Friday 4 April 2014

Our Twins: The Delivery

Today marks my babies 11th week outside of my belly.  I have wanted to tell their delivery story since it happened and I finally had some time to sit down and type this story out.  In some regards, I feel like a petulant child and have to say some of what we experienced was “Not Fair”.  While we are grateful for two beautiful, healthy children, they had to go through a lot of unnecessary issues, and for my husband, myself and our families, a lot of unnecessary heart ache.  Here’s our story:

First I should share some back story:  Our region recently restructured the maternity wards in the all of the hospitals in our area, routing all deliveries to our neighbouring city’s hospital, The General.  This sucked as our local hospital, the Greater, is literally down the road from us.  So we went from getting to our local hospital in 2 minutes to driving 20, I know it’s not a lot but I didn’t want to go to the General.  I had (and now have even more) a lot of distrust for the General as they nearly killed my Dad years ago and as far as I am concerned are responsible for another of my loved one’s deaths.  For this sole reason, I chose to use a midwife.  The midwives have hospital privileges so I chose to deliver in the hospital.  Then we found out we were having twins, and we were bumped to be considered a “Risk 2”. The region dictates that we are no longer allowed to have the midwives deliver us alone, we had to have shared care with an obstetrician.  And you are at the mercy of the obstetrician that is on call the day you deliver, so whatever obstetrician you choose to see you during your pregnancy is not guaranteed to be the one at your delivery.  I also had to deliver in an operating room, as twins are very susceptible to being delivered by emergency c-section. 

Early on in my pregnancy, one of the midwives was concerned with my blood pressure, I did not have high blood pressure yet, I was at the higher end of normal, and she said I “didn’t have a lot of wiggle room.”  Pregnancy can elevate blood pressure, especially if you are pregnant with twins.  It’s a lot of extra strain on your body.  By the time I hit my third trimester, the midwife had been correct, I was getting high readings.

The midwife and my obstetrician, on three separate occasions, had gotten such high readings they sent me to the hospital to have a NonStress Test, to make sure the babies and my liver were ok, (this is done by running blood work to check my liver enzymes).  High blood pressure can lead to Preeclampsia (Downton Abbey fans, that’s what Sybil had) which can cause liver failure.  If developed, the only way to stop preeclampsia is by getting the placenta out of the pregnant woman, so you have to deliver.  Twins have a higher risk of preeclampsia as there are two placentas.  All three times I was sent to the hospital, my blood pressure lowered itself by the time I was checked at the hospital.  Two of those occasions, the same rude obstetrician on call sent me home, refusing to run my blood work to see what my liver enzymes were doing. He told me I don’t have high blood pressure and demanded I pass on a rude message to my own obstetrician, (apparently they can’t all play in the school yard together)  The other time, I had a nice obstetrician who ran the blood work.

The Tuesday, three days before I delivered, (I was 38 weeks and 2 days at the time) I had a midwife appointment and my blood pressure was very high. They sent me for my third Non Stress Test (NST).  I had the rude obstetrician, who insinuated I was wasting his time and I was sent home.  That night I had horrific pain in my upper abdomen that at the time I thought was really bad heartburn.  (Common for preeclampsia patients to think they are having heartburn)  I ate tums all night and all day Wednesday.  Wednesday I started getting sick to my stomach and was sick all night long.  By 5am Thursday, (now at 38 weeks and 4 days) I said to my husband, I think I should call the midwives as I don’t think it’s good I have been barfing all night.  The midwives agreed, it wasn’t good, so they asked us to meet them at the hospital for my fourth NST. 

The midwives can’t order bloodwork in the hospital, so they got the obstetrician on call, a nice one, thank God, and he agreed to order the bloodwork.  My husband and I figured we were going to be sent home again, so it was a bit of a shock when the midwife came in and said, “Your liver enzymes are way too high, we have to induce you, today.”  It’s funny as you prepare 9 months for this moment and it still came as a shock. Luckily, I had been driving around with my delivery bag packed since November. 

We were finally induced at 5pm that day.  Let me tell you, I took the morphine and the epidural.  My obstetrician told me that if the second twin turns himself when the first twin is born, the doctor will have to stick his hand up inside me and flip the baby, and they don’t do it without an epidural so it was in my best interest to have the epidural.  Let me tell you, they aren’t kidding when they say labour pains hurt. Turns out, my body doesn’t take morphine and it didn’t take the epidural. So I was not frozen, I could feel the bags of ice they used to test this.  I felt all of the labour pain.  At one point I begged my husband to take me home.  I was 10cms dilated and the obstetrician on call made me wait 2.5 hours, I was told to hold them in.  I was not allowed to deliver with the midwives in the delivery room, I had to wait for the obstetrician for the operation room.  The obstetrician had three emergency c-sections and an emergency D&C to perform, so I had to wait.  At this time I was whining to the student midwife and husband that it wasn’t fair. 

