The Twins Birth Story: Ayla and Kiana
This time I decided to go with Kaiser Birth Clinic. They have a
lot of midwives but their midwives work in shifts so you aren't
guaranteed a particular practitioner at the birth. I was tired of
stressing out over when or if my provider was going to arrive and
decided I'd rather just get to know the various midwives during my
pregnancy and be assigned to whoever was on shift for the birth. This
plan started out great until my first appointment. That's when the
midwife saw the twins on the ultrasound and I was promptly transferred
to the high risk unit.
Twin pregnancies are managed completely differently. I had a
bazillion ultrasounds and was initially told that I would have to have
an epidural and a vaginal birth wouldn't even be attempted unless both
babies were head down. Even then, I had to be prepared for an
emergency C-section because sometimes the second baby flips after the
first baby is born. For that reason, a lot of twin moms just schedule
a C-section so they won't have to face the prospect of both a vaginal
delivery AND a C-section. Fortunately for me, my babies both settled
down to a head down position, although I had enough ultrasounds so
that I got to worry about that for several weeks first.
The late ultrasounds stressed everyone out. My doctor thought that
Kiana wasn't growing very well (turns out she's just a small baby and
there wasn't anything wrong, but they couldn't know that.) They also
saw a shadow around her heart, which my doctor was quick to tell me
was probably one of the very common late ultrasound errors (which it
was) but still it stressed me out. All in all, my doctor thought that
the sooner the babies were out the better so she scheduled an
induction for 38 1/2 weeks.
I really didn't want to take pitocin, as I've heard enough horror
stories about that. But I also agreed with my doctor and was so
awfully huge and uncomfortable that I started getting really anxious.
As soon as Kindra (my sister and doula) stepped off the plane (at 37 weeks) I told her, "OK,
let's get these babies out." We got home and she checked me and said
I was about 2cm dilated but not real effaced. She also said that
Kiana's head didn't seem to be in the right position. After she
checked me we went for a walk and I started having contractions. They
didn't hurt at all but they were definitely contractions and they were
regular and didn't stop. I started getting excited. That night she
checked me again and said I was 5cm but not effaced. I asked how that
could be when I haven't had any pain. She shrugged but I figured, OK,
5cm usually means active labor so let's head to the hospital. When I
got there they put us in triage and kindly allowed both Payam and
Kindra to come in. They kept me in traige for a couple of hours.
Then the doctor said that even though I had dilated a lot I still
wasn't effaced and the contractions didn't seem to be very effective
yet so she sent me home.
Nothing really changed for the next two days. I kept having regular
painless contractions and then finally they stopped altogether. I
felt like I was going crazy. Over the next couple of days I got
depressed and cranky. When Kindra checked me on Thursday morning for
the umpteenth time and said I was now at 3cm I lost it. I told her
that I didn't care what she had to do, we had to get these babies out
'cause I couldn't handle the suspense anymore. So we headed to the
health food store and bought a bunch of blue and black cohosh and some
castor oil. The castor oil just gave me diarreah. But the herbs got
the painless contractions going again. I was too stressed to deal
with the boys so we sent them to Payam's mom's house and Payam,
Kindra, and I played cards and waited to see if the herbs would work.
After a few hours the contractions started getting somewhat painful
and they were solidly regular. It was getting close to bedtime so we
decided to stop the herbs and go to bed. The contractions got decidedly more
painful and now were about 5 minutes apart so we called Kindra out of
bed and she came and checked me again. I was 6 1/2 cm but still not
real effaced. So we headed back to the hospital.
This time the doctors checked me in. I liked both of the doctors
right away and I really liked it that they were there and I could talk
to them about the birth plan right away. They were young and
respectful. They suggested that the best way to avoid the second baby
flipping after the first is born is for the doctor to reach up and
grab her head as soon as the first one was born. I agreed to that and
asked if I could try it without the epidural. They were willing to
let me try but asked me to have the epidural tube placed just in case
I ended up having an emergency C-section. Then they told me I could
check in to my room and take a walk around the halls if I wanted.
