the birth story

I hope I can remember the details!

I think the early stages of labor actually started on May 10th.  I could be grasping at straws but looking back at things I can piece together certain oddities that would be indicative of early labor.  Kara and I had an appointment with our lawyer on this day and the appointment did not even wear me out.  I also woke up feeling really great and realized that my contractions were almost nonexistent.  However, I noticed that the boys were being super inactive.  I got a bit worried and spent most of the day poking and prodding my stomach to make certain I still felt some movement.  I now think the boys were resting up in anticipation of labor.

I got up the morning of May 11th and when I went to the bathroom I lost my mucous plug.  It worried me a bit but I knew that this rarely meant that labor was imminent.  I sent a message to my good friend and she also reassured me that while labor could be only a few hours away it was more than likely still days or weeks away.  I knew I would have to start dilating at some point and I would lose my mucous plug as a result.  I still felt really great this day.  My contractions were minimal.  I did get a crazy nesting instinct too.  I jokingly mentioned to Kara several times this day that I thought the boys would be born this weekend.  She took me seriously and she also went into nesting and cleaning mode around the house.  Thank goodness for that decision.  Our cat Monroe got sick during the day and needed to go to the vet in the evening.  The last thing I needed to do was make a trip to the vet but the cat was really sick and Kara had to work that evening.  I asked my Dad to come over and take us all to the vet so that I wouldn't have to do too much work.  The vet took a long time but for the most part I was not tired or having any contractions.  The vet tech even jokingly said, "If we had you wait any longer you would have gone into labor." ... Oh how true that statement would become in just a few short hours.  I went to bed that even feeling rather good and I was only having sporadic contractions.  I did take some Procardia prior to going to the vet because I did not want to get contractions.  I beat myself up for leaving the house to go to the vet but I do not think in the long run that decision would have changed what was about to happen.

The early morning of May 12th I woke-up to some contractions around 1:00 am.  I went to the bathroom and noticed that I was losing some more of my mucous plug.  I decided to sit down in the chair and time my contractions.  They were sporadic at best.  The contractions came at 10 minutes, 15 minutes, 10 minutes, 6 minutes and 10 minutes apart.  They also did not feel any different to me.  I decided to go back to bed around 2:00 am.  At exactly 2:50 am I woke-up to a painful contraction.  This has happened before.  However, during the contraction I felt a pop and my heart just stopped.  I knew my water had broken.  I did not feel any fluid during the contraction though so I just laid in bed and waited for the contraction to end.  As soon as the contraction ended I felt a huge gush of water.  I was facing Kara in bed at the moment and as quick as I could possibly move I slapped her on the back and yelled "My water just broke" as I hightailed it out of bed and into the bathroom.  I was in shock.  I was going to give birth to the boys today!

Kara immediately went into overdrive.  I would like to pretend that we both remained calm but that is the farthest thing from the truth.  We both panicked.  It was just like the movies.  I yelled for Kara to bring me my phone so that I could call the OB.  I was sitting on the toilet the entire time because my water was leaking like crazy.  There was no way I could move without making a mess.  I called the OB while Kara took the dogs outside to go to the bathroom and to also start loading up the car (and covering the front seat).  It took me six tries to successfully call the OB.  Yep!  That's right.  No panic on my end.  How about I did not have my OBs number in my telephone?  We recently got new phones and I worked hard to make certain I had every phone number I would ever need in my contact list for when I went into labor.  How the heck did I forget to put the OBs phone number in the contact list?  Fail #1.  I looked up the number and proceeded to make the call.  I had to enter my return phone number and I was so nervous and shaking so bad that I kept entering the wrong number.  I would have to hang-up and dial again each time.  Oye!!   I finally left the following message, "This is Mary H and I am 34 weeks pregnant with twins.  My water just broke.  I am absolutely certain.  We are going to the hospital.  Please call me back."  I then proceeded to hang-up and call my parents.  Interestingly enough my mother told me later that she had woken-up at 2:50am for no particular reason so she was awake when the phone rang around 3:00am.  My dad answered the phone and all I said was, "My water broke.   Let me talk to Mom."  I then asked her how the heck I was suppose to get from the bathroom to the hospital when I was continuously leaking fluid.  She basically told me to suck it up and make a run for it!!  I received a call back from the OB on call while I was on the phone with my parents.  That was fast.  The conversation went as follows ...

