Twins vaginal delivery (very very long)
regenab
member
July 9th 2008 -
I had my 36 week check up with my OB, everything was still all normal and since I had made it to the 36 week mark we decided to schedule my induction for the next week 37w1d. My OB decided to do a cervix check since I had not had one ever up until this point. I was 2-3cm dialated and 90% effaced. She said that could mean nothing or that I might be back that night.
The next day I had my final growth scan with my MFM (maternal fetal medicine doc) to check the babies size and make sure I was all good for my induction the next week, as long as they were good size they would go through with it. I was measuring 48 weeks pregnant at this point and was ready to evict those babies, I was quite miserable and uncomfortable. He said they looked great and estimated Baby B to be 5 1/2 lbs. He tried to get measurements on Baby A, but she was so low in my uterus he could not get a good measurement of her head to calculate her weight. He took at guess at the measurement and approximated her weight to be 4 lbs. 13 oz., so we were all clear for the induction the next week. He decided to do a cervix check to see if I was anymore dialated. He measured me at 3cm and 100% effaced, he said he was touching Baby A's head. I then went and had my scheduled NST (non stress test), not showing any contractions on the monitor that made another NST appt. for 3 days later and told me they would see me then.
We got home and my DH decided to go to the gym while I parked my big butt on the couch to watch some recordings on the DVR. I got up to pee again for like the 10th time that hour and my water broke while on the toilet (perfect timing). I was not sure it had broke at first. I just heard fluid coming out of me and into the toilet, but I had not started to pee yet, I still felt like I had to pee. I thought that was strange because I didn't feel the pee coming out like I normally did. So I did pee and felt that. Once I stopped peeing I could still hear fluid hitting the toilet water and thought, well I guess my water is breaking. I stood up to see if it would still flow out and then there was a big gush and it all came out. It would not stop. After a couple of minutes it finally slowed down and I grabbed the 2 hand towels hanging (I was in the powder bath downstairs) and put them in my underwear. I went to grab my cell phone to call my DH. I called him and of course voicemail, he was still in the gym. I then decided to call the vet, because we had to take our dogs into be kenneled while we were at the hospital, they had been expecting us to call at any time to bring them in so I just needed to let them know were would be in as soon as we could to drop them off. It was exactly 3:58PM when my water broke.
I called my Mom to tell her I would be having the babies soon and she should be waiting for the call. My DH is in the military and we are stationed in VA. My family and his family are all in Florida and none of them could be at the birth.
DH showed up from the gym and I was upstairs at this point in our bathroom sitting on the toilet as I had a continous flow of fluid coming out of me from my water breaking. I was on the phone with labor and deliver telling them we would be coming in a few hours. We lived in Northern VA, which is the DC Metro area and it was rush hour traffic time, I was not about to get on the beltway at that time of day. I told my DH my water broke. He got in the shower to clean up and I made a few more phone calls to friends and family. Once he was done in the shower I got a shower, because I figured it would be a while before I would get another shower. At this point it has been a half hour since my water broke and I had not had one contraction yet.
When I was done showering I came downstairs and DH was making final preparations for leaving. I got my first contraction at 1 hour and 10 minutes after my water broke. It wasn't too bad, just felt like a bad cramp, that lasted about 2 minutes. I ate a peanut butter sandwhich and had some water before we left. We dropped the dogs off at the vets office and were on our way to the hospital at 6:30PM.
