On January 20, 2016 at 11:29 and 11:30pm, respectively, Elizabeth Alice and Jacob Andrew made their grand entrance into the world. Like their big sister Abigail, their birth has, in my opinion, an interesting story behind it, and then they decided to one-up her by making their first few days earth-side exciting as well.
*Note: This is a L.O.N.G blogpost. I don't want to forget anything that happened so I'm pretty much writing the whole story down in all its glory. Feel free to skim as you'd like! In addition, there are surgical pictures. You've been warned!*
Their birth story actually starts around week 29 of gestation when I began showing signs of preterm labor. At a routine doctor's appointment I was doing a non-stress test (NST) when it was shown that I was having mild, irregular contractions as well as being a little over a centimeter dilated. From the appointment I was sent to the Labor & Delivery (L&D) floor of our local hospital for further monitoring (the first of many, many monitoring visits). After a few hours, and a shot of Terbutaline to stop contractions, I was sent home. The next doctor's appointment had me testing positive for an enzyme indicating labor could come at any time and my cervical length had significantly shortened. A week later I was at home when I felt strong contractions and, once I started feeling them in my back, I sent myself to be monitored in L&D as Abby was born via constant back labor. This time it took two shots of Terbulatine to stop labor. Three days later a doctor's appointment, where contractions showed every 2-5 minutes, sent me back to L&D as the doctor felt that the shots a few days earlier should have lasted longer than they did. After hours of monitoring it was decided to send me home but have me come back to the hospital the next day for another fFN test (same enzyme test I took earlier). When that second test came back positive I was officially admitted into the hospital for preterm labor, given steroid shots to help develop babies' lungs should they be birthed eminently and spent
Christmas in the hospital. After being discharged after Christmas as my contractions and dilation had stagnated I was still sent back to L&D for monitoring once more. But then I hit the magical gestational age of 34 weeks and everyone's attitude switched from "keep these babies in as long as possible" to "we take them whenever they decide to come". So at each appointment there was a feeling of "still pregnant?" in the air when I came in. And since I was being seen twice a week that was a lot of quizzical faces. :-)
The entire time I'd been monitored for contractions I was also being monitored for elevating blood pressure. I went from my normal 120/60 at the beginning of pregnancy to 138/82 for the majority of the pregnancy. But then blood work showed I had elevated liver enzymes and elevated uric acid and my doctor requested I come in a day early for monitoring as those were worrying signs of pre-eclampsia. Later that night I had a pretty scary dizzy spell that lasted about ten minutes, scary enough that I made sure I had my phone in my hand while I lay down in case I needed to call Nate or 911. But after laying down and drinking lots of water I felt right as rain again.
On January 20th I went into my moved up doctor's appointment and my blood pressure was 148/93. Baby A's heartbeat was elevated at 180 (had normally ranged between 130 and 150) and Baby B's heartbeat was elevated at 167 (normally 140 - 155). When the doctor stepped into the exam room he turned to me and, without hesitation, said "well, today is the day we do your c-section...these kids need to come out now". Okay, then. Let's do this. :-) Granted, I was pretty worried as we flipped the switch from "whenever" to "NOW" but was excited that I'd finally get to meet these babies that I'd so longed for. Leaving the office I had an appointment for a scheduled c-section at 3pm and I excitedly called Nate with the awesome news. We both rushed home and finished up some last minute "to do's" (i.e., paying bills, picking up the house, packing Nate's hospital bag, etc) and just as we were about to head out the door we got a call that our c-section had been pushed back to 7pm because of staffing issues. We were a little bummed that our time to finally meet he babies wasn't as soon as we'd thought, but since I'd been fasting since a protein drink at 8am I was excited for a small reprieve to have a quick lunch (and take a quick nap as we knew it'd be the last good sleep we'd get for a while) and then show up at the hospital at 4:30pm to begin the c-section process.
