Birth Story: Unmedicated, Double Breech, Twin 2VBAC
The last few months have been times of uncertainty for me and my family. We had moved to a new province amidst a pandemic where we virtually knew nobody. Before we moved, my 17-month-old was completely out of diapers day and night, so we gave away all her cloth diapers and elimination communication (EC) supplies. And boy, was it nice to road trip with 2 children out of diapers and no accidents! We thought we were done with children. Well, at least for the next few years or so.
Soon after arriving in our new home, I started feeling awful. I recognized this feeling. I knew I was pregnant even before taking a pregnancy test. However, the pregnancy symptoms I was feeling were worse than those from my other uncomplicated pregnancies. I thought, Am I getting old? Is it because my body is getting worn out? I'm only 30... I don't think I'm "old."
It turned out that we were having TWINS! Two babies at once when we weren't even planning to have another single one now or possibly even ever!
Through a very emotional, tiring, and difficult pregnancy (compared to my first two easy ones), we now had to navigate the decisions we would need to make about birth.
Me at 37 weeks and 4 days pregnant!
My First Birth
My first child was a planned home-birth that ended up in a long labour at the hospital, every medical intervention I was hoping to avoid, then eventually an emergency C-section. My introduction to birth was traumatic. In my eyes, everything had gone wrong. Even the C-section itself wasn't smooth-sailing. My blood pressure dropped causing it difficult for me to breathe which was scary. I believe my anaesthetic wasn't working properly because I felt a lot of pain and even felt the needle going in and out of my as I was stitched up. I was told this was not normal. I wanted to avoid another C-section!
My Second Birth
My daughter was born with amazing midwives in a birth centre. It was my first vaginal birth and it was unmedicated. Active labour lasted about 8 hours and the birth was an incredibly healing experience for me. Yes, it was painful and difficult. At one point in the birth, I even thought that a C-section would have been better than what I was going through. However, it was everything I had hoped it would be. The midwives were incredibly respectful, calm, kind, and informative. I was ecstatic about how birth went this time!
My Twin Pregnancy
For this surprise twin pregnancy, I wanted to replicate my VBAC (vaginal birth after C-section), but I soon realized I couldn't. I had no access to midwives where I lived. We decided against a free birth for several reasons. And I had a negative view and fear of hospitals and obstetricians. We prayed a lot throughout this pregnancy for wisdom and God's providence every step of the way.
I ended up finding and liking my doctor: one of only 3 obstetricians in town! She was nice, albeit very busy, and had had twins herself! Finding her was a great blessing.
Threatened Preterm Labour at 32 Weeks
At 32 weeks, I went into threatened preterm labour and was admitted to the hospital for 4 days. Thankfully, the situation didn't escalate and I was sent home on bedrest. This stay in the hospital scared me. Until then, I had a perfect twin pregnancy: great, steady weight gain, no gestational diabetes, perfect blood pressure, and steady growth of the twins. However, the time at the hospital allowed me to talk and get to know the nurses. Every single one I encountered was very kind and patient. By far, this hospital's labour and delivery nurses were the kindest nurses I had ever met. I also had the opportunity to ask questions about hospital policy and how birth was done at the hospital. Most of all, I was concerned with being pressured into medical interventions. Because of my first birth experience, I had a prejudice against hospitals.
I ended up being discharged and sent home on bed rest for the rest of my pregnancy. It was a huge relief to be home! Especially since there was one episode of contractions at the hospital that seemed like I was really going to go into real labour! I went home and my husband took great care of me and the children. I napped often and drank water like a fish! We discussed the birth daily and prayed to go until 35 weeks at least or better yet, to 38 weeks.
Breech Babies: Choosing a Vaginal Birth
At the hospital, I was monitored daily and had a few ultrasounds. I was not pleased to see that my Twin A (the one that would be born first) was breech! Then transverse. Then breech again! He had been head down before then. As time went on, I tried various positions to try to get baby to turn to no avail. I must admit that my efforts weren't as significant as I had hoped they would be because I was incredibly uncomfortable during the third trimester of my pregnancy. My back hurt daily and my huge belly tired me out. Also, I was exhausted all the time it seemed.
My doctor offered me a scheduled cesarean delivery. I gave all my concerns and was open about how I would rather try for a vaginal delivery. I had done my research and knew that breech vaginal birth was possible and once common. Three times, she offered to schedule a C-section. Three times I smiled and talked about a vaginal birth.
