Graduated: Labour and Delivery

If you are reading this and have not yet indulged in my article entitled, “the World of Antepartum and pProm”  it is a precursor to this.

I was slowly starting to get into a routine at the hospital. The food was actually quite tasty, and I looked forward to receiving my menu every morning (or maybe I was just pregnant with twins and hungry). My nurses would come in twice a day to perform a non-stress test – which sometimes proved stressful. They needed to monitor each baby for 20 minutes simultaneously, and most of the time the babies didn’t want to cooperate, so 20 minutes usually turned into an hour or more. They start doing this kind of monitoring at 28 weeks, but because of their small size, the babies are able to move around and away. I think every time the babies didn’t cooperate, my nurses would tell me their stories about the hardest NST’s they’d ever had to perform, and most were stories about women carrying triplets or quadruplets – my heart went out to those women. Two babies in my tummy had given them enough trouble.

Through these NST’s they did discover that Fin had a little heart arrhythmia – I have convinced myself that Ethan developed this as a way for us to tell the two babies apart on the monitor. It was always comforting to hear their little hearts beating, but Fin didn’t like all of the attention and spent most of his time hiding.

As it happened, if the NST didn’t cause enough drama, distinguishing between who was Baby A and who was Baby B sure made up for it. Saskatchewan Health and Alberta Health have different ways of classifying twins in the womb, which ended up a confusing mess. In ultrasound, the presenting twin (the one that would ultimately be born first) is labeled Baby A, and the other baby is labeled Baby B. Our monkey H was originally our Baby B, but as he ruptured his membranes he also took Fin’s place as the presenting twin. In Alberta, because they had already labeled them – they didn’t switch labels at subsequent ultrasounds – H stayed Baby B and Fin stayed Baby A. For my brief week in Regina, however, they felt this was ridiculous and switched their labels – giving H Baby A status and Fin Baby B. I spent the bulk of my days explaining to my nurses who Calgary A was, and that yes – I was aware that my Calgary A (Fin) had a slight arrhythmia.

Everyday that passed uneventfully was a good day. I was having ultrasounds regularly to check Henry’s growth and ensure he was thriving without his protective bubble of fluid. There was a weight discrepancy between the two babies but they were both in the normal range for their gestation. If that discrepancy were to change, however, they would have to deliver me. The bleeding had subsided for the most part, it would still come and go – in nowhere near the amounts it had been. I found no interest in reading or watching TV (although it was during the winter olympics so I almost always had some kind of event playing on in the background)- I passed my time looking out the window – and was lucky to have had an incredible view of downtown. The sunrise was to die for, I purposely slept with the blinds open so I could enjoy them day after day. I had a pretty good view of the Calgary tower, which they would light a flame on every time Canada won an Olympic medal (there was only one medal-less day during my stay).

Here is a similar view of downtown that I had – with the Calgary Tower flame lit. Unfortunately, none of my photos turned out like this one:
(credit to Calgary Tower website)

Calgary Tower

 

K, my mom and the kids would visit me on the daily (my highlight), the kids would bring a snack and a board game, and we’d end our visits with a  cuddle and some treehouse tv. On a really good day – K would come back in the evening just to keep me company.

The night before my labour began was just like any other night had been. The kids had spent some time with me – we played Disney Yahtzee and they sang “Hush Little Babies” to my belly before they left for the day. My favourite nurse happened to have been on shift  – she came to say goodbye and to let me know that she would be off for the next few days – and for me to “stay pregnant”. A bad omen? Perhaps.

My night nurse came in to do my evening NST and surprisingly both babies cooperated. I laid there peacefully listening to their little heartbeats when something different happened – I felt a contraction. Just one. My nurse returned with her student nurse and started showing her student how to read the NST – she pointed out the contraction, which had registered on the NST, and asked me if I had felt it. I had. She made an intriguing face and just asked me to let her know if I felt any more. I curled up to go to sleep and just held my belly in my arms, asking my babies to hold on a little longer… my original goal was to get them to 30 weeks, and here I was at 29 weeks and 5 days. I should have known – they hadn’t listened to me thus far, why would they listen to me now.

