Tuesday, March 09, 2010

Twin Birth Story (Repost)

I'm reposting this for reference for the story below.
There have been a few different versions of this story and I lost the original when I edited it for the Colorado Midwives' newsletter awhile back. So, this is my attempt to breathe some of the life and details back into it. But, it's a bit long. ;) Our love and thanks to so many friends and family who made this story what it is. Each year, I sit in disbelief and I remember this story and how blessed we are to have these girls.

Two years after our first beautiful homebirth, we were planning our second. I had a very normal and healthy pregnancy, just a bit tired and more aches and pains than the 1st time around, all to be expected when running around after a toddler.
Around 20 weeks, my midwife started getting “ambiguous” measurements when she measured my fundal height. “I could measure it here, or……here”, she said as she moved up a bit on my belly. Then, she and my doula friend Ranelle started to joke about twins, something that was never a possibility, nor was it funny, in my mind. Meanwhile, I also started getting comments from random people asking if I was having twins. Note to those of you addressing a pregnant woman – if you want said pregnant woman to ever speak to you again, never ever, even if you know it’s true, ask a woman if she is carrying more than 1 baby. It’s wrong.
During my 30 week appointment, my fundal height was no longer “ambiguous” but was measuring clearly at 34cm. My midwife felt “a lot of baby” and estimated the weight to be around 6 pounds if it was just one baby. But she estimated size based on the baby’s head to be around 4 pounds. We discussed the possibility that there were 2 babies in there, due to all the “little parts” she was feeling, and she suggested getting an ultrasound. Unfortunately, this was the one appointment (in both pregnancies) that my husband wasn’t able to attend and I was in complete shock. I called him from the car and said, “you’ll never believe what just happened.”
We got a second midwife’s opinion who suggested singleton pregnancy with polyhydramniosis (too much amniotic fluid) and confirmed the suggestion for an ultrasound. So, at 32 weeks, I reluctantly entered the ultrasound office concerned of all of the possibilities that could be causing the excess fluid, still convinced that there was only ONE baby in my belly. After a few normal questions, and about 3 minutes of scanning, the ultrasound tech asked, “Did you know you are having twins?”
WHAT?! My husband laughed, I cried.
I was completely overwhelmed. We have no history of twins in either of our families and though we joked about the possibility earlier on, I just “knew” it wasn’t possible. Ranelle had always prayed for twins for herself and at one point during my pregnancy had said, “Well, maybe God is giving you the twins”. I made some sort of desperate comment about how he would be making a horrible mistake if that was the case. She sweetly replied then, and many times since then, that God doesn’t make mistakes.
All I could think about was that I would have to give up my homebirth (and by the way how in the world were we going to take care of these babies!? but that's a whole other story). Homebirth is completely legal in Colorado and parents have the right to make the decision about where they have their babies, and who attends them (including having an "unassited" or unattended birth). The reason I thought I would have to give up my homebirth, is that we were not comfortable with an unassisted birth and due to the regulations for Colorado midwives, our midwife would not be able to attend us. Midwifery is regulated by DORA (Department of Regulatory Agencies) and the midwives have partnered with DORA to create statutes, rules, regulations, and policies regarding their practice. Included within the regulations, are also restrictions and in Colorado regarding twins, they read, "midwife shall refer mothers for evaluation by a qualified licensed health care provider and shall not continue as the care provider when a multiple gestation or a presentation other than vertex at the onset of labor are noted."

However, having been a hospital doula for 7 years, I couldn’t imagine how I was ever going to have a hospital birth. I had seen too much and my fear was too deep - I believed I would cause my own c-section.
We began to weigh our options. Do we still consider a homebirth? Isn’t delivering twins scary? Maybe we can talk the HMO staff into considering an “alternative” twin delivery in the hospital.
We talked with a very nice OB with one of the best reputations within the HMO who, after offering us an elective C-section, gave us statistics like "75% of twins born (in our hospital) are delivered by section" and "prolapsed cord and breech presentations are common and serious complications of delivering twin B." She delivers one set of twins a year, about average for all the other OB's. She said, “The doctors at our hospital like to think that they are prepared to do nothing and everything,” but she gave every indication that they would most likely do everything because "we’re not calm when twins come in and we don't sleep well when something goes wrong and we lose a baby or a mom. We really don't."
She suggested my husband do his own research using the resources available to him through the HMO as an employee. What he learned was that with as healthy as I and the twins were, the risk was not higher than a normal healthy singleton birth. We talked to many midwives who said that "if mom is eating right and babies are healthy, you should go to term." This coupled with the fact that we had no choice or control over which of more than 25 physicians would attend our birth, helped us come to our final conclusion.

Believing that home is a safer place to have healthy babies than the hospital, we began to believe that this was the safest place for the twins to be born!

So the question changed from “Isn’t delivering twins scary?” to "Who is more confident in their ability to assist vaginal birth of twin and breech babies?" Gabbe's Obstetrics and many of the studies supporting vaginal delivery of twins warned that the delivery should only be performed by someone well-versed and comfortable with external version and breech extraction. Our OB said that breech extractions were becoming more common with the increase in twin births, but most doctors still tend toward cesarean. And again, we had no control over which of the many HMO OB’s would actually be on-call for our birth and whether the one attending would be more comfortable with a breech extraction, or a c-section.
With all of the information we gathered regarding our choices and my growing anxiety around a hospital birth, we began to believe this wasn’t the best option for us. However, unassisted birth or asking a CO midwife to put her license on the line for our “underground” experience, didn’t really seem like a viable option for us either.

