Disclaimer: I am sharing information about a supplement plan reviewed and suggested by my naturopath. Please see your/a health care professional(s) before taking anything new or changing your supplementation plan.
Almost 2 years ago, I shared my birth story. And ever since bringing the twins into the world my body has struggled and is struggling to heal. I’ve had high liver enzymes every since giving birth.
Discovering I Had Poor Liver Health
Around December of 2020, we finally found a family doctor in Port Alberni to take care of our whole family. We went in to meet the doctor and I asked for routine bloodwork to be done.
And that’s when we discovered that several Liver Enzymes were quite high. My ALT was 83 U/L in a range where 10 – 55 U/L is deemed normal. A few months later in February of 2021, we decided to test all of them. My ALT fluctuated from 54 U/L to 62 U/L to 75 U/L throughout the month. ALP ranged between 114 U/L, 110 U/L and then 109 U/L in a range where 35 – 100 U/L is deemed normal. And GGT fluctuated between 98 U/L to 91 U/L to 111 U/L in a range where 0 – 50 U/L is deemed normal. The doctor immediately referred me to a liver specialist on Vancouver Island and I was hoping to see them as soon as possible. Unfortunately a month later, we decided to move back to Ontario and I wasn’t able to get the help I needed.
After moving back to Ottawa, I went back to the medical clinic where we were before and started working with a new doctor (who is covering my doctor’s mat leave). We measured my liver enzymes in May and they were still high. I asked my Ottawa doctor to refer me to a liver specialist and they referred me to a Hepatologist. At the time of writing this blog, I finally have an appointment mid May. A year after the referral was sent in.
Tracking My Liver Enzymes Over A Year
I was curious to know where my liver enzymes were so retested my enzymes in May of 2021. They asked me to go off of 2 supplements (NAC and ALCAR) and then re-tested in July. The markers all shot back up in July so I went back onto the supplements.
Date
Enzyme
Level
May
AST
24 (< 31)
July
AST
30 (< 31)
Sept
AST
32 (< 31)
May
ALP
125 (35 – 122)
July
ALP
134 (35 – 122)
Sept
ALP
121 (35 – 122)
May
ALT
32 (< 36)
July
ALT
44 (< 36)
Sept
ALT
50 (< 36)
May
GGT
46 (< 36)
July
GGT
59 (< 36)
Sept
GGT
Not Measured
Since going off of 2 supplements didn’t work I booked an appointment with a local Naturopath and went to see them at the end of August.
Improving My Liver Health
My naturopath suggested I take 2 supplements. Advanced Tudca (by CellCore Biosciences) and 4 homeopathic tinctures for biotherapeutic drainage supporting the liver & kidneys. It was a 60 day protocol which lasted September to November. I did another round of both supplement protocols and we retested my liver enzymes in January of 2022. All but one had been reduced back to [almost] normal levels.
AST: 32 (< 31) – almost there
ALP: 121 (35 – 122) – normal range
ALT: 50 (< 36) – high
GGT: 38 (< 36) – almost there
I continued another course of Tudca for 60 days and I asked for another lab requision from my family doctor. The April 2022 are in and drum roll, please….
AST: 26 (< 31) – normal range
ALP: 82 (35 – 122) – normal range
ALT: 36 (< 36) – just on the edge of normal
GGT: 37 (< 36) – almost there!!
While I know what has worked to help me reduce my liver enzymes, I of course want to understand what caused this in the first place. From an MS perspective, take a look at the second link in the resources section below. I found some shocking new news on TUDCA supplementation for MS patients!
So What Caused My Liver Enzymes To Skyrocket?
Here is where I will always find fault with the conventional medical system. While they did try to find causation… They tested for everything from hemochromatosis to liver cancer to hepatitis to autoimmune hepatitis to primary biliary cirrhosis to primary sclerosing cholangitis to wilson’s disease all they could land on was Non-Alcoholic Fatty Liver Disease (NAFLD) as I hadn’t had alcohol since 2018.
I continue to ask questions and continue to look for answers. Was it the blood transfusions I received after giving birth? Was it the iron infusions to increase my hemoglobin? Is it the Vitamin D supplementation I’ve been on since my MS diagnosis? I continue to search for answers and I’ll be happy to share them as I connect the dots.
Disclaimer: I personally use essential oils to support my body during pregnancy and after birth. These statements have not been evaluated by the Food and Drug Administration or Health Canada. I’m sharing my personal experience with the oils. As always, please consult with your health care team when incorporating new products into your health care routine.
