Here I am, nearly four months removed from my daughters' birth day. We're all pretty fantastic. They have lovely Welsh first names like their big sister. I think that on the internets, they shall be Little and Bit. Without much further ado, I desperately need to get their birth story recorded. Two parts, I think, perhaps a third for the hospital stay, with part one being a bit more background-y and part two being more of a procedural.
So, while I was quite happy to find an OB who said only baby A needed to be vertex for a vaginal birth to be possible, it turns out this was sort of a lie. Or at least not quite as truthful as it first appeared. As my pregnancy progressed, it became clear that not everyone at the practice would be okay with a vertex/breech vaginal delivery scenario. There was one other big piece of news that had somehow not been shared with me after my big ultrasound at the Geisinger hospital in Danville, PA: delivery at 37-38 weeks was recommended. I had read a bit about this general recommendation, but I thought my practice was being refreshingly relaxed as to putting a deadline on delivery. Wrong. They just failed to share that part of the tertiary care center's report. While I ultimately came to wholeheartedly agree with this recommendation, it was not presented in a very good way - or in a very timely fashion - and I did not react well. (Long story short: previously uncomplicated monochorionic twin pregnancies have a 1.25% chance of stillbirth after 37-38 weeks. This is unacceptably high in comparison to the risks of delivery at 38 weeks.) By "I did not react well," I mean that the huge, hormonal 36-weeks pregnant lady stormed out of the hospital crying after one of the twice-weekly non-stress tests.
What I wanted: a totally natural vaginal birth. Why I couldn't have it: baby B was just switching between being breech and being transverse. I knew perfectly well that I wasn't going to spontaneously go into labor by 38 weeks, having had my first child at 40w2d and not having shown any signs of premature labor thus far (cervix o'steel, apparently). I came to the conclusion that an induced labor with a breech twin was not safe, especially given the lack of experience with breech births most practitioners have. I can sum up weeks of research by saying that IF you are going to have a spontaneous delivery with an OB who is experienced with breech deliveries, THEN it is reasonably safe to do, but if you can't meet all of those conditions (and more, like your twins being the same size and not being your first live births) then it's time for the dreaded c-section.
I felt, and still feel, pretty comfortable knowing I had done what I could and that not all c-sections are unnecessary. I worked on controlling what I could: scheduling it for as late as possible (37w6d because my favorite OB at the practice was going on vacation the day after), contacting the hospitals IBCLCs to make sure they would be part of the birth team, insisting on having the catheter inserted after I got the spinal (it may seem inconsequential, but why have it inserted when you still have feeling?), and generally making sure everyone knew I wanted to touch and feed my babies as soon as possible. We planned to have my husband accompany the girls out of the OR so that they would be brought to me in the recovery room as quickly as possible, and not given eye ointment, a hepatitis shot, or a bath.
Going from a homebirth to a c-section was an exhausting journey. I was seriously very ready for pregnancy to be over. Finally, we gamely set out for the hospital around 9:30AM on May 3, leaving the Bee with my mom at our house... and knowing we were just hours away from meeting two new little humans.
TBC...
So, while I was quite happy to find an OB who said only baby A needed to be vertex for a vaginal birth to be possible, it turns out this was sort of a lie. Or at least not quite as truthful as it first appeared. As my pregnancy progressed, it became clear that not everyone at the practice would be okay with a vertex/breech vaginal delivery scenario. There was one other big piece of news that had somehow not been shared with me after my big ultrasound at the Geisinger hospital in Danville, PA: delivery at 37-38 weeks was recommended. I had read a bit about this general recommendation, but I thought my practice was being refreshingly relaxed as to putting a deadline on delivery. Wrong. They just failed to share that part of the tertiary care center's report. While I ultimately came to wholeheartedly agree with this recommendation, it was not presented in a very good way - or in a very timely fashion - and I did not react well. (Long story short: previously uncomplicated monochorionic twin pregnancies have a 1.25% chance of stillbirth after 37-38 weeks. This is unacceptably high in comparison to the risks of delivery at 38 weeks.) By "I did not react well," I mean that the huge, hormonal 36-weeks pregnant lady stormed out of the hospital crying after one of the twice-weekly non-stress tests.
What I wanted: a totally natural vaginal birth. Why I couldn't have it: baby B was just switching between being breech and being transverse. I knew perfectly well that I wasn't going to spontaneously go into labor by 38 weeks, having had my first child at 40w2d and not having shown any signs of premature labor thus far (cervix o'steel, apparently). I came to the conclusion that an induced labor with a breech twin was not safe, especially given the lack of experience with breech births most practitioners have. I can sum up weeks of research by saying that IF you are going to have a spontaneous delivery with an OB who is experienced with breech deliveries, THEN it is reasonably safe to do, but if you can't meet all of those conditions (and more, like your twins being the same size and not being your first live births) then it's time for the dreaded c-section.
I felt, and still feel, pretty comfortable knowing I had done what I could and that not all c-sections are unnecessary. I worked on controlling what I could: scheduling it for as late as possible (37w6d because my favorite OB at the practice was going on vacation the day after), contacting the hospitals IBCLCs to make sure they would be part of the birth team, insisting on having the catheter inserted after I got the spinal (it may seem inconsequential, but why have it inserted when you still have feeling?), and generally making sure everyone knew I wanted to touch and feed my babies as soon as possible. We planned to have my husband accompany the girls out of the OR so that they would be brought to me in the recovery room as quickly as possible, and not given eye ointment, a hepatitis shot, or a bath.
Going from a homebirth to a c-section was an exhausting journey. I was seriously very ready for pregnancy to be over. Finally, we gamely set out for the hospital around 9:30AM on May 3, leaving the Bee with my mom at our house... and knowing we were just hours away from meeting two new little humans.
TBC...
