Giving birth

Blood. My heart froze that night in the bathroom. Everything vanished in my focus except the blood. Fourteen weeks pregnant, out of the danger zone I had thought, yet all I could see was blood. I yelled for my roommate who helped me to my bed. I lay there trembling in shock, sobbing. Having been stunned by a surprise pregnancy during a particularly difficult time in my life, I had come not only to accept but cherish this little life growing within me. I was going to be a mother again! But fears icy grip paralyzed me that night. Was I going to loose this life so soon?

The E.R. visit was routine. Long waits, a hard bed in a cool room. A doctors exam. They found nothing wrong. I waited a while longer for a quick ultrasound to make sure everything was okay.

By 3 am I was physically exhausted, bleary eyed from the events of the evening and emotionally spent. As the machines warmed up, my heart was tense with fear. What if something was wrong? What if the heartbeat that I had heard a week before was no longer there? My mind rushed as the technician began her exam.

The look on her face confirmed my fears. I could see it in her eyes, intently looking with a frown at the screen, and then at my belly as she searched it with her machine. My heart sank as she returned her focus to me and stated coolly, "You haven't had an ultrasound yet have you?" Her words pregnant with some dreaded knowledge. "No," I anxiously replied, wanting to scream but staying in surreal control, "why, what's wrong?" She kept looking at her screen, moving the wand over my small but growing belly. The icy dread pounded in my heart, amplifying as every second passed. She finally responded quietly, "because there are two."

Two?!?! My heart flipped as a flood of profound relief rushed over me; my baby was okay! Yet in the same instant my mind seemed to explode as it struggled to comprehend the word two. Overcome with so many conflicting emotions, all I could do was laugh hysterically and cry at the same time. "Oh my god, you aren't freaking serious." I exclaimed in utter disbelief, "You cant be serious, there are two?" She turned the screen towards me as if to prove her point. I could see their two little heads, and two beating hearts. I was having twins.

Initial shock wore off to the reality of making plans. My first birth, though in a hospital, had been natural and without drugs, an amazing and empowering experience. I was hoping for a similar experience again. Little did I know that everything was to be more complicated with twins.

I quickly realized that in most clinics, certified nurse midwives will not take twins cases. They are considered too high risk. I wasn't thrilled with my choices, but nevertheless started seeing an obstetrician. I was even less thrilled as I began to understand the hospital policies regarding twin births.

As my pregnancy progressed, I grew more dissatisfied with my lack of options. My chances of a Cesarean were high, and there was the possibility that I could deliver one baby naturally, and the second by section. I could not imagine trying to take care of two infants and recover from major surgery at the same time.

I was still determined to birth my babies as naturally as possible. I strongly felt that interventions like drugs would lead to more interventions and a higher risk of complications. I also wanted to experience the profound and exhilarating experience of an unmedicated birth.

At 26 weeks, I hit a small complication. There was still plenty of time, but my second baby was presenting breach. My obstetrician knew I wanted a completely unmedicated labor, but the hospital policy was that every mother of twins have an epidural. She graphically described to me what a breach delivery would look like and why the epidural would be necessary: the doctor would reach her hand into my contracting uterus and pull the baby down and out of my birth canal by her feet. This was called a breach extraction, and from what I could determine, the only way they would deliver a breach baby vaginally.

I was not thrilled, to say the least. Appalled would be a better description. I knew breach deliveries were highly uncommon in the hospital, but was this entirely necessary? Traumatic memories of a manual extraction of my placenta with my first daughter, a similar and excruciating procedure, left me crystal clear on what I did and did not want inside my uterus.

As the fearful scenarios were unfolded to me, and reality told me that I was most likely in for a traumatizing experience, the excitement and anticipation of my upcoming birth gave way to fear and doubt. Frustrated and hoping that there were other options, I began looking into the alternatives of birthing centers and direct-entry midwives.

I was familiar with the idea of home-birth from friends and acquaintances who had done it. And though I did not fit into the all-natural, hippie-mama stereotype, I was never the type to be content with the mainstream either. Although this was a bit outside the box for me, I was cautiously open to the idea. I decided that there could be no harm in exploring the possibility.

Though many did not take twin cases, I was quickly referred to a direct-entry midwife who had 25 years of experience, and had delivered several sets of home-birth twins.