I get asked all the time which essential oils I used during pregnancy and which essential oils I’m using now that the twins are born. I did a round-up of oils that I used throughout the trimesters. You can read about the oils I used during my first trimester here, second trimester here, and third trimester here. And now to round out these posts here are the essential oils I used during the fourth trimester (or the first three months with the twins’ earthside!)
Essential Oils for Fourth Trimester
While each trimester was hard in it’s own right, NOTHING prepared me for how hard the fourth trimester would be.
Healing The Perineum: I put together a spray bottle with Frankincense, Geranium, Lavender, and Sandalwood. I used an empty 15ml and purchased spray tops for 15 ml bottles from Amazon. I packed this in my hospital bag in anticipation of a vaginal birth. Because of the episiotomy, (you can read my birth story here) I ended using the whole bottle while we were in the hospital for 2 weeks. I even made a second bottle when I got home. It helped immensely with healing and when I went to see my OB at 4 weeks post-birth she had great things to say about how I was healing!
DIY Padsicles: I made a batch of Padsicles to help heal my vagina should I be successful in giving birth vaginally and boy did I need them. I didn’t end up using all of them as I was in the hospital for 2 weeks and they gave me padsicles there. By the time we got home, Mike’s parents were at our house and I just didn’t think to go to the freezer and then back into the bathroom to put them on. I ended up gifting most of these to a new momma to be in town.
Stress: There is just no way around it. Having twins and taking care of them is stressful. There are some days when I really forget to take deep breaths. I have an Adaptive roller bottle in my bathroom. Everytime I go pee, I roll this onto my wrists and take a big inhale.
Milk Production: I made a roller during my third trimester to support milk production. I keep this by my bedside and roll it on before bed. It includes Clary Sage, Basil, Fennel, and Geranium essential oils.
Sleep: I have a diffuser beside the bed where I’m diffusing OnGuard and Easy Air to support my immune system. Other nights I will diffuse Serenity or Adaptiv so I can calm my mind and get as much sleep as possible in between feeds.
If you used oils in your fourth trimester what did you find helped?
One of the many questions I’ve been asked on social media is what steps am I taking postpartum to ensure I don’t have any MS flares. Which involves having a checklist of things that I can do for myself as postpartum self-care.
If you’re new around here I was diagnosed with MS in 2014 but am living well with no symptoms or disability. I believe it’s because of the overall holistic way that I look at health and take care of myself.
See I believe in these 6 pillars of health:
Nutrition
Supplementation
Exercise
Stress Management
Quality & Quantity of Sleep
Reducing Toxic Load
So as I prepped to bring our twins into the world I wanted to ensure that I was able to maintain how I take care of myself. Here are the ways that I’m taking care of myself post-partum
Post-Partum Self Care
Hire a Doula
With no immediate family in Port Alberni, hiring a Doula was instrumental in giving me back some time during the day to take care of me. I hired Tanis from Island Moon Doula and am so grateful for her support. While Mike’s parents came out for the first 2 weeks after we got back from the hospital, I hired Tanis to come on Monday – Friday from 10 am – 12 pm after they left. It allowed me to go into our bedroom and sleep for at least an hour. She would make me lunch, prep our freezer meals for dinner, vacuum, wear a baby, rock the other one to sleep and lend an ear to my venting.
Nutrition
I prepped freezer meals over the last few months before our induction date to ensure that we would have nutritious meals that were easy to make. I used the recipes found on Unbound Wellness’s website. I also continue to stock nutrient-dense foods. So when my Doula was over she could easily make me a jam-packed salad for lunch each day and throw a freezer meal in the Instant Pot.
Supplementation
I booked a virtual phone call with my Naturopath to review the supplements that I was taking pre-pregnancy. Due to my birth complications, we reviewed what I’d need to take to bring me back to health. Here is the list of what I’m taking and why:
Prenatal: I was told to continue this until I stop breastfeeding
Feramax: Because I hemorrhaged several times I needed to increase my iron intake to get my ferritin stores back up.
NAC: I was taking this pre-pregnancy and during my pregnancy to ensure my body was getting enough glutathione for immune system support.
Magnesium Citrate: Pregnancy and feramax causes quite the constipation so I’m taking Natural Calm to relieve the pain.
Placenta Capsules: I had to hold on taking these until it was confirmed that I actually didn’t have an AVM anymore.
Vitamin D: I take 4,000 IUs during the summer months and 8,000 IUs during the darker winter months.
After 2 months, I also brought 2 supplements back that I took prior to birth.
CoQ10: I take this for cardiovascular health, it promotes immune system function and is an antioxidant.
ALCAR: I take this for cognitive function and cellular energy production.
