Wednesday, July 18, 2007

My Twin VBAC/HBAC Birth Story

Okay, so I wrote out my birth story 2 days afterwards to share on some of my birth boards. I cleaned it up a bit and took out some of the more gory details so I could share it here. I figured that some of my online pals may be curious about it, and hope that some of the folks finding my blog by searching about twin pregnancy will read this, be encouraged and inspired, and know that natural birth IS a safe option for women having multiples.

So, here it is-- the birth stories of HM and BN. Enjoy!

The background (skip it if you just want the birth details):

I guess it really begins with the birth of their older brother, my third child, born in 2001. I had planned a homebirth, as I had really hoped to avoid unnecessary hospital interventions. As things would turn out, I ended up transporting to the hospital and having an emergency cesarean due to transverse lie. When I transferred to the hospital, they were clearly in no rush to get me on pain relief, and I labored flat on my back until I was 9 cm dilated. During the surgery, the doctors all laughed loudly and joked with each other, not paying any attention to my crying. When I had a medication reaction and didn't think I was breathing, nobody could hear me whispering for help between their music and loud talking. I spent most of the surgery afraid that I was dying, and was amazed at the hospital's dehumanizing treatment of me and my baby. Before his birth, we had wanted a large family one day. Afterwards, I was so devastated by the loss of the birth I had planned, and so overwhelmed by fear that I would never again experience natural childbirth due to a prior cesarean, that my husband and I decided we didn’t want any more children.

Just last year, things shifted in our thinking a bit. I had researched vaginal birth after cesarean (VBAC) enough to know that it is a safe option in situations where induction, augmentation, and other interventions could be avoided, and we decided to try to conceive our fourth child. After I was pregnant, I began my search for a provider, and found that several local hospitals no longer allowed planned VBACs, and that none of the local doctors would be fully supportive of a VBAC. I looked into homebirth with a direct entry midwife, only to learn that the midwife licensing board made it illegal for direct entry midwives to deliver VBACs in my state as of 2004, even though they had successfully been attending VBAC homebirths for many years before then. Only a CNM could deliver a VBAC at home, and no CNMs in my state could find a backup OB to support them in a VBAC homebirth.

Through referrals from our many friends who had given birth at home near us and online acquaintances, we found a very naturally-minded midwife in a nearby state who used to work our area before she moved away. While she was not willing to drive all the way to SC (a several hour drive from her) while I was in labor, she was willing to take me on as a client provided we were willing to drive for appointments and for the birth. We agreed, and began our search for somewhere to stay for two weeks before and two weeks after our due date, so that we would already have a temporary home to have our homebirth VBAC (HBAC).

A month after securing our midwife’s services (but just before our first appointment with her) and feeling confident with our course of action, we went in for a non-medical ultrasound to find out gender, and were SHOCKED to learn that we would be having both a little girl AND a little boy. The sonographer took several extra pictures for us (including several showing that we had two placentas, which later proved valuable information), and later that day we panicked, calling our midwife and letting her know we would be finding an OB and switching providers. We were just too scared to go through with a twin HBAC.

We did a little more research, though, and found that twin VBAC moms are no more likely to suffer uterine rupture than singletons, learned that twins with two placentas have minimal complications (if any) compared to singletons, and began to wonder if it was really necessary to resign ourselves to a mandatory cesarean at the hands of a surgeon. I called my midwife back and asked her what her experience had been with twins. It turned out she has delivered tons of twins when working in hospitals, and almost 20 sets of twins (including many twin VBACs) since switching to a primarily home-based practice over a decade ago. All twin births were successful, none required transport. We switched back to the original plan, and began preparations for a twin HBAC.

