Pregnancy, Birth and Beyond

http://www.pregnancy.com.au/birth-choices/birth-information/birth-articles/so-called-high-risk-birthing.shtml

So Called High Risk Birthing

"The important thing to remember about the so-called high risk situations (and there’s many more situations usually included in the list than the three here) is the role of fear. Fear clouds the mind, fear has us revert to basic survival instincts – fight or flight. Fear stops labour." This extensive article provides facts and details on VBAC, Breech Birth and Twins.

By

So Called High Risk Birthing

The important thing to remember about the so-called high risk situations (and there’s many more situations usually included in the list than the three here) is the role of fear. Fear clouds the mind, fear has us revert to basic survival instincts – fight or flight. Fear stops labour. Risk brings up fear, if it’s risky then it’s not safe. But we need to put that into perspective, everything has its risks, everything.

“Breech birth, vaginal birth after caesarean (VBAC) and twins birth can carry additional risk. The risk must be measured rationally however. The risk of uterine rupture for example after a primary c/s is not quite 1%. The vast majority of Obstetricians do not support women to achieve a VBAC. Many paint a picture of fear and death citing uterine rupture as a compelling reason to elect for a repeat caesarean. The risk of spontaneous abortion after amniocentesis is 1-2%. This test is routinely offered to women over 35 without any of the trappings of death and injury.” Justine Caines

If you are in a so-called high risk group it doesn’t mean that you have to give away your decision making to someone else. Rather, you need to be sure that you are making informed choices about everything. What tests you’ll have or won’t have, what kind of birth you plan for, who your primary care giver is etc.

Once you have ALL the information, and you are clear that you are not handing away your decision making to someone who says words to the effect of:

VBAC, Twins and Breech births require the level of trust that is possible, that you are capable of. Trust that everything will be perfect, that you will make the perfect choice for you and your baby. You are not separate. What’s good for the mother is good for the baby. Let go of your fears and expectations and trust in your life’s journey and your baby’s life journey.

Maybe you want to ask yourself these questions:

Journal the answers to these questions and any others that arise for you in the process. There are no right or wrong answers, it’s simply a process for you to come to know yourself more fully and understand your life journey.

When I thought about why my first birth had ended up a caesarean I could see how it reflected my inner belief that I was not safe and that under no circumstance should I surrender. I didn’t realise I felt this until I went hunting within, a good while after I ‘surfaced’ from being immersed in Sam’s newborn time. Further in depth exploration took me to my experience as a four year old when I was in hospital with pneumonia and ‘nearly died’. My soul searching revealed that in my decision to live, back then when I was four, I decided I wouldn’t give in to anything, especially if it was bigger than me. This gave me strength to ‘live’ through adverse or threatening situations, but when it came to surrendering to the ‘birth force’, I couldn’t or wouldn’t – and without consciously even realising that. Bringing this self awareness to my next pregnancy and birth enabled me to tend to my terrified four year old self and make new choices that suited my current situation. I learned that surrender is safe and preferable in certain situations, especially in making love and giving birth.

Know that if a doctor performs a caesarean section, from a medico-legal perspective, it will be deemed that he has done all he could.

There has been case in Australia where a mother refused the obstetrician’s recommendation for a caesarean section following her two previous caesareans. When she didn’t turn up to her next antenatal appointment, the doctor reported her to the law enforcing arm of the government responsible for the safety and wellbeing of children. The officials arrived at the woman’s home to question her and she was in labour! The Mother had found another hospital supportive of her desire to give birth vaginally and was on her way there. She had a vaginal birth after two previous caesareans.

You won’t make a friend of your obstetrician if you go against his recommendations.

Would you rather be told that you’re a good girl or know that you are a powerful woman?

“What I have learnt via research and through practical experience is that 'risk' is a conjecture from practitioners who have little if any understanding or faith in normal birth. Unfortunately birth in Australia is dominated by medical practitioners. These practitioners create labels of 'risk' often with little regard for research evidence. On the whole these practitioners only believe in the safety of birth after the event. To me this is most telling and explains our huge rates of intervention, and resultant morbidity.” Justine Caines

The range of experiences women encounter during birth are so varied. This is a clue to the need for you to get all the information available and make an informed choice about the care you will have and the birth you will plan for.

