MellyH
Pregnant (Twins!)
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- Jul 23, 2013
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'Positive' in the sense that I got what I wanted - 'full term' with twins, a vaginal delivery with no epidural, and healthy babies who didn't need NICU time, and that I am pleased with the final experience, even though so much of it (meds/stuck in bed/induction) was not what I had been hoping for, I still managed to generate the birth I wanted out of it.
TLDR version:
Made it to 36 weeks!
Admitted Tuesday night, January 27th, for high blood pressure and protein in urine
Decided to induce because of severe pre-eclampsia
Induction started 2:30am Wednesday morning
4cm at 6:30am Wednesday morning
5cm at 2am Thursday morning
7-8cm at 7:30am
9cm at 1pm
10cm at 2pm
Pushing at 2:40pm
Baby girl born at 3:10pm! APGARs 8 and 9.
More pushing!
Baby boy born at 3:31pm! APGARs 8 and 9 as well.
Super detailed version (I included lots of detail because I don't want to forget anything, so good luck to anyone who wants to plough through!).
Lots of people were hoping for Australia Day (January 26th, 35+6 week) babies, but I was hoping to get to 36 weeks gestation at least. I was warned by several people that what I hoped and what would happen might differ considerably! But on Tuesday, January 27th, when I showed up for my check-up with my awesome OB, Dr Ewina Fung, who I had seen throughout the pregnancy, we were both extremely happy to have reached the 36 week milestone. She reiterated that if anything started happening, that the twins were a great size, a great gestation, and things would be allowed to continue. While there, we went through the usual routine of checking the protein levels in my urine and my blood pressure. Both were higher than normal, and coupled with my mention of having headaches for the last few days, she sent me for some detailed blood and urine work, and told me she would email me or ring if things looked more serious by the end of the day. Just after 5pm she called to say that my protein levels were indeed high, and some other levels, especially the platelets, were moving out of range, so she wanted me to head in to be monitored. I called my husband to head home from the new faculty gathering he’d been hoping to attend, and we grabbed the labour and hospital bags and drove over to Kaiser Sunset. The whole way, I was convinced they were going to monitor me, assure themselves everything was fine, and send us home!
At 7pm we arrived, my husband dropped me off at the labour and delivery entry and headed off to park the car. The security guard who took me up to the ward offered me a wheelchair, but I declined, because I wasn’t actually in labour, I was just here to be monitored, right? I was still in denial. After settling into triage, they took some more blood for labwork, and started monitoring my blood pressure. The readings were high still, but nothing too bad, right? And the first lot of labs came back with a slight improvement over the morning’s labs, so that was good, right? They were going to send me home! But... they were still worried - the labs were better but not yet back in range, and coupled with the headaches/spots I’d seen over the last few weeks/extra swelling, they wanted to keep me in. While the resident, Doctor Hong, was describing pre-eclampsia to me, my blood pressure spiked quite high - 154/95 - and that sealed the deal (quite unfairly, I thought at the time - it was a stressful conversation!). No way they were sending me home, and now the attending obstetrician came in to talk about induction. At this point, since the babies were ‘full-term’ for twins and good sizes, the priority turned to my health, which I struggled with but my husband was having none of it - the cure for pre-eclampsia was delivery, so we were going to do it.
At 11pm I was admitted, and when they checked it turned out I was already 1cm and 50% effaced! So things had been happening without my notice already. Also, the checks were much more painful than I had expected! Wow, if this was the checks, how was I going to deal with labour?! Since I was already on my way, they decided to skip the misoprostol gel and go straight for the foley catheter, which is a balloon that inflates inside your cervix over a few hours, up to 3-4cm. At 2:30am on Wednesday morning, the catheter was placed. I dozed from about 3-5am and my husband slept in a very uncomfortable-looking pull-out chair.
