**WARNING!! This post includes scientifically accurate words for all female reproductive body parts, as well as honest and detailed descriptions of what happens during inductions and childbirth. So if you’re not into reading about my vagina, cervix, etc, and all the horrible, graphic things that happened to them over the two days it took to convince the twins to exit my body, then this post probably isn’t for you**
***And this second half of the story is where that disclaimer is really warranted, lol***
Okay. So. We left off with my (spoiler!) first epidural being placed (that’s right, my first epidural of the evening), and the Pitocin being turned up pretty well to the max dosage, even for someone not trying for a VBAC. The reason they went so much higher with the dose than my doctor had previously approved was that up to this point, the babies and I were handling the induction better than anyone could have ever hoped. Like I mentioned in Part 1, the contractions caused by Pitocin come on stronger and faster than contractions tend to do during naturally occurring labour, and that can cause a lot of stress for the babies. Because they get squeezed so tightly, it can actually compress the umbilical cord and cause their heart rate to drop with each contraction, or for the baby to get insufficient oxygen. That’s why once you start Pitocin the baby has to be constantly monitored because you never know when this might happen, and some babies handle it worse than others.
Not my babies, though! Even in the early hours of my induction, Freya and Archer were already being referred to as rock stars, because their heart rates were absolutely perfect. Every time a new nurse would check their read-out they’d be a bit surprised and say, “Oh! This is great!” So, thanks kids, because the most common reason for an induction to turn into a c-section is “The babies aren’t handling it well”.
Unfortunately for me though, the second most common reason is “You aren’t progressing quickly enough”, which was definitely the case for me. By the time they administered the epidural at 8pm, we were 28 hours into the induction, and my water had been broken (well, Baby A’s anyway) for 12 hours… Which meant I had 12 more hours until the hospital would want to start talking c-section because that’s when the risks of uterine infection start to creep up.
The first hour or so of the epidural was fine. It seemed to be working well enough, I wasn’t feeling much pain, just pressure and tightness. All totally normal. Then suddenly I started having more and more pain in the right side of my lower back. At first I didn’t think much of it, like “Oh, maybe Ive got a muscle cramp from laying in this same position for so long”, except I wasn’t supposed to be feeling pain, and I realized that what I was feeling was coinciding with my contractions. It started off slowly, and then built to a point where we let the nurses know that I was feeling more pain that we thought I should. Their response was to play a fun game where they put ice on my face, then on my lower back, abdomen, etc, and asked if it felt the same as it did on my face, which… I had a hard time with because cold and pain aren’t the same, and it did honestly feel different all over (and is it really surprising that cold would feel different on your face than on your back? I have questions about this method). I also found it hard to concentrate on how the ice felt when I was having awful, searing pain in my back every 2 minutes. And for anyone who doesn’t know (I sure didn’t!) that doesn’t mean there’s a 2 minute break between contractions, the timer begins a the start of one, and goes to the start of the next; and since mine were lasting about 1 minute each, I was only getting a 60 second break from the most excruciating pain I’d ever felt (including during my first pregnancy when they tried to turn Luna from breech to vertex, and the doctor actually thought he broke my rib during that procedure). And because all the pain was all localized to one spot, it felt so much more intense. After about an hour of this, the pain started wrapping around the front of my belly, and the nurses started to really believe I really was feeling more than I should so they gave me a bolus, which is basically an extra injection of meds into the epidural line thats meant to bump up it’s effectiveness. Half an hour later, they put in another bolus. Still nothing. Except not nothing, the opposite of nothing, because the pain had gotten so bad that I started losing track of time and I wouldn’t let Adam touch me. This was when the nurse told me that if I did need a c-section (and I could tell she thought I’d need one) I’d have to be put under because the epidural wasn’t numbing me enough for the surgery, which was the exact opposite thing I needed to hear right then. I remember turning on my side and sobbing into my pillow for what felt like forever. I was trying so hard to breathe through the contractions, but they were becoming so overwhelming that my moans were turning screams muffled by the pillow. I started hyperventilating and crying “What was I thinking? Why didn’t I just have a c-section? I can’t do this!!” I felt so defeated and like I’d made the wrong decision. What if I completely missed the babies being born, and exposed them to all the possible complications that come with general anesthesia, and all because I’d been hell bent on having a vaginal birth which was seeming less and less likely anyway? What if I was just one of those women who couldn’t give birth naturally and I was putting us all at risk?? Adam tried to pet my hair and hold my hand to comfort me, but I cringed and shouted at him to stop; my nerves were so overloaded with the pain that anything or anyone touching me caused a strong visceral reaction, and made everything feel worse.
