Month: November 2015

A Story of Small, Squishy People: My Breech Twin Homebirth

Davey and Micah

This is probably the longest post you’ll ever read on this blog, but I don’t want to cut anything. Feel free to skim.

During my pregnancy and in the few days after, I didn’t really want to share my birth story on a public forum. But I realized that reading stories like this (and these) played a large role in giving me the confidence I needed to make the decisions I made about my boys’ birth. I’d love to be that kind of encouragement to others if I can.

So here is my story, and if it serves to empower even one woman to take charge of her own pregnancy rather than living through it in fear or undergoing countless unnecessary procedures, it was worth getting out of my comfort zone to share. The point of this post is not to defend my decisions. I’ll just say that women should (must!) take the responsibility to educate themselves about what is best for their babies, then make the decisions they feel comfortable with, as I did.

My first pregnancy ended in stillbirth. Two months later, much to our surprise and right in the middle of moving from Guam to New England, my husband and I discovered I was pregnant again. Two months after that, I went in for an ultrasound based on my midwife’s suspicions. Almost immediately we saw two little sacs and two little heads, and everything changed a little.

Twins Ultrasound

I had been planning a home birth from the beginning, and finding out I was expecting twins didn’t change that.

I’m the kind of person who reads everything under the sun on a topic when faced with a decision. I’m also the kind of person who tends to believe that the less we mess with nature and our bodies, the better. I had read the studies and statistics that showed that hospital births weren’t necessarily safer; in fact, that they could be more traumatic for both mothers and their babies. I had read story after story of women who were forced or bullied into completely non-evidence-based procedures that were not only unnecessary, but harmful. 

I already had a foundational conviction that “high risk” by standard obstetrical terms isn’t always risky at all. I believed that twins are a variation of normal and that there is no reason to plan for a C-section at worst or an epidural, operating-room delivery, and early induction at best, both of which are standard protocol for twin delivery in most U.S. hospitals.

When I found out I was expecting twins, I emailed Glenda, my midwife. “How do you feel about delivering twins?” Glenda is amazing. She sent me this video:

She contacted another midwife in the area, introduced me to her assistants, and we put together a team and an action plan. There were no rules, no deadlines or timelines; Glenda was there to support me. “At what point would you feel comfortable delivering them?” I remember asking, thinking that she’d want my twin pregnancy to be as textbook as possible in order to deliver at home. “When would you feel comfortable delivering at home?” she asked.

Many of Glenda’s responses prompted me to do more research and soul-searching of my own. When would I feel comfortable having the babies at home? What if they came early? How would I know when it was time to transfer to the hospital—if that even became necessary? I couldn’t make those decisions at 12, 16, 25, or even 30 weeks. I knew I had to be okay with a hospital transfer if it became necessary. I also knew that my decision shouldn’t be based on an arbitrary number or textbook protocol. According to the textbooks, I should be in a hospital operating room anyway. Because twins. But I had done enough research to know that the textbooks and standard protocols are often wrong, and Lord willing, my pregnancy was going to defy them.

The entire pregnancy was terrifying and beautiful. Despite my determination to enjoy every minute, I convinced myself that something tragic would happen again. I delighted in every wiggle and despaired whenever an hour would go by that I didn’t feel movement.

Around 25 weeks, I was about the same size I had been at 37 weeks the first time around. I was enormously pregnant. Everything hurt. And suddenly I couldn’t imagine feeling normal ever again.

30 Weeks With Twins

Manny put up with colossal mood swings. I wanted to go on a hike, wanted to explore a Renaissance Faire with my husband, wanted to stretch my muscles and have my body back to myself again, but my body wouldn’t let me. I even wanted to go for a jog. I hate running. But I would have paid money to feel like I *could* jog without falling flat on my face (or belly). That’s what every long day and every short week of my twin pregnancy felt like. Lots of sleep, but little real rest.

My blood pressure was high. There were leukocytes in my urine. Blood tests showed elevated white blood cells but nothing else abnormal, and because there were no signs of infection my midwife attributed the unusual numbers to twin pregnancy and told me to take garlic and echinacea, get all the rest I felt like I needed, watch carefully for any new developments, and go on with life. So I did.

So. Many. Braxton-Hicks. Around 30 weeks, I was thoroughly sick of being pregnant, and they became annoying. Every time I stood up, one would wrap around me—not painful, but powerful enough to make me want to stand still long enough for it to pass. It wasn’t unusual to have 4-6 an hour when I was up and active. They went away as soon as I’d sit down, though, so I started resting more and doing less. It wasn’t bed rest—it was more like self-imposed naps throughout the day, and they were heavenly. Thankfully, I didn’t ever have much trouble sleeping. If I had, I probably wouldn’t have coped with life well at all.

I started losing my mucus plug the last week in September. On October 1st, my husband and I were watching television and I timed 9 painless contractions in an hour. I was 34 weeks along. The combination made me think things were going to start happening, but… it was too early. It must just be another example of a twin pregnancy being more intense, I thought, though I knew that more than 4 or 5 contractions in an hour was reason to be suspicious. There’s no way I’ll go into labor this early, I thought. It’s just a fluke because I had been up so much that day, cleaning, cooking, and canning apple butter. I had an appointment with Glenda and my other midwife, Tammy, the next morning, so I shrugged it off and went to bed.