They continued to monitor my bloodwork overnight, and by 5am my platelets had dropped to 80, so in the end the decision to admit me was a good one (I hate being proven wrong!) - I was upgraded to severe pre-eclampsia and started on an IV drip of magnesium sulfate, which kept me in bed for the next three days, and a bladder catheter. Fun times!
At 6:30am on Wednesday, the foley catheter was removed, and I was 4cm dilated (hooray!) and still 50% effaced. The resident OB, Dr Saba Saadat, started me on the pitocin drip at 1, which was then ramped up throughout the day. From 7-9am I slept hard (the magnesium made me very groggy) and when I woke up, my husband’s aunt Lisa had arrived as our extra labour support person (and we will thank her to the end of our days for all her help over the following days!) and Kathleen the chatty nurse was on shift. We all loved her, she got us through a long day with lots of support and stories and smiles. My husband headed home to feed poor Molly, and to pick up a few of the things we had forgotten, including my precious hot water bottle. At noon, there was nothing much happening labour-wise, but the pre-eclampsia/magnesium headache was pretty stunning, so I was offered a morphine shot for the pain and took it. At 2pm, I was still 4cm (“Maybe 4.5?” Dr Saadat said, hopefully) and just cramping, no regular contractions yet, so they tried to break baby girl’s waters. Her head was too low though, so it was a bit anti-climactic! At 4:30pm, I was still 4cm, but now 70-80% effaced, with the pitocin at the original maximum of 16. Dr Saadat tried again to break the waters and this time they went with a spectacular warm gush! They were clear, which was a big relief to hear. By 5pm I was having regular contractions, lasting about a minute, three minutes apart, but they were bearable. Lisa headed out for the night, and for the rest of the evening I chatted to people online, listened to my relaxation tracks, and breathed through the contractions.
At 2am on Thursday, January 29th, I had made it to 5cm. Woohoo! But by this time, my back pain was severe. I had had extremely painful back problems for the last couple of months of the pregnancy - sciatica combined with symphysis pubis dysfunction (SPD), and having to lie in the hospital bed for 24 hours at this point, I was unable to sleep and unable to find a comfortable position from all the pressure. I was offered another morphine shot at 3am, this time at half strength, and took it, and slept some.
At 7:30am, I was checked again, and suddenly was 7-8cm! Finally some real progress, and I was told that I could expect to progress ~1cm/hour from now on - unfortunately not, as it turned out! In light of the sudden progress, the nurses turned down the pitocin, hoping my body would take over and keep labouring naturally on its own. Jenny was our nurse for Thursday and was also awesome - we loved all the carers (and they really did care) that we had. Lisa arrived and by now I was settled into my routine of breathing deeply throughout the contractions, counting each breath out loud on the exhale until the peak of the contraction, and then counting down again as it subsided - my husband and Lisa watched the monitors and let me know when it was coming back down again. The numbers really gave me something to concentrate on, and also a sense that the length of the contraction was finite and would be over soon. At 9:30am, I was still 7-8cm, so we started increasing the pitocin again. At 11:30am, I was *still* 7-8cm, so the pitocin was increased to a new maximum of 28. my husband and Lisa were rubbing my back and my thighs as I lay on my side, rotating sides often because of the pressure on my back, breathing slowly with my eyes closed. Just before 1pm they checked again and I was 9cm! Getting so close. I was told to let them know when I felt pressure. The next hour seems like it went by in a blink - I know the contractions were peaking faster and stronger, and Lisa recalls that the only way they could tell from my reaction was that I started interjecting my counting with conversational-tone comments like “Oh my goodness, guys, this one really hurts”. Finally, the last few contractions I started to lose it a bit and exclaiming more shrilly between the counting that I could feel pressure, I could feel pressure, I could definitely feel pressure! And at 2pm they checked and I heard the fabulous words - “She’s complete.”