We arrived at the hospital (the big Navy hospital in the area - some of you can figure out which one I am sure, but I will not name it due to my after birth story part) at 7:10PM. We went right to labor and delivery and they took us into a triage room. I was no longer leaking fluid and since they couldn't see any fluid in my vaginal canal they told me then needed to do an internal to test to see if my water broke. I laughed at the guy and asked if he was joking (he was a med student). There is no way I was mistaken in what happened earlier, my water definitely broke. He kept insisting that I needed an internal because he had to be sure. I gave in and let him do it. A resident came in during the middle of it and there was another small gush and fluid came out right away. The resident was of course asking why he was doing an internal on me, since clearly my water had broken. Anway they put me on a monitor and still no contractions. I was terribly uncomfortable at this point, they had me on a hard metal table with no back support what so ever. At this point I am 36 weeks and 2 days pregnant with twins and I was measuring 48 weeks pregnant. Laying on a hard metal table for an hour and half was not my idea of a good time. They were waiting until a labor room opened up. I guess all the other pregnant women at the hospital decided to go into labor the same day I did, they were overcrowded with no rooms available. Finally at 10:00PM a room opened up for me.
I got to a room and had only had 3 contractions so far and was not in any real pain, just back ache from the hard table I was on for 3 hours. My L&D nurse was great, she got my IV's started (I needed several because I had Gestational Diabetes and they needed to give me insulin throughout the labor because I wasn't allowed to eat). She asked me what my pain management goals were and I told her I had none, just order the epidural now. My OB's gave me no choice about an epidural. I had to have one if they were going to delivery my babies vaginally. Since I wanted a vaginal birth if possible (both babies were head down) I told them just go a head and get it done. They will only deliver twins vaginally if I had an epidural in case something went wrong and they needed to do an emergency c-section, I would already have the epi in. This is common for twins births, also I had to deliver in an OR room, also in case something went wrong they could open me up right away.
At 1:00AM the epi was placed. I was so happy, not because I was in any pain at this point (still hardly any contractions) but because they put in a catheter and I no longer had to ge up and go to the bathroom to pee every 2 minutes. Docs came in and checked me and I was still at 3cm. They said it was time to start the pitocin since I wasn't having many contractions at all and they were no strong contractions. They started the pitocin at 1:30AM, DH and I settled in to get some sleep for the next day. At 5:00AM the docs check me again and I was still at 3cm. They upped the pitocin again. At 8:00AM they checked again and I was still at 3cm, the monitor said I was having contractions but I was not progressing. They inserted a vaginal monitor to see how strong my contractions were and upped the pitocin again. At 11AM, I was at 4cm. At this point they started talking about a c-section if I didn't start progressing soon. They upped the pitocin some more since the babies were doing great and were tolerating the high amount of pitocin. At this point my L&D nurse (which was a new nurse since 7AM) said that it was a good thing I had an epi. because the amount of pitocin they were giving me was making my uterus contract non stop and there is no way I would have been able to handle that kind of pain, no one can she said. At noon I was at 6cm and they decided to up the pitocin again and put me at the maximum amount allowed. At 1:30 I started to feel uncomfortable I was having pain, so they called Anethes. to check my epirdural and give me more meds in since I was in pain. Anethes. showed up and check the line and could not figure out what I was feeling pain, it was only on one side, so they decided to up the amount of meds they were giving me to try and numb me back up on that side. It didn't really work, it started to numb me back up for like 20 minutes and then it had worn off again. The Aneths. asked when was the last time I was checked and it had been about an hour, so she asked them to check me again. I was at 10cm, that is why I was feeling so much pressure, not pain it was pressure. They didn't give me any more meds at this point and started to prep me for delivery.
We pushed in the room for about an hour and I had gotten Baby A's head to crown. They told me to hold that position and keep her head crowned while they moved me down the hall to the OR room. I thought they had to be joking, I was supposed to hold her in that position for that long. They wheeled me down the hall and into the OR room, no one was there waiting, that is because they took me to the wrong OR room. They moved me next door to the next OR room. Hooked me all up for delivery. There were 2 sets of Pediatric teams (each team had 4 people) 1 attending OB, 2 residents doing the delivery, 1 Anethes. prepared for a C-Section if necessary and to monitor my viatals, my L&D nurse and my DH and 3 medical students observing. All in all there were 16 people in the room not counting DH or myself. My epi. had worn off at this point and I was feeling everything. I pushed for 10 more minutes and Shayne Elizabeth was born at 3:49PM. She was 4 lbs. 14 oz., screaming her head off. They cleaned her up and checked her and held her up for me to see from across the room.
