Asha & Lauren's Birth – August 2005


Present were me (Yvette), my husband Lindsay, friend & birth attendant Kelly, my daughters Lola, who was 12, and Ruth who was 8, my mum Irene, three shifts of Midwives, the Senior Registrar and the House Doctor. Our son Angus, who was 15 months, was being looked after by a friend, Nadia. The 2nd and 3rd Midwives overlapped and were both there for the birth. We'd met the 3rd Midwife once before and she'd read the birth plan. I've put the birth story together using Lindsay's notes, the photos which have the time on them, and the video which has occasional glimpses of the clock on the wall, as well as my own memory.

My periods returned 4 months after Angus was born, about when he started having some solids as well as breast milk. Mon 4th Oct 04, then Mon 1st Nov — 28 days, then Tuesday 30th Nov — 29 days. On 30th December 04 I had a positive home pregnancy test. Woo hoo!

With this pregnancy there was more nausea and tiredness than usual in the first trimester, I developed pelvic instability (symphysis pubis disorder) early on which became worse than with the last pregnancy, and I was very much bigger! I was 72kg when I conceived, not having lost all the weight from the last pregnancy yet, 92kg just before the birth, and 78kg 2 weeks after. Towards the end of the pregnancy, I not only stopped driving, I could barely walk around the house sometimes. Still, I was wonderfully healthy! I didn't have the luxury of nesting this time, but that energy was channelled into researching about twins.

We were thrilled to be told we were having twins at the first ultrasound, and there were lots of ultrasounds throughout the pregnancy. The babies shared a placenta, so we had to monitor for twin to twin transfusion syndrome. We found out they were girls (I've never managed to keep it a surprise). They also found that they each had 2 vessels in the umbilical cord instead of 3 (no drama, Lola had the same thing) and one had a cyst in the brain (also no drama, the other kids had the same thing, and it had disappeared by the next u/s).

This was my 4th pregnancy, & I gave birth at Birralee, Box Hill Hospital. Lola and Ruth were born at home and Angus at Birralee also. All were vaginal births with no problems, intervention or pain relief. I wanted the same this time, but it became clear early on that it would be a struggle even to have a vaginal birth, with a 65% or higher c/section rate in Melbourne for twins.

The due date was 5th September 05, and I had no intention of agreeing to induction at 38 weeks as recommended. No evidence was offered to me to support the assertion that carrying twins past 38 weeks is dangerous, and I still don't believe it. At the last minute though, I agreed to be induced by ARM (artificial rupture of the membranes) on Wednesday 24th August, at 38 weeks & 2 days.

The reason I agreed to it was because the -good' Obstetrician (Consultant) was rostered on that day, and we were convinced I had a much better chance of a vaginal birth with this guy & not some random doctor. I'd never had a doctor present at my births before, but with twins that wasn't going to happen unless I had another home birth. This Obstetrician was experienced enough to deal with extracting a second twin if needed rather than sending me to theatre, as it seemed most doctors would do at the drop of a hat, not having those skills. He assured us he would be there for the birth if we had an induction that day. It was such a rushed change of plan, following speaking to some Midwives about the possibility of a home birth, & seeing a private Obstetrician one week before the birth, at the recommendation of one of them. He was apparently one of the best for supporting vaginal birth for twins, and had the same plan to achieve this as the Consultant I'd been seeing, i.e. have an epidural in so they can extract the second baby if need be. He said he'd trained under the Consultant I'd been seeing & strongly recommended him. My journal has the full story about my efforts to plan the birth.

The day arrived and we were up bright & early. I had a shower, washed my hair & had some nice toasted sandwiches for breakfast. (The birth plan said pizza, having been written when I was planning to go into labour naturally, and for some reason assuming it would happen at dinnertime).

We arrived at the hospital at 7am on Wed 24th Sept 05. Thankfully the big room was available so we had plenty of space. I pottered around setting up: I got out the CDs, got the aromatherapy going, put my toiletries in the bathroom, put 2 doz juice boxes in the fridge (yes we needed them all), looked in all the cupboards (to locate towels, blueys etc), put my pillow on the bed, put birth plans (copies for Kelly, Lindsay & extra hospital copy — there was already one on my file which the 3rd Midwife, the Consultant, and possibly the Senior Registrar had read) & food out on the table (mandarins, apricot lolly things & mini flakes) etc. Kelly arrived at 7.45am.

At 8am the first Midwife came in to do some monitoring, which we did with me sitting on the couch. The heart rates were 153 and 142. Oh how I got sick of the monitoring!

