A Tale of Two Babies
Dateline: September 4th, 2001. At 36 weeks and 4 days, we were scheduled for our by then weekly check-in with my ob-gyn, Dr. Rinehardt, and an ultrasound with perinatologist (high-risk pregnancy specialist), Dr. Troyer.
A Regular Checkup...So We Thought
Both babies (A & B) at this point had been head down for a couple of weeks. Ultrasound weight estimations betwixt the two had always been fairly close, within a few ounces...until that Tuesday. On this fateful day, all skilled surveyors of the images were guesstimating approximately a one-pound difference between Baby A/Boy Child & Baby B/Girl Child. Whereas I thought, "How sweet! He's a bulky boy and she's a delicate flower of a girl," Dr. Rinehardt was less amused.
Although not too serious, a broadening weight discrepancy between twins can indicate a beginning trend toward one twin siphoning off more nutrition than is his fair share. Forty weeks is considered full-term for a single birth, 37 weeks for twins. We were pretty dang close. As a matter of fact, we were told labor should begin on its own after 34 weeks; nothing would be done to stop or slow the process.
Dr. Rinehardt said, "It's time for us to start thinking about inducing these babies soon," and he left the examining room briefly for a tete-a-tete with Dr. Troyer. My husband, Scott, and I, heady with the reality of pending births, were discussing which birth date sounded better, when Dr. Rinehardt returned. Apparently "soon" is a very subjective term; he came in and chirped, "I'm on duty tonight. Go on home, get your bag, and let's bring those babies!"
Holy smokes! We must have staggered out of the medical building and gotten to our car somehow, but I barely remember it. What I do remember vividly is getting home, the two of us grinning like idiots, and making key calls to a few family and friends. As we walked out of the house to head back to the hospital, it hit me. The next time we crossed that threshold; we'd be a family of four.
What an indescribable feeling.
Arriving for the Arrival
We got to the hospital front desk, carrying all our insurance verifications. Sure I looked ready to pop, but I was smiling. (Note: I wasn't in labor yet!)
Now we loved our hospital, but our one negative experience came as a result of inefficiency (or lack of caring) by the individual who took our insurance information. My husband was suspicious right off the bat about how accurately our details were input into the hospital's computer system. His suspicions were justified. Believe me, the last thing you want mid-labor is for your hubby to have to leave your side to "clarify" admittance details.
In a nutshell, take every card, letter, and verification you have received from your insurance company to the hospital with you. We did, and we needed to show them repeatedly. Keep them in your "packed bag," or the glove compartment of the car you plan to take to the hospital. Better yet, make copies and keep a set in both locations. Bad enough if your man has to leave the room when you are in labor, heaven forbid he need to leave the building!
Hooked Up & Monitored
Back to our story: By 10 p.m., I was naturally 2 centimeters dilated, and almost fully effaced. (Side note: words like "dilated" & "effaced" become so frequently used during your pregnancy that you'll forget your non-pregnant friends and family may have no idea what they mean. Both refer to the status of your cervix, the membrane holding the babies in. Dilated is how "open" the membrane is; effaced is how "thinned" the membrane has become. For the metrically challenged, a centimeter is about the width of your fingertip.)
Dr. Rinehardt was predicting we'd have our A & B before noon the next day. We were put into a Labor & Delivery Room, where monitors/sensor pads were belly-mounted to track Baby A, Baby B, & Mommy -- keeping an eye on everyone's blood pressure and stress levels. An IV shunt was attached to the back of my hand to be ready for any/all drugs to be administered. Except for the epidural (the anesthesia shot that desensitizes abdomen, pelvis, and gal parts) -- that one goes in your lower back, and much later in the game.
After a short while, you feel like an octopus. Tubes seem to be coming out of you everywhere. A sensor was even attached through my vagina to the top of Baby A's head. (There is a great pulse point atop babies' noggins. Even after your babies are born, you can often see their heartbeats through the top of their heads.)
