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Normal Twin Birth Despite Induction For Pre-Eclampsia

5/20/2013

16 Comments

 
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When I was 34 weeks pregnant, my blood pressure was becoming more and more problematic.  I was already on “take it as easy as possible” bedrest for two weeks at that point, so I was kind of annoyed.  At my weekly appointment that Wednesday my blood pressure was 170/95, and my doctor was like hmm, that’s not good.  So we ran some tests, and when I got a call back directly from my doctor (instead of his nurse), I knew that was a bad sign. 

I was officially diagnosed with pre-eclampsia and he said we should move towards induction and birth  He was GREAT on the phone call, apologizing because he knew my plan for a natural Hypnobabies birth.  He explained everything slowly and let me process as much as possible, saying that he already scheduled the induction for the following day at Woodwinds (Hudson Hospital wouldn’t take me because I wasn’t 36 weeks).  I trusted him and knew if he said an induction was necessary, it was.  Both my doula, Lindsay, and my doctor reassured me that when your body has these sorts of complications, inductions tend to go much smoother because your body wants to be done being pregnant.  

So Saturday morning (when I was exactly 35 weeks) my whole birth team was ready and arrived at Woodwinds.  My husband, mom, Lindsay my doula and Erika my birth photographer all settled into my room.  My mom was prepared to be my guard dog with any medical questions/decisions, which I think worked out fabulously because I was able to stay in my bubble and only be bothered if actually necessary.

Dr. Hartung came in and explained how we would start the pitocin, and I’d need to have a magnesium sulfate drip to prevent seizures and keep my blood pressure down during labor.  Then he gave my husband and I an hour to just settle in (completely free of monitors and IVs and nurses) and everyone just left us alone.  It’s amazing how that little bit of time really helped calm both of us down.

We got me all hooked up to fetal monitors, an IV (with three different drips going into it) and we were off by 11 am.  My doc checked me to know my starting point and it turned out I was already 3 cm dilated and 75% effaced.  My bishop score was a 9, which is great for a successful induction.  Not that I was told any of this until well after the fact.  He even told my doula we’d have these babies by dinner time.  (She was like really? Are you sure? And doubted him.  Turns out he was right!)  The worst part about the interventions was the mag sulfate, because it meant I wasn’t allowed out of the bed except when I wanted to use the bathroom.  (There was a real risk I would get lightheaded/dizzy and pass out. I learned they weren’t joking after my birth when I was still on the mag sulfate and tried to stand up and almost passed out.)  But as long as I stayed in bed, I could move however I wanted.

During the next few hours they would slowly increase the pitocin at a manageable rate. I would turn my light switch off during a pressure wave, then come up and be totally fine.  We would chat, my husband brought me a popsicle, and I’d periodically snack on some beef jerky.  It wasn’t a particularly quiet room if I wasn’t off, but the mood was light and cheery.  My doctor came in after we put up our door sign and spoke in a whisper (when clearly no one else was at that point) and I just had to chuckle.  I told him it was okay, you don’t have to whisper right now, but thank you for being awesome enough to do so.

Once the pressure waves got slightly closer together and more intense, I started to rely on my support team more.  I have vivid snapshot memories of this period of time.  I remember Lindsay ad lib-ing birth prompts on one side of me with my husband periodically whispering peace or relax in my ear.  I LOVED super cold washcloths because the stupid mag sulfate made me super hot.  I got all annoyed that my mom’s hand was hot, but it turns out it was mine, ha.

The video below shows me using my Hypnobabies tools: Listening to a cd, with my husband and doing using the Release and Relax cues, and Lindsay doing birth prompts.
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©Erika Torkelson
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©Erika Torkelson
At one point I was leaning back against my mom and she’d sway and I would stay completely off.   I felt surrounded by people who completely loved and supported me. 

