Saturday, June 28, 2008

Twins Born Vaginally - A True Birth Story From The Land Down Under

Karen's Birth Story

(Karen at 37 weeks)

On 17 June 1994 I gave birth to my beautiful twin girls in Adelaide, South Australia. It was without question the most wondrously special and memorable day of my life.

I loved every moment of being pregnant and read everything I could get my hands on, concentrating of course on multiple births. I carefully followed the progress of what my babies would look like in utero, their development at each stage of each trimester. I was endlessly fascinated by all of it.

Unfortunately my pregnancy was not without the odd problem. For instance at about 18-28 weeks I was constantly fainting. More or less every time I stood for more than a few minutes I would go down like a ton of bricks. I was hospitalised for a week while they investigated the cause and after exhaustive tests and even being taken by ambulance to a bigger hospital to have a heart scan, they finally found out what the problem was. Apparently my little cherubs liked to snuggle up at the back of my stomach and were in fact lying on a major artery. This would then cut off my blood supply making my blood pressure drop to very low levels, hence the fainting. Once the pregnancy reached 28 weeks they were forced to remain more stationary due to a lack of room and it rarely happened after that.

At 32 weeks I was admitted to hospital with high blood pressure. It was only high for an hour and then returned to normal but from that moment on I was not allowed to leave. They had also discovered that even though I was expecting fraternal twins who were in separate sacs and had separate placentas, somehow one of the babies had too much amniotic fluid and one did not have enough. The doctors required constant monitoring on a daily basis so they could keep an eye on their growth and heart rate. I had a scan every Friday to ensure that both babies were growing and developing at an acceptable rate and all in all I was very well looked after. This was in a public hospital I might add where I had my own private room and I did not see one bill for what turned out to be a 7 week stay.

My doctor was looking after me for my whole pregnancy and certainly all the time I was in hospital. We had many discussions leading up to the big day about my birth plan. All women were encouraged to write a detailed plan of how they would like their birth to happen right down to the music they wanted (which of course they would provide themselves) and who they would like to be present.

My doctor was well aware that it was very important to me to try and deliver my babies vaginally as in all likelihood this would be my only pregnancy. He was more than happy for this to happen as long as all was progressing well without endangering the babies. That of course was without question.

There was only one possible snag to this option and that was that one of the babies was in the breech position. As the pregnancy progressed and the babies starting engaging ready to be born it was obvious that the first baby was head down which made a vaginal birth a more viable option. My doctor was happy for me to try and give birth vaginally but there was one concession he wanted me to make. He wanted an epidural inserted in my back so that if things started to go wrong they could quickly rush me off to theatre and top up the epidural so I would still at least be awake for the birth no matter what the emergency. I considered that to be a fair enough compromise. I was well aware that a multiple birth by its virtue does carry higher risks.

Finally at exactly 38 weeks I awoke at 4.30am with a definite cramping pain and a very damp bed. The first lot of “waters” had broken. I called for the nurse who organised for me to be taken to the delivery room. I had just enough time to call my husband and alert him that the babies were on their way.

Within 20 minutes I stepped off the gurney into the delivery room and hurriedly made my way to the toilet. I got half way there when the second lot of waters broke. Boy…this was happening quickly. It was funny because the doctors and nursing staff who were on the night shift were just finishing when I was brought in and some of them asked if I minded if they stayed around for the birth. I readily agreed although had I known how full the room would become I may have given pause to this decision.

The pains were coming fast and furious and within one hour I was fully dilated and ready to push. The anaesthetist was called in to insert the agreed upon epidural which wasn’t too painful and then I got down to business. As luck would have it David arrived just in time and I now had four obstetricians, two midwives, two pediatricians and their nurses, a couple of student doctors and Craig, my husband. My mum came in for support for Craig but with the crowd that was in there she was quickly out of sight at the back of the room. Yes it was a bit of a sideshow but I didn’t really care at this point.

