Birth Story

Katie’s Vaginal and Inverted-T Twin Birth

Didn’t see that coming…

When I sat in the dark in my bedroom at 4:30 am holding the positive pregnancy test 6 months after the birth of my first son, I cried tears of fear. I knew it. I had been so tired for no reason. I wanted a lot of kids but not this close together. I showed my husband who immediately found joy in the situation and gave me reassurance. After all, our first birth was literally perfect. I went into spontaneous labor with Tim in the very early morning at 40 weeks and 1 day. My mom was with me and a natural birth pro having birthed all 5 of us unmedicated. She made the call when it was time to get to the hospital. After 2 hours of surprisingly peaceful active labor, I pushed for four minutes and met the most beautiful little boy I’d ever seen. I felt like superwoman. The first 6 months with Timmy were absolute bliss. So I started focusing on the good. Maybe this next one will be a girl, and they will have an amazingly close relationship like my brother and I do who were born just a year apart. Or maybe it will be a brother, and they’ll feel like twins.

I waited as patiently as possible until that 8 week appointment and first ultrasound. The early symptoms were exactly the same as the first time around, but they came sooner and seemed more intense. I told my husband Frank half-jokingly that it’s probably twin boys. As I laid on the table waiting to catch my first glimpse of the newest member of our family, I saw it right away. She didn’t have to tell me. Two sacs, two babies. “Oh my God. Oh my God. Oh my God.” I couldn’t formulate any other words. I had just recently come to terms with the situation. I never wanted twins. Every time anyone would ever say they wish they would have twins, I always thought they were crazy. I also hate pregnancy in general even though I love babies. This is going to be miserable. And it was miserable, but it was completely complication-free which I was very thankful for. At our 20 week ultrasound, we found out that we are really good at making little boys. Three boys under 2? At this point the insanity of the situation was almost comical, and the fear had turned to determination. I’m going to birth these babies like a champion and be supermom.

D-Day

At 34 weeks and 5 days, it was a supermoon. It was 3 days after my last OBGYN appointment where my cervical check revealed that I was not dilated at all. That day had been unremarkable. I went to bed at my normal time. At 1 a.m. I woke up with what felt like a very dull period cramp. I told myself that it was weird, but the boys are probably just having a growth spurt or readjusting. I tried to go back to sleep. About 15 minutes later, another cramp. I never felt period-like cramps during pregnancy before, but I knew other women had described contractions that way. I waited again. Another cramp. I decided to get in the bathtub to see if the hot water would relax my uterus. Nope. I was still cramping every 10-15 minutes, but they were still not painful. I woke Frank up. He tends to be much more anxious than me. He wanted to call the nurse hotline. The nurses weren’t sure if there was anything to be concerned about, but decided that because I was having twins, that we’d better be safe than sorry. Dang it. My mom’s not here yet (she lives in another state). Let’s call our doula team and see if one of them can stay with Tim. Of course, one of them had a birthday that night and turned her phone off. The other one said she’d meet us at the hospital. Frank woke Tim up as I quickly gathered up a hospital bag and got down to the car.

I was annoyed. This is probably going to be nothing and now Tim’s going to be fussy tomorrow. As soon as I got settled in the front seat – boom. Holy crap. I feel like I’m in transition. “Sweetie. You need to drive fast.” When I lose my cool, he definitely loses his. He booked it. We only live 15 minutes away from the hospital. I got out of the car and had to sit on the ground through a contraction before being wheeled in. They made me sign a bunch of forms. I told them the babies are coming. They acted like I was overreacting and got me back to triage to do a cervical check. The nurse tells me I’m completely closed. I told her I was not. I just did this 15 months ago. I am not closed. The second nurse said I was closed. I told her I’m going to push this first baby out soon. They brought in the big guns. The third nurse looked like a labor and delivery veteran of war. This lady was probably the oldest woman on the floor, and she did not look like she had time for anyone’s crap. “She’s complete.” The matriarch had spoken. Total panic set in. They plopped me in a wheel chair, sat me outside an OR (the doctor wanted me to labor in the OR just in case), had a nurse take Tim from Frank, and scrambled to get everything ready. My doula was yelling at people to move faster because I was desperate to push. Finally, everything was in place. I got up on the table, and the doctor did a quick ultrasound to make sure the first baby was head down. “Yep we’re good! I’m going to break your water. Go ahead and push when you’re ready.” My doula paused and asked if I was ok with them breaking my water. I said that was fine. They did that with Tim when he was coming out too. So she did. I pushed, and at 2:26 a.m. out popped Danny. The doctor says “oh wow he was breech.” What? I just birthed a breech baby in one push? But they just said he was head down. The first thing I asked was “is he ok?” The nurse said “do you hear those lungs?” He was screaming like a banshee. He still has a serious set of pipes on him to this day! They wrapped him up and showed him to me, but I had more work to do, and they wanted to make sure everything else was healthy. So away he went. I was feeling good. Let’s get this second one out.