Exercise
I wasn’t cleared to exercise due to the possibility of an AVM until week 9 postpartum. After getting the go-ahead, I immediately started daily walks and even joined a mom walking group organized by our local Public Health unit. I also started the Tone It Up Mama workout program on the Tone It Up App.
Stress Management
This area I would say is the one I need to focus on the most. I easily get anxious and it’s been amplified post-partum. I find myself fighting off panic attacks when our dog Rogue paces non-stop. It just seems like some noises set me off after a full day of caring for the twins. To combat this, I still take nightly Epsom salt baths at least 3-4 times a week. I keep an Adaptive roller bottle in the bathroom. I roll this on my wrists and take a moment to inhale whenever I go to the washroom. This helps, especially if the twins are both screaming and I just need a moment to pee and to myself.
This is really the only area I’m struggling with. The babes are sleeping in 2-3 hour stints. So I’m sleeping from 9 pm – 12 am (3 hours), then around 1 – 3 am (2 hours), then 3 am to 6 am (3 hours) and then Mike takes over and I get an uninterrupted hour from 6 – 7 am. So in total I’m sleeping on average around 8 – 9 hours albeit it it’s in blocks of time. I don’t feel that tired during the day except I maybe get sleepy around 3 pm and usually nap with both babes on me. I believe one of the reasons I’m not feeling too tired is that I’m still not drinking caffeinated coffee. I’m only drinking decaf and that seems to be helping with keeping my energy high enough to care for 2 babes.
Reduce Toxic Load
Nothing has changed here. I’m still using the same products I was before in my beauty, laundry and cleaning routine. Since I’m basically doing a load of laundry a day I made sure I had an ample supply of my DIY Laundry Detergent on hand. Ps. The OnGuard Cleaner Concentrate that I stock in the house is amazing for getting poop blowouts out of onesies!
I think one of the most important aspects to postpartum self-care is having a mindset of grace. Knowing that sometimes you may not do all the things you had hope to do, so you try again the next day. AND like everything baby steps. Don’t try to accomplish the full list of self-care in your first day postpartum!
After our private childbirth education classes with our postpartum doula, she recommended we create a breastfeeding/pumping/diaper changing cart that we could roll around the house.
She recommended making one for our bedroom and one for the living room. However, we live in a bungalow or a rancher (what they call single-story houses out west) so we don’t have to navigate any stairs. I figured we can easily roll this from the bedroom to the living room in the first few months of life with the twins. I also decided that once the twins are sleeping in the nursery more, I can wheel this into the nursery beside our glider.
Here are the items I included:
Breastfeeding Items
Nipple Cream
Breast Pump
Handsfree Breast Pump Bra
Washable Breast Pads
Hakaa
Milk Booster Essential Oil Roller Bottle
Burp Cloths
Breastmilk Storage Bags
Diaper Changing Items
Diapers
Diaper Cream
Wipes
Tissues
Change Pad
We ended up buying a joovy playard that we set up in the living room. It has a changing pad on top of it so we’ve moved all the diaper changing supplies to this area.
Baby Comfort Items
Unscented Moisturizer
Swaddles
Vitamin D
Probiotics (Fridge)
Snotsucker
Onesies
Mom Comfort Items
Lip Balm
Water Bottle
Snacks
Kobo eReader or Paper Books
For details and shopping links to the exact products that I’m using to stock our cart keep reading…
Breastfeeding Supplies
Nipple Cream: I purchased the Earth Mama organic nipple butter. I really liked the ingredients, and while I might want to make my own DIY version in the future, this was one product I figured was easier to buy now. It contains olive oil, beeswax, cocoa seed butter, shea butter, mango seed butter, and calendula flower extract.
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Breast Pump: I actually have 2! Someone I met in Port Alberni gave me the most amazing gift basket of baby items and it included her Medela Freestyle pump. I started with this on the breastfeeding cart due to its smaller size but ended up storing it in the kitchen so I could easily put it in our diaper bag for travel.
We also bought a second pump after a twin dad shared that their breast pump died at the most inopportune time and his wife was in so much pain so he said if we could afford it, purchase a second pump just in case. Thankfully our benefit plan covered 80% up to $300 so I purchased the Medela Pump In Style and stored this in the cart.
Medela Freestyle Pump
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Medela Pump In Style
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Hands-FreeBreast Pump Bra: I posted an IG story asking for everyone’s best recommendations for a hands-free pumping bra and I got several suggestions to grab the Medela Hands-Free Pumping Bra. So I grabbed a large and it fit perfectly. I also got a few recos to just cut holes in an old sports bra but none of mine fit anymore.
