And Then There Were 5

Any woman who has been pregnant knows how terribly uncomfortable those last weeks can be.  My first 3 children were all early (born at 36 weeks, 35.5 weeks, and 38.5 weeks).  The 38.5 week term killed me - I was due Oct. 5th and therefore my third trimester was throughout the HOT New Mexico summer.  I hated everyone.  I would lay in my bed with ice cubes placed all over my body because I was so miserable.  I couldn't believe my baby hadn't come out by week 37 - all my others were early, why was she taking so long?  Little did I know that the discomfort with number 3 would literally be doubled (maybe more) with my twin pregnancy.

A twin pregnancy is considered full-term if carried to 36 weeks.  Being that the majority (2 out of 3) of my previous children were born early and considering that the average twin gestation is 34 weeks, I never thought I would make it to "full-term."  Well, I did.  At 34 weeks I was in the hospital for a false alarm (contracting, but the contractions stopped after I was admitted)...2 weeks later I was back again and this time it was the real deal. 

I was terrified I might deliver the twins on my bathroom floor because my water broke at home.  Many people experience their water breaking at home, but my previous experience with my water breaking meant the baby was coming down the home stretch immediately.  So, at 3:00 am, after contracting consistently for 2 hours (and the breaking of the water) I decided it was time to wake my husband.  Earlier that evening before we went to bed he asked that I wake him with enough time to shower.  I had already gotten ready (because what else was I going to do at 1:00 am between contractions?!) and although I was so ready to get the babies out of my belly, I was extremely nervous about the delivery.  My midwife had prepared for the fact that my twin birth had to occur in the operating room in case an emergency c-section was required, but I was determined to do it naturally.  Everything that could go wrong was flashing through my mind at this point; meanwhile, my husband was taking his sweet time in the shower, picking his clothes, brushing his teeth, and then asking me multiple times "Are you sure you don't want to labor here?  You know, you're going to be in the hospital waiting a long time!"  Of course I frantically refused his suggestion because - as I said before - I really wasn't into the whole bathroom floor delivery.  And I wanted to have all the medical attention available for the twins in case of an emergency.  I was so bugged he even asked me such a question!  Yet again, many things are annoying to a laboring woman!

So finally, after our early morning squabble, we headed to the hospital.  I was so uncomfortable and kept begging my husband to avoid any and all bumps, regardless of how small they were.   The car couldn't drive me there fast enough.  He dropped me off in the ER and they wheeled me up to Labor & Delivery.  I think it's quite hilarious how all the nurses that I came in contact with on the short elevator ride between the ER and the Delivery floor constantly asked me "Do you feel the need to push?!"  My answer was "No, not right now," but what if I did?!   What choice did they have but to help me?  Anyways, I made it to Triage without incident, and of course, no one was there.  All the desks were empty and few lights were on.  I kind of panicked, but right before I could have a mini-tantrum, the nurse came and helped check me in.  After, of course, asking for my social security number and medical history - WTH?!  Has anyone else ever experienced the ridiculous amount of questions posed by the nurse and delivery staff?  They really expect a laboring woman to answer these things when contractions are 5 minutes apart and one's water has broken??!  LOOK UP MY CHART.  And get me in a room NOW!

A delivery room would be too efficient.  Before they could "admit" me they had to go through the hoops of fetal monitors, blood pressure, etc.  Last but not least, the nurse, (did I mention this nurse was a 70 year old male?!  Not my first choice when laboring twins, but that's just me...), had to check my dilation.  I told him my contractions were consistent and growing closer together since 1:00 am.  I told him my dilation at my last appointment was 4cm.  I told him my water broke.  And how do you think he responded when he finally checked my dilation?  "Oh WOW, you are 7 CM!!!  AND YOU'RE WATER BROKE!"  Really?  REALLY!  I know. That's what I JUST said.  I've had three kids and was about to pop out 2 more, simultaneously.  I think I know when I need a room.

It gets better.  The charge nurse started gearing me up to head into my room, but on the way, the doctor comes up (finally) and starts asking me my medical history yet again.  How many live births?  Miscarriages?  DOBs of children?  Last Menstrual Period?  Allergies to medications?  Apparently they lost my chart and despite their "efforts" could not locate it that night.  And I had just been into the hospital 2 weeks before (that doc said I would deliver that night - obviously she was wrong).  Sigh.  They were asking me these questions as they were taking me to my delivery room, and as we arrived there they said the first thing they were going to do was insert my epidural.  Epidural?  What?  Then there is the epidural story.

Rewind a few weeks.  My husband and I had spoken to my midwife as well as the head anesthesiologist stating that we had no intention of getting an epidural.  They want you to, of course, in case one requires an emergency c-section, but I was terrified of the epidural and my husband was uncomfortable with the idea as well.  (I never had an epidural with any of my previous childbirths).  The doctors and midwives highly discourage one from doing this, but we did have a long conference with both my midwife as well as the head anesthesiologist, and they agreed we could go forth without one.  Of course there are risks associated with the other path (general anesthesia) but we accepted them and knew they were only in the event of an emergency and made an informed decision we were comfortable with.  That was taken care of - so we thought.