At my appointment, I told Glenda what had been happening, and again we discussed the prospect of going into labor earlier than expected. It was Friday, and I was 34 weeks, 6 days along, according to the ultrasound date. If I had been going by my own dates, of which I was certain, I’d be 34 weeks even. I still couldn’t decide about an absolute cutoff for hospital transfer, so we decided to play it by ear. Surely I wouldn’t go into labor that weekend. After that weekend, I’d be solidly in the 35 week range anyway, which had been something of an unstated goal all along.

Glenda’s perspective was that early babies needed extra care for sure, but that usually the best place to get that care was right on their mother’s chest—NOT in a hospital, where they would be whisked away and placed in an incubator. So I determined that as long as their heart tones remained strong, as long as I was healthy and confident in my decision, we would all stay at home.

I woke up from an afternoon nap around 4:30, spent ten minutes trying to get up off the sofa, and felt a huge gush of water the minute I managed to stand up. An hour later, the contractions were strong enough that I didn’t want to talk through them. Manny and my midwife’s assistant/doula, Tashina, worked magic to get the birthing pool set up and filled so quickly (thought it felt like an eternity at the time), and I could tell it wouldn’t be long before my first baby was going to be born by the time I stepped in.
Warm water has never felt so good.

Everything that happened after I stepped in the pool, I remember as a series of snapshots. Each one is crystal-clear, but they seem totally separate from one another, like I was present in hundreds of individual moments, and that time wrapped around them like a totally separated thing.

I remember someone saying that he was breech, and thinking kind of absently that he was supposed to be head-down.

I remember thinking that an epidural would be very nice.

I remember thinking that second babies were supposed to be easier than this.

Then his entire body was out except his head (Manny looks back on this part with horror).

T12072802_921097498141_4921615055306034193_nhere was an overwhelming sense of relief and I just wanted to be finished, to hold him, but it seemed like another contraction would never come to help me out. I’m not sure how long we stayed like this. It could have been two minutes or twenty; it was probably five or six. Tammy said, “Steff, next time you feel a contraction at all, you need to push as hard as you can. We need to get him out.” She was so calm.

“I don’t think I can,” I said.

“Well, I think you need to.”

There was no arguing with that. I evicted David with the next contraction. He needed several rescue breaths to get started breathing on his own; I remember asking if he was okay, thinking that he was remarkably tiny, feeling a little concern but also an overwhelming sense of peace and even more overwhelmingly, relief at the break in labor.

In fact, I think I was so happy to *not* be delivering a child anymore that my labor stalled out somewhat of my own volition. I could go for awhile without repeating that process, thank you very much—and my body obliged. An hour and a half later, I forced myself out of the tub to use the restroom. Walking made the contractions start up again (that had been the goal); I had to stop twice in the ten steps it took to make it to the bathroom and two or so more times on the way back.

Newborn Twin By the time I got back to the tub, I was determined. I was getting back in the water, and I talked myself into getting that second baby out. There was no way around it; Baby B had to come, and sooner was better than later. “You can come out now, little one,” I remember saying to him as I leaned on the side of the tub between contractions. “We’re ready for you.” Two hours and forty minutes after David was born, Micah came into the world, also breech, one hand up by his head.

Davey was tiny—so tiny that it was almost scary to hold him at first. He weighed just over 5 lb when he was born, and Micah weighed 6 lb. They each lost about 8 oz. in the days following their birth. It should be noted that they both had incredible amounts of very fluffy hair from the beginning.

Because Micah, the second one to be born, was a pound larger than his brother, he was more challenging to get out, and it’s his fault that I needed stitches afterwards (something I won’t soon forget and might remind him of when he’s old enough to be embarrassed about it). The fact that they were both breech threw a wrench into our plans, too. We had been so sure that at least one was head-down.

I feel like this is the point in the story where I’m expected to talk about how beautiful the whole thing was, and how it was such a special healing birth after Miriam, and how magical/ethereal/fulfilling it was to hold those babies for the first time. And I guess it was, in a way. But the truth is, it was messy. It hurt (go figure). I handled labor well, but everything happened so fast—and I think a part of me had so completely expected something to go wrong—that I’m still trying to wrap my mind around it and fully realize that I’m not pregnant anymore. I still wake up sometimes, see a baby snuggled beside me in bed because he won’t sleep anywhere but up against my chest, and think, ooh, a baby. Where did you come from, little one? And I still wish their sister were here to meet them.

Now, looking back, I’m surprised at some of the decisions I made—like not going to the hospital even though they were only 34 weeks old, or not getting more monitoring during the pregnancy itself.

I’ve always thought it was a little ridiculous when women talk about how they just trusted their intuition and knew things about their bodies and their babies. The truth is, I didn’t know that things would be okay, but for some reason I still had peace with the decisions I made. 12243484_10156224913015274_6911222073545422424_n

I am a believer in Christ. I trusted God with my pregnancy and had put it into His hands multiple times. But I also recognized from losing my first baby that trusting Him with everything doesn’t guarantee that it will be okay by my terms. Trusting Him doesn’t make life perfect, though in sunshiny seasons it’s tempting to think of it that way.

I trusted Him with Miriam and I lost her. I trusted Him with these babies and still wondered what would go wrong. He was (and is) still good. I doubted my decisions but prayerfully stuck with them, because they seemed like the best choices I could make. And I’m so thankful for every single decision that seems improbable or even unwise in hindsight. If I were in the same spot again, part of me would like to say that I’d do things differently—be more cautious, maybe—but I’m so thankful that everything happened exactly as it did.

And I’m very thankful to be through with pregnancy (and labor) for awhile.