Being wheeled to the Operating Room in my hospital bed felt a little bit surreal and like I was sitting in a chariot with all the hospital staff around me. I had been unhooked from the pitocin and to my surprise, I had no more contractions from that point on (not sure if thats normal for when the pitocin is stopped or not). We passed the nurse's station and I waved and smiled at them. I don't even think I was nervous. I felt completely normal sitting up on a comfy bed just rolling down the hall towards the OR.
We passed through a set of doors into a big steril room which acts like a waiting room for the OR. There were two OR's connected to this room and I could see though the windows into the other room that they were cleaning up and someone was getting ready to leave. They wheeled me into the empty OR and parked my hospital bed next to a hard, narrow table. The table I would give birth to my twins on. I transferred myself awkwardly onto the OR table and they slid a wedge under my back that kept me slightly propped up.
Around this time, my doctor and husband both arrived in scrubs. In a somewhat annoyed voice, my doctor instructed someone to clear all the people out of the hall who were lingering. Thank you, since there are windows that look straight at my open legs. The nurses had me put my feet in the stirrups and my doctor took his place in the middle.
All along the wall facing me, staring straight at my open legs, were a bunch of nurses and an anesthesiologist (I was told there were 14 additional people to myself, husband and doctor). They seemed to be casually chatting amongst themselves waiting for the babies to be born. Some had their arms crossed looking bored others a bit more engaged in the scene about to unfold.
My doctor checked my cervix to be certain I was fully dilated and he said in the most straight forward, calm but no nonsense voice, "OK, go ahead and push the first baby out."
Excuse me...? Push the first baby out...? I just peered at him very confused; maybe he was joking I thought, and stammered, "But I'm not having any contractions."
Again he repeated, "That's OK, go ahead and push the first baby out."
It took me a second to wrap my head around what he was saying. I think I expected to be coached through some contractions and how to push them out like they did in my previous birth. That wasn't something I wanted, quite the contrary but I was still expecting it. I glanced around nervously and did a timid trial push.
I was annoyed that the stirrups were unstable and the wedge under my back kept shifting and sliding back. It was just set under me, not secured by anything. I think that 99% of the OR births are C Section's and in those, the lower half of the mother is completely limp and in the occasional vaginal twin birth, the mom has an epidural so her legs are also relaxed. My legs however were fully functioning and my ability to push felt inhibited by the lack of stirrup stability.
I cannot emphasize enough how strange it was to be laying there feeling completely normal and trying to push out a baby. It felt almost embarrassing and awkward to be trying different pushes with all those people staring at me. In my first birth, that pushing phase was so intenseband it was so natural to be pushing. It was something I couldn't even control, that primal fetal ejection reflex that I had experienced in just those two contractions earlier.
Each time I tried a new push, I pushed a little stronger but they started out pretty timid. Then after four small, experimental pushes, my doctor said, "You just moved the baby about an inch." I had found The Push. I still felt awkward and unsure each time I pushed but now I knew what to do.
Each time I pushed, I would inhale a deep breath and briefly hold it at the top for several seconds as I started to push and then I gently exhaled, continuing to push through the full exhale. I'd take a few normal breaths and then repeat. It wasn't something I even thought about, it just felt the most natural way to achieve an effective push. I didn't really realize what I was doing until after the birth until one of the nurses commented in awe, "You just breathed those babies out!"
It only took a few minutes of this pushing until I felt an intense stretching and burning feeling. The ring of fire. I never felt that ring of fire in my first birth. I think the pressure was so great and I was working so hard, I never noticed it. However, this birth was utterly painless until this point (with the brief exception of my two contractions earlier). I glanced around the room a little franticly exclaimed, "It burns! It really, really burrrrrrrnnnnns!" For me, vocalizing what I was feeling helped me manage the pain and process the experience.
The burning gave me a little bit of a mental block that made me not want to push anymore. I had to give myself a few seconds to mentally talk myself though it. It was a mild, uncomfortable overstretched feeling when I wasn't pushing and a really intense, about-to-rip burning when I was actively pushing.
I vaguely remember my husband at my right side whispering encouraging words in my ear and kissing my forehead between pushes. I'm very thankful for his love and presence but honestly, I wasn't even paying attention to him. I squeezed my eyes closed to deal with the impending pain and gave one last big push. The feeling of the baby coming out was like a pressurized pop when the head finally came out and then the limp, little body quickly slid out behind it. The speed at which the baby's body exited was a bit unnerving. It was too quick; so quick it was almost uncomfortable.
My doctor held up the baby and my husband announced the sex of the baby. *Per Matt's very insistent request, no one gets to know which baby came first. He is convinced that there will be sibling rivalry about who is older and no amount of persuasion on my part can sway him so I will no be disclosing which baby was which.* I reached out and took the baby from my doctor and placed them on my chest, clinging to their slimy little body.
