And into the world they came . . .

Monday morning, May 24, 2004
35 weeks, 2 days pregnant

I had seen my OB the previous Friday and she was getting decidedly nervous with me walking around 5 cm dilated and 80% effaced. She asked me to meet her up in the Labor and Delivery unit on Monday morning and she’d check me there. If I was making progress, she’d break my water and get the ball rolling even faster.

We arrived at the unit just after 7 am~shift change for the nurses. They knew we were coming (didn’t expect that) and immediately showed us to a huge corner labor room. We were told it was one of the largest since we were expecting twins. We would need at least 2 nurses as well as our OB and her resident. There also needed to be room for the neonatal team if anything went wrong. Besides my bed, the monitoring equipment, and a private bathroom and shower, we had a table and chairs, TV, and several recliners. I changed into a hospital gown and climbed into the bed. I kept thinking things like, “Those are the last maternity clothes I may ever wear!” and “My babies will be born in this room!” It was extremely surreal.

The nurses did my admission paperwork and asked all the typical questions. We had 2 nurses since one was being trained. Colleen was the nurse who we saw the most~she wasn’t a new L&D nurse, but she had moved to our city about a month ago. We chatted for a while about nursing, she threw an IV in me, and then Dr. H showed up. I know that a lot of people refuse the IV or are reluctant to have it. I guess I’ve been in enough Code situations at work that I know it goes much better if IV access is already established. I’ve been in situations where people needed medication to start their heart or bring up their blood pressure and we had nowhere to put the medication. Of course, I didn’t expect this to happen to me, but I was reassured that everything was in place, just in case.

7:45 am

Dr. H checked me and I was 6 cm dilated, 80% effaced, and Baby A’s head was at zero station. They got the amniohook and were all ready to break my water when Dr. H said, “Hey! You know what we should do first? How ‘bout a quick ultrasound?” Probably a good idea. It would stink to break my water and then find out that Baby A had moved to a nonvertex position. The ultrasound machine was wheeled into the room and we confirmed that both babies were still head down. They were, so she broke my water~thankfully a nice clear pink color~and we were off.

So my question immediately was: how much amniotic fluid is IN that sack?! It felt like I lost liters upon liters of fluid. My sheets were changed and Colleen gave me the “loincloth” look with a towel folded between my legs. Every time I laughed (and with A around I did that a lot), more fluid came out. Getting up to the bathroom was NOT my most graceful moment. I had to lumber the 15 feet while holding the loin-towel between my legs and trailing the monitoring equipment and my IV.

Somewhere in here the resident came and asked me some questions. She was very hopeful that I’d deliver before she went home so that she could see a vaginal twin birth. When she told me she went home at 5, I declared that she had BETTER see this birth or else I would be one unhappy camper.

I also had some labs drawn and the anesthesiologist came and talked to me. We went over the risks and benefits of an epidural and she told me what would happen if I needed to have a c-section or emergency c-section. She didn’t come right out and say I should get an epidural, but by going over the “worst case scenarios,” it was kind of implied. I stayed strong which was easy because I had yet to experience any pain.

8:45 am

My mom and mom-in-law, R, showed up. Our room was so large that people would knock on our door and not hear us call out, “Come in!” The monitors showed me having regular contractions every 2-4 minutes but nothing I could really feel. A started to get hungry (I had told him to eat breakfast but does he listen to me?!) so the moms went to get him some food. (A: I had Cheerios for breakfast!)

9 am

A asked if he could draw on my belly~it would be his last chance. I refused. This became a common theme for us. I never acquiesced. There were also a bunch more forms to fill out about breastfeeding, permission to be treated, and some other stuff.

9:30 am

We entered into a discussion of names while my contractions started getting higher and higher on the monitors. Once I explained to my mom what she was looking at, her eyes never left the screen. It was like I didn’t exist. I was, instead, subjected to, “Hey, that was a big one!” quite regularly. My mom explained to R what she was looking at and then I lost my mom-in-law to the equipment as well. Thankfully, A was on the opposite side of the bed and couldn’t see it so at least he was still focused on me.

10 am

Colleen checked me again and I was now 7 cm dilated, 90% effaced, and still at zero station. She called Dr. H to let her know my progress. I started to get a bit hungry, despite my Carnation Instant Breakfast and 2 granola bars at 6 am.