They started doing ultrasounds to see what Baby B was up to, making sure she didn't turn herself sideways after her sister had come out. She stayed head down and was moving down into position for delivery. They broke her water and it was time to push again. I pushed for another 3 minutes and she was born at 4:00PM exactly. Sydney Reese weighed 4 lbs. 15 oz. and was crying just as loud as her sister. 24 hours after my first water broke I had my 2 beautiful girls. I just kept saying over and over again to my husband that I had done it, I really had done it. They brough the girls over to us to see. I was so happy they were beautiful, very healthy and they took them to our room right away, no NICU time. I was told they would be waiting for me back in the room.
The next part is where the problems started, so if you don't want to hear about my scary post partum experience you may want to stop reading.
Most of the room had cleared out with the babies, I was left with my DH, the residents, the attending, my L&D nurse who was cleaning me up, and the Anest., we were waiting on my placentas to deliver. It was taking longer than they had hoped and at 45 minutes my first placenta still was not delivered. Finally it delivered and the second followed right away. They appeared to be intact and I was told everything looked fine. But then my uterus was not clamping down and I was still bleeding a lot. They put me back on the oxygen and started pulling clots out of me, a lot of clots, some as large as sweet potatoes and the bleeding was not stopping. I was in a lot of pain, they kept reaching up into my uterus and pulling out more clots. Everytime they put their hands in me I was in so much pain. Finally after 20 minutes the bleeding slowed and they were not pulling out anymore clots. I had only a very small tear from the birth and it only required 1 stitch. They cleaned me up some more and put my catheter back in at this point because they wanted to make sure everything was ok for a few hours before taking it out.
They wheeled me back to the L&D room because they had no post partum rooms available because of the overcrowding from earlier. I got back to the room and my new nurse came on shift, my L&D nurse from delivery was still there going over everything with the new nurse and helping me to get set up to nurse. We put Shayne onto nurse and she did really well for the first time. I was so nervous because I didn't know how nursing would go and I was very pleased that she was doing well. They had given both babies some formula before I had gotten to the room because their blood sugars were low at birth because of my gestational diabetes. Even though she had some formula she still was hungry and ate well. We then put Sydney on to nurse, she did not latch well at first, so we kept trying and she finally got a good latch. She was only nursing for about 2 minutes and I started feeling really dizzy. I told the nurse I didn't feel well and she put the oxygen mask back on me and everything started to go black. I remember telling my DH, take the baby I am going to drop her and I passed out.
I woke up a few moments later when they were all pushing on my uterus and yelling my name. I was bleeding again, a lot. The attending came running in the room along with the 2 residents from my delivery and they started working on my uterus right away. There was blood pouring out of me and they were again pulling clots out of me that were enormous. I was in so much pain. I have never been in so much pain in my life. The nurse kept giving me shots of medications to help with the pain, but nothing was helping. They kept paging Anethes. but no one was answering. I was trying to move off the table to get away from them and screaming in pain. I was completely panicked and begging my DH to make them stop hurting me. The attending told my new nurse to go down the hall and grab an Anthes. out of one the OR rooms and get them down to my room and told the other nurse that arrived to have them prep an OR room for me, I might be going in for surgery. They typed my blood and ordered blood to be brought upstairs for me in case they needed to tranfuse me. Again during all of this I am screaming at the top of my lungs, my eyes are swelling shut from crying and I my heartrate was at 190. The attending kept yelling at the nurses to get someone from Anesthe. in my room now to put me out because I was in too much pain and was moving around way to much for them to get the bleeding to stop. Finally 4 Anethes came into the room. At this point from all of the caios and my screaming that could be heard on the entire floor, there were more than 15 people in my room. They started giving me drugs by injection, but did not put anything into epi., which was still in my back from the delivery. I was still in pain and still moving and screaming even though they had given me everything they could think of for pain at that point. I was so upset and was screaming at husband to make them stop, saying he was my husband and he had the right to make them stop, he outranked some of them and they had to listen to him and he could make them stop. They were reaching inside my uterus and pulling out handlfuls of clots over and over again. Finally my husband was so upset and started crying a little himself (he told me later he was terrified, he thought I was going to die on him in that room) and asked them if they could please move me to an OR room and put me under. They decided to put medicine back in my epi. line to numb me from the waist down. It finally kicked in, I finally started getting some relief from the pain and stopped moving and the bleeding slowed down.