I was transferred to a gurney (very painfully, my poor back) and wheeled to the operating room. It wasn’t very big, but it seemed even smaller because it was crammed full of equipment, and people! Kaiser Sunset is a teaching hospital, and a natural birth of twins is not something they see every day, so the back of the room was lined with residents and interns. In fact, it was the first natural twin birth without an epidural that the attending OB, Dr Rodriguez, had ever seen! Also in the room was the resident OB, Dr Saadat, who took the lead on the birth, plus a nurse team for me, and two paediatrics teams for the kidlets. And God knows who else. For days afterwards people would pop by to see us and introduce themselves by saying they had been in the operating room with us, but I didn’t remember a one! The only other person I remember is the male nurse in charge of the ultrasound who was standing to my right, whose hand I grabbed at some point and didn’t let go of again and who was a great coach through the pushing, luckily enough!
At about 2:40pm, we were all set up, and it was time to start pushing. It was completely surreal. Dr Saadat coached me through directing my pushing correctly, and holding my breath, and keeping my chin to my chest. After starting to get the hang of it, they then helped me grab my legs during each contraction (a nurse to my left and the male nurse to my right were pushing on my feet for me), and I really got into it. It took awhile to feel any progress and I kept checking after each contraction - had baby girl come further down? And she had. She was taking her time because she was presenting asynclitic - forehead first. Immediately after birth and for the next few days, her little forehead was swollen and she had a tiny black eye, like a prizefighter.
Eventually I could start to feel the extremely intense pressure and I knew her head was nearly there - everyone was encouraging me to push one more time during the contraction I was having, but I ran out of puff. I apologised profusely to everyone for not having another push in me that moment and they all laughed, and I heard someone say that I was too gracious. For extra inspiration, they encouraged me to reach down and I could feel the top of her head. It was warm and wet and hard and definitely not me! We then waited an unbearable few minutes with her head half out for the next contraction and this was the biggun. I pushed and pushed (my husband thought my eyes might explode!) and there was the burning I had heard about, and her head was out! Then they told me to breathe quickly, and give little pushes, just little pushes, a few more… and then a big push! My body felt like it convulsed entirely of its own accord and I felt her come out, at 3:10pm. My husband was by my head, with a high-pitched voice, saying “She’s out! Melly! She’s out!” and I heard her cry. Thank God! She was whisked away to the first paed team, and I only saw a flash of a little purple body as she disappeared behind a wall of people. My husband was with her the whole time though, narrating for me from across the room - it was only a couple of metres, but it felt like a mile! Her APGAR scores were 8 and 9.
While I was craning my neck to try and see her, the ultrasound had shown that baby boy was right there, ready to go. Already?! This was the only time I really lost my cool through the whole process, as I swore loudly at all the people who only had to do it once. But, we were ready to go, and though I was more tired this time, I knew better how to direct the pushing, so things progressed quickly. Before I knew it, I heard them call for mineral oil (I don’t remember hearing that for baby girl, but definitely heard and felt it for baby boy) and the intense pressure started again, and his head was there! They offered again for me to touch it but I didn’t need any more encouragement - I asked if I could just push please, without waiting for another contraction, and they all jumped to action and we were pushing again! And again, the sweet relief when he seemingly gushed right out of me, and started to cry, at 3:31pm. He was also whisked away and this time I didn’t even see a glimpse, so I started to fret. Not to be outdone, his APGAR scores were also 8 and 9.
The next part is a bit of a blur, because there was some retained placenta and a lot of bleeding (since my platelet count had stayed very low, still hovering around 80, they were very alert for bleeding), and intense uterine massage (it felt like they were punching me in the very sore stomach!) was employed to encourage the placenta out and to encourage the contractions to halt the bleeding. This part was worse than labour, in my opinion! Mostly because I hadn’t prepared mentally for it and it meant I couldn’t concentrate on what was happening with the kidlets, although my husband kept narrating what he could. But, within 15-20 minutes they were satisfied that the bleeding had slowed sufficiently that they didn’t have to ‘pack’ me (*shudder* I don’t want to know!), and they were sewing up my first degree tear after a quick shot of lidocaine. Then they transferred me back on the trolley, loaded me up with my babies, one on each arm, and took us back to our room at 4pm. We were a family!