Labor Begins:

For WEEKS I had been having strong and uncomfortable contractions-- so many so that I was terrified of preterm labor. Somehow I made it to 36 weeks (the earliest my midwife would attend a twin homebirth) and we relocated. My husband stayed with me and the kids Fridays through Mondays, and went home every Monday to work a full week. In spite of regularly growing contractions, I made it past 38 weeks, and when I was 38 weeks and 1 day (with a fundal height measuring 50 cm), my husband went back home to work his week. That night, I tossed and turned, having contractions in my sleep. Tuesday morning, May 8, around 3:30 am, I was awakened with painful contractions coming every 2 minutes. This had happened before, so I tried all my usual tricks to make the “false labor” go away. I had a glass of diluted wine, drank lots of water and rested on my side, and around 4:15 am I gave up and got into the bathtub to see if that calmed them. At 4:45 am, still unsure if I was in real labor or not, I called my husband and asked him to come be with me just in case it was time. At 5:00 am, I called my midwife and let her know what was going on. She told me to call my other labor assistants and get everyone on their way.

Around 5:30 am, as I was making the bed and getting my birth pool ready (I had really wanted a water birth), my water broke and things intensified. Around 7:00 am, the midwife arrived and said it was fine for me to get into the birth pool to take the edge off the contractions, and the water was SO soothing! By 7:15, the midwife’s assistant arrived, and by 7:30 my husband was there. Things get a little blurry after that point, since I was in a good bit of pain. At first, I did really well, breathing through the contractions, relaxing, staying calm. My doula and friend from back home would pray with and for me during the tougher ones, helping me to stay focused and peaceful. By around 9:30 am, I was thrashing about so badly during the worse contractions that it took four people holding my arms to keep me from drowning myself! At that point (in transition, obviously), I was exhausted already, and moved to the bed so I could lay down.

The births:

Soon, I told my midwife I thought I might be feeling the urge to push with contractions, and that it actually made me feel a little better to push a tiny bit. So, with the next contraction, I began pushing. As things would turn out, I pushed a LONG time for a little baby who had spent the last two weeks at a +1 station. It didn’t take long for him to crown, but then he couldn’t make it any farther thanks to an overenthusiastic episiotomy repair from a previous birth. I was crying, worried about how this was affecting the baby, but my midwife checked his heart tones after each contraction and reassured me that as long as his heart rate was good, we were okay. Finally, after 15 minutes of pushing with very little progress, my precious little son was born at 10:46 am. He was crying as soon as his head was out, and was nursing like a little barracuda 20 seconds after he was born! He pinked up right away, and they delayed clamping and cutting the cord until it had stopped pulsing. He weighed 7 pounds, 4 ounces, and was 20 inches long.

We left him at the breast, since the nursing might stimulate contractions to get baby B into position, and from the time he was born until the time his sister’s head was firmly engaged in the birth canal, my midwife’s assistant held her in place from the outside so she wouldn’t flip. After a few minutes, contractions started up again but they shortly became uncomfortable again and I asked someone to take my little angel boy so that he would be safer than I felt he was in my arms, with all the discomfort I was in. I switched to using a breast pump between contractions to keep things going, and soon enough I knew it was time to push her out. I was exhausted, and not very enthusiastic about it at first, and couldn’t bring myself to push that hard. Plus, I was expecting that after just birthing one baby, the second one would be easier, so I don’t think I was expecting the challenge she became. At some point the midwife suggested a squatting position to push for a few contractions. It was so hard to support myself, that once the baby’s head was engaged, I was begging to lay back on the bed again. So, I pushed for the next several contractions propped up in a half-sitting position. She wasn’t moving down very much, and I was getting discouraged, so I forced myself to get a little more energetic about the pushing (since that’s what my body was telling me to do anyway). After several contractions, there wasn’t a lot of progress, and I was in pain and needed to get back on my side again. My midwife, for the second time during the births, asked everyone to take a moment and pray with me. At that point, things started to move along, and after a VERY long pushing stage, my precious daughter was born, posterior and forehead-first, with her cord wrapped around her neck and shoulders, at 12:49 pm. Her posterior position had contributed to my extended pushing phase and slow descent with her. She was a little slower to pink up, and took a little longer to figure out how to nurse, but soon enough was alert at my breast like her brother had been! She weighed 7 pounds and was 21 inches long.

