Two years ago, I wrote one of my very first blog posts, chatting with you about my thoughts on making it to 24 weeks pregnant with my identical twin girls. Today, they are officially 21 months old, and I’m kind of flabbergasted that there are two full-on toddlers in my home (along with a very active 6-year-old). Two years ago, I wasn’t sure how long my pregnancy would last, if I’d eventually be put on bed rest and have to stop working, if I’d have to have a c-section, if my babies would be healthy, if they’d be in the NICU, etc. I was hopeful at that point, but still nervous about the coming weeks of my pregnancy. I figured now would be a good time to chat a little about my birth story, since there is a very large gap in between my “Making it to 24 Weeks post” and my next post when the twins were 3 months old. I’m going to share my entire birth story, so if you’re squeamish at all, it might be a good time to stop reading. 😉
At around 30 weeks, I made the decision to stop working in a month, at 34 weeks, unless anything medical happened sooner that would make me stop working. 34 weeks was the end of March, which for work, made the most sense. I would have ample time to re-assign my caseload to another speech pathologist, and tie up any other loose ends. At almost 34 weeks, I started noticing my stomach was looking a bit bruised under my belly button, was kind of itchy, and I had lost some feeling. I went to the doctor for a normal appointment and they said everything looked fine. I also noticed little bumps, one of the front of each of my shoulders and one on each of my thighs. I asked the doctor about them and he said it was “odd,” but didn’t see any reason for concern. The next week, I started getting itchy all over, and the rash started spreading on my stomach. I figured it was PUPPS, a commonly-occurring rash that occurs in pregnancy (Here’s the Reader’s Digest version of it…literally, it’s from RD: https://www.rd.com/health/conditions/pupps-pregnancy-rash/). Typically it occurs in the third trimester and causes pretty intense itching on the belly. I had had it during my first pregnancy. It was bothersome and pretty uncomfortable, but not overly concerning. When I went to my OB again, he thought it was PUPPs, but we also wanted to confirm it wasn’t cholestasis. That’s a another condition that causes itching pregnancy (usually on hands and feet) where there’s an issue with the liver, usually resulting in inducing delivery at 37 weeks. I was going to be induced at 37 weeks regardless, since that’s the “eviction” date for identical twins, so it wouldn’t have meant all that much for me. Anyway, after a negative blood test for cholestasis, we confirmed it was PUPPs.
At that point, the rash had spread up my entire torso to my chest, my shoulders, both arms, my entire back, and up my legs including my thighs and hips. It spared my hands, feet, neck, and face. But it was literally EVERYWHERE else. It was almost unbearable and looked absolutely disgusting. I took cold showers because that was supposed to help. It didn’t. I would get in the shower, hit the rash over and over (because I knew if I itched it, I would scar), and sobbed. I put lotion all over my body several times a day. It was unrelenting. I wouldn’t wish this on my worst enemy. I was getting tired, I couldn’t really get comfortable, and I felt like I wanted to rip my skin off. And then the sinus and ear infections began. I just kept getting sick, and I’m rarely sick. I woke up one night and thought my left ear drum was going to rupture. I went downstairs at 2am, cut open a piece of garlic, wrapped it in a tissue and placed it in my ear (not in the canal, just inside). Then I rubbed lavender essential oil around the outside of my ear and down my neck. I swallowed and swallowed and about an hour later, my ear finally popped. At least I knew it wouldn’t rupture that night and I got myself to the doctor the next day. As soon as I finished my antibiotics 10 days later, I could feel the infection coming back. The PUPPs rash continued to get worse. I was having ultrasounds every other week to make sure the babies each still had enough fluid (we had to rule out Twin-to-twin transfusion syndrome over and over) , as well as weekly non-stress tests and weekly OB visits. So many appointments; thank goodness I had finished up at work. I was 36 weeks pregnant. I wasn’t yet dilated. The babies were doing fine. But my body was just done.
I had a day scheduled to be induced, April 18th, 2017. I would be 37 weeks pregnant. My parents came into town and I was told that I would be called to come in “after dinner.” Well, “after dinner” happened, and hours “after dinner” happened, and still no call. So, being antsy and anxious, I said good night to my 4-year-old, reminded him that I was going to the hospital to have the babies while he was sleeping, and called the hospital about 8pm. The nurse told me they literally had no space for me and they would call me when they did. There’s no word for all the emotions that came over me at that point, and where my brain went. My high risk OB said I had to be induced that week and the only OB I really trusted to deliver these babies started his 24 hour shift soon. I NEEDED him to deliver those babies, and since I wasn’t even dilated and tend to have longer labors, I NEEDED to get into that hospital to get started. By 9pm, I still hadn’t received a call, and I was getting pretty upset. I know they had no room and I wasn’t technically an emergency case, but I had gotten myself all revved up to be induced that night and someone was telling me it wasn’t going to happen. When I called again, the nurse said there probably wouldn’t be space tonight. I almost went off the deep end. She asked if there was a cutoff time when I wouldn’t want to be called to come in. I told her, “Not a chance. If it’s 2am and you have room, you need to call me to come in.” Well, someone was looking out for me that night and about 30 minutes later, they told me to come in for 11pm. THANK GOODNESS! I sent my husband to go take a nap and told him I’d wake him in an hour so that we could go. I got myself mentally prepared, hung out with my parents, and an hour later got my husband up. We drove to the hospital and I checked in. It’s funny. I’ve had two pregnancies and never once had the experience of rushing to the hospital like all my friends have told me about. I guess that’s a good thing?
