First I want to say that however someone gives birth is amazing! Women are freaking warriors and are capable of so much. The female body is incredible and I am in awe that I was able to carry two healthy babies to 36 weeks and that I was able to produce milk to feed them for 14 months (and counting).
I am also extremely grateful for modern medicine, the highly capable and skilled team who performed my c-section and who monitored me through the entire pregnancy, and the health of my perfect little boys.
With identical twins who both had less than ideal cord insertion (marginal for Twin A and velamentous for Twin B), I knew that c-section was the safest way for them to be delivered, so I didn’t give it a second thought. That being said, it was a very different experience than my first son's vaginal delivery and to be honest, I didn’t love it.
This is not a bad birth story, it actually went perfectly and for most people, I’m sure they would be thrilled. I want to be sensitive to the fact that many moms have terrible life threatening experiences and my experience was not that at all. I know that I am extremely fortunate, but just because it all went the way it should, doesn’t mean I have to be thrilled with how it happened.
I think a lot of my disappointment in my experience is due to the fact that I had a vaginal delivery with my first son, at 41 weeks. I had a midwife, no complications, and was home in less than 24 hours. Going from this scenario to a scheduled c-section at 36 weeks with twins, was quite a drastic change. That being said, I do think reading other twin moms birth stories helped me prepare. And I hope sharing my story will help others who might be in a similar situation feel less alone in their experience and thoughts, and possibly serve to prepare you for what's to come (with some tips along the way, too)!
Before I start with my birth story, I want to share what you need to know about a scheduled c-section. I will expand on each of these below, but I am capturing them here off the top for you:
Just because it's scheduled, doesn't mean it will happen on time. Our surgery was 4 hours later than planned and for awhile it looked like it might even be pushed to the next day.
The time without your partner before surgery will feel the longest (and hardest, IMO). I didn't realize how long you are in the OR being prepped before your partner can join you. I wish I would have brought my phone and headphones with music to help calm me during that time!
Your baby might need this NICU, even if they are healthy. All babies born before 36 weeks automatically make a stop at the NICU following birth, regardless of their size, health etc. We originally had our surgery scheduled two days prior, but made the change once I learned about this. *edit - this was the rule at the hospital I delivered at, but might not be the case for everyone
Formula might be your only option early on. I thought I would have access to donor breastmilk, but was informed after surgery that it was reserved for babies born prior to 32 weeks gestation. Needing to use formula those first few days, was not part of my plan. I wish I had been prepared for that ahead of time.
Recovery from a c-section is a marathon, not a sprint. Just when you think you're feeling better and able to do a bit more, something will knock you back down to square one. I struggled with the guilt of not being able to do much those first few weeks, but when I tried to do more I paid for it days later. I likely would have had a quicker recovery if I had just prioritized my rest a little longer.
Discuss your birth plan with your medical team the day of the surgery (even if you had done so previously). I had mine printed, I gave it to my surgeon before the surgery started, but we didn't walk through it together in detail, she just looked it over. In the moment it was the last thing I was thinking about, but looking back, I feel like it would have made a big difference in my experience.
Birth Story
Getting Ready
The week leading up to our delivery, I was extremely anxious. I had never had a surgery before and my first birth was a vaginal delivery so knowing that this would be so different, was really hard to wrap my head around. I was worried about the risks that come with delivering identical twins (no matter the method), the risks of surgery, all of the unknowns, and what recovery would be like. I was also having terrible reflux, not sleeping, and really worried about the babies health and if they’d need to be in the NICU - since they would be coming at 36 weeks.
The night before the surgery, I was told to wake up at midnight to eat and drink since I had to fast 8 hours before hand. I wasn’t hungry, but I knew I’d be starving the next morning if I didn’t eat. Unfortunately my mid-night snack caused the worst reflux I’d had to date and I ended up vomiting several times, and then not being able to sleep at all. I couldn't lay flat at this point because even with the prescription heartburn medication, the reflux was intolerable. I just laid there going over my birth plan and hospital bag lists in my head, and kept thinking to myself, soon it will be over and then I can breathe again.
If you're interested in what my birth plan or hospital bag lists looked like, I've included them below made into pretty templates thanks to canva! I hope these are helpful in making you feel more prepared.
Twins Birthday!
It's a bizarre thing to know your babies birthday in advance. With my first son, I was 8 days past our due date and had no clue when he would finally come. There was something nice about being able to mentally prepare for the birthday this time, even though technically I could have went into labor anytime before the scheduled date.
Our surgery time was 9am on June 17th (36 weeks exactly), but we had to be there at 7am so we left for the hospital at 6:30am. We made our way through the many Covid screenings and admitting desks before heading up to labor and delivery. We were taken to triage and got set-up on the monitors to track the babies movement and heartbeats. Thankfully I could feel the babies moving, because it took over 15 minutes for the nurse to find both heart beats. They didn't have an ultrasound machine and we had no idea how those babies were positioned, so finding two separate heart beats was quite the feat. After that there was just a lot of waiting... I probably should have tried to get some sleep, but I was too anxious.
