I have a post sitting in my drafts folder that's the final part of my twins' birth story. It's 1500 words already and not close to finished. I abandoned it months ago, but I haven't forgotten that I never finished it. I just got stuck.
My friend A'Dell gave birth a few weeks ago and ended up having a rather traumatic delivery and postpartum experience. All that is her story to tell, not mine, but watching her go through it made me realize that processing Linus's and Ambrose's birth is still a Thing I need to do. It's not going to go away. And yes, I've done a lot of internal work on this over the past 21 months, but writing the birth story is necessary for me. I can't get to the other side of all this without finishing it.
The birth story I originally began writing has lots of details. So many details that I've gotten bogged down in them, and missed adding the life to it. I'm not feeling it.
Instead, here's the story roughly as I've been telling it out loud for 21 months. Because it's worth telling. I want you to hear it and I need to tell it.
My twins' birth was one of the biggest experiences of my life. I mean that in a good way. Afterward I kept going over it in my mind, thinking did that really happen like that?
The part after the birth was terrible. I'm going to say that up front so I don't have to dread talking about it at the end. Linus and Ambrose were born healthy, with APGARS of 8 and 9, and there was no distress or scary part after they were born, but because they were twins they were born in the operating room and because they were preemies they were whisked to the NICU directly after birth. I got to kiss them each once before the nurses hurried them away, and by the time I saw them several hours later they were wearing wires and tubes and sucking on pacifiers under warmers.
Babies are supposed to have their mothers after birth. Linus and Ambrose were supposed to have me, you know? It hurt that they didn't. It always will. And the seventeen days that followed hurt a damn lot too.
But anyway (now that I'm crying, sheesh) the birth was great. For many reasons. It makes me happy that I'll always have it in my pocket to pull out and remember. I did that. That happened to me. I was lucky.
The only part I can take credit for is choosing the doctors I did, and even that was mostly luck, as most people don't have a top-notch maternal-fetal medicine practice AND a birthing hospital with Level III NICU within 1.5 miles of their houses. But I could've gone with different doctors. In fact, my midwives expected me just to switch to the OBs in their practice. I chose my MFMs instead largely because they're comfortable with multiples deliveries and I thought having them do my care would both minimize the risks for the babies and me AND give me the best chance of a vaginal delivery. Win-win!
I saw a team of three doctors and I liked them all, but I was hoping I'd get one of the two women for delivery because I appreciated their enthusiasm about it. They encourage women who are willing/able to deliver twins without surgery (for lots of reasons) and they're comfortable delivering twins who are vertex/breech (many will OBs only do vertex/vertex). This was a big deal to me during the doctor-choosing process, and by the time I delivered I was just happy with my doctors overall. I felt we all liked and respected each other and that I could trust them to manage risks and help me make the best decisions for the babies and myself no matter what curveballs we got thrown.
The curveball we ended up getting is the one I already wrote about in the earlier parts of this birth story: preterm labor hospitalization at 33w3d, steroids and release, rising blood pressure at 34w1d, re-hospitalization. Bloodwork and overnight tests continued to show that I did not have preeclampsia but in the meantime I dilated to 7cm without even being in labor. So there I was, on the morning of May 11, not in labor, not in a condition that called for medical induction, just stuck. Stuck at the hospital until delivery. Whee.
The good news was that Dr. Happy Chatty was on call that week. She was the one who checked me and discovered I was 7cm, at which point she actually sort of... cheered. Because she was excited that she'd get to be the one to deliver my babies. (Gratifying!) And I was excited about that too.
This is one weird thing about going to high-risk obstetricians: they have way different standards about what is "good" outcome. The prospect of any NICU at all (the neonatologists who came to talk to us predicted a 1-3 week stay) felt terrible to me. But my doctors were all: Look at this! You're almost to term and your babies might have to be in the hospital a little but their prognosis is great! Everything will be fine! Hooray happy outcomes!
(Interesting side story: a week later I ran into Dr. Happy Chatty at the hospital and she told me in confidence that she was pregnant herself, eight weeks along with spontaneous twins. (!!!) And I was in the middle of NICU ennui at the time but she said, "I'm really hoping for an outcome as good as yours." That was a sort of... clarifying moment for me. As in: okay, yes, this NICU is not fun, but we're fortunate overall.)