OB: "This is Dr. Underwood.  I received your message."
Me: "Thanks for calling me back."  (Great response Mary!)
OB: "Who is your OB?"
Me: "Dr. C."
OB: "And do you know how the twins are positioned."
Me:  "They were both head down as of last Tuesday."
OB: "Awesome! I will meet you at the hospital."  (I think I made his day.)

I also noticed that the fluid I was leaking was quite bloody.  This made me nervous and feel a bit uneducated as I thought I had read everything I needed to know about labor but for the life of me could not figure out if the bloody fluid was normal.  But because I did not have to pull out the pregnancy guide I tried to ignore it and kept moving forward.  In the meantime Kara had finished getting everything together and so I sucked it up and but on a big pad and some jogging pants and said a little prayer to the pregnancy Gods that I would not ruin the front seat of our new car.  I remember pulling out of the garage and I said aloud to Kara, "I will not be pregnant when I return home."  That's when the reality of the situation hit me.  Our boys were coming and there was nothing I could do to stop it from happening this time around.

I managed to make it to the hospital without soaking through my pants!  We made our way to L & D (on the 2nd floor) and proceeded to get all checked-in.  It is great to go into labor in the middle of the night because there is no waiting in line.  I remember I was terrified of leaking all over the chair they had in the lobby for the mommas to sit on while signing the paperwork but eventually I just gave in to the contractions and had to sit down to rest for a moment.  I managed to not get anything on the chair!  We got escorted to our triage room and got all situated.  The nurse put the babies on the monitors (they looked great) and also put the contraction monitor on my stomach.  I was having contractions which definitely felt different (the contractions were low in my belly and more like menstrual cramps) but the pain was not unbearable by any means.  I think I was contracting every five to ten minutes.  The nurse asked me a bazillion questions.  I remember getting frustrated because the nurse was speaking very quietly and I had to keep asking her to repeat herself over and over again.  The nurse checked to see if my water had broken.  Duh?  No question there.  The resident on call then came into the room to do a quick u/s to check on the position of the boys.  Both were still head down!  I could not believe it.  So I then got my first cervical check of the evening ... OMG ... that was the most painful part of the entire experience.  I swear the nurse was trying to reach my tonsils.  I was already dilated to about 4 cm so ... it was time!!!

A shot of me while in triage ... It's baby time!

We quickly got admitted to the hospital and transported to our L&D room.  They made me walk to the L&D room and I remember looking at the nurse going ... "Huh?" ... I was leaking fluid everywhere.  I did not know this at the time but I guess your body continues to replenish the fluid over and over again so you really never stop leaking fluid.  The nurse gave me a towel to shove between my legs and then I hobbled over to the L&D room.  I made a quick bathroom trip when I got to the room and then hopped up into bed for the duration of the delivery.  I laughed because when I walked into the L&D room there was a dry erase board on the wall with the following ... Birth Plan:  Twins & Epidural.  Yep.  That sounds about right!  The nurse got me all set up on the monitors ... I was attached to a bazillion machines.  I had the BP monitor (it went off every five minutes), a pulse oximeter, the monitors for each boy, and a contraction monitor.  The nurse started my IV.  It took two tries but she did a great job.  I was fairly dehydrated because I went into labor in the middle of the night.  She eventually got the IV started in my hand.  They started me on fluids and then to my disappointment the nurse started me on penicillin via the IV because the hospital did not have the results of my GBS test ... How do you not have the results when I took the test at this hospital??.  Do you know how much penicillin burns when entering your bloodstream.  The nurse even said, "That will be worse than delivery."  It was.  Once I got all set-up I was asked if I was ready for an epidural.  I was shocked!  Of course I was ready for an epidural.  The best part was my contractions were not even all that bad.  Sure they were painful but I was still able to breath through each contraction.  But because I was already about 4 cm dilated it was prime time for the epidural.  It only took about five minutes for the anesthesiologist to enter the room.  This is when I got nervous for the first time ...

