birth story of the week: journey to a natural cesarean birth of twins

Today's Birth Story was sent in by Jodi Mockabee, whose inspiring vba2c was featured here on Marvelous Kiddo two years ago.  During Jodi's most recent pregnancy, this time with twins, she had to confront the reality of having a third c-section, so she set out to make the experience as natural as possible for her and her babies.  I love how this mom took control of a less-than-ideal situation and enlisted the help of an open-minded medical team to make the birth of her sons more gentle and breastfeeding-friendly than is usually the case with surgical birth.  How refreshing to see mother and baby care prioritized over standard hospital protocol.  Thanks for sharing, Jodi!

--Leigh

Planned cesareans don't make very interesting birth stories as most of them are quite similar, but I wanted to document this cesarean as it was such a different experience than my two previous ones.

I have made it quite clear to my dearest friends and family and on my blog that I have struggled with many aspects of my past c-sections. Although I never battled with post-partum depression or felt that I was disconnected with the two oldest boys, I did feel completely robbed of the birth experiences and the emotions that come with bringing a baby into the world by using my mind and my body.

Scarlett's birth was such a story of redemption for me, an experience that satisfied the desire that I had been longing for since I had learned the concept of birth. I am forever grateful for her and the way she decided to enter the world!

Learning of our fourth pregnancy and still on my VBA2C high from Scarlett, I was confident that this fourth baby would be brought into the world unassisted. I had visualized birthing him or her in the tub, by myself, in the peace of my home and the silence of the bathroom. Mid through the pregnancy, I learned of the twins' existence. A few weeks after, I learned that they were mono-chorionic/ di-amniotic, which meant that they were at high risk for TTTS and acute TTTS. Acute TTTS happens usually right before birth or during birth. The results are often still birth of one or both babies. The closer one gets to the due date with mono/di twins, the more at risk they are for Acute TTTS. Also, vaginal birth multiplies the risk for Acute TTTS as the pressure from delivery causes great stress on the shared placenta. Causing the blood to transfer from one twin to another.

I poured over books and did my fair share of research to fight for the birth that I wanted with the boys. My midwife listened to my dreams of delivering the boys in the tub, she listened to my plea to assist with their delivery, and never told me I couldn't. But the peace of that envisioned birth started leaving me, and my maternal instinct took over, warning me that this choice was more about their safety than it was about my birth plan. As I shared this with my midwife, she agreed and took a large sigh of relief.

Once I was settled with the idea of a third cesarean, I started researching on how to make the process more birth-like. I looked for ways to change the standard routine of how distant the newborn is from his or her mother upon their immediate arrival. I came across this video that brought me to tears. There was hope.

This technique had started in Australia and was just beginning to be practiced in the UK, chances of it meandering it's way through the US medical system was something I was willing to try for. Thankfully, I knew a few of the nurses at our Birth Center. I also knew that they were like-minded in the department of birth and other natural parenting decisions. I contacted one immediately and asked her to help take part in the twins' birth. She helped inform other nurses of the technique, showed them the video, talked with my doctor, and provided me with all the information I needed in order to make sure I got the "birth" that I wanted.

The day before their planned c-section date (which was scheduled for 37weeks, 1 day--again, due to Acute TTTS risks), I went in for a standard non-stress test. Twin A, August, immediately showed the nurse a deceleration in his heart beat. Then, my body decided to start contracting more regularly. After another heart deceleration, the nurse decided not to allow me to leave. She was aware that I was walking around at 3cm, and with the combination of my contractions and August's heart decels, she didn't want to risk it. We were told that within three hours, we would meet our baby boys (we found out in the OR that I was at 5cm, so I was indeed in labor)!

I was trying to be excited, but the fact that it came so unexpected through me for a loop. I mentioned on their birth post that I had not showered and had great plans to be prepared for the very next morning. Not for...now. But the idea of trying to sleep one more night with those two lodged in my ribs and pelvis allowed me to focus on the excitement of getting them out, and being able to hold and know them.

Two of the nurses I had been in contact left their families to help assist me in my "natural cesarean". They prepped me, and filled in the other nurses on what was to take place with this birth. Jason took off his shirt so that one of the babies could be placed on his chest immediately as well.

We arrive in the OR and the anesthesiologist did a fantastic job at keeping my meds level so that I can be actively participant in the birth. He made sure not to tie my arms down and even placed my vital stickers somewhere other than my chest so that nothing would interfere with my skin to skin contact. Within a few minutes, I got to meet and touch my fresh-from-the-womb August. He was placed immediately on my chest. He was covered in vernix, crying strongly and the tiniest little guy I had ever seen. He was alert, looked into his Mommas eyes, and even placed on my breast. For a moment, I forgot that the lower part of my body was in mid-surgery. It was just him and I. It was perfect.

No more than a minute later, I saw Baby B, Elias born. He was blue and I could tell he was much bigger than August. I had prepared myself for this as I knew they would be early, and often the second baby in multiple deliveries tend to have more risk. He was not brought to me or my husband's waiting chest. Instead he was whisked to the corner to ensure that he could breathe. It took some work and love from the respiratory therapist, but he was somewhat stable as we all were wheeled out from the OR.

August and I were brought into recovery together. I got to stay with him. He was never weighed or bathed. He never left me. Elias was still getting tended to and Jason was there with him the entire time. The nurses helped bring Elias into me, put him on my chest and even tried to get him to breastfeed. This helped stabilize his breathing even more. They pushed for him to have the contact with me that he would have never gotten given the wires and tubes he had attached to him. I think this is part of what helped stabilize his breathing much quicker. They were both weighed in the room with us, August at 5lbs,6oz and Elias at 5lbs,14oz.

Unfortunately, he had to be transferred to a hospital with a NICU, which was 1.5 hrs away. Jason went with him and was able to bring some donated breast milk so that he wouldn't have to be given formula (which I had learned was protocol in the NICU).

Elias was discharged no more than 30 hours from the NICU and made it safely back to his brother and I. From the moment they were together, the peace and beauty of their relationship was relevant. We decided to stay the entire four days to really bond with the two and establish tandem breastfeeding as we knew the second we were home with our entire family that we wouldn't ever get that quiet time again.

The cesarean ended up being the best situation for these two babies. I can't believe what a difference it made when the nurses and doctor prioritized me and my babies' needs over what is standard practice or protocol. Nothing was effected on their end as far as sanitation or time, and they got a very happy patient in return.

I write this in hopes that the growing number of women experiencing emergency cesareans or repeat cesareans will learn that all it takes is some pushing on their end to get a more birth-like experience. I have read the studies linking successful breastfeeding to immediate skin-to-skin contact. I have also read the studies linking post-partum depression to cesarean sections. I would imagine if this problem was solved in the operating room, there would be a lot more happier moms and healthier babies. I know I was, and am forever grateful to the staff that allowed for me to get the cesarean birth that I wanted.