It all started around 7:00 a.m. on an otherwise “normal” Tuesday morning. I had gotten up with the two older kids to get their breakfast and was feeling pretty crampy. No regular contractions, but definitely uncomfortable. More telling was my complete lack of patience for preschooler whining and incessant question asking. After everyone was settled I sat down on the couch to kind of assess my situation. I felt different than I had at any other point in this pregnancy, but wasn’t really sure that labor had started. I knew that I had been given directions to leave as soon as I thought I was in labor, but I really didn’t want to drive all the way to the hospital for a false alarm.
Things continued for the next hour or so and then it was time for Jay to leave for work. I still wasn’t sure that I was in labor, but I knew that I didn’t want him to leave. I figured that we should probably go. Worst case scenario we would have to come home. I had my bag packed and everything ready to go, so Jay threw everything in the van, changed out of his uniform, and we hit the road. Luckily things were not that intense during the car ride to the hospital, but I came to the conclusion that I was not doing the drive again. The babies were going to be born, even if that meant consenting to some method of induction. My doctor had said that if she did think it was necessary to induce that I would be easy: she could break my water, have me walk around and things would get going. I was 37 weeks and six days, so I felt pretty confident that things would be okay and the babies were ready.
We arrived at the hospital, checked in, and were given a room. Upon initial inspection I learned that the room did not have a tub for laboring. They had put me in the room just outside the doors leading to the OR since I would be pushing there, but I asked to be moved to a room with a tub. Ironically I never ended up using the tub, but it was important to me to have the option. I changed out of my clothes and was hooked to the monitor for 20 minutes and had my first cervical check. I was only five centimeters. I had thought it would be more considering my doctor had seemed convinced things would happen quickly. That being said, I wasn’t too surprised since things had slowed down considerably since arriving at the hospital and I was thinking that maybe we had jumped the gun. Anyway, I said no to an IV but yes to a hep-lock and started to mentally prepare for what could be a long day at the hospital.
After my 20 minutes on the monitor we started walking the halls. Contractions were weak and far apart while I was lying in the bed, but considerably more intense when I was up and about. Things were picking up, but it was slow going. I had never arrived at the hospital this early in labor with any of my other three kids. I never had to walk the halls or do anything to speed things up; I always arrived as late as possible. I was not a fan of hanging out, intermittent monitoring, walking laps around labor and delivery…but I was no fan of the idea of waiting too long and not making it to the hospital, so there we were.
My doctor stopped by in the morning then went to her office to see some patients before canceling her afternoon to focus on me. That was surprising, but I appreciated it. After some time she and my nurse brought up the idea of heading to the OR early to be settled and ready when things picked up. One of my concerns about pushing in the OR was the idea of having to move during that phase of labor and this would address that concern. They suggested wheeling a regular L&D bed into the room since it was more comfortable, bringing the birthing ball, and letting me move around in there if I wanted to. I thought it sounded like an okay idea and agreed. It was probably a bad idea. We walked down the hall (my nurse was excited that I was the first patient she walked with to the OR) and were greeted by the ten or so people assembled to join us in the room when the action started. Thankfully they stayed outside until it was almost go time. I settled into the freezing cold OR, had them turn the lights down, and continued to labor.
It seemed like things were taking forever. I had been so excited at the idea of a fast labor that I couldn’t help looking at the clock and calculating how long it had been going on. Contractions were definitely more intense, but still very irregular. Jay commented that sometimes minutes would go by where we could have normal conversation and then a contraction would hit. Then other times they would be coming really fast. At some point my doctor suggested breaking my water. I was very hesitant to do that. I didn’t want to do anything to make things more painful and had never had my water broken before. Generally my waters break as I am pushing. But I was getting impatient, so I agreed. What an unpleasant experience that was. Basically combining a cervical check with a long stick up there looking for a good spot to poke. I think things picked up after that, but it’s hard to say. Finally I was checked and fully dilated. That was another way this birth was different than the last two. I never needed anyone to tell me I was complete and it was okay to push. This time everything felt so much more managed and I found myself looking for more reassurance and direction. I didn’t like it. I started to push a bit with each contraction. My plan had been spontaneous pushing without bearing down. It takes longer, but allows everything to stretch and reduces the risk of tearing (ever since the episiotomy that extended to a fourth degree tear with Madeline my focus has been on doing things in a way that minimizes the risk of tearing). After several contractions like that I really started to question whether things were moving forward. No one seemed that impressed. I felt like it was so painful and there was no end in sight. For the first time in four births I actually asked if it was too late for any kind of medication. I was thinking something light to take the edge off (I have no idea what I actually had in mind). Jay said he was shocked. I was shocked too because this labor was no more intense or painful than any other one. It was just different. There were more people waiting around for these babies to be born, and despite never really needing it before, I was looking for some positive feedback about my progress and not getting any. I was in this cold, sterile room and I just wanted it to be over. Regardless, it was too late for anything. Before I knew it the team of doctors and nurses had filled the room and everyone was in their delivery garb ready for some babies to be born. It got really fun then. I was still pushing some with each contraction, letting my body do most of the work, but now when I opened my eyes after the contraction I had about 6 people staring at me. And no one looked like they were any closer to catching a baby than before the contraction. That really messed with my mental game. I think I asked my doctor if it looked like I was making progress. I forget her exact response, but she told me that if I wanted to bear down and push for ten counts that I would be holding my baby girl in three pushes. I told her I did not want to tear. She told me that she was pretty sure I wouldn’t. I guess I believed her. I agreed to go for it during the next contraction. Three ten counts later and I was holding Elizabeth. My doctor got the eager baby nurses to back off and made sure I got some skin-to-skin and we got to delay cord clamping.