Vaginal Birth After Caesarean (VBAC)

“A cesarean delivery can be a life-saving procedure for the mother and her child. However, it is also major abdominal surgery that puts the mother and her infant at increased medical risks. These include infections, hemorrhage, transfusions, and injury to other organs, anesthesia complications, and a maternal mortality two to four times greater than that for a vaginal birth. Long term complications in subsequent pregnancies and labors include risk for uterine rupture, and placental problems such as placenta previa, placenta accreta, and abruptio placenta*. Studies also show that a cesarean delivery, particularly when it was unexpected, may put some women at increased psychological risk for depression and post-traumatic stress. Taking a closer look at these risks may help women to make an informed decision.”

With the caesarean section epidemic at a rate that is currently 1 in 3 births and rising every year, the medical community has had to really look at what they are doing and why.

In many cases, as stated in the media - where our culture debates its rights and wrongs -women have been blamed for the increasing rate of caesareans. Women, it is claimed, are becoming “too posh to push”, preferring a controlled birth rather than whatever Nature had in store. And women are demanding caesarean births to fit in with their schedules. The real reason is that doctors have been promoting caesarean sections for decades and women trust them.

“Once a caesar, always a caesar” has been the well known phrase spoken to support the ongoing practice of repeat caesarean sections. Although a repeat caesarean for no reason ie no ‘medical indication’, is known to be more dangerous for the mother and the baby than a VBAC , it is still what many women are told during their antenatal care and is still the dominant medical practice.

Women have been led to believe that caesarean sections are safer than normal vaginal birth. Safer for the baby, safer for the woman, preventing damage to her pelvic floor muscles, safer because at a scheduled time all the right staff will be there etc etc.

And all this is unfounded and actually contrary to the research, in other words – it’s lies.

It’s all about controlling the environment. The birth environment to a large degree is unpredictable. Not in terms of unpredictable hazards and dangers, they are unlikely, very unlikely. But in terms of the timing, when the labour will start and how long it will go for and how the woman will be with her experience of labour.

Caesarean section on the other hand is a step-by-step operation, booked at a convenient time or within a certain time frame. Problems of course can arise and that’s the issue, however for the obstetrician the environment is basically in his or her control. But, caesarean sections are major abdominal surgery and add significant risks to the birth process. If the caesarean is unnecessary, then these risks are unnecessary.

So often a caesarean delivery is the result of the ‘cascade of intervention’. A woman labouring in a hospital labour ward is rushed along with intravenous drugs via an infusion, strapped to electronic monitors that keep her immobile in the bed, the pain becomes too much from the forced contractions and her inability to move, so she has an epidural. The baby gets distressed from the unnaturally forceful contractions and the effect of the mother’s lowered blood pressure from the epidural and a caesarean follows.

But the story that’s usually told is ‘lucky you were here so we could help you because you didn’t labour fast enough and with all these machines we were able to pick up quickly that your baby wasn’t coping with labour, so we could rescue her.’ Or something very like that.

“I look back on when I was having my first baby and so many parts of the story confuse me. The midwife told me to push if I felt like it, I thought I felt like it and so I pushed. The doctor examined me and I was 6 cms dilated with a swollen cervix! I asked the doctor how much longer, he said at least 4 hours, I couldn’t imagine being able to do that so I gladly took the epidural he offered me. Labouring on with an epidural was strange, the energy changed completely. I was flat on the bed, connected to monitors, Adam had been helping through each contraction and now there was nothing for him to do. We just lay around waiting. Three hours later I was 8cms dilated and the doctor said it would be unlikely that I would progress and my baby’s heartbeat was showing signs of distress. He recommended I have a caesarean, so I did. For my next birth, twins, at 38 weeks, I had an epidural, an induction (in that order) and a caesarean after ‘only’ getting to 7cms before dinner time. With what I know now, I feel like I have been deceived.” says Maggie, pregnant now for the third time and planning a VBAC at home.