 The anesthesiologist was very nice.  I was trying to crack jokes to keep me relaxed and the anesthesiologist played right along with me.  They made Kara sit in a chair in front of me during the epidural.  I think they were afraid she would pass out.  The nurse had me sit very far off the side of the bed and I was terrified that I was going to have a contraction during the epidural and fall right off of the bed.  I mentioned to the nurse, "I'm afraid you are going to drop me." and the anesthesiologist responded with, "Nah.  We won't drop you.  Although we did drop two patients the last hour."  The epidural itself was not all that bad.  I think the anticipation of the unknown worried me the most.  The worst part was the injection to numb my back.  Otherwise all I could feel was pressure.  It only took about five minutes.  And I did not have any contractions that I can remember during the epidural.  It only took about 30 minutes for the epidural to fully go into effect.  I was really nervous about the epidural failing to work but for the remainder of my labor I never felt a contraction.  I only felt pressure.

The new nurse came on duty at this point.  Her name was Jen and she would be the one to see me through the rest of my delivery.  She was amazing.  She was also excited because she had not been at a twin delivery since she began working on the L&D floor over a year ago.  I was glad to have made her day!

Once the epidural went into effect the nurse checked on the progress of my dilation and put in a catheter because I would no longer be able to get up to use the restroom.  The catheter was pulled right before delivery.  It is so much easier to get a cervix check and have a catheter placed after you have had an epidural.  No problem!  I was about 6 cm dilated at this point.  Things get a bit fuzzy at this point.  So some of my sequence may be out of line.  I'm not even sure what time it was at this point.  I remember the OB coming to the room to visit at some point.  I think around the time I was 7 cm (I remember the nurse indicating the OB would be called in at 7 cm) because he was afraid I would dilate super fast once I hit 7 cm.  He was really impressed that my labor was progressing at such a great speed and at this point my body had not needed any medication to cause me to have contractions.  The contractions would actually come back to haunt me in a few hours.  I guess often times even though your water breaks your body will not go into labor and as a result you would need medication to encourage the contractions.  I also got a second round of penicillin at some point.  I think around 9:30am.  This was once again a very painful experience.  I thought my arm would fall off.  This time the nurse slowed down the flow of the penicillin and also flushed some fluid through the IV to reduce the pain.  Otherwise I spent the next couple of hours just laboring.  I dealt with nausea quite a bit during the entire process but I never threw-up until I was actually pushing Baby B out.  The nausea was worse when I was laying on my back so I spent most of the time laying on my left side.  I tried my right side on occasion but the boys did not like that side and both would fall off of the monitors.  I nibbled on ice chips like they were going out of style (this would be important later) and I also had a Popsicle.  I got excited because they had banana Popsicles to eat!  It's the little things. I also had the shakes very bad off and on.  The nurse indicated the shakes were just caused by rapid changes in my hormone levels.  The nurse also indicated that the shakes can be intensified by adrenaline and also be around during the transition stages of labor.  I know the nurse continued to check my progress on occasion and within only about an hour I had reached almost 10 cm (or so we thought).  The nurse got excited and announced that it would soon be time to push these babies out!  But then things slowed down ... way down.  I think it was about 10am at this point.  The nurse had the OR prepared for the delivery because we thought I would be making my way down to deliver within only minutes.  I even told Kara to grab a snack real quick because it might be a while before she could eat again.  The nurse requested that the delivery room (the OR) be prepared for delivery.  The nurse wanted me to try a couple of practice pushes in the L&D room just to get the hang of things before heading to the OR.  I was so nervous.  I tried one round of pushing and I could instantly tell that my body was not ready for delivery.  The nurse could immediately tell that too.  She had previously called the OB to tell him to head over to the hospital for delivery (he was at his office doing paperwork) but she immediately called him back to tell him that Baby A was still high in the birth canal and there was a small part of my cervix that still needed to dilate.  But the OB actually came into the room a few minutes later and requested that I spend some time "laboring down".  Basically this meant allowing my body to naturally push Baby A lower into the birth canal without actually doing any pushing on my own.  The nurse had me labor down by turning me on my left side and putting my right leg up in a stirrup.  I think this gave more room in my pelvis to get Baby A to start making his way to the light!   Haha.

