Wednesday, August 26, 2009

Introducing John Daniel & Walter Joseph!

John and Walter made their appearance today, weighing in with John at 4lbs 11oz and Walter at 5lbs even at 35weeks and 6 days. In this picture, Walter is on the left, John on the right.


I started having contractions in the morning, around 11am, but chalked it up to braxton-hicks until about 5pm when they began to seem closer together and more irritating. By 8pm I realized I would have to take a visit to the hospital L&D. I was feeling them both moving a little less and was nervous. It took my husband and I a few hours to mobilize and by the time we got to the hospital it was 11pm. I had called ahead earlier in the day to find out if it was my OB on call and turns out it was one of the doctors who would not deliver breech. When we got to L&D to be checked, the nurse told us they would get me going shortly with the spinal and discussed all the basic preparations for a c-section. I mentioned that had my primary OB been available he would have gone with a vaginal breech. "Poor you!" she said and made a face as if that would be putting me through a harrowing ordeal.

When she checked me I was surprised to find I was already dilated 6cm. I thought it didn't matter anyway since I would be having a c-section and although the pain was not out of control, the contractions were annoying me and I wanted them to stop. Suddenly the RN returned to the room and said, "Your OB is coming in. He said he will deliver your babies vaginally." Part of me was so scared to hear this, but mainly I was floored that he would come in on a night he was not on-call to give me this option.

I was sent upstairs to the OR recovery room (It is standard to deliver twins in the operating room, regardless of c-section vs. vaginal birth) where I met a resident who did a scan. I recognized her from my previous hospitalization for pre-term labor and she went over some of my questions about the safety of a breech/transverse presentation with vaginal delivery. By the time my OB entered the room (had been at the hospital for an hour and 1/2), he checked me and I was 9cm! While the contractions were still painful, I still mostly found them annoying and could not believe I had progressed that far. Over continuing intense contractions I had the conversation with him that I had been agonizing over which was to take place the following morning--all my questions about the risks and pros/cons of a vaginal delivery vs. a c-section as well as questions about his skills and background delivering breech and what interventions would be employed. I had written out a page on a Word doc of questions and issues I wanted to discuss. Of course we had the abbreviated version of this.

Me: "What are the risk to breech?"
OB: "A breech vaginal delivery is slightly more risk, with head-entrapment the number one risk that occurs about 1% of the time."
Me: "Heh heh heh heh whooooo" (contractions)
OB: "I think a vaginal delivery is better for these babies."
Me: "Ok! Let's do it"

I had fortunately addressed my main concerns with the resident earlier when I was able to articulate my concerns more and one point we addressed was the back-up plan to move to Cesarean if needed. She recommended the Epidural so as to avoid general anesthesia. My OB also recommended this and requested the anesthesiologist to give me the lowest dose possible. The OB looked at me and said, "This is all you. I want you pushing."

We moved into the OR to get set up while my husband stayed behind in the recovery room to get his scrubs on (and looked so handsome!) At this point I was fully dilated though not quite at the pushing point. They administered the epidural--which I had to fight really hard not to get freaked out about, as I really don't like needles going into my spine--then someone brought my husband back in the OR. I laid down and the medical team--which had to have numbered about 12+ people by then--got me positioned to start pushing. Although the Epi was the lowest dose, it came on strong and numbed me so when the nurse asked, "How was that contraction?" I looked blankly and said, "What contraction?" I could still feel sensation when the OB reached inside to check the position of Twin A, and so when they told me to push I was able to with full feeling, just not much pain. I pushed for about 5 minutes--maybe 5 pushes--with Twin A, and out he came! My husband describes seeing the bag of water coming out like a balloon as big as a babies head and then it ruptured and our John entered the world, butt first, at 4lbs, 11oz and 17 inches. From my perspective, it seemed that that rupture sprayed the entire room with amniotic fluid, but that may be my exaggerated view.

He was out and cried right away. I saw him briefly and then he was brought to the pediatrician for checks, the nurses giving me regular updates. His apgars were 8/9.