TLDR version:
Made it to 36 weeks!
Admitted Tuesday night, January 27th, for high blood pressure and protein in urine
Decided to induce because of severe pre-eclampsia
Induction started 2:30am Wednesday morning
4cm at 6:30am Wednesday morning
5cm at 2am Thursday morning
7-8cm at 7:30am
9cm at 1pm
10cm at 2pm
Pushing at 2:40pm
Baby girl born at 3:10pm! APGARs 8 and 9.
More pushing!
Baby boy born at 3:31pm! APGARs 8 and 9 as well.
Super detailed version (I included lots of detail because I don't want to forget anything, so good luck to anyone who wants to plough through!).
Lots of people were hoping for Australia Day (January 26th, 35+6 week) babies, but I was hoping to get to 36 weeks gestation at least. I was warned by several people that what I hoped and what would happen might differ considerably! But on Tuesday, January 27th, when I showed up for my check-up with my awesome OB, Dr Ewina Fung, who I had seen throughout the pregnancy, we were both extremely happy to have reached the 36 week milestone. She reiterated that if anything started happening, that the twins were a great size, a great gestation, and things would be allowed to continue. While there, we went through the usual routine of checking the protein levels in my urine and my blood pressure. Both were higher than normal, and coupled with my mention of having headaches for the last few days, she sent me for some detailed blood and urine work, and told me she would email me or ring if things looked more serious by the end of the day. Just after 5pm she called to say that my protein levels were indeed high, and some other levels, especially the platelets, were moving out of range, so she wanted me to head in to be monitored. I called my husband to head home from the new faculty gathering he’d been hoping to attend, and we grabbed the labour and hospital bags and drove over to Kaiser Sunset. The whole way, I was convinced they were going to monitor me, assure themselves everything was fine, and send us home!
At 7pm we arrived, my husband dropped me off at the labour and delivery entry and headed off to park the car. The security guard who took me up to the ward offered me a wheelchair, but I declined, because I wasn’t actually in labour, I was just here to be monitored, right? I was still in denial. After settling into triage, they took some more blood for labwork, and started monitoring my blood pressure. The readings were high still, but nothing too bad, right? And the first lot of labs came back with a slight improvement over the morning’s labs, so that was good, right? They were going to send me home! But... they were still worried - the labs were better but not yet back in range, and coupled with the headaches/spots I’d seen over the last few weeks/extra swelling, they wanted to keep me in. While the resident, Doctor Hong, was describing pre-eclampsia to me, my blood pressure spiked quite high - 154/95 - and that sealed the deal (quite unfairly, I thought at the time - it was a stressful conversation!). No way they were sending me home, and now the attending obstetrician came in to talk about induction. At this point, since the babies were ‘full-term’ for twins and good sizes, the priority turned to my health, which I struggled with but my husband was having none of it - the cure for pre-eclampsia was delivery, so we were going to do it.
At 11pm I was admitted, and when they checked it turned out I was already 1cm and 50% effaced! So things had been happening without my notice already. Also, the checks were much more painful than I had expected! Wow, if this was the checks, how was I going to deal with labour?! Since I was already on my way, they decided to skip the misoprostol gel and go straight for the foley catheter, which is a balloon that inflates inside your cervix over a few hours, up to 3-4cm. At 2:30am on Wednesday morning, the catheter was placed. I dozed from about 3-5am and my husband slept in a very uncomfortable-looking pull-out chair.
They continued to monitor my bloodwork overnight, and by 5am my platelets had dropped to 80, so in the end the decision to admit me was a good one (I hate being proven wrong!) - I was upgraded to severe pre-eclampsia and started on an IV drip of magnesium sulfate, which kept me in bed for the next three days, and a bladder catheter. Fun times!