A shot of me "laboring down" ... I'm still smiling at this point because the pressure to push has yet to arrive.

See my death grip on the bed rail.  I asked the nurse if anyone had ever ripped the rails off the side of the bed!

I remained in this position until about 11:30 am or Noon.  The nurse ran to lunch real quick and I remember I was suddenly getting a real urge to push with each contraction.  It became very difficult to fight the urge to push.  I could finally tell the difference in the pressure amounts.  It was just my mom and Kara in the room at this point and with each contraction I would say, "The nurse better eat fast!"  I was all but begging for the nurse to return to the room.  When she did walk in the door (only about 20 minutes later) I remember going, "Oh Thank Goodness.  I have to push.  Please check me."  The nurse did a quick check and said that it was time to try doing a few more practice pushes to see what happens.  This is where things start to get super, super blurry.  I don't know how many times I pushed in the L&D room.  I do know that Kara was holding one leg and my mom was holding the other leg.  Eventually the OB came into the room to see how I was doing.  Suddenly the room became super chaotic.  I was having too many contractions.  I wish I could say this was a shocker but of course I was not surprised.  I have been having contractions my entire pregnancy.  My uterus knows all about contractions.  I guess Baby A's heart rate was dropping significantly during each contraction because of the stress.  So suddenly I was back to laying on my side.  I was also shaking really bad and just felt super out of control.  They put oxygen on my face.  And the OB gave me some Terbutaline via the IV to slow down the contractions.  I remember the nurse saying it was time to go the OR.  My mom came over to give me a kiss and wish me good luck and I remember seeing Kara with the nurse in the corner of the room putting on scrubs.  It was then off to the OR.  Doesn't she look cute??  My mom took this picture after I left for the OR.  Kara was waiting for the nurse to come and get her for the delivery.

The trip to the OR was a blur.  I remember pulling the oxygen mask off my face a couple of times because it was bothering me.  And each time I would pull it off a nurse would jam it right back onto my face.  I was a bit out of it.  I remember getting wheeled into a room of about 20 people and each and everyone of them was looking at me.  I wanted to be like, "Hi.  Sorry to keep you guys waiting so long.  Let the party begin."  The nurses / and surgical techs transferred me from the bed to an OR table.  I remember all the blankets being taken off of me and my feet were put in these scary big boot stirrups.  Nothing like a room full of people staring at a naked pregnant woman!  The big boot stirrups ... so comfortable.  I actually think they made pushing a bit easier.  My feet couldn't move in the so it gave me something to push against.  I was then covered in about a hundred paper sheets and staring back into the face of the OB and three residents.  I remember the OB going, "The residents don't get to see too many vaginal twin births.  Do you mind if they stay?"  ... Um?  Did I have a choice??  The more the merrier.  Everyone has seen me naked at this point.  I remember getting concerned because I had not felt the pressure to push for several minutes.  I said to the OB, "I don't think I am having any contractions."  I was in fact still having contractions but the Terbutaline had spaced them out to about every three or four minutes.  I also got nervous because Kara was not in the room but only a few minutes later she appeared by my side.  She was a superstar the entire delivery.  She couldn't hold my hand because I was grabbing my legs to push but she kept her hand on my shoulder the entire time and kept telling me, "Good Job."  And even better ... she never passed out!

It was now time to push.  I had Kara on one side and my L&D nurse on the other side of me.  I told my L&D nurse each time I would "feel" a contraction.  She would then check the monitor and tell me to wait a few seconds into each contraction before I actually pushed.  I would push for ten seconds three times through each contraction.  Let me tell you ... This was the hardest thing I have ever done.  And most of my pushing is a complete blur.  I kept my eyes closed most of the time to block out some of the distractions.  There are several things I remember ...

• I was so thirsty.  I asked on multiple occasions about when I could get something to drink.  My L&D nurse repeated each time, "You can have whatever you want to eat or drink once you push these babies out."

• I could smell the gum my L&D nurse was chopping on behind her mask.  It made me realize that I had not brushed my teeth since the night before.  Then I got paranoid that my breath stunk.  Yep.  Just leave it to me to be paranoid about my breath as I laying stark naked in a room full of 30 people.  Even though every one else in the room had a mask on and could not smell my breath.  And then I worried because I never put deodorant on before I left the house.  