*Can we take a quick break and discuss how very not cool it is that women’s pain is often downplayed or disbelieved?? Before things got really bad and I was still able to speak normally, I was told that I couldn’t be in that much pain because I was laughing at Adam’s jokes while breathing through contractions, because I was still saying ‘please’ and ‘thank you’, because I was able to smile in between. Seriously?! So what, if I’d been a grouchy bitch and treated my nurses like shit, maybe they would have tried to help me sooner? How messed up is that? Because I have a high pain tolerance, try to manage difficult situations with humour and positivity, and try to be as polite as possible, I must not be feeling what I say I am?? Just because I was tolerating the pain for a while doesn’t mean I wasn’t feeling it, and doesn’t mean I should have had to suffer through it when there was supposed to be perfectly good pain meds going DIRECTLY INTO MY SPINAL COLUMN.
End rant. For now.*
I don’t know for sure how long the screaming phase went on, maybe an hour? I do know that at one point I looked up into the room and there were a bunch of people there I hadn’t seen before. Apparently my nurses had started taking breaks and switching off with other nurses because they were finding it difficult to watch me suffer the way I was with no way to help me. Epidurals are effective about 98% of the time, and people don’t labour with Pitocin this high without one, so this wasn’t something most of them had seen to this degree. Adam had been standing next to my bed the whole time and as far as I know was holding it together pretty well. All I was allowing him to do was hold my water cup and pass me tissues. My wonderful doctor had been called in by this point and was questioning the nurses, since the last time she’d seen me I was smiling and positive, feeling pain but working through it, and about to get my epidural. Now I was suffering so much that I hadn’t even seen her come in the room; my voice was hoarse, my eyes were red and swollen, and Adam was obviously distraught. By this time, the epidural wasn’t working at all and the pain was everywhere.
One of my main nurses (the same one who had told me that Baby A would definitely be going to the NICU) made a comment about the epidural not numbing pressure, and was I sure it was pain and not pressure I was feeling? Dr. P answered for me with, “If she was just feeling pressure, she wouldn’t be screaming like this”. Goodness, I love that woman. Somehow the babies were still doing just beautifully and none of my stress or pain was effecting them, so it was decided I’d get a second epidural, but it took nearly another hour for the anesthesiologist to be available again.
It was the same anesthesiologist as before, but this time he was a bit kinder. He examined the epidural placement, and the looked over my chart. “The placement was perfect” he said, “I’m afraid it may just be your anatomy, but we’ll try again a bit higher up.” He also told us that what I’d been having was ‘hot spots’, which is when the medicine doesn’t reach certain nerve roots in the epidural space, so your brain never gets the message to turn off those pain receptors. He was hopeful that putting in a new line in a slightly different spot would fix it. He still had waayyyy less patience than he should have while actually placing it though, and I of course found it even harder this time to get into the position he wanted and to stay still while I was there.
This time he also stuck around for a bit after the line was in. Everyone waited, watching me, to see if there would be any change, and within minutes I could feel the warmth and numbness washing over me again. It was working and there was no reason to believe that the first time hadn’t just been a fluke. All the extra staff left, Adam and I had a long hug, and I took a minute to catch my breath. Dr. P was finally able to check me, and you’d think that several hours of insanely intense contractions would have helped me to dilate, right? Wrong! I’d been in so much pain, and my body had been so tense that there was no progress at all, and I was still at 5cm. Not only that, but although Baby A was nice and low with their head right on my cervix, they were turned sideways which would make it really hard for me to push them out. So they brought in this peanut shaped exercise ball, and had me lie on my side with that between my knees. This apparently helps keep your pelvis opened up, and the hope was that the baby would shift on their own as I slept, and we could avoid having to manipulate them and potentially stress them out.
It was now 1am, and we were finally going to be able to get some rest. Adam tried to sleep on the reclining chair in the corner, and I chatted with the nurses while they fed me ice chips and popsicles until about 2:30am. I wanted to sleep, but I was so happy to feel well enough to ‘eat’ something, and I was honestly still terrified that the pain would come back and just couldn’t relax. My nurses were wonderful, even (especially) the one who I’d disliked during the day. They took turns sitting next to my bed all night, chatting me with, keeping a close eye on the babies heart rates, taking my temperature and blood pressure, and making sure I wasn’t feeling anything I shouldn’t be. I was finally able to fall asleep.