(Dr. HC did have her own twin girls at nearly full term about 6.5 months later. Everything went well for her! Yay!)
At any rate: my doctor, not considering 34w2d to be scarily preterm, was excited about my delivery. She advised I eat a big lunch and then see what happened. Since we'd discovered that baby B had flipped head down and he and baby A were "battling it out" (her words) for prime position, she warned me that we might need a little Pitocin to help get them into delivery position. But since the twins' sacs were intact and they were acing their monitoring sessions, she said she saw no need to rush things. The choice about when to start Pitocin would be mine.
Some time later, I realized that when Dr. HC said it would be my choice, she really meant I could stay in the hospital for days if my condition stayed the same. She wouldn't have made the decision to induce me at preterm without a pressing medical reason. Unfortunately - or maybe fortunately; I've never been able to decide - I didn't understand that at the time, and assumed that if I didn't make the call to start Pitocin she would make it for me at some point. Even though she never said that.
What ended up happening: after Bryan ran out and brought back the most delicious Jimmy John's lunch of my life, he and I hung out at the hospital all afternoon. We walked the halls a little, but that made my back hurt (baby head pressing into my spine!) so I couldn't do it for long. Standing up would give me contractions but also so much back pain that it didn't feel worth it. I talked on the phone with a few people. I took a nap. We watched some TV. My nurse was kind of grumpy (and had a cough, which I did not appreciate) so I was glad that it looked like I would definitely not deliver before the shift change at 7:00pm.
My sister brought Camilla and Blaise to visit around dinner time.
I loved cuddling them, touching their soft skin and hair and hearing their chirpy voices. I was feeling emotional, worn out, hating being stuck in the hospital. Seeing them pumped me up (oh! that's right! THIS is why we go through this pregnancy stuff, because kids are awesome) and wore me out (because I was missing being home with them. hospitals stink) and so when they left I decided I was ready to get my twins out. I wanted to get the labor over with so I could get home and be with half my children, since the babies would be in NICU anyway.
Plus I did not want to have another uncomfortable night on an L&D bed only to start Pitocin in the morning anyway. I wanted to get things moving and make the inevitable sleepless night a useful one at least.
I asked the nurse to get me one of the residents and the resident called Dr. HC and talked to her about the plan. She came back and told me that the doctor was fine with waiting longer if I wanted -
(This is the part with the misunderstanding: she meant indefinitely and I thought she meant until the next morning. So basically, I made the call for an induction myself. I have complicated feelings about this but I've worked to make peace with it; I just have to trust that somehow things worked out the way they were supposed to.)
- but that if I was ready to go ahead, we'd start Pitocin at 7, get an epidural at 8, and move right along to delivery.
And that is pretty much how it went. My grumpy daytime nurse started the Pitocin before she left, and then my night shift nurse came in. In a happy coincidence, it was Catie,* the same nurse who'd been at my sister Branwen's delivery the previous August. I was thrilled to see her: she's young and friendly and kind, and I felt like I could trust her.
Pitocin picked my contractions up to a reasonable rate, but they were mild enough that I was talking through them. I couldn't believe it when the anesthesiologist showed up to give me my epidural. How could this be it? I just got to... opt out of the rest of the pain? It felt weird and good both.
(My previous two pain-med-free births? Still what I'd choose if given the chance to go back. But in this case, for many reasons, I'm glad I made the decision to get the epidural. It ended up being right for this birth.)
Once my epidural was in and doing its work, it was waiting time. Dr. HC arrived not long afterward. We sat around chatting. Catie was in and out, charting and checking in on things, joining in on the conversation when she could. It was FUN, honestly. I wasn't in pain, the babies were tolerating labor beautifully, and I was progressing. The doctor did a couple dilation checks and had the nurse turn the Pitocin up to help force one of the babies' heads to engage. We talked about all kinds of things - our families, pregnancy and children generally, Catholic stuff (it turned out the nurse was Catholic and I already knew the doctor was, and you know how much I love Catholic stuff. We had some interesting discussions). Dr. HC sat back with her feet up. Bryan and I were relaxed. It was very different from my previous two labors, which required such concentration during transition. I felt almost bewildered by the difference, but it was nice.