Finally, on Friday morning, at 3 am, we were brought to the operating room.  (I had now been up for almost 64 hours) Our daughter was born at 3:15 am Friday, January 17.  (7lbs and 5 ounces, Yes, I know, a full sized baby) Then my contractions stopped.  My Oxytocin IV had run out, Oxytocin brings on contractions.  NO ONE WOULD GO GET MORE.  THEY ALL JUST STOOD AROUND SAYING, WE REALLY SHOULD HAVE MORE OXYTOCIN.  We sat there for an hour and fifteen minutes waiting for my contractions to come back, YOU CAN’T PUSH WITHOUT CONTRACATIONS, waiting to push my son out.

The nurses, the midwives and the obstetrician on call all stood around in the operating room waiting. My husband and I didn’t know that wasn’t normal. We hadn’t done this before.  It was the midwife who had the idea of getting my brand new baby daughter and having her breast feed.  Breast feeding releases natural Oxytocin.  When my baby girl breast fed, I had two giant contractions and I was able to push our son out.  I was told that once the baby gets under the pelvic bone, they can no longer perform a c-section, the only way out is vaginally.  When my son was born he was put on my stomach.  I am no expert, but I have seen enough baby birth videos to know, not to panic if they don’t cry right away, however, he didn’t cry and he was blue and floppy.  We found out afterwards he had an Apgar Score of 1/10.  Our daughter was 7/10. It’s based on if the baby is breathing, has a heart rate, crying, and muscle tone.  OUR SON HAD NEXT TO NO LIFE.  They whisked him quickly to the room next to the operating room, it had windows so we could kind of see.  They had to resuscitate him.  Within minutes we heard him crying in the next room. (7lbs and 8 ounces, Yes, I know, TWO full sized babies, nearly 15, FIFTEEN pounds of babies) They allowed my husband to see him.  The only thing I saw of my son as that stage was he had a full head of black hair, I still hadn’t seen his face.  The midwife came to me and said they are taking him to the special care nursery as his blood pressure had dropped during delivery and that I could see him shortly. 

Later, my own obstetrician said to me, why didn’t they go get more Oxytocin? I said I don’t know, you tell me.  They told us they had run out of Oxytocin in the operating room.  My obstetrician said why didn’t they call for more?  I said, I don’t know.  He asked, why they didn’t give you a shot of Pitocin, it would have done the same thing?  I said I have no idea, I’m not a doctor. 

One thing to clear up, for some reason I keep having people tell me that “they should have done a c-section back at Christmas”  My babies were very healthy.  They don’t take babies early unless there is a problem with the babies.  The best incubator for a baby is it’s mother’s uterus.  The only reason I was induced was the liver enzymes went high the last two days of my pregnancy.
My husband, my daughter and I were brought back to our hospital room.  We had a pediatrician come in to see us and told us our son not only did our son’s heart rate drop, he had lost oxygen during delivery and they had to monitor him longer in Special Care.  I got to officially meet my son soon a couple of hours later.  He looks like his Daddy.  Our daughter looks like me.  We had our first family photo taken with my IV pole and our sons IV pole flanking us. 

The next morning, at 6am, there was a knock at my hospital room door.  There was my midwife and another pediatrician.  The pediatrician informed me that my son, who was still in the Special Care nursery, had started having seizures at about 2:30am
Due to his loss of oxygen at some point during delivery, we found out that my son had swelling of the brain, which caused the seizures.  ITS NOT FAIR, HE SHOULDN’T HAVE LOST OXYGEN. Had the delivery team gotten more Oxytocin to bring on my contractions again, he would have been born faster. HE SHOULDN’T HAVE HAD TO GO TO SPECIAL CARE.  HE SHOULDN’T HAVE HAD SEIZURES.  ITS NOT FAIR TO WATCH YOUR BRAND NEW BABY BOY STRUGGLE AND HAVE LIMITED ACCESS TO TOUCH HIM.  They tried to control the seizures at the General Hospital but they decided that it was better to transfer our son to the Childeren’s Hospital for a more specialized care.  We sat with our son the whole day and into the night as they waited to make this decision.  When the decision was made, they called in the transport team to pick him up.  At around 1am Sunday morning, the transport team arrived and loaded our son into a glass box attached to numerous tanks and wires.  IT’s NOT FAIR THAT THAT WAS HIS FIRST CAR RIDE.  His first car ride should have been coming home with his Mom, Dad and sister. 

My daughter and I were discharged later that morning.  My husband, daughter and I hoped into the car and headed to the Children’s Hospital.  My son spent a full week in the Children’s Hospital.  His seizures stopped, but he had to go through lots of testing to see what had caused the seizures for certain and any long term effects.  They could see his brain had swelling.  They won’t know until he is older if there is damage or the extent.  THAT IS NOT FAIR.  ITS NOT FAIR TO HIM.  HES JUST A SWEET INNOCENT LITTLE BABY. 