10:10 am

My first painful contraction! This would become less and less exciting as the day wore on. Colleen had me rate my pain on the 1-10 scale and I believe I started off around a 2 or 3. I think at this time I honestly believed that things wouldn’t get any more painful.

10:25 am

We had now entered into a discussion of the game “Settlers.” We chatted about how R gives hilarious directions with a ton of extraneous information included and my contractions increased to every 2-3 minutes and my pain to a 5. A left momentarily to call his work and let them know that yes, today IS the day!

11 am

Another cervical check with little good news: everything was the same except the head was a little lower, maybe +1. I think Colleen just said that because she saw my disappointment. By now I realized that I would not be following my mom and sister’s less-than-3-hour-labors. I was displeased, to say the least, because I really believed I’d be in and out of there by noon at the latest. Silly, silly girl.

11:15 am

My pain with contractions had increased to a 7.

11:35 am

I was starving to death. I had eaten a billion ice chips and not felt one iota better. Despite my “ice chips only” status, I had A sneak me glasses of water. C’mon, if I did have to have an emergency c-section, the water would be out of my stomach by then! (A: Besides, do you know what ice chips turn into when they grow up?) There’d be no danger of me aspirating it and developing some horrible pneumonia. I put my order in for a large, ice cold Coke and a soup/salad combo from Panera bread: Fandango salad and broccoli cheese soup. Man, was I craving that Coke!

11:45 am

I declared, “Ice chips suck.”

Colleen brought in a rocking chair and suggested that I try it for a while. After lumbering to the bathroom (which I’d been doing almost every hour on the hour), I settled into the chair. It was nice and a good substitute for my birthing ball which I didn’t even want.

12:15 pm

Baby A had moved down so low that we were having a horrible time keeping the monitor on. The heart rate kept coming and going despite my manipulations and Colleen’s.

12:30 pm

Our moms were fascinated with the fact that my contractions were off the charts. The peaks didn’t even register on the paper. I could still talk between the contractions, but I needed to be silent, breathe, and concentrate through them.

12:40 pm

Dr. H arrived. Her office is across the street so she spent the morning seeing patients and then popped over during her lunch hour to check my progress. I was still 7-8 cm dilated and 95% effaced (c’mon, can’t we just say 100%?!). She declared that I needed a “whiff of pit.” Sometimes with multiples the uterus becomes overstretched and doesn’t contract efficiently. I immediately became concerned. Yes, I was excited to meet my babies and would prefer that it happened sooner rather than later, but I was dead set against the potential snowballing of pitocin to epidural to c-section. I realize that it was just that: potential, but I was still concerned. I asked about how the pitocin would increase my pain and she told me that it wasn’t the pain that increased, but I wouldn’t have the slow crescendo and decrescendo during the contractions. I would suddenly be in the midst of a painful one and then it would just as suddenly stop. This did not sound appealing, but I trusted my OB and I agreed.

Colleen started the pitocin at 2 (don’t ask me how they measure it~milligrams, grams, whatever) and over the course of the next hour decreased it to 1 and then 0.5. Apparently, I have a very sensitive uterus.

I decided to ask our moms to leave. I was having to concentrate harder and harder during the contractions and things were definitely more painful. I couldn’t carry on the pretense of a conversation anymore and I wanted just A in there with me.

1:05 pm

I considered an epidural, but decided against it.

1:15 pm

I started feeling warm and shaky and Colleen warned us that transition was fast approaching. As cool as it was to know that we were reaching the end of the first stage of labor, transition isn’t the right word for it. I think “mind-blowing, agonizing pain that can never be described” would be more accurate.

1:40 pm

Colleen checked me since I felt like I had to have a bowel movement: 9 cm, 100% effaced! Woo-hoo! I slogged off to the bathroom once again. It was getting harder and harder to make it there. It wasn’t just all the crap that I was dragging plus the amniotic fluid dripping~I had about 2 minutes between contractions and then I had to stop and concentrate. So I had 2 minutes from the end of one contraction to get all my stuff together and get to the bathroom, I would have several contractions while in the bathroom, and then I had 2 minutes to get back in bed before the next one hit. It was awfully hard to coordinate.

2:20 pm

The pain was becoming horrible and overwhelming and yet at the same time, I was extremely tired since we hadn’t slept well the previous night. I’d have a contraction, then yawn, contraction, yawn . . . you get the idea.