When I got to my room, the nurse and the resident explained to me what was going to happen in order to induce me. They checked the babies and found both of them in the head-down position. Thank goodness, because Twin B enjoyed flipping breach several times over the past few weeks. I allowed the med student to do the ultrasound and the dude had no clue what he was doing. Both the resident and I had to tell him to push down harder. I almost grabbed his hand and showed him what to do. It was a bit of comic relief on an otherwise stressful night. There are many different ways to be induced, but I had the type where they insert a big long tape-like thing into the cervix (it’s called Cervadil) to dilate it. They explained that it stays inserted for 12 hours and if my body hasn’t gone into labor I would be given Pitocin. I’d had Pitocin with no epidural with my son and that medicine is kind of evil. Labor is so intense with Pitocin, and if I could avoid it this time around, I would like to. Around midnight, the doctor inserted the Cervadil (man that’s a weird feeling!), and once that was done, I set up my diffuser (with Eucalypus and Thieves to help me breathe better amidst my sinus and ear infections that had returned), settled in for the night and told my husband it was ok to go and be home with our son for the night. He had school the next day and it was important for my husband to be there with him, especially when he woke up in the morning.
That was a long night. I was having fairly intense cramps that did not let up the entire night. I felt like they were labor pains, but because they didn’t stop and it was constant pain, I was unable to fall asleep. Around 9am, I texted my husband to see when he was coming back. He arrived a bit later and the doctors removed the Cervadil around noon. When the Cervadil was removed, I was able get up, get in the shower, and walk around a bit without the monitors on. My labor had started and was progressing, so we got to hold off on the Pitocin for a while. I was able to take the monitors off for a few minutes at a time, which was great because I had three of them on…one for each baby and one for me.
A lot of the day is a little blurry, but several hours later, a nurse came in and asked me if I would be wanting any pain medication. I didn’t have any pain meds with my son, and wasn’t totally opposed to pain medication with the twins because I’d had the med-free labor already, and also I was about to push out TWO BABIES. That’s two babies, out of a tiny hole, one after the other. Nothing to shake a stick at. When I said I was on the fence about the epidural, she told me that if I delivered the first baby and then it happened that an emergency c-section had to be done to get the second baby out, if I didn’t have an epidural that I would need to be put under general anesthesia. I would be asleep and my husband would have to leave the room while they delivered Twin B. I wasn’t about to have the potential of missing my second baby born, so I decided to go with the epidural. I was still confident that I would be able to deliver both of my babies vaginally, but I didn’t want to take the risk of missing it. And not only me missing it, but not having any of her parents there when she was born was not something I wanted to have happen.
A little while later, the anesthesiologist came in. I sat on the edge of the bed, and leaned on the nurse. She made my husband sit behind her so as not to pass out from watching the procedure. He did say he caught a glimpse of the needle though, and told me (much later) how big it had been. The procedure was relatively easy and it is absolutely amazing how well it worked. My OB came in a little later and said that since the epidural was in place, that he wanted to break Twin A’s water. My labor was progressing, but I was halted at about 4-5cm for the past few hours. It was after 8pm by then and none of us thought I’d be delivering these babies that night. I’d never had my water artificially broken before (my water had broken at home when I went into labor with my son before I was even having any contractions). He took out a long hook-like gadget, verified Twin A was on the left, and I heard that all too familiar pop that I remembered so well from 4.5 years earlier. I hadn’t had any sleep (or even meaningful rest) for over 24 hours, since the nap I took the afternoon I knew I would be going to the hospital. I was able to lay down for a couple of hours and just had some quiet time. I may have even fallen asleep. When I opened my eyes and looked at the monitor, I was astonished. I was having frequent contractions and from what it looked like on the monitor, I was in transition. How glad I was that I had accepted that epidural! My doctor also must have seen what was going on on the monitor, because he came in shortly thereafter and wanted to check me. I was 9cm! I had progressed a full 5 cm over two hours…all because I could finally get some rest! He said he’d be back in in about 30 minutes and we’d move to the operating room.
For the past few hours, hospital staff had been coming into my labor room and taking out equipment to bring to the OR: baby warmers, bassinets, etc. Is anyone wondering why I’m talking about going to the OR to deliver the twins when I was planning on having them vaginally? It’s standard protocol that when delivering multiples, even if they are most likely going to be delivered vaginally, that they be delivered in the operating room in case there needs to be an emergency c-section for one or both of the babies.
About 10 minutes after my OB left the room saying he would be back in 30 minutes, I realized I wasn’t going to make it another 30 minutes. I told my husband he had to go find the OB right now, that I could pretty much feel the baby’s head and I needed to push. The OB came in right away and they wheeled me into the OR. Then came the fun part. They said, “Ok, scoot on over to the stretcher.” WHAT?!? I had to move myself from my labor bed to the OR bed pregnant with twins, in very active labor, also trying to hold in the first baby so she didn’t shoot out of me and onto the floor? Sure, I’ll get right on that. Truth be told, they did help me a little, but it was pretty much all me…3 monitors, bag of fluids, bag of Pitocin, bag of antibiotics (because oh yeah, I also was diagnosed with Group B strep at 8 weeks pregnant so I had to be on 4 rounds of antibiotics throughout my labor), and the cords from the epidural. And yeah, the epidural had left my left side pretty much completely numb…made it super easy to move over under my own power. It was almost 11pm by this point. Maybe I would have these babies tonight after all!
(Stay tuned for Part II!)