Barbara had 4 caesareans in a row. Her first one was due to ‘lack of progress’. The doctor suggested the idea of a vaginal birth for her second baby, but Barbara said her fear of repeating that first labour stopped her from trying. The births for her third and forth babies were elective caesareans because that’s what the doctor told her to do. “He didn’t tell me I had another choice. I trusted him, he was the doctor.” Pregnant with her fifth child, Barbara is planning a VBAC. “There needs to be more encouragement from the doctors for women to have VBACs. I’ve needed help to overcome my fears, fear is what holds one back. It should not be an easy option to have a c-section.”

To plan for a VBAC is a very confronting experience. You need to confront your fear of death head on, and everyone else’s fears too. All the demons come out of the cupboard and everyone feels scared. And the main fear is that your uterus will rupture.

I had a VBAC for my second birth, Ellie. Ellies’ father, a doctor, with his peers telling him how dangerous it would be for me to have a home VBAC, absolved himself of all responsibility, saying if anything happened it was ‘on my head’. I felt totally trusting of my ability to give birth and my baby to be born and was taking complete responsibility for myself and my baby in my choice. My complete conviction helped Chris to deal with his fears. Ellie was born at home after a six hour labour, with her Dad and big brother in full support.

The medical language used around VBAC serves to scare everyone even further. ‘Trial of scar’ is the term used! What a set up.

The environment in which a woman has a VBAC needs to be trusting and supportive of her. Homebirths have a much higher success rate for VBAC’s than hospital. In a recent audit of the homebirth statistics for myself and two colleagues, we had a 90% successful VBAC rate compared to a NSW rate of 18%.

Fear is used to get women to comply with surgical birth as well as discrediting a mother’s innate desire for a natural birth. “Why would you care about your experience of the birth more than the health of your baby?”

If you need a caesarean you need a caesarean, if you don’t, you don’t.

A new (2007) documentary called “The Business of Being Born” made by USA’s Ricki Lake and Abby Epstein exposes the birth ‘industry’ and sheds light for all to see the motives and agendas behind the rising caesarean section rate in the industrialised world.

In a VBAC labour you may get to the same place in labour where you stopped or were interrupted last time and may need to confront whatever happened and what it represents to you, to move through it this time. This may be a specific fear and may be linked to a patterned response to similar situations in your life. The best preparation for this is to examine your previous experience during your current pregnancy and come to know all you can about yourself and why that happened. In doing this you will get what the gift or lesson from that experience was/is and be ready with your new tools of self awareness, should you need to face that specific issue again. Its safe to have a VBAC and it’s a fantastic experience. Let go and trust and have support people who believe in you.

“I had an emergency caesarean for my first baby, Jasmine, she was premature and breech. Having a VBAC at home for my second baby Grace, was more empowering than I ever could have imagined. To feel every part of my inner strength and focus on birthing was enlightening.  I knew I wanted to push a baby into the world and what a feeling that was. I feel complete as a woman.” Kath

VBAC information:

Breech

Mandy was having her first baby. Toward the end of her pregnancy the baby was in a breech position and despite moxabustion, acupuncture, homeopathics and positioning exercises, he stayed breech. Michelle found the only doctor around experienced in breech births and decided that she would have the baby in the local hospital. When Michelle started contracting, I went to her home and we stayed there until the end of her first stage of labour. The doctor met us in the hospital and Michelle gave birth on all fours on the floor to her beautiful baby boy, Jack.

Belinda Jane’s first baby was breech and after 6 hours of 3 minutely contractions her cervix was 5cms dilated and after another 6 hours it was 5cms dilated. “The pain of the contractions was so intense but they felt ineffective, I couldn’t feel the baby, she was so high up.” Her doctor suggested a caesarean section, she agreed. Indigo Joy was born. “Having the caesarean was a relief because I knew she wasn’t coming down.” Belinda Jane had a VBAC at home for her next baby, Angelica. “I was so determined that I would give birth vaginally next time, and I did! I felt the baby and was able to work with her. It was very different to the first time.”