At 6:30am on Wednesday, the foley catheter was removed, and I was 4cm dilated (hooray!) and still 50% effaced. The resident OB, Dr Saba Saadat, started me on the pitocin drip at 1, which was then ramped up throughout the day. From 7-9am I slept hard (the magnesium made me very groggy) and when I woke up, my husband’s aunt Lisa had arrived as our extra labour support person (and we will thank her to the end of our days for all her help over the following days!) and Kathleen the chatty nurse was on shift. We all loved her, she got us through a long day with lots of support and stories and smiles. My husband headed home to feed poor Molly, and to pick up a few of the things we had forgotten, including my precious hot water bottle. At noon, there was nothing much happening labour-wise, but the pre-eclampsia/magnesium headache was pretty stunning, so I was offered a morphine shot for the pain and took it. At 2pm, I was still 4cm (“Maybe 4.5?” Dr Saadat said, hopefully) and just cramping, no regular contractions yet, so they tried to break baby girl’s waters. Her head was too low though, so it was a bit anti-climactic! At 4:30pm, I was still 4cm, but now 70-80% effaced, with the pitocin at the original maximum of 16. Dr Saadat tried again to break the waters and this time they went with a spectacular warm gush! They were clear, which was a big relief to hear. By 5pm I was having regular contractions, lasting about a minute, three minutes apart, but they were bearable. Lisa headed out for the night, and for the rest of the evening I chatted to people online, listened to my relaxation tracks, and breathed through the contractions.
At 2am on Thursday, January 29th, I had made it to 5cm. Woohoo! But by this time, my back pain was severe. I had had extremely painful back problems for the last couple of months of the pregnancy - sciatica combined with symphysis pubis dysfunction (SPD), and having to lie in the hospital bed for 24 hours at this point, I was unable to sleep and unable to find a comfortable position from all the pressure. I was offered another morphine shot at 3am, this time at half strength, and took it, and slept some.
At 7:30am, I was checked again, and suddenly was 7-8cm! Finally some real progress, and I was told that I could expect to progress ~1cm/hour from now on - unfortunately not, as it turned out! In light of the sudden progress, the nurses turned down the pitocin, hoping my body would take over and keep labouring naturally on its own. Jenny was our nurse for Thursday and was also awesome - we loved all the carers (and they really did care) that we had. Lisa arrived and by now I was settled into my routine of breathing deeply throughout the contractions, counting each breath out loud on the exhale until the peak of the contraction, and then counting down again as it subsided - my husband and Lisa watched the monitors and let me know when it was coming back down again. The numbers really gave me something to concentrate on, and also a sense that the length of the contraction was finite and would be over soon. At 9:30am, I was still 7-8cm, so we started increasing the pitocin again. At 11:30am, I was *still* 7-8cm, so the pitocin was increased to a new maximum of 28. my husband and Lisa were rubbing my back and my thighs as I lay on my side, rotating sides often because of the pressure on my back, breathing slowly with my eyes closed. Just before 1pm they checked again and I was 9cm! Getting so close. I was told to let them know when I felt pressure. The next hour seems like it went by in a blink - I know the contractions were peaking faster and stronger, and Lisa recalls that the only way they could tell from my reaction was that I started interjecting my counting with conversational-tone comments like “Oh my goodness, guys, this one really hurts”. Finally, the last few contractions I started to lose it a bit and exclaiming more shrilly between the counting that I could feel pressure, I could feel pressure, I could definitely feel pressure! And at 2pm they checked and I heard the fabulous words - “She’s complete.”
