How I ended up having a vaginal AND cesarean section at the same birth!
Knox and Theodore made their entrance into the world on Oct. 12, in the wee hours of the morning. Here's the funny thing about our family: 1) all my kids were born on a Friday 2) we all have even birthdays that are mid-month 2) we all "share" our birthdays with other immediate family members. My husband is May 14 and Henry is May 16 (thus the "share" and not a full out, non-quotation mark share); I'm October 16 and the twins are October 12; Otto is December 18 (so he "shares" with Christmas) and our anniversary is January 18. We love even day, mid-month events in this fam! My twin pregnancy went better than expected, so of course the birth was a bit of a wild ride. Here's how it all went down, and how I managed to have both a vaginal and c section birth on the same day.
The morning of Oct. 12 I had an OB appointment. She had thought I'd have delivered the twins by now; I was 37 weeks pregnant! That's dang near unheard of for twins, as the average gestational age is 35 weeks and I had a big bout of preterm labor that started at 32 weeks. But a month of bedrest and contraction-limiting drugs kept those babies in for another FIVE weeks!
Fast forward past all the bedrest boring-ness and to the morning of Oct. 12. I went in for my appointment and they did a quick ultrasound to check on the babies' heartbeat, position and fluid levels. Baby A was still head down and baby B was still breech (they were like this for the bulk of my pregnancy) and Baby A's fluid had decreased quite a bit. My OB came in to check me, and wouldn't you know, all those preterm labor contractions had dilated me to 4cm and baby A's head was fully engaged and ready to go, which meant I could go to the hospital and get checked in! My OB said she'd be along shortly to break my water and get things moving along. "Today is your day!" she said to me. Whoohoo!
I went home, grabbed a bowl of cereal, my husband packed our bags in the car and off we went. We were admitted right away and got placed in the labor room. For singletons, you labor, push and recover in this room, but for twins, you only labor here. You push in the operating room so that you're all set for a c section in case of an emergency.
We waited for about five hours for my OB to come and break my water. I was having mild contractions but nothing consistent or strong. Five hours where we just sat around, chatted with the nurses and wrestled with all the damn monitors they had me hooked up to (normal part of VBAC deliveries - all my births after Henry will be considered a vaginal birth after cesarean since he was a c section for being breech). If I could change one thing about the birth, it would be to not have immediately gone in to the hospital, but to have coordinated times better with my OB!
 |
| Too wee for their Halloween bibs ($1 from Target... No waste there!) |
Finally she came and broke my water. My water has always broken on it's own and I imagined that hurting... It didn't! She put a monitor on baby A's head so that I could get one of these large, clumsy monitors off my belly. These dumb things kept sliding off because they're SO big and my belly was so round, it was like the proverbial square peg, round hole situation: all they did was slide off. The nurses were even trying to rig me up using towels and menstrual pads because they kept falling off! Anyway, I sat up for about an hour after she broke my water and started to feel contractions come closer together and harder.
My OB checked me at 8pm and I was at 6cm. "I don't think you're going to need any pitocin!" she said. Let me tell you about pitocin, which I had for Otto's birth. It makes contractions absolutely UNBEARABLE. Regular contractions like I was experiencing? Totally manageable with breathing! Pitocin contractions? They're like death. I knew I'd have to have an epidural before I started pushing (they wanted it all set up in case I needed a c section) so I told her to have the anesthesiologist come in whenever he had a chance and we'd get that all set to go.
He came right in and got to work on my epidural. And when I say work, I mean he really had to work. I don't know what his deal was, but he could NOT get the catheter placed in my spine. He kept hitting bone. Yes, you read that right, I kept having needles hit my f'ing spine bones. He made some FIVE attempts at getting this epidural placed. I almost told him to f off; I wasn't in much pain anyway and he was just making things worse. Finally he got it and took his needles with him. Good riddance.
With that placed and my body naturally progressing. we waited. By this time it was about 10 pm so both my husband and I tried to get some sleep. Since I had Otto some three years ago, they changed up the way they do epidurals and I have to say, I'm not a fan. The meds aren't as strong and you can always feel pressure and move your toes. You have a drip with a button that you have to press for more meds. And it makes you drowsy and insanely gassy (and after you're done, you'll itch for DAYS). Honest to Pete, if you're going in to just have a normal vaginal delivery, skip the epidural. This new way of doing it is bunk! I loved my epidural with Otto but this one I could do without.