I changed into a hospital gown & at 8.40am the Senior Registrar attempted to rupture the membranes of the presenting twin. I gather that although it was closed it was very soft, so quite easy to get a finger in there. The thing used to break the waters was like a rubber thimble worn on the end of the finger with a tiny little barb on the end. It was quite painless. The Registrar said baby's head had bobbed back up with the pushing, making it difficult, so he asked me to walk around for a bit to bring it back down & he would try again. I don't really know why, but it seems they need the baby's head to be down low to break the waters. I walked around the room, listening to Lisa Miller, and baby dutifully dropped back down. I wonder now whether this means her head was -engaged' in the pelvis. My other three babies never engaged until well into labour. Was it different this time? Or can the head be felt through the vagina without being engaged in the pelvis? At 9.20am he came back & successfully broke the waters, & I felt the warm ooze starting. I put some undies on with a pad.

I now had a couple of hours to wait for contractions to start before they started hassling to put up Syntocinon. I walked around the room, stood leaning over the bed with my legs wide apart swivelling my hips, did some stepping with legs far apart as suggested by Kelly, & listened to music. Had a few nibbles & drank some juice.

At some stage a doctor came in to put a cannula in my hand. She said she was the House Doctor. I told her my veins could be a bit tricky to find, so I've ended up quite bruised before. I couldn't remember which hand worked better. She seemed to misunderstand what I was saying, thinking I bruised easily or something. She had a good look at the veins in both hands & decided on the left one. I looked away as she put it in, not wanting to put her off as I was slightly anxious about the sting. It wasn't too bad, but being quite a thick needle it continued to hurt a bit after the initial sting, for 15 seconds or so. It stopped hurting and felt wet, and I looked around to see blood everywhere. Nothing was wrong, there'd just been a big squirt. Anyway, she'd done a great job with it and afterwards there was only a tiny little bruise. There was a bit of blood on the sheet which they just covered up with a bluey.

10.50am I discussed music selection with Kelly, & told her that I like heavier music as the contractions get stronger. Had Moby playing. We checked the aromatherapy, I was dancing.

11.09am Kelly was massaging my back with me sitting on the edge of the bed. It was lovely, but I was starting to feel nervous. I wanted the contractions to come, but I was scared of them coming.

11.42am first contraction noted by Lindsay, lasting 1 minute 10 seconds.
11.47am: 1 min.
11.51am: Feelings of lower pelvic pressure when walking — not contracting — ongoing.
11.53am: ?? brief contraction 10 — 15 secs.
Between 12 & 1pm there were some scant amounts of slightly blood stained mucous.
12.20pm: Several stronger contractions of short duration.

Kelly painted my toenails, but wouldn't let me paint hers. Some lame excuse about me being in labour. It was a really nice colour.

At 12.30pm I was leaning over a beanbag on the floor, a rubber mat with a quilt over it under me, and Kelly was again massaging my back. I was listening to Kirsty MacColl. I looked slightly nervous. I was feeling a bit hot & dizzy & feint. Although I was still having mild contractions, they weren't regular, so began the pressure to put up some Syntocinon.

At 1.10pm I was sitting in bed & they'd (the Registrar, Lindsay & the first Midwife) got me to agree to the Syntocinon. It was to be started at 1.30 at half strength, with a view to allowing around half an hour then adjusting the rate according to response. There was talk of wanting me to give birth during daylight hours etc, even though both Obstetricians (the Senior Registrar and the Consultant) were rostered on call all night. I had no intention of trying to give birth within a time frame to suit the hospital, yet somehow they still managed to get me to agree.

1.25pm Consultant Ob came in, & I was making some sounds during contractions. He said it seemed things were under way & Syntocinon wouldn't be necessary. Phew! This was the only time I saw him, but at least he did this one useful thing for me & saved me from the drip for now. I discussed with him not having an epidural as both babies were head down. He denied having said this, but was happy to have it in without drugs, & I agreed to this.

2.00pm I was sitting in the pink chair. A saline drip thing was attached to my hand in preparation for the epidural. Apparently you need saline going in when you have an epidural to stabilize your blood pressure (epidural tends to lower it).

2.07pm I was sitting in the pink chair, Lindsay was giving me a wonderful neck massage, and we were listening to The Smiths. I was making soft sounds with the contractions and Lindsay was holding my forehead with each one. This really helped. Between contractions we were bopping to the music together. I had another stronger contraction with a good sound, and opened my eyes when it finished.

