You can’t really grasp the birth without the context of the pregnancy, nor is it something I want to forget. In April of 2019, after trying for about three years, I became pregnant with twins—who in utero were known as “Captain Daffodil and the Duck.” After two miscarriages, we were cautious to get too excited those first few weeks that our rainbow babies were real (I was a wreck until I hit 12 weeks), but they stayed the course. This is our story.
First Trimester
Early on, we saw the same OB that had managed my ectopic and second miscarriage for assurance that all was well. This meant ultrasounds and regular visits until we could be assured that the babes were thriving. Though we were attending those visits, I always knew I’d birth at home. Not because I’m a crunchy hippie or brave (as folks have often labeled me), but because for me, that is genuinely what I felt was safest, most likely to honor my autonomy and most aligned with my values.
Walking between what felt like two different worlds early on—home birth care providers and OB care providers—was extremely hard (hint: not because of the home care team). We had saved money for three years in anticipation of having a home birth—though we didn’t realize we’d need three birth attendants!—who would do my in home-prenatal appointments and attend the birth. Meanwhile I’d use my insurance to continue seeing the OB in order to utilize the tools the home birth folks didn’t have (ultrasound, bloodwork, etc). At our visits, the home birth team assured me over and over in what I already knew: me and my pregnancy was good and healthy. Because we’re fortunate enough to have good insurance with an HSA, I was also able to afford a naturopath to ensure that my nutrition and physical game was strong, and I worked with my endocrinologist and primary care provider to be make sure my autoimmune issues were well taken care of. I got acupuncture and attended pre-natal yoga regularly, and walked everyday. But our OB, who’d been great during my miscarriages, seemed unable to help herself from labeling me as high risk for everything because of my age, having multiples, my previous losses--and I think the clincher was being up front with her about a desire to have a home birth. It was as if she suddenly control of her ability to see me as the autonomous, capable being she’d once known me to be, and when I’d see her would share a laundry list of why my babies would likely be born early, why I was likely to end up with pre-eclampsia, and a host of other things that sent me into an anxious spiral. Visiting her ate at my confidence and trust of self. When I worked up the courage to confront her about it, our conversation went horribly, and it was clear that our values were not aligned, that she'd be looking to manage my care and birth from a place of fear and scarcity, and that I would not be able to fully participate in directing my care. The emotional labor of seeing her became suffocating, and I developed severe anxiety about pre-eclampsia and early labor, ensuring that anytime any doc took my blood pressure my white-coat syndrome would soar through the roof. I broke up with that OB during my second trimester, and though for some reason I was scared to do it, it was the best decision I ever made.
Second Trimester
By 28 weeks I looked as if I was nearing full term with one baby. I was starting to respond to questions from friends, family—and strangers—about our birth plans since it looked to others that I was farther than I was. People couldn’t help but ask about the likelihood of our babies coming early (read: more anxiety for me, thanks) and about whether or not home birth would be a safe choice for us (read: “I don’t trust you, you are naive.”). Sure, many friends and family were supportive, but it didn’t take much to sense the distrust and assumptions people made about our choice to birth at home. I didn’t let it get to me, but it surely didn’t always help to feel responsible for others’ emotional needs while trying to ensure that I kept myself and the babies at the center of my emotional, physical and spiritual focus.
Third Trimester
Still, when L and the MFM (maternal fetal medicine doc) reviewed our ultrasound results, they shared their concerns referencing statistics, percentages and Duck and Daff’s estimated birth weights (which ultimately, for the Duck, would turn out to be way off). Even though I knew that the Duck was OK, they asked us to complete a non-stress (NST) test to reassure them that her heart tones, movements and etc. were in a range they were comfortable with. We were already monitoring these things regularly with our home birth team (gauging heart tones, accelerations, variability and movements) but the information MAHEC shared led me to question everything I knew, and I ended up in tears—questioning myself, them, the Duck, everything. I asked L and the MFM what would come of anything we’d learn during an NST, and the MFM responded that next steps/recommendations could be one of three things: “We’ll either recommend a c-section today, induction at 37 weeks, which is our standard practice for twins, or suggest that you come in for NST’s every 2 days for the remainder of your pregnancy until the babies are born.” None of these felt like optimal options to ensure mine or babies’ well being.