The way she managed twins was that I would see a perinatologist at the university hospital who would send her all the lab reports and ultrasound findings, and we would take things step by step. If we were all comfortable with the way things were by the end of the pregnancy, I could proceed with a home-birth. If not, I would give birth in the hospital. The freedom of choice felt like a breath of fresh air after feeling so confined by hospital policies and practices. I decided to transfer my care to this perinatologist so at least I would have the option in the end.

My pregnancy entered the last stretch as I began my 30th week. My breach baby had turned vertex, a very good sign. And they were both growing concordantly. With each baby having her own placenta and sac, I was in the lowest risk category for twins. But though things were going well, I was still not sure if I was going with the midwives or not, I still had a major issue with my insurance company paying, even though the cost would be minimal compared to the astronomical costs of a medicated hospital birth. My delivery date was drawing nearer, and I still had not established care with my midwives due to this issue.

I was 34 weeks along when my doctor discovered that I was nearly 5 cm dilated. I had felt nothing other than constant braxton-hicks contractions, but nothing to alert me that I was in labor. I went on immediate bed rest, knowing that a delivery at this stage would definitely be in the hospital, and I would probably have very small, preemie babies. Whatever I decided to do, I knew I wanted those babies to be healthy and strong, so keeping them inside as long as possible was my sole focus.

But the days slowly turned into weeks and my babies soaked up every extra ounce of nourishment my body provided them. Time seemed to stand still. By 36 weeks I went off my bed rest and still nothing happened. Large and very uncomfortable, I began to think that I was never going to have these babies.

That week I went in for my appointment, and another doctor checked me. By his measurement I was more than 5 cm dilated, and my contractions were regular, but not painful. I tried to tell him that I was not in labor, but he insisted I go over to labor and delivery to make sure.

I knew the procedure well, having gone in for some false alarms; you aren't allowed to eat until they are convinced you are not in labor. That can take anywhere from 2 to 10 hours. And that long without food for a ravenous mother of twins is an eternity! Annoyed but afraid to go against his authority, I grudgingly went over, but not before the rebel in me wandered around the hospital for a while and ate a big lunch.

When they determined what I already knew, I was indeed not in labor, they still decided I should stay at the hospital. The doctor on duty was concerned with the slim chance of a uterine infection, since I was so far dilated and 90 effaced. Another fear was that my labor would be quick and I would not make it to the hospital in time. I understood their concern since my previous labor had been 4 hours long and I lived nearly an hour from the hospital, though in the back of my mind I wondered if they were attempting to control the situation. It was written all over my charts that I was planning on having a home-birth, and the overwhelming consensus in the hospital was that I was crazy to even think of such a preposterous idea.

What they didn't know when I entered the labor and delivery floor that week was that I had all but given up on the home-birth. After being given the run-around, I finally realized that there was no way my insurance would cover the midwives, and I had no extra money to pay them. Still being so many weeks before my due date and the doctors predicting delivery any minute, I had pretty much resigned myself to the fact that I was going to have these babies before I left the hospital. My last hope was to fight for the kind of labor experience I wanted and hope that I got a doctor who was understanding enough to allow it.

So the hospital became my new home. Not having much else to do, and wanting to prepare myself for my natural hospital labor, I had my sister bring me some books to read. I devoured The Thinking Woman's Guide to a Better Birth in one sitting, scribbling down the questions that had been burning in my mind. Could I decline the epidural? Could I use positions that were most comfortable or would I have to labor and deliver on my back (an excruciatingly uncomfortable position already)? Could I hold my babies immediately after they were born or would they be taken from me? Would I have to be induced immediately after the first baby was born? If the second turned breach, could I try to deliver without the extraction as long as she wasn't in distress?

The longer I stayed, the more questions I had about what my birth would look like, and the more I disliked the answers. One late night after about a week in the hospital, I sneaked down to the labor floor and asked a nurse if shed let me take a peek at the room that I would deliver in, the ominous Operating Room.

Looking in, I envisioned with vivid clarity the frustrating picture the doctors had painted for me. There I was, lying flat on my back on that hard little table in the middle of a bright, sterile room. My feet in stirrups no less! Epidural in place (though with the option not to use the drug unless necessary) and strapped to various machines beeping around me. Bright lights glaring down on me, and a myriad of strangers (perinatologist, nurses, residents, anesthesiologist, pediatricians, about 10 people in all) packed into this small little room ready to take my babies the moment they were born. All watching with curious interest this strange and primitive woman who wanted to have her twins without drugs.

At that moment my hopes of having a gentle and memorable birth shattered into pieces. And then a surge of angry defiance welled up within me. The timid rebel, until now too intimidated by the system, suddenly emerged with sheer determination and resolve. That would not be me in there!

