Here is part 2 (aka the conclusion) of my twin pregnancy experience – the delivery! You can catch the first half here.
I was 38 weeks + 1 day pregnant. My twin pregnancy was coming to an end. I was on my way to the hospital trying to wrap my brain around the fact my high-risk pregnancy was nearly over. I was (apparently) in labor, but not really feeling major contractions like I did with my first pregnancy, and I was about 5 cm dilated. It was totally uneventful. There was no feeling of exhilaration, or “This is it!” kind of attitude. I had my bag in the car, and my husband and I drove 3 minutes to the adult hospital to check in at labor and delivery. I walked over to triage, like a hospital visitor (not the patient), and they checked me in as if I was walking up to the front desk at a hotel, “Dickstein? Oh yes, we have your room over here.” Uhhh, OK.
We set ourselves up in my labor and delivery room (L&D), but I knew I would not be delivering in this room because all multiples are delivered in the operating room in case of an emergency and surgery was needed. In such an urgent situation, the minutes needed to travel down the hall could mean life or death. So, I viewed this as a waiting room… and wait I did, for about 4 hours with nothing going on.
I kept waiting for labor to really pick up, but even after breaking one of my waters (because I had 2 sets of everything with the twins), not much happened. After 4.5 hours of nothing, the nurse, doctor and my husband finally convinced me to get a “whiff” of Pitocin (synthetic oxytocin), the hormone which induces contractions and labor. I wanted to avoid Pitocin because I knew it could increase my chance of a c-section. Still, things were not moving along and the recommendation was to get a little “push.” I weighed the pros and cons, and because the doctor told me I was already in labor, my risk of c-section was still low and I acquiesced to getting my “whiff.” (In part 1, I mentioned I was a tough patient!)
HOLY MOLY did things pick up! I went from feeling happy and comfortable to gripping the side of the bed to get through the crazy intense contractions and feeling rather murdery towards my husband who sweetly asked how I was doing. “How do you think I’m doing?!” <<I ROARED in my head!!!! And if I could have leapt across the room to attack him for his seemingly benign (but to my hardcore contraction addled body – absolutely ludicrous!) question, I would have!>>
Thankfully, the most wonderful nurse anesthetists entered the room, my husband very happily exited and after two tries, I had the best epidural I could have ever hoped for (the “princess dose” which is half a c-section dose – yes thank you, come again, I love you… ). I was numb and I felt blissful.
The whiff of Pitocin did the job and I was fully dilated and ready to push in a short period of time. I was wheeled to the operating room, and my doctor, Dr. Mancuso, met me there shortly thereafter and we chit-chatted about her previous evening, going out to dinner with her family (she’s a mom of twins herself). It was like we were not preparing to deliver multiples with a team of many doctors and support staff at the ready. Dr. Mancuso was super relaxed, so I felt super relaxed (the AWESOME epidural definitely helped set the mood too).
Dr. Mancuso and I had talked, at length, about delivering both babies vaginally, as long as it was safe. A general hospitalist would most likely deliver Baby A vaginally, then go for a c-section if Baby B still presented breech. That would be the worst of both worlds for me – a vaginal ouchy and literally gut-splitting surgery. The good news was Baby A was head down, and both babies measured about the same, which is another good sign. If Baby B was significantly larger than Baby A, a vaginal breech delivery would not be in the cards. The baby would not make it through the birth canal safely. As it was, Baby B was always flip-flopping in utero, so I didn’t know what to expect once Baby A exited and Baby B had the whole womb to move around.
Being super numb meant I needed to be told when contractions were coming, and told when to push. Delivering Baby A took about 20 minutes and it was the COMPLETE OPPOSITE FROM MY FIRST DELIVERY. With my first pregnancy, I pushed for what seemed like an eternity and here it was like a scene out of a romantic comedy: I sneezed and a baby popped out! Really, after three pushes, Baby A, now named Miriam, had arrived crying and pink. I felt like things were going really smoothly. I always thought Baby A was a girl, so I was overjoyed (another girl!)
THE NEXT 6 MINUTES ROCKED MY WORLD:
After my husband cut the cord and they whisked Miriam to the exam table for weight, length, Apgar, etc., we focused on the task at hand. It was time to see what Baby B was up to. My doctor quickly checked the position and no bueno. Baby B was not playing ball. Dr. Mancuso tried to externally manipulate the baby to move, but still no budging. She tried internally manipulating the baby at which point I said, “I feel some pressure, should I push?” A chorus of hospital staff forcefully said, “No!” The pressure I was feeling was the doctor’s hand and arm in my uterus trying to move Baby B into position.
