Monday, February 23, 2015

Twin Pregnancy: Labor and Delivery

When writing birth stories in the past, I've written one loooooong post all about labor, delivery, and our hospital stay. However, this time I've decided to split it up and do several shorter posts (or in theory they'll be shorter, but I know how wordy I can get *grin*). The labor and delivery alone is quite the story, so I think it deserves a post all its own! 

Okay, so rewinding a bit to the end of January, I saw Dr. N when I was 37 weeks and 1 day pregnant with the twinbies. At that appointment, we scheduled my induction date to be February 3rd when I would be 38 weeks and 1 day along. Throughout this pregnancy, Dr. N had said that he would induce me on February 2nd if I didn't go into labor on my own before then. However, when his nurse tried to schedule my induction for that day, the hospital did not have any openings. I was dialated to a little less than 2 centimeters (although my cervix was still very high) at that appointment, so I sincerely thought I would not make it another whole week until my induction date. Even Dr. N expressed that he thought it was entirely likely that I would go into labor on my own. 

As you all know - and much to my disappointment - I didn't go into labor on my own. I did have some painful contractions, as well as a good deal of Braxton Hicks contractions. I even downloaded a contraction timer onto my phone, but my contractions were never consistent enough to use it. 

By the time the last few days rolled around, I was beyond huge and miserable. I could barely walk due to the incredible amount of pressure I had down low, I couldn't bend at the waist at all, I couldn't squat or get down on the ground (and if I did manage to get down, I certainly couldn't get up!), and it was impossible to roll over in bed. 

My mom had gotten into town on Saturday, and my dad came into town on Monday evening. We were scheduled to check into the hospital at 5:00am on Tuesday, February 3rd, and my mom left our house at the same time we did (4:15am!) and followed us to the hospital. My dad stayed at my house with Brianna and Brenson. 

Here I am on the morning of February 3rd - 38 weeks and 1 day pregnant - right before we left for the hospital:

We arrived at the check-in counter right at 5:00am, and were soon taken to our labor and delivery room by our first nurse, Becky. She got me situated in my gown and bed, took my vitals, started my IV, and began asking a battery of questions. 

Excited to get this show started!

My Mom has always come up to the hospital several hours after us, so she's never experienced the check-in process with us. She was surprised at how long it took and how many questions I had to answer. I think she was especially stunned by questions like, "Do you understand that your baby's care is your full responsibility even while in the hospital?" and "Do you feel safe in your home?"

I was so happy to have my Mom there with me! Definitely a perk of being induced!

It was 6:30am by the time we were ready to actually begin the induction process. Becky did a cervical check and determined that I was about 2 centimeters dialated with a very high cervix. This was so disappointing to me! I had told Mom that I wanted to have these babies before noon, so I was hoping to be more progressed than that (especially since that's exactly what I was a whole week before). Becky started pitocin in my IV, and we were officially on our way to evicting the twinbies!

At 7:00am, the hospital staff changed, and we had a new nurse named Krystal. We had prayed for good nurses, and I was very happy with the care we received from them!

Between 6:30am and 8:00am, things were pretty quiet.  I had three monitors on my belly . . . one for each baby and one for my contractions. Baby A kept kicking hers off or moving away from it, so Krystal had to come in a few times to get the monitor back on her. Both babies were being super active during this time, so it was fun to watch their movements on the monitor.

Dr. N stopped by at around 8:00am, and of course he came in like a whirlwind. He said, "Let's get this party started!" Then, he looked at my Mom and said, "Do you stay in the room while she gets naked?" Haha . . . my Mom was a little taken aback by this, but she just said yes and stayed :-). He did a quick cervical check, then broke my water. I hadn't felt any contractions yet, so I was expecting him to say I was dialated 2 centimeters, but he determined that I was dialated about 4 centimeters, at a negative 2 station, and about 80 percent effaced. I was thrilled to hear this! He then told me that if I wanted an epidural, I needed to get it immediately. I must have looked at him a bit puzzled because he went on to explain his statement. He said, "These things can sometimes to go to hell in a hand basket, so that's why you need to get it now."

I was pretty encouraged by this. I told my Mom that he must think labor is going to progress quickly, and I was right. And so was he :-).