Since it was suggested to me in labour with my first baby, I've always vocalized through contractions. It feels very natural and right, and it would be very hard not to do it. I feel that without it, panicky breathing would soon exhaust me. Naturally it's much louder as contractions intensify. I'm sure it must be very hard to listen to, but also useful in describing the contractions and measuring their timing. It's like a low howl, oooaaaaooooooh, quite controlled, and I sustain the sound as long as possible. It's a bit like vocal exercises for singing, and gives me some sense of control and something to focus on during the contractions. Shorter contractions might only need one, the long hard ones take 2 or 3 with a breath between each one

2.30pm The Anaesthetist arrived, a young bloke, very pleasant. I was sitting in the pink chair, which was quite comfortable & had arms I could grab during contractions; (I find I need to hold something). He gave me the warning spiel (you may grow an extra head, one of your legs may drop off, sign here".) and asked me some medical history questions. He was interrupted at regular intervals whilst I vocalised through contractions. You would think they'd have got him to see me much earlier so we could talk properly. I should have insisted on speaking to one during the pregnancy. I told him I was having it with just a test dose, so I could labour without drugs & that we were having it in place "just in case” to keep the doctors happy. I then had to get up onto a trolley & sit on the side of it. He lowered it for me to get on, then raised it once I was sitting on it and I think I put my feet on the chair. He got me to hold a pillow and hunch forward. Because of the contractions & holding something with my right hand (the trolley, Kelly's hand? I'm not sure) I was just really holding the pillow under my left arm. I felt like I was leaning a bit to one side and was not curved over as far as I could go, but he said that was right & started. I felt a bit of pressure from the local anaesthetic going in, & didn't feel any pain when the epidural thing went in. Lots of tape then went on, with a little thingy hanging over my left shoulder where drugs could be added to it later if needed. (By the way, it really hurts getting the tape off later). He'd used a tiny test dose of lignocaine, which I felt no effect from. He said that it was not possible to tell whether it was correctly in place without putting a proper dose of drugs into it. My contractions were getting pretty strong already & I asked him what would happen if I decided I did want pain relief through the epidural. He said if needed he would be back in 20 minutes, then it would take up to 15 minutes for the drugs to take effect.

3.10pm Kelly got me in the shower. I was having pretty strong painful contractions, & was quite uncomfortable in there. I had a shower chair to sit on, rails to grab hold of and nice hot water, but it didn't help. I just got cold, and even colder coming out & drying off. I stayed naked from here on. When I'm in labour modesty is not my thing.

3.25pm I was lying on my right side on the bed listening to PJ Harvey, my head on the purple pillow and a sheet over me. Kelly was stroking my forehead and I was moaning through contractions. Lindsay's notes say contractions were now very strong & about 2 to 6 minutes apart. I was alternating between lying on my side and up on hands and knees on the bed. I asked for someone to ring Mum, as I could feel with my hand and from within the pressure of baby's head bulging with each contraction, although she wasn't crowning. Maybe this is when she engaged, I'm not sure. First Midwife was saying goodbye. Kelly looked like she was trying to have the contractions for me (or perhaps she was just tired, having been there with us nearly 8 hours already, and having a breastfeeding baby at home herself). I squeezed a hospital pillow with each contraction. Midwife wished me well & said all was going spot on so far. Kelly said I was doing an amazing job. Lindsay said the kids would be there in about half an hour.

3.35pm Lindsay's notes say contractions were very strong, regular 2 — 4 mins apart, around 1 min or less duration. "Adamant she wants analgesia via epidural.”

I started saying I wanted the Anaesthetist to come back. Kelly tried to discourage me, but I felt transitional & scared. The contractions felt more painful than with my previous labours and I just didn't feel right. As well as the difference in physical sensations, it was very different for me not having a midwife I knew who was there just for me. Thank goodness for Kelly; I think her presence was a source of strength for Lindsay too.

3.43pm I was on my hands and knees on the bed, Kelly & 2nd Midwife were present. I was really struggling now & not coping. My sounds were really loud and out of control, going wobbly and hoarse. There was a sudden and very distinct difference in contraction sounds. Several full breaths of sound for each contraction, which is normal for me in full on labour. Very full on. I was barely aware of the 2nd Midwife's presence. I didn't really connect with any of them or feel that they were -with' me. When I think back to this part I'm confused. I know I thought the first baby could be coming at any moment, yet I was calling for the Anaesthetist, which doesn't make sense.

3.50pm the anaesthetist was contacted.

The next camera shot shows me on my hands and knees on the bed leaning over pillows. "Aaarrrrrrrrggghhhhh where is he" in one breath, sounding sad and desperate. Kelly has a cloth on my forehead. I asked where I'd need to be for the anaesthetist, & they reminded me it didn't matter as he only needed to access the thing taped to my shoulder. "Is he coming where is he?” "She was on the phone to him. I'm sure she's probably got him by now sweetie”. "Is mum on the way?” "10 to 15 minutes tops”. "Baby's coming”. Kelly: "you can feel the pressure of the head?” Me: "bloody oath I can”. Kelly: "do you feel like you're getting close to pushing?” Cut. It wasn't crowning I could feel so what was it? Baby descending into the pelvis?

