Asher and Boston: A Birth Story

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.

Asher minutes after birth

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.

Boston minutes after birth

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.

Mommy meets Boston for the first time

Mommy meets Asher for the first time

Kangaroo care is bliss (Asher and Mommy)

Asher and Daddy

Boston and Daddy

Asher bright eyed and bushy tailed!

Boston trying to chew the IV off his hand!


Embodied Presence and Breathing During Delivery

If you’ve read about my birth affirmations and the meditation I did to prepare for labor then you know that breathing was a big part of my birth preparation.  It seemed counterintuitive to me then to let someone else tell me how to breathe during the penultimate moment of delivery.

While I was pregnant I was part of a year-long leadership development program with NASA.  One of the speakers we had was Wendy Palmer.  She is an amazing and dynamic person and her practical workshop was the type where you wonder “how is this helping me?” and then you can’t get it out of your mind for…well, years.  Her book The Intuitive Body talks about using the non-aggressive Japanese martial art aikido and meditation to cultivate awareness, attention, and self-acceptance.  Part of the practice is breathing and I used her technique when I was in the pushing phase of labor.

Here is my adaptation of Wendy’s breathing technique.  If you want to learn more I really recommend her book.

  1. Develop a positive intention.  This is usually one word that focuses on what you want to happen instead of what you DON’T want to happen.  I used “peace baby.”  That might seem like a weird word to use during labor but I didn’t want to get caught up in the anxiety or even the excitement spiral.  I wanted to stay above the hub bub of what was going on around me and focus on the magical moment that was happening between myself and my baby.
  2. Inhale fully through your nose when you feel the urge to push.
  3. Exhale slowly through your mouth while holding your intention word in your head.
  4. Imagine the breathe spiraling from the top of your skull down through your feet, releasing as it goes down.  Releasing all the tension and bringing your intention word to fruition.  As a relaxation technique this sprial releases tension or anxiety.  In labor I used the spiral to imagine the power of my push helping my baby along the birth canal.
A few important points.  First, I directed my pushing NOT a nurse.  I was on my back and numb from the waist down with an epidural (not ideal, obviously, but I had some complications and it was the right choice for me).  I was on my back.  I was attached to a monitor.  When I first began to push my midwife was not there but another nurse.  She was looking at the monitor and told me when to push and then encouraged me to hold my breath while she counted to ten loudly.  I asked her to stop!  I didn’t want to have an unnatural breath.  Luckily my midwife got there quickly and I had talked this all out with her (and it was in my birth plan as well).  I was fortunate to be able to feel my contractions (not always possible with an epidural) and asked them to detach the monitor and let me guide.
Second, this breathing should feel natural.  If breathing through your nose and exhaling through your mouth feels artificial then it won’t be helping you realize your intention.  However, if you practice breathing through your pregnancy then it will come naturally during labor.
I did breath cycles approximately 3 times during each contraction.  Aellyn was born within 30 minutes of pushing and I caught her.  It was magical, beautiful, peaceful.

This post is part of the 5th Healthy Birth Carnival at Science and Sensibility.  Visit the Carnival for more great posts about the 5th Lamaze Healthy Birth Practice:  Avoid giving birth on your back and follow your body’s urges to push.

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The Amazing Placenta Part 1: What’s So Amazing About It Anyway?

I think that the placenta is a truly amazing thing that deserves a moment (or two) of your attention.  Will you open your mind for a moment and let me sing the praises of this amazing organ?

Western culture tends to treat the placenta like a bodily excrement.  Like a booger, ear wax, menstrual blood, a turd, a clipped fingernail, shaved hair, etc..  It isn’t like that at all though.  It is a fully functional and complex organ.  And, it is a very unique and interesting organ at that:

The Placenta Is Cool

Aellyn at 3 days old
  1. The placenta is a common feature with most of our mammal relatives. Only the platypus, as an egg-layer, and marsupials don’t have a full placenta (they have what is called a choriovitelline).  There are also some lizards and snakes that have a placenta.
  2. The placenta is the only “transient” organ. It completely grows and dies for a short period of time.  No other organ in the human body does that (mammary glands, for example, don’t always function in milk production but they are always there).  I think it is amazing that this important organ grows so fast and does something so amazing so quickly.
  3. The placenta is the only organ that is genetically two people (besides the rare condition of the chimera).  The placenta isn’t “mine.”  The placenta is a fetomaternal organ that means the final organ consists of genetically fetal and genetically maternal cells.  This is part of the reason I kept Aellyn’s.  It isn’t mine – it is ours.
  4. More than half of the cells present on day 5 post-fertilization (blastocyst stage) becomes the placenta while the rest becomes the embryo.  Isn’t that amazing?  When we first saw Aellyn at 3 days old – we were looking at as much placenta as we were baby girl.  This is why some cultures believe the placenta is the baby’s twin (it is in a way).