During this entire affair my girls were in their bassinets next to my DH sleeping away. I cannot believe they slept through all of my screaming. After a couple more hours they moved me to a post partum room. They kept my catheter in and didn't let me get out of bed because I had lost so much blood. I felt awful, I was very swollen from the amount of pitocin they had given me earlier, every part of my body was swollen. I looked like the Michelin man. I tried to nurse again, but I was so week I couldnt' stay awake to hold the babies, my DH tried holding them for me, but the girls didn't want to latch if I wasn't holding them. Finally he broke down and fed them formula. He stayed with me all night and took care of the girls when they woke up, which wasn't a lot, thank goodness. The next day I was still very week. I ate some food and drank some water and tried to get myself back to being able to nurse. That afternoon we made the decision to let them give me a blood tranfusion, because I was just too weak. That evening they started the transfusion and my DH had to leave to go and get our dogs out of the kennel. They could not be boarded any longer the kennel was full and needed their spots for reservations they had for the weekend. He also needed to get some sleep, he pretty much had gotten a total of 2 hours sleep in the last 72 hours.The girls were in the room with me all night and I was able to nurse them again with the nurse helping me. The next day I felt so much better, the transfusion had done the trick. I was able to get the catheter out and walk for the first time. They told me we would all be discharged that day and could go home that evening. Then 15 minutes later the Pedi. came in and said one of my girls had to go under the lights, her billirubin levels were too high, so we were not going home after all. The put her under the lights in a portable unit right in the room. It was awful, she cried for the next 15 hours straight. It broke my heart, I was only able to take her out every 2 hours to feed her and hold her for a couple of minutes then she needed to go back in under the lights.
The next morning my DH arrived again and the pedi. came and took the one twin to check her levels. They brought her back and said she was good to go home and we were being discharged.
Now to explain, the hospital does not have a nursery, they only have a NICU and if your babies are healthy they stay in the room with you at all times. Since my girls did not need to be in the NICU that is why they put my baby in the portable unit in the room with me. The Pedi. told me that because of what had happended to me and that I really needed to rest as much as possible that normally they would have moved the baby to the NICU and had her there so I didn't have to see her cry for so long and could sleep, but there were three other sets of twins that were born the day along with my girls and the NICU was full because the other sets of twins all required NICU time since they were born before 36 week and had lung troubles, there was no room for my baby and since technically she was healthy she had to stay in the room with me. I understand why it happened, but I was not happy about it. This Navy hospital handles all of the multiples births in that area for the military healthcare system because they are the only military hospital in the area that has a level IV NICU and can handle very premature babies.