The grandiose idea of having a "moving labor," where you can walk around and maybe even shower for comfort seemed pretty darned impossible. Shoot, even shifting slightly in the bed could be cause for readjustments of sensor pads in all their various and sundry locations around my body. The best part? The nurses didn't mind at all. Shift as you need to. You will want to do anything you can to alleviate discomfort, and if rolling to your side helps, do it.
After all our monitors and machines were attached, Baby A's water sac was broken, labor-inducing drug, Pitocin, was administered through the shunt, and the contractions began. Pitocin is not a "slow build" kind of drug. The contractions begin rapidly, and magnify in strength quickly. As a first-time woman in labor, the big surprise for me was that my contractions felt like intense menstrual cramps.
Of course at that point, it became obvious that I had been experiencing some mild contractions off and on the whole preceding weekend. The searing, knife-cut pains I had imagined, and that I had seen portrayed so vigorously on TV, didn't exist. However, they do intensify...and come more frequently. After all our Prepared Childbirth classes, I knew it wasn't advisable to get an epidural prior to a 4 cm or so dilation. So I started riding it out.
Keep in mind, with a twin pregnancy, almost every ob-gyn will heartily encourage you to have an epidural. Even if both babies are head down when labor begins, after the first baby is born, the second, who all the sudden has some room, can go breech or transverse (side to side). Baby B can also go into distress for whatever reason, and an immediate c-section may be necessary. My opinion? For your health, your comfort, and for the safety of the babies, don't be a hero. Get the epidural. As Vicki Iovine wisely illuminates in The Girlfriend's Guide to Pregnancy, no one is there to give out awards when the birthing process is done. You may as well be as comfortable as possible...and she is talking about single births.
So there I was, at long last, laboring away, watching the intensity of each contraction form its individual bell curve on the bedside ticker-tape printout, feeling pretty uncomfortable (to put it mildly). I had to stay on one side or the other throughout the bulk of my labor. As we discovered when I nearly passed out in our non-stress test, the weight of the babies and uterus contents was substantial enough to cut off my circulation if I lay on my back. So on my side it was.
The only real relief I could experience was my husband pushing his fist with all his force into the small of my back during contractions. Bless him, he tried to remember the exact placement between contractions, but the relief spot would move. One of my clearest labor memories is of me grabbing his fist and shifting it, perhaps a wee bit violently, to coincide with the pressure point. The romantic hand massages and eye-to-eye gazes I had imagined seemed ludicrous mid-labor.
Feeling pretty rough. The nurse offers me Stadol. She assures me it is a totally safe drug that will "take the edge off, and feel like I have had a couple of cocktails." I'm game, and into the hand IV shunt it goes. A couple of cocktails? For me, it was like a bad keg party. Literally, I had bed spins. The edge of labor was off temporarily, but I was miserable. (However, don't use my experience with Stadol as your sole perspective. Most women I know were thrilled with the relief it provided...it just wasn't good for me.)
Ready for Delivery
The bell curves on the printout kept getting higher and higher, and coming more and more often. Determined not to be a wimpy "Give-Me-The-Drugs-Prior-to-4 cm Mommy," I looked at the clock, and was determined to hold off on being measured again until 3:00 a.m. Looking at the clock became fixation on the clock. The "focal point" framed photo of Scott and me in Vegas never made its way out of our bag. The clock had my total attention. Our nurse had departed our room for a delivery in progress, and had other nurses checking in on me.
No doubt you have heard it already, but labor and delivery room nurses are amazing, amazing women (and men). One of my "check-in nurses" arrived to find me weeping slightly around 2:30 or so. Plus, I was experiencing uncontrollable shivers, the teeth-chattering kind...but I wasn't the least bit cold. (Unbeknownst to me pre-labor, nerves, adrenaline, drastic hormonal fluctuations, all can cause pronounced shivering/chattering. Don't be alarmed if you vibrate mid-labor like I did. You're normal.) She went back and told our designated nurse, who had at this point wrapped the delivery she was assisting, and was cleaning up.