A few times my doctor would come into the room and I wouldn’t even realize he was there if I wasn’t facing the door (he even took the time to take his shoes off so they wouldn’t squeak).  He’d just stand there patiently waiting if it looked like I was focusing on a pressure wave.  One time I was startled by his presence and laughed at the fact that he snuck up on me. 
Around 4:30 pm or so they had increased the pitocin to the point that the waves were very very intense.  They really did feel like just intense pressure, but it was difficult to relax fully when there wasn’t a decent break in between.  I remember bearing down at one point, and I think it was my body’s way of instinctually trying to slow the waves down.  It actually felt good to just put that little bit of internal pressure.  That led to my doctor checking me, and I was at a 5.  I really wanted to know what I was at, but nobody would tell me (and I’m glad they didn’t  - I think I would have been really disappointed).  My doctor crouched down right in front of my face (the only way to really get my attention) and told me I was doing absolutely fantastic.  I told him he wasn’t allowed to lie to me, and he laughed at me and said he wasn’t.  
This video shows my team in action even more! I was tensing up and Lindsay helped me keep using my tools to relax.
Over the next hour or so I would switch between being on all fours and resting my head on the bed in between waves, and side lying.  My doula would put a peanut ball in between my knees to keep my hips open and it was not at all comfortable, ha.  But I knew why it was there so I let it go and said fine.  I would periodically look at my IV to see what the pitocin number was and be like “16?! That’s high!” and start to fixate on the number. So Lindsay eventually found a towel and covered up the monitor so I couldn’t see it, ha. 

By 5:30 or so I was checked again and I was a 9! So I’m very glad my doctor didn’t freak out that after 5 hours of pitocin I had only progressed to a 5.  That whole 1 cm an hour thing is just silly.

At that point my doctor said that everyone should start getting ready to go into the OR.  Because I was having twins, Woodwinds has a stupid policy of having the actual birth in the OR (super lame).  After that I kept fixating on “when are we going to the OR? When? Why not now?” because I knew that once we actually went, that meant I’d get to meet my babies soon.   Around then my nurse, who was okay but definitely not my favorite person, said you’ve only got one centimeter left, and for a good minute I was super angry.  I was totally in my birth bubble and even then I thought “hey bitch, don’t you know the rules of my room, I said I don’t want to know.”  She also kept forcing Baby A’s heart monitor to stay on and the strap was horribly uncomfortable, so I did my damnedest to keep moving it off (the pressure bothered me). 

There was also big hubbub about my nurse telling us earlier that I could have three people in the OR (husband, doula, and mom), and then came back and said oh wait, sorry, only two - doctor says.  (None of us believe it was actually my doctor because he couldn't care less).  I got really upset having to choose between my mom and doula, but eventually picked my doula. 

Around 6:15 pm I was on all fours and bearing down again, but definitely in a different way than before.  My doctor came and checked me again and I was +1 and 10 cm.  (He was jotting down my progress on a sheet for my doula, and for this one he actually wrote “10!!” and the double exclamation point still makes me chuckle.)  As he checked me I was pushing and he was like oh! Time to go! So I have to assume I was pushing effectively.

 I finally got to be wheeled into the OR.  The nurse tried to tell my doctor that I needed to lie down to be moved, and he was like no. and put his foot down.  (Did I mention I love him?) So off I went down the hall on all fours (I was wearing a hospital gown, but backwards so it was like a robe).  As we went, my doctor crouched down by my face and rubbed my back and said “you’re going to be a mommy!” and even in all the craziness I grinned.  

Once in the OR it was super bright and there were quite a few nurses (for the babies) and I think it threw me for a bit.  I was in the same position, but my pushes became ineffective.  My doctor even tried to talk me through how to bear down “like I’m pooing” (My husband jokes that he totally understood what my doctor was saying.)  Someone suggested I try a different position so I did side lying, with my doula holding one of my legs up.  That definitely worked better, and was all it took to get my pushes to be effective again.  I remember trying to breathe through the pushing (aah baby out right?), and someone said “hold your breath!” so I did and bam! I could feel his head right there and knew exactly how to push.  It turned out I was a momma who needed to really push. (Editor's Note: In Hypnobabies we teach mother-directed pushing.  Some Moms find they need to actually "push" very little to give birth, and others push quite a bit and both ways are wonderful!)