Back to delivery day.  What do you mean epidural?  So, here we go explaining this entire epidural situation to the midwife and the on-call anesthesiologist and they are looking at us like we are complete fools and actually proceeded to speak to us in a condescending manner.  "You know, you could very well die if you have to be put under," the anesthesiologist said to me.  I was shocked; I could not believe this woman told me that while I was just hours away from delivery!  My husband continued to argue with her (on my behalf as I was too busy trying to deal with my pain) and then the midwife chimed in and sort of ganged up on him and basically told us we were stupid for choosing that path.  More arguing.  Finally, they stepped out and my husband whispered to me, "You know, as much as you and I don't want this, I think you should go ahead with the epidural because I don't want the doctors to be stressed and out of their element if there indeed is an emergency."  We did compromise, however; put the epidural line in my back without medicine.  This way, in the event of an emergency, everything would be in place and the medicine could be administered and have me ready for surgery in 30 seconds.  At that point I just wanted the babies out as quickly as possible.  So, they ran the epidural line, they inserted my IV, they administered a dose of a pain killer, and one by one they drifted out of my room.  I asked my nurse, "So, when are you going to wheel me into the operating room?"  "Whenever you feel ready," she replied.  "I have to go to the restroom real quick before you deliver...I'll be right back."  Crickets.  Every nurse and doctor had left the room.  I called my husband over frantically - "Where did they go?  What are they doing?  When are they coming back?  What am I going to do if I have to push?  Call them back right now!  I am ready to go to the operating room to deliver!"  He did as I instructed yet reassured me that if I had to push, and no one was in there, he would catch the baby.  But that's not the point - the point is no one was READY!

It took about 25 minutes for my nurse to come back in even though we called for her right away.  I told her I was ready for the operating room.  I was beyond nervous and uncomfortable.  She rolled me down the hall in my bed and had reassured me that I would not have to move to any other beds or tables in the operating room - I could deliver from where I was.  As my nurse wheeled me in, the charge nurse met us at the door.  Nothing was ready in the OR - the light weren't even on!  He started to get things ready but told my nurse to check my dilation before he continued.  So, she checks me, and low and behold I was 10 CM!  And nothing was ready!  No midwives, no doctors, no anesthesiologist, no computer monitors, no tools table...nada.   Of course, now they were freaking out, frantically getting things ready, paging people - the works.  The dressed the table, scrubbed down, and were ready to catch these babies...but before they could do that they said I had to MOVE to the operating table.  I about died, and refused.  They had told me I could stay in my bed, and if they wanted me up on that table I told them they would have to move me!  So, they did - they lifted the baby whale from her bed to the table as quickly as they could and were finally ready to deliver.  But now I was even more uncomfortable.  The table was just that - a hard, metal, cold table.  I complained and they provided me with some pillows, so that helped.  A little. 

The time now was close to 6 am; we had arrived at 3:30 am.  There was a team of people surrounding me, guiding me, holding me and encouraging me.  I distinctly remember one nurse because she not only looked exactly like my grandma, but comforted me just like my grandma might if she had been in the delivery room with me.  She held my hand, rubbed my back, cooled my head, and softly cheered me on.  She was an angel disguised as a nurse and I attribute my amazingly healthy, natural labor & delivery to her.  Baby A, who we named Bella, was born at 5:47am and weighed 6lbs.  Baby B, who we named Sophia, was born 14 minutes later at 6:02 and weighed 5lbs 13oz.  No c-section, no epidural, no hemorrhaging - and the twins were perfectly healthy!  I was the talk of the hospital (I must say I am quite proud) as it is extremely rare to deliver twins naturally (no c-section) and without an epidural.  Operation Twin Childbirth was a success!

And then there were 5.  Officially.  We now had (have) 5 children, and a 7 person household.  Crazy could not begin to sum up the daily life with 5 kids.  They say the first year with twins is the hardest; but the first year with twins and 3 older children was hard and in many cases, unbelievable.   

My Story, Part 2

Double the Everything

I will start by saying the shock of the twin pregnancy never went away, and to this day we still find ourselves saying "can you believe there are two babies?!"  Oh, and I must not forget to mention that no matter what went on - whether it was emotional, physical, preparational, or mental - it was double!  The most common thing people said (and still say) to me in reacting to our twins is, "double the trouble!"  It really should be "double the everything!"  And that's just a fraction of it. 

So, in the midst of the shock (double the shock, of course), the next best thing one can do in such a situation is prepare.  However, I could only think about the gargaturan task of preparation for the first trimester. I spent most days laid out and hardly able to move - I had horrific headaches, extreme fatigue, and the most excruciating, unimaginable, unbearable hip pain.  These symptoms had begun earlier and with greater severity than all of my other pregnancies - and no wonder - I had double the hormones and double the babies to cook!  I would literally lay in bed ALL day long, rarely getting up to even eat as the nausea would override my appetite.  My older children (then 4, 2 and 1) ran around like newly freed cage animals, screaming in delight, fighting every other second, and taking advantage of mommy in her bedridden state (actually, this sounds like the state of my house daily, minus the bedridden part).  But at that point in time I could care less.  My husband did a lot to help, thankfully, because it took everything I had to just exist.  So right when the misery started to taper off, I began my routine check ups.  Of course, this was after my ER visit which also required a follow up with my midwife as I had then been diagnosed with a subchorionic hemorrage and was terrified of what complications might arise. 

