I have twin sons!! Asher Charles and Boston Robert arrived on Monday night, 2/28 and this is the story of their birth.
As you know, I have been on hospital bed rest since February 11. I had been on magnesium sulfate to stop preterm labor and had received 2 shots of steroids for helping mature the babies’ lungs. At that point making it to 32 weeks was the goal after which time we would not stop labor if it progressed. I was on continuous contraction monitoring (intermittent fetal monitoring) and had anywhere from 4 to 10 contractions per hour. They were a “tightening” feel but not painful and my cervix did not continue to change after the initial preterm labor.
On Sunday, 2/27, I completely stopped having contractions and started just having uncomfortable, mestrual-like cramps. I had tested positive for Group B Strep in my urine and was on oral antibiotics for that (I was symptomatic so I thought antibiotics were a good idea) so, they thought perhaps I had developed a yeast infection that was irritating my cervix and causing the cramps. Since the cramps did not include a contraction of the whole uterus (the monitor is at the top on the fundus) they were not considered contractions. I was uncomfortable on Sunday but also thought this might be due to being in bed for so long and being sore from head to toe.
On Monday, 2/28, my cramps were much worse. They checked my cervix and I was still “2-3 cm” as I had been since 30 weeks so they thought irritated cervix was the probable cause. They gave me two percocet and I slept for 3 hours. I woke up and had lunch and took a shower. By 2pm the cramps were becoming very painful – but I wasn’t registering contractions on the monitor.
An aside here – I always advocate for trusting your instincts and what your body tells you and here I was ignoring what was going on. I think there are a couple reasons. One, being on electronic monitors for so long you learn to trust the machines instead of your body’s signals. Two, being on bed rest and not getting to see my daughter due to flu restrictions was very hard. I know bed rest sounds like bliss – 3 weeks with nothing to do! – but I assure you it is not. It is boring, lonely, causes aches and pains, and feels helpless. I ended up torn between wanting the boys to stay in and bake and praying they’d come out to end my misery! It was a constant struggle to remind myself that every day I stayed on bed rest was one less day the boys needed NICU care. Anyways, with a subconscious desire to go into labor I didn’t really want to “be responsible” for a self-fulfilling prophecy.
So, 2 o’clock on Monday and the cramps are so bad I’m kind of moaning through them and decided I should call the nurse. I told her I didn’t know what was wrong because I wasn’t having contractions but that the pain was getting worse. She saw me literally breathing through the pain and said “it looks like labor.” The OB resident checked me and I was 5cm. DUH! I was in labor!
They quickly put in an IV and began mag (for its neuroprotective effects) and transferred me to Labor and Delivery. By the time Pete got to the hospital the contractions were INTENSE. Very painful (if you’ll remember, my pitocin-induced labor with Aellyn was very painful, not stop and a weird kind of “butt labor”). I knew I wanted an epidural because I wanted to be prepared for a quick c-section of baby B if needed. However, I would have requested one anyways. The pain was very bad. Next I started throwing up. Throwing up through a contraction is not fun at all.
The epidural guy needed slapped. When you get an epidural you need to sit up and round your back out like a “C” and he kept indicating I wasn’t doing it enough. The nurse was literally pulling me forward and telling him “there is no room there is another baby in there.” But he insisted on saying I wasn’t “helping him” and he kept asking why I was “so tense.” Dumbass. I could tell the nurse wanted to tell him to shut up too. Either way, I was finally getting some relief from the pain when my perinatologist got there.
Immediately after the epidural she wanted to check me and break my bag of waters and insert a scalp monitor to Asher (baby A). However, when she checked me I was 9cm (hello, the puking was transition) with a bulging bag of waters. She said if she broke the bag the babies would be born before we got to the OR. I was thrilled Asher didn’t need the scalp monitor and we were off to the OR (I was delivering in the OR in the event that baby B turned breech or went into distress and required a c-section although they were both vertex and we were hopeful for a double vaginal birth).
It took a little time to get to the OR. The room had 2 doctors (my perinatologist, Dr. Silber, and a resident OB), 3 nurses, and the anesthesiologist (aka epidural guy). Immediately off the OR is the “resuscitation room” (hello, new name needed for that!) which had a neonatologist and three neonatology nurse practitioners per baby.
Dr. Silber checked me again and asked me to do a “practice” push and voila! Asher’s amniotic sac popped out! Everyone kind of laughed and realized I didn’t need a practice push! Asher was going to be born. On my next push Dr. Silber had to duck as my water broke in a spectacular manner! 2 more contractions later and Asher was born at 5:11PM! I couldn’t see him as they suctioned his breathing passages but I saw his leg and thought “that looks like a regular newborn leg!” He wasn’t scrawny at all! I heard a small cry and then one of the nurses whisked him off to the resuscitation room.
I could breathe!! Boston had room to move down and NOT be in my lungs for a change! However, all that room is one of the tricky parts of a twin delivery. With all that room he could turn breech, requiring a breech extraction which my dr. had agreed to, or a c-section. They immediately had an u/s machine out to find Boston’s heartbeat and position. He stayed head down and was ready to be born right away!
Dr. Silber broke Boston’s bag of waters which also spurted like a fountain through 2 pushes. Honestly, I think that Boston would have been born on that contraction but we were all laughing too much at the drama of my water breaking! The next contraction and Boston was born at 5:19PM! I got a better look at him and heard him cry as well before he too went off to the waiting doctors and nurses.
I felt like Wonder Woman! We all were in awe of the ease and speed of the delivery and I was overjoyed that I delivered vaginally. I had a 2nd degree tear that they stitched up after the placentas were born (it ended up not being a big deal that we kept the placentas). As a note here I am in WAY less pain recovering from a tear than from my episiotomy with Aellyn.
After a few minutes Pete was allowed into the resuscitation room to see the boys and get updates. Boston needed to be intubated (placed on a ventilator) but Asher only needed some oxygen. We were told they looked wonderful and were big! Asher was 5lbs 1.5oz and Boston was 5lbs even! Big boys!
The doctors finished there jobs and left me with the nurses. Suddenly I became violently ill. I tried to sit up to puke into the puke bag but instantly blacked out. For the next few minutes I was barely conscious and unable to help myself as a vomited all over myself. The nurse and Pete had to tip me on my side. It was scary and I was completely helpless. It passed as quickly as it had come on. The nurse explained that my blood pressure had went from the 180s/110s to 110/80s very quickly and my body responded in that way. I was shivering uncontrollably and felt very weak. I honestly felt this way for the next 24 hours because that is how long I needed to be on the mag. Ugh, that stuff makes you feel terrible. It also might be one reason that the boys needed extra breathing help at first.
It was after 9PM when I finally got to the NICU to see the boys. Boston was on the ventilator and Asher was on CPAP (continuous positive airway pressure) which helps the lungs not to deflate completely between breaths which causes labored breathing. Boston had also received a dose of surfactant – the substance that enables the lungs to stay inflated during exhalation. They were gorgeous! Asher has lighter hair and possibly might have blue eyes while Boston has tons of dark hair and will certainly have brown eyes. They are small but meaty. For being tiny they are still chubby and adorable.
By the next morning they were both on CPAP and by that evening they were both breathing on their own! As of today they were under bililights for jaundice and eating 20cc’s of donated breastmilk every 3 hours. They are gaining weight and doing spectacular! Tonight when I visited and did kangaroo care they both latched and practice nursed at the breast. It was wonderful.
Ok, enough words. Here are some pictures.