When I woke up the next day around 7am there was a change in nurses, and they checked me for any progress, the good news was that I’d dilated to 8cm, and the baby had turned!! I was allowed to sit up, and try to let gravity help a bit. Adam and I started talking about what songs we should play while I pushed, and after a long and scary night we were getting excited again. It seemed like we were back on track for a vaginal birth! Around 8am a nurse popped her head in and said my dad was there, and would I like to see him? This was super weird because we were always really clear about no one coming to the hospital until we were ready, and that I didn’t want anyone waiting around while I laboured. Plus if I had to bet on just one person who would absolutely respect my wishes, it’s my dad. But (fair enough) I guess we’d really freaked my family out, because I’d been updating them pretty regularly up until I got my epidural, (plus I’m almost never without my phone and hadn’t answered any calls or texts either) then they didn’t hear anything for 12 hours and were starting to worry. We explained what had been going on, and since (in his words that I wasn’t supposed to hear) I looked like I’d been “dragged down the road”, I think he understood that we’d been through an ordeal and truly just hadn’t had the time or the wherewithal to fill anyone in (and Adam did apologize later to him and my mom for worrying them, which I thought was really sweet).
Nothing else eventful happened until 10:30am when Holly, our favourite nurse, came to check me and found that I was at 9cm! Normally they make you wait until 10cm to push, but she said we could give it a try since Dr. P was only meant to be at the hospital until 12pm, not to mention my water had now been broken for nearly 27 hours, which is 3 hours past the normal cut off. I could also feel my body pushing on it’s own with each contraction. She had me do a ‘practice push’ to see if I understood how to do it, and said I was very ‘competent’ pusher. I felt in control, and confident, and pushing really was the most enjoyable part of the whole experience for me. I pushed for about half an hour before Dr P came to join us, and they brought in a mirror so I could see the progress I was making (which I never thought I’d want to do, but it was really cool!). Someone once told me they thought I’d like the pushing phase because it’s almost like an endurance sport, and they were right! It was like the ultimate physical challenge, I got a rush from being able to push more times and for longer then they asked me to in one contraction After 2 hours I was finally at 10cm, and the baby was getting close to crowning. We could see their little head appear and disappear at the height of each push now, and we were getting really close to a successful VBAC for at least one baby.
But, as you can imagine, this was all really hard work and I was starting to tire out. My contractions had slowed down a bit through the night, but were still 2-3 minutes apart.
For anyone who hasn’t witnessed a vaginal birth, every time a contraction begins, they have you pull your legs up to your chest and pick up your head so you’re kind of curled in a ball on your back. You inhale as deeply as you can, then push for a count of ten while holding your breath so that all your energy is going into the push. Adam was practically sprinting back and forth to the ice machine every 15 minutes or so because I was taking long drinks between push cycles, alternating between ice, water, and ginger ale. Somewhere around the 1 hour mark, Dr. P told me it was important that I tell her when I was ready for ‘help’ with pushing, and that’s when we would move to the operating room (which was always where the babies were going to be delivered, just to be on the safe side) so we could use the ‘good’ stirrups. Everyone assured me I was doing a fantastic job, but the concern was that I’d use up all my energy on Baby A and then need a c-section if I was to tired to push out Baby B.
They covered me up, wheeled me next door to the OR, and moved me to the operating table where the stirrups were indeed much better, haha. They were way more comfortable and made it easier to keep my legs where they needed to be. Why aren’t they like this in every delivery room? By this point Dr. P had to go back to work at the clinic so the delivery was taken over by Dr. H, the head of OB. He was great, and while I didn’t have the same rapport with him as I did with my own Dr, I think he got a good grasp of my personality pretty quickly when he said something about the risk of uterine rupture and I quipped “Nah, that’s ok. You can have my uterus after this, I don’t want it anymore. Burn it all down.” He chuckled and said “Well they do uterine transplants now, you could always donate it”, and I came back with “Yeah, no, I don’t think anyone wants my scarred up, stretched out uterus”.
I had all the same nurses as in my birthing suite, but they were now joined by few more, as well as an anesthesiologist monitoring my epidural, a pediatrician, and a whole bunch of extra people who were pretty much just there to watch. I’ve always heard that mothers don’t end up caring who’s in the room by the end but I never, ever thought that would be me! It was true though, I had long stopped caring who was there, and I honestly think that your belly being in the way of everything that’s happening helps you forget that you’re completely naked from the waist down, probably pooping (no one said I did, but I mean, come on), and leaking various fluids. Not including Adam and myself, there were 18 (EIGHTEEN) people in the room while I gave birth, and there were more in the grand total because I found out later that a few of the staff traded places a couple of times since there were more people interested in being present than were allowed in the operating room. I had become a bit of a spectacle, but in the best way. Everyone was so supportive and respectful, by this time I’d been in the process of trying to have these babies for 21 hours. That meant we were on our 4th set of nurses, some of whom were now on their second shift with us, and it really made it feel like everyone was pulling for me at this point and felt invested in the outcome. It was wonderful to see a nurse light up and say “Oh, I’m so glad I get to be here when you have the babies after all!” We’d been introduced to two different pediatricians who would care for our babies, a few different NICU charge nurses who would handle their care if necessary. And most importantly, the new anesthesiologist.
