Sunday, April 8, 2012

Vaginal Twin Hospital Birth- WOW!

I am so glad this mother sent me her story.  She said she was a little reluctant at first because most of the stories I post are "sunshine and roses"!  But I am so grateful she changed her mind.  You will see a mom who really is somewhat high risk (pre-eclampsia, twins, and some losses before this birth) but who still has a vaginal hospital birth of twins.  
 I am AMAZED at her strength and her fortitude through all of this!  Women simply blow me away.  
 Enjoy~
(Photo submitted by one of our readers, this is not the babies in the story.)
 
A little background: My first pregnancy ended in an emergency induction at 35 weeks. I had severe pre-eclampsia with central nervous system involvement. I was in really bad shape, and the MFM who saw me said we should pray the induction worked because a c-section would kill me. There were warning signs at 30 weeks, and I reported them to my OB, but he blew me off as a first time mom who didn't know what pregnancy was like. Lesson learned: I was determined to manage my pregnancy better in the future.
My second and fourth pregnancies were both lost in the first trimester.
My third pregnancy (second birth) went a lot better as far as the PE was concerned. I found a new OB who monitored me much more closely. I still got PE, but it was milder and later. I was induced at 37 weeks, a decision I do not regret, but I seriously regret the way I was induced. I had trusted my OB and the hospital staff to make the best decisions regarding my care. 
I ended up with an incompetent substitute nurse who wasn't comfortable being in L&D in the first place. She ODed me on Cytotec, refused to believe I was in labor (she even reset the "faulty" monitor at the height of a contraction so they wouldn't show up anymore, while telling me to stop tightening my abs!) and had a full blown panic attack when she realized I was pushing. She injected Nubain into my IV without my knowledge or consent, which caused my baby to have trouble breathing and sucking, and screamed at me until I agreed to a spinal despite the fact the baby was just short of crowning. Lesson learned: I needed to be proactive about my birth as well as my pregnancy.
For my fifth pregnancy (third birth), I did a lot of research both on PE and on natural childbirth. I was looking into homebirth midwives when I found out that there were two heartbeats. Once there were twins in the picture, I knew the hospital was the right place for me. I found an OB practice with two OBs and a CNM. While not fantastic, they were the best bet for a natural hospital birth in my city. I also consulted with an MFM in a city an hour away, which is where I would be transferred if we needed a level 3 NICU.
I primarily saw the CNM for prenatals, although an OB would attend my actual birth with the CNM assisting. One of the OBs was assigned as my primary, and I wasn't thrilled with her. At my 20 week appointment, she wanted to "get my section on the schedule." I told her I wouldn't be having a section without legitimate medical need. She told me she'd "let" me labor, but I'd have to have an epidural, which I also refused. Then she said I'd have to have the epidural placed, even if I didn't have any meds in it, so it would be ready when (not if) a section became necessary. I told the staff I didn't want to see her again. Luckily for me, the OBs had a falling out before my next appointment, and she left the practice.
My blood pressure rose dramatically at 22 weeks, which was terrifying. I started BP meds, partial bedrest, and an army of prayer warriors. Amazingly, I stayed stable until 31 weeks when I started spilling protein and officially crossed the line from pregnancy-induced hypertension to PE. I went on full bedrest at that point. At 33 weeks, I started having visual disturbances, a sign that the central nervous system is involved, and was hospitalized.
When I arrived at the hospital, I was scheduled for transfer to the other hospital the following morning for induction. After staying stable overnight, however, we decided to wait. My local hospital would keep me at 34 weeks, so we scheduled the induction for then. But the pediatrician wasn't comfortable taking on babies that early, so since I was still stable we decided to reschedule for 35 weeks. Then the MFM said as long as I was still stable, why not try for 36 weeks? But all of us, the OB, MFM, Ped, and most importantly DH and I, were in agreement that 36 weeks was as far as we would push it, and if I got worse or if labor started on its own, we were ready to go.
Once I reached 35 weeks, I started doing nipple stimulation and pressure point massage for 15 minutes at a time every two hours to try to induce labor myself. I was already in the hospital, so what could it hurt? As long as I was massaging, I would have contractions, but they'd stop when I stopped. It was helping, though. The night before my scheduled induction, I was already dilated to 4. Both babies were confirmed head down, and we were cleared to proceed. I spent the whole night massaging and got myself into a pretty good pattern, not really strong enough to be considered active labor, but definitely heading there. When the nurse came in at 4:30 to start my IV, I convinced her to keep the Pit at the lowest setting since it wouldn't take much to put me into active labor. We started the Pit at 5:00 and were on our way.
At 7:00, the OB came in to check me out. He proclaimed me to be in active labor. He agreed to my plan to leave the Pit at 3. (Note: I don't know how the Pit was mixed in this hospital or what the actual dose was; I know their standard rapid-induction protocol is to start the IV at 3 and increase by 3 every 15 minutes until labor is established or the max dose of 75 is reached at 6 hours.) 
The nursing shift changed at 7:00, too. I don't know if the new nurse wasn't informed of the doctor's orders, or if she chose to ignore them, or if he told me one thing but ordered another. All I know is she started to increase the dose without my knowledge. Since the doctor had just proclaimed me to be in labor, I have no idea why she felt it necessary to increase the dose.