I birthed the placentas at 1:09 pm, and although there were clearly two separate placentas, they had fused together in the middle and came out in one giant piece that likely weighed between 5 and 6 pounds-- almost like delivering a third baby, but without the giant head! I needed one stitch to fix a small tear from my difficult second birth. I was bleeding heavily, and over the little while after the birth had one intravenous shot of pitocin and two shots in the hip. I was also given my first dose of methergine (which I took for 2 days postpartum), and given a lot of blood-building and iron supplements to help replace what was being lost. I also had several clots remaining that my midwife manually removed, and after the clots were pulled out my bleeding began to subside. Apparently, excessive bleeding is a bit more common with twin pregnancies since my uterus had two raw areas from two placentas instead of just one.

Thoughts on the experience:

So, I have now had my first completely unmedicated, natural birth, my first home birth, my first VBAC, and my first twin birth. What an experience! I feel so good about how it all happened, and am so thankful that we chose the path we did because I KNOW that I otherwise would have been forced into an unwanted, and completely unnecessary, cesarean. Although I worried a bit before the birth about the toll that being so big was going to take on my uterine scar, during labor I never once questioned how my scar was holding up. I have no regrets about my birth experience, for the first time ever, and feel only positive about how it all went down-- not exactly easy, but definitely uncomplicated.

My babies were at the breast within minutes of being born, and my precious husband was able to be more involved in this birth than any other-- what a wonderful support he was! My other children were able to come in shortly after each birth to see their new little siblings, and the babies’ first night was spent bonding with their parents and siblings, rather than being poked, prodded, weighed, and messed with all night long. I’ve been able to rest when I need to, recover in a way that feels best, and avoid being poked, prodded, and beeped to death during an already exhausting and physically challenging time. I am SO THANKFUL for these beautiful little babies, their curious little eyes, and their sweet little cries. They are beautiful, precious, sweet, and fun to watch and be with.

I am thankful for my incredible midwife, her guidance throughout the pregnancy, her competence and patience during the birth, and her friendship postpartum. I am thankful for my birth team, my incredible midwife’s assistant, and for my friends who drove up from back home to be a part of that experience. I am thankful for my family, for my precious children for their excitement and awe of these babies. I’m thankful for my sweet husband for being there for every moment, holding my hand, stroking my hair, and kissing my forehead; for encouraging me, believing in me, and helping me out; and for being a complete and active partner in the birth process. And most importantly, I’m thankful to God.

Many times during this pregnancy, I prayed for this pregnancy to be safe, to protect us during this uncertain time, to guide us as we made choices about our birth plan, to keep me and my unborn children safe and healthy throughout the pregnancy and birth, and to help us to somehow fit all the pieces together for the birth to come together according to the Divine plan. I committed that if all went well, and my babies were born safely into the world, I would give back to others planning for their twin births. Ultimately, it wasn’t just me, or my midwife, or my birth team, or my husband who brought these children into the world. It was pure Spirit, whose wisdom guided every aspect of the experience. I truly believe that the universe provided the perfect people to surround me during birth, the perfect place for me to birth, and the perfect babies to hold in my arms, grateful for the opportunity to parent two more little ones and in awe of the divine aspects of motherhood. What a blessing!

If anyone reading this has heard any of the usual doubts cast upon the ability of twin or VBAC moms to birth safely, please know that there are options. Natural twin birth or natural VBAC (or a natural twin VBAC) may not be the right choice for everyone, but it can be the right choice for some women, and it can be done safely. I have proof!

(And there's now a video to go along with the story )

Monday, July 16, 2007

Lookin' for fun, and feelin' groovy!

Two weekends ago was a FIASCO of a weekend. I didn't blog about it here, but suffice to say it was a prime example of how Murphy's Law can be demonstrated in a family's life. Over and over and over. I started off the weekend with best intentions, including listing two beds and a large TV on Freecycle just to get them out of my storage unit and attic. Two nice families were going to take the beds, and the TV was going to be delivered to a local children's home that responded to my ad so that their boys would have a TV if they ever could afford to get a game station of some sort. I was so excited to be donating the TV, that I called up my sweetheart of a little brother to ask if he'd donate his old Nintendo 64. Turns out, he sold that Nintendo years ago, but since he only plays his Gamecube and XBOX360, he donated his nice Playstation 2, and a bunch of games.