He had a much better bedside manner, and since he was there the entire last two hours of my labour it meant he got to know me, and his entire focus was keeping me comfortable and safe. By this time though, the second epidural was beginning to fade. I was ok with that because it meant pushing had gotten easier for me to control and I could feel where Baby A was. However after another hour and a half or so of pushing in the OR, I was still struggling to get the baby past crowning. I would get her head just starting to exit then when I relaxed after pushing she’d pop back in (what a disturbing visual, I’m sure she didn’t exactly ‘pop’ but it’s the least icky word I can think of to describe it). We were now three and a half hours into pushing, and I was already SO tired. I had to have a nurse hold my head up for me during each pushing phase because my neck hurt so badly from pulling my chin to my chest, and I had broken blood vessels around my eyes from the pressure of pushing (it felt like my eyes were going to pop right out of their sockets each time, to be honest, and Adam said they were looking pretty bulgy). And since my pain was returning more and more with each push, Dr. H said he thought we should move to a vacuum assisted birth. This meant an episiotomy, and Adam said “Wait! I though you definitely didn’t want that.” (seriously though, bless this man for listening to and caring about everything I have ever said in regards to giving birth), I thanked him but told him that at this point it was an episiotomy, or a c-section, so I didn’t really have a choice.
This was when it became super, duper clear to everyone that, yeah, I really could feel everything again. Because as the episiotomy was performed I told Holly that I was feeling way too much, why did it still hurt so much, why can’t they give me more medicine?? Dr. H assured me that I was just feeling the pressure of what he was doing, and I said “No. I can feel you cutting me. You just cut me diagonally from left to right.” That’s when there was a definite shift in the energy in the OR. Because I’d already completely maxed out on what they could give me through my epidural line, I’d been given all that I could safely have according to my height and weight. This wasn’t just ‘hot spots’ anymore, my body was metabolizing the drugs much more quickly than normal (which is apparently something that’s common with redheads), and I was now receiving zero pain relief.
With the vacuum now attached we got Freya out in just a couple of pushes and everyone gave a little cheer as she came out screaming. And, Oh. My goodness. It was everything I’d ever expected it to be. The sensation of her leaving my body; using all of my effort, willpower, and strength to give birth to her was the single most empowering thing I’ve ever done. I felt like a forking super hero, and I kept saying “I did it!” Adam had the honour of telling me she was a girl, and I could not have been more full of joy and triumph.
Tiny Freya. Just 5lbs 12 oz, she looked like a perfect little doll from the very start. Dainty and feminine, but strong and loud, and perfectly healthy. We had a few names at the top of our list, but as soon as I saw her she was Freya to me. They cleaned her up and I was able to hold her for a few minutes on my chest, and it was just as amazing as the first time I’d held Luna. I think every second-time parent wonders if they can really love another baby the way they love their first. Your love for your child is so all encompassing, that it’s just so hard to imagine feeling that way towards more than one person. But the cheesy saying is true, and your love does somehow multiply and there’s more than enough for everyone.
After about 10 minutes they wanted to get going with Baby B’s arrival, so some of the nurses who were watching off to the side took Freya and cuddled and fawned over her. This made me feel so much better, that she wasn’t just in the warmer, and she was getting lots of attention and love, because I needed Adam to focus on me again.
They broke baby B’s water, and they didn’t tell me right away but their was meconium (baby’s first bowel movement, which can cause a dangerous infection of they swallow it or inhale it) in the fluid. This meant there wasn’t any time to waste in getting the second baby out, since he might need extra medical attention. Unfortunately though, the baby wasn’t taking advantage of his sister being out in the world, and even though he now had tons of room he was still staying way up by my ribcage. He was still head down he was over to one side and facing sideways too, which meant there was no way I could deliver him on my own in a time frame that anyone was comfortable with. We decided that using the vacuum again was the best option, except it proved to be difficult to place it just right without being able to see the baby’s head. Since a newborn’s skull is made up of floating bone plates with soft spots in between, it’s important that the vacuum is placed just right, or it can cause bleeding, a skull fracture, or even brain damage. Since the baby was still nowhere near my birth canal, Dr. H was attempting to do this by feel, which. Yeah. Involved having his arm nearly up to the elbow inside me. Without pain medication.