Author of Gentle Birth Gentle Mothering, Doctor Sarah Buckley, gave birth to her fourth baby, Maia, an 8 pound unexpectedly breech baby in her bath at home, attended only by her husband and children.

Genevieve’s first pregnancy at 26 was very normal, she felt fantastic “I had never felt so strong and energised before.” She was planning a natural birth and there seemed no reason for any intervention anyway. For Genevieve there was one issue. Her mother had been induced with both her children, and she had some fears that she may not go into labour, and need an induction like her mum. At the last visit to her obstetrician, he said “I’ll see you in hospital when the baby decides to come.” “As I got up I said - I just wonder, is it possible that the baby is upside down? I feel a niggle as if toes were prodding me where the head should be. He opened the ultrasound results and took a look and there they were the toes, ready to step out. The baby was footling breech. He said that changed everything and I should have a caesarean! Being my first baby I didn’t question him.”

“The epidural gave me the shakes which was horrendous and the birth seemed surreal. I was drugged and felt so detached. When the baby and I finally found ourselves in the room together later on, I remember wondering when the baby’s mother was going to come and get him. The pain from the caesarean was overwhelming, just the simplest tasks seemed to bring tears to my eyes. The nurses were completely insensitive expecting me to walk, and stand up straight the next day. “She can, why can’t you.” she said of the woman across the hall.”

Two years later Genevieve was pregnant with her second child. Her doctor wanted her to have a repeat caesarean, but on researching her options for that birth, Genevieve found that other doctors and hospitals said she could have a vaginal birth. “It was the randomness of the hospital policy and doctors opinions that was so telling. Without scientific evidence some were telling me to have another caesarean whilst others supported my choice to have a vaginal birth.” Samantha was born a VBAC after an induction (‘just like mum’) at 41 weeks.

Then in another three years, given all the time she needed, at 42 weeks Genevieve went into labour naturally and gave birth to Madison at home in the bath with a midwife supporting her.

Merran's first baby, Jordan, was a breech. Eighteen years ago when Jordan was born vaginal breech births were still common. Merran's doctor offered her a caesarean but said he was quite confident in delivering her baby vaginally. "It didn't seem such a big deal, he was experienced and believed in his and my ability." She went ten days past her due date and had an induction. "The labour was quick and intense. The worst part was the episiotomy." Jordan, 3.3kgs, was born vaginally and put straight up onto Merran. "I felt ecstatic. She was gorgeous and on her first day her legs kept springing back up straight against her body to the position they had been in-utero!"

Breech presentation occurs in about 4% of all births. The problem with breech births is that most of the doctors and midwives around haven’t got a lot, if any, experience in catching them. And the reason for that is the 2000 ‘Term Breech Trial’ which has cemented the already dominant obstetric practice of caesarean sections for breech babies.

Routine cesarean section for breech presentation has been recommended over the last forty years. As a consequence, the rate of vaginal breech delivery has decreased sharply. In the United States, the rate of cesarean section for breech presentation rose from just 10 percent to nearly 80 percent in 15 years (1970-1985). On closer examination, however, it is clear that the association between breech presentation and perinatal mortality is due principally to the confounding variables of prematurity and congenital malformation. Traumatic injury and complications giving rise to birth asphyxia in a vaginal breech delivery are uncommon. The recommendations for routine cesarean section have therefore been made on the basis of imperfect data. The issue of vaginal delivery compared with abdominal delivery of the term breech pregnancy is currently being addressed in a worldwide multicenter randomized controlled trial ("The Term Breech Trial"). -MIDIRS 9:1, March 1999

The “Term Breech Trial” was completed after the year 2000 and the results were spread worldwide, defining the scientifically proven best practice for breech births to be elective caesarean section. The Trial has been criticized widely as biased toward this outcome from the start and reflective of the lack of experience in vaginal breech births by the practitioners involved in the study.