The next day, I let our home birth team know about the MAHEC visit, and they listened compassionately as I cried about what we'd heard and my own doubts that were creeping in. Even though deep down I truly felt the babies were fine, I'd been shaken. They responded by offering to come over every two days or so to do a home version of monitoring and NSTs—they’d come more frequently to listen and ensure that babies’ heart tones, variability, accelerations, movements, were still indicating that they were thriving. I was immediately put at ease by that. I knew that if they started to suspect something was wrong, they’d be direct and objective, encouraging me to find my way without fear tactics or an over-reliance on stats and numbers that may not have anything to do with me and my littles. I knew they wouldn’t encourage me to induce. Plus, our team already knew me and the babies so well I had far more trust in their ability to decipher what was normal from abnormal with regard to the babies.
The In-between (Weeks 37-40)
I cried a lot during those weeks. I was at my physical and emotional edge. Al rubbed my aching body several times per day to relieve me of the constant pain, cramps and discomforts in my back, legs, and hips. The nights were the hardest. The discomfort was beyond anything I’d ever experienced. Since I hardly slept, sometimes in the middle of the night, Al would come over to my side of the bed, get behind me and let me rest back on them while they massaged my head, face and neck, helping me calm down. Even still, during the days we laughed between cries, and loved each other hard, savoring the last days before our lives would be forever changed (even though the laughter meant several underwear changes for me per day as I no longer had control over my bladder!). We would stand at our altar, light candles, wish, hope and dream. We’d wonder when and whether they’d ever come. Al would check my cervix to see whether I was dilating and if Captain Daffodil was descending, and we’d monitor the fluids coming from my body (looking for mucus plug and bloody show). I took a million deep breaths and did gentle yoga as much as I could. I overflowed with gratitude for these healthy babies moving around inside of me while longingly begging them to make their descent. We saw our midwives and occasionally ventured outside to breathe fresh air. It was as if we’d stepped into a new realm and with everyday that passed, were going deeper and deeper into another time and place.
Labor Day 1 (Saturday, 40w)
Labor Day 2 (Sunday, 40w1d)
I woke up around 8am, and when the contractions didn’t come back by mid-morning, the birth team packed up and left. Al and I spent the day “resting” and recovering from a long laborious night, meal prepping, and tidying the house. I cried with some disappointment, but also welcomed a much needed rest after a long, long night, knowing that my continued labor was likely to be around the corner. I took a shower and leaned on Al who continued to take amazing care of me. I also continued to feel cramping and light contractions which made me wonder whether I’d get some organized contractions again that day or night. We watched more Mrs. Maisel and Great British Baking Show and called in patience. That night, while I tried to sleep, contractions came and went, keeping me up most of the night—not that I would have slept anyway. It seemed there was some weird irony in that anytime I laid down, contractions took hold, so though I wasn’t fully in labor, somehow, I kind of was too.
Labor Day 3 (Monday, 40w2d)
Labor Day 4 (Tuesday, 40w3d)
When contractions petered out Tuesday morning, I not only felt exhausted, defeated and emotionally drained, but extremely dehydrated. My physical self was fully depleted, as if every nutrient, ounce of water and reserve of strength had been drained from my body. I told my team that I felt I'd hit some sort of rock-bottom. By today it was also hard to pee—like my bladder had become blocked by the babies—so anytime I sat down to go, I’d get a few little streams but no full release. The babies were still chillin’—heart tones good, movements strong. Meanwhile, I was starting to meet my edge. I’d been laboring hard on and off for almost 4 days. The discomfort of carrying (what I’d later learn was) 15lbs of baby + another 10lb at least of water, fluids and placentas, was at times unbearable, pulling on ligaments, muscles, skin, tissues—my soul. Goddess bless Al and the birth team. They gave moral and directional support, suggesting that we place small snacks all over the house so I could take little nibbles when I walked by something rather than feeling pressured to “eat” (just so you know it’s impossible to eat an actual meal when you’re THAT pregnant, even though I desperately needed to), and Al was all but force feeding me water and electrolytes as much as possible. When I half-jokingly made the statement that “I just feel like I need a line of IV fluids,” they googled to find out whether such a possibility existed, and turns out there are places you can go just for an IV. That New Years Eve Al and I spent an hour at an urgent care office filling up on a “ringer’s lactate” IV drip in hopes that when labor came back on, I’d be in better shape and more hydrated. Instead I watched my ankles swell--after a pregnancy without any swelling, I was finally starting to see some edema in the lower portion of my legs. My plan was to sleep that night—I even took a half a Unisom to try and help me rest—and then leave any and all induction plans completely alone. I resigned myself to knowing that the babies would come when they were ready, that I was not in control, and that it could still be days. I was surrendering. So it figures that when I got in bed that evening, the contractions picked up, and took me through most of the night. Not super close together, just frequent and strong enough to keep me uncomfortably awake, coming probably every 20-30 minutes or so.