They measured me, and I was 10 cm, ready to deliver! Dr. Rinehardt, rather than whisking us off to the emergency room as we had been told was protocol with twins, said, "We're going to do this here!" Bless him. In came the double fleets of NICU (Neonatal Intensive Care Unit) personnel, isolettes (incubators/baby warming boxes), and delivery paraphernalia. We pushed a few times so I could feel the muscle groups required to do the job.
The anesthesiologist was roused from his slumber at no doubt the most dreaded hour of the night to perform the epidural, which he did bleary-eyed, but marvelously. Yes, the needle is daunting. Yes, you have to be immobile, often during a contraction, to receive it. With the pain you will likely be in at the time the epidural is administered, the needle will look like nothing. Plus, you know it holds relief.
Seemingly Never-Ending Pushes
Between pushes, I had to roll on my side to ease my aforementioned circulation challenges. So I would push, on my back, to a slow count of 10, and roll over onto my side until the next contraction began. Be forewarned. When you push down in your nether-regions, all the muscle groups down there are next-door neighbors. With my first push, I wee-weed a parabolic stream that my husband still giggles about. Many, if not most, women poo on the table as well. Now is not the time for modesty. Believe me, your doctor and delivery staff have probably seen far worse than you are capable of, so don't let that worry you.
Scott and I were starting to get a little giddy with excitement, thinking the 8 a.m. status calls we had promised friends and family might actually become birth announcements. No such luck. After a few rounds of pushing, Dr. Rinehardt came back in. [Note: The doctor doesn't spend all the pushing time with you. He or she will check in during the pushing, and will be there for the entry into the world of your twosome.] Looking at my cervix, he said it seemed to be closing slightly, and there was no reason to make Baby A push through quite yet. Out go the fleets of NICU folk. Into the shunt goes some more Pitocin. Epidural kicked up a notch, and encouragement followed from all to "try and nap." We rested a bit; Scott claims he actually slept some. I enjoyed watching the contraction bell curves ascend to heretofore unseen heights almost pain-free.
Around 9:30 a.m., I started getting a bit uncomfortable again. New nurse Ginny on duty measures and checks and we are ready to push again. Dr. Rinehardt agrees.
Counting the Ticking Clock
We were pushing. And pushing and pushing. My right leg seemed to have collected more than its share of the epidural juice, and was so numb it had to be lifted into the stirrup each pushing session after I rolled onto my back. I was a comical sight.
After many of the pushes, I was offered oxygen. I think it helped. Even if it didn't help physically, psychologically, the regularity of the roll to back, take deep breath, push to 10-count, exhale deep breath, roll to side, suck on oxygen seemed like a nice rhythm. The rhythm would have to do, since my idea of burning a vanilla scented candle was out of the question with oxygen tanks in the room. Who knew? Thankfully, my husband brought some of our favorite music to play.
I was back to fixating on that clock. Surely by 11:30 a.m., our boy would be here. Surely by 11:45. Surely by noon. Hadn't Dr. Rinehardt said noon? My stamina was diminishing. Instead of pushing to 10-counts, we began pushing in 2 sets of 8-counts each contraction. Surely by 12:15. I was getting pretty tuckered. All the nurses and Dr. Rinehardt kept bolstering me up with how great each push session was. If so, why wasn't he here yet? I leaned to Scott, and sought a second opinion. Was our boy's head even visible? He assured me it definitely was. He saw hair, and it wasn't mine.
Dr. Rinehardt said our boy was wedged in there pretty well, and if all that pushing wasn't getting him through, he needed to "guide" him out with forceps. No, it wasn't scary. At this point, he needed to greet the world. Out come these much larger than imagined, but beautifully designed Williams-Sonoma-esque tongs. In our Prepared Childbirth class, we were told that a mirror is positioned to allow the mother a visual of the birth. In multiple births, not necessarily so. At no point were we offered a mirror to watch the births, and I am confident that was a good thing in our case. I do have a hyper-vivid memory of a reflection in the wall-mounted TV screen when the forceps were placed in the birth canal. Scott was a trouper. Hopping between views of the birth and reassurances to me. Pretty quickly it became obvious why the tongs are called "force-ps," not "guide-rs."