There was a chapter in the twin book I had read and it talks about having to deal with babies in NICU.  To have both twins in NICU, to take one baby home and leave one behind.  To have to wait for permission to hold your child.  To have someone else taking care of your child.  The guilt, you may feel.  The helplessness you may feel.  I read the chapter during my pregnancy and thought that’s awful, I hope that doesn’t happen, AND IT DID. 

ITS NOT FAIR.  It sucks huge. 

I had often wondered, during my pregnancy, what I will do when both babies cry.  I didn’t think my first experience would happen where I was holding my son, who was hooked to a slew of wires and machines, and my daughter was crying just out of my reach.  (The nurses had been great and brought us a crib for our daughter to sit in our son’s cubicle so we didn’t have to leave her behind.)  The next time my being pulled between two children was when our son had diarrhea one day and he was put under quarantine.  Our daughter’s crib was moved to the hallway.  We had one child hooked to monitors and another child sitting in the hallway.  We could see her from where we sat.  THAT WASN’T FAIR.  IT WASN’T FAIR OUR SON HAD TO BE HOOKED TO ALL OF THOSE MONITORS.  IT ALSO WASN’T FAIR TO OUR DAUGHTER.  WE SHOULDN’T HAVE HAD TO BE SEPERATED.  WE SHOULDN’T HAVE HAD TO ROTATE WHO WE SAT WITH.  The week we were there was the coldest week.  OUR DAUGHTER SHOULDN’T HAVE HAD TO BE LUGGED IN AND OUT OF A HOSPITAL REPEATEDLY IN THE COLDEST WEATHER TO VISIT HER BROTHER.

That first Sunday, my husband, daughter and I had to leave the Children’s Hospital and drove the hour ride home.  Leaving our son.  We took our daughter’s photos as she entered the house.  HER BROTHER SHOULD HAVE BEEN THERE TOO.  We had our first night at home without our son there.  HE SHOULD HAVE BEEN THERE.  The next night, the Children’s Hospital arranged for us to stay at Ronald McDonald House, which was a block from the hospital.  They were a God send.  Every morning you are supplied breakfast and every night a chef comes and cooks a full dinner, if you are there you can eat, if you miss out, you can have leftovers when you return.  We had a beautiful clean room. They gave us a beautiful quilt for both our children made by a volunteer.  They give quilts to the sick kids, as we had our daughter they gave her one too. They are beautiful quilts.  I can’t talk enough about how amazing Ronald McDonald House is and the staff and volunteers.  They were a relief to have a place to rest our heads and shower after sitting at the hospital all day. 

The nurses at the Children’s hospital were amazing.  Every day we went in, our son had a different nurse, except his last three days, we had the same sweet young nurse.  Every nurse was supportive and seemed to give us what we needed that day.  The first day I couldn’t even function and that nurse took care of all four of us.  The next day I needed a mental break and the nurse on call was quiet and sweet.  The next day everything was getting to me and the nurse on call was hilarious and had us laughing.  Then we had the sweet kind nurse.  If I couldn’t care for my own son, I knew he was in good hands.  BUT HE SHOULD HAVE BEEN IN MINE.  The following Sunday, his seizures had long since stopped, he passed his car seat test and we were allowed to take our son and daughter home, TOGETHER. There had never been such sweeter words as you can all go home today. We brought our son home and took his photos as he came in his house for the first time with his sister.  A week late, but thankfully he’s home.  He’s doing really well and will follow up with the Children’s Hospital every three months until he is 18 months and then once a year.  Only time will tell if there is any lasting effects.  The human brain is an amazing thing.  It can regenerate cells. It may fix any damage on it’s own.  The part of his brain that had been swollen was his motor skill area but we were warned it may have touched his Cognitive thinking area.  He could potentially have learning disabilities when he grows up.  Or he may be perfectly fine, with no problems, only time will tell.  So far he is very bright, and alert and neck and neck with his sister for their three month developmental check list.  Thank God. 

Really, we were very lucky.  We were only in NICU for 8 days.  There are parents there for months, even years.  I was lucky as I did eventually bring home both of my babies, some parents don’t. I know how lucky we are.  I know how blessed we are.  It just sucks and it wasn’t fair.  You shouldn’t have to wait for a nurse to help you hold your son as he is so full of wires. Your first day as a parent, you shouldn’t have to worry if your baby is going to make it.   Your first week as a parent you shouldn’t have to sit and watch your baby struggle.  You shouldn’t be in a city an hour away from your home and support systems because your local hospital, who fucked up during delivery, was not equipped to care properly for the child they nearly killed.  IT’S NOT FAIR that the babies we looked so forward to have had to go through so much in their young lives already.


We never would have made it through this without the love and support of our amazing families and friends.  I wouldn’t have survived this with my husband, my constant rock and support.  What we went through should NEVER have happened, but I think it made us stronger as individuals and stronger as a couple.  Our beautiful babies were what kept us going, and now we look forward to our lives as the Fabulous Four.

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