Labor Day 5 (Wednesday, 40w4d)
So much for rest Tuesday night. One member of our birth team, E, came over Wednesday because she felt like we could use some support even though we weren’t sure when active labor would return. Her instinct was spot on—we were so grateful she came. Contractions stayed about a half-hour apart Wednesday morning, but she led me through some movements and position changes every half-hour or so, and after a couple hours they picked up. I’d later learn that she had told Al that her plan was to do a blend of tending and torturing—both of which she did, and both of which were productive. In the meantime, I continued to drink and eat as much as I could, which was hardly much at all, but I did what I could knowing I’d not be able to fit much food in or pee much out. Thank goodness for straws and force-feedings by loved ones, otherwise I’d have let food and drink go completely. That afternoon Al filled the birth pool that had now been sitting in the house for several days, and though I wasn’t in full labor, I had to give my body a rest and got in. It was literally life changing! I hadn’t felt so relaxed in days—gravity be damned! E was still listening to the babies every so often, and their ranges and variability continued to be perfect; they also continued to let us know they were fine through their movements, kicks and rolls. Wednesday night played out much like the day had—I was somewhere between early labor and labor, with contractions spaced wide apart, probably 15-30 minutes. I was feeling the contractions more in my back, sacrum and deep pelvis than the previous nights, and getting rubbed and hands on support from E and Al helped me through. It felt as if my contractions had been practicing all week and gaining momentum, and were now old hats at mustering strength and intensity, even when they were spaced out. Some would even last 1-2 minutes, and were often strongest when I was laying down. That night I got in bed and managed to rest without real sleep and may have fallen asleep a couple times that night without much rest. But I grabbed what I could.
Labor Day 6 (Thursday, 40w5d)
Today was pick up day. My rest-non-rest from the night before, coupled with some eating, drinking and knowing that my contractions were organizing without the support of castor oil or desperation (just some homeopathics, movement, and position changes at this point) gave me a little hope for the day. Babies were doing well, and it looked like labor was imminent—or rather, that I was finally going to stay in labor when contractions became 5-10 minutes apart. I tried to stay out of the pool though I desperately wanted to go in, because I didn’t want to risk labor slowing down. Still, at this point laboring for so many days had really begun to tax me. By Thursday it was clear—this had become the hardest week of my life. It was, above anything else, the most intense and emotionally, spiritually and physically trying thing I’d ever done. Tears, laughter, the biggest love you’ve ever known, every feeling you’ve ever felt, venturing into altered states—this is labor--and I’d been in it all week. It’s the in-between of coming and going, life and love, mothering and self-preservation. Beautiful, messy, horribly unknown and animalistic. And though I was exhausted, curious, taxed—I was never scared. I was in severe pain, but never fearful. My gut was in check and intuition steady as iron. I was surrounded by reminders that I could do it—poems and gifts from my blessing way on my altar and counter, candles burning, reassurance from the birth team and Al, my inner mantra “through” that found it’s way to me after realizing that there was no going over or under this pain and process—the only way was through. Breath and breath and breath and breath, and more and more breaths.
