I want to share my twin birth story for two reasons. Firstly, to remember it once time has made the details more fuzzy than the gas and air, and secondly, because I want to add a positive birth experience to the mix.
When I found out there were two babies at my 12 week scan I spent a lot of time
researching Googling twin birth stories. They often end in a c-section and the very idea of one terrified me. The thought of lying awake while someone turns my insides out is one that I find hard to stomach.
Reading about natural twin deliveries did not do much to set my mind at rest. It goes without saying that two babies equals two babies worth of possible complications.
The problem with twins
A twin pregnancy is considered high risk, which means that it is consultant led from the beginning. You get regular growth scans, the frequency of which depends on the type of twins and whether or not they share a placenta. The scans also monitor the babies’ position, which impacts on the options available for their delivery.
When it comes to planning a twin birth, provided there are no other complications, the presentation of Twin 1 (the baby that is presenting first) is most important. If they are well behaved (head down) when the mother goes in to labour, a natural delivery is possible. Twin 2 could change position after Twin 1 is delivered, but doctors can pull them out any which way, which means that their presentation prior to delivery is less important. I can imagine that having a doctor turn your baby, or pull it out by its elbow, could be very painful.
There is also a small risk that Twin 2 will get in to difficulties and need to be delivered by c-section even if Twin 1 is born vaginally.
For these reasons an elective c-section is offered, and an epidural is usually recommended if the mother wants a natural delivery.
Further, it is recommended that twins are delivered by 38 weeks gestation, which makes induction quite common.
Preparation is key
I never set my heart on giving birth in a particular way but my fear of having a c-section made me want to avoid intervention that took me on a path towards one, unless it was absolutely necessary.
Fortunately, 38 weeks (well 26 weeks, as I didn’t know there were two babies until my 12 week scan) is a long time to come to terms with something. I read lots and asked a lot of questions, so when d-day arrived I had made my peace with every eventuality. I arrived at the hospital ready to accept whatever assistance was needed to deliver the twins safely; if a c-section was necessary I would deal with it at the time.
I had growth scans every four weeks from 26 weeks pregnant.
My 26 week scan revealed that both babies were breech. The consultant told me, oh so matter of factly, that they were unlikely to have space to turn. She wanted to book my c-section there and then. In the end we agreed to postpone the decision until my next scan.
By 30 weeks, Twin 1 was head down and I delayed the c-section conversation for another day. Inaccurate growth measurements saw me back again two weeks later, and guess what…Twin 1 had turned again. This time the consultant wasted no time in booking my ‘elective c-section’. With a date in the diary, I had to get my head round this being a realistic prospect for the delivery of my babies. I read as much as I could from the hospital, read The Bump Class pregnancy book, attended a hospital talk, and I talked to my friends about their experiences of surgery.
Twin 1 continued to keep us guessing. Two weeks later she had turned again, which meant that she was head down at 34 weeks. Twin 2 was still breech as he had been throughout.
After my scan I had a lengthy discussion with the consultant (not the one who booked the c-section) about my options. We talked about the merits of c-section versus induction and I was able to ask lots of questions. The consultant told me that because everything looked good she, “didn’t care how I gave birth”. It was just what I needed to hear.
After Twin 1’s somersaults we agreed to keep the scheduled c-section, but I was also booked for induction at 37 + 2 weeks. The plan was to scan to check the babies’ presentation before things got under way and if they had turned I would attend for the c-section at 37 + 5 weeks.
I went away to read more about induction to ensure that I understood what was involved. Again, the matter of fact explanation in The Bump Class book was invaluable. I also searched online for positive stories. I’d heard so many negative things about induction that I needed to find a way to feel comfortable with it. Justified or not, in my head, c-section followed induction.
Induction day arrived with no sign of the babies, so I went in to hospital at lunchtime as planned.
