Friday, March 20, 2015

Birth Story {Home birth of twins with a skilled midwife}

Last week I shared with you Jeanelle's journey to home birth for her twins, and now, the much anticipated birth story.

Devastated to learn that being pregnant with twins might ruin her chance at a natural birth, this mother followed her instincts and pursued every option until she decided to birth at home. With the help of an independent midwife and the support of her partner and a doula, she had the birth of her dreams. With twin A breech and a cord prolapse handled by a skilled midwife, Jeanelle, a family physician in Illinois, defied all odds and birthed two beautiful babies with zero subsequent complications. 

We met with the midwives once and I felt immediately comfortable with them as a team. I felt so blessed to have another option other than cesarean section for my twins’ entrance into the world. The midwives were confident that I would deliver vaginally but also explained that if things did not progress normally at home that I would be transferred to the local hospital for a cesarean. I prayed the home birth would be successful and transfer would not become necessary.

In the next week my husband and I prepared for our birth – we set everything up for the twins and shopped for the birth supplies. We felt funny purchasing shower curtains for our bed and cookie sheets for instrument trays but we felt we were doing the right thing for me and our twins. I continued to see my OB provider for check-ups and antenatal testing (ultrasound for biophysical profile) but did not share with her my home birth decision since she would likely not agree and would remind me of the extreme risk I was taking when I was confident in my decision and trying to stay positive as my due date approached. She did agree to let me wait for labor to begin before performing the cesarean since I refused to schedule a cesarean in advance of labor. I was very nervous and often doubted my ability to birth my twins at home in the week leading up to the birth but I prayed and trusted God to see me through.

At 2:45 am on Ash Wednesday morning at 38 weeks and 2 days, the day after my last ultrasound that again showed my twin A to be happily breech and about the same size as his vertex sister I started having contractions as I lay in bed. I got up and went to the bathroom 3 times before I was convinced that this was real. I labored until 3:15 am then I began to feel leakage and knew my water broke. My previous two labors ended with my water breaking so I had never experienced membrane rupture this early on. I was Group B Strep positive so I knew I had to have these babies soon to minimize the risk of complications from that. The contractions were getting more intense and closer together, about every 7 minutes now so I woke up my husband at 3:30 am and called my doula and midwife at 4 am. I felt that the twins wouldn't come for a while so I told my team to take their time, they arrived about 6 am and the contractions had intensified more and were every 3 minutes and lasting at least a minute. I continued to leak fluid. I was informed shortly after my midwife arrived that her preceptor with twin and breech experience would not be able to make it to my birth because she was attending another birth close to her home, an hour and a half away. I was terrified but prayed and felt peace that God would work it out. My midwife, her student, and my doula were believers and also trusted that all would work out and my midwife agreed to assist me with delivery alone if necessary. I continued to labor in my kitchen holding onto the counter as my husband applied heat to my lower back (my labors are always in my back). A short time later my midwife announced that a substitute experienced midwife had been found and was on her way from the next state to attend my birth. I was nervous to have someone in my home helping me give birth who I had never met, but again I trusted God to work things out. The substitute midwife arrived about 9 am (she just happened to be on her way to an orientation closer to my home then her home and it was snowing that morning so it took her twice as long) and I liked her immediately. She was calm, confident and kind.  At this point I was laboring in my large bathroom standing at the sink with my husband and doula applying heat and massaging my lower back, the contractions were much more intense and I was starting to feel pressure. My doula was feeding me a banana and making sure I was drinking water; this was so much different than my previous two hospital births where I was not allowed to eat or drink or move around as I pleased. The midwife and her student came in periodically and unobtrusively checked fetal heart tones which continued to be strong. The midwife offered to check my cervix for dilation but was supportive when I declined since I was Group B Strep positive and felt that things were progressing well – this also was in sharp contrast to my previous hospital births. I was in pain but actually enjoying the relaxed atmosphere of my own home and a natural minded birthing team. If my twin A had been vertex and I had had a hospital birth I would have had to labor in an OR without my doula and with a huge team of people watching me just waiting and ready to start a cesarean if something didn't go according to their plan.