At 6:58 pm I gave birth to my baby A, Jackson.   I even felt that flutter kick reflex as I pushed his body out.  He came right up onto my belly (couldn’t reach my chest because he had a short cord) and took a few seconds and then started screaming.  All the special care nurses were anxious and annoyed that my doctor let his cord stop pulsing, but he knew we were all fine (apgar scores of 8/9!).  Eventually he clamped the cord and let daddy cut it.   He was all gooey and had lots of vernix, and I couldn’t stop talking about how much hair he had.

Once I started feeling pressure the nurses and daddy took him over to a warmer.  Daddy was right there the whole time, even though I’m sure the nurses would rather he had gotten out of the way.  He even took his shirt off to do more skin to skin with him.  The nurses tried to tell him this is an OR, you have to wear a shirt, but he didn’t pay much attention.  So they awkwardly draped some gown over his shoulders (because that made it more sterile).

At some point during this time, my doctor checked me to make sure that baby B was still head down.  She was, so he broke her amniotic sac.  He ended up keeping his hand up there for longer than I expected, and apparently I said “what are you doing down there?!”  I’m still not sure what his answer was. 

Either way, her head engaged right away and with the next pressure wave I was ready to have her out.  My doula said that I said something about “oh gosh, I have to do this again!” Poor daddy was so distracted by Jackson that he had to be reminded I was ready to have his sister! He quickly came back and grabbed my hand, and with three or four pushes (just one pressure wave) I had Mackenzie at 7:09 pm, 11 minutes after her brother.  She was a bit smaller, but no less feisty.  And she peed on me the second she came out, ha. It took her a second to start crying, but once she did she was letting everyone know she was there.  Two perfect babies. 

Daddy went back to hold Jackson skin to skin, and by the time Mackenzie’s cord stopped pulsing he almost didn’t want to cut her cord (too distracted, not enough hands).  Well the doctor didn’t give him much of a choice because he just put the scissors in his hands and said here you go! So he’s wearing a gown that looks like a superhero cape, holding Jackson and cutting Mackenzie’s cord.  Behold – super twin daddy! 
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The madness of my OR room ©Erika Torkelson
A bit later I birthed my placentas, which was a very satisfying feeling.  And my doctor even took the time to show me the two separate sacs and placentas, which was pretty neat.  Then he gave me a quick stitch (thanks to Mackenzie coming out super fast). They handed me back both babies and I got to hold them as they wheeled me back to my room.  Just a few minutes later, Mackenzie latched on like a pro and began breastfeeding.  With a bit of help, we even got Jackson breastfeeding at the same time.  One of the special care nurses hung out in the room with us, keeping an eye on the babies, but she was great in letting us cuddle skin to skin and get some breastfeeding time in before bringing them to the nursery.  I liked that nurse.
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Tandem breastfeeding my tiny babies! ©Erika Torkelson
Eventually they took the babies to the nursery, and daddy and my mom went with them.   I got to stay behind (which was very hard) and deal with the after effects of a mag sulfate drip.  The nurses kept telling me I’d be on it for an additional 24 hours, but my doctor (once again) put his foot down and had them take it out 12 hours later.  Once they did that, I was finally able to get myself into a wheelchair, not get lightheaded, and go see my babies! 

We spent about a week in the special care nursery.  Thankfully, they did fantastic for 35 week babies, and just needed to gain some weight.  I was so thankful to have the support system I had, and my doctor truly advocated for me to have as close to my original birth plan as medically possible.  I didn’t plan on developing pre-eclampsia, but I’m very very happy with how my birth went. 
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Two of my three fabulous supporters – my momma and Lindsay my doula. Josh was already off in the nursery with Mackenzie, I still had Jackson. ©Erika Torkelson
Note from Doula Lindsay: Sam did so amazing!  Even when her plans changed and she needed to be on pitocin and magnesium, she was able to remain calm and deeply relaxed and in hypnosis with her Hypnobabies tools and techniques!  This story is a beautiful example of how a mom can use her Hypnobabies tools and techniques even if the plans change!  They are always there, and a mom can always choose to use them.  Within the first hour after giving birth, Sam told me that her birth, while intense, was still comfortable.  Wow!!  
16 Comments
Ricky link
5/20/2013 07:37:32 am

Awesome story! I am a doula and Hypnobabies instructor in Canada and I will definitely share your story with any twin mama students I have. Sounds like you had an amazing birth team surrounding you! Well done!

