Gimmee your ear!
So one of the main reasons I started this blog was because I could find no resources on-line (or on the bookshelf) that I felt addressed some of the things I wanted to know as an expectant twin mom...
Is it realistic to try for a natural vaginal birth?
How does breastfeeding practically work with twins (and I'd gotten enough of the two extremes: 1) don't even attempt it, and 2) of course only breast feed until the kids are two)
In an effort to get out info on the first, here are some stories I got by asking around for peoples' twin vaginal birth stories. Turns out I was able to have natural twin delivery (though it wasn't totally by choice... my platelet count fell when I went into labor, so they wouldn't place an epidural because of the bleeding risk -- but now I know it can be done!).
Lessons from my experience -
- Be flexible. You just never know what will happen. We didn't have a birth plan, but talked about what we wanted with my doc instead. That seemed to work out for the best.
- I didn't end up having an epidural, but I knew all along that the risk was I would have to be put under general anesthesia if either twin had a problem and they had to do an emergency C-Section. Both girls did come out vaginally, but then because the placenta didn't fully deliver I was put under for a D and C. So the risk for general is real and the epidural is a great backup to avoid that. I'm glad the way things worked out for their delivery, but I was groggy for the girls' first hours. Always a trade off...
- Try NOT to be induced. I know that's hard with twins, but it is really intense when those drugs start up. I ended up having just 4 hours of active labor because I was already dilated 4 cm when I went in and the drugs were super strong. But it was quite something. For the first hour or so I relied on a hypnobirthing CD I had practiced with at home. And then I switched to doing lamaze breathing with my husband that we had practiced from a library book for the final 4 weeks before the girls were born.
- Try to have your own doc there if you'd like to deliver vaginally and s/he is into that. While I would still try to do all I could to avoid being induced, I'm glad my doc was there advocating for what I wanted (she was leaving on a vacation the next day). As it happened, I overheard the OB assisting her ask why she delivered my twins vaginally instead of a C-Section, so it's possible another doc would have tried to convince me to just do the surgery.
- The recovery can be just as difficult, if not more so, than a C-Section depending on how much tearing you have. Just be prepared!
- If you are interested in no drugs, make sure you've talked about this with your doc beforehand and see how realistic this is and under what circumstances they would consider it. My doc wasn't encouraging about it which I found discouraging, but in the end she did all she could to have that happen. I think she was just trying to get me to be flexible going in...
#1 – Our kids’ delivery was induced at 37 weeks. It was a vaginal birth, after the epidural all was alright, here is the situation: the drugs used to induce birth are very effective and your body gets out of control the epidural eased the pain and I was able to push the kids out more comfortably. Note that my kids were small 5.5lb., and 4.14lb. Due to the twins size I have to say that it may be easier for us to deliver two small babies than for a mother to deliver a 10 or 12 pounds baby.
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#2 We ended up with another OB doctor since mine was on vacation. If you have a preference on certain things tell the doctor at the hospital or have it in writting to give them. We told the doctor we wanted to exhaust all of our options to deliver vaginal before going c-section. He ended up using a vacum to help and I had my babies vaginally. My next step was a c-section since I had been in labor 24 hours and I was too tired to push.
Once my first baby came out I saw him just for a moment since the doctor said we had a very short time to get the second baby out. With mutiliples the risk is more on the second baby. I didn't get to hold my babies until about 1 1/2 hrs later. At XXXXXX you will deliver in the Operating Room as a policy. It is a cold room, bright and not cozy. But you will stay in a nice room until a baby is ready to come out. If you don't have a private room you may want to request one when you sign in. The standard rooms are really small with twins and their beds, etc.
Also, typically when a mother is in labor she cannot check in the hospital until she reaches 7 or 8 cm. But with twins you are monitored more closely and if you are early in the delivery you will probably stay. I wasn't sure if my water broke so they checked and it did and they kepted me eventhough I had no contractions yet.