When 7pm finally rolled around my mouth felt like the Sahara Desert. While I understand the reasons behind not having me eat or drink anything before surgery, telling a pregnant woman who'd been drinking 28 oz at least every hour or two to not have ANY type of liquid for 8 hours during the daytime hours was pretty brutal. I'd resorted to enjoying a quick mouth rinse without swallowing any water every time I simply couldn't stand how my mouth felt. But, since we were right at "go" time, I persevered. Then our nurse came in to inform us that our c-section had been pushed to closer to 8pm as our doctor was late getting to the hospital from the office and still had an inversion procedure (attempt to flip a breech baby into a vertex/head down position) to do ahead of us. It was a quick procedure and so we resigned ourselves to waiting just a few more minutes.
At a little after 8pm our nurse (whom incidentally I went to high school with - seriously, you do not mess up in this small town because EVERYONE will know) came in again with the good news that the operating room was being set up for a twin delivery and I was almost able to meet our babies. I took the medicine they give so that if I should throw-up and aspirate into my lungs the outcome won't be so bad (and I'll fully admit that as nasty as that drink tasted it was like heaven as it was my first actual drink of anything in almost 9 hours). We were literally walking out of our room when our nurse got a phone call that our c-section had been bumped due to a Mom with a placental abruption. Now, my first and foremost thought was that I totally understood the situation. We were a scheduled c-section that, while we needed to deliver sooner rather than later, wasn't a necessity right that minute. That Mom and her child was. But there was a small, selfish part of me that was grumpy that we'd just been bumped from meeting our kids for the third time. sigh.
10:00pm rolled around and our nurse returned letting us know that the operating room was again open and being set up for our delivery. Comically, as soon as she finished that sentence her phone rang, and...you guessed it....she got a call that a forceps delivery wasn't going as well as expected and they were putting a hold on the operating room as they thought that Mom was going to need an emergency c-section in the next few minutes. At this point in time Nate and I seriously discussed going home and coming back the next day for our c-section. I'd not had anything to eat or drink (besides the medicine) in 10 hours, we'd been in the hospital exam room for over six hours, we'd been bumped four times for our c-section, and were emotionally and physically exhausted. When our doctor stepped in to again check in with how we were doing we brought up going home to him and were pretty much turned down flat. I'll admit that it wasn't until this point that I really understood how serious our situation was and how hurt my babies could be. Previously, I'd just figured that yeah my blood pressure was high and pre-eclampsia was a concern but that the decision for a c-section was made as a precaution. Once our doctor basically said he thought going home would be very detrimental to the twins, let alone me, did it really sink in that this was more than just a cautious decision.
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| Nate looking all handsome in his surgical scrubs. |
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| Excited and looking forward to meeting my babies. |
Finally, at 11:00pm (8 hours after our original c-section time) we got the green light that the operating room was ours! I think our nurse, Nate, and I practically ran down the hallway to the operating room to ensure we got in. :-) We even got applause as we passed the nurses' station from all the nurses there! I think they were just as excited for us that we finally got to go in.
When I first entered the operating room (without Nate who had to wait outside the doors) I was excited to meet our babies, but pretty nervous for major surgery. This is only the second surgery I'd ever had (first was a laproscopic surgery under general anesthesia) and just such a different birthing experience than my unmedicated, vaginal delivery of Abby that I felt..I don't know, it's hard to describe...I guess I felt like how much would this really feel like a birth? But everyone was moving so fast that I didn't have a lot of time for introspection. The local numbing shot went in (ouch that hurt - and I totally reverted to my labor breathing pattern with Abby without thought to get through the pain) and then a second shot as I'd felt the spinal shot start it's journey. Then I was positioned onto my back with my arms out and immediately started to get the shakes. I kept telling myself this was normal and was just nerves but when your teeth are hitting each other so hard they hurt you're not really keeping the shaking motions to yourself. :-) I had a few warm blankets place on me, the nasal oxygen put in place, and then I saw the doctor pick up a pen and start drawing where he would be cutting. I was a bit concerned that I could still feel my legs, even though they felt really numb, but my anesthesiologist did the smartest thing (for me, at least). He asked me to move my knees. When I tried I realized I couldn't move anything on my legs! Had he just told me that I really couldn't feel anything I would have still worried that maybe the drugs weren't as effective as they should be. By having him tell me to move something he put the result in my hands, which was really important as I felt very out of control. That's the feeling I was trying to describe earlier. I felt very out of control from start to finish.