She was an experienced doctor having practiced in several different countries where vaginal breech birth was still considered normal. She told me that in Canada, the obstetricians were recommended to encourage a scheduled cesarean delivery for breech babies. She, however, was confident in her skills to oversee a breech birth.
I had 3 major factors that would lead many to choose a cesarean:
- I had a previous C-section.
- I was pregnant with twins.
- Twin A was breech.
I am very grateful to have met my doctor who, after deciding that I was determined enough to pursue a vaginal birth despite these factors, would support me! And support me, she absolutely did.
Choosing Not to be Induced
From being afraid of going into labour prematurely, I was faced with the decision to induce (artificially start labour) or not as the weeks rolled by. We passed 35 weeks and were able to relax more. Then we hit 36 weeks and my doctor started mentioning induction. She scheduled a date, yet I felt very uncomfortable. I had a previous C-section and the changes of uterine rupture increases with the use of chemical induction agents like Pitocin. From my research, Pitocin is also not recommended for breech babies.
My husband discussed the induction topic so often that my 4-year-old son once finished my sentence! I said, "You know how I really don't want to get..." and I paused. He finished my sentence by saying, "Induced?" It was hilarious!
Instead of having a hard stance on induction, I decided that I would take it one week at a time. I requested my date to be pushed back and my doctor agreed to schedule it for 39 weeks. Then we would wait and revisit the matter if I hadn't gone into labour spontaneously.
I probably would have rejected induction more confidently if an acquaintance of mine hadn't had a stillbirth at 40 weeks 2 years prior. This painful experience of hers deeply impacted me as we were pregnant together. A little voice seemed to tell me that I would rather be induced and have a repeat C-section even at 36 or 37 weeks and have my babies alive rather than have one or both babies be stillborn. It was a challenge to navigate all the risks: hoping for the best, yet considering the possibility of the worst.
I ended up going into labour the day after the initial induction date that my doctor had scheduled and I had fought to postpone. Even so, I was happy to be able to go into labour spontaneously and know my body was ready!
Birth at 38 Weeks
At 38 weeks exactly, on my birthday, my water broke around 6:00 AM. My amniotic fluid was not leaking, but really gushing out of me every time I stood up and as I walked around! We packed up the children and some food, then headed to the hospital. My glamorous outfit consisted of a pad folded bath towel in between my legs, my husband's sweat pants to hold it in place, and slippers.
Before, a concern of ours was that labour would progress so fast that we wouldn't make it to the hospital in time since the drive was 1 hour. However, my water was continue to leak and there wasn't a contraction in sight. We prayed for 2 things: that I wouldn't get infected and that labour would start spontaneously and within 12 hours so that I wouldn't need to be faced with the decision of induction.
My doctor was already at the hospital. She did a cervical check with sterile gloves and I waited for labour to begin. Walking around wasn't very comfortable because my amniotic fluid would leak so much. I chose to sit on the birthing ball and bounce. My husband and I were pretty bored. We prayed, talked, read a bit.
At around 11:00 AM, mild contractions were coming and going. I was grateful, but hoping they would pick up. It's very interesting that I knew how uncomfortable and painful labour could be from my previous unmedicated VBAC, but I prayed for it to come so that I could avoid unnecessary interventions and drugs.
A Pushy Anesthesiologist
The plan was for me to deliver in the OR (operating room) in the case that an emergency cesarean would be needed. It wasn't exactly what I wanted, but I choose to be content with certain procedures. The entire surgery team was ready in case I'd need to be rushed off. My anesthesiologist came to visit me. He pushed me repeatedly to get an IV in my hand and prepare to get an epidural. I refused 3 times. I'm not a confrontational person. I like to say, "Yes" to everybody when I could.
First, I said that I would think about it. I thought he would respect that and leave. But he pushed me to make a decision at that moment. Then, I said I would talk to my own doctor about it (who knew my preferences and I trusted). Finally, I exclaimed,
"I don't know how many times I need to say 'no,' but I don't want it!"
He left saying he would be back later. Thankfully, he didn't return to my room. I ended up seeing him as we headed to the OR and he was courteous and help my hand during the birth. My impression of him changed after that.
I didn't want too much monitoring, but I didn't want to turn every decision into a battle. So I consented to any intermittent monitoring they requested.
Real contractions that became very intense began around 5:30 PM. I vocalized through them and tried to relax my body. I had read that the right kind of vocalization encouraged relaxation and the opening of my cervix instead of the tensing up that usually comes with pain.