Mum, Lola and Ruth arrived shortly before 4pm. Apparently a Paediatrician visited briefly around then too, but I didn't see him/her. I was still on my hands & knees on the bed. I said hi to Mum (maybe I couldn't see the kids). Mum & 2nd Midwife were looking at my bum. Lindsay said to Mum "she's getting her epidural topped up if he gets time”. I said "what do you mean if he gets time, where is he?” Lindsay said "well if he gets time before this first one gets out sweetie that's all. He's coming as quick as he can”. Kelly: "he said 10 to 20 mins last time we spoke to him, won't be long”. Me: "gotta wait for it to work, where is he?”. Lindsay: "everything's Ok, you're doing really good”. 2nd Midwife monitoring.

3.55 Another contraction. Long and strong, sounded transitional, wobbly. Lola & Ruth were sitting on the couch writing. Mum & Kelly were with me, 2nd Midwife monitoring.

3.57 I'm still on my hands and knees. Mum handed Kelly a refreshed wash cloth. 2nd Midwife was still monitoring. Mum put her hand on me.

4.00 Registrar came in. Another contraction. Registrar said "he's coming”. (I must have asked where the Anaesthetist was again). Footage of machine going ping. (They had brought in 2 baby cribs with warmers, & one of them kept going off and beeping. It was funny at first, the machine that goes ping, but we soon got well sick of it.) Unknown Midwife near it.

The very painful contractions kept coming as I listened to P J Harvey. Mum, Kelly and Lindsay reassured me while the Registrar stood with folded arms, looking slightly uncomfortable, and the 2nd Midwife put gloves on and opened packets. I moved & lay down, sheet off, pillow between my knees. A basic surgical tray was set up for the anaesthetist. An unknown Midwife was in the background. The kids were on the couch. A long, strong contraction came. My sound was loud, hoarse and wobbly. Kelly was crouched on the floor, holding my hand, looking again like she wished she could feel it for me.

The Anaesthetist arrived (it must be nice for them how everyone's always happy to see them) and added drugs to the thing on my shoulder, a bolus dose, which is where they put it in directly rather than an infusion which is through a drip. I think what happens is they start you off with a bolus and leave instructions for more drugs via infusion. He told me it would be about another 15 mins before I start to get some pain relief, & said "we may need to get you sitting up". I was still lying on my side, pillow between knees, no sheet on me. 2nd Midwife was still monitoring. My sounds were getting softer.

I sat up in the bed, which is where I'd have to stay now, not being able to move my legs. I was tilted to one side, with the bed head slightly elevated & a pillow behind me. I could see the room now, and asked an unfamiliar Midwife who she was. Kelly held my arm, and Mum was on the other side of me with a washer. 2nd Midwife was fussing 2 monitors with gloves on. I was shaking; Kelly said it was the drugs. Lola was at my side now also. I looked more in control, must have been feeling some effect from the epidural.

The Registrar asked if I was happy for them to do a bit more monitoring with the 2nd twin. Strange I thought, as they had not been at all shy about monitoring so far. Under normal circumstances I would have been confident to object to the monitoring & have them just use a Doppler now and then, but with the epidural in things were different, and I was too busy to initiate a discussion about it now. This is the kind of thing I'd tried repeatedly and unsuccessfully to discuss during the pregnancy. I said it was fine, I just wanted to stay upright. The Anaesthetist was fiddling with drip bags. Ruth and Lola were standing by the bed. Registrar said "I think what will happen is when the 1st twin is out, we'll quickly examine you & work out what 2nd twin is doing”. He was interrupted by another contraction coming, a big one. My sound went from low to high pitched, then hoarse. Not super long. I asked for water, which Mum gave me, & I said "it was really strong”. Kelly said they'd put some more drugs in & it would kick in soon. The Registrar was saying something about the heart rates, which could be heard on the monitor.

At some stage I vomited (from the Fentanyl in the epidural drugs). Lindsay was pretty sure the anaesthetist had ordered Marcain only, but we're not sure. The drugs to be used were not discussed with me, or I could have told them no opiates.