As with all randomized controlled trials both the study and control groups did not have a "strong management preference". The act of giving birth in highly interventionist obstetric childbirth cultures will automatically see those women who wish to achieve natural childbirth exclude themselves from randomization. As this self-excluding group was not studied it is unknown whether the results are generalizable to those women who have a strong preference for natural breech birth. Fundamental to good outcomes for breech babies is the act of supporting the woman and unborn baby in a labour that is not induced/augmented by prostaglandins, amniotomy or oxytocics and where the woman (and baby) is not sedated or anaesthetised. While the report analyzed these aspects separately, the equally important variables of the woman's desire to achieve natural and healthy birthing and the effect of known caregivers were not studied. The knowledgeable companionship within the continuity of care/carer relationship that the midwife offers is fundamental to providing the opportunity to enhance the physiological process of giving birth. Her setting the scene with a dimly lit room, the use of warm water, avoidance of fear-inspired language and sedation or anaesthesia, her competence at manoeuvres to facilitate difficult birth are all skills that are fundamental to the practice of midwifery.

Obstetric ‘management’ of births is associated with increased morbidity and mortality, more damage and more death. Midwifery care is associated with less morbidity and mortality. For breech births with their extra requirement for trust, midwifery care will always be most supportive. Find out as much as you can and make an informed choice about who you will employ to care for you and how you will plan to give birth.

“I attended around 50 breech births at home and the major learnings for me were: Breech babies are extremely rare in women definitely pregnant for the first time, they often follow a tragedy in the womb – terminations of pregnancy, miscarriage, stillbirth or some grief around its elder siblings birth; maybe grandma died, maybe it was particularly shocking birth last time.

Another common scenario is that the mother is just not getting the support she needs or the birth arrangements she wants. I believe that the baby flips breech to have its head closer to the mother’s heart, partly to comfort itself, partly to comfort mum. Its breech-ness is often the card that engages the father, or extended family, to see that this birth and this mother are special and need some extra attention.... Don't all pregnant women? However, some don't have to ask for it.

I would question the mother gently about what she thinks it means and how does this positioning affect her plans. I would proffer the idea that the baby is staying close to her heart and encourage her to say things like: "That's fine darling baby, you stay there 'cause you're just a little baby and if you need to be close to Mummy's heart that's good for both of us, and know that as each day passes you grow bigger and stronger and more ready for this birth. Daddy and I and Nanna and midwife and whoever, will be there to help you, whichever way is best for you".

I would also ask the mother to think of other affirmations that will work for her in her particular circumstances.

Moxabustion and "tip up" stuff is great for those who want to DO something, and sometimes these methods work.

Finally, we know that strong labours that move along without any great delays are the ones that are most likely to help the mother and baby achieve a vaginal birth. Encourage the mother to rest well in early stages but once labour begins to move up the ladder of increasing intensity, a mother who can "will on" the contractions to be intense and long and "ride them" either physically or metaphorically, will have the birth she and the baby want.

Positions for the birth don't matter that much, some women do flat on their back very well. Do support her to be wherever she is most comfortable , but note the signs of edginess and lack of progress that indicate a change of position might be just too difficult for her to suggest/manage on her own. Hot nappies on the vulva are particularly encouraging to little babies bottoms descending.”

Maggie Lecky-Thompson, Social Worker, formerly a Homebirth Midwife

Breech Information:

http://www.gentlebirth.org/archives/breech.html#Breech

http://www.breechbabies.com/

Twins

Kylie was pregnant for her third time and realised pretty soon that she had two babies inside her. She’d had quick easy births for her first two (her words), Dakota and Mia. Her girls were eleven years apart and according to an ultrasound, here were coming two boys. Kylie had wanted to have a homebirth for this baby, but now that it was two it wasn’t such a simple choice. There wasn’t a homebirth midwife experienced with twin birth in her area and her partner wanted her to have the babies in hospital. Kylie was an ambulance officer, and felt she was well equipped with knowledge and experience of how the hospital system worked, so she decided she’d work the system and have the natural vaginal twin birth she wanted in the local hospital. I helped Kylie through her pregnancy to navigate her inner and outer journey.