So, it is unique right?  Would you agree “cool” even?  Ok, cool and unique but who cares?  It just passes oxygen right?  Things the amazing placenta does:

The Placenta Is Powerful

  1. Nutrient transfer. The placenta passes nutrients from mom to baby and passes waste back to mom to eliminate.
  2. Oxygen transfer and CO2 removal.
  3. It secretes hormones responsible for maintaining the pregnancy and growing the baby.  We often think the mothers body is doing the hard work but it isn’t.  Everything it does is in response to the placenta’s hormone messages. 
    1. Progesterone is released by the placenta to stop egg production and thicken the lining of the uterus. 
    2. Somatomammotropin increases the mothers metabolism to support the energy needs of the baby.
    3. Relaxin is released by the placenta that helps soften the pubis symphysis to enable delivery of the baby.
  4. It serves as an immune buffer to protect the baby from mom’s immune system.  It secretes Neurokinin B containing phosphocholine molecules.  These molecules are like high-tech cloaking devices that render the placenta invisible to mom’s immune system.  the same cloaking device used by parasitic nematatodes (ewww, worms) in diseases like heartworm and trichinosis.
  5. Ewww, worms (nematatode)
  6. It starts and maintains labor. The baby releases cortisone when its adrenal gland is mature.  Cortisone makes the placenta convert estrogen to progesterone which then causes the mother’s body to produce prostoglandins that cause contractions.

Still with me?  Cool and amazing maybe?  Here’s where I may lose some of you – but bear with me – even if you don’t agree it might help you understand other people.  Lots of cultures have seen the placenta as spiritual, mystical and very important.

The Placenta Is Mystical

  1. Among the Navajo Indians of the Southwest, it’s customary to bury a child’s placenta within the sacred Four Corners of the tribe’s reservation as a binder to ancestral land and people.
  2. New Zealand’s Maoris have the same tradition of burying the placenta within native soil. In their native language, the word for land and placenta are the same: whenua.
  3. The indigenous Bolivian Aymara and Quecha people believe the placenta has its own spirit. It is to be washed and buried by the husband in a secret and shady place. If this ritual is not performed correctly, they believe, the mother or baby may become very sick or even die.
  4. The Ibo of Nigeria and Ghana treat the placenta as the dead twin of the live child and give it full burial rites.
  5. Filipina mothers are known to bury the placenta with books, in hopes of a smart child.
  6. Other cultures place a symbol of their people with the placenta when burying it, as a kind of heritage insurance.
  7. Among the Hmong culture of Southeast Asia, the word for placenta can be translated as “jacket,” as it’s considered an infant’s first and finest clothing. The Hmong bury the placenta outside. They believe that after death, the soul must retrace the journeys undertaken in life until it reaches the burial place of its placenta jacket (source).
  8. The Parigi of the Celebes Islands also view the placenta as the older brother. It is carefully preserved in a special pot, wrapped in white cotton, and is ritually buried by the mother. Palm trees are then planted to honor the burial site. Similar beliefs can be found in Java and Bali.
  9. The Toba-Bataks of Sumatra believe the placenta is the younger brother. It is also thought to contain one of the seven souls that each person possesses, which can act as a sort of conscience for the child.
  10. In Iceland, it is held that the child’s guardian spirit resides in the placenta, leading them to name it “fylgia”, which means “guardian angel”.
  11. In western Australia, the placenta is considered to be the child’s companion. It is stored in a covered pot for three days before burial, during which there is an honorary silence.
  12. The Baganda of Ugandabelieve that the placenta is actually a second child. Not only is it the child’s double, but the placenta also has its own spirit that resides in the umbilical cord. The portion of the cord attached to the baby must be carefully preserved to ensure the good health of the child. If the child is of royal blood, the placenta itself is ritually preserved and carried in processions by a high-ranking officer.
  13. Ancient Egyptians
    believed in duality of the souls – one soul inhabited the body, the other the placenta. The placenta even had its own hieroglyph, which looked like a crosscut section of a human placenta. In royal processions, a high-ranking official would carry a standard representing the placenta. This standard, or symbol, is depicted as an organ with two lobes, an umbilical cord, and membranes folded back. In certain ancient texts this symbol is even the correct color; dark brown with touches of red. Entire tombs may have been built to house the royal placentas of the pharaohs. Neter-Khet of the Third Dynasty built the step pyramid of Saggara, but his body is interred at Bet Khallaf. Menkau-Ra of the Fourth Dynasty built Her, the smallest of the Giza pyramids, yet his body is entombed at Abu-Roash. Some experts interpret this to mean that the second tomb was created specifically for the placenta (source).
The first of the four Royal Standards carries the Royal Placenta or the King’s Twin (more info here)

Stay tuned for The Amazing Placenta Part 2, where we’ll look at modern ways to honor this amazing organ.