Another contraction. Kelly was sitting on the bed to my left with her hand on my forehead. Mum, Lola and Ruth were on my right standing beside the bed. Midwife was – you guessed it – monitoring. I said I could feel the head, pressure, warm leaking. Kelly was now holding one of the monitors with her left hand. The Anaesthetist was checking with the cold thing, testing it down my legs and on my tummy, comparing it with how it felt on my upper body. I could feel it all. Everyone laughed (apparently at the Anaesthetist, not at me). It seemed the epidural was not a huge success.

4.30pm They now had Mum & Kelly holding monitors while 2nd midwife checked my blood pressure. I looked calm but mildly annoyed. It wasn't enough that there wasn't a Midwife in the place with time for me, now they had to enlist my personal support team to join in this annoying activity. My tummy looked very wide in this position. The bed was quite upright & there were 3 pillows behind me. I glanced to my right and smiled, (probably at the kids). Kelly was still on the bed to my left, Mum was standing to my right holding a monitor & looking at heart rates, 2nd Midwife was crouching on the floor near my feet monitoring, Registrar standing at foot of bed. I was shaking again. A contraction started. I was much quieter. The Registrar came around and ? took my pulse. The Anaesthetist asked how my contractions were, & I said that one was Ok.

5.19pm I had the quilt over me. I was having contractions. Mum & the kids were there.

At some stage about now Registrar wanted Syntocinon commenced due to non progression. Again, I was not now in a position to initiate a discussion about how to define non-progression, but I managed to hold them off. I was 5cm dilated.

6.03pm I still had the quilt over me. The 3rd Midwife would have arrived around this time, the one we'd met. My original Midwife had become unavailable to be on call for me right at the end of the pregnancy, and had arranged for this one to be on call for me instead, as much as she was able to be; someone she knew would support my birth plan. She came to us after putting in a full day's work. Thank goodness for a familiar face.

At some stage about now the Registrar convinced me to allow the scalp electrode to be used on the first twin. I finally agreed; it did look really tiny and I was getting really sick of them constantly mucking around with the monitors. I remember him asking me (about the vocalising) if it helped. I'd love to have given him a long answer about this, but managed only a very definite "yes!”

I'd had some pain relief from the epidural, but only on one side, only slightly, and it quickly wore off. I was really struggling again with the pain, which was getting worse, and I was scared of how much worse it could become, given that it had been up to a level of 11 already and I had no idea how much longer I had to go. The Anaesthetist offered a spinal (or was it my idea?). At 6.30 the spinal was given (after several attempts at getting it in the right place; I remember the 3rd Midwife questioning whether the Anaesthetist should call a Consultant). The spinal drugs go directly into the spinal space, whereas the epidural drugs go in through a catheter left in position in the epidural space. He repositioned the epidural catheter so it would work better. He said the spinal would last for about an hour, and left instructions for 2 bolus doses to be added to the epidural, the first to be put in before the spinal wore off. The spinal worked perfectly and it seemed as much a relief to everyone in the room as it was to me. Total block, couldn't feel a thing!

And I stayed upright! The bed was reclined a few times, but I just kept getting back up again. I was determined to have gravity on my side. Don't let anyone tell you you must lie down for an epidural or a spinal.

The 3rd Midwife introduced herself to the House Doctor. I was lying on my left side, more reclined, with a pillow between my knees. The BP cuff was on. 3rd Midwife was fussing the monitor things. We smiled that both the Registrar and the Consultant were on call all night. I realise now they would only have called the Consultant back if something was wrong, and he probably would not have got there in time and the Registrar would have dealt with it anyway. (Doh and der to me! I suppose the Consultant went home and the Registrar stayed when we went -after hours'. Still, if I'd gone naturally and showed up at an unpredictable time, a different Registrar or Consultant could have stuffed things up). The Midwife said she could only stay til 9pm. Mum and the kids were relaxing on the couch.

6.50 Syntocinon went up. I don't know why I agreed to this or why they thought it was necessary. I don't know how much because it wasn't discussed with me.

7.00 They put in a bladder catheter because of the spinal.

7.18pm I was semi reclining, a washer on my forehead, BP cuff & monitors on, a contraction starting. Lola was holding the camera, Ruth sitting on the bed, Lindsay and 3rd Midwife walking around. I was very softly moaning with my eyes closed.

7.20pm Kelly was back, 3rd Midwife was sitting at the table, Mum and the doctors were gone. I opened my eyes as a contraction finished. I could feel it. Mum walked back in. Ruth was sitting on the bed. I asked: "have I got the Syntocinon in now?” Someone said "yeah, it's been in for a while, been going for half an hour”. I was moaning softly with another contraction. Then the pain suddenly came back in a big way. Lindsay asked me how bad and I said 7. He's noted 1 — 3 mins apart, short duration.