I switched from side to side with the nurses while I progressed. I never did end up needing pitocin! My OB came in at 3am and checked me. "You're at a 9.5. Here, I'll help you. Bear down!" I don't know what she did - maybe helped dilate me that last half centimeter? - but she checked again and said, ok, you're at a 10! Let's go push these babies out. I'm going to go make sure the room is ready for you."
I hadn't been keeping up with pushing my epidural button because of the wack-ass side effects of the anesthesia, so I frantically began pushing my button to make sure I was as numb as possible for the pushing and upcoming external cephalic version they'd have to do on baby B for me to push him out. I had one of these without drugs with Henry, as we did everything we could to avoid the c section with him, and I knew dang well how NOT fun they are. So I pushed that little epidural button with the fear of a woman about to push 12 pounds of lead out of a very small hole in her body. I do not need to feel that, thanks.
 |
| Knox Thatcher (Baby A - firstborn twin) 4lbs 15oz and 19 inches |
We get to the operating room and it's BLINDINGLY bright compared to my dimly lit labor room. I'm good and numb from my frantic button pushing. They move me over to the operating table, but low and behold... They put my head where my feet were supposed to be! I guess they had recently gotten new state of the art tables and in the process, changed the way they faced. My OB was livid with the support staff and was baffled why they didn't know how to transfer a patient to the table correctly. I thought the hole thing was rather funny because my OB was trying to hold back from tearing these people a new s-hole! They decided not to rotate me because the babies needed to come out, so they put some pillows under my head to prop me up for pushing.
Baby A, aka Knox Thatcher, was born in just five pushes. Cheers to all the yoga I did while pregnant and maintaining ab strength for a fast, easy delivery! He was held up so I could see him, but handed off to a NICU team to make sure he was good to go. Despite being smaller than we expected (4 pounds, 15oz) he was totally healthy. I heard his beautiful cries as I delivered his placenta and mentally prepared for round two.
Next up was baby B, who was breech. My OB was checking things out via ultrasound to make sure he was still breech and to see what needed to be done to get him head down. One of his legs was up my his head and the other was bent so that his knee was towards his abdomen and his foot was down towards his bottom. She began the external cephalic version (basically, attempting to rotate the baby manually from the outside so that he'd be head down). She tried one way and then the other. She was trying so hard, her muscles were shaking! Then all of a sudden, his foot came out of my vagina.
It was still in the sac of water - only baby A's water had been ruptured to start my labor process. She put it back inside me and told me what happened. She said, "If that foot breaks the bag of water and there's an umbilical cord with it, this is going to turn into an emergent situation really fast. You'll immediately go under general and we'll start the c section in less than 90 seconds." She started to put all the staff in the room on alert that things weren't looking promising for a vaginal birth and to stand ready for a cesarean.
It's weird. I remember her telling me this, but being completely calm about it. I really thought he was going to turn for me! I truly didn't think I'd end up with a c section. Even the staff were like, "It's amazing how calm you are! Wow, we wish every patient could be as easy going as you!" I think the thing I've learned about birth, now that I've done it so many times, is that you are NOT in control. You can do only what you can do up to a certain point to get what you want, or had hoped for. But the babies call the shots on how they enter the world. The more relaxed and go with the flow you are about it, the better off EVERYONE will be.
 |
| Theodore Dallas (Baby B - second born) 5lbs 11oz and 18.75 inches |
My OB gave the version one more good attempt. She had one hand up my vagina, holding on to baby B's foot and rump, trying to keep that from popping out again, and one hand on his shoulders and neck, trying to coax him head down. It wasn't happening. She switched her grip and tried to get him to rotate the other way and boom! There went that foot again. "Ok, we're going to have to c section you. I can't have that foot breaking the water and potentially compromising the umbilical cord!"