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| Getting the spinal put in. It hurt, but I can honestly say Abby's unmedicated birth hurt way worse. It's funny but her birth has really screwed up the 0 to 10 pain scale doctor's ask you to determine your pain level. Having her turned into the proper birthing position was a pain level 10. Everything else seems so much less painful that it's hard at times to describe what I'm really feeling and I tend to remind myself that I need to take labor out of my mental memory when answering a pain scale now a days. |
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| I didn't realize until this picture that my belly is WAY bigger than I thought it was. It's almost twice the height of my head! |
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| And the c-section begins! Nate is finally allowed in the operating room, which I was very thankful for. |
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| I may be smiling but I really wanted to throw up right about now. Very thankful I didn't though! |
Next, with scalpel in hand, the doctor started cutting me open and Nate was allowed inside the operating room. He sat next to me and did his very best to keep me from worrying. He's really awesome that way as my normally "man of few words" husband becomes the chattiest Cathy in an attempt to keep me engaged in conversation so I'm not able to too intensely focus on what's going on around me. After a few minutes of conversation the anesthesiologist suddenly said "Mom/Dad, look!" and as Nate looked over the surgical curtain and I looked into the surgical lights (they were so reflective that I could see everything...yes, everything...that was occurring in my abdomen we saw our daughter's head coming out of my stomach. Our DAUGHTER!!!
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| It's Elizabeth! We weren't expecting surgery to go so quickly so we didn't get a snapshot of her coming out of the womb but the next best thing. |
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| Getting checked out by the NICU staff. |
Nate immediately jumped up and began taking pictures. In his excitement for our child he started to step around the surgical cloth and had to be grabbed by the anesthesiologist and brought back to our side of the curtain. LOL. I think the anesthesiologist had practice with this as he was so quick to grab Nate. :-) Then baby girl was whisked away to a monitoring table and we returned our attention to my stomach. After a little rooting around and some commentary on what body parts had been captured ("I have one...no, two legs") our son was brought earth-side. Our SON!!!
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| Notice the cord wrapped around his neck multiple times and the knots as well. Even though having the c-section really hurt (seriously, vaginal all the way if possible) I'm so thankful we ended up with the surgery. |
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| I thought this picture was cool with the juxtaposition of his old "home" and his new one. |
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| And this is just a gratuitous surgery shot as you can actually see inside me! So weird. |
Immediately I was concerned as I saw the cord wrapped around his neck and what looked like a knot in the cord. This moment right here cemented the fact that our decision to do a scheduled c-section as opposed to a vaginal attempt of a breech baby was the right one. I honestly believe that had we attempted a vaginal delivery we would have ended up in an emergency c-section scenario. I'm so thankful that we didn't risk his health for my own fears of surgery. Finally, our son was taken to the monitoring table to be checked out. Nate left my side to go over to the kids to see how they were doing and introduce himself and I stayed on the table being sewn up. (Only later did I find out that me staying on the table *might* have been a good thing for me emotionally. When Jake was born he was in some significant respiratory distress and required the CPAP machine to help him breathe. He was working so hard for oxygen that Nate said his stomach was being sucked in to almost his spine. The NICU nurses who were in the operating room with us (as Jake and Beth were only 36 weeks gestation there was a real chance they'd be whisked to the NICU as twins at that gestation are not guaranteed a healthy status - this was also part of why we'd been bumped the first time for our c-section as there weren't enough NICU nurses available at that time to allow for 6-8 to be in the operating room with us) gave serious consideration to taking him back to the NICU with them, but after getting some breathing assistance he started to do better on his own and ultimately it was decided to give him a chance to recover with me).