My contractions were definitely regular and they were somewhat painful
but I could definitely walk around and talk. It seemed like I should
be in more pain at 6 1/2cm. The nurse showed me to my room and the L
and D nurse said she wanted to monitor the heart rates for about 20
minutes first. So she hooked me up to the machines and that was the
last time I was allowed to move until the babies were born. Ayla's
heart rate wasn't varying much and so they didn't want to take her off
the monitor until they could get better readings, which never
happened. I still wasn't in much pain but I could see the
contractions on the monitor and I was really feeling the need to get
up and move or take a shower or something to help move things along.
After several hours I got up to 7cm but still almost no pain.
Finally, one of the doctors came in and told me that we really needed
to get things moving as I wasn't really progressing. She suggested
that we break the waters but left the decision up to me. After
talking it over with Kindra and Payam, we decided to go ahead and try
that.
As soon as the doctor broke the water, the contractions jumped up in
intensity. I welcomed the pain, thinking that I had finally hit
transition. Now it felt like something I was familiar with. I told
myself, okay, here we go. A half hour of this and then I can push and
I'll finally meet my babies. I blocked everybody out and fell to my
prayers. After a half hour I asked for the doctor and said I should
be ready to push now. The doctor came in and said I was still at 7cm.
I was totally shocked. 30 minutes of back to back killer
contractions usually opened me up. What was going on? She said that
Kiana's head wasn't quite centered and that might be causing the
problem. Another 30 minutes went by and she said I was at 7.5.
The lack of progress really started breaking through my defenses. I
wasn't allowed to move or do any of the natural things I would
normally do to get things moving. I tried to focus on my prayers, my
body, and talking to my babies but my worries started breaking through
my defenses. I didn't know how the delivery was going to go and
wasn't sure if I could tolerate having the doctor's hands inside me on
top of everything else. Because of those worries and the relatively
long transition I caved and asked for the anesthesiologist. Payam and
Kindra tried to talk me out of it (since I tend to withdraw into
myself it's hard for others to gauge the pain) but I had made up my
mind.
I asked the anesthesiologist to give me only enough epidural to take
the edge off while still allowing me to feel enough to push. She
actually did a pretty good job in that I felt no difference
whatsoever. A third half hour of killer contractions and I finally
started getting angry. I asked them to bring the anesthesiologist
back again because I didn't think she had given me anything at all.
Turns out it was a shift change so a male anesthesiologist came in and
said it didn't seem like the medication was reaching the uterus at all
so he wanted to up it. Before he did, my doctor came back and checked
me again. Then she said I was ready to push! So she advised me not
to get more meds (something that annoyed the anesthesiologist
greatly). As soon as I heard that we were ready to push I felt much
more optimistic and I didn't want the meds anymore anyway.
They wheeled me down to the operating room and there was a tense few
minutes while everyone got set up. At the last minute, I managed to
talk them into allowing Kindra and Payam to both be there (only on the
strength of Kindra's medical credentials). The doctors lay me flat on
my back on a narrow metal table with my butt on the bottom (so there
was nowhere to put my legs) and my arms straight out. Then they told
me to push.
I laughed and shook my head. Push against what? Thin air?
Fortunately, Kindra knew how to help. She took one leg and Payam took
the other. They pushed my legs up to my chest and Kindra helped me
raise my head with her other hand. I could definitely still feel the
contractions but at this point it seemed like the epidural was finally
kicking in because they didn't hurt as much as I was expecting.
I pushed a couple of times and there was Kiana. They held her up for
about a milli-second and whisked her off to the warming table. I lay
back down and tried to gather my strength but as I did I felt the
doctor shove her hand up into my uterus. For a moment, I forgot what
the plan was and I asked her, "what on earth are you doing?" I was
thinking that I would have a break because I'd heard that the
contractions usually stop for awhile after the first baby. She
reminded me that she was grabbing Ayla's head to stop her from turning
and told me to go ahead and push.