She was inundated with negative stories about twin birth from doctors, midwives and the internet. Fears of premature birth prevail. Compulsory epidurals at 38 weeks, which was considered term, followed by induction, labour driven by artificial syntocinon with the mother numb on the bed connected to monitors. Following the birth of the first twin, the membranes of the second would be ruptured and the baby extracted within 10 minutes. Or an elective caesarean.

Kylie did not want to do any of this at all. She was feeling the negativity of these sorts of birth stories beginning to erode her confidence in her body to give birth and her babies ability to be born. She got scared. At last she found some positive twin birth stories, many of which occurred at home, and some in water. She read and reread them, rewiring herself with faith in her body to give birth to her two babies.

Kylie found a doctor who would go along with her desires for the birth and at 37 weeks and six days, her blood pressure started to rise. The doctor was keen for the babies to be born and maintaining her convictions for the birth she wanted for her babies, Kylie agreed to having her membranes ruptured (only) to start the labour.

Four hours later, she gave spontaneous vaginal birth to Jarvis weighing 3045 grams/ 6 pound 11 ounces and two hours later, Finley weighing 2845 grams/ 6 pound 4 ounces. Kylie was much more relaxed than any of the hospital staff and I’m sure they will talk about her birth for a long time.

A week after giving birth to her twin boys, Kylie wrote:

Looking for the sacredness of birth -

My second birth, two years ago, was devoid of any sacredness. It was a two hour intravenous syntocinon driven expulsion of a baby after my waters broke 2 days earlier. Even my partner said “well that was easy”.

For my first birth although beautiful, thirteen years previous, I wasn’t in the headspace to even think about birth being sacred.

So for this pregnancy and birth, my third and forth babies, I recognised that there was a spiritual journey to be had and I needed to have this.

I realised in my desire to have it this time, that I had denied it before.

Even though I chose more obstetric involvement for this twin pregnancy, than I would have if it was just one baby, I was looking deeper into the experience than ever before.

So here I am, a week after the birth of my boys and I can see from my inner journey through this pregnancy of self discovery and self realisation, that I have some new tools to use. I can see now how determined I was. From the beginning I had a date in my mind for their birth and worked hard with my diet to make sure they would be over 6 pounds each.

I look back at how big and uncomfortable I was during my pregnancy, and how I just had to take one day at a time. This prepared me well for after the birth, to take one day at a time.

I knew from my pregnancy that I could survive on three hours of sleep, or less, per night, and this prepared me well.

I have changed so much through this journey. One of the big moments of my pregnancy was having my dear friend and mother figure Kym tell me to accept the help on offer. I did and I am able now to accept help from people, the free flowing generosity of the women around me enabled me to accept it. I’m so much more open to receiving now – having opened twice as much with two babies!

Through my inner journey of pregnancy, I started to match cause and effect. I could understand why I am who I am and even why I came to be pregnant with two babies.

I’m so much more aware of my thought process, I can see how before my logical mind would override my base wisdom, my intuitive mind.

One of the big milestones for me was reaching 36 weeks. If I didn’t, I would have had to leave my home town and go to a city hospital, where they are set up to look after premature babies, far away from my family, for the birth. I lived the way I wanted it to happen, I didn’t pack a bag for the hospital and I didn’t even get the baby car seats ready. Even the lady who delivered our vegetables said – you must have had a very clear picture of what you wanted.

Yes I did, I was very pleased with myself.

At her pregnancy workshop reunion, Kylie spoke about how happy she was to realise after the birth of her twins, that it all went very normally and she could, as her intuition had told her, have had the babies safely at home without any medical interference.

Maggie had an induction at 38 weeks for her twins, Cameron and Luke. To start the process she was given an epidural followed by an intravenous induction of labour. The epidural, it was explained, was in case the doctor had to ‘go in’ to get the second twin out in a hurry, “I just accepted that without question.” The labour started and “they kept turning the drip up faster and faster, I couldn’t feel anything because of the epidural. I was lying still on the bed connected to monitors. It felt weird, Adam and I were just there twiddling our thumbs, waiting. It was really odd. Time dragged on, it felt really slow. About 6 o’clock in the evening, the doctor said I wasn’t progressing fast enough and suggested a caesarean. We weren’t really disappointed, we trusted his judgement. The caesarean wasn’t very nice, I got a bit panicky with all the drugs and being paralysed. They left me in the recovery room for about an hour without my babies and the nurses were there in the background talking.”