It seems the timing was not quite right with the epidural drugs. Full on pain out of the blue, from no pain at all. 3rd Midwife got the gas thing out for me. I had a go, but it did nothing (other than keep me quiet).

7.22pm on Lola's watch. I was much more upright. My eyes were open and I looked really worried, the gas thing in my left hand, contraction coming. I said "oh here comes another one, oh shit”. I asked if I'd had the other bolus yet. (They must have already put one in since the spinal). I turned my head to the right with my face screwed up. 3rd Midwife was standing beside me with her hands on the gas thing I was holding. Kelly was sitting on the bed to my left. Then suddenly very loud high pitched wailing. 3rd Midwife told me to suck on the gas. I said "the gas doesn't work” and I put it to my mouth. She was holding the monitor things. I can tell by the expression on my face (& I remember clearly) that although I was quiet because of breathing the gas, it wasn't reducing the pain at all, and it was a long, hard contraction. I took it off and said "vomit bowl”. They got it to me just in time.

I sucked on the gas for 2 contractions. Between contractions, I think after the second go on the gas, I was suddenly really stoned for about 30 seconds. I caught sight of the ceiling and said "oh wow, look at the ceiling”. They asked me what about it, and I said it looked just like the one at work (where I'd worked about 3 years ago) but not as grotty. I don't know what I was on about; I think anything that came into my gaze at that particular moment would have been just as fascinating.

It was really weird how alert I was between contractions, not how I normally am at all. My eyes would be open and I would be quite lucid, but extremely anxious about the next contraction. Although very alert, still not capable of asking for things, for example music, aromatherapy, pressure on my forehead, time, how are the kids, get these other people out of the room unless they can make themselves useful to me, stop that bloody machine going ping before I throw something at it, if you're going to keep stuffing around with these monitors could you at least tell me how the babies are doing from time to time, etc. I'd asked them to check how far dilated I was again at some stage about now, and had only been 6 cm. My contractions now rated 12 out of 10, the most painful I've ever had. Since I started feeling them again after the spinal wore off, there was also back pain. Baby B had turned posterior. I'd heard about back pain labour, but although Angus had been posterior for a good deal of that labour, I'd only felt it for one contraction. This was unrelenting, not even stopping between contractions, and nearly as painful as the contraction itself. It seemed I was not progressing at all and had hours of this still ahead of me with no prospect of pain relief. The spinal had worn off, the gas didn't help and the epidural wasn't working. I was panicking and thinking I would end up in theatre after all. I was confused about the mechanics of the spinal/epidural thing too, so thinking I might have to have GA for a c/section. I didn't really understand the spinal/epidural thing properly til now writing this & asking Lindsay questions (he's a nurse). I had thought the spinal went in through a catheter too, but the drugs are injected in directly.

I was between contractions, and really worried now. Everyone was standing around looking worried. Lindsay decided to have a peek between my legs to see if he could see anything going on at all, and found Asha was out up to her ears! What absolute joy and relief I felt at that moment. I had not felt any crowning at all. I didn't feel any more pain after this, so I think the epidural drugs must have kicked in. I don't remember pushing at all, but maybe I did. I don't know if they told me to or not. Anyway, she was all the way out quite quickly, and the midwife lifted her straight onto my tummy.

The video missed it, but started again just as Asha was being lifted to my tummy, pink, wriggling and covered in vernix. The cord was fairly short, and her foot was caught in it. My tummy looked bigger on my right, where Asha had just come from. There were lots of voices. "that was a surprise”. Lola & Mum's voices fussing about the camera. "her head was right out". 2nd Midwife brought a warm towel to put over us. I said "my precious girl”. Someone said "yeah, we paged him”. In 29 seconds Asha cried strongly. Lindsay was standing beside me and put his hand on my hair. I was smiling. My face would be sore the next morning from all the smiling. 3rd Midwife asked "are you Ok if we cut the cord?” I said "only if you have to”, then, "I can feel another contraction coming”. I was still upright but slightly more reclining now. I got them to hold off clamping the cord.

Kelly and 2nd Midwife were to my left, the House Doctor at the foot of the bed, Registrar sitting on the bed with his finger up me. Asha was softly crying on my tummy. I asked the House Doctor to please move out of the way; she was standing in front of my daughter! I'd written on the birth plan that if anyone wanted to watch it was Ok only if they were unobtrusive and didn't get in anyone's way. I should have told this woman to stand at the back of the room or get out. 3rd Midwife was monitoring and asked 2nd Midwife for some more gel, which she put on my tummy.