At about 10:30 am I felt the urge to push, my doula notified the midwives who were in the other room allowing me to labor in peace. The midwives and the midwife student came in calmly and began setting up the birth and baby equipment. I had been laboring fully clothed in my pajamas so they recommended I undress from the waist down at this point, definitely different from the hospital where I would have been laboring strapped to baby monitors, in a hospital gown and hooked to an IV.

I undressed and got on all fours as recommended in the breech birth book I had read in preparation for this birth and felt my body start to push, my midwives told me to do what my body told me to do so I did. It was amazing – not pushing to the count of ten, no lithotomy position, only my body doing what it needed to do to birth these babies. After the second push the midwife with twin and breech experience calmly but urgently stated that she saw cord and needed me to either squat or get on my back to push my breech baby out as soon as possible. I quickly was assisted by the midwives and my husband onto my back, the midwives reported they saw a foot and they insisted that I push this baby out now since he was not getting any oxygen since they could not feel any cord pulsations. I was scared but confident that I could do this and that God was with me. I took a deep breath and pushed with all I had in me. I felt an intense vaginal pain which I found out later was the experienced midwife helping to pull baby A out by his foot, then I  felt my baby boy enter the world at 10:45 am. The midwives quickly placed my baby right next to me, keeping his cord intact (this would have never happened in a hospital situation, they would have immediately cut the cord and whisked him away) and began resuscitation since he was not breathing. I was calm remembering that the breech birth book had said breech babies are often slow to breath as a protection for them since their head comes out last and it wouldn't be good for them to take a deep first breath when they are still in the birth canal. As they were bagging my baby boy I heard little whimpers then a loud cry, I praised God! The midwives placed him on my chest and my husband and I cried tears of joy. The midwives quickly got to work again listening to twin B's heart rate which sounded good and checked her position externally, she was still vertex. As I was enjoying snuggling with my precious baby A I began to feel intense contractions and knew twin B would be coming soon. I handed baby A to my husband and was helped up to labor and deliver in the position of my choosing to birth baby B after my husband cut baby A's cord. I was squatting and leaning over the bathtub when my body began to push. I got into a semi squat position and on the next push my baby girl was born head first at 11:05 am, 20 minutes after her brother. My husband cut baby B's cord after I had had a chance to snuggle her for a while, then the fused placenta delivered without a problem. I was sitting on my bathroom floor holding my precious twins in my own home with a wonderfully supportive birthing team and my husband by my side just praising God for his faithfulness! I did it! I delivered twins with a breech twin A at home and we all were fine, even after a cord prolapse! It was a miracle!

I was helped to my cozy bed to rest and nurse my twins as the midwives cleaned up the bathroom. My doula fed me breakfast and I was allowed to take my time bonding and nursing before the midwife did the newborn exam and showed me the placenta. I was not rushed as I would have been in the hospital, I did not have an IV or a blood pressure cuff in my way. I did not have a surgical wound, a urinary catheter or numb legs as I would have had if I had had a cesarean. Even though there was a complication, I was so glad I had decided to have a home birth. It went perfectly. My twin A weighed 6 pounds and was 20.5 inches long and twin B was 5 pounds 12 ounces and 21 inches. The midwives and my doula stayed with me for hours after the birth helping me with nursing and answering all my postpartum questions. I had a normal amount of bleeding even though my OB had warned me that hemorrhage was likely after a twin birth and I would need IV Pitocin. My husband and I enjoyed our first day with our twins in the comfort of our own bed, in our own home.

My recovery went very smoothly, the midwife returned 2 days later at my convenience to check the babies and me, we didn't have to be bothered at 6 am by doctors checking me and the babies and nurses checking vitals all night long. Nursing went great and the babies did not have excessive weight loss or more than normal jaundice. The midwife scheduled her next visit for 2 weeks later; she would return to my home to see how I was recovering. I didn't have to leave the house at all until the babies’ first pediatrician appointment at 2 weeks old! My experience was nothing short of amazing, I do believe my birth was a miracle and I am so grateful to my husband for supporting me in my decision to have a home birth to avoid an unnecessary surgery and to my birthing team for being willing and skilled to assist me with a home twin breech birth!

Can't get enough? Here's another beautiful birth story of a footling breech born vaginally in the hospital

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Jennifer Valencia | Labor & Postpartum Doula | 928.300.1337


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