A much-awaited, belabored arrival

(Please forgive the disjointed narrative. I've been piecing this together for the past few weeks.)

All of the gory details

Thursday, September 24, 2009

Gestation: 38 weeks plus 4 days

The day started with an 8:40 OB appointment with Dr. Gerber. The babies were both head down, vertex. Perfect. I hadn't had my cervix checked at any previous appointment because we were afraid it might start labor. But Kevin was there with me, home for at least a few months, and my mother was staying with us to help with the boys, so I was ready to have the babies. Dr. Gerber checked, 3 to 4 cm dilated, 60% effaced. I asked her to strip the membranes, which she said were already pretty separated. I started having mild contractions immediately, but Mom and I went on with our errands and Kevin went to work. After lunch I took a bath in an effort to make the contractions go away to see if it was false labor. The bath was heavenly, the contractions went away and I even fell asleep in there. But as soon as I stood up the contractions came back, though still not very strong. They stayed with me through the afternoon. I can't remember what I did all afternoon. I think I got the babies' bag ready. By 5:00 p.m. they were painful enough to make me want to squat in order to get through them. I called Doris Ann, the doula I had with Joshua in Fort Bragg. I told her I was laboring with twins and asked her for some advice. She listened to me breathe through a couple of contractions, could tell I was in active labor, and reminded me of the relaxation techniques we used with Joshua's labor. She encouraged me to take a shower and then go into the hospital sooner rather than later.

My hair was still wet from my earlier shower and looking really shabby. I realized this was real labor and that I wasn't going to feel any better until the babies came and that the next shower wouldn't be for a while. So of course, I took the opportunity to dry my hair in between contractions. After my hair was under control (priorities!), I got in the shower for some back-pain relief. But our tub isn't big enough to squat in , so I quickly yelled for help and stumbled out of the shower.

It was dinner time for the boys, so Mom started throwing something together. A pasta dish that I'm sure was good but smelled horrid to me at the time. I sat on the couch with a heating pad on my back and blankly watched the boys watch 1967 Spiderman cartoons on the computer with Kevin. Every three to five minutes I'd yell, "Help!" Mom would drop what she was doing and came running to rub my back and hold my hand through the contraction while I squatted. She made me some soup and crackers that I foolishly ate.

By 7:00 the contractions were 2 to 3 minutes apart, Kevin had eaten dinner, and I was starting to feel a good amount of lower pelvic pressure. It was raining outside and we got into the car to go to the hospital. Doris Ann called me back to check on me. She talked me through another couple of contractions. We got to the hospital and realized I'd forgotten my I.D. card. Back home, back to the hospital. (It's only a mile away, thankfully.)

Then the long, long walk to the door of the hospital. It's maybe 400m, but it took forever to get there. We must have stopped 15 times to squat through contractions. Several people asked if I needed a wheelchair. One guy even came back and asked again, just to make sure. I must have looked crazy. A big, big lady in a red dress squatting on the sidewalk in the rain.

At the Hospital

Finally made it up to Labor and Delivery, only to wait in the waiting room. I guess she couldn't tell from looking at me how far along I was, but that unconcerned nurse was in no hurry.

Of course they made me get up on a bed and a nurse tried (unsuccessfully) to attach the fetal monitoring belts around my large contracting belly. Dr. Wakefield finally came in with an ultrasound machine and made me lie down so he could see the babies' positions. Lying flat with two big babies on your spine and having a contraction is just about the worst pain I've ever experienced. Trying not flip myself off of the table and squat through each contraction required a lot of self-control. It was taking him a long time to find the babies' heads. That should have been my first clue. But every doctor had a hard time finding anything in an ultrasound during the last trimester because the babies were so big and folded over each other.

And then he said it. "They are both breach. Transverse. We are going to have to do a C-section, if they don't move."