“On the third day the babies had tubes in their noses and they didn’t even tell me they were going to do that. When I asked why they said they had to be a certain weight to leave hospital and they were giving them formula. I didn’t want that. Luke ripped out his tube and I was so upset. I insisted they take out Cameron’s and not replace them. To this day Luke has a very sensitive nose.”

“When I was emotional they implied there was something wrong with me and sent the social worker to see me. The day before I left hospital they suggested I go home for a few hours and rest, it felt terrible leaving them and going. It didn’t make me feel better.”

I asked Maggie given her experience what would she advise other mothers having twins.

“to get as much information as possible before hand and speak to mother’s who’ve had successful vaginal twin births. It is different to a single birth, its two babies! Afterward it’s full on so you’ll need as much support as you can get. Also emotional days are ok, and it doesn’t mean there’s something wrong. Reading back over my story, it seems a bit of a sad experience compared to the others but I guess that was my journey.”

Julia’s third pregnancy was twins. She’d had two previous vaginal births.

The pregnancy with the twins went very well with no complications.

"I was extremely uncomfortable towards the last 5 weeks of the pregnancy, very large and unable to sleep. My obstetrician and I decided to induce the babies at 37 weeks. I booked into the local public hospital, my waters were broken at 830am, I was given the drug is to hasten the labour intravenously and an epidural. I had a huge fear towards the epidural because during my first pregnancy I had one and it only worked on one side. I had dreadful memories of the pain whilst the doctor tried to put in the epidural. I was strongly encouraged by my obstetrician to have an epidural for the twin delivery but I was not convinced that I wanted to go down that track again. However after speaking to other multiple birth mums and further investigation, I agreed to it. The birth went beautifully. The epidural was a wonderful relief. I delivered baby number 1 Isabella at 1.24 pm and after two more contractions delivered Oliver at 1.35 pm.

The babies were both healthy - Isabella weighing in at 3060 gms and Oliver at 2980 gms. It was the most rewarding birth, relatively pain free and beautifully to plan. There were no complications and everything went as the obstetrician had said it would, it was quick and managed extremely well. I am very happy with the way I was managed through out the pregnancy and the birth. I didn't feel bullied into having the epidural, I was confident that I could do the vaginal birth however for my peace of mind I needed the epidural as a "just in case". This was a great comfort to me.

My only complaint is the lack of help I had with the breast feeding of the twins. I breastfeed both of my first two boys, the second for 2 years. Feeding two babies at the same time was a huge challenge, I felt totally inadequate and not properly supported by the nurses. Oliver was a little slower with his sucking. He has a slightly undershot jaw which made sucking very difficult. I was left stranded on a number of occasions (whilst in hospital) holding both babies on the breast, sitting up in bed, told by the nurse to buzz her if I needed help. I couldn't reach the buzzer! I persevered for about 5 weeks but found it way too difficult and gave in to the bottle. At my 6 week check up with the pediatrician, I spoke to him about the feeding and what had happened in the hospital. His advice was not to try and feed them together until they were at least 6 - 8 weeks old.”

Justine, gave birth to her fifth and sixth babies, her twin girls, at home in water at 40 weeks and one day. She pushed each of her babies into her own hands with her family and midwives watching on. The first born, Majella, 3.1kgs, was head first and the second, Rosie, 3kgs, was born 13 minutes later and was a footling breech. Justine, the founder of the political party What Women Want, has her inspirational twin’s birth story available to be read on: http://www.homebirth.org.uk/justine.htm

Giavanna’s first birth was twins. Everything was going well, she was planning to give birth vaginally and at 32 and a half weeks her membranes ruptured and she started having contractions. She went to hospital and they gave her intravenous drugs to stop the labour. “I was advised to lay down on the bed and not move, I was allowed nothing to drink. My mouth was extremely dry and I needed water but was not allowed a sip just in case I had to have operation. When the contractions came, I was not allowed to move, I had to lay down on the bed and not move. Marty and I were separated while I was being pumped with the drugs, the whole experience was terrifying.”