Krystal, and another nurse who was helping her, kept trying to get me to lay flat on my back because that is how the baby monitors were working best. However - as I've blogged about several times before - throughout this whole pregnancy I've had trouble with lightheadedness and feeling like I was going to pass out if I laid flat on my back. Dr. N was still in the room when I almost passed out after 3 seconds of being flat on my back, and he said, "Oh, she's very vagel . . . one of the most vagel patients I've had." After that, the nurses tried to at least have me propped a little on my side, but I continued to have issues with feeling like I was going to pass out.

The anesthesiologist came in at 9:00am to give me my epidural. It felt really strange to me to get it that early because I still hadn't felt even one painful contraction! However, I trusted Dr. N and since he said to go ahead and get it, I did. Mom had to step out while I was getting the epi, but Chris was allowed to stay with me. The hardest part this time was arching my back out enough for the doctor to administer it. Physically, it was impossible to take deep breaths and lean forward at the same time! Chris and Krystal had to push my shoulders down to lean me forward, and even then my belly was touching the bed. Despite this, receiving the epi went very smoothly, and I could soon feel the numbness start to disperse through my body.

However, about 10 minutes after receiving the epi, I started to feel extremely lightheaded and cloudy. My peripheral vision began to go black, and my blood pressure dropped to 77 over 35. The nurses began to pump extra fluids into my IV, as well as 10ml of ephedrine. Although I started to feel better, I still didn't feel normal or good. My head felt so cloudy, and I just felt physically unstable.

At 9:30am, Krystal did a cervical check. I was now about 4 to 5 centimeters dialated. Shortly after that, I started to feel really bad again, so my Mom called for a nurse. Sure enough, my blood pressure had fallen to 80 over 49, so at 9:40am I received a second dose of ephedrine in the form of a shot in my bottom. About ten minutes later, my blood pressure was up to 119 over 69, and I was feeling somewhat better though still weak and a bit cloudy-headed.

At about 9:00am, my sister had come to my house to pick Brenson up for the day. My sister, her daughter, and Bren had all been sick with colds and fevers, so none of them were planning to come to the hospital. We were incredibly sad about this, but it was just one of those things that was out of our control. After Lisa picked up Brenson, my Dad brought Brianna up to the hospital and they got there at about 10:30am.

Brianna was very quiet at first, acting a bit overwhelmed. I was sure happy for some hugs from my oldest girl!

At 10:35am, my Dad left the room so Krystal could check me again. This time I was 6 to 7 centimeters dialated. We had lost both babies on the monitors (they just wouldn't stay still!), so Krystal and another nurse spent the next 40 minutes trying to find them and keep the monitors on their heartbeats. It was really ridiculous! They brought in a handheld ultrasound machine to locate the babies, but still couldn't get their heartbeats on the monitors (even though we could see them moving on the ultrasound). Finally, they had the hospital OB come in with a larger ultrasound machine to try and locate the babies. I kept asking if the babies were okay, and everyone kept assuring me that they were. They just couldn't get the heartbeats on the monitors!

I started to feel tremendous pressure down low at about 11:15am. I remembered this sensation from previous labors, and asked Krystal to check me. She did, and I was 9 centimeters dialated with a small lip. It was at this point that everything started to move extremely fast!

One of the nurses said, "We need to call Dr. N now!" while the other started getting me, Chris, and Mom ready to go to the OR (it's hospital policy that twin deliveries take place in the OR). Chris and Mom looked cute in their scrubs :-)!

I was still feeling really unstable physically, and now my adrenaline was pumping pretty good, too! But, we were ready to do this!

Right before we left the labor and delivery room to head to the OR, Dr. N popped in and said, "Are we ready to have babies?!?" Of course, we said yes :-). The nurses were still trying to find the babies on the monitors, and Dr. N said, "Don't worry about that. They're fine. Let's do this!" I was thankful that he finally put an end to that mess.

It was about 11:30am when the nurses started wheeling me down to the OR. As soon as we got there, the two L&D nurses that were with me, along with about 10 other hospital staff members, began buzzing around the room at a rapid pace preparing everything for the delivery. Pictures are truly worth a thousand words, and this one perfectly sums up how I was feeling at that point! I had no idea Chris was taking this photo of me.