I was also posting on Twitter occasionally, and it was fun seeing all the excitement and the #moshertwins hashtag. I loved knowing so many people were thinking of us, praying and pulling for us.
In the back of my mind the whole time, I knew that eventually I would get wheeled down to the operating room (our hospital, like most, requires that multiples be born in the OR even if they're not delivered surgically) and that Ambrose and Linus (as I already thought of them even though Bryan and I were the only ones who knew their names) would be taken away. They'd been with me - and each other -since conception and it was awful to think about how that was about to end.
Really, though, I didn't think about it much during those hours between 8pm and midnight. We were just hanging, everyone was healthy and happy and things were happening the way they were supposed to. At one point Bryan asked Dr. HC, just out of curiosity, if she could predict a time of birth. She guessed they'd probably be born by midnight.
But May 12th came before the excitement started. It actually came a little after midnight. Dr. HC had declared me nearly complete at my last check about half an hour before. I was starting to feel some serious pressure and she decided to check again.
Oh! I should mention that at our hospital, the epidural works thusly: the patient gets a big bolus of anesthetic when the epidural is placed. That achieves the initial effect. After that, it's up to her (and there's a big sign saying only the patient may push the button) to decide how strong her epidural is. She can push the button and get another small dose of anesthetic as often as every 10 minutes.
So by midnight, I could have had a couple dozen doses of anesthetic... but I had pushed the button only once. Compared to the pain of anesthesia-free birth, the numbed pressure of contractions on the epidural was not bad, and I was concerned about being able to feel things at pushing time. I'd only ever done this the other way, you know? And I knew something might happen that would require getting the babies out fast and I wanted to be sure I'd been able to push as best as I could. I definitely hit the button when I felt like I needed it... but by midnight I'd say I had a pretty weak epidural going on.
Then: pressure. Big time. I KNOW that pressure, and I told Dr. HC I thought babies were getting ready to come out. Both sacs were still intact (artificial rupture of membranes is riskier with multiples, so the doctor would not break my water until 10cm so as not to increase risk of cord compression or prolapse) and the plan was that when I was complete, she'd break the bottom sac and it'd be go time.
Which is... kind of what happened. Except that as she was putting gloves on to do the check, one sac broke. But not the bottom one, the top one. Ha! Complicated. Also kinda messy.
Dr. HC did NOT (bless her heart) tell me what was going on a the time, but she suddenly got really focused. I was still chatting away, actually, but Bryan noticed, and then I noticed that he was watching her. He asked her if everything was okay, and she was reassuring, but she was also working hard to get the bottom sac broken. Ironically, it turned out to be really tough. She tried, like, three different implements to break it. She had the nurse leaning on my belly (comfortable!) to make the sac bulge as much as possible and she was discussing the possibility of a needle amniotomy, when the little glove with the pokey thing on it finally did the trick.
And BAM. Baby head. Right. There.
The rest of this labor had been different from my previous ones, but this. This feeling I knew. I'd been chatting still, and smiling (having taken the doctor at her word that everything was okay) but suddenly I was focused. I spoke firmly. I might've kinda shouted, actually. "There's a baby there. He's ready to come out."
Suddenly there were people everywhere, and Dr. HC gave me a reassuring grin as she gowned up. "Can you hold on for two contractions? Just give me two and then we'll get those babies out."
I could, I thought I could, so I focused on keeping the baby in. They threw a sheet on me. A tech was helping Bryan into operating room gear, and I remember checking to make sure he was holding the camera. Then we were rushing down the hall, just fifty feet or so. I was glad it was the middle of the night and the place was empty.
There were SO MANY PEOPLE in the operating room. Neonatologists and NICU nurses, and labor and delivery nurses and every OB resident in the hospital (probably some other residents too) but I only thought about who all those people were later, because right then I had a job: I REALLY NEEDED to get some babies out of me.
They pulled me over near the operating table and I realized they wanted me to get onto it before I could give birth. WHAT. The residents were getting ready to lift me (over my two hospital stays I'd gotten to know all four of them and I really liked them all - I was glad they were there) but I was like, "No, I'll do it," and I hopped over onto the table.