Sidenote which may be TMI: Now when I see Dr. Mancuso, I like to ask her to show me just how high up on her arm she was in my body – almost up to her elbow. I didn’t feel it and this is CRAZY to me!
ANYWAY, Baby B was not interested in moving, so Dr. Mancuso said, “I think you should go for it.” I answered frightfully, “With a c-section?” Dr. Mancuso: “No, vaginal breech delivery.” I watched as the Chief Attending physician tried to pull Baby B out, but she was struggling. Dr. Mancuso (my super-skilled and amazingly well trained doctor) was talking her through the manipulations/maneuvers but I could see she was getting anxious and eventually told the attending to step aside and she took over. The umbilical cord was wrapped around Baby B’s shoulder and leg, and Dr. Mancuso needed to untangle the cord before pulling her out without rupturing the placenta. She managed this with great strength, and then began pulling the baby out feet first. I could see little feet, legs, and a tushy emerge and they were all a sickly shade of blue. I gave a push at the very end and they flipped the baby over to reveal another girl, but this was second to seeing a blue, limp baby who was not crying or breathing. This was the scariest moment of my entire life, the earth stopped moving for me and everything was moving in slow motion. Again, the team whisked Baby B, Ilana, to the side table and I immediately looked at Dr. Mancuso for answers. What was going on?!
Once again, Dr. Mancuso provided the comfort and support I needed in the moment. She calmly explained the delivery was traumatic for the baby and it’s not unusual for the baby to need a bit of oxygen to get going. I looked at my husband and I saw an expression of extreme worry and utter fear on his face. I had never seen him look like this before and it took everything in me to think, “Keep it together Michelle. She’s in the best hands, she’ll be OK” instead of crumble into a mess of tears.
Not even a minute later we heard a small cry grow louder and it was like everything that was frozen in those moments sped up and we were back on track. The earth was moving again. Shortly thereafter, the placentas were delivered, no stitches needed on my end (pun intended), and we were back in the L&D room where I was able nurse both babies together for the first time. It was the most powerful and exhilarating moment I could ever imagine. It’s clear to see the emotional roller coaster I was on from the start of the day!
A week or so later, Josh and I became teary thinking about Ilana’s shocking delivery. I asked him if he thought I did the right thing by delivering her vaginally. He had the best and most unexpected answer for me, “Yes, because who knows how long it would have been before she was able to nurse if she was delivered by c-section. What she needed most was your milk and she got it right way.” Whoa. I just fell in love with him all over again.
So, to recap, my goals were achieved!
- Get as close to full-term as possible: I made it to 38 weeks + 1 day!
- Try to deliver them vaginally by an experienced doctor (essentially avoid a c-section): All the credit goes to Dr. Mancuso and the team at MFM for ensuring an amazing delivery.
- Have 12 pounds of baby in me: Miriam was 6 lbs and Ilana was 6 lb 1 oz. I had just over 12 lbs of baby in me and there was no need for a trip to the NICU for low birth weight.
- Try to breastfeed: When the girls first latched to nurse after the incredible birth experience, I felt on top of the world. I felt like we could accomplish anything together. I gained an incredible amount of support and warmth from the IBCLC, Liz Maseth, so much so, she inspired me to become a Certified Lactation Counselor and give back to other new moms – essentially pay it forward. I love helping new moms in any way shape or form, so I’m so happy to have a real skill-set and knowledge base to do so.
I look at my birth story as, “That time Akron Children’s Hospital doctors saved my babies’ lives.” Dr. Mancuso kept me relaxed and I knew I was getting the absolute best care for me and my babies, and we were going to be OK. I am certain any other doctor would have advised me to go for a cesarian, but instead I was able to hold my babies and nurse them right away in the recovery room. The MFM Center at Akron Children’s Hospital is staffed with the most caring people (like the whole hospital!). They have expert training and a skill set beyond comparison. Under their care, I could have the pregnancy and delivery I had hoped for while keeping safety and the health of me and my babies as the top priority. I am not exaggerating when I say I honestly owe the health and life of my girls to Akron Children’s Hospital MFM, and my gratitude for their care goes beyond words. My patient experience truly speaks to the mission of the hospital, to treat every child as if they are our own, and it makes me so proud and thankful to be a part of the Akron Children’s Hospital family in more ways than one.
Lastly, my experience as a patient at Akron Children’s Hospital inspired my very first blog writing experience! Check it out here.