We were about to head into town to pick up the TV from our storage unit and take it to the children's home cottage, when the family who wanted the bed from our attic called and asked if they could come pick it up. We said sure, and I decided to go check out the leaky spigot on the back of the house while waiting for them to arrive. Long story short, the pipes were OLD, and after gently twisting the spigot a little to see how hard it would be to replace, the entire pipe broke and we had to turn off water the the whole house. We tried calling a plumber, but couldn't reach anyone at first. And then, the family who came to get the bed managed to break the spring on our attic ladder and left before we noticed. GRRR! So, in South Carolina in the ridiculous heat of a July day, my husband and 10 year old climbed into the attic, and I held the door shut for ten minutes while they fixed the spring. I opened the attic to let them out, and SPROING!!!!! The spring came off again. So, back into the sweltering attic they went, for round two of fix-the-spring. Ten minutes later, they emerged, smelling like camels and soaked to the bone with sweat. With no water to do so much as wash their hands, much less take a shower.

Frustrated, I called the family that wanted the bed from the storage unit and the children's home houseparent and let them know we'd just have to bring their things Sunday, and we went to swim at my dad's house so the kids and my husband could rinse off. While there, I managed to reach a plumber, who came by the house that afternoon and got the water working again, just before dinner and bedtime. That was Saturday, July 7.

Sunday morning of the 8th, we woke up and decided things would be different. We skipped out of Sunday morning church because we accidentally overslept (we usually attend Saturday vigil anyway), got up and ready, and went to the storage unit after lunch. The family who wanted our storage bed met us there and picked it up. And then, the real fun began. On Friday, I had arranged with the storage unit rental office to move all of our things into a smaller unit in a different building on the other side of the property, since we'd be getting rid of a lot of stuff and never really needed the bigger one to begin with. So, we borrowed a pickup and a hand truck from the family business, and spent an hour and a half loading up our pickup. The kids worked so hard, and I was so proud of them for all pitching in! And the babies slept peacefully in the back of the minivan the entire time. Once we got it all loaded, we were so excited to have it all finished, loaded up the truck and minivan, and drove across the property to the building where our new, smaller, unlocked unit awaited.

At least that's how we had envisioned it.

When we went inside the building to find our new unit, it had a lock on it. A big, red lock. I called the office, hoping it would have an after-hours phone number for situations like this, but no. So I left a frantic message begging for help from anyone who might check the messages over the weekend. And then I went back to the building with the locked unit, and check the doors of EVERY unit, hoping to find one unlocked that we could claim. Locks. On every door, even. After half an hour more of brainstorming some way to make lemonade out of lemons, I gave up. We decided to move everything back into our old unit. But first, someone was going to feel my pain, at least a little.

By now, both babies were in their car seats screaming their heads off. I got into the van with the babies, rolled all the windows up and closed the doors (to improve the sound quality, of course), sat in the middle of the van between the two screaming babies, and called the storage unit office voicemail one more time, with babies howling in the background foreground.

"Hello, this is Christy again. We've decided to move everything back into the old unit. We will not be able to borrow a truck again until next weekend. And I'll look forward to hearing from you Monday so we can work out some way, perhaps a big credit on our account, that we can make this all a little more fair. Thank you very much!"

And then, with babies screaming, and our 5 year old son crying, "Mommy PLEASE don't make us move it all back-- I don't wanna move it all back," my sweet husband and I moved all the big stuff quickly into the unit. Then I sat in the van and nursed babies while my husband and children made a billion trips to move the rest of the small stuff. It took an hour to move it all back in.