While I held Elizabeth they did an ultrasound to make sure Daniel was still head down. He was, but according to the monitor there were some concerning decels. Nothing indicating we really needed to start rushing things, but some steps were taken to move things along. My doctor gave me a quick catheter to empty my bladder and give him more room to move down (I think I was also peeing a little with each contraction). Then she broke his water. Just after that he moved down and I heard her say she had cord. She never pulled her hand out, so I knew she meant it was prolapsed. She told me to push hard on the next contraction. I did. Basically three successive ten counts without a break. She was able to hold the cord and keep it from compressing while I pushed him out fast. Luckily his cord did not really slip out ahead of him, but came down kind of next to his head where she could keep a hand on it. He went right to my chest where he hung out for a minute before one of the nurses thought he needed a little more attention. He was checked out and was fine and then I was able to hold both of them. Elizabeth was 6 lbs even (a full pound more than the last ultrasound estimate) and Daniel was 5 lbs, 12 oz (the exact size as his last ultrasound estimate two weeks earlier).
I delivered the placentas without any issues. It was cool to see their two sacks and where their cords each attached to their placenta. I was given some pitocin in an IV to facilitate uterine contractions and also a dose of cytotec (which is a rectal suppository, FYI) just to help things along. It wasn’t long before I was out of the OR and being wheeled back to my labor and delivery room to recover. We were there forever. I was freezing and just kept needing more warm blankets. The babies were doing great at breastfeeding and it seemed like they both kept wanting to take a turn. I finally got to eat a sandwich, pee, and move upstairs to the mother and baby unit where I spent the next two nights awake and figuring out how to manage two babies.
Overall, things went well. I do not recommend delivering babies vaginally in an OR with at least ten people there to do various jobs (many of which were never necessary). That seriously had me off my game. I wish we had not spent so much time at the hospital, but like I’ve said before, a 45 minute drive is not something to be messed with when you are dilated to 4-5 and your doctor urges you to leave immediately. In hindsight it wasn’t necessary to leave that early, and I wish I had been able to labor more at home. I think things actually would have gone a lot faster that way. My labor nurse was great and I really came to appreciate the importance of having a care provider I really trust. My doctor was awesome and the trust I had in her made it easy to follow her directions when things got a little scary during Daniel’s delivery. She made sure I got to hold my babies immediately and that we delayed cord clamping. She even grabbed my phone and took a few photos on our way back to labor and delivery.
This was not the peaceful fourth birth at an amazing birth center like I had planned when I first found out I was pregnant, but I managed to have twins vaginally without an epidural or continuous monitoring or many of the other things people often think are routine with multiples. Despite the assumption that twins generally are and should be delivered early, mine cooked to almost 38 weeks (according to my calculations that I based on my other three babies whose due dates all changed to about a week earlier after a very early ultrasound, these twins may have been closer to 39 weeks). No one had to spend any time in the NICU and we all came home right away. The adjustment to five kids, two of whom are newborns, has been difficult. My mom has been here since about a week before they were born and I don’t know how I would be managing without her. Our generous friends and family have been providing our dinner for the past few weeks and that has been a lifesaver. These are our last babies, so I will do my best to enjoy every phase. Except the sleepless nights. There is nothing enjoyable about being awake in the middle of the night dealing with a hungry/poopy/fussy baby…and then another hungry/poopy/fussy baby.
We love them. They are adorable and an adventure all their own.