2:35 pm

I couldn’t even talk to A. It took all my energy and concentration to make it through each contraction. The recovery time between them kept getting shorter and shorter and I had a hard time not dreading the next one. I couldn’t even open my eyes. It took everything within me to make it through each contraction. A was good about standing back and not touching or talking to me very much. I remember that he had a cold cloth that sometimes felt nice and sometimes felt obnoxious on my face.

Colleen checked me again. I was beyond disappointed to learn that I was only 9.5 cm dilated~my cervix had an anterior lip. I sincerely believed that I couldn’t do any more. Colleen had me turn over onto my right side (I had been sitting in the rocking chair, straight up in bed, or on my left side). She said that my next few contractions would be very painful because the baby’s head would push on my cervix from a different angle. Hopefully this would open up the cervix to 10 cm. Well, she was definitely right about the more painful contractions and luckily about everything else, too.

3 pm

My pain now was not even on the 1-10 scale. I remember thrashing around in bed, swearing, and moaning. Colleen checked me again and declared me completely dilated and effaced with the head at +2 station. Dr. H must have been called over from her office because suddenly she was there. I remember seeing a ton of people in the room and realizing that they were the neonatal team. Dr. H was obviously annoyed that they were there. I heard her tell them that I was a “prima” meaning this was my first pregnancy. We had no idea how long I’d have to push and she didn’t think they wanted to stick around and find out with us. They left and it was me, A, Dr. H, her resident, and our 2 nurses in the room. The lights had been lowered earlier, but now a light from the ceiling descended and a spotlight was shown upon my crotch.

3:11 pm (according to the nurses notes)

I started pushing. I have some conflicting feelings about this stage. I remember feeling like I was hyperventilating and going to pass out. Someone put an oxygen mask on my face. Dr. H and her resident kept wanting me to push in 10 second increments, but the most I could manage was 5. I think that pushing in shorter spurts helped me tear less than I did, but I felt a lot of pressure (no pun intended) to push for the longer time. I kept apologizing to everyone for not being able to push the entire 10 seconds. Looking back, I only pushed for about 20 minutes and I wish I hadn’t felt like I needed to apologize for doing it differently than they asked.

The mirror was pulled out around now in accordance with my birth plan and I started pushing in earnest. It took me a few practice pushes before I got the hang of it. For those of you who have never pushed a baby out, let me explain what the hang of it is: get over your fear of pooping and push with those muscles. Once I remembered the slogan “If you ain’t poopin’, you ain’t pushin’” that I read somewhere, my pushing got much more effective. The resting time in between contractions was a blessed relief, but the feeling of someone sitting in my vagina was totally bizarre. At some point, Dr. H told me to look in the mirror when I pushed and I would see my baby’s head. That was an amazing sight and gave me the oomph I needed to push her out.

Dr. H had suggested a pudendal block when I started pushing and at that time I would have taken crack had it been offered for pain relief. I agreed, but the baby came down the birth canal too fast~they didn’t have time to administer it. I remember screaming and thinking, “Ring of fire! Ring of fire!” as I felt her head crowning. (A: Damn! I missed my opportunity to sing the Johnny Cash song “Ring of Fire.” Probably for the best.) I think the resident took that moment to administer lidocaine to me since I was tearing and I remember screaming at her to stop it. Then L was out, crying and peeing all over.

My mom told me later that she had been outside the door as I was screaming and she started crying. Luckily, there was a very sweet nurse who stopped to comfort her and said, “Listen, I’ll bet we can hear a baby crying!” and they did.

3:34 pm

Dr. H placed L on my stomach with the declaration, “You have a girl!” and I started crying and touching her. Colleen wiped her off with a towel while A and I stared at this blue, cheese-covered miracle that we helped create and he cut the cord. I noticed immediately that she has my freakish little toe. It doesn’t look like a toe; it looks like a hump with a nail. (A: Or a comma.)

A asked if he could go tell the grandmas that we had a girl, but Dr. H advised against it. I’m sure he would have gotten back in time, but why take a chance? After all that, it would really suck for him to miss the birth of his second child.

I was told to relax and it would be a few minute before I had to push again. Honestly, as awesome as it was to see L and know that she was born and healthy, I just wanted to run away so I didn’t have to do it again. I couldn’t stand the thought of going through all that pain once more, no matter what the reward.