We waited there for almost 4 hours... it was a really busy morning and our surgery time kept getting bumped for emergency c-sections. I was starving and my reflux was terrible, my anxiety was through the roof. I just wanted to get it over with and see my boys.
We met the anesthesiologist and said hi to our OB who had been following me my whole pregnancy. We were so grateful that she would be performing the surgery and she assured us no matter how late, we would be having the twins that day. That was a huge relief because the woman in the bay beside me was told her surgery would be pushed to the following day. I didnt think I could do another night of no sleep and fasting. Finally at 11:45am we were taken to the OR.
Surgery Prep
I had downloaded a bunch of my favorite songs and some meditations on my phone to listen to leading up to and during the surgery to help me stay calm, but I left my phone with Russ when they took me into the OR. I didn’t realize just how long the prep would take and that your partner joins you just minutes before surgery begins. The time I was alone in the OR was when I needed that music the most. I was so nervous I was shaking. My reflux and nausea was at an all time high. I was so scared of all the unknowns and what could possibly go wrong.
Looking around the room, there were two warming tables set up for the babies labeled with “Twin A” and “Twin B”. The room wasn’t as large or as cold as I was expecting. There was no viewing gallery like I was expecting either. It was just like a big birthing suite with some extra equipment. My OB came in and said hello again and the team introduced themselves to me. There was about 12 people in total in the room once the surgery started. Several nurses, drs and the NICU team for the babies, just in case. The anesthesiologist started to prep my back for the spinal. I was nervous that it wasn’t going to work and I’d need to be put under general anesthesia and miss the birth. I looked out the window and tried to slow my breathing. I really wished Russ was with me to hold my hand, like he was the first time when I had my epidural.
The spinal needle hurt a lot. Way worse than I remember the epidural feeling, although I was in active labor and in a ton of pain when I had that, so perhaps that was the difference. I kept repeating to myself you can do hard things, you can do hard things and asked “when does Russ get to come in?” with tears streaming down my face. “When the sheet goes up” they said.
My legs started feeling warm and tingly. They laid me down on the table with my arms spread outwards on both sides. There were monitor cables, IVs and what seemed like a lot of cords hanging off both my arms. I was so nervous I didn't ask if they had all read my birth plan, as in there I had asked that one arm remain free from cords so I could hold the babies. I wish I would have remembered to double check all of that.
As I laid there I could see my bump and legs in the reflection of the large surgical light hanging above me. It was switched off, so it acted like a mirror. I watched as they spread a brown liquid over my skin to prep the surgical site. It made me feel sick and I asked for something to vomit in to - I couldn’t move anything, other than turn my head. It was awful and I just wanted my husband.
“You can do hard things. You can do hard things”
Go Time!
Finally they brought Russ in to sit next to me. I burst into tears as he looked at me spread out on the table. His eyes welled up and I knew he was worried, like me. But he held my hand and said “you can do this, we’re going to meet our babies soon”.
I think what made this birth so much harder for me is that I felt like I wasn’t really doing anything. I was laying there, completely helpless. I had no control over anything and all the worries I had held my entire pregnancy were coming to a head. All I could focus on was the fear. And being without my husband for that time made it that much worse.
Russ stood up to look over the sheet. “You need to sit down, dad” they said. He was disappointed. Another piece of our birth plan was to have a lowered sheet so he could watch the birth. “We’ll tell you when you can look” my doctor said. He sat and looked at me instead. I was bawling at this point, so they asked me if I was in pain. “No, just scared” I said. I was literally terrified.
It’s a bizarre sensation to “feel” everything, yet be in no pain. To have multiple hands inside and on top of you. To just lay there and wait, completely out of control of your body and what was happening to you. Completely different than my first birth where I was in control. I was pushing, I was listening to my body and I was bringing that baby into the world. This time, all I could do was pray all was ok. I couldn't see, hear or feel a thing.
And then just like that “ok dad, here comes baby A”. “Take a picture” I said! But it was done before he could. “You have a little blondie” my OB said as the nurse brought the baby boy around the sheet so I could see him. He was so tiny he looked like a doll. Wrinkly face and fuzzy blonde head. His whole body covered in white hair.
Russ went over to the warming table and I was left there alone again. “Take pictures” I yelled to him. I could hear lots of activity but all I could do was stare at the blue sheet in front of me. Then he came back and stood to watch Baby B be pulled from inside me. He got a good picture this time and then B came around the curtain looking just the same as his brother.
“Are they ok”? I asked. “They’re perfect” they all said. “Can I have them?” “Not yet”. This was hard too. Last time, the second I pushed out my son he was on my chest. I could kiss and smell and hold him against me. I was able to nurse him immediately and had that euphoria moment. That sense of relief and accomplishment that filled me with the most amazing amount of joy. This time, I just felt empty and alone. Strangers still inside my belly. My husband and nurses holding my babies and me just needing to lay there and wait.