8.00pm I agreed to clamping the cord, which they said had stopped pulsating, and the Registrar put 2 clamps on it. He then went to cut it, and Lindsay reminded him just in time that he was doing that. 3rd Midwife adjusted Asha's position on my tummy, and was still monitoring. She wasn't getting anything, so felt my tummy and realized Lauren was on the other side. A spare Midwife was giving something to the Registrar.

I said I could feel a contraction, but no pain. The machine that goes ping was beeping in the background. The Registrar announced he was going to break the waters. I had wanted to let this happen on it's own, but agreed. I reasoned that Asha's waters had been broken, and with numb legs I couldn't get up off my bum to help Lauren out, and the sooner she was out the less chance the Registrar would want to interfere. Lindsay was standing at the foot of the bed with the quilt wrapped around Lola and Ruth. Two spare Midwives were watching at the back.

Lauren's amniotic fluid started oozing out. I asked for someone to get the mirror, and directed Kelly how to tilt it so I could see. The Registrar asked if I had a contraction. I didn't, but was pushing anyway, which he thought was a good idea. He popped his finger back in and wiggled it and asked if I could feel it, which I could. This is surprising, as obviously I had some sensation there, and I could feel the contractions as well, but no sensation of the babies descending or crowning and no pain at all.

I was happily giving another push, and 3rd Midwife said to rest if I wasn't really feeling it, not be continually pushing. The Registrar said "just gotta make sure contractions keep coming. He felt for Lauren's head again. 2nd Midwife was standing to my left, House Doctor still at the foot of the bed, her presence there annoying me. The Registrar soaked up some fluid with a towel, and asked if I had a contraction. Someone was paged on the intercom PA. The Registrar held the catheter tube out of the way. 3rd Midwife was still monitoring, and said I was doing a fantastic job. There was another page on the PA. 3rd Midwife popped a fresh bluey under me. Someone said "116”. I asked one of the Midwives at the back who she was. There was another page on the PA. The Registrar asked if I'd had the second bolus dose, and 3rd Midwife told him they had just been getting it when Lindsay had seen Asha emerging.

Lauren suddenly shot out, face down (confirming that she was posterior). Lindsay said "whoa & Mum squealed. (Er, guys, the birth plan says no squealing, and specifically says to remind Mum, lol). Lindsay: "very dramatic entrance there”. Lauren took about 4 or 5 seconds to emerge, all at once. Just after her head there was a big gush of blood and fluid which went right to the end of the bed. I hope it splashed the House Doctor. I'm not sure if I'd been having a contraction, but I had been pushing. I had no idea she was coming at that moment though. The mirror was a great idea, I saw my daughter being born!

The Registrar lifted Lauren straight onto my tummy next to her sister. Asha was on my left and Lauren on my right, opposite sides to where they had been in the womb. Lauren was also pink, wriggling and covered in vernix, and cried in about 5 seconds. They both looked really healthy. I said "that's good, that's good, my other precious girl”. The Registrar was holding some clamps and looking eager to use them, so I said "can we leave the cord” (twice). He said "Oh, Ok, sure”. Me: "leave the cord for a minute & just see how it goes if it's alright”. I was all smiles, feeling euphoric and invincible. Mum: "she jumped right out didn't she”. Lindsay: "just when we thought we might be going -t' operating room”. The Registrar checked the depth of the puddle. I asked what Asha was doing, as she'd curled up and I couldn't see her face. Lindsay: "she's having a kip”. Kelly "she's looking around”. 3rd Midwife told me they were going to give some Syntocinon to help contract the uterus back down. I said "if you think it's necessary”. Midwife: "there's a fair amount of blood”. Me: "looks like it to me too”. I asked was there any meconium. Midwife indicated Asha, Lindsay said "tiny bit baby one”. Midwife was holding a belly button clamp. I got them to hold off clamping and cutting the cord for a few minutes, til it had stopped pulsating. Lindsay and Ruth cut it together.

Asha Frances Langmaid-Buttery born at 7.56pm Wednesday 24th August 2005.
3075g, 6lb 12oz, 48cm long, head circumference 35cm. Apgars 9/9

Lauren Rose Langmaid-Buttery born 8.07pm Wednesday 24th August 2005.
2670g, 5lb 14oz, 47cm long, head circumference 33.5cm. Apgars 9/9

It was just magic to have my two beautiful babies in my arms. My family, except my baby boy, were all with me and everyone in the room enjoyed the moment. Nobody tried to take the babies away from me like they do on TV, we were just left to cuddle together as a family. Both babies latched onto my breasts easily very soon after birth, but only for a few sucks.