At my last appointment, we had just talked about how a vaginal twin birth generally goes. The doctor had said that if the second twin is breech, she’ll go ahead and attempt a breech extraction. I was happy that she was so willing to help me do this all vaginally. So she broke my water to begin the breech extraction. “I can’t grab his legs.” She tried again. “He seems to have turned transverse, and I’m having trouble finding his legs.” The second doctor in the room tries. She can’t get him. My doctor tries again. Nothing. I’m not exactly sure how many attempts were made, but it was starting to become clear that this was not happening. So then my doctor relatively calmly says, “He just doesn’t seem to want to turn, there is a lot of blood, and we can’t find his heart rate. We really recommend a c-section at this point.” In my head I thought, “NO!!! Ugh are you serious? This totally stinks. Now I’m going to have this stupid scar and a crappy recovery.” But I said, “well I don’t really see any other option I guess. Let’s go ahead.” The anesthesiologist appeared out of nowhere with an oxygen mask in hand. He introduced himself (I don’t remember his name to this day), and then everything went dark.

The ”Recovery”

I woke up to beeping sounds and pain in my throat like I had swallowed a cactus. “Where’s my baby?” “He’s ok. They’re both in the NICU for monitoring.” “My throat hurts.” That’s all I remember from the OR recovery room. I woke up again in the maternity wing in a room that looked identical to the one I’d labored in 15 months earlier. But instead of feeling like superwoman, I felt like I had been hit by a train. But my babies were out and supposedly in good condition, and eventually I’d get through this recovery. The nurses popped in and out doing what they do. They wanted me up and walking around as soon as I could manage it. We tried the first time, and I couldn’t even get out of bed with support I was so light-headed. We tried again later, but a big gush of blood came out vaginally, and I almost passed out again. I just wanted to see my babies. I hadn’t met Nicholas. Someone get my baby. They told me not to worry. If I can’t get up and walk around soon, they’ll wheel my bed up to the NICU. My doctor came in at some point that day to check on me. I don’t remember anything she said except for one thing, “He was stuck, so I had to do a second vertical incision. It’s called an inverse T incision. If you want to have more children, they’ll have to be c-sections.” I couldn’t even process what she said at the time, but I do know I told her that I was very upset about that.

At some point the following day, I was finally able to stand up long enough to be put into a wheelchair so I could see my boys. They were so small. Danny looked like me, Nicky looked like my husband. Polar opposites. I could barely hold them let alone attempt to breastfeed because of the pain. For the next couple of days, I was in writhing pain from my lower abdomen up through my shoulders. I couldn’t sleep. Pain meds don’t tend to work on me. I had an absolutely lovely nurse also named Katie who felt so much pity for me even though I rang for her probably 10 times a night. At the end of the standard c-section stay, the nurses were preparing me to be discharged. Katie was not working that day. I told them I could not leave yet. I was still in massive amounts of pain. I still felt nauseous. I could still barely walk. They brought a doctor in to check me out. I’d never met this doctor before, but she basically told me to suck it up and that she was going to go ahead and discharge me. So home I went, with my worthless meds, leaving my babies behind in the NICU.

My husband was home for two weeks taking care of Tim. I don’t remember much from that time except that I was nauseous for a couple of weeks. But I dragged myself to the NICU every day for at least a couple of hours to be with my babies. There were days where a good chunk of that time was spent lying on the little couch bed in the room because I wanted to vomit. I couldn’t hold both at the same time. They have completely different personalities, and I was too sick to manage it. I tried to breastfeed eventually. Danny’s latch was terrible. Nicky tried, but wasn’t always successful. I decided to exclusively pump but wasn’t making enough milk for both of them so they had to supplement with donated milk. There was one day where I vomited and physically couldn’t get up off the couch at home. It got later and later in the day, and I hadn’t been well enough to go see them. I cried my eyes out and told Frank to please go see them so they know we didn’t forget about them. So he went after putting Tim to bed. He sent me pictures of their sweet faces, and I cried some more.