That night we invited a chiropractor over to do an adjustment for me in hopes it’d help Daff descend a little more, and the adjustment triggered something that caused me to burst into tears and weep. When she left, the contraction intensity increased. Babies remained good. Around 9 or 10pm that night, when 5-10 minutes apart became 3-5 minutes, I got in the birth tub, and to my surprise labor picked up. That evening I knew I was finally in a labor pattern that would sustain itself. I also officially couldn’t pee anymore so in the middle of the night S gave me a catheter which hurt like a bitch but I was so grateful. We went ahead and did a cervical check to see about dilation and station, and I was around 4cm and 0 station. Honestly I thought I’d be further by that point but know from experience attending births that things can change quickly, so didn’t put energy into disappointment or concern. I was starting to feel some curiosities—like “Why isn’t Daff lower?” and I remember being in the tub several times thinking “Why isn’t there any poop in here?” (For those who are squeamish sorry, but when your baby comes down, there’s poop, it’s just a thing, get over it.)
Thursday night was a mixture of relief, excruciating pain, excitement, and courage. I was in the tub, up and down stairs, on a birthing stool, pumping, (to try and intensify contractions), resting and in and out of various positions. By the middle of the night I knew that somehow, some way, Friday would be their birthday. I just knew it. “Through. Breathe. Through. Breathe. Through ….” And repeat.
Labor Day 7 (Friday, 40w6d)
The sun was up again. For whatever reason I felt grateful to see the sun and blue sky. Still contracting heavily, it was like the switch from dark to light gave me a boost of energy after what had been my longest, hardest night yet. Aside from the catheter the night before, the only way I’d been able to release small amounts of urine was to stand in the shower or do an upright squat over the toilet (which did or didn’t work), but this morning I felt like I needed to move my bowels (hopefully a good sign!) so I sat on the toilet and tried to go. While there I had a contraction and felt a warm gush of water release - Daff’s waters had finally broken. When I looked down I noticed a lot of fresh meconium (for those unaware, this means a baby has pooped in their amniotic sac). Meconium can indicate distress, but doesn’t always, so I didn’t feel concerned. Instead a wave of gratitude washed over me, and my immediate reaction was “Thanks Daff.” It felt like he was giving me an indicator that something was up, and I calmly let Al and the team know. Though I briefly considered staying home to labor a little longer, deep down I felt like I’d received a message from my son that we needed a change, so we packed a small bag and off to the hospital we went.
S came with us. On the drive over, I called L, the midwife we’d seen at MAHEC, and was really grateful to hear that she was there that morning (and it was her birthday too!). After talking to S and me, she blessedly arranged for us to come right onto the Labor and Delivery floor, and compiled a team who would care for us during our stay. L, the docs and nurses greeted us kindly and without judgement, saying “We know you don’t want to be here, but we’re glad you made the choice to come, and whatever you do from here on out is your call. We’ll be by your side the whole way.” During our stay, they honored those sentiments entirely, and I’m beyond grateful to L, Dr. M and Dr. S for the care we ultimately received.
L asked if they could do an ultrasound and we obliged—of course they confirmed what we’d known all along—the babies were good and no emergent situation had arisen. I said yes when she asked if she could check my cervix, and she shared that I was about 4cm, completely effaced and around the same station I’d been the last time S had checked. This all showed no major changes from when S had checked me the night before. Her response was similar to my internal dialogue—“everything seems normal but I’m surprised Daff isn’t lower.” She then excused herself to let Al, S and I talk about how we may want to proceed for the day, reminding us that nothing was emergent, and that in a twist of fate, the floor was pretty quiet that day with no surgeries or immediate deliveries on the horizon. Without inserting her opinion on what she thought our next step should be, she left the room, inviting us to talk about how we wanted to proceed.
I knew then I would have a c-section. I can’t say why but it felt like the only option. Somehow 2+2 was not equating to 4. Al was the first to say out loud that they felt ready to meet the babies and wanted me/us to consider a c-section now. S chimed in that she felt that a c-section would be a good choice at this point, and that no matter what we chose, she’d be with us all the way. I was grateful they both said the words first, even though I’d already known them for myself. It felt clear that continuing to labor as I had been was not going to take us anywhere new, and for whatever reason, I knew a c-section was the path. I thanked Daff again for his cue that something needed to change. And so it was my babies would be born via surgery. In less than one hour, our babies would finally be earthside.