The placenta came out just before 8.30. There were no after pains because of the epidural drugs, and I couldn't stand up to let it fall out because my legs were paralysed, so I agreed to let the Registrar tug gently on the cords while I gave a push. First I got him to tell me how he could be sure it had completely separated, and he said because of the lengthening of the cords and something else which I've forgotten. It came out easily. The birth plan asked for it to be examined in front of us like last time, but this was forgotten. The Midwife who examined it said she was pretty sure it was one placenta and not two fused together. They gave me some ibuprofen as a suppository to take care of the after pains when the drugs wore off, and this worked well. I still felt them, but not as painful as last time, when all I had was paracetamol orally.

At 9.00pm I tried offering the babies my breasts, and both sucked but only for a few sucks. As I got one latched on the other would fall off; it was tricky to balance and line them both up at once. So I tried one at a time. Lauren would only suck for a few sucks every time she latched on. So Ruth held Lauren, sitting beside me in the bed, while I fed Asha, who sucked well. The midwives came back at 1am and 5am etc to help me feed them. For Lauren they helped me express colostrum into a syringe.

At about 10.30pm Mum took the kids home to sleep. Lindsay stayed with me and we attempted to sleep a bit, quite unsuccessfully. The babies stayed on my tummy like that til 11.30pm, when a new Midwife convinced me to let them have a bath. Lindsay bathed one and we let the Midwife bath the other one, as we were both exhausted. Neither baby was too impressed about the bath idea. Once they were dressed & wrapped up in their special twins bed, Lindsay helped me have a shower. I had my legs back, but they were still pretty wobbly.

Next morning Lindsay went home and came back with the other three kids; Angus met his sisters, but was more interested in exploring the hospital room. The Consultant popped in to say "what a great outcome”. Yes, it was.

Writing this is as much a debriefing for me as anything else, especially as there was so much stress during the pregnancy about the birth, so I have to add my analysis. How do I feel about asking for epidural drugs? The really full on pain was from 3.30 to 6.30, only 3 hours. Even more surprisingly the second lot of really full on pain was from 7.20 to 7.50, only 30 minutes. When I look at it like that it doesn't seem so bad, but it was definitely much more intense pain than with the other 3 births. Or perhaps it just seemed that way because there was not the usual slow build up. With the other 3 births I'd say the last 6 hours was really hard slog, and the last 2 hours was extremely hard. Of course it could have been more painful with twins regardless of the induction, and there was the back pain as well for the last part, but I'm convinced it would have been quite different if not for the ARM. The whole thing was 11 hours from when the waters were broken, just slightly shorter than the other kids' births, or about 8 hours from when contractions started, but the contractions went from quite manageable to full on so quickly I wasn't able to get into the groove like I had before.

I feel fine about the birth. Although I feel I was conned & bullied & let down in various ways, it really did go well. I had a normal vaginal birth and the babies looked really good and healthy as they came out. They came out on their own rather than being extracted, I had no damage at all, the cords were left to stop pulsating before being cut, the babies didn't leave me at all, I was able to stay upright etc. The Registrar was a good bloke, the Midwives were nice; nobody gave me any hassle or did anything without my permission. Having had three kids naturally already, and being in such good health, they would have to have tried really hard to stuff it up. Still, I think all the energy I put into planning for the birth was well worthwhile. Even though I've had really good birth experiences each time, I always think of things that could have been done better. That's just me, I like to analyse things like that. I'm a perfectionist and it annoys me when things aren't done as well as they could be. Although I'm finding fault, I was ecstatically happy after the birth. I think I must have gotten a double dose of happy hormones this time, because I felt quite euphoric for ages.

If I did it again, I'd book a private Midwife to be on call to meet us at the hospital. I wouldn't be induced, I'd just wait to go into labour naturally. I'd insist on using the bathtub, & kick up a stink as soon as I got there until somebody gave in and ran it for me. I'd take more CDs, and have a family meeting about who was operating which cameras and when. I'd have a birth plan meeting with everyone there.

Still, my family and Kelly were a wonderful support, and we did get some great pictures & video. I stayed in hospital the night the babies were born, and the next night, and we all came home on the Friday. They wanted me to stay a bit longer because Lauren was not sucking at the breast & was being fed with a syringe, but I really needed my own bed and some decent food, so they made a feeding plan for me and we were on our way. The Midwives were all brilliant about helping me with feeding and expressing, and visited daily to continue that help at home. Asha and Lauren will be 8 weeks old tomorrow, and I'm only just getting this finished, having been flat out breastfeeding and trying to keep up with the washing. They're thriving and Lauren has been sucking well at the breast since about two weeks. I have five beautiful children and a husband who loves us all, and I have to remind myself how lucky I am, as I type one handed amongst the chaos.


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