Musings of a Marfan Mom

Ashley’s Birth Story #2

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Awhile back I invited readers to submit their birth stories, to be posted while I take a maternity leave. Since Baby J is here, it’s time to post them! Some of the women have Marfan syndrome like me, but not all. If you have questions for the authors, feel free to leave them in the comments section; I’ll also try to email them any questions I see (as soon as I have time).

Ashley
Mother of a 3 year old girl and 20 month old boy/girl twins, pregnant with #4
Marfan syndrome

(Ashley’s first birth story was published yesterday)

#2 (twins) At my first OB appointment at 8 weeks, I fully intended to go in, guns blazing about a VBAC. I’d done my research and I now felt my first c-section had been unnecessary and I was hoping to avoid a second surgery. On the ultrasound, however, we got a little surprise when we saw not one heartbeat, but two beautiful beating hearts. This changed things a bit.

Throughout the pregnancy I made it clear that I would prefer to birth vaginally if possible. “If possible” meant that the babies were both head down, there were no other complications, and the weights of the two babies were less than 1.5 lbs. apart. My babies were transverse for a while, then breech, but I used some of the techniques on spinningbabies.com to help them turn into the head down position. By the time I was late into my third trimester, my babies were both head down and my daughter was nestled deep into my pelvis.

I was in a lot of pain.

Then we had our 36 week ultrasound and I found out that my daughter was nearly two pounds lighter than my son. This presents a significant danger to the second twin in a vaginal birth because the second twin can descend too quickly which can compress the umbilical cord. Also, there is increased opportunity for the cord or the baby’s limbs to come out of the vagina first. There is always the possibility of a vaginal birth with the first twin and then a c-section with the second twin. That wasn’t a very appealing scenario for me.

Since I had no chance of my doctor supporting a VBAC and I was close to immobilized by pelvic pain and contractions by this point, I opted to get the babies out as soon as possible. At 37 weeks 1 day I had an amnio to determine lung maturity. They checked my son’s amniotic sac since he was the larger twin and usually the larger babies and the boys mature more slowly. The results came back that his lungs were mature, and we scheduled a c-section for the next day.

We arrived at the hospital at the requested time and I was matched with a sweet nurse who got me gowned, prepped, and got my IV started. We had to wait a bit since my doctor is a high risk MFM OB and often has to attend births which are emergencies. Finally it was time to go to the OR.

I was pretty nervous about the spinal anesthesia. I had hoped for the same anesthesiologist I had with my daughter’s birth but I didn’t get my wish. This doctor was nice, but not the angel the first was. I was shaking and crying a bit from anxiety and the doctor and nurse tried to keep me calm and get my spinal administered.

I kept worrying that I wasn’t numb until I was told they had already done the pinch test and I hadn’t felt anything. It was a very strange and heavy sensation with the spinal, much stronger than the epidural.

People were pouring in. It is hard for me to remember exactly who was there but there was my OB, the anesthesiologist, my nurse, the attending OB who was assisting my doctor, two students (I forget if they were nursing students or going to be doctors) and at least 2 nurses for each baby. I know there were NICU nurses as well but I forget if that was in addition to or included in the 2 for each baby.

My husband came in just as my OB was getting ready to make the incision. After a few minutes of tugging, my daughter was born! I was worried that she didn’t cry at first but once she had been wiped off and and done the apgar tests and vaccine she was giving her lungs a workout! They brought her to me to hold while they worked on delivering my son. While I was holding my daughter I began to get extremely nauseous and dry heave. At this point I didn’t feel safe holding her so I handed her over to my husband. My OB was applying a lot of pressure at the top of my belly at this point and the nausea was incredibly intense.

My son’s amniotic sac was intact, what the nurses called a “fishbowl baby”. Everyone put on their goggles, and his sac was ruptured. He was a little blue when he was born and the nurses were rubbing him vigorously to stimulate breathing. Finally he began to cry as well and then he was brought to me to hold. I was still very nauseous but the heaving had stopped so I was able to carry the babies on my chest to the recovery room.

As soon as we got to the recovery room, my husband noticed the babies rooting and helped me get them placed on my breasts for their first nursing session. I am so glad we did this.

In the recovery room it became evident that the babies were fine, but I wasn’t doing so well. I’m not exactly sure what happened, but I believe that due to the spinal, my blood pressure and body temperature plummeted. I was in and out of consciousness but I was conscious enough to know I felt absolutely terrible. I needed my strength to recover and my husband had to go pick up our older daughter (I had a friend staying with me) so the babies were taken to the nursery where they could be under the warmers and I was taken to the high risk unit where I could be on telemetry.

I asked for my babies around 11 pm and I got to see and hold them, but since I was still in and out of consciousness, my friend had to be awake while the babies were with us. After about an hour or so I sent the babies back so I could sleep. It wasn’t good sleep, but it was sleep. At around 5 am I woke up again and I asked if I could have my babies and nurse them. I was feeling much better at this point and the nurse checked with my doctor who said I could! I nursed my babies that morning and I was not separated from them after that. It was so nice to be with them again. Being separated from your newborn is so surreal.

I started to recover much better after that, and I had the typical c-section hospital stay of 3 nights. My milk came in really well this time and it was easier nursing my twins than it had been my singleton. We did a little supplementing in the hospital because it made the nurses feel better, but when we got home we ditched the formula until my twins had a growth spurt that nearly made me lose my mind.

My first two weeks postpartum I had a blood pressure spike which was not terribly high for a normal person, but a bit high for someone with Marfan and on beta blockers.I thought I had a spinal headache until I went to the doctor and my blood pressure was checked. Luckily, since I was already on atenolol I could just double up on my dose (still low enough to breastfeed) and that took care of my blood pressure and the migraine. Then I felt much better, and I really started to enjoy taking care of my new little ones.

Overall, both of my births were positive experiences. My first c-section could not have gone more smoothly, but the difficult part was coming to terms with how my labor had gone. My second c-section was much less difficult emotionally, but the recovery was yucky. While I would strongly prefer a vaginal birth this time, there is some degree of comfort with the known. I am lucky my hospital does all they can to make a c-section as normal as possible. My babies were dried off, tested, and vaccinated quickly while I was being sewn up and after that they were mine. I was allowed to carry my children out on my chest and nurse as soon as I was in recovery. I am grateful I was allowed these experiences, and I would encourage anyone facing a c-section to ask for anything that would make the experience more comfortable and enjoyable for you.

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