After 3 pregnancies and childbirths one would think that I would be a pro.  The complication and twin pregnancy was so new to me that the only thing I was a pro at during that time was asking questions.  I came to her office with a list (below) which she answered quite concisely, and in the most comforting manner:

• What are the risks associated with a subchorionic hemorrage?  
• The main risk is a threatened miscarriage of either one or both fetuses.  
• What is a subchorionic hemorrage? 
• A subchorionic hemmorage is when the placenta detaches from the wall of the uterus and causes bleeding during pregnancy. In many cases, it heals itself over a long period of time. (Mine was a moderate hemorrage).
• Can I do normal day-to-day activies? 
• Daily activies must be modified. No lifting heavy items (laundry baskets, children, grocery bags), no excercising. Bed rest is not necessary at this point.
• How much do I have to eat? 
• Expected weight gain is 50lbs. Caloric intake should increase by 600 calories per day. The nutritionist at the pernitatologist's office will track weight gain and diet and adjust as necessary.
• How many vitamins do I take? 
• Two babies = two prenatals.  Plus calcium, vitamind D, selenium, and omega-3.
• How can I possibly breastfeed twins? 
• It's easy...that's why God gave you two breasts!
• How often will I have ultrasounds? 
• In this office, the standard 20 week ultrasound, but the perinatialogist will do approximately 1 per month to monitor the twins' growth and development.
• Will I have to be on bedrest at a certain point? 
• Only time will tell!

The funny part is, I didn't expect any of the answers she gave me!  Shortly after that appointment I had a follow up with the specialist/perinatologist and it was with both of their guidances and recommendations that I had an extremely healthy pregnancy.  The hemorrage was the biggest stress as we were terrified of miscarrying, but I was extremely careful.  I noticed that I would have increased bleeding on the days I was more active (grocery shopping, family outing) even if it had subsided significantly in the days before.  I even went in for a "viability check" once because I thought the activities of the babies had decreased.  Everything was fine, and each month's ultrasound showed the placenta had reattached bit by bit, fully healing at 20 weeks.  It was then my restrictions were lifted.

The nutrition aspect was extremely important and highly stressed in my prenatal care plan.  After the "sticker shock" of having to gain 50lbs, I was also burdened with the increased risk of gestational diabetes.  Our families have a history of diabestes in each generation, and that adds to the already increased risk a twin pregnacy alone presents. That being said, the nutritionist suggested I eat low carb...and let me tell you, I have never followed a diet so carefully as I did that one.  I actually kept a food journal and would count and record every meal, snack, and dip in the candy dish.  It was recommended that I eat between 200g and 300g carbs per day, but my daily records proved I would hardly reach the 200g mark.  Before I started counting my carbs, I craved loaded baked potatoes and would eat them for breakfast, lunch and dinner, and often times more than one!  That must be why I was able to be so strict - I had maxed myself out before the cut!  To my surprise, however, that low amount of carbs was keeping me from gaining the proper amount of weight.  At my appointments, the nutritionist would actually graph my weight (every time) and show me where my growth/gain was in relation to the suggested curve.  For many weeks, I was below the curve and not gaining enough.  Finally I was told "add nuts (nuts are caloric) to everything you can...and milkshakes, drink a milkshake everyday!!!"  Those were the best doctor's orders I have ever received and I had no problem following them! 

The rest of my pregnancy was a healthy one, but I was SO miserable with each growing day! Remember the hip problem I mentioned earlier?  Well it only grew worse.  I felt like my pelvic bones were slowly cracking.  There were many days where my husband had to literally drag me around on his back because it was too painful to walk.  My husband works at night, so when he was gone I remember laying there crying because I literally couldn't even get up to go to the bathroom.  I would fall asleep with the lights on, hold my pee in for hours and just feel sorry for myself.  I couldn't even get up to answer the phone.  If an axe murderer attacked me in the middle of the night I would have been an easy kill in my incapacitated state!  The only thing that slightly helped was a maternity suppport belt, but my doctor didn't prescribe it to me until I was 33 weeks despite my begging at every check up!  And then of course, there was the whole sleeping issue.  I had about 25 pillows which varied in shapes, sizes and firmness that I would position just perfect for me to fall asleep.  But of course, I could never stay asleep because my arm would go numb, my belly would hurt my back, my leg would cramp...it was miserable!  That was in addition to the insomnia.  Biologically, you would think pregnant women would sleep so sound and comfortably for 9 months in order to build up energy for the future countless sleepless nights spent caring for newborns - TWO newborns in my case (many cases) - but no, biology didn't work that way...for me, at least!

And so, with a elephantine twin-housing belly comes an exponential amount of elephantinely rude comments regarding bellysize, family size, living accomodations, and so on and so forth.  And I shall end there, because not only does this topic infuriate me, it requires an elephantine amount blog space...