The OR was such a different atmosphere than what I had experienced in the past during delivery. It was sterile. It was bright. It was noisy with all the staff. There were so many machines and tools. Just the number of people in the OR alone was overwhelming. There were four L&D nurses, two NICU staff per baby, Dr. N, an anesthesiologist, one of Dr. N's nurses from his office that came to observe (Tiffany, seen in the photo below in yellow), a med student who was observing, Chris, my Mom, and of course, me. Chris and my Mom had to stand in the corner of the room while the nurses prepared everything, so I felt kind of abandoned (I couldn't see or hear them at this point). Directly after the photo above was taken, the nurses moved me to a {very narrow} surgical bed. I was still feeling unstable (from blood pressure issues) and shaky (from nerves), so I was worried that I was going to fall right off the bed.

I noticed Chris taking this photo of me, so I put my game face on :-):

About 10 minutes after arriving in the OR, Dr. N had me push through a contraction. I did three, good, 10-count pushes, and when the contraction was over, Chris exclaimed, "I can see her head, Chelle, and she has a ton of hair!" I said, "Really!?!", and Dr. N said, "Oh yeah, it's a nine pound head!" Not exactly what I wanted to hear, but that's his way . . . lots of jokes! However, what Chris said about seeing her head was the perfect thing for me to hear because it really motivated me to push with all my strength during the next contraction. Two more pushes (a total of five, 10-count pushes through two contractions), and Brooke Eliana Mae was born at 11:41am. She cried out, and Dr. N immediately held her up for me to see. I asked, "Is she a good size?" and he said, "Oh yeah! She's a big one!" Their size was a major concern for me, so I was extremely relieved to hear this!

Chris was standing to my left down by Dr. N. My Mom was on my left by my head, taking these photos.

I love this photo of Dr. N showing Brooke to me! He was proud!

During the next seven or so minutes, there is a gap in photos. Things started to get serious very quickly, so Mom was kind of pushed away from me by nurses. Besides, I don't think she was thinking about snapping pictures at this point anyway.

I thought I would have a little bit of a break after pushing Brooke out before I had to push for Brecklyn. However, it didn't work out that way. About one minute after Brooke was born, Chris cut her cord, and a NICU staff member took her off to an adjoining room to check her out. I laid back on the bed, feeling exhausted, and Dr. N said, "Get ready to push! We're going to turn Baby B."

Throughout *almost* my whole pregnancy, Baby B was breech. I had asked Dr. N several times how that was going to work during delivery, and he assured me that he would try and turn her before I delivered her. He explained that it should be fairly easy to turn her since there would suddenly be room in my womb after Baby A was delivered. At my last appointment, I asked, "What if we can't get her to turn?" and he replied, "Then we'll just deliver her breech . . . no biggie."

So, as soon as I had another contraction, Dr. N and the L&D nurses worked on turning Baby B while I pushed. They tried to turn her through two, 10-count pushes, and while this wasn't painful to me, there was a ton of pressure when they were trying to manipulate her. After two unsuccessful turn attempts, her left leg came out. Dr. N said, "Okay, we're going to have to do this breech." He didn't seem worried at all, so I wasn't either. Chris was still down by Dr. N and watching everything. He said, "That's so weird, Chelle, her leg is just hanging out!" Ha.

Before the next contraction began, Dr. N tried to grab her right leg and pull it down. He reached for it twice, but couldn't get a hold of it (and his attempts to grab it were pretty painful). When the next contraction began, he instructed me to push. As I pushed, he pulled Brecklyn Sarah Faith out by her left leg. Her right leg was parallel to her body with her foot behind her head/ear. She was born at 11:47am doing the splits. . . just six minutes after her sister.

Although Dr. N didn't say this out loud, I think he had to make a quick choice between pulling her out by one leg or doing a c-section. I'm thankful he chose what he did since I'd already had one baby vaginally, but pulling her out like that tore me up pretty badly. He had given me an episiotomy during Brooke's birth, but I tore in a different place during Brecklyn's birth. However, I wasn't even concerned with that at this point because Brecklyn did not come out crying.

Things in the OR were suddenly very quiet, and I knew something wasn't right because Dr. N did not hold Brecklyn up for me to see her. He held her down and out of my sight, so of course I started panicking a bit when I didn't hear her cry. Chris told me later that her cord was wrapped around her neck and body very tightly. Dr. N also later said that her cord was short.

