Sunday, February 29, 2004

Carrie Anne and Allison Jane

Carrie Anne and Allison Jane, born Friday February 27, 2004 at 2:39 and 2:45 p.m. 6 lb 7 oz (2920 gm) 18 ½ inches and 6 lb 1 oz (2749 gm) 19 inches.

Thursday afternoon I was feeling generally anxious about Baby A. She seemed sluggish to me. Melanie had left a Doppler at my house so I had a listen to her heart rate, which was just fine, but I still felt like she wasn’t moving very much and I was looking forward to seeing her the next day on the ultrasound.

Friday morning Melanie came with us to see Dr. Love for a biophysical profile of the twins. We just wanted to make sure that they were doing OK. Dr. Love is very supportive of midwifery and homebirthing, so we knew that we were going into a friendly environment. They called us back for the sonogram, and the technician started taking measurements of Baby A. Her head and femur seemed to be measuring small as compared with previous measurements, which seemed odd to me. She was also not moving very much. Her heart rate was in the 120s, which is perfectly normal but still quite low for her – she had been measuring all along in the 130s/140s. Baby B passed her test very quickly – lots of breathing movements, good muscle tone. Baby A, on the other hand, was quite still, and after 30 minutes of watching her on the monitor it was clear that she was not going to pass. I was holding back tears, partly because I felt a little bit anxious about her health, but mostly because I realized that a homebirth was slipping away from me. I knew I could force the issue at that point and go home and wait, but I wasn’t comfortable any more with waiting, in my gut I wanted her out, and had wanted her out since the day before. Still, I felt anxious about the whole procedure, worried about what the pitocin drip would feel like, and also worried that this might lead to a C-section for Baby B. Melanie was very supportive through the whole process. We spoke to the doctor who recommended a non-stress test, but it was clear that he would be recommending an induction no matter what the results of the NST, so I said why bother, let’s just get this whole thing started. I didn’t want to spend any more time testing. Brian went to get sandwiches (I was determined to have them sneak my some food before labor started – I knew I was going to need some protein to be able to push two babies out and avoid a C-section).

Melanie and I went up to labor and delivery where they immediately roomed us and I got into my gown. This was about noon. The nurse’s name was Melanie as well. I made my wishes clear to her – the usual birth plan stuff. They hooked me up to a saline drip and got the monitors on me. Baby B’s heart rate, as usual, was impossible to find (she spent the last trimester lying transverse and posterior to Baby A). I think most of the time the monitors were both picking up Baby A, but as long as there were some numbers up on the screen no one seemed too worried about it. Brian came in with the sandwiches and snuck bites to me whenever the nurse left the room. I got about a quarter of an Italian sub into me that way…carefully washing down the food before the nurse came back! I hated having the BP cuff and the saline and the monitors on me and all the nurses coming in with the carts and the worried faces. But what could I do. I tried to have an attitude of surrender – I needed to let the experience just unfold, and try to do my best with what I had.

After about 15 minutes of lying there, but before they started the pitocin, I felt a contraction in my low back that seemed an awful lot like a labor contraction. I was hesitant to even say anything because with all the stress of the day it could just have been a regular B-H contraction and some low back pain. But then, five minutes later I had another one. And then, going to the bathroom I had yet another one. I wasn’t watching the clock but they seemed awfully close together. Dr. Love came in and I told him “we don’t need the pit, I’m in labor.” He was pleased, as was Melanie. Everything started to move fast at that point. He checked me and I was about 6 cm dilated. I got out of the bed as much as I could to labor on my feet, even though they wanted me in the bed so they could continue to monitor the heart rates. As the contractions got more intense I sat in a chair and leaned forward on the bed, sometimes rising to my feet so I could move my hips back and forth and help the baby to descend. The nurses were surprisingly accommodating of my desires to keep getting out of bed, in spite of the fact that it made it basically impossible for them to get two heart rates.

Contractions were starting to hurt, now, and I was vocalizing a bit through them. Kind of softly, but it helped. It was frustrating having the monitor strips on me and the IV cord to deal with, not to mention the stupid cuff which kept going off every 15 minutes. But mostly I was being left alone and I was able to stay off the bed. Dr. Love came back and we talked about position – I said the last thing I wanted was to end up on my back unless he felt it was absolutely necessary for getting Baby B out. He said that he thought hands and knees might work. I remember looking at the bed and wondering how I would ever climb back onto it. But then I was back in bed again, on my back. Somebody (the nurse?) checked me and I was a 7. It was 1:45. I said to the nurse, whose shift ended at 3, that I was sorry but I didn’t think she’d be seeing the babies. Melanie said she wouldn’t be so sure. She went back in my record from the previous birth and read to me how quickly I had progressed from 6 to 10. I still thought it would be a couple more hours. It was around this time that transition kicked in and the nurse called for Dr. Love to come back from his office. I had some intense contractions on my back, and I remember feeling like I didn’t want to be in that position, but also realizing that now that I was there, I would probably push from there, and it would be OK.