The midwife talked me through the induction process, explaining that the pessary, used for the first stage, could be repeated up to four times over the next few days, including allowing a 24 hour ‘rest day’ after three pessaries so as not to overload me with hormones. I was facing the potential of several days in hospital with very little activity.
The babies’ heartbeats were monitored and I had a position scan, which showed a totally unexpected result. Both babies were now head down! I am almost certain that Twin 2 made his bid for exit whilst I was strapped to the monitor. The midwives wanted to crack on with things as soon as possible.
On examination I was already 2 cm dilated, which meant that I had bypassed the first stage. I was given a sweep and sent out for a walk whilst I waited for a place on the delivery ward where they would break my waters. There were four ladies ahead of me and I had no idea how long I would be waiting.
The walk allowed me to process what had happened so far. I felt confident that my body and my babies had started to do what they needed to. After talking it over with Tall Dad we decided to go straight back to the ward, to speak to the consultant and ask if I could go home.
As they say, if you don’t ask…The midwife said we could go home until a space became available on the labour ward, which looked like it would be the following day. I asked if I could wait longer on the basis that I had avoided several days of pessaries. The consultant agreed to discharge me with a new plan. I was to return five days later (at 38 weeks) to have my waters broken if I’d still not gone in to labour.
38 weeks pregnant
A week of analysing every twinge followed and I got more and more uncomfortable.
Of course, nothing changed. 38 weeks came round and off we went to the hospital. After more monitoring and an hour to walk around, I was off to delivery.
The first thing I did was talk to the midwives about what I wanted from my birth. I asked for time to allow each stage of the induction to work, and time to mobilise, before starting the next stage, provided the babies were ok. We agreed to keep an open conversation about pain relief as things progressed and I was provided the information leaflets for Remifentanil and Epidural.
Breaking my waters
My waters were broken at 4.30pm. The point of no return. The babies were on their way.
The babies were monitored to check how they were coping with the change in their environment then, at 6.00pm, I was allowed to leave the ward for a walk and to get some food.
Whilst eating a disappointing hospital grade jacket potato I started to feel period type pains.
At 7.00pm I returned to the ward for more monitoring. During that time the pains worsened and started coming frequently. It wasn’t long before I was contracting. (My notes say I was in established labour by 8.00pm)
I was able to get on my feet and a monitor was attached to Twin 1’s head because they were struggling to keep track of her heartbeat. At this point it all felt too similar to Tall Boy’s birth, during which I spent a ludicrous amount of time standing within the range of the monitor because they couldn’t get the mobile one charged or working properly.
As the contractions came closer together I remembered that gas and air would take a bit of time to build up in my system. It’s a good job I asked for it when I did because Twin 1 arrived within 40 minutes of active labour.
Twin 2’s heart rate dropped in the process of delivering Twin 1 and I remember hearing the midwife ask me to get on the bed after my next contraction. I wasn’t able to move and simply said, “I need to push”. Twin 2 arrived 5 minutes after his sister, surprising everyone in the room with his speedy entrance.
As the adrenaline surged through my system I couldn’t quite believe it was over. After expecting it to be complicated, I was surprised and relieved by how straightforward everything was. When it came to it, my body did exactly what it needed to do. The midwives and consultants who looked after me listened to my wishes, and of course I feel extremely lucky that both babies were healthy and didn’t need any intervention.
My thoughts on preparing for labour
In my view it’s important not to get too hung up on the type of delivery you want to have. Read enough to understand what can happen, including the different options for pain relief and the different types of intervention, but avoid negative birth stories, they will only scare you.
Ask questions every step of the way so that you understand why things are happening and if there are alternatives. The more you ask, the more your medical team will tell you, and the more in control of the process you will feel.
Don’t be afraid to ask for time if everyone is doing well.
Trust your own instincts about what your body can cope with and keep an open mind because you have no way of knowing how you will deal with the labour.
Be proud of yourself however your baby arrives. What matters is that they are happy and healthy, not how they got here.
And finally, whatever anyone says, know that twins can turn, right up to the last minute!