We were discharged and all seemed well. A week later I started hemoragging again at home, but it quickly stopped so I never went to the ER, I had lost some large clots but all seemed well once they came out. My milk supply was still low and I was supplementing with formula because one of my twins had dropped down to below 4 lbs. and needed the extra calories to gain back the weight. I kept having constant fevers so I went back to the OB as an acute care case, they felt my uterus on the outside and since I didn't seem to be in pain they said they couldn't see a source of infection and that my milk was probably just coming and that was the reason for the fevers. I saw a lac. cons. because my smaller twin was having major latch issues and was not eating well. I started pumping that day to try to get my supply up. I was told I had to pump every hour when I was not nursing. Basically I was not sleeping at all. My DH did everything he could to help me, everything but nurse and pump for me. He was the one taking care of the girls by himself when they were not feeding because I was either pumping or trying to catch 20 minutes of sleep. I tried to sleep when they slept, but since they were up every 2 hours to feed and I had to nurse each one seperately because they each had latch issues, then had to pump afterwards while DH supplemented them with formula, it was a never ending cycle. Then at 2 weeks PP, after I got up to feed the girls at 3AM and then pumped, I had an attack of severe pain that would not stop. It was not cramps it was pain. I was in such horrible pain I felt like I was back in my PP room again going through all of that pain over again. My DH found me lying on the floor in the living room with the pump in my hand crying in so much pain. He immediately loaded us all up in the car and took me to the ER at the Army Hospital on post where we live. After 5 hours in the ER I finally got an ultrasound and they discovered I had retained products of conception in my uterus from the birth. I saw the head OB at the Army hospital and he said he thought it would pass on its own, but if I was still in pain in a few days to go back to the Navy Hospital and have my OB's decide if maybe I needed an D&C. He gave me a precription for Vicodin and sent me on my way.
At this point my DH's paternity leave had run out and he needed to return to work. My BFF's parents were driving back from Florida (where she lives) to there home in PA and decided to stop in and see the babies. They are both school teachers and were off for the summer. They took one look at me all doped up on Vicodin and decided they needed to stay and help. Thank God they did, we didn't know what we were going to do, I couldn't be left alone with the babies because as soon as I took a Vicodin I was out of it for at least 2 hours.
Fast forward to a week later, I am still on Vicodin 24/7 and I am still running fevers off and on, but every time I call my OB's office at the Navy hospital they tell me the clots will pass on their own and give it some more time and keep taking the Vicodin and Ibuprofen them gave me at discharge. The next day my DH can't take it anymore because I am melting down daily from trying to constantly pump and get my supply up, at this point the girls are not nursing from me anymore because I am passing out while they are trying to nurse from the Vicodin, so they are bottle feeding half breast milk half formula, he decides we are driving to the OB at National Naval and we are not leaving until someone examines me and give us a solution. We go there and set up camp in the lobby until they finally give in and have someone see me. I get to a room and the nurse is of course rude, just like the rest of the staff that we talked to that morning because they didn't want to deal with us. And she takes my temperature and says I am running a fever or 102 and how long has this been going on. I tell her since I was 2 weeks pp. I am now 3 1/2 weeks PP. The OB comes in, who I have never met before he is there only 1 day a week because he is normally stationed at another Army hospital close by, but they all have to take a shift at the Navy Hospital one day a week. He does an ultrsound and says it is time to get the "gunk" out of my uterus. He set me up for a D&C for that night. It is now 3:00PM. I was sent up to the surgical floor and prepped for surgery later that night. My D&C takes place that night at 11:30PM, I had to wait for the OB team to finish several other D&C's that evening from women having miscarriages (very sad). I wake up 45 minutes later and am placed in a recovery room. They tell me that got it all out and that it appears to have been infected, which was causing the pain and the fevers. They kept me for another 24 hours to give me IV antibiotics. I am discharged the next day. I feel like a new women. This is how I was supposed to feel after my delivery. Before my D&C my HCG levels were still at 80, so my body still though I was pregnant and would not let my milk come in fully. My body finally figures out that I am no longer pregnant and my milk finally kicks, but at that point I had already stopped nursing and pumping so my girls were on full time formula and we decided to let them stay that way. I needed my rest and to be taking care of them, not strapped to a pump all day long.
My girls are now 4 months old and doing very well. We are all very happy and glad we will not be doing this again. No more babies for me.
I had a wonderful birth, just a horrible post partum experience. I am not knocking the military healthcare system this could have happened at any hospital, I just wish that they would have been more proactive with my post partum issues instead of the constant wait and see approach they were taking.
Re: Twins vaginal delivery (very very long)
DD #1 passed away in January 2011 at 14 days old due to congenital heart disease
DD#2 lost in January 2012 at 23 weeks due to anhydramnios caused by a placental abruption