The staff was tremendous. In the OR, they hooked up our birth playlist, so we heard the familiar voices of Neil Young, Rising Appalachia, the Dead as I started to get my spinal (which they had to do twice). Al and S were in what I called “marshmallow suits” (big white surgery scrubs and hats) and Al stayed up by my head, holding my hand as the drape went up. S and L got to stay below and watch the surgery (I’m kind of jealous about that one). I felt a lot of tugging and pushing and pulling, and appreciated that for the most part people had kept their voices low—we’d asked them to try and help us ensure that the first voices our babies would hear would be ours. While Jerry’s voice sang out about a Brokedown Palace, Dr. M held up Daff, and we saw him in his big purple baby glory, my son was finally here.
What I didn’t know at this point was that they’d pulled Daff—who we’d soon start calling Sam—out of a bandl’s ring, where his head had been lodged. A bandl’s ring is a rare uterine muscular development that occurs in about .02% of deliveries; it’s believed that they form during the last weeks of pregnancy or in prolonged labors and essentially create a strong muscular ring that babies cannot pass through. Without a c-section, the likelyhood of uterine rupture, cerebral palsy, and fetal demise is significantly increased as vaginal delivery becomes impossible. From what the docs said, my uterus was in the shape of a figure-eight, the band being at the center and gaining strength with each contraction. Sam’s head was below the band, and he and Starr’s body were stuck above it. That’s why he never descended further—he literally couldn’t.
At this point for me, things got a little fuzzy as I began to lose a lot of blood, got extremely shaky (more than the hormone shakes that often happen after birth) and began throwing up. L was with me for some of this, and then later S was—holding the emesis bag for me and again offering the most attentive and nurturing support she could muster. What I’d later learn was that when the babies came out, Starr was extremely limp, pale and only scored 3 on the APGAR scale. Al followed Starr to where the NICU team began working on her while S had gone to be with Sam. Starr was bagged for resuscitation, had meconium sucked out of her belly, and started retracting. Meanwhile Al cheered Starr on, talking to her nonstop and holding her hand while she quickly improved—all the while watching me across the room violently shaking and vomiting. By minute 5, Starr’s APGAR was up to a 7 and Al was able to tuck her away in their marshmallow suit, holding her safe and warming her up. Sam had done well, and when Al had both babies, they came to sit near me, though I don’t remember very much of that, as I continued to throw up and shake for a long while; at one point I remember asking if I could go to sleep as I started to feel extremely faint and out of it. Once in recovery we all started to perk up and began doing a little better. I finally got to hold and nurse my babies about two hours after they were born.
We stayed in the hospital for a total of 3 nights, and I wish I could say that the hospital stay was as positive and empowering as the birth experience, but it was extremely hard for reasons I'm going to skip getting into here. Let's just say that the hospital hardly feels like a place for wellness, rest and healing--instead it felt like a place for disruption of natural processes, for interrupting bonding and healing while being reduced to a number or statistic. On Sunday we told the docs and nurses that we'd be going home Monday, whether they were ready to release us or not--and we did.
It was never my hope to have a c-section, but I was ultimately beyond grateful that I was able to choose one. As someone who originally wanted a home birth, that I was able to choose a c-section autonomously, based on my gut and intuition felt empowering. I knew. I just knew. In the end, I’d strengthened the hell out of that intuitive muscle during my pregnancy and labor— so much so, that I made a choice I thought I’d never willingly make, because I simply had the space to be in my knowing.
I’m now a mom of twins and wouldn’t change a thing about my pregnancy and birth. Sam (formerly known as Captain Daffodil) and Starr (formerly known as the Duck) are the most gorgeous, amazing creatures I’ve ever laid eyes on, and I’m lucky beyond measure to have fallen in deep love with them from the moment I was able to release them from my body. All of us are doing well, adjusting and finding our way, doing what we can to savor each moment, as we can already tell that the days and moments will fly all too fast.