We needed something to make us happy, so we took all my brother's PS2 games (which were all rated T) to our local used game shop, explained that they had been donated but would not be appropriate for the children's home, and asked if we could get some credit to swap out for rated E games. The game store manager was so sweet, he gave us full retail credit, and we got 6 new, fun games for the boys. We called over to the cottage, and went by to deliver the TV, PS2, and games ourselves. Our kids LOVED it, and the looks on those boys' faces were priceless! What fun!

Anyway, that was the weekend before last.

I was hoping, praying, that this weekend would be better. And it was!

Friday afternoon we moved our stuff to the new storage unit (I got my credit, by the way). Friday evening, we left the three oldest kids in good hands, and the Mr. and I got to go out on a pseudo date (milkshakes at Hardee's while the babies slept in their car seats next to us). Saturday was spent preparing food, playing with my new birthday present (which will be announced once I have time to post about it properly), and enjoying family time. And Sunday was spent in family time until the afternoon, when our new friends came over for a cookout. We had so much fun, the kids played well, and the grownups had a great time! We were even able to discuss religion over dinner without things falling apart (we're currently attending a Catholic church, they're Adventists), which is no small feat on a "first date" with new buddies. And the dad is cool, which is a good thing. Many of the dads we meet in this area are macho Bubba types, so meeting another nice, semi-progressive dude was a good thing. At one point, the other mom and I walked from the kitchen to the livingroom to find the two dads there talking, each one with a baby in their arms. Sweet!

So, I woke up this morning feeling slightly tired out from visiting into the evening, but feeling very, VERY much at peace and content. It's amazing what a refreshing and fun weekend can do for the spirit.

New Friends

As you may remember, I live in a tiny town. It has ONE grocery store. Two days ago, we went shopping there.

As we were heading into the store, I saw another mama with her minivan parked next to mine. She commented the standard comment I get when I go anywhere with three big kids and baby twins-- "Wow, you have your hands full!" She said it smiling, though, instead of snotty like they usually say it, and I liked her. I laughed and said, "sort of!"

Three cute kids jumped out of the car and followed her as she walked into the store. They looked like little ragamuffins-- in a good way! Big curly locks falling into their eyes, play outfits on that didn't match. I bet they homeschool, I thought to myself, and I made a mental note to try to find an opportunity to chat with her if I could work it in. But I didn't see her again in the store.

Later, while loading my groceries, I saw her come out and load up her van. "You have a beautiful family," I said, hoping to strike up a conversation. "Thanks," she replied. And then I chickened out. That stupid social anxiety welling up, I got into the driver's seat and closed the door. Disappointed in myself for not saying more, but still harboring some hope that we might still get to chat, I rolled down my windows (something I NEVER do when it's 100 degrees outside) to remain a little more accessible. She got behind the wheel of her car, cranked it up, and shifted into gear. Then, a funny thing happened. She drove her van right up next to mine, rolled down her window, and shouted, "Do you homeschool?"

Turns out she's a homeschool mom who has only lived in the area a few months. We talked in the parking lot for a few minutes, and then exchanged phone numbers before leaving. I called a little while later to invite her and her kids over to swim, and we had a BLAST! Turns out, they homeschool, they're vegetarian, they're into whole foods and natural living, and fairly crunchy in a few other ways!

Meeting her has been the highlight of my week, and it just goes to remind me to get out of my shell a little more!

Oh, AND I got an early birthday present tonight. But it's special enough to require its own post (maybe tomorrow) to present it to you. :-)

Wednesday, July 11, 2007

New Hobbies!

Okay, some of you TS old timers may remember my post, Do It Yourself = Therapy for Stubborn People. Well, I've been at it again. But THIS time around, I'd like to do it right. So, I've been learning some new tricks.

First off on our hit parade of DIY magic (as opposed to the DIY madness of years past)-- gardening. Successfully, even!

Since we have a limited area in the back yard that gets enough sunlight, Mr. Thinking Southerner read up on "square foot gardening," which is a method of gardening that helps you grow more stuff in smaller spaces. So, we have three big garden boxes full of tomatoes, squash, zucchini, cucumbers, green beans, okra, canteloupe, swiss chard, spinach, lettuce, peppers, and more! And our live to die plant ratio has been pretty good!