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#3 regarding vag birth, the biggest shock for us (since we had had a midwife delivery in a quiet room the first birth) was the O.R. was so intense and crazy! it's a tiny room and it is stuffed with people. there was maybe 12 people in there. it was NUTS!!! they let you have one person with you, and 2 if you have a strong-spoken OB who can make that demand. but it's pretty crazy in there. just know that the O.R. part will be brief, and you'll be so jazzed to see your kids that it won't really matter.
we did manage to vaginally birth both girls without any drugs, but twin B (who is usually the more at risk) breathed in some blood, so it was life-saving that all those people were in the O.R.. the respiration specialists vacuumed her lungs out quickly before she could suck it down further, and that saved us about a month in the NICU. so as crazy as it is to have all those people, it's worth it! and afterwards, they wheel you back into the same room you labored in.
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#4 I delivered my twins vaginally and it wasn't perfect, but overall it was a fantastic experience. I have four pieces of advice:
1) be as flexible as you can and stay focused on bringing healthy little
girls into the world; try not to get attached to the way they come into the
world, because then you'll be disappointed if it doesn't work that way;
2) get the epidural as early as you want it; don't be a martyr - it does
help the pain and new research shows that it doesn't delay labor; mine
wasn't done perfectly so one side of my body did have some sensation, but it
was so much better than having hours of contrations without the epidural;
3) ask your nurses lots of questions -- really use their expertise and don't
feel like any question is dumb; and
4) give your partner or labor coach of being your advocate (e.g., getting a
new epidural if yours isn't done perfectly, getting you water, blankets,
whatever makes you more comfortable) and particularly giving him/her the job
of informing the labor & delivery nurse, the delivering Ob, and anyone in
the delivery room that you'd like to at least see Baby A and preferrably
have her on your chest for at least a few minutes (if she is healthy and not
in distress, of course) immediately after she is born and while you are
delivering Baby B.
Here's my story. I was induced at 36 weeks due to preeclampsia. They induced me at 8 p.m. with a small amount of pitocin so I would start dilating but not deliver in the middle of the night (Ob's like their sleep! :)). Unfortunately, they gave me too small a dose and so the next day, after about 16 hrs. of pitocin, they had to speed things along by breaking my water and increasing the pitocin. When nothing more happened after another hour, it looked like I was going to have a c-section. But suddenly, I dilated from 4 cm to 9 cm in 45 minutes - ouch! but I was able to deliver vaginally and it was a great experience.
Honestly, I did get sad when the dr said we might need to have a c-section, but our nurse kept us focused on the outcome - healthy babies. And then after I was all ready for a c-section, suddenly I found myself wheeled into the operating room pushing them out.
I was in 2 hrs. of active labor -- about 1.5 hrs. for my son, baby A, and 20 minutes later came my daughter. I had an episiotomy because over an hour of pushing out my son, I wasn't getting very far. As soon as she made the incision it only took a few more pushes for him to come. My daughter was sunnyside-up in the birth canal so I had some back labor until the dr turned her around. The turning around hurt, but she came out quickly after that. Although there was more pain than there should've been b/c my epidural only worked on one side of my body, the entire time I kept thinking about how amazing it was that these kids were going to come out of me and that made the experience really wonderful.
Our delivery nurse was an amazing coach. She told us everything we needed to do - when to breathe, when to push, how to push, how my husband could help me, etc. She was so incredible. The only thing I wasn't prepared for was that they did not give me baby A after he was born. I didn't even see him until after I was back in our room and I really wish that I'd been able to hold him immediately after. My husband held him in the room and carried him to the nursery so I don't feel so awful, but it really would've been great. I got to see my daughter right after, but she I only got to hold her for a second.
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#5 I delivered vaginal birth for both kids. It was a wonderful experience... just not your typical, singleton birth. Know you will have drugs (epidural) and that you will deliver in the OR with what may feel like an army of docs and nurses.... just in case. As for childbirth classes.... didn't really use the information, but it was good to get a tour of the hospital. At least that was my experience. But I don't know what your feelings on the whole birth process are. I think some moms want to have a real natural, maybe touchy feely experience.... I'm not that type of person, I did not write a "birth plan". I really trusted the docs to know what would be best and that the most important thing was the health of my babies and of myself, I did not expect to have a "natural, drug free" birth experience when I found out I was having twins. I sat on the bouncy ball a lot (the rocking chair sucked). That and my husband's hands got me through to the point when I decided to get an epidural. For me the epidural was magic. My body completely relaxed and I went from 4 to 8 cm in about 10 minutes (Not what you hear about an epidural, that it will slow your labor). I was in for only about 12 hours (they induced me at the end of 36 weeks, I was induced at 6pm on a Wed. night, my water broke at 1 am, I got an epidural at 12 pm and the kids were delivered at 2:35pm and 2:45pm on Thurs. (less than 24 hours)).