When I went to get my staples removed, the woman had to bring in someone more experienced because she had never seen an incision like mine. The boys came home after two weeks. They slept and ate at completely different times. I am a stickler for getting babies on a schedule, and it never happened. I was up all night every night for the first 2 months pumping every drop of milk I could get and then feeding them on their separate schedules, supplementing with formula. I had to stop pumping after that because I began bleeding from my nipples. My supply dried up. At my 6 week appointment, my incision was healing as well as could be expected. Mercifully, my vaginal birth had healed after about a week. I tried to share with my doctor how upset I was that as a vaginal birth champion who wanted a lot of kids, I was told that I could never have a natural birth again. I reminded her that I have religious and other personal reasons that I will never use any form of contraception and that being “done” having children is never a guarantee for us no matter how well I track my cycles. She didn’t have anything to say. She apologized. I asked her if she knew of any doctors anywhere in the area even at a different hospital that would attempt a VBAC with me next time. She said no. I told her that it seemed like everything went wrong after she broke my water with Nicky and asked her if she felt that was accurate. She agreed. That was it. I never spoke with her again.

The Real Recovery

In the following few years, my twins grew and thrived. The boys all became best friends. I was lucky enough to be very good at tracking my cycles so as not to fall pregnant again too soon. But I had sustained months of nightmares and depression about my experience and never fully recovered emotionally because no one understood what I had gone through. When I tried to confide in the people I was closest to, they said what they thought might be helpful which was of course always the wrong thing – usually “at least you are all healthy”. My husband has been my biggest source of support, probably because he was traumatized in his own way when they kicked him out of the OR without letting him say goodbye to me. I reached out to midwives and my local ICAN chapter trying to find someone to talk to about a VBAC. Many midwives were sympathetic but not allowed by law to VBAC with me and unwilling to perform an HBAC. I spoke to the most VBAC friendly doctors in the area. All of them strongly recommended a repeat c-section at 37 weeks. At the same time, I made friends with someone who was having her first baby. She and I had like minds. I told her my first birth story and reassured her that her birth would be wonderful. She ended up with a c-section after a relatively quick labor but pushing for 4.5 hours at the same hospital. I shared my story with her. We mourned the loss of our natural births together, but she doesn’t know if she ever can have a natural birth. I know I can. I still felt that no one could fully relate to me, but it was helpful to share my feelings with her in solidarity. She is a licensed psychologist and said it sounds like I might have PTSD.

I decided to take charge of my life and started using my math degree and statistical skills to research and read every study I could find on VBAC’s, particularly regarding special scars. I got all of the notes from my horrific birth. I had lost 2500 cc’s of blood – half of my blood volume. They never gave me a blood transfusion which I was thankful for for various reasons, but it was very likely the reason that I was so ill for so long. My uterus struggled to contract after delivering Nicky and the placentas. They had to take it out of me multiple times and wrap it up with a special suture to get it to stop bleeding. They had read the ultrasound wrong. Danny was the one who was breech, and Nicky was vertex. If everyone had let everything progress naturally, this never would’ve happened. Wow – I was vindicated. Nothing is wrong with me. The doctors screwed up big time.

My husband and I started longing for more children. We were fortunate that my fertility wasn’t damaged and almost exactly 3 years after the twins’ birth, I found out I was pregnant again. I went back to my local hospital, found a random OBGYN associated with it, and made an appointment. I gave him the news that I had an inverted T incision. He said, “well that makes the decision of delivery method easy doesn’t it?” I said, “No. It makes it harder. I want to VBAC.” He strongly recommended against it and cited the “10%” chance of rupture as if I hadn’t been researching this for the last two years. I started spouting off information and statistics in business mode. And he said “Well, I feel like it’s more important that we offer you a safe place to have a vaginal birth than for you to labor at home by yourself.” I did it!!! He hesitantly agreed to work with me. So here I am, 36 weeks and 6 days into my third pregnancy which has again been completely complication-free. I am determined to do this. If I need to, I’ll labor in the car in the parking lot of the hospital until I’m ready to push if I sense that I’m going to feel bullied at the hospital. I know I can do this. I’ve done it twice before. I’m so close to being fully healed.

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