I didn't react. It was not what I'd wanted, of course. I'd been praying for them to move head down for 4 months, ever since that technician at the 24 week ultrasound said, "Baby A is breach. She's transverse right now. But she can move." And here I was at the end, after enduring a long, heavy pregnancy, and laboring at home, and they moved back to breach? But there was no time to think. Another contraction came and I tried to relax through it.
The doctor checked my cervix and said, "Oh. Wow. You are at 6 to 7 cm dilated. We're doing this right now." There wasn't any more time for them to move. This was it. Then up came my soup and crackers dinner. Ew.

I guess they didn't believe me when I said I was in labor, that this was my third pregnancy and that I was feeling pelvic pressure (which was a precursor to feeling the urge to push). Then everything went crazy for 15 minutes. Kevin left to put on scrubs. Nurses flurried about me, this one telling me to be still so he could draw blood. (Still? Yeah right. You are going to wait for me to tell you when I'll be still.) And that nurse trying to put in the IV. All of these things I didn't have with Joshua.

So if they were going to make me lie on that bed and be still, then they better hurry up with that pain reliever, I thought. I might have even yelled that. I had an epidural with Caleb and didn't like it. But it was out of my hands now. A C-section right away meant getting a spinal. I kept asking, how much longer until that spinal? Answer: 25 minutes. It was the longest 25 minutes I could imagine. Lying on that bed, they wheeled me to an Operating Room (I wish they'd have let me walk). Now making me switch to that tiny OR bed and it was freezing in there. I shook convulsively from the moment I got in there, all the way through the surgery, until I left 45 minutes later. And Kevin was still not in there to calm me down. (They don't let husbands in the room during a spinal or epidural. A woman died during an epidural at Bragg while we were there and the husband flipped out, understandably.)

Dr. Wakefield checked my cervix one more time before the spinal: 8 to 9 cm. I had been in transition while lying on that tiny, cold, lonely OR bed. No wonder it hurt so much.

Looking back, I realized how close we came. If I had waited any longer, I would have had the urge to push (which is an absolutely involuntary reaction when you don't have anesthesia). And trying to push Evelyn out with her back presenting, not her head or even her bottom, would have been really dangerous for all three of us. So I am thankful for God's timing and Doris Ann's prompting me to get to the hospital before it got too far. And I'm thankful that there was an experienced OB there and for the modern medicine that made my could-have-been-complicated delivery smooth sailing.

I received the spinal after a contraction. But I went down fighting. I pinched two of the nurses that were holding me still because another contraction came on right as the anesthesiologist was inserting that large needle into my spine. About three minutes later my legs started to feel numb and then I couldn't feel the contractions anymore. Then Kevin finally came in and found me like this:

But I was still freezing cold. I shook so hard, the nurse had to practically sit on my arm to keep my upper body still while the doctor made the incision.
They kept telling Kevin to sit down on the stool next to my head, behind the drape they put up at my chest. But he kept popping up and looking at my now-gaping abdomen. He tried to snap a few pictures, but there were too many doctors in the way. I kept reminding the nurse to lower the drape when the doctor pulled the babies out.
Before I knew it, the drape was down, and I saw a little white bottom. Dr. Wakefield had to pull Evelyn out of the incision bottom first because he was trying to keep the incision small and he didn't have time to reach in and turn her. So out she came into the world- backwards, but beautiful.

That's Evelyn out of focus in the middle there. You can see her tiny bum.

After I glimpsed her face and heard her first cry, I was looking back at my stomach to see Gideon entering the world screaming from the first second. I could tell right away that he was bigger. He sounded strong. Evelyn's first cry didn't come for a long 30 seconds because they had to clear her airway, but Gideon wailed from the second he was taken from me.

And here's the doc showing Gideon to me. He looks so big!

My hysterical shaking did not stop despite the warm blankets the nurse had put over my upper body and some weird warm-air balloon thing they put across my shoulders. And this is the part I regret, the nurse put some narcotic in my IV to "calm down the shaking." Maybe this was medically necessary so that the doctor didn't have to worry about my shaking while he was sewing up seven layers of tissue, but the nurse should have asked. That made me a little loopy, but I was still conscious and heard the weights called out to me-
"Baby A weighs 6 pounds 3 ounces. What's her name, Mom?" "I don't know," I replied, "I have to see her face." Then they asked Kevin, but he refused to answer, saying it was up to me. Once Kevin brought her around to me, I saw her face and thin frame and said, "Evelyn. It was always Evelyn." (We considered naming her Deborah, because of the amazing character of Deborah in Judges, and because Gideon was a great Judge of Israel, too. But she just didn't look like a Deborah.)