With unwavering clarity, I called my midwife the next morning. I told her I didn't care what it took, I had made it to 37 weeks and I was going straight home to have my babies there. That same morning, eight days into my hospital stay, the doctors gave me the option to induce or go home. I didn't think twice. Strangely triumphant, feeling that I had won some unseen war of wills, I packed my belongings and was never so happy to be going home.

Excited and invigorated, I quickly rushed to get the supplies needed for my home birth. I felt a profound sense of relief knowing I was not going to have to fight my whole way through my labor. In the competent hands of women who trusted the natural birthing process, all I would have to do was relax and let my body do its job.

Friday morning comes: 3/4/05. I am 38 weeks and 1 day. Everyone, including the doctor (who wants to induce at this point) thinks it's time these babies come. Rayyan wakes me up at 7:30 in the morning and exclaims excitedly, "common mom, were gonna get these babies comin' today!" So I drink some red raspberry leaf tea, and we waddle around my apartment complex as fast as a full-term woman with twins possibly can.

When I noticed a dribble of liquid run down my leg later that day, I was ecstatic. Filled with excitement and anticipation that my long awaited day had finally come, I called the baby's father, my mother, sister, best friend and midwives with my news. These babies were indeed coming today.

By the time everyone arrived, my labor was well underway. I was resting comfortably on my couch surrounded by my favorite pillows, breathing through my contractions, eating a bit here and there to keep my strength up. The labor grew intense, but in between contractions I was joking around about what the neighbors must be thinking or text messaging updates to my friends. It was so comforting to have my family around me, experiencing this amazing event with me. And at every turn, I reminded myself what I would have had to be doing if I had been in the hospital. Through a particularly difficult contraction I winkingly moaned to my midwives, "Right about now is when I would be taking the drugs! You sure you don't have any hidden in your bags?"

An hour and a half after my bag of waters completely ruptured, Anayi made her entrance. My whole body bore down to urge her gently into the world; a surreal moment of physical relief and emotional elation flooded over me as she was born. The sudden absence of pain and utter tranquility of my body in contrast to the intense contractions I had just experienced was indescribable. 5 pounds 12 ounces, looking just like her daddy, Anayi was born into my arms, on my living room floor.

Following her birth, I had an hour of complete rest, where my body did nothing; the calm in the center of the storm. I was no longer in labor. The midwives monitored Baby B, who was doing fine, enjoying her only time she would have my womb to herself. Anayi and I had time to bond and breastfeed and relax before I started feeling mild contractions again.

Had I been in the hospital, I would not have enjoyed this peaceful time. The doctors made it clear that within minutes of the first birth, they would do everything in their ability to get my labor going. And if after rupturing my membranes and administering pitocin, my body had still refused to work within their time-frame, I could have faced a section. How grateful I was to be at home!

The midwives were comfortable allowing me to labor when I was ready, for which I was very thankful. With the pain and intensity still vividly fresh in my mind, I was not ready to push out another baby anytime soon!

If there was one thing I felt from the midwives, it was their overwhelming confidence in the birthing process, and the absence of fear and worse-case-scenarios. They were so reassuring. What a difference it was from the fear-charged atmosphere of the hospital. And so I took my time. So long in fact, that we were getting close to having twins with separate birthdays!

About 5 hours later, I was mentally ready to do it again. They broke my second bag of waters and within 10 minutes I felt the intense contractions and urge to push. Half jokingly I lamented that it wasn't fair to have to do this twice in one day! After twenty-five minutes of intensity, on my hands and knees, my preferred birthing position, Eliyah was born at 11:45 that night, 6 pounds, 2 ounces.

And so my precious girls were born, in the soft light of my living room, with a warm spring breeze floating through my open windows. Without the bright lights or sterile machinery beeping around me; born not into the hands of a waiting band of doctors ready to whisk them away, but into the arms of their loving mother.

People will say that it doesn't matter how your babies are born, as long as they are healthy. But the indescribable beauty of my birth and bonding I experienced with everyone present that day will last a lifetime. And the knowledge that I found the inner strength to birth my babies is empowering, and very helpful, because now is when the real work begins.

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Comments

[Hannah]

What a beatiful testimony! I would just love to have a link to this post on my sidebar. If I have your permission to do so, I would like to create a category on my sidebar titled "Homebirth Stories" or something to that effect.

Thank you so much for sharing your story!

Hannah

You can contact me @ confessions_ucb@hotmail.com