At 8:00, the door to my room burst open and a doctor I'd never met charged into the room. "I'm Dr. 'X' and I'll be doing your epidural," he announced. I didn't ask for an epidural. "Well, I'm here to answer any questions and get the consent form signed." No, you don't understand. I'm not getting an epidural. He launched into the standard speech about how birth is dangerous, yadda yadda yadda, and I should have it in place before a c-section becomes necessary. Well, I'm not having a c-section either, so no thanks. He gave me the most condescending look he could muster, and said, "Honey, you're having twins. You're GOING to have a c-section." I said it's illegal to operate without my consent, and I don't intend to give consent without legitimate medical need. He gaped at me for a few seconds, then turned on his heels and marched out.
Things got intense pretty quickly soon after that. I was limited to laboring in bed because of the PE, as I had been for my previous births, but I was handling contractions pretty well with visualizations and breathing. I would picture flowers blooming, doors opening, etc, while breathing deeply and chanting "ooooooopen."
At 9:20, I used the bathroom. When I got back into bed, I had a REALLY intense contraction that was clearly transition. I said, "I can't do this!" My DH said, "Yes, you can!" just like I'd trained him. My brain said, "Twenty more minutes!" just like I'd trained it. I had read somewhere that when you get to the point of thinking you can't do it, you'll probably be ready to push in twenty minutes or so. I know that's not always true, but it's what I held on to. Little did I know transition would only last that one contraction.
As the contraction ended, I opened my eyes just in time to see the nurse TURN UP THE PIT! It was now set at 27! I was so appalled, it pulled me completely out of Labor Land. In my best teacher voice, I said, "You need to turn that off!" She told me she couldn’t turn it off without a doctor's order, which is total bull. I said, "You need to turn it down!" She said we should wait through a few contractions and see how I handled this new dose. I said, "I'm pushing!" and immediately sank back into labor land. The nurse ran to the end of the bed in time to see Baby A crowning.
The only thing my OB had insisted on was that the babies would be born in the OR just in case. Chaos erupted in the room. Four nurses each grabbed a corner of the bed and literally ran me out the door and down the hall to the OR while a sweet labor tech ran next to me holding a sheet up to protect my privacy. I was naked from the waist down, lying on my side with one leg pulled up in the air. The nurses were all screaming at me to stop pushing, but I did exactly what my body directed despite the chaos. My beautiful baby girl was born at 9:30 as they made the final turn into the OR. No one caught her. The fact that I gave birth unassisted in the hallway is my favorite part of my birth story. I DID IT! The way my body directed! And the nurses could suck it! It was amazing. My son's birth 19 minutes later was a completely different story.
As soon as Riley was out, the contractions stopped completely. I held her on my chest until the doctor got there two minutes later and cut the cord. (He told me later he set a speed record from office to hospital--7 minutes instead of the usual 12.) He did a quick ultrasound and discovered that Baby B had turned breech as his sister was born. He gave me the option of trying an external cephalic version or delivering breech. He preferred the ECV. I really wish I had said just do it breech, but at that point I wasn't able to think clearly. We made a couple attempts at a version. At one point there were five hands on the outside (a nurse, the CNM, and the doctor) and one inside when the door to the OR burst open and in came Dr. 'X' again, furious that he hadn't done an epidural yet. He yelled and cursed while the OB ignored him and continued working. 
Baby B wasn't turning, and he told me he wanted me to have a spinal so he could be more aggressive. Again I wish I had said let's just do it breech, but I wasn't thinking clearly. I do know the OB said to give me the lightest dose possible because he needed me to be able to push, but Dr. 'X' gave me the full range of c-section drugs including the one that makes you space out during the repair. I don't remember much of the rest, but DH said he was pretty horrified to see how hard they pushed on my stomach. The next thing I remember is them yelling at me to push, but I was so numb I don't know if I was actually doing anything. The OB grabbed the vacuum at that point and delivered my amazing son at 9:49.
So my best, most natural birth, was followed immediately by an intervention-heavy delivery. The difference between Riley, who had no drugs in her system and was born with natural pushes, and Gavin, who had a high dose of spinal meds, an aggressive version, and a vacuum delivery, was amazing. She was very alert, latched on right away, and did really well. He was groggy, had a weak latch, and had breathing trouble that landed him in the level 2 NICU that evening.
After staying stable and doing so well for an amazing 14 weeks, I was in really bad shape after the birth. I had severe post partum PE. By noon, I had slipped into a coma. After that glorious first hour of bonding and nursing, I didn't see my babies again for over 24 hours. I quite literally pushed the pregnancy as far as I could. Once things started turning around again, I insisted on nursing the babies side lying until I was strong enough to sit up. I had to have someone with me at all times, and got an extra day in the hospital to make sure I stayed stable. But by 2 weeks post partum I was able to handle the four kids on my own. My precious babies were worth every moment, and I'd do it all again to have them. Even now that they're 2.5 and driving me crazy.