The other nurse took L to put her under the warmer and check her over. Her apgars were 7 and 8. Dr. H wheeled the ultrasound machine over to me again to make sure that Baby B was still head down. Everything looked okay, so A says she started pushing on my stomach and watching it deflate like a balloon was strangely fascinating. She pushed Baby B down as far as possible and then I felt the warm gush of fluid as she broke my water again.

The contractions started up almost immediately. I was much better at pushing this time, but still could only push in 5 second increments.

3:47 pm

E entered this world face up and chin forward with her beautiful little face all covered in bruises. I heard, “You have another girl!” and looked down to see this one peeing all over as well. Dr. H said that since she came so fast, her bruising was much less than others she has seen. E was placed on my stomach and we marveled over our second miracle. A cut the cord again.

At this point, the mirror at the foot of my bed should have been taken away. Instead, I watched myself lose what looked like, even to me, a ton of blood. It turns out later that my hemoglobin dropped 3 grams, so that wasn’t a small amount of blood. I remember the resident saying that I had 2 “short cords.” The next thing I knew Dr. H was holding both cords and telling me to give a push. Both placentas came out immediately and looked normal, which means gross. (A: Dr. H dropped one of the placentas. It smacked against the tiles like 4 lbs of raw liver.)

I had a partial third degree tear and I had to ask for clarification about what that meant. Apparently, I had only torn a few muscle fibers. Or maybe she was just trying to keep me from panicking by using the word “partial.” The resident stitched me up under direct supervision from Dr. H and later on I was a lot less sore than I thought I would be. I was expecting my first bowel movement to be torture, but everything was fine. I was religious about changing my ice pack maxi pads, taking my stool softeners and fiber, and using my perineal squirt bottle, though, so I’m sure that helped.

While I was getting sutured, the nurses were weighing, suctioning, measuring, and cleaning the babies. E’s apgars were also 7 and 8, just like L. One of them, I’m not sure who, had some sternal retractions and they were keeping a close eye on her. I was worried that she’d need to go to the intermediate unit, but they resolved within about a half hour and she was breathing normally.

It was kind of funny, but while everything was going on and my legs were still up in stirrups, Dr. H pointed out that I had a mole somewhere down there and asked, “You want me to take this off for you?” It makes me giggle now to think of it. But take it off she did and you’ll all be glad to know that it was benign.

I was (and still am) very jealous that A got to go out and make the big announcement to our moms. They were thrilled~there was much hugging and rejoicing~and phone cards and address lists were immediately pulled out to begin broadcasting the news.

As soon as I was stitched up and decent, our moms came in to see the babies. I know that I shed a lot of tears and I think they did, too. We traded them around between us with no one wanting to give up the baby they held, but still wanting to hold the other one. A made some phone calls to our friends, David and Lisa, who were to spread the news to everyone else, his work, and his sister in Germany.

The girls were reluctantly handed over, one at a time, to be given the ultimate spa treatment by one of the nurse’s aides. Shampooing seemed to be the most popular therapy and why not? I know that I love getting my hair washed by someone else. I remember E screaming during part of her bath and looking over to see a squashed, bruised, bright red little bundle in the warmer. (A: Her quivering lower lip is what did me in.) She was in one of my favorite positions: on her tummy with her knees drawn up underneath her. Totally adorable.

I was given a dinner tray which contained food I normally never would eat (lemon jello? Chicken pot pie?), but I devoured every morsel. My mom got me a Coke from the vending machine and it was the most glorious nectar of the gods that I had ever tasted. After that I felt well enough to get up to the bathroom. Colleen had asked me to let her know when I was ready since she wanted to be in the room. I guess me falling on the floor and sprouting a brain hemorrhage wasn’t on her list of things to do that day.

I very slowly made my way to the bathroom, scarcely believing that the last time I had gone in that closet of a room I had been pregnant with my girls and now they were here! I’m glad that Colleen warned me that it would look like I was losing a lot of blood because it really did. It took me quite a long time in the bathroom, mainly because I had to keep resting. Even with my naturally porcelain (read: pasty) skin tone, I looked sickly and green. I found out later that my hemoglobin was 9.5 and that’s why I felt so dizzy and weak. My first clue that I had my bladder back was when I peed out a liter right then and there. It’s been marvelous to pee every couple hours or even longer (!) instead of every 15 minutes.