Preparing for Birth with Affirmations

This post is part of the 2010 API Principles of Parenting blog carnival, a series of monthly parenting blog carnivals, hosted by API Speaks. Learn more about attachment parenting by visiting the API website

I’ve written before about my birth affirmations and how they helped me prepare for and participate in labor.  If you’ve never created affirmations before it might seem daunting at first.  I honestly believe they are powerful and more so when they are created by you.  I think this process will benefit your birth experience even if you never get to say a single affirmation during labor or delivery.  It is the preparing itself that is so powerful.  I’d love to share with you how to make your own Birth Affirmations.

What Are Affirmations?

An affirmation is a declaration that something is true.  In a nutshell the idea of self-affirmation is that when we are faced with a stressful situation (such as the unknown of labor and birth) we can improve our outlook about the situation by replacing our mind’s fear statements (called ruminations) with new statements.  The basic premise you have probably heard before in different ways.  “What you think about you bring about.”  or “be the change you want to see in the world.”  or “you are what you think about.”

How Do I Create a Birth Affirmation?

  1. Get to the root of your worry/fear.  Give it a name and it already takes some of the power away.  For example;

    I will be a wimp and not be able to handle the pain of my contractions.

  2. Restate your worry/fear with an opposite statement.

    I will be strong and able to handle the pain of my contractions.

  3. Make it present tense.

    I am strong and am handling the pain of my contractions.

  4. Affirmations are declarations!  They should be short and to the point.  Think of writing them on a picket sign.  Divide your statement into the smallest divisible parts.

    I am strong.
    I am handling the pain of my contractions.

  5. Remove weak or negative words.  “Handle” implies barely getting by, perhaps “conquer” or “stay with” the pain of my contractions (some people don’t like the idea of a contraction as being something to overcome as if it were the enemy – consider your thoughts before choosing a word).  Pain is negative.  It was useful for me to think of them as intense or powerful instead of painful.  And I liked to think of my contractions as a powerful wave.

    I am strong.
    I am riding with the power of my contractions.

  6. Review your worry.  Did you get the meat of it?  Was it really that you think your partner will find you wimpy?  That is a different worry in many ways.  Take a moment to determine if you captured the heart of your true worry.
That is the process I used.  There are variations on this theme you might find useful here and here.  Try it for another worry:
  1. I’m afraid I won’t be able to breastfeed and will resort to formula.
  2. I know I will be able to breastfeed and will not resort to formula. (write the opposite)
  3. I am able to breastfeed and will not resort to formula. (make it present tense)
  4. I am able to breastfeed.
    I will not resort to formula.  (short declarative statements)
  5. I am a successful breastfeeder. (able could imply that you are still uncertain.  You might instead say “breastfeeding comes naturally to me.”  Notice I took the second statement out all together.  It was all a negative “resort” statement.
  6. I am worried that I won’t be able to give my baby the best I can through breastfeeding.  Perhaps going through the process again would be useful to come up with an additional affirmation – I am doing the best for my baby.
One more example:
  1. I’m afraid my labor will take too long.
  2. My labor will not take too long.
  3. My labor is not taking too long.
  4. (already short and declarative)
  5. My labor is proceeding perfectly.
I really think this process itself helps you through so many of your fears and thereby eliminates them!  Now what do you do with them?

What Do I Do With Them Now?

I think that working with these affirmations helps ingrain them.  Then when you need them during labor they just come to you even if you can’t find where you wrote them!  I created for myself a booklet of Birth Affirmations.  I bought spiral bound notecards and different colored markers to create my own little reminders of my affirmations.  I’ll be honest and tell you that I did not take them out of my suitcase at the Birth Center.  However, I truly believe that the ritual of writing them down was infinitely valuable!  If you are a scrapbooker? – embellish it up!  Computers your thing?  Do it online and print it out.  Treat it as something sacred and it will be!
If you are comfortable with it take a few minutes each day to spend quiet time with your baby and your affirmations.  Flip through, visualize, and breathe!  
I truly believe that Affirmations about my in vitro were crucial in my positive outcome.  I meditated on them daily (sometimes with the help of great guided meditations from Belleruth Naperstak and Anji Online).  Imagining my body growing healthy, strong eggs and a thick, nutrient-rich lining to accept the embryos brought me peace and the power of my intentions to bear.
If you are interested in guided meditations or affirmations for pregnancy, labor and childbirth I recommend Belleruth Naperstak.  
Happy birthing!  You are strong! 

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