The drugs didn’t work at stopping the contractions and Giavanna had an emergency caesarean. “I was totally overwhelmed, this was not what I expected and I wasn’t prepared for it. I was laying on my back in the operating theatre as they were preparing to do the caesarean and there were about 15 or 20 people in there. It felt so invasive, I just wished they would all go away.”

Jett, 4 pound 11 ounces and Braedy, 4 pound 9 ounces, identical boys, were born. “After the boys were pulled out of my tummy, I had a brief moment of seeing them then, they were whisked away for their checks ups. The doctor sewed me up, and I was taken to a room and poked and prodded. I felt out of it and disillusioned about what had happened. I saw the boys again about an hour and a half later. They took me in a wheelchair to the neonatal intensive care unit.”

The boys spent their first 3 days in humidicribs and then the next 5 weeks in the intensive care unit.

“I vomited all that first day from the drugs they’d given me, I was in pain from the operation and had doctors and nurses constantly coming and checking out my scar every 3-4hrs. My room was quite a distance from the neonatal area and after having a caesarean it was painful to walk so it took me almost 15 minutes just to get there to see them.”

“I went home on day 7 and went back and forward to the hospital everyday for 5 weeks. I was on auto-pilot. The boys were fine, they didn’t suck for about a month, until they were the equivalent of 37 weeks pregnancy, and so they were fed by tubes in their noses. The midwives made me feel like they were a lot worse than they were. I felt like I had to ask their permission to pick up my own babies. There was one midwife who put the boys in the cot together, I knew that was right and she said she thought so too, but the others were against that. I was so confused.”

“The boys came home at the equivalent of 38 weeks pregnancy and I fully breast fed them for 8 and a half months.”

“When I went home it felt weird, I’d been told what to do all the time the boys were in hospital and now I could do what I wanted. I was a bit worried, wondering if I was getting it right, I had thoughts like, if they cried too much they’d come and take them away from me again!”

“It took a while to get over the caesarean, I felt physically restricted for about 12 weeks. A year later I could still feel slight pain around my scar.”

Giavanna had her third baby, Skyla, 4 years later, a VBAC in hospital after a 7 hour labour, she weighed 8 pound 4 ounces. “It was such a different experience, a healing experience. I was free to move, free to do whatever, whenever. The pain was a beautiful pain, I felt in control the whole way through labour.

The only difficult part was 6 hours into labour, I was about 4cm dilated and the midwife said that if I did not dilate quicker then I may be heading for another caesarean. I used the powerful tool of focus, even more than I already was, and less than an hour later, Skyla was born!”

“After Skyla's arrival I was able to hold her for as long as I wanted, I was free to move and was only checked out by a midwife then a doctor once each!!!”

They went home the same day. “People said to us - why would you go home so fast? and we said - why would you stay! We didn’t want them to take our baby away from us like last time.”

“It was beautiful and amazing getting home with Skyla, totally different to the boys, I was so much more relaxed.”

“I had a midwife come to my house daily for about 7 days, always at times suitable to me. I felt fine to walk and had no pain at all 1 day later and definitely none a year later.”

“I support natural birthing 100%. Looking back on both births, a cloud of haze covers my head for the Jett & Braedy and with Sklya I am so clear.”

Research and read all you can about giving birth vaginally to your twins, without all the invasive technological procedures. It is possible and it is the best for all of you.

Twin birth stories:

“There came a time when the risk to remain tight in the bud was more painful than the risk it took to blossom.” Anais Nin

Ten Moons

TEN MOONS: THE INNER JOURNEY OF PREGNANCY PREPARATION FOR NATURAL BIRTH

A unique guide to pregnancy and birth. Written by a homebirth midwife, mother and grandmother, this book gives the power back to the woman to be the centre of her birthing universe, returning to her the keys to the long locked gates of the realm of feminine strength and the spiritual essence of birth.

Purchase online


Published 16th August 2013