Friday, February 5, 2010

How It All Went Down: The story of my pregnancy and childbirth - Part 3

My doctor told me that if there was anything abnormal about my ultrasound I should get a call from her office.  I'm thinking twins are pretty abnormal.  Two days later.  No call.  So I call and talk to the nurse.  I don't remember what she said except that the ultrasound showed that they were both perfect.  Big sigh of relief.  Of course I had been researching multiple pregnancies in every spare moment of my time and knew every risk there was.  I had to wait to talk to my doctor until my next appointment.

Jonathan and I showed up for next appointment eager to get answers to all our questions and find out what I should be doing differently with a twin pregnancy.  We found out that they were in fact identical girls.  What we didn't expect to hear was that she didn't want us to have sex anymore and she wanted me to have a c-section.  After recovering from the shock of this, I asked why a c-section would be necessary if both babies were head down.  Her response was that she felt confident that she could get a baby out no matter what position it was in, but that there was an increased risk of placenta prevaria with a twin pregnancy and that meant my placenta could detach between the birth of Baby A and Baby B and Baby B could die.  I had never heard of this before.

So I researched.  And researched.  And researched.  Until I finally found a study that gave me actual numbers of what the increased risk was for multiple birth pregnancies to have placenta prevaria.  Turns out the increased risk she was so concerned about was something like 0.08% greater than the risk for a singleton pregnancy.  In addition, in most of these cases the placenta only partially detached and the babies were born healthy.  In fact, in trying to find the previous study, I ran across a study conducted between 1997 and 2000 that says there is no greater risk.  So I'm thinking, "I know that a c-section is considered a "routine procedure", but the risk of something going wrong there has to be greater than this."  I told my doctor that if it was physically possible, I was delivering my babies vaginally.  To this she told me that I would have to deliver in the OR and have an epidural.  At this point, I was willing to negotiate.  I should have just switched doctors.

One month later, the morning of a scheduled appointment, I woke up with mild cramps.  They weren't really painful, I just couldn't get comfortable.  I decided not to call the doctor since I would see her later that day, so I got dressed and went to work.  When I mentioned them at the appointment she sent me directly to the hospital.  I was terrified.  They took a urine sample and had me hooked up to the fetal monitors.  I was there all day.  I was finally told that a bladder infection had caused my cervix to shorten.  I was sent home with a prescription and put on strict bedrest.  I was to lie down at all times except to use the restroom and take a 10 minute shower each day.

I was devestated.  I am a very active person and this was like a prison sentence for me.  My husband had to bring me breakfast and dinner and my mom came over to get me lunch each day.  Thank God I had such a great support system.  I had to stay that way for one week until I went to see my perinatologist (I started seeing him when they found out there were twins).  He did an ultrasound of the inside of my cervix and determined that I was still closed up tight inside.  At this point, I was allowed to sit, but was otherwise still restricted to my bathroom breaks and 10 minute showers.

Despite my bladder infection healing and no further change in my cervix, I was ordered to remain on bedrest until I was 36 weeks pregnant.  I was forced to go on short-term disability and wasn't able to tie up any loose-ends at work.  I did the remainder of my registering online and watched as Jonathan set up the nursery.  I refused to open more than one of each thing for fear that both babies wouldn't make it.  We were really blessed in that we had a large group of people taking turns bringing us meals three nights a week.  This continued until after the girls were born.

This was at one of my showers in early January - about 2 months before the girls were born.
(I made bedrest exceptions for showers)

At 36 weeks, I was thrilled to resume my normal activities.  I went back to work, started mall-walking to get back in shape, and since both my babies had been head-down since 27 weeks, I continued to look forward to the vaginal birth of my children.  At 37 weeks that all changed.  During an ultrasound with the perinatologist the girls moved.  Now both heads were in my right hip and all four feet were in the left side of my rib cage.  They were oblique.  At my OB visit that week, my doctor sent me to the hospital to have a biophysical profile.  This is simply an ultrasound to determine a baby's (or babies) development.  Mine showed that everything was functioning properly and they could come into this world at any time.  It also showed that Julia's shoulder was now lodged in my cervix.

They called my OB and told her and then everything became crazy.  I was going to have to have a c-section.  My OB's husband had an out-of-state surgery scheduled for Monday so she asked if I wanted to deliver the next day.  The next day was Leap Day.  I didn't think it was fair for my twins who already have to share a birthday to only get one every four years, so I nixed that idea.  Then she asked if I wanted to do it that day.  Are you kidding me?!?!  I came into the hospital still thinking I was going to deliver vaginally.  I needed some time to process.  She told me that I would have to call her office the next day (Friday) and schedule a c-section with the on-call doctor.  I agreed to this.

The next day I got a phone call from my OB's office.  Turns out her husband's surgery was postponed, so she could do my c-section Monday.  I walked and walked and walked all weekend trying to get my babies into the right position so that maybe we could do an induction rather than a c-section.

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