Again I was surprised. How could I push without contractions? But
Kindra told me to try anyway. Then, all of a sudden, the doctor got
panicky and started telling me to push like mad because we had to get
the baby out NOW. I was too scared to think so I just did what she
told me. Then, just as quickly, she said, "no, stop. We're going to
C-section." I hadn't the slightest clue what was going on. At first,
I kept pushing, hoping against hope that the baby would just pop out,
but then she yelled at me to stop. So I lay back and started worrying
about the medication. The epidural was helping but it wasn't nearly
enough for a surgery. Would my refusing medication delay getting Ayla
out?
Then, a second doctor pushed her hand up and the doctor told me she
had changed her mind and we were going to try again. I pushed as hard
as I could (I still wasn't having any contractions) and could feel the
baby crowning. Then the doctor panicked again and grabbed a vacuum to
help bring the baby out faster. And there she was. Ayla had perfect
Apgar scores and wasn't in distress at all. The time between Kiana's
birth and Ayla's was seven minutes.
Later, Kindra explained to me that the problem had been Ayla's heart
rate. They had me on continual fetal monitoring the whole time and
apparently, Ayla's heart rate dove after Kiana was born. The doctor
wanted to do a C-section but then the charge nurse convinced her to
wait just a minute and, sure enough, Ayla's heart rate recovered. The
second doctor was putting a heart rate monitor on Ayla's head. When
she was crowning her heart rate dove again, hence the vacuum.
All in all, I was just grateful that my babies arrived, safe and
sound. A pediatrician took a look at Kiana's heart and said there was
absolutely nothing wrong with her at all. They examined the placenta
for a clue as to why her growth was slow and said there was nothing
wrong there, either. Kiana's still small. Her pediatrician says that
she's just a little baby but that there's nothing at all wrong with
that because she's growing along her growth curve just fine. It's
just her genes. As for Ayla, her Apgar's clearly indicated that she
wasn't in distress at all. Kindra says it's common for babies to have
little dips in the heart rate during delivery. Most of those aren't
even noticed when you're monitoring occasionally, but since the
continual monitors pick up every second, it gives cause for worry when
there's really not a problem at all.
I wasn't allowed to hold my babies in the surgery room but
fortunately, they took me back to the L&D room quickly and I was able
to hold them there. Kiana was the ugliest baby I've ever seen, but it
was just because she was so small. Her skin was all wrinkly and
translucent. She looked like a monkey. As soon as she started
gaining weight she filled out and became absolutely beautiful. Ayla
looked like a little princess from day one. They both caught on to
nursing right away and did great.
Back in the delivery room the medical staff finally finished messing
with me and took me off of all the fluids. I thanked the
anesthesiologist for his help and he kind of half smiled half glared
at us all and said that he could have helped a lot more and it was
unnecessary for me to have experienced so much pain. I, on the other
hand, was thrilled with the epidural precisely BECAUSE it still
allowed me to feel enough pain to work effectively with my
contractions (until, of course, they became non-existent after Kiana's
birth.)
The boys were still at home asleep when the girls were born but they
came as soon as they got up in the morning. I stayed at the hospital
for 24 hours because I thought I could get some rest there, since my
house is so nuts. Still, I was relieved to get out and it was worth
the fight with the doctors to get home early. They were still a
little worried about Kiana because she was so small. A nurse came to
the house a couple of times to check her weight but from the get-go
she grew great.
I have had some of the most profound experiences of my life in the
process of birthing my children. I've learned to trust my body and
learned that it can surprise me. I've learned that God will truly be
there at the most challenging times of my life. I've learned to
appreciate different perspectives and to be patient with and grateful
for alternative perspectives that come my way. I've learned how to
embrace pain and how to let it go. And I've learned to consider the
needs of my family, rather than just my own ideals, in making
important decisions. All in all, our birth experiences have brought
Payam and I closer together as a couple and have helped to solidify
our identity as parents. Sharing them with my mom and my sister has
brought us closer together, too, and looking to my little sis for
advice was really inspiring. I feel very grateful to have had three
wonderful experiences with childbirth. I feel even more grateful that
the Lord has entrusted me with four beautiful souls to nourish and
guide as they start their own journey in this world.
No comments:
Post a Comment