Evelyn Janelle

"Baby B weighs 7 pounds, 5 ounces. Wow! Those are some big twins!" All the nurses kept exclaiming how big these babies were "for twins." But I wasn't that surprised. Didn't they see the size of that belly before he cut into it? I didn't gain 55 pounds for nothing.

Gideon David

After that the only notable thing was the strong pain in my upper back and shoulders that the nurse attributed to the doctors' tugging on my internal organs. Indeed, Dr. Wakefield was inspecting my uterus outside of my body, on top of my stomach, Kevin said. And they cleaned out my body cavity after that, all around the other organs in there. It was a truly strange sensation feeling the abrupt tugs and pressure in my stomach but not feeling them acutely.
About thirty minutes after they were born I was wheeled into a room where my mom was waiting for us. I nursed them each right away. They both had a great latch and each nursed for about 20 minutes. Evelyn first, then Gideon. That was the most alert they'd be for a nursing session for the next two weeks.

Proud (ecstatic even) new grandparents of twins. My dad with Gideon and Mom with Evelyn

Some visitors at the hospital: my sister Amanda with Gideon, and friend Donna holding Evelyn

The rest of the story

The rest of the labor story is just recovery. Having a C-section is way different than birthing babies vaginally, of course. But I just wasn't prepared for how long the pain would last. People who say, "Oh a C-section isn't that bad. The recovery isn't that hard," have just forgotten their recovery. Time has a manner of helping us block out pain and difficulties. And the incredible love that floods a new mother's heart is a better pain reliever than Percocet. Feeling like my guts might fall out of a small slit in my tummy was a weird pain. So was sneezing.

"Just try not to use your abdominal muscles when you stand up," the nurse said.

What? How do you do that? I'd trained my core for almost two years after having Joshua and now they were telling me not to use it? Your core is involved in every movement.

The hardest part was getting up and down with two babies to feed and change them so often those first two weeks. My mom was here for a few days which was a terrific help, and then Kevin's mom came. Also a big help with the babies.

But I don't want to complain too much because here I am 4 weeks postpartum and there is a thin scar between my hips and a sizable uter-belly but I'm okay. Up and walking around without much hindering me. Running and Olympic weight lifts will have to wait another two weeks, but I'm fine now.

Still, don't believe a woman who says that a C-section is a breeze. If that's true, then there wouldn't be a rule in many auto insurance policies stating a woman who has an accident within two weeks of having a C-Section is liable because she has had "major abdominal surgery." It's "major" and it's "surgery." But it was a blessing to have such good, efficient care. I'm safe. Babies are safe and hey, at least I didn't have to worry about temporarily football-shaped heads. They both have perfectly round little noggins.

I'm also thankful for the smaller transverse incision. My Aunt Gina said they often have to do the down-the-middle of the belly cut for breach twins. I'm thankful for my "bikini scar."

Lots of people have asked with sad eyes how I felt about having the C-section. I made it no secret I wanted to try to deliver these babies naturally, without drugs, like I delivered Joshua. But I have no regrets. I couldn't have done anything differently. I was able to stay off of bed rest. I even went for a 4x400m jog the day before I had the babies. And I labored at home all day, not going to the hospital until Doris Ann and I thought I needed to. If the twins had been head down, I could have labored in the hospital for that hour I was getting an IV and a spinal, been at 9 cm at 10 pm, then pushed them out not much later. But they were breach. Nothing I could do about it. I had the best possible outcome, considering. If I lived 100 years ago, who knows what would have happened. I'm thankful and thrilled. I have two beautiful, healthy babies. With appetites and loud cries that wake me up at night. I love them.

(And by the way, just so I don't get accused of being superwoman, I am going crazy, despite how much I love those little cuddlebunches.)

Read more...