Finally they brought the babies over, they were swaddled up and in my husbands arms. Again, looking back I am so sad that I didn't get that skin to skin immediately like I had asked for in my birth plan. I had to wait until we went to the recovery unit almost 45 minutes after their birth. But, I was glad that we got these pictures. Pictures of a day I will never forget.
Recovery/Postpartum Unit
I was so relieved when the NICU team said they were safe to come with us directly to recovery. Thankfully I found out a few weeks prior to our original surgery date that babies born before 36 weeks gestation automatically go to the NICU (regardless of their size/health/etc.), so I moved it back two days to 36 weeks exactly. For some reason that was a pressure point for me. I really didn't want those babies away from my side at any point if I could help it.
The twins were born at 12:02pm and 12:03pm. The surgery was done at 12:45pm and we were taken to a tiny space in the recovery unit where we waited until they had room for us in postpartum. It was then that I got to hold the babies for the first time, and the lovely nurses helped me to try and latch them for their first tandem feed. I was frozen still from surgery and I couldn’t really move my body or adjust the babies myself, so it felt awkward and unnatural. As much as the nurses tried to help me get them in position, it just wasn't working. I was told that their blood sugars would need to be tested, and if they were too low, they would be taken to the NICU. My options were to hand express colostrum and feed with a syringe, or move straight to bottles of formula.
I asked if we could be provided with donor breastmilk, but what I didn't realize was that at the hospital I delivered at (or perhaps it was just at the time I delivered) donor milk was reserved for babies born before 32 weeks gestation. This was really difficult to hear, as I had discussed this preference (over formula) with my OB before hand and noted it on my birth plan. This is something you should definitely look into with your health care provider ahead of the birth.
The nurses helped me start hand expressions and I was amazed to see my body immediately produce over 9mls of colostrum for the babies, that we fed to them in a syringe. Then I was able to snuggle them while the nurses filled out the paperwork.
This was just the beginning of my breastfeeding journey. If you'd like to learn more about my feeding experience you can read more on this blog post.
When we were moved to postpartum I was surprised how small the room was, but I was so grateful to have the space to myself with Covid numbers at an all time high. There was only a small patio-type chair for Russ to sit on, so I knew he wouldn’t be able to stay with us overnight. The nurse came in and delivered all our supplies (pump parts, diapers, wipes, pads, ice water etc). I was so hungry but still wasn’t allowed to eat more than ice chips. The babies were asleep swaddled in their bassinets, but were being woke up every couple hrs for bottles (formula mixed with colostrum), and to have their blood sugars checked.
After awhile the nurse asked me to sit up and try and stand to get my blood flowing. It was flowing alright.. all down my leg and into my shoes. I didn’t realize how much you bleed after a c-section, it felt like it was more than with my vaginal delivery, but then again it had been almost 4 years since that day, so perhaps I just didn't remember.
The recovery experience after a c-section was very different than my previous birth. There was a lot more pain, it was difficult to move around and I felt super incompetent and out of control. I didn't like that I couldn't be more involved in caring for the babies. Russ and the nurses really did most of everything those first 24 hrs - diaper changes, swaddling, bottle feeds, tracking of inputs and outputs. I felt like I was just a milk machine, because I needed to pump and hand express as often as I could between nurse visits and resting. I also needed to prioritize my own healing and recovery, which wasn't really a thing the first time around (other than padsicles and warm baths).
On day 3 we were discharged from the hospital and headed home. I was instructed to take it easy, only carry one baby at a time, avoid stairs, and basically everything outside of feeding and changing the babies. Having a 3 year old at home, plus twin infants, that was really difficult. I'm so grateful that my parents were staying with us and took on so much so that I could rest.
Some of the best things we did that helped with my recovery, and navigating newborn twin life were:
Mini fridge in our master bedroom filled with snacks, water, and pump parts (if you haven't heard of the fridge method, check out @bemybrestfriend on instagram here - game changer!)
Pack n plays & diaper changing stations set up on both levels to avoid needing to go up and down the stairs throughout the day for naps and diaper changes. The babies would nap on the main floor during the day (napping in daylight helps the babies set their clocks for day and night), and sleep overnight in our bedroom on the second level.
High-waisted compression underwear and leggings. For the first while after a c-section your stomach feels really loose and uncomfortable while things shift back into place. Having tight fitting, high-waisted pants and underwear where a huge help (belly bands also work well).
Prioritize rest. I remember feeling pretty good about a week postpartum and venturing out of the house to run some errands. The next day it felt like I had just had the surgery all over again. Every time I pushed myself, I would experience a rough day or two and feel really discouraged.
Full-time help . My parents stayed with us for the first month so there were always extra hands to help with feeds, taking my older son to preschool, cooking, cleaning, shopping and trading off for sleep breaks. This was by far the most helpful thing and I can never repay them for all they did for us (and still do). We are so lucky!
Navigating an identical twin pregnancy & delivery can be very overwhelming. I hope reading about my birth experience and the points above will help. As always, please reach out if you have any questions or if there is anything I can do to help you in your twin mom journey.
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