The babies gave me a fabulous night sleep. I fell asleep shortly after 10:00 pm and awoke around 5:30 the next morning. I awoke because of a contraction. I quickly wrote it down as my mother would have done had she been with me. I laid there for a little while, and even fell back asleep, only to be awoken by another contraction at 6:00 am. Then 6:30, 7:00, and 7:30 when breakfast arrived. They were consistently coming every half hour. I texted K to ask him what he had going on that day… and that I had a feeling something was going to happen.

My day nurse came in around 8:30 am and I explained to her what had been happening that morning. She hooked me up for my morning NST and sure enough I was registering contractions about every 20 minutes or so. My nurse contacted the OB on call and they decided to bring me up to labour and delivery for monitoring. I felt like I had graduated – being wheeled upstairs to be with the popular kids, although I still wasn’t sure if I fit in. Before leaving me, my nurse turned and said, “I’m sure things will calm down, and once they do, they’ll bring you right back.” For some reason I knew, I wouldn’t be going back.

My contractions had picked up fairly quickly, they were now about every 15 minutes and they were painful – I was finding myself breathing through them. A team of doctors, none of whom were my own, were trying to decide what to do with me. Because they were both still presenting head down, the OB on call was still willing to attempt a natural delivery. However, because of their small size, she was concerned that once the first baby was out, the second baby would have so much room to move around and would move into an unfavourable position. This prompted her to say that they were going to have me deliver in the OR, with an epidural and set up for an emergency c-section in case the second baby changes position.

Woah, woah, woah – hold the phone… I’ll give you a little picture as to how I wanted my last and final pregnancy and delivery to go:

Before 18 weeks (before we found out we were having twins), I was seeing a midwife for my prenatal care. I was going to deliver intervention-free with my midwife in the hospital, and get to go home 3 hours after having my baby.

After 18 weeks and the surprise of twins, my midwife transferred me to an OB who specialized in high-risk pregnancies and multiple births, who would be in favour of an intervention-free natural delivery, during which my midwife would be there to act as a doula or labour coach, and would re-assume my care after the babies were delivered, and we would all go home 3 hours after my babies were delivered.

Speed forward to 29 weeks and 6 days. I’ve spent 12 days in the hospital, 6 of those spent out of province, having flown twice in a tiny little airplane. They were having me deliver in the OR, which meant I could only have one support person with me, I was going to have to have an epidural, an intervention I had never planned on ever experiencing, and it was quite possible I was going to have to have a c-section after delivering one baby naturally.

That was all I could bear and I literally started bawling like I’ve never bawled in public before. The nurse that had been looking after me was in the middle of redoing my IV when she stopped, handed me a tissue and told me to call my husband. It turns out, she had twins of her own, and had lots of entertaining twin stories to distract me with.

My OB returned shortly, not realizing how upset she had made me and apologized. She did say depending on how I am doing, she could attempt a breech delivery but can’t guarantee it. I told her I understand and quickly came to terms with the fact that nothing was going to go the way I had hoped. I asked a lot of questions about c-sections and epidurals – it really helped that she was a female and had had an epidural twice before, and one of my two nurses had just returned from maternity leave and had had an epidural during her labour (she had a little boy who she named Zachary). It slowly started to seem less scary.

They moved me into the private room I would be staying in until I was ready to deliver in the OR. It was a fabulous environment considering it was a hospital room, a completely different atmosphere from my room downstairs in the Antepartum Unit. Shortly after, both my mom and Caleb arrived. The contractions were coming quickly now and I was getting more and more uncomfortable. I believe I was 4 cm dilated. The nurse asked me if I wanted to try this gas that they had to relax you during contractions. At this point, my birth plan was officially out the window so I said why not. And like that, the gas became my new best friend. Every time I felt a contraction coming on, I would grab this tube off the wall and start breathing through it, the tension of the contraction releasing itself from my body.