Medela Hands-Free Pumping Bra
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Breastmilk Storage Bags: Basically Medela is getting all my money! I ordered a box of 100 bags and I received another box of 100 bags as a gift. I should be good for a while to create a great freezer store for our babes. I’m currently not making enough milk to store so I’m not sure if I’ll ever need these.
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Washable Breast Pads: I ended up using these A LOT. I had thrush for 3 months so I was constantly applying cream to my nipples after each feeding and instead of getting my bras messy, I would just throw these in the wash consistently.
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Hakaa: So while I’m going to attempt to tandem feed as much as possible or pump both breasts at the same time there may be times where I’m only breastfeeding one babe at a time. To ensure that I’m saving every ounce of milk I have a Hakaa that I can use to catch milk from the other boob! *Updated* I never ended up using this as I was barely making enough supply to feed our daughter. I actually only used this to unblock clogged milk ducts.
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Milk Booster Essential Oil Roller Bottle: I cleaned out an empty 10ml roller bottle and made up my own essential oil blend that I will use to support my milk production. As always I only use dōTERRA essential oils due to their potency and purity. I chose Clary Sage, Basil, Fennel, and Geranium. Because I experienced so much trauma post-birth, I just wasn’t making enough milk supply. I tried everything from these essential oils to lactation cookies and smoothies. I ended up gifting this roller bottle to another new mama who had much more success with it than me.
If you’re interested in purchasing, click the links above and it will take you to a shopping cart for the products at retail prices. If you’d like to learn how you can purchase dōTERRA products at 25% off CLICK HERE to find out more about getting a wholesale account.
Burp Cloths: We received a ton of hand-me-downs and gifts off our registry so we have an ample supply of these! One of the brands we put on our registry was the Hudson cloths.
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Diaper Supplies
Diapers: There are several ways you can get free diapers to start out. I applied for the Pampers, Huggies, and Hello Bello free diapers so we could try them all out and then order more once we figure out which ones we like. We also received baby shower gifts of Honest Diapers and Bamboo Natural so we have lots of different kinds to trial. Once those ran out we purchased the Hello Bello bundle but found they were not good for blow outs. We landed on Pampers Pure Protection and are still using them for the twins now.
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Diaper Cream: Thankfully dōTERRA makes an amazing diaper cream. I started stocking up on this over the course of the year leading up to the twins birth so I wouldn’t have to worry about running out.
If you’re interested in purchasing click the images above and it will take you to a shopping cart for the products at retail prices. If you’d like to learn how you can purchase dōTERRA products at 25% off CLICK HERE to find out more about getting a wholesale account.
Wipes: Along with the free diapers we were sent a few different sample wipes to try out. I also bought a box of the Babyganics Baby Wipes after checking out their rating on the Think Dirty app. We keep getting the Pampers Pure wipes or the Huggies Natural Care wipes.
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Tissues: A good ol’ box of Kleenex
Change Pad: We put the Kushies Organic Change Pad on our registry. It comes in a bunch of different colours but we have a thing for grey.
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Onesies: I have onesies in the cart for easy changing in case of a blowout.
Baby Comfort Supplies
Unscented Moisturizer: Another dōTERRA fan favourite is the hand & body moisturizer or lotion.
If you’re interested in purchasing, click the images above and it will take you to a shopping cart for the products at retail prices. If you’d like to learn how you can purchase dōTERRA products at 25% off CLICK HERE to find out more about getting a wholesale account.
Swaddles: There are so many different swaddles that you can purchase. We found the most success with good ol muslin swaddles.
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Liquid Vitamin D: I ordered the Genestra D-Mulsion through my Naturopath’s Fullscript Dispensary. Each drop contains 400 IU.
Pacifiers: I was hoping to avoid using a pacifier for as long as possible to minimize nipple confusion for breastfeeding. We received the Phillips Avent & Itzy Ritzy pacifiers. Our son Ryland was primarily bottle fed from the beginning and had a wicked witching hour so we use pacifiers with him for much success.
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Snotsucker: We received the NoseFrida off of our registry but I’ve heard amazing things about the oogiebear brand as well.
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Mom Comfort Supplies
Lip Balm: Another dōTERRA product that I love is the lip balm. I usually always have these on my order for myself or because I include them in welcome packages for new customers.
If you’re interested in purchasing click the images above and it will take you to a shopping cart for the products at retail prices. If you’d like to learn how you can purchase dōTERRA products at 25% off CLICK HERE to find out more about getting a wholesale account.Water Bottle
Water Bottle: I recently purchased a Yeti (Seafoam colour) tumbler and I love how cold it keeps my water.
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Snacks: My go-to snacks are Kind, RX, and Vega Bars.