So, I sent out a probing email to a few of my midwifery mentors asking them what suggestions or ideas they might have to help us have the natural birth and holistic care for our newborns that we were hoping for. What followed, was nothing short of a miracle. I learned that in many states, unlike Colorado, the regulations did include vaginal breech and multiple gestation. Some of these include Tennessee, Texas, and Utah.
I put out a call to my natural birth community and the flood of emails and phone calls of support was absolutely amazing. We began pursuing The Farm in Tennessee, due to their amazing statistics regarding normal vaginal birth at their birth center, and were amazed to find that those numbers included twins and breech babies! I spoke with Ina May and she was encouraging and supportive but couldn’t confirm a place for us until one of her other twin mamas gave birth. With the help of our Colorado midwife, we were put in touch with her mentor and midwife in Texas. She was happy to accept us as her clients and we continued to move closer in our plans to leave Colorado.
A couple of days later, a doula in Austin heard of our story and suggested a wonderful and experienced midwife in Utah, even closer to home. After we interviewed each other, she invited us to come on out. Simultaneously, the Texas midwife had a freak and debilitating horse accident and called to let us know that she was sorry, but she wouldn’t be able to help us with our birth after all.
From there, a cascade of people knowing people pulled everything together, including a double-wide trailer with 3 bedrooms, minimally furnished by new friends, and air-conditioning – all for just the basic cost of utilities. In a matter of 4 weeks, we made the temporary move to Utah.

The first couple of weeks went by pretty quickly. Caleb went to work each day using the wifi connection at the Borders coffee shop in the next town over, about 10 minutes away. Malachi and I spent our days playing in the park, exploring the town, visiting our favorite natural foods store, and playing in our “yard”, with “Goldie” the dog on the other side of the fence. In the evenings we would pick Caleb up from “work” and go for a walk on the trail, take a swim, or explore the town. We took many weekend trips visiting Bridle falls, Strawberry Reservoir, and Salt Lake City and the temple.

About 2 weeks in, our support plan kicked in. We had rotating family members and friends start coming in to help take care of Malachi. The first shift was our sweet sister and brother-in-law. They were a welcome encouragement and new energy to help entertain Malachi. Then, our Colorado midwife and her family joined us as labor support and their daughter was a fun playmate for Malachi. Then, my mom arrived as Brigitte and Andrei had to head back to Colorado. We always had loving support by our side which made our double wide in a strange town, feel more like home. Though, one by one, they were all running out of time to stay, as my pregnancy continued on and on. My mom approached me with 1 day left before she would have to leave with tears in her eyes.
After a month in Utah and 41 weeks of pregnancy, we had tried almost every “natural” thing to get labor started. When I asked the midwife to check me, she found that I was walking around at 5cm. So, at 5:30p I had her strip my membranes, a big decision for a person who touts no interventions. Her instructions were for us to call her once I was in a "contraction pattern". Right, like that hasn’t been going on for months. So, we headed out for a short walk, a little doubtful. But, it worked like a charm, and by 7p I was having contractions 5 minutes apart, increasing in intensity. When I requested that Malachi and Caleb fill the birth tub, Caleb said, “If you want the tub, I’m calling the midwife”. Reluctantly, I agreed.
The midwife team came flying in the door about 15 minutes later, and there they sat for the next few hours. Caleb and Malachi were so sweet, and Mo was concerned with how much each “traction hurting, mommy”. Around 10p, when he was losing steam, I had my mom take him for a van ride to help him to sleep.
At 11:41p I started pushing on my knees in the birth tub. And, at 12:16 a.m. Acacia was born in the water, in the caul. They broke her bag and passed her to me. My midwife held my belly so that Baby B wouldn't turn in any funky positions. I held Acacia in amazement and before I could imagine how much time had gone by, my midwife said that Baby B was ready whenever I was ready to push. “What, are you serious?!” While holding Acacia, I pushed in semi-sitting position and at 12:26 a.m. Ameena was born in the water, in the caul. It took 2 people to break her bag. We had to stimulate her some, they cleared her mouth with a bulb syringe and she began breathing. Once I knew she was ok, I leaned back in my husband’s arms and wept. And as we held our girls, I felt the weight of the previous 9 weeks lifting……until all 3 kids started crying at the same time. The girls weighed 7# and 7#1 oz, and latched right away. I had minimal blood loss but could barely walk without constant support of my very empty belly. My mom flew home the next day and my mother-in-law flew in to help us return our double wide to its’ previously vacant state and make the two-day trip home. Thirty six hours after they were born, we were packed up and on the road. We made a few stops along the way, including many truck stops (with babies in slings trying to avoid gaulkers and germs), one or two postpartum breakdowns on my part (sorry Karen!), ice cream cones, and an overnight stay in Wyoming.
We made it safely back to a beautiful Colorado welcome from our sweet family and friends.
And, my dear friend Ranelle, you were right.....God doesn’t make mistakes.


Anonymous Anonymous said...

That is such an incredible story of love and support!! <3

Thanks for reposting!

10:56 PM  
Blogger Jenna said...

Thank you so much for this post! I recently sent you an email seeing if you'd be interested in letting us reprint this sotry in our magazine. Let me know if you're interested:

7:16 AM  
Blogger Us :) said...

That's an amazing story! ~Cassy

8:59 AM  

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