• I kept repeating, "I have to do this again?" to both Kara and my L&D nurse.

• I remember the OB was a great cheerleader.  He was completely calm and collected and would also encourage me through each push.

• And for my readers who may have stumbled upon this blog and are currently pregnant and waiting to give birth for the first time.  You will poop when you push out the baby.  It happens.  It means you are doing a great job pushing.  You will not care the least bit!  In fact, you will be able to have a conversation with your OB in between contractions as the poop is still coming out of you!!

• I remember the OB got a page during the pushing process and I watched as he went over to the corner to return a phone call.  A scrub tech was holding the phone against his ear as he talked on the phone.  I remember thinking, "I feel like I'm on the set of Gray's Anatomy."

So I kept pushing and pushing and pushing and pushing.  I was exhausted and I felt like we were not making any progress. You have to remember that I had been on bedrest for two months.  I had next to zero stamina coming into this process.  Eventually I remember silently begging Baby A to come out.  I never made any noises.  I swore up and down I would not be the screaming pregnant lady.  There was no shouting (except on the final push with Baby B).  I would just close my eyes and push while silently yelling at myself to get these babies out.  I'm not sure how long I pushed but the OB knew I was getting tired.  It had been at least an hour.  He was afraid that I was going to end up with a c-section.  The OB eventually indicated that on the next push they were going to use the vacuum extractor to help me out.   I did not have the energy to fight back.  Does that make me a bad mom?  Perhaps.  But at that point I just needed my boys to be on the outside.  The next several pushes were very scary.  I could hear (and feel) the vacuum extractor get placed over Baby A's head but the worst part was that no matter how hard I pushed the vacuum extractor kept popping off Baby A's head.  I felt horrible.  And then finally Baby A's head just pushed through and out came Jakob Daniel at 1:01 pm.  

He was crying up a storm.  I felt sudden relief!!  They rushed Jakob over to the NICU team.  Kara immediately followed Jakob and I did my best to sneak a peek of my baby boy but could not really see anything from where I was on the operating room table.  The next several minutes were a blur.  Kara came back over and told me that Jakob was perfect with ten fingers and ten toes and that while he was having some trouble breathing he was doing great overall.  I heard the OB go, "Mary you need to push now." and for some reason or the other I did not think Baby B would be arriving so soon.  I gave a half push and then it dawned on me that I might be trying to push out Baby B.  I said to the OB, "Am I trying to push out a baby?"  ... Yeah.  He just looked at me like I was dumb.  So I turned my attention back to Baby B.  The L&D nurse was moving the monitors around on my belly to track Baby B as he descended lower into my uterus.  The OB was crawling around inside my uterus with his hand to make certain that Baby B did not turn while making his way out.  Nice?  Huh?

Let's just say that Jakob opened up the pathway for Baby B to follow!!  The OB still had to use the vacuum extractor on Baby B but only on a couple of pushes.  I only pushed through one or two more contractions before Baby B came out.  I do remember thinking that I did not have anymore pushes left in me.  On my very last contraction I finally did the pregnant lady scream.  I was just at my breaking point.  But out came Alexander Robert at 1:14pm.  He did not cry immediately but within a few seconds I heard the sweet sound of tears from Alex.

So we have learned with the whole twin delivery ... sometimes you only get one set of pictures.  We do not have any pictures of Alex immediately after delivery because Kara actually got to go around the other side this time around and cut the umbilical cord.  That was exciting.  But it meant there was no one to take pictures.  Sorry Alex!

The next several minutes were spent with Kara moving back and forth between the boys to get pictures and to get updates from the NICU team.  I eventually got to give each boy a quick kiss ...

Meeting Jakob Daniel ...

Meeting Alexander Robert ...