I put on my fancy mesh panties and ice pack/maxi pad. God bless whoever invented the ice pack/maxi pad. I don’t know if all hospitals have them, but it’s just like it sounds: a thick maxi that you bend in half to release the cold and then stick to your swanky mesh panties. It provides instant relief to sore and swollen parts~lovely.

I hobbled back to bed and Colleen suggested that I try breastfeeding. I was a bit nervous~I had made such a big build up in my mind. What if I couldn’t do it? E showed her stuff by latching and sucking a few times. L looked at me like I was out of my mind. This would be the pattern they would follow for several weeks. I guess I should have been warned then!

7 pm-ish

My mom left to get some rest at home (hey! What had SHE done that she needed to rest?!) and we prepared for me to transfer to my postpartum room. There was a lot of pressing on my uterus~this would get better. At first it was extremely painful, but by the next day it was just a mild cramping. I’m glad it was contracting like it should and no one had to massage it.

R tried to get in contact with the new great-grandparents, but no one was answering their phone. We found out a few minutes later that was because they were already at the hospital and on their way upstairs. Grandma and Grandpa arrived and were delighted to coo over the girls. I was mildly amused that most of the conversation consisted of how each girl looked liked someone on their side of the family. If they came across a feature that was not from their side, like their long fingers, they looked mildly confused. I felt like reminding them that my DNA was in there, too!

The new night shift nurse took my IV out, got me in a wheelchair, piled my babies on my lap, and whisked me away to my lovely corner room with big windows and a beautiful view. Well, as beautiful a view as you can get of my city which, I guess, is not that great. (A: It’s not bad.) She went over the bedside meds I was allowed to take by myself (Motrin, Tylenol, and a stool softener) and made sure I knew that stronger pain medication was ordered if I needed it.

A’s other grandma, Mormor, showed up along with his stepdad, Walt. They all stayed about 20-30 minutes, passing the girls around and exclaiming over every feature. E was making what I can only describe as mewing sounds for much of this time. L was regarding everyone solemnly. Soon our family left and A and I were alone with our daughters. We spent some time silently holding them and then looking up and smiling at each other. There are times when words aren’t helpful and this was definitely one of them. Our hearts were so full that we thought they would burst. A year ago we were about to embark on a disappointing summer filled with canceled or postponed IVF cycles and now we were holding our two beautiful daughters. Nothing could have made that moment more complete and perfect.

I received another dinner tray with a sandwich, fruit, yogurt, pie, and ice cream and I devoured this one as well. Giving birth makes me hungry! I kept having hot flashes and getting all sweaty. Dr. H had assured me that this was normal and as I write this, two weeks post-delivery, I tell you that it still happens occasionally. I guess my body just needs to get my hormones figured out again.

I tried BFing again and was still unsuccessful. The best nurse in the world, Nancy, told us that if they weren’t eating regularly by 12 hours after birth, I would need to start pumping and we’d have to feed them a different way~syringe, bottle, cup, etc. By 4 in the morning, they still weren’t doing well, so I started my relationship with the pump. Over the next two weeks, we would have a lot of BFing issues that I’m pleased to say are pretty much resolved. The lactation consultant that I saw in the hospital pointed out that they had just gotten their sucking reflex at 34 weeks gestation. She said it would take a few weeks, but once I hit 37 or 38 weeks gestation, they would suddenly figure it out. Since my girls are brilliant, they figured it out around 36.5 weeks. I’m so glad that I stuck with it through the difficult times. I’m even more thankful for “Lactation Linda” who helped us while the girls were under the bili lights. They are now very consistent with latching on and will nurse for about 10-15 minutes per session. It’s a very fulfilling experience and I’m so thankful for the many lactation consultants (I think I spoke to 4), La Leche Leaders, and our pediatrician for their recommendations and support. Also, there’s no way I could have done it without A. He rocks. (A: Like Hendrix. In what ways do I rock? I think we all want to hear MORE!)