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| Both kids getting checked out after delivery. |
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| Nate meeting Elizabeth for the first time. |
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| Nate meeting Jacob for the first time. |
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| Jake needing CPAP help to breathe. |
I'll admit that this was probably the hardest part of having a c-section. The fact that my babies were over there and I was stuck over here was really, really hard. After Abby's delivery I held her on my chest immediately and for what felt like hours before letting the nurses take her away to be cleaned up, etc. This time I was across the room from the two people that I'd waited years to meet. It was helpful knowing Nate was right there with them but it wasn't the same as me and frankly, I felt really, really left out. I'd been the one giving myself multi-daily shots for months, suffering through intense morning sickness in the first trimester (I threw up, literally, 3-4 times a day, every day for almost 8 weeks), back pain that required physical therapy, sciatic nerve pain, almost hourly heartburn (who knew that water could be so problematic), sleepless nights, exhausted days, bedrest that removed any idea of muscle strength and stamina, putting my stay at home daughter in daycare when I was on bedrest, and a sense of guilt that never left over what I couldn't do for my husband, daughter, family, etc. And yet when all that was over and the babies were finally here it wasn't me that they first got to experience. I don't want to take away from the awesome experience Nate had with them. I just wish I was also by his side.
After what felt like hours of waiting my daughter was finally brought over so I could see her. I got to introduce myself, tell her how happy I was to see her, got a neck nuzzle or two and then she left. Then my son was brought over and I got to introduce myself to him, tell him I how happy I was to see him, got a neck nuzzle or two and he left. Nate left with them (as I wanted him to do) and I remained behind getting stitched up. I'll admit it was neat to watch the doctor's finish my surgery (again that amazingly reflective operating room light) but I was anxiously awaiting getting to hold my babies. Once the surgery was finished I returned to my exam room to recover but ended up having to wait another 15 or so minutes before Nate and the babies arrived. Everyone had told me that I'd be the last one into the room but I think they forgot that checking out two babies took longer than checking out one. :-)
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| I got to meet Elizabeth. |
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| Meeting Jacob. |
Finally, finally, finally I got to hold my two precious babies in my own arms! Oh, how I longed for this moment and how wonderful it was when it finally arrived. We remained in the exam room for another hour until I could sort of feel my legs and then we were transferred to the OB section of the Pediatric wing of the hospital (our hospital is under construction so part of the L&D unit is not available for patients - hence they took over a part of the Pediatric wing for L&D recovery patients). The L&D floor was plumb-full of patients and, since I wasn't in labor anymore nor did the babies end up in the NICU, it wasn't necessary that I remain on the second floor. Funny moment though, as we were leaving we set off the Kidnapped Infant alarm as the nurses had forgotten to register our transfer from one floor/unit to the next. :-) At least we know it worked! I ended up being very thankful for our transfer as the Peds wing was much quieter and calmer. I think we were one of only three OB patients in the wing. And so we began the process of getting to really know our children and marveling at the fact that they were finally outside rather than inside me. :-)
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| Getting to hold my babies for the first time. |
I'll wrap up the rest of our hospital stay in hopefully a shorter length than the beginning. But we'll see. :-) The first day we anxiously looked forward to Abby meeting her siblings and were amazed at how loving and excited she was in meeting them. There was simply no jealousy and instead a big sister beginning to love on her younger siblings. It was such a sweet moment and one that I will cherish forever. The kids also got to meet a few other family members (my Mom (Dad was sick) and Nate's Dad (his Mom was sick). We loved on them a whole bunch that first day, but we did notice that Jake still worked hard to breathe at times. We mentioned this a few times to the nurses that were taking care of us but were told that he was an early baby who needed breathing assistance at birth and that it should go away in a bit. Both babies had been checked out health-wise and it was actually Elizabeth that we were a bit more concerned about at this time as a small heart murmur had been detected with her. However, we were told it was a common symptom of early birth and that it would most likely go away as she grew a little bigger.