8 comments:

mamamia said...

Wow! You are an amazing woman! Congratulations on getting through a twin delivery as best you could, well done!

I would love to have twins, but my OB and I argue about the epi as well, lol. If ever I get the opportunity, I shall remember your story and stick to my guns! Thanks for sharing, and enjoy your lovely children, even at 2 and a half, lol!

Lauren said...

What an amazing story! I ended up having my first twin in the regular room (they had an OR policy as well) and my second twin breech in the OR (after waiting in the hallway as well lo1). I hate that twin natural births have to literally FIGHT for everything. Thanks for breaking the norm!

Manda said...

Here is a great hospital twin VBAC story: http://highheelhippiemommy.blogspot.com/p/ella-and-evelyns-twin-vbac-birth-story.html

melissa v. said...

Gorgeous story, I am so amazed!! Congrats to you, strong momma, and who wants to join me on a witch hunt for Dr X??!!

Women are so amazing. I'm sorry you have such complex pregnancies. Your ability to advocate for yourself is amazing though, and a good example for all of us. Thanks for sharing!! =)

Tom and Juli said...

Thanks for sharing your lovely birth story. You did an amazing job!

-Juli

Misty Pratt said...

Whoa!! Awesome mama!! You did so well despite considerable challenges. Big thumbs up to you :)

Ariel Niemeyer said...

Wow. You just gave me hope! I had my first child all natural and I about cried when they said it's unlikely to deliver both babies vaginally. I truely want to deliver them both naturally unless it's medically necessary.

Ariel Niemeyer said...

Wow. You just gave me hope! I had my first child all natural and I about cried when they said it's unlikely to deliver both babies vaginally. I truely want to deliver them both naturally unless it's medically necessary.

LinkWithin

Related Posts with Thumbnails