We spent that first night waking to every little sound or movement. (A: Entering sleep deprevation central.) Since they had come out so quickly, they still had a lot of mucus to cough up and we were using the bulb syringe quite frequently. E’s temperature dropped later that night, but Nancy was awesome and let A do skin-to-skin (Kangaroo care) with her for a few hours instead of taking her to the nursery and putting her under the warmer. After several hours of being close to the furnace that is her father, she was nice and toasty with a normal temperature.

We were released on Wednesday, just 48 hours after they were born. I couldn’t believe that I had achieved my top three goals: healthy babies, normal vaginal delivery, and no pain medication. Let me discuss that third goal really quickly. I am proud that I delivered my children without any pain medication. However, if I was going to do it again, I would have gotten that epidural the second I walked into the hospital. I had no idea that childbirth pain felt like that. Of course it’s worth it, but if we are blessed with any more biological children, I will feel no shame in asking for an epidural because DAMN, THAT HURT! I will also encourage other women who are having their first child to keep an open mind. I was so focused on the “medication is bad” mentality that I think I forgot that pain meds were even an option. Once again, I made a grey issue into a black-and-white one.

As the girls and I were wheeled out to A waiting in the car, I caught a glimpse of how our lives will be. We were stopped no less than a dozen times in the short ride to the front of the hospital. While I was waiting for A to pull up, there were at least another dozen people who didn’t stop, but smiled and murmured, “Look! Twins!” to each other. We’ve experienced it each time we’ve taken them out~so far just to the pediatrician’s office and to have blood drawn. We have found out that the entire world is made up of twins: our pediatrician, his receptionist has twin boys, someone in the lobby has twin sisters, the lab tech is a twin . . . the list goes on and on. We’ve been asked the same questions over and over again: “Do they sleep at the same time?” “Are they identical?” “They’re so small! How much do they weigh?” “Do you get any sleep at night?” etc. So far the questions have all focused on how we manage two babies at the same time. No one has made any inquiries into our fertility status. It’s controllable right now, but there have been times when we’ve really needed to leave and we’re still being grilled.

I am pleasantly surprised by how my belly is returning to close-to-normal. It’s not like I had a flat, sculpted stomach to begin with, so I’d be shocked if I ended up with that. But besides the stretch marks and the slightly looser skin, I think it’s about the same size it was before. I am not so confident as to try on my jeans yet. I’m currently living in elastic waist bands and t-shirts. My stretch marks started fading almost immediately. They’re no longer an angry reddish-purple, but more of a soft rosy-brown color. And as many of you predicted, I don’t care about them at all. When I look into my girls’ beautiful eyes or watch them fall off my breast, drunk with milk, I would do it again in a second. I have no regrets.

I’d like to put down my first impressions of their personalities, just to look back in 10 years and see if I was close or way off base.

L~L is a thoughtful and calm baby. She rarely cries, even during the lab sticks. She will be detail-oriented and methodical. She’ll finish things she starts and we’ll be able to count on her to follow through. She’ll have a streak of mischievousness, though, and a highly intelligent sense of humor.

E~E is a quick, decisive baby. Even while sleeping, she kicks and grunts. She started doing that while still inside me. She will constantly be on the go and have a quick temper. Already she gets mad as all get-out while having her diaper changed or getting stuck. She turns a fierce shade of red over her entire body, but is easily soothed. She will be intensely loyal with a quick smile and a warm heart.

Comments

[Sol]

Hi there. I just wanted to say how wonderful your birth story is and thank you so much for sharing it. I recently started to read your blog and cannot wait to know more about you and your girls.

[amy]

Hi. I just started monitoring my site traffic and saw I was getting several referrals from your site, which until this week was unaware of. Thank you very much for including me under your "Multiples" blogroll.

I am going back and reading all of your archives, so you may see comments from me in the coming weeks from long-ago posts. Your birth story is beautiful. I sat here and cried as I read it for two reasons--one, just because bringing new life into the world is such a miracle and you recounted it so well, and two, I had to have an emergency c-section for my twins and I still mourn not getting to experience what you went through, as mine was quick and frightening.

I am looking forward to reading all of your entries and gaining some insight into my future with my babies, as yours are right at a year older than mine.

[Ashramama]

Hi! Just wondering if you were right in your personality guesses for E & L so far??

[CaraH]

You know, I've been reading you for what feels like forever... I just went back and re-read your birth story today. It was beautiful; I can't imagine how glad you were to have captured it all so well. Keep on keeping on - I love to continue reading you, five years later!