Dr. Rinehardt used Herculean strength, and at 12:34 p.m., our son was born. Our boy was placed on my chest briefly, Scott cut the cord (which he said felt like celery), and our A-Child was whisked away to be cleaned up and Apgar-tested. (Apgar is a test administered to babies at both one minute and five minutes after their birth. The test gauges the baby's color, respiration, heart rate, muscle tone, and reflexes. The one-minute test assesses how the baby fared during the birthing process; the five-minute test determines how the baby is coping with the outside world.)
We started to push for our daughter, also known as B-Child. My cervix began to start closing again! Then it happened. I began dry heaving. (You don't eat or drink anything during labor but ice chips) Dr. Rinehardt said, "Go with that!" Apparently, my push muscles had given out. The miracle of creation provided a secondary set of muscles to get our girl. Dry heaving continued, and by 12:41 p.m., our daughter was born.
That's a Wrap
Both babies were out, but we still had placentas and all sorts of uterine goo to extract from my gal parts. And of course, my ever-modest cervix really started to close when the babes were both out. My hubby, who wasn't squeamish at all through the process, looked to see Dr. R almost up to his elbow extracting remnants of the birthing process. (That got to him a bit.) The post-baby deliveries are other reasons I heartily endorse that epidural.
After Mommy's uterine cavity was cleared, the babies weighed and Apgar tested, Daddy and I finally had a misty moment. Realizing the magnitude and miracle of the birthing process is overwhelming. You always hear of "death-bed" conversions of faith. You can't tell me that a "birth-bed" doesn't inspire you to an even greater degree.
Shortly, the two sweet, clean, swaddled, greasy-eyed babies were brought to us. Absolutely precious. Have your camera ready.
Reality of Labor & Delivery
No "Baby Story"
The night after our twins were born, a dear friend of ours took my husband out for a celebratory meal, and to get the real skinny on the birthing experience. His advice to her, "Stop watching A Baby Story! It's more like an outtake from Gladiator." Whereas I think his assessment was a little gorier than reality, by no means is the experience as pristine & clean as TV mini-documentaries would have you believe. (Writer's Note: Let me say right now, I enjoy A Baby Story. However, don't think for a second that you will be done and home with your babies in 30 minutes.)
Every labor story is different, single or multiple births. Aspects of my labor experience were picture-perfect. Others, obviously, not so much. Your story will have the same balance of pros and cons. Your labor story will be yours and yours alone. Share it with those who need to hear the positives. Share it with others so they'll see you made it through the negatives. The end result (and in your case, results) makes it all worthwhile. You will never in your life be more convinced of, and feel an active part in, the miraculous cycle of life.
Condensed "Breeder's Digest" Version of Birth
So you've read the unabridged version of a twin labor/delivery and want your partner to have some preparatory insight, but doubt he'll plow through that lengthy description?
We began with an unexpected induction, followed by the tossing away of predicted circumstances and environment, a surprising revelation of what contractions actually felt like, a determined-not-to-be wimpy-lady in labor, tears, bad drugs, good drugs, an ever-supportive husband, false-alarm pushing, cervix closing, 14 hours of labor (two ardently pushing), clock staring, a numb leg, laughter, oxygen, forceps, a son born, brief meeting, more pushing, dry heaving, a daughter born, brief meeting, cervix determined to close, hard-fought afterbirth retrieval, gynecological embroidery, cleaned/Apgar tested/greasy-eyed babies returned, full family hug and photo, and at last, more tears. Daddy passes two suggested names on a piece of paper to Mommy. Perfect. More laughter. Lives changed forever...in 14 short hours.
Cheryl Lage is a full-time, fully fulfilled mom to fraternal twins Darren and Sarah. During twin-synchronous sleeping hours, she is the Web host of www.twinsights.com, a Web support site for new and expecting twin parents.
Originally published on AmericanBaby.com, May 2006
All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.