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#6 I delivered vaginally at 39 weeks. I am very glad that it turned out this way, that I did not need a c-section, as I think it would add another layer of exhaustion to the post-partum period. However I was always keeping in mind, Baby B could turn at the last minute, and whatever the babies required was what we would do.
I would say... you might not be able to walk around, I was induced and had 2 heart monitors on my belly. When I see my (unused) birth ball I just have to laugh. :)
I don't know how you feel about an epidural but I wish I had gotten one earlier, mine ended up not working well, basically delivered "naturally", ouch (that's an understatement).. not really a twin thing specifically though.
You will deliver in the OR (operating room).. my nurses were waiting, per doc's instructions, till I got to 10 cm dilated to move me from Labor room to OR. Well at 9.5 cm, the babies decided they wanted out, NOW, and it was a mad dash to the OR! Quite exciting. My OB told me pushing would take 1 - 2 hours.. but it ended up being only 15 minutes.. the girls were born at 11:54 and 11:57 pm.. just 3 minutes apart! (my advice would be, before you get too far underway, make it clear you want to be in the OR by 9 cm... just in case!!)
The nurses are great. They brought me extra lunch (after delivery) because I was ravenous.. one nurse taught me to double- breastfeed both babies in the middle of the night. Definitely ask for the lactation specialist to visit!
I don't know if you are planning on 'rooming in' with the babies (assuming they are born full term, and are not in the NICU). I decided not to, that is, I had them in the nursery both nights and had the nurses bring them to me to feed. I figured that was my last chance to sleep for a while and since we did not have n ight time help... I was right. :)
Also I could not believe how long it took for the nurses to leave us alone after the birth.. the weighing and monitoring of vital signs, back in the labor room, took forever. I think it was 4 am when I got to sleep. That's not particularly a twin thing either. :)
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#7 i found my doula invaluable. she was truly marvelous and, i think, the reason why i didn't have to have a c-section. otherwise, you'll have the epidural, so that's not a question. embrace it.
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#8 I was able to deliver vaginally at just over 39 weeks after being induced and then having 27+ hours of labor (not as bad as it sounds as far as I can remember, except towards the end). Your labor & delivery will depend on so many factors (and every woman/delivery can be so different) that it is hard to know what will happen until the moment they arrive so the main point of advice I have is be prepared for as much as you can, but know that anything can happen and try your best to go with the flow. Also, while I know now that it is possible to deliver twins vaginally I was completely ready to do c-section if that was necessary (and I think it's important to keep that in mind). So I took childbirthing classes and it helped me a tiny bit, but otherwise I was just breathing & pushing however I could remember. Three things that were "unexpected" for me were:
1) I had a lot of bad back labor. I don't think this is necessarily more common with twin deliveries, but I did not think about what back labor was beforehand and had no idea how tough it would be, and since delivering two kids can generally last longer (esp. if it's your first time delivering) it also prolongs the pain a bit and the epidural did not help as much
as I would have thought or liked(!);
2) length of time after the 1st birth -- my second baby came out 18 min later. I know it can be anywhere from a few min to upwards of 30 min(?) but I did not personally hear of too many that were more than 10 min apart so that longer wait in between was tough and you just need to stay strong. Luckily baby #1 paved the way (she was quite a bit bigger and has a large head) so at least that helped a bit; and finally
3) The biggest "I wish I had known" was actually postpartum experience. I think vaginal delivery recoveries can be very tough given what your body has undergone (it seemed like so many of my friends with c-sections had a far easier recovery than I did!), so be ready for that potentially (you may be just fine, but I had a tough time). Your recovery will depend on the degree of tearing (probably not too bad given that twin babies tend to be smaller on average so the likelihood of a major tear is generally lower, but I'm a small person who had pretty normal sized babies with the full-term pregnancy so I had a bit of tearing), the degree of difficulty with your labor, amount of blood loss, and generally speaking your body's ability to bounce back amongst other things.
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