My OB was busy working on getting me cleaned-up from delivery.  I fortunately did not have too much bleeding immediately after delivery.  Unbeknownst to me at the time my bleeding issues came during delivery.  I noticed my OB was concerned with getting my bleeding under control immediately after delivery but did not understand why until the next day.  Fortunately my uterus cooperated and after only one dose of Pitocin my OB was able to start putting in the stitches ... I was nervous about this part.  I'm not sure why I thought I would be able to feel the stitches but I remember getting a bit panicked.  At this point Kara followed the boys up to the NICU. We had determined prior to delivery that Kara would be with the boys at all times.  I would be fine.  Plus I knew my mom would be back in my recovery room to help me out.  I had a second degree tear (thanks Jakob) that needed a few layers of stitches.  I could feel some poking and pulling but otherwise I was not in any pain.  Once all the repair work was done the OB came up to talk for a few minutes.  The nurses finished getting me all cleaned-up.  I was shaking so BAD.  It was crazy.  I had zero control over my body.  My L&D nurse had to eventually move my BP monitor and pulse oximeter to my leg and toe because my arms were shaking so bad.  Once I was all cleaned up I got moved back to the gurney for my trip back to the L&D room for a brief recovery period.  I remember my L&D nurse telling the others helping me move over to the gurney that I weighed even less now and to be careful moving me over.  It was then that I looked down at my belly for the first time and realized the boys were gone.  It was a weird feeling.

We got back to the L&D room and my parents were waiting for us.  This was the first time I started to cry.  It doesn't matter if you are three years old or thirty years old ... if you have been in a stressful or scary situation you tend to cry when you see your mother.  I don't remember a whole lot about the recovery period.  I know the nurse kept checking my uterus about every fifteen minutes.  I remember asking about pumping for the boys.  I knew that I needed to start pumping within a couple hours of delivery.  The nurse said they would help me pump as soon as we got up to my new room.  The nurse put in a straight catheter at some point to let me go to the bathroom.  And then I was unhooked from all the monitors and IVs.  That was awesome.  I thought I would be connected to something in the long run but because I had a vaginal birth I was unhooked during the recovery process.  I got to put on a clean gown and those sexy mesh underwear which I would come to love in the next few days.  It was funny because they could not find a pair of mesh underwear small enough for me so the nurse had to tie a knot in the pair I was wearing.  Some comment was made about my underwear being styled like the shirt ties from the the 90s.  See ... I remember random things.  At some point Kara came back down from the NICU with an update and pictures of the boys.

Alexander Robert ...

Jakob Daniel ...

I was so excited to see them.  We had my parents come back into the room and we started the announcement process.  I wanted Kara to be the one to tell my parents the names we had chosen for the boys.  Jakob Daniel was named after his mother, Kara.  This explains the "K" in Jakob and we chose Kara's last name to be Jakob's middle name.  Alexander Robert is named after my father, Robert.  There is no significance to the first name other than the fact that Kara and I both like "Alex".  My dad started to cry when we announced the names and of course I lost it again.  I'm so glad we were able to give Alex the middle name of one of the greatest men I know in my life.  It was at this point that other phone calls were made and text messages were sent.

I was eventually moved to the mother and infant floor.  I was told that I could go and see the boys after my epidural wore off and I got up to go to the bathroom.  This took about four agonizing hours.  And even when I was able to get up and go to the bathroom I had no success peeing.  I was shaking so bad and was getting super frustrated because all I wanted to do was go and see the boys.  Eventually the nurse understood my frustration and simply said, "You owe me a pee."  It was time to go see the boys ...

I was immediately overwhelmed at the craziness of the NICU.  It happened to be a busy day.  But as soon as I saw the boys I had tunnel vision and could see nothing but my beautiful boys.

A few pictures of me meeting the boys.

Jakob Daniel

And Alexander Robert ...

The boys are now home.

We got to bring Alexander Robert home on May 20th after an eight day stay in the NICU.

We got to bring Jakob Daniel home on May 24th after a twelve day stay in the NICU.

We feel so blessed at the moment.

Our lives are beyond chaotic but when I look into the eyes of my boys my world completely feels perfect.

I'm not sure about the future of this blog.  I wanted a place to document our journey to bringing our children into the world.  I told Kara the other day that I feel as if the day we brought both boys home from the hospital was the conclusion of one journey and the start of another journey.  This journey is complete.  And both boys will one day get to read all about it.  And for that I am grateful.

Welcome Home Jakob Daniel and Alexander Robert!

Mary