Kobo eReader or Paper Books: I still have my Kobo eReader from when I worked for the company with a ton of books still loaded on it, so I’ll be catching up on as many books as I can while breastfeeding. *Update* This never happened. It was easier to watch TV since both my hands were kinda full with twins.
My birth story is definitely one I didn’t think I’d be writing. At this point in my journey, I’m really not sure how many women experience a positive birth experience in a hospital setting. So that kind of sets the tone for this post.
When Mike and I found out we were pregnant with twins we had a quick discussion about home birth vs. hospital birth. Mike has trained as a paramedic as one of his 3 college diplomas and he has seen several births. His non-negotiable was to give birth in a hospital in case of hemorrhage. And with a twin birth being more high risk than a singleton it was definitely decided early on that we’d have a hospital birth. As much as I would’ve loved a home birth I knew the risks involved in a twin pregnancy so we agreed on this. To feel empowered I started writing out my birth plan (wishes) early on. I shared them with our doulas, our midwife, and our OB and they morphed and changed as we discussed the nuances of my wishes with each practitioner. One doula I initially spoke with called a “Birth Plan” “Birth Wishes” so your mindset wasn’t tied to a plan (that can so easily change).
My Birth Story
My birth story started on the morning of Tuesday, July 28. Throughout the month of July, I had to negotiate with my OB on an induction date. She had initially wanted us to come in for an induction on Sunday, July 19th because she was working that day. To which I said no. I wasn’t going to schedule our birth just because of someone’s work schedule. My last day of work was Friday, July 17th which coincided with the start of week 37. I wanted one week off to relax, schedule some self-care appointments, and nest & clean the house a little.
My OB then asked that we get induced at least by week 38 as there is an increased risk of stillbirth in twins after 37 weeks (which is considered full term for twins). I decided to surrender to an induction during week 38 as the risk of stillbirth was important for me to factor into my decision. I was really hoping I’d go into labour naturally before our induction date and definitely tried everything to make that happen.
I tried everything from red raspberry leaf tea, to eating dates, evening primrose oil suppositories, nipple stimulation, sex, orgasms, acupuncture, clary sage essential oil, and eating all the pineapple. My body just wasn’t ready to give birth. The babes were really comfy in the womb and we’d basically have to evict them.
Induction Day
We called the Nanaimo Regional General Hospital at 6:30 am to ensure the labour and delivery ward wasn’t too busy and then drove in. They asked us to arrive around 7:30 am but we arrived an hour later. I was in no rush to get there. That morning, we finished packing hospital bags, and the diaper bag and grabbed loose items like a cooler for the placenta, a gift basket for the nurses, my breastfeeding pillow and pillows, and blankets for myself and Mike.
We even stopped at Starbucks for coffee (decaf for me) and breakfast for the road and headed out for the 1-hour drive from Port Alberni to Nanaimo. I texted our Nanaimo Doula that we were on our way and she called to inform me she’d been with a client since the day before who had gone into early labour and would be sending her back up Doula. I had texted with the backup Doula a few times but we had never met. Needless to say, I was a bit disappointed but went in with an open mind to meet the new Doula.
We checked in at the hospital, had our temperatures taken, and were shown to our birthing suite. There was debate about keeping us in the initial room we were shown as it was far from the nurse’s station but I think they were a bit busy so we ended up staying in that unit. It was incredibly spacious. The bathroom had a tub and shower and a window bench doubled as Mike’s cot for sleeping during the length of our stay. We handed over a gift basket of treats for the nurses including granola bars, fruit snacks and candy corn from Coombs Candy.
The Induction Begins
They started me on an oxytocin drip as my cervix was only dilated to around 2cm in hopes of kick-starting my labour. Through the course of the day, my contractions went from fairly nonexistent in terms of pain (around a 1 or a 2 out of 10) to one huge painful contraction that I rated around 10/10 that gave me full-body sweats, shakes, back labour pain and intense contractions. From there they went back down to a 1 or a 2 and never increased in intensity. After around 13 hours of labour, our OB recommended we stop the oxytocin and give my body a break to sleep and rest. My night nurse that night was a godsend. She took me off the monitors, told me to have a bath, and we went to sleep for 4-5 hours. I’ll come back to this nurse as she was my angel during our hospital stay.
When they stopped the oxytocin drip, I asked the backup Doula to go home and get some sleep. After she left I sent her a text that we had decided that she not come back the next day. She just wasn’t a fit but I was in no way capable of communicating that in person as my energy was spent for the day. I felt weird communicating it over text but I just didn’t have the energy in me to do so another way. She had several mannerisms that bothered me and even my husband sensed our energy wasn’t a match with hers the minute she walked into the room. This meant that I didn’t have a