I was laid back, my epidural was increased and my belly prepped for a c section. Baby B, aka Theodore Dallas, was born a half hour after his brother, weighing in at our expected birth weight of 5 pounds 11oz. He came out screaming, so I didn't wonder at all if he was ok! The NICU team took him and looked him over, but quickly assessed that he was a healthy boy.
While they were sewing me up, my husband brought Knox over and I was able to really get a good look at him. Then my husband was managing holding and seeing the babies, and I remember fighting all the sleepy anesthesia drugs. It was nearly 4am by this point, and I was so so so uncomfortably tired! And then... A wave of nausea hit. I told a nurse I didn't feel well in enough time to turn my head to the side and puke on her.
I was wheeled back to the recovery room and given some Zofran. Theodore was handed to me and literally latched to my breast within 15 seconds. Those healthy, loud lungs created quite an appetite! He was nursing away, my OB was sitting at a desk nearby and doing some charting, I was shaking and convulsing from the anesthesia and then boom! Second wave of nausea. My OB got me a barf bag (it was literally a bag) and put in more nausea med orders for me.
 |
| Baby Knox after his first bath at home |
Teddy nursed for about 20 minutes while my husband held Knox. Since he was smaller, he was a little more sleepy than my big, loud Teddy. Finally it was Knox's turn for a chance at nursing, about two hours after he was born. He took a little more convincing than Teddy did, but I got him latched after a few minutes. It definitely helped being an experienced mom who's nursed all her babies! by this point, I'm well versed in how to get a baby to latch. Had they been my first babies, I'd have been overwhelmed trying to get two small infants to breastfeed, but at this point in my "mom career" there isn't much I haven't seen or experienced. Again, I was complimented on how calmly I managed them.
I mean, I was shaking and convulsing from the drugs, randomly projectile vomiting (several people got hit, oops) and desperately trying to stay awake, and here I was latching underweight, sleepy babies like a damn pro. Moms can multitask like friggin' heroes.
Right as we were about to be released from the recovery room and relocated to the suite we'd be staying at, a nurse who had been in the delivery room with us popped in and told us that the NICU pediatrician wanted me to supplement the babies with formula since they were so tiny. I can't remember, but she may have been one of the nurses who complimented my cool, calm demeanor. Anyway, my head shot up, I looked her right in the face, and said, "NOPE. Absolutely not. Trust me, I produce tons of colostrum, we'll be fine."
 |
| Teddy giving me the stink eye as I attempt to make him Instagram-worthy |
I think she saw the instant change in me and said, "Ok, we'll let you try and see how it goes. The babies will get blood sugar checks every three hours. If their blood sugars stay level, you'll be fine to continue exclusive breastfeeding. But we'll have you pump to ensure they're getting enough."
I told her pumping I was fine with, but formula would mess up my supply. I mean, when you're trying to INCREASE milk production, the last thing you want to do is introduce formula! Again... experienced mom Paige knew this and I'm so thankful I had my twins after having other children so I know what to do with them! And wouldn't you know... Knox and Teddy always had fantastic blood sugar reads, never even got on the scale for jaundice, and I pumped ounces upon ounces of colostrum several times a day. Every lactation consultant who checked on me was in awe! Heck, I was even in awe of how much I was producing.
It's nice that breastfeeding is currently working out, because my birth sure didn't go like I had hoped! I say currently, because you just never know for how long it will work in everyone's favor, but for right now, we're all happy and healthy nursing, and we'll continue as long as it stays that way. In the end, I my twins were and are healthy and didn't need a minute of NICU time. I wrote on social media that when I found out I was having twins, I really wanted only two things: a VBAC birth and no NICU time. I ended up with 75% of what I wanted, and 3 out of 4 isn't bad! No NICU and totally healthy babies, one successful VBAC (albeit with a second degree tear) and one c section.
The twins' birth left me bruised (literally - bruises on my belly from the ECV), cut, torn, sore (my shoulders and upper back were so tired from the excessive shaking and convulsing!) exploding vomit and stitched up. But no emergencies happened, everyone pulled through and now we're home and bonding well! I didn't get my "prefect birth plan" but like I said, I know better than to even write one of those worthless things. Babies come how they want to come, and moms, you're just along for the ride.