I was starting to feel a little bit pushy and the nurse checked me – I was at 9 cm. She called again for Dr. Love and they said “he’s on his way.” He walked in while I was having another contraction and I told him, “I think I might be feeling pushy but I’m not quite sure yet.” My contractions were very interesting – I’d have a really strong, difficult one followed by a relatively mild one, back and forth. They were extremely close together and I remember wishing I had a little space in between to collect myself. I had a small contraction followed by a big one which I really started making noise through. Brian was sitting on the end of the bed facing away from me and having a conversation with Dr. Love about something technical. I said, “No talking! Please!” and he shut up immediately. The contraction ended and I said “No talking during contractions.” That’s about as snippy as I got during labor! Brian got the hint and came up to pat me and hold my hand.

With the next contraction I said, “I’m going to try to push.” Brian was back down near my legs and so was Melanie (the midwife). I started pushing and almost immediately felt a gush as the waters broke, the head in my canal and then crowning – I noticed out of the corner of my eye that Dr. Love was walking away from me, not realizing how close the baby was. Melanie and Brian ended up catching the baby together, as she came out in one push (I stopped pushing briefly as she crowned, but basically she came out all in one contraction). Melanie was very nervous about catching the baby as it is technically illegal for her to catch babies in the hospital, so apparently she kept moving to grab the baby and then sort of pulling back, not sure what to do. But Brian of course could do what he wanted so he grabbed hold of her as she was coming out. He was thrilled to have been able to catch her, something he had wanted to do all along.

Dr. Love hurried back over and I remember him saying to Melanie, “we’ll let the cord pulse a little bit,” and Melanie saying, “no, let’s clamp it now.” I can remember thinking to myself, “I can’t believe I just heard a conversation where an MD was advocating for letting the cord pulse and the midwife was saying clamp!” Apparently she took the clamp out of his hand and did it herself! She knew that we needed to move fast on Baby B, I guess. Dr. Love just looked at her funny. Somebody put the baby on my chest, which was when I realized I still had my bra on under my gown – how did that happen? Luckily it was a nursing bra. A minute or two went by as I tried to nurse Baby A but she just wasn’t interested. They got a handle on Baby B’s heart rate, which was in the 80s. I gave the baby to Brian, not really wanting to hold her while I still had more pushing to do.

Dr. Love started moving Baby B’s head towards my cervix while Melanie held the Doppler on me, keeping an eye on the heart rate. Apparently there was a sudden drop in heart rate into the 60s, and I heard Dr. Love say, “go over to the other side and help me push this baby. The whole tone in the room changed. Melanie hurried over to my right side – the uterus was so floppy that the baby had sort of fallen over to the side, and her heart was very low. Dr. Love showed Melanie exactly how he wanted her to push the baby over and down. Meanwhile he was reaching through my canal into the cervix and feeling for her head. They asked me to push and Melanie was pushing down also on the baby, pushing her into the canal. I tried pushing but really had nothing to push against as she wasn’t engaged yet.

I heard someone say “vacuum” – apparently there wasn’t a vacuum in the room and one had to be ordered. Dr. Love said, “push again, keep pushing.” They both were looking really worried and I started to freak out. Suddenly I felt the head in my cervix, fully engaged, and I pushed down really hard. “That’s it!” someone said. Melanie told them to give me oxygen. Dr. Love said “hold your own legs,” which I did, and one of the nurses told me to put my chin to my chest, something I’d forgotten about. I did all of those things and gave it the hardest push of my life, and Baby B was born into the world, still in her amniotic sac, which shredded around her as she came through the canal. I was afraid that I might have torn with the second one since I pushed so hard and without the help of a contraction, but there was no tearing. Then there was lots of calls to “cancel the vacuum!” and I remember being so happy! I had pushed her out on my own. A few more minutes and he would have been ordering a C-section, I’m fairly convinced.

Both babies pinked up right away and were healthy, strong, absolutely perfect. I’m not sure what their apgars were, I need to get the record from the hospital. I also didn’t get the head circumferences.

I had no tearing and felt absolutely great. I immediately finished the sandwich that Brian had brought me for lunch. It was now 3 p.m., just 4 ½ hours since we started the biophysical profile, and 3 hours after being roomed in L&D.

I opted to spend the night in the hospital and come home the next day. Baby A (we still hadn’t decided on names until after we left the hospital) took to nursing right away, Baby B was a little bit slower to catch on, but both are nursing very well now. My nipples are really sore. I had some nasty afterbirth pains as the uterus came down, enough to ask for narcotics (have I mentioned my love for Vicodin? LOL). Pains are mostly gone now, I’m just waiting for my milk to come in and that lovely feeling of engorgement.

The babies are doing great – Carrie Anne (Baby A) is definitely the more aggressive one. She is more demanding, and nurses more eagerly. Allison is quite laid back about the whole thing, but has learned how to latch on and is doing a great job. I am not getting ANY sleep yet, but we’ll figure that out later. They are absolutely beautiful girls, so sweet and pink. Brian’s mother says they look just like he did as a baby. It’s not absolutely clear if they are identical or not, but they are VERY similar looking to me, and everyone mostly agrees. Carrie is bigger and she came out pinker, but my midwife says she is ruddier because she got more blood. They are too precious! Brian is over the moon, of course, these being his first progeny. He could not be happier, it is really sweet to see.

That's it for now. We're all just happy to be home and snuggling up with each other. I think I may not get a full night's sleep for at least another year, but it was all completely, totally, worth it. I'll be sure to post pictures soon.

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