After an hour or so, I found out I hadn't progressed in terms of cervical dilation (still at 6-7 cm) although I felt the contractions becoming increasingly intense. My doctor suggested I lay down on the bed rather than be upright. This went against everything I knew about physiological birth since I thought gravity and movement would help me as I stayed upright. However, it seemed to do the trick. In an hour, I was almost fully dilated.
I got the "shakes" where my arms and lower jaw were shaking and out of control. The only time they stopped was during contractions. The contractions became so intense. I thought about the epidural. I started saying that I couldn't take it anymore and begging the doctor when it would be over. I desperately looked at my husband and asked him if I should ask for it. He reminded me (as I had asked him to before birth many times) that it was almost over! I would be done soon. And we didn't want any drugs to go to the babies unless absolutely necessary.
I even asked the doctor if an epidural at this point would slow down labour. She said, "No," and asked me what I wanted. I said I'd think about it for 5 more minutes. Every time I felt like I needed the epidural, I just told myself I'd wait 5 more minutes to think about it. Just 5 more minutes. I didn't want make an impulsive decision I'd regret because of an intense moment.
Well, labour progressed pretty quickly and I was soon being wheeled to the OR. Nurses were rushing to get dressed. It was an exciting time. I didn't feel the fear I thought I would feel going to the OR. In fact, being brought to the OR was encouraging to me! The excitement and transition to the OR made me feel like I was progressing and that the birth would be over soon.
As everybody was getting the OR prepared, I was waiting for a few minutes outside still shaking in between contractions. I overheard the anesthesiologist discussing the epidural with my doctor. I heard my doctor respond,
"No. She doesn't want it. And it won't help her push effectively."
I was touched and felt deeply respected and understood. Once inside, I was positioned on my back with big lights all pointed to my private parts. But surprisingly, the number of people in the room, nor the lights bothered me. All I cared about at that moment was getting these babies out of me! I remember I gave some weak protests about being on my back as I thought it would make pushing more difficult and longer.
When I became fully dilated, I remember telling the nurse that I had to push. I felt an overwhelming urge to push that I couldn't control. I hadn't felt this with my previous births. The nurse called the doctor, who was on the other side of the room. In 3 short pushes, our breech twin A was born breech! His bum emerged first, then his legs released, followed swiftly by the rest of his body. His birth was completely untouched and unassisted. The doctor took the hands-off approach that I had desired and heard was the safest for a normal breech birth with no complications. All she did was catch him.
I wish I had been able to see him being born. I was so relieved when he came out. Unfortunately, my work wasn't done.
My doctor attempted to turn the second baby who was also breech guided by an ultrasound. This was painful. Then she decided that a breech extraction was the best option as baby was distressed. She put her hand inside me and told me to push as she pulled him out feet first. He came out in one swift motion.
I didn't even know that my doctor had inserted her hand and arm inside of me until the nurses told me after.
Initially, I had hoped for the second baby to be birthed spontaneously, but as I look back, I was in a lot of pain after the first baby was born. I'm glad I didn't need to wait a long time and have to push a lot after. Because of the breech extraction, the babies were born 6 minutes apart. The time was around 8:30 PM. Babies were 6 lbs 7 oz and 6 lbs 14 oz.
I had 3 hours of active labour. During my pregnancy, I had prayed for a labour that wasn't too short nor too long. I kept telling my husband that a nice 3-hour labour would be perfect! It is incredible how God answered this prayer of mine!
After my the births, I wept in the OR as the babies were being cleaned off. I wept for how intense and painful it was. I also wept for joy for having been able to give birth unmedicated and vaginally to these breech twins against all odds. I was overwhelmed with a whirlwind of emotions that poured out of me.
Overflowing with Gratitude
We are so incredibly grateful to God for His guidance and many miracles along the way like the doctor we got, preventing preterm labour, and giving me a nice 3-hour labour.
I'm grateful to my doctor as well. She was incredibly respectful of what I wanted yet was direct in all her communications. I felt comfortable enough to speak openly with her.
I'm also grateful to all the support and information I received in Facebook groups and on the website of Breech Without Borders. Strangers took time to respond to my flurry of questions and share their stories. Medical professionals in those groups also gave me informative insight that helped guide my discussion with my doctor.
I'm grateful to my wonderful husband who was an amazing doula! I went into this birth feeling a bit uncertain because my first VBAC was with the support of an amazing doula. He was my strong support when I felt weak and did everything we talked about before!
Thank you so much for anybody who has read my story until now. And I hope my story gives hope to those that may feel trapped by the circumstances of their birth.