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Sam
7/5/2013 01:07:05 pm

Yay! I love fellow Hypnobabies twin mommas :-)

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Tonya
6/10/2013 06:10:51 am

What an AWESOME birth story! All too often we hear about reluctant/completely uncooperative doctors, so it was a joy and a great pleasure to hear about how thoughtful, caring and cooperative your doctor was. He deserves OB-GYN award of the year!!! Blessings to you and your amazing family.

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Sam
7/5/2013 01:06:04 pm

He definitely does deserve that award! A bunch of us joke about what are we going to do once he retires?! (seriously though, there needs to be more of him, haha).

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Gifty
6/13/2013 12:56:10 am

God bless your heart.. Truely an amazing Story!

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Sam
7/5/2013 01:03:57 pm

Thanks so much!! I'm glad to share!

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Nicola
6/25/2013 11:43:20 pm

Well done, I wish there was more support from medical staff. In our unit UK anyone with PET would be strongly recommented an epidural. So nice to know that our badies can still cope with this natural process even when there are some complications if only we belived in ourselves and the hypnosis.

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Sam
7/5/2013 01:03:30 pm

Most OBs here would also push for an epidural, both because I had pre-eclampsia and especially because of the twins. Thankfully, I sought out my amazing doctor and he trusts women's bodies to be fully capable of amazing things. He doesn't feel the need to "save" women from birth, just accompany them along their path like a lifeguard, just in case. Thanks for reading my story! :-)

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Jacqueline Levine
11/11/2013 09:38:38 am

Wonderful! Extraordinary! Not likely to happen much here on Long Island! WHO IS THAT DOC? Where are youj and where does he practice? Always good to know ! You should go to www.thebirthsurvey.com to tell your story. It's an all volunteer birth website where you can tell other mothers (anonymously) all the info they may need to make decisions about caregivers in your area. Its part of the Coalition to Improve Maternity Services and your birth is just what's needed! Bravo to you and your new babes and a hearty welcome to them both!

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Patty
11/12/2013 04:56:25 am

Great story!!! That is a wonderful doctor!!! Can you tell us who, and where? best in Your Mothering Journey P.S. First babies,, or do you have older kids?

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Anne
11/13/2013 08:22:46 am

Dr. Dennis Hartung is our local "midwife in OB's clothing" and is featured in more than one story on this site. He's amazing!

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Mindy
11/15/2013 03:24:54 am

Wholeheartedly inspirational and I will be sharing with my classes. LOVE the photos and commentary. Congrats on a beautiful birthday!

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Irma
3/14/2014 12:13:25 pm

Pass the tissues! What an amazing birth story! I'm still mopping happy tears :-) You are fantastically strong and rocked your twin birth! And what a cool doc! (He took his shoes off?! If only we had more like him, lol!) Your hubby sounds like a super - daddy indeed. My sister is having twin soon and i so wish she could have the kind of birth (minus the pre-e and necessary treatments) you had.

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April link
6/11/2015 03:39:41 am

WOW!! LOVED THIS!! I am 32 weeks with twins right now and just spent 2 days in the hospital under observation for preeclampsia. I am able to go home as its pretty mild right now and will be watched every couple days and checking my BP a couple times a day at home. I also want/plan as natural of birth as possible but clearly these two have other plans. So glad to see this went well for you it was the positive story I needed on preeclampsia and induction of twins. Thanks so much for sharing.

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Jessica
6/23/2015 03:37:45 am

Thank you so much for sharing this story! I am weeping here at my computer. I am a first time mom pregnant with twins and I am really hoping on a beautiful hypnobirth!

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April
5/3/2021 02:23:43 am

Thank you for sharing this. I'm currently 32 weeks with twin girls and looking at an early induction due to cholestasis. This story made me feel a lot more confident about still being able to use my Hypnobabies tools during my unexpected induction.

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