It quickly became evident that baby number 1 was not making any progress down the birth canal no matter how hard I pushed and on further examination it was discovered that she was actually stuck at the top of the birth canal. The more I pushed, the more stuck she became. Apparently her head was presenting at the wrong angle and so there was no option but to introduce the forceps. I cannot even begin to tell you how horrified I was at the thought but this is where sometimes you have to adapt your plans. Births don’t always go like a well scripted play.

I had an episiotomy to enable them to reach the baby more easily with the forceps and it was at this point I was grateful for them to crank up the epidural. Everything happened so quickly from that moment on and with a couple of good hard pushes my first baby girl was thrust into the world with a lusty cry. They quickly looked her over and after bundling her up she was handed to me for my first glimpse of my precious angel. The rush of pure love I felt for this tiny little human being was indescribable. I had wondered for so long what my babies would look like and here was one of them in my arms strongly objecting to being wrenched out of her warm safe haven.

Before long I was reminded by the doctor that I still had the job ahead of me and baby number 2 was on her way. This was the breech baby and they had hoped that once the first baby had left the premises she may have flipped over the right way but unfortunately she chose to stay right where she was. Again the forceps were introduced and as I pushed and then raised my head I saw two little blue legs sticking up in the air. Within five minutes after Emily’s birth, Chelsea was born at 10.05am. I couldn’t hold her because by now adrenaline had kicked in and I was trembling violently. Chelsea did not make a sound for what seemed like an eternity but once they had suctioned her nose and throat she too gave a hearty cry and I visibly breathed a sigh of relief.

So many emotions were rushing through my body and I was relieved and overjoyed that really it had all gone very well. Emily weighed 4lb 15oz and Chelsea was 4lb 14.5oz. Ironically Emily had been the one with the least amniotic fluid and was the one they expected to be smaller.

They had to spend the first night in the neo natal nursery because their temperatures were a little low but after that first night they spent the rest of our stay with me in my room. I breast fed them both without any problems in fact from the very first try they took to it like ducks to water.

It was indeed my only pregnancy and birth and I felt so grateful that I was able to experience everything as nature intended. As it happened it was necessary for a little intervention from a medical point of view but I didn’t feel cheated by that. It was necessary and I accepted that. Giving birth was a beautiful moving experience and one I wouldn’t trade for the world.

Thursday, June 19, 2008

Safety of Home Births In Question

Over the last 30 years the c-section rate has gone up each year under the care of OBGYN's. Currently we are hovering at a c-section rate of almost 50%.

Under the care of Midwifes, many whom offer home births, the rate of c-sections is 3-4%.

Read the fact sheet regarding the statistics on home birth.

"An obstetrician is a medical specialist who focuses on labor and delivery. Obstetrics is actually a surgical sub-specialty, meaning that an obstetrician attends surgical training and then specializes in the care of pregnant women and in surgeries which are related to labor and delivery, such as Cesarean sections." -Wise

Rates for premature birth have been increasing, and recent studies have connected this increase with the increase in cesarean sections.

Sadly these same OB's who have brought the c-section rate to its highest ever and who have brought premature birth rates to its highest ever are calling for an end to the option of home birth.

Why is the c-section rate so high?

Doctors are denying food and drink during labor, preventing or discouraging mothers from walking and other physical activity during labor, using drugs to "start labor” (ie, induction) or hasten labor (augmentation), not“allowing” mothers to be in a vertical position to push the baby out, using directed breath-holding pushing, are all examples of routine hospital/obstetric practices that have been shown to interfere with the normal process of labor and cause complications, causing harm and not benefits to mother or baby.

All of those methods listed contribute to an exhausted mother who doesn't have the strength to push when the time comes, which leads to uneccessary interventions leading up to c-sections.

Most Midwifes encourage eating and drinking, movement and position changes, and encourage breathing techniques that aid in labor and delivery. And most home birth Midwifes have an extremely low c-section rate and low transfer rate to the hospital.

With the evidence glaringly in favor of mothers and babies fairing better in home birth situations why is it that the AMA is trying to ban this option to laboring mothers?

Ask your physician his or her c-section rate, episiotomy rate, rate of epidural and pitocin as well as the same information for the hospital you plan to birth your child in. Then call a Midwife in your area and ask the same questions. Then decide which seems better for the health of the mother and the baby.