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| Abby meeting her younger siblings for the first time. |
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| Checking out their heartbeats with the nurses' stethoscope. |
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| Abby was beyond excited to hold each of the babies. She melted my heart with immediately telling them that everything was okay because big sister was there. And then promptly began singing to them. Oh, I melted into a puddle of Mommy emotions with that one. |
The next day Jake's breathing was still the same and we once again brought our concerns up, but this time we somehow got our concerns conveyed to the right person and a more thorough checkup on him was done. It was actually a huge whirlwind from how he went from being treated like a typical newborn to a baby with a major health concern. The pediatric hospitalist had taken both babies to do a status check on them, with Nate going along in attendance and I staying behind to get in a glorious nap. Elizabeth's murmur was less than the day before (yay!) but it was discovered that Jake was still in a decent amount of respiratory distress. After trying to bottle feed both babies (successfully with Elizabeth and very unsuccessfully with Jacob) the whole group came clamoring into my room, woke me up from my nap, and without any time to process what was going on began to all talk about how Jake needed to nurse NOW as they were concerned about his declining health and they wanted him next to me to perk him back up. I don't wake up in the best of moods from a nap as it is, but to be woken out of one, told my son is sicker than anyone thought, and that both babies had been given formula against my previous wishes....well, let's just say this Mom wasn't too pleased with any adult at the moment.
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| Nate during an early, early morning feeding. He's making the exact face that I made when decisions were made without my input. Plus, this was just too good a picture to pass up. :-) |
Right after that interesting wake-up we learned that Jake would be placed on an NG tube (feeding via a tube down his nose into his stomach), put under Bili lights due to excessive jaundice, and have an IV line inserted to deliver antibiotics as it was discovered that he had some sort of infection that might be part of what was causing the respiratory distress. I know that my son could have been a lot sicker with as early as he was born and that we had a very good outcome probability but watching all the medical procedures done on my two day old son was heartbreaking. He cried and cried and nothing I could do could fix the problem. His poor little heels were poked again and again as they took more and more vials of blood trying to figure out what was going on in his tiny system. Thankfully, over the next two days all of these medical issues went away. His CRP (I have no idea what this actually stands for, but it's essentially how much infection he had) initially went up from the first test to the second but then was back down on the third test. His jaundice had significantly decreased from his stay under the lights and he'd actually gained weight instead of the typical weight loss from the NG tube feedings (although those feedings were tough as they caused lots of vomiting issues if we weren't careful with how we held him right after a feeding).
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| Elizabeth and Jake (with his feeding tube in). It was hard seeing him with all the wires and tubes attached requiring him to stay within a certain distance from the bed while she was completely free to be walked around the room to anyone. |
But twins being twins, just as soon as we got the word that Jacob was back in great health we learned that Elizabeth had significantly lost weight and was just shy of the 10% weight loss mark and would mean an additional day of hospitalization until we brought her weight back up. I truly believe I have more gray hairs after their birth than before! Fortunately, we started supplementing a bit more with Beth and by the next day she was showing enough signs of improvement that both she and Jacob were given their official discharge notifications. (I'd been discharged on day 2 - happily, everyone understood that even though I was officially discharged from the hospital I'd be staying with the two kids until both were allowed to come home.) We had to wait around the hospital a few more hours after the verbal discharge for the official one (just like the military a hospital is definitely hurry up and wait) but at 8:30pm on Monday, January 25th we were officially released and on our own.
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| First picture of our new family. |
Now that we're home we are finding it surreal to have Beth and Jake here. We tried for almost four years to have another child/sibling for Abby and after all that heartache to have finally achieved the dream we'd been dreaming for so long...well, let's just say that sometimes I look around at my life and wonder at how it really is happening. That THIS "is" my life. We're exhausted. The house is a disaster of epic proportions. I'm constantly feeling overwhelmed and under prepared (even being a second time parent!). I feel completely inadequate at being able to parent an almost five year old and two newborns at the same time. And yet....it's the most wonderful feeling in the world. We're a family of five. FIVE! And that is a family I'd long since given up hope for.
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| Elizabeth and Jake chilling at home. |
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| All three of my babies. |
But after all is said and done, I can't wait to experience life with my newly created family structure. I look forward to watching Abby love on her siblings (she's already singing them songs, giving hugs and kisses, and running to get me when she feels they need attention), seeing Nate interact with this children (making a Valentine's box with Abby for school then turning around and reading from The Economist to the twins as he holds them after a feeding), and just staring into the eyes of my three precious children. I finally feel at peace. And what a wonderful peace it is.