During this time, we received an extra special visitor. A nurse working in labour and delivery had noticed my name on a chart on the wall and had to make herself known to me. It was the same nurse who had been calling me everyday on the phone while I was in Regina. She was so happy to see me safe and sound back in Calgary, ready to deliver my babies. I thanked her profusely, and let her know how much each phone call she made had meant to me. Apparently I was famous, because as soon as she realized, my nurse with her own baby Zachary, exclaimed, “You’re the one they sent to Regina?!”

At 6 cm – about 45 minutes later, it was time for my epidural. The anesthesiologist was absolutely incredible. She talked me through everything very thoroughly, pausing for my contractions and showing me all that was involved. She made me feel completely at ease and before I knew it I was laying back down on the bed, with no pain. It was the strangest thing to know that I was in labour, but to feel nothing. Every time I had a contraction, my stomach would just tighten and it kind of felt tingly, like all my muscles had fallen asleep. Looking back, I almost feel as though it was a little gift from God – I had endured so much, it was an opportunity for me to relax.

It wasn’t much longer after that, I started feeling pressure down below. I was 9 cm – go time. They wheeled me down the hall to the OR. They showed my mom the “viewing room” where she could watch behind a glass window, and sent Caleb to get all suited up from head to toe in his blue garb. People were swarming all around me. Each baby had their own team from the NICU standing by, and I had a whole group of people standing around me – my nurses, the anesthesiologist, my OB and a resident OB. My mom said she counted 17 people altogether – a scene out of a movie.

The nurses guided me on as to when to push because without any pain I wasn’t really sure. Whenever they said push, I  would just push, as hard as I could. 10 minutes of pushing, and H was out. Baby B born at 1:35 pm on February 25, 2014, weighing 2 lbs. 15 oz. She couldn’t hold him up for me to see because she wanted to give him a little extra boost of blood from the cord, but from what I could see he was perfect. He even let out a cry. However, the membrane had to basically be peeled off of him because he was surrounded by absolutely no fluid. They quickly passed him off to his team and set their sights on baby number 2.

They had an ultrasound machine on stand by so that they could quickly check on Ethan and see how he had changed his position. For a minute the room turned into utter chaos as the ultrasound machine had not been charged and they were frantically looking for an outlet to plug it in. They eventually got it working and it seemed all systems were a go – we could attempt to deliver him naturally.

Again, I started furiously pushing as the nurses coached me along, it was as if within seconds his waters spontaneously broke – which was when trouble ensued. I guess along with the bursting of his membrane he turned and changed positions. The OB grabbed onto his one leg and encouraged me to keep pushing – she ended up delivering him breech after all. Born only 10 minutes later at 1:45 pm on February 25th, 2014, Baby A arrived weighing 3 lbs. 7 oz. A little more in shock, she wasn’t able to give him his extra boost of blood and quickly passed him off to his team. Luckily it was only a few seconds later when we heard him in turn give out his own precious cry.

I think that was what I was expecting the least, for them to cry. It was the most comforting sound in the entire world. In my head I pictured these two little fragile creatures, not ready to face the world. What I got instead were two little fragile creatures, ready to fight with all of their might to make their mark on that world.

After that, it was a whirlwind of congratulations and celebratory “you did its!” K followed the babies to the NICU and I was wheeled back to my private suite where I was met by my mother. We hugged and cried and talked about how beautiful and perfect they looked from afar. I laid there praying that they were doing all right outside of the safety of my tummy – anxious to meet them, but nervous all at the same time.

 

20140710-121936-44376615.jpg
This is the last picture of my pregnant belly – at 28 weeks and 6 days (a week before they were born). I was about the size I was full-term with my two singletons.

Up Next: – Life in the NICU

2 thoughts on “Graduated: Labour and Delivery

  1. Christie

    We have the same taste in names! My son’s name is Anderson, and my daughter’s middle name is Aubrey! I really enjoy reading your blog 🙂 You are an inspiration

    Like

    Reply

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