I felt the next contraction coming and I looked to Dr. HC for confirmation that I could push and she nodded, so I did. With all the strength I could summon, and it's weird how pushing always feels brand new and yet completely familiar each time, but I could tell it was working and my doctor and the residents were encouraging. And then the next contraction, and I gave it everything, and there he was.
I always say he popped out and he literally did: all his brother's fluid and stuff was waiting up there behind him. It sprayed everywhere. People were covered with liquids that had come out of my body. I mean: ewwwww. For them, anyway.
It would've been mortifying except that I didn't have time to concentrate on that because as soon as that baby was out I felt his brother's head engage. I kinda gasped, I think, at the doctor, "The other guy is there! Can I push him out too?"
And she laughed and said, "Hold on! We haven't even clamped this baby's cord yet."
But they clamped fast and it was good that they did because it was one push, and one more, and then our second baby was born. The first twin at 12:38am, the second at 12:41am. May 12th was their birthday.
Both of them were yelling as they got weighed. They were strong and healthy and they looked good, although the first baby was kind of pale and the second extra red. (We'd find out why later.)
They asked us their names, and I glanced at Bryan for a nod before telling everyone that the first baby was Linus Michael and the second was Ambrose John.
5lbs, 7oz for Linus, 5lbs, 12oz for Ambrose. Both 18.5 inches long.
Here's a funny thing: in medical terms, the baby who's born first is baby A and the second baby B, which means at birth Linus was A and Ambrose was B. But! During my pregnancy Ambrose had been closer to the cervix. He was baby A and Linus was baby B. I remember asking one of the doctors if baby A always came out first and she said that he almost always did, but that every once in a while something weird happened and baby B was born first.
Well, it happened to us. Linus, that quirky and determined little guy, stayed breech on top until the last 24 hours before he was born, then flipped head down, nudged his brother out of the way, and got born first.
We still gave them the names we'd been planning - somehow I just knew which one was which while they were still in utero, so we'd already named them - but more than one NICU nurse asked why we didn't give baby A the name that began with A. And I was like, "Well, we did! But we were thwarted."
I'm only going to talk about the fun parts from after the birth because, like I said before, a lot of it was awful. I got to kiss my babies on the forehead, once each, and then they were gone. I sent Bryan with them because I couldn't bear the thought of them being alone.
So it was my doctor and the residents and me, and they were busy with post-birth stuff. I remember delivering the placenta and having Dr. HC show it to me. It was huge! And had two cords coming out of it, which just looked bizarre. But it was nice and healthy-looking, she said.
After that I just kinda chilled and chatted with everyone as I got stitched up in the OR. I like to talk in times like that, and I'm sure I said lots of nonsensical things. The head resident did the stitches, and I remember asking her to give me a local anesthetic, because my epidural had worn off by then. I'm okay with anesthesia-free birth but I will not do anesthesia-free stitches. No way.
And my doctor told us what had happened at the end, why the babies were so different in color from each other: when the top amniotic sac broke, my uterus started to clamp down. It caused me to bleed and it caused transfusion in the placenta: Ambrose, whose cord was centered, started getting more blood than Linus, whose cord was on one end. That was why Dr. HC had suddenly gotten focused when A's water broke: she realized what could happen and that we needed to get the babies out as fast as possible.
"When we were running to the OR," she told me, "I was praying to myself that you were good at pushing, because we didn't have much time. And then, whoa! You really were!"
Still makes me grin thinking about that.
I wrote Dr. HC a long gushy thank-you note a couple weeks later. I feel like I owe her so much - for believing this birth could happen, for respecting me as a patient, for managing the risks, for keeping that reassuring face on when it was game time and giving me the freedom to focus and give birth the way I did. It could've been so scary, but with her at the wheel I got to just... be in it. And it was so, so good. My babies are healthy and I am healthy and I got lucky but she gave me all the best chances and it was so good.
NICU ended up being good for me in a lot of ways. Long-term ways, that I'm still working through. But at the time it was brutal, slogging through it, and I was so grateful that the part right before NICU was exciting and happy and a once-in-a-lifetime kind of story to tell. I still am.
Linus and Ambrose got born and it was good and I'm grateful. I guess that's the whole story really.
(The picture that feels right in this spot is NICU homecoming day. But if you want to see pics from right after the birth, they're here.)
*This is (basically) her real name.