I had laid all the way back on the bed as soon as she came out, but when I didn't see her or hear her, I sat up part way, looked at Dr. N, and said, "Why can't I hear her or see her? Is she okay?" He got pretty stern with me and said, "Lay back and take deep breaths now!" This shocked me a bit as I could see that my jovial, funny-man doctor was suddenly very serious. I laid back on the bed, and Dr. N instructed the anesthesiologist (who was standing at my head on the right side this whole time) to give me oxygen. Soon after that, we heard Brecklyn's sweet cry. I later asked Chris how long he thought it was that Brecklyn was not breathing because I felt like it was several minutes. Chris said it was probably less than a minute . . . it sure felt like longer!

The only photo we have of Brecklyn's birth:

Dr. N held her up briefly for me to see, allowed Chris to cut her cord, then they whisked her off to the adjoining room to be checked by the NICU staff. Someone (maybe a nurse? I can't remember) explained that Brecklyn was probably okay, but that she would have to be observed in the NICU for several hours. Dr. N then told Chris to go with Brecklyn while we finished up. It was an intense few minutes, for sure!

Because of the number of people crowded around my bed, Mom had a very hard time getting a good angle for photos (but I love them all). In this photo, Chris is cutting Brecklyn's cord.

I delivered the first placenta, and for the first time ever actually felt it come out. I said, "What was that?!?" and Dr. N said, "One HUGE placenta!" haha. After delivering the second placenta, he began stitching me up. During this time, Chris returned from the adjoining room with Miss Brooke.

Here I am holding Brooke for the first time . . . still stunned from Brecklyn's delivery and feeling unstable from the blood pressure crashes and adrenaline rushes. Shortly after this, I told Chris to take her because I didn't feel like I could hold her without risk of dropping her.

Looking at my sweet Baby A:

Feeling mentally cloudy but so happy to see my baby:

Proud Daddy:

I found out that she weighed 6 pounds and 11 ounces. Yay for a heavy baby!

As Dr. N stitched me up, G-Jo and Chris enjoyed the baby :-).

While Dr. N was still working on me, Chris took the camera and went back to see Brecklyn again. He said it was hard for him to see her because the nurses were really working on her to help her breathe. But, he was able to get these two photos:

Mom got to sit and hold Brooke while Chris was with Brecklyn.

When Chris came back to me, a NICU nurse came with him and brought Brecklyn out for me to see. She offered to let me hold her, but I was feeling so weak and unstable that I declined. I was overjoyed to see her, though! She reported that Brecklyn weighed 6 pounds and 5 ounces. Together, they weighed 13 pounds!

I was trying hard not to cry. I was concerned about my girl and just feeling such a rush of emotions.

Before leaving, Dr. N told me that I would be feeling extremely sore and to keep on top of my pain meds. He also explained that just after Brecklyn came out - while he was trying to get her to breathe - the only oxygen she was receiving was from me since we hadn't cut the cord yet. When I sat up and inquired about her, he got stern with me about laying down and taking deep breaths because I had been holding my breath. Therefore, Brecklyn wasn't getting oxygen from me, which is what she needed. He also made a joke about her being a gymnast :-). I just smiled and said, "Thank you." He's a good doctor that Chris and I trust, so I wasn't concerned about an explanation (although I do think it was nice for him to give me one). Shortly after Dr. N left, the nurses wheeled me back to my L&D room. Mom pushed Brooke in her bassinet, while Chris stayed with Brecklyn who was on her way to the NICU. It was 12:30pm when we arrived back in the L&D room (we had been in the OR for just about an hour).

Whew! I think that I'll wrap this up here for now. Stay tuned for more in a few days :-).


Cheryl said...

I love how you tell a story! My goodness, I was holding my breath as I read the actual delivery part! You did so good and I know y'all are so thankful to have two more precious babies in the family!

Heather said...

What a beautiful birth story. I'm glad you were able to have a safe delivery without c-section. Sounds like your OB is an awesome Dr. Hope your recovery is going well!

Jessah @ Dreaming of Dimples said...

I love that you delivered them vaginally. So many twin deliveries go straight to c-section because so many doctors don't do breech vaginal deliveries. Beautiful birth story.