I was transferred to a gurney (very painfully, my poor back) and wheeled to the operating room. It wasn’t very big, but it seemed even smaller because it was crammed full of equipment, and people! Kaiser Sunset is a teaching hospital, and a natural birth of twins is not something they see every day, so the back of the room was lined with residents and interns. In fact, it was the first natural twin birth without an epidural that the attending OB, Dr Rodriguez, had ever seen! Also in the room was the resident OB, Dr Saadat, who took the lead on the birth, plus a nurse team for me, and two paediatrics teams for the kidlets. And God knows who else. For days afterwards people would pop by to see us and introduce themselves by saying they had been in the operating room with us, but I didn’t remember a one! The only other person I remember is the male nurse in charge of the ultrasound who was standing to my right, whose hand I grabbed at some point and didn’t let go of again and who was a great coach through the pushing, luckily enough!
At about 2:40pm, we were all set up, and it was time to start pushing. It was completely surreal. Dr Saadat coached me through directing my pushing correctly, and holding my breath, and keeping my chin to my chest. After starting to get the hang of it, they then helped me grab my legs during each contraction (a nurse to my left and the male nurse to my right were pushing on my feet for me), and I really got into it. It took awhile to feel any progress and I kept checking after each contraction - had baby girl come further down? And she had. She was taking her time because she was presenting asynclitic - forehead first. Immediately after birth and for the next few days, her little forehead was swollen and she had a tiny black eye, like a prizefighter.
Eventually I could start to feel the extremely intense pressure and I knew her head was nearly there - everyone was encouraging me to push one more time during the contraction I was having, but I ran out of puff. I apologised profusely to everyone for not having another push in me that moment and they all laughed, and I heard someone say that I was too gracious. For extra inspiration, they encouraged me to reach down and I could feel the top of her head. It was warm and wet and hard and definitely not me! We then waited an unbearable few minutes with her head half out for the next contraction and this was the biggun. I pushed and pushed (my husband thought my eyes might explode!) and there was the burning I had heard about, and her head was out! Then they told me to breathe quickly, and give little pushes, just little pushes, a few more… and then a big push! My body felt like it convulsed entirely of its own accord and I felt her come out, at 3:10pm. My husband was by my head, with a high-pitched voice, saying “She’s out! Melly! She’s out!” and I heard her cry. Thank God! She was whisked away to the first paed team, and I only saw a flash of a little purple body as she disappeared behind a wall of people. My husband was with her the whole time though, narrating for me from across the room - it was only a couple of metres, but it felt like a mile! Her APGAR scores were 8 and 9.
While I was craning my neck to try and see her, the ultrasound had shown that baby boy was right there, ready to go. Already?! This was the only time I really lost my cool through the whole process, as I swore loudly at all the people who only had to do it once. But, we were ready to go, and though I was more tired this time, I knew better how to direct the pushing, so things progressed quickly. Before I knew it, I heard them call for mineral oil (I don’t remember hearing that for baby girl, but definitely heard and felt it for baby boy) and the intense pressure started again, and his head was there! They offered again for me to touch it but I didn’t need any more encouragement - I asked if I could just push please, without waiting for another contraction, and they all jumped to action and we were pushing again! And again, the sweet relief when he seemingly gushed right out of me, and started to cry, at 3:31pm. He was also whisked away and this time I didn’t even see a glimpse, so I started to fret. Not to be outdone, his APGAR scores were also 8 and 9.
The next part is a bit of a blur, because there was some retained placenta and a lot of bleeding (since my platelet count had stayed very low, still hovering around 80, they were very alert for bleeding), and intense uterine massage (it felt like they were punching me in the very sore stomach!) was employed to encourage the placenta out and to encourage the contractions to halt the bleeding. This part was worse than labour, in my opinion! Mostly because I hadn’t prepared mentally for it and it meant I couldn’t concentrate on what was happening with the kidlets, although my husband kept narrating what he could. But, within 15-20 minutes they were satisfied that the bleeding had slowed sufficiently that they didn’t have to ‘pack’ me (*shudder* I don’t want to know!), and they were sewing up my first degree tear after a quick shot of lidocaine. Then they transferred me back on the trolley, loaded me up with my babies, one on each arm, and took us back to our room at 4pm. We were a family!
and kudos to you for going for a natural birth - I don't know how you did it, especially with twins!