Number two on our hit parade of DIY magic: Canning and pickling!

With all those tasty garden treats, might as well learn to preserve them, right? So two weeks ago, I made my first ever pickles-- bread and butter. DELICIOUS! And then two nights ago, I made dill pickles. They were fabulous, though not as good as bread and butter. I've always liked homemade sweet pickles better than dill, even though I like store-bought dills better than sweet.

Number three on the hit parade: Sewing!



I'm not that great at it yet, but I'm learning, beginning with small and simple projects. I've made a few baby carriers and slings, and a couple of play dresses for my girls. And beginning this fall, I'm going to start taking sewing classes at the local fabric store to get better at it.

Number four on our hit parade of newly acquired skills: Basic carpentry!

Last summer, we put together a very complicated build-it-yourself playground for the kids, from a kit that had all the parts pre-cut and ready to assemble. It boosted our confidence, so when we found out we were having twins and wanted bunk beds for the kids' rooms, we decided that instead of buying bunk beds, we would make them ourselves using construction plans we ordered from www. . We bought all the lumber and hardware for the project, cut it, sanded, drilled, stained, painted, and assembled it all ourselves, and VOILA! Bunk beds!

So, there you have it! Just as stubborn as ever, but the therapy is working. AND, I'm actually learning new skills now. What's next on my DIY learning list? Who knows where the wind will blow me...

Tuesday, July 10, 2007

Dear Blogger,

I'm afraid I've been a bit unfaithful in our relationship.

I've been cheating on you, with a slew of hussied up parenting discussion forums with big hair and too-dark lipstick. Sure, they're not as fulfilling and meaningful as this relationship has been in the past. But they served a purpose for me for a short time, during a period of weakness on my part.

During my pregnancy, I was a bit freaked out. You see, I hadn't been pregnant in years, and the thought of being pregnant again was alien to me. After monkey #3 had been born, we spent a few years thinking we were done having kids. Planning for a new kid meant shifting my thoughts and focus back to having babies again! Planning for a new kid also meant having to learn everything I could about the safety, methods, and preparation regarding giving birth naturally after a prior cesarean. Monkey #3's birth (a cesarean) had been fairly traumatic for me, and had led to a LOOOOOOONG period of post-partum depression, so I was interested in avoiding a similar trauma this time around.

And then I found out it was TWINS-- WHOA! That of course necessitated trying to find other twin mamas online who had similar views on birth, breastfeeding, cosleeping, etc.

So, I'm afraid I became a bit addicted to the online support and chit chat I found on Babycenter, MDC, and NPT.

So now, the babies are here. The birth went well. Breastfeeding is established and going off without a hitch. Cosleeping rocks for lazy breastfeeding moms, twins or not. And all is well in the world of The Thinking Southerner. I have no excuse for my behavior. As it stands now, most of my online discussion forums are no longer uber-useful, and are primarily a form of entertainment. It's so different from my typically dysfunction-free real life to watch supposedly grown women fight online as if they are still stuck on the middle school playground. So different, so exotic and unusual and enticing...

And then there's the nak. In case you, Dear Blogger, are not familiar with the mommy discussion board lingo, nak stands for "nursing at keyboard." Most of the time that I'm sitting still long enough to open a browser and hit the keys, there's a baby hanging off my boob. Typing one handed lends itself to shorter and less meaningful posts, which isn't exactly my preferred blog posting style. Typing two handed while nursing means that I have to perfect my acrobat routine, as balancing a baby (or two) on my knees (which are propped up on the computer desk) while trying to hold a stream of thought is not easy.

And that, old friend, is why so many of the posts you've had lately have been quizzes, or reposts, or plain old lazy and un-thought-provoking.

So, Dear Blogger, there you have it. My lame attempt at an excuse for my infidelity. I know I am not deserving of your love, but if by some chance you'll have me back, I'll try to do better from now on. Just be patient with me as I rebuild our relationship-- I've been through LOTS of change.