Now was Twin B's turn and my OB was instructing the resident on the breech extraction. As Twin B was still in transverse, she reached up until she got a foothold and gently pulled him down. I did not quite understand all that was happening, but heard my husband explain in awe: "There are his feet!" And I was called upon again to push, and another 4 pushes brought Twin B all the way out--except his head. I looked down between my leg and saw a slimy little back and butt and body and some dark hair peeking out. His head had not fully emerged with the push and the OB pulled up forceps to nudge out the head. Now I knew from my reading that forceps can be used for breech extractions with some risk but also with success. But I have to say seeing those forceps brought up over my little babies head was the scariest moment for me, as they are quite large metal instruments that look pretty capable of being used as weapons! But it was not long before they did nudge him out and our Walter was born, weighing in at 5lbs even (yay a 5lber!) and 17 & 3/4 inches. He was more quiet which made me nervous and they brought him quickly to the pediatricians. I did not wait long before hearing his cry and hearing good reports from the doctors. His apgars were 5/9. As Walter had a bit more trouble getting out, it took him a minute to perk up.

The entire room started cheering and I looked at the clock--2 hours since we had arrived at the hospital and I had two healthy twin boys!

As I sat back happily exhausted and full of adrenaline from the birth, I heard my OB talking to a medical student. The student said something along the lines of "That was really cool to see," to which my OB replied, "And I don't know when you will see again. Birthing breeches is a dying art..." Later on my OB told me he had spoken about my birth to his associate on call who told him she would have delivered the twins by c-section, thus elevating my OB to "White Knight" status for coming in to offer this option that so few other doctors would.

With our healthy babies thriving we are really and truly blessed. And I can't help but find it interesting that my three children have all arrived 3 different ways--head, butt and feet! How will that come to define their personalities :) I am so thankful for all of the support and encouragement we have had throughout this process! I am so happy to have the babies on the outside!

12 comments:

  1. Wow! That gave me goosebumps! I'm so happy that your OB came in to deliver the twins. What a great person and strong beliefs he must have. Breech births really are a lost art.

    I trust that you are all doing well. Your journey together as a family had a great start.

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  2. Congratulations! I am a friend of a friend and she had asked me to share my breech/breech twin birth (although my B was born vertex--he flipped as his sister was born footling) and directed me here when she heard your news! Welcome to the amazing world of raising twins. :)

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  3. What a blessed birth story! I hope I get the doctor in our practice who will deliver breech. Your boys are gorgeous!

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  4. Congratulations on your beautiful, healthy boys!!

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  5. What a great story! Thanks for sharing!!!!!
    COngratulations!!! Both boys are absolutely beautiful!!!!
    Best wishes to you and your family!

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  6. Jess, thank you so much for sharing!

    I'm so glad you got to deliver them vaginally. Your OB is definitely an exception to the rule!

    Congrats again on your beautiful boys.

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  7. amazing jess. you are such a strong women with a wonderful husband- what a great team you make, and those 2 boys couldn't be luckier. thinking of you loads and hoping your transition to the home front is a smooth one! thanks for sharing your story- a really special one.
    xoxo

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  8. Amazing! That is so great that you found an OB who was so dedicated to delivering these boys without surgery. Im glad it was such a quick process and that everyone is doing so well!

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  9. Brilliant account to a great birthing story ... Congratulations again! Just think if there were more doctors like your OB - perhaps our healthcare system wouldn't be such a financial drag. Kudos to all - Enjoy! : )

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  10. I can't tell you how grateful I am to know you Jess, and more grateful to be a part of your experiences. I forgot to tell you, last week I had a dream (no joke!) that your pregnancy/birth was being filmed by lifetime television. Gwenny was in the dream holding your hand at your bedside (pre-birth). I am SO PROUD of your accomplishments. I am so PROUD to know you. Thank you for sharing your story....

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  11. Wow I was mesmerized with your story! Great job Momma! You are lucky to have such a great OB mine scared me into having a second C-section, I'm a little resentful. So happy to hear all went well.

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  12. What a wonderful, wonderful birth story! Know how happy you are to have been able to deliver them vaginally..kudos to you and your doctor!

    Please try not to obsess about the weight checks...I did, and it was a source of stress in retrospect I wish I'd paid less attention to.

    All the best to you and your gorgeous family!

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