thing I remember until several hours later.

Just after I passed out, I was started on blood transfusions.  I got 3 units of blood that day.  The doctor (who was absolutely great) wanted to keep me overnight for a 4th transfusion, but gave me the choice to go home since I  was eating, looked good (all my color was back and I was coherent).  I chose to go home that day because I wanted to get home to the girls since I had spent the first 14 hours of the girls' life in the hospital without them.  My blood count was in a "safe" range and the doctor was ok with me leaving.

While I was in the hospital, I had 2 really good friends drop everything that they were doing to wet nurse the babies since I really wanted to avoid formula feeding them.  I cannot tell you how reassuring that was for me.  To know that the babies were being well cared for and fed while I could not be there just took so much stress and worry off of me and gave me the relief I needed to get well enough to get home to them.

The next few days were a bit of a haze (as it is for any new parent).  The twins started out on very different sleep and nursing schedules that I was only getting about 45 minutes of sleep at a time.  I did have friends and family over all day long that helped with my other kids so I could spend all my time in bed resting and taking care of the babies.  It took about 2 1/2 weeks for me to really get used to having twins.  But I found, despite most other advice, that keeping them on their opposite schedules actually suited me (and my family) very well.  With not having to nurse, burp, and change 2 babies at the same time all the time, I have the time to really spend with each girl. I can nurse, change, and burp each individually and then cuddle with each one by themselves.  I really love the one on one time I spend with them.

Overall, my homebirth was very good.  Excellent, even.  I did learn, though, that if there is any apprehension or concern about anything that is going on during the birth, you have to put your foot down and make the decision for yourself.  You are in charge of your birth, every aspect of it.  I should have told the midwife that I wanted to go to the hospital immediately when I saw those blood clots.  I don't, completely, blame the midwife for not transferring me sooner, but I do think she waited too long.

But, with everything considered...I am very happy with the birth.  It was still a great experience and I have very little regrets and I am very happy to have successfully, and safely, delivered my twin girls in the warmth, comfort and safety of my home.  I couldn't have asked for anything better, except a midwife who would not be afraid to transfer sooner.