I started begging them to give me more drugs, and Dr. H kept asking “What else can you do for her?” but the anesthesiologist gave the same response each time, “I’m sorry, there’s nothing else I can do”, and eventually out of frustration he said “If I give her anymore it could effect her ability to breathe”… which stopped the asking. At that point, it was go on with no drugs, or have a c-section completely unconscious, but there was no way in hell I was consenting to that so I told them I could keep going. After a short discussion they decided they could give me a small shot of morphine to help with the vacuum assist, and it dulled the pain a bit. For a while.
Dr. H wasn’t having any luck getting the vacuum in the right spot, and the next 5 minutes felt like an eternity. He said it was time to think about moving forward with a c-section for Baby B. Thank goodness, this was when they decided to call Dr. P back. In her infinite wisdom, she had asked them not to make any big decisions without consulting her first so she came up from the clinic and got a quick update on what had happened so far. When Dr. H told her he couldn’t reach the baby to properly place the vacuum (despite now having my entire uterus to themselves, Baby B was still hanging out under my ribcage) she shrugged said “Well, I have smaller hands, let me try”. Super calm, no big deal. One of the things I love about Dr. P is how casual she is about pregnancy and childbirth. She’s so confident in her skills, and she never let on that she was worried about anything, or that anyone was in any danger. She acted quickly and gave me her honest opinion on how we should proceed, but without scaring me or threatening me with the worst case scenario. Sure enough, she was able to get the vacuum in place on the first attempt, and pulled Baby B down into my birth canal so I could start pushing again.
I only had to push for about 10 minutes this time. I was so tired that I was losing control over how long I could push for though, and it was felt like my muscles would suddenly lose the signal they were getting from my brain even though I was still trying to push as hard as I could. Knowing that we were getting to the point where I wouldn’t be able to push at all, Dr. P began pulling even harder with the vacuum during each contraction, and suddenly there was a loud POP! and the vacuum flew back. There was a moment of terrifying silence where I thought “Oh my God, they broke the baby’s neck” (and Adam apparently thought for a spilt second that the baby’s head had popped right off, haha). Then Dr. P quietly laughed and said “Well that’s a first”, and assured us that everything was fine, the vacuum had just lost it’s perfect seal on the baby’s head as they descended. She reattached it easily this time, since the baby was crowning, and in a few more agonizing pushes, 28 minutes after his sister, Archer was born!
There wasn’t a cheer from our audience just yet though. Because he was silent. Which was terrifying. I found out later that there was meconium in his mouth and nose, so it’s actually a good thing that he didn’t take his first breath right away. They quickly scooped it out of his mouth and he finally took a big breath and began to cry. It was less than a minute, but it felt like forever. Everyone relaxed and congratulated me. I did the damn thing!
My boy. Archer was my first choice for a boy’s name since before I was even pregnant with Luna, so there was no question that it was his name. He looked like a boy from the start, and looked much more like a typical newborn than his sister, all swollen and puffy, and red. My memories of Archer that day are limited so it’s difficult for me to talk about him right after he was born. It’s hard because I can’t remember. I had so little time with him during his first 30 hours of life (and none at all for the first 12 or so), and honestly there were times in my post-partum haze and exhaustion that I’d forget we even had a second baby in another part of the hospital, and I feel so much guilt over all of that even though it was beyond my control. It took me a long time to get past that, and I still get emotional when I think about it.
I do know that after working on Archer for a minute, they brought both babies to me and I got to hold them together for the first time. It wasn’t long, and I didn’t feel like I could really take it all in because this was also when they were stitching up my episiotomy and checking my cervix for any tears (this can happen with a vacuum assisted birth). I have a short video of that moment and you can see how much pain I’m in because I don’t even my eyes open to look at the babies, and I say “I kind of want to squeeze you, but I WON’T”. After a couple of minutes they said they had to take Archer to the NICU, just to monitor him for a while. He had a mild injury on his head from the vacuum (it looked kind of like a large swollen bruise) and his oxygen levels weren’t where they wanted them to be yet.
Once I’d been thoroughly checked over for additional injuries, they took Freya and I back to the room I’d been labouring in, where I was meant to stay for just a few hours to make sure there were no post-delivery complications. In the end though, I had to stay put for another full day.
Oh yes, there’s so much more to this story. Tricked you! And me! See, I thought having to labour and push two babies out of my body with all the risks that come with having twins on top of having a VBAC, would be the scariest part of this whole experience… boy was I wrong.
To quote the movie we watched during my induction: Hold onto your butts.
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