I don't remember what happened next but I know what my doctor told me he would do once Baby A was out. He manually put pressure on my belly with his hand to guid Baby B down and make sure that they stayed head down and didn't get caught up at the top of the uterus. At some point in this process, Baby A, the first baby was taken from me to be weighted and examined. I was instructed to push the second baby out and that baby, Baby B was born five minutes after Baby A.
I announced the sex of the second baby as my doctor held them up for me. We didn't know the sexes until the birth but I had a gut feeling that we were having a boy and a girl. I even guessed right who was who and it felt more like a confirmation rather than a reveal.
I was put back on a high dose of pitocin as soon as Baby B was born to prevent me from postpartum hemorrhaging and to help me deliver the placentas. The delivery of the placentas is also a blur but I know that they were both delivered after both twins which was something I had to Google during my pregnancy. I didn't know if the placentas were delivered immediately following the twin who they belonged to or if they were both delivered at the end. Turns out both babies come first then both placentas.
Once both placentas were delivered, my doctor went in and did three manual sweeps of my uterus with his hand to remove any remaining pieces. He did this because Atlas, my boy twin's placenta was completely degraded (this is why he was so small and why we induced at 37 weeks instead of waiting one more week to 38). It came out in pieces and he wanted to make sure all of it was removed. This was by far the most painful part of their birth. I arched my upper back, pushed my head back into the bed, winced, squeezed my husband's hand and took ragged breaths through the whole procedure.
This procedure was not a new experience. After Sterling, my first son's birth, this same doctor had to reach in and dig out clots with his hand and I remember it being excruciatingly painful that time too. There's something about a hand and arm going in (rather than something exiting) and then digging around that just feels so disturbing and is downright painful. After the third sweep, I pleaded with him to be done.
I started to hemorrhage unexpectedly and was given another medication to stop it along with aggressive uterine massage since I was already on pitocin and which was not effectively stopping it. The hemorrhaging was stopped and my doc finished stitching up the small perineal tear that I'd suffered during the birth.
I am surprised that I tore with such small babies. 5 pounds, 8 ounces and 4 pounds, 14 ounces but I think it was because they came so quick. Normally, the pushing takes much longer and the body has a chance to stretch. I just popped these guys out in a matter of minutes.
I ended up hemorrhaging two more times back in my labor and delivery room. The second round of hemorrhaging started while I was attempting to breastfeed them for the first time. I started to feel absolutely awful and the babies were taken from me and I was given an oral medication and then a shot when the oral med did not effectively stop the bleeding. There was only one more medication after the three I had already been given that can be used to stop the bleeding.
I was also given pain medication during this intense time. I was unable to stop shaking and my entire body was tense from the pain. My breathing was labored as I tried to cope with everything my body was going through. I remember consenting to the pain medication but because of the state of mind I was in, I wasn't able to fully comprehend what I was agreeing to. I wasn't ready to surrender to pain meds just yet. I wanted to wait and see if I could ride it out without painkillers but I remember her asking and I said yes because I had to answer something and I honestly just could not think.
I received pain meds AFTER Sterling's birth after my postpartum hemorrhage too. I probably would have eventually caved and asked for them but I had intended to try to do it without. It's so strange to me how I'm such a bad ass at the labor and delivery part of birth but then both times, I've completely crumbled afterwards. Maybe I'm like a sprinter trying to run a long distance race and I just burn myself out before its over?
My post delivery experience is something that I'm still working though now. The emotions surrounding my tendency to hemorrhage are very turbulent. Both births I nearly bled to death. The first time it was completely unexpected. With the twins, my doctor and I had a very detailed plan in place to prevent it because I was high risk for it and even with that very specific plan, I still struggled.
During my rough recovery, my babies were with the NICU teams in my Labor and Delivery room that I was back in after leaving the OR but before being transferred to the Maternal Recovery floor. The twins each ended up getting one feeding of formula which breaks my heart but I didn't come prepared with donor milk and they had dangerously low blood sugars. I was later able to obtain donor milk from a close friend who was nursing her six month old twins and she pumped me a few bags for while I was in the hospital and waiting for my milk to come in.
Pictured above is Olympia on the left and Atlas on the right.
This is the story of my twins' birth. It's important to respect every mother's unique birth experience and embrace them as they are. I have shared mine because it's a story dear to my heart and in the hopes that other mothers can learn something from it. I have read, watched and listened to hundreds of birth stories since becoming pregnant the first time and that is something that helped me feel prepared and empowered for my own two births. I think that childbirth is utterly fascinating and though at some points painful, I very much enjoy it both times.