My planned Caesarean for twins was the best option for me

Leo and Sid current photo

Author: Chelsea Millemaci

I was booked in for an elective planned caesarean section for twins on the 18/10/16 to have my little boys. Good date. I like even numbers. Why an elective section when both babies were head down? To put in simply and after having a year to look back and think about it. Fear. I was so scared of three things. One – being induced. I have only heard horror stories about induction, and most of these stories end up in emergency sections anyway. Two – pushing one out and the second one getting stuck and ending in a section anyway. Three – something happening to the babies during vaginal birth, the option of having a section made me feel more in control. If my babies were to get distressed, no worries. We had the support of a full medical team anyway.

Did I discuss these fears with a doctor? No. Should have I? Probably. Do I regret it? NO. I am proud of myself and confident I made the right decision regarding the birth of my baby boys. It was safe, swift and perfect. I have a glimmer of regret that I never felt labor. I feel a glimmer of sadness that I never got to push out a fresh beautiful baby and bring it to my chest. But who am I kidding? How much more can I ask for? I have two beautiful, healthy, thriving baby boys. I am the luckiest lady alive.

Preparing for a planned cesarean for twins

I was admitted to a large public tertiary hospital on the Monday 17th October, the obstetrician wanted to give me a steroid injection to boost the strength of the babies’ lungs, as they will be born at 36+6 weeks gestation.  Also, due to my gestational diabetes, my sugar levels needed to be monitored. I was calm. Not nervous, not anxious, I was excited. I was incredibly uncomfortable. I just couldn’t wait to feel not like a swollen, pained, tight incubator covered in itchy burning welt-like stretch marks (pregnancy is beautiful).

My Mum and husband Andrew kept me company that evening (I wont go into detail about the biggest needle I’ve ever seen that went into my butt containing wonderful lung strengthening steroid),. They went home at about 8ish and I wrote in my diary. That night I didn’t sleep a whole lot. Hospitals are obviously quite loud and busy.  They aren’t compatible with a restful night. Neither is two almost full term babies kicking about inside you and having a dance off.

The next morning Andrew arrived at about 6:30am

My lovely midwife Mel came and introduced herself. Mum popped in about 8am (my Mum is an RN who worked in the Special Care Nursery at the hospital and wanted to keep an eye on everything). I was due to go into theatre at about 8am, however it got delayed due to an emergency. At this stage I would say I wasn’t nervous. I was kicking back in bed in my hospital gown attached to the monitor watching the Today show. Mel popped in and said the last thing to check off was a catheter for me. It could either be popped in now while we were waiting or have it in theatre. I thought hey why not pop it in now, kill some waiting time. Mel was a professional and popped the catheter in, simple, easy, not painful just slightly uncomfortable.

It was this tube hanging out of my urethra that undid me.

I freaked out and I’m blaming pent up nerves, as I could have sworn I was weeing around the catheter. I could have sworn I was wetting the bed, this feeling amplified my anxiety (I am a Registered Nurse and I know very well that I wouldn’t have been weeing around the catheter), I needed to be out of bed now. NOW. Andrew didn’t really know what to do with me. In my flapping open butt baring gown and my pee bag I needed to be out of bed STAT. I hobbled to the toilet insisting I needed to wee (DUH Chelsea you had tube draining your bladder. You’re a NURSE. You KNOW THIS) and demanding poor Hubby and Mum to change my bed linen because I had wet the bed.

I can still feel the sensation now, like I was holding onto the biggest bladder full of wee and it was escaping. A full blown anxiety attack was heading my way. Luckily the orderly came to collect me as I remember thinking ‘God Chelsea, pull yourself together’ so people wouldn’t think I was crazy. So, deep breath, collect my thoughts and my sanity, clench my vagina muscles together to grip that bloody catheter, and get on the bed.

(Side note: later a more experienced midwife had a little laugh as I was telling her the worst bit about the birth was the catheter. She said NEVER put a catheter in a woman who has two babies, two placentas and a tonne of fluid pushing down, the pressure is too much to bare. Yeah. I’d agree with that.)

 

Undergoing a planned cesarean for twins

We ended up waiting in the theater waiting room for 45ish minutes.  Andrew entertained me so I could think of something other than the catheter. It was weird. I was more focused on that bloody thing than the fact I was about to go into an operating suite, be sliced open and in an instant be made into a mother to two small infants? Yeah no biggie. Suddenly it all happened fairly quickly. We were wheeled in and introduced to the anesthetist.

At least 20 people buzzed around me purposefully doing their jobs. Obstetricians, a pediatrician, midwives, nurses, anesthetists, interns, a team of professionals for myself and for each of the babies. Such an AMAZING well operated system, if I wasn’t overwhelmed I would be in awe.

The anesthetist asked me to wiggle over onto the operating table (“Um hello, no I can’t move, there is a tube up my vag” said my inner mind, “OK no worries” said Chelsea). He explained my spinal injection while the junior anesthetist canulated me with the biggest needle I’ve ever seen (bigger than the one with the steroids) – they even used local before it was inserted. That didn’t hurt, honestly I could barley feel it, same with the spinal injection. Must be adrenaline, because they were some seriously big needles.

Before I knew it I was lying down and I couldn’t move my heavy legs.

I was fairly comfortable lying flat on my back. This happened faster than I could explain, too quick to become nervous, but not quick in an anxiety provoking way. More in a ‘wow they are so professional I feel so safe’ kind of way. The anesthetist was lovely. The obstetric team were trying to find the boys heart beats and they were having trouble finding twin ones (I wasn’t nervous, twin one was always hard to find). To distract us the anesthetist reassured Andrew he wasn’t in the way, encouraged him to feel comfortable, and informed us how many people in the room. Holy hell we were in good hands.

At 10:52am a healthy little boy was born.

Laying there, watching up at the lights trying to see exactly what was happening in the reflection. I felt some slight tugging but not even uncomfortable. They dropped the curtain and lifted my head up. I was surprised at myself. In the movies the mother gets overwhelmed with joy, she cries out “oh my baby”, and has tears of joy streaming down her face but all I remember seeing was a scrawny baby screaming.

I looked at him and felt calmness, relief and satisfaction. He was healthy, certainly a boy and was a splitting image of my brother Sam – weird. They delayed his cord clamp for 60 seconds as per protocol. My head got placed down and the curtain was tugged up again, and again I tried to watch for the reflection.

10:54am twin 2 was born

My head was guided up, and HOLY HELL I could breathe again! Yeah yeah there was my beautiful baby, slightly less scrawny than his older brother, again looking like his uncle Sam. However, these were fleeting thoughts because oh my god I could breath RIGHT to the bottom of my lungs!!!!! Again, 60 second wait before they clamped the cord and I lay down again.

A delicious sense of relief

An amazing combination of two healthy babies, a happy husband, the ability to breath to the bottom of my lungs and morphine. What a heady delightful feeling. I was happy just lying back letting the doctors stitch me back up. Andrew cut the cords for both boys, even after he always confidently stated never would he ever cut the cords – I guess he got lost in the moment. The nursing, midwifery and medical staff were all very excited, they were asking if the boys had names – of course they had names!

We found out at 20 weeks they were both boys.

We argued and wrestled with countless names. Twin one was always going to be Leo, Leo Mack was decided on quickly. I don’t really know why, mainly because we both agreed. Sidney Lloyd took a lot more discussion, but we got there in the end. I remember being a bit flustered when we were asked the names. I didn’t want them written down wrong, or I didn’t want them misheard. But we got them out, we told them – twin one is Leo and twin two is Sid. One by one the babies were placed on my upper chest, I can’t remember who I got first.

This was an awkward moment, again, not as amazing as I imagined. I could barely see my babies, they were beautifully wrapped with their heads tucked in to protect them from the cold theatre. I wasn’t wearing my glasses and to be honest I was getting a little nauseated. Andrew,  Leo Mack and Sidney Lloyd left to go to the special care nursery to be properly assessed. I was taken to recovery. It was an incredibly busy day in the hospital on October 18th.  The staff were flat out and I kept bleeding. My midwife didn’t have a break all day, so it was a couple of hours until I got to see the boys again.

Special Care Unit

I was wheeled into the special care unit, Andrew was there with Mum. Leo was tiny, he had a feeding tube down his nose, both boys had been given a formula feed. They were perfect really and I had another awkward cuddle in the middle of that unit before I was wheeled to my room. Thankfully, that afternoon Sid was cleared from special care nursery so he came to room in with Andrew and I and it was then I really got to study my little boy. I fed him and cuddled him and loved him. Leo stayed in the unit over night, but he came up to me for breastfeeds where I got to cuddle, study and love him. He was cleared from the unit and the feeding tube removed the next day.

 

 My thoughts about my planned cesarean for twins

There were a few factors about having an elective cesarean section that made me feel like I was missing out on having a wonderful birth. Mainly missing out on immediate skin to skin time. As a registered nurse who has always been interested in midwifery I did a lot of reading. I read countless birth stories, blogs and articles and almost everything I read stressed the importance of immediate skin to skin time for Mum and baby. For bonding, for breastfeeding, for temperature regulation, for the prevention of PND. So many important benefits I would miss out on.

However, in my particular circumstance none of that mattered as when all the visitors had gone home I had my special bonding time in our hospital room. And when the staff had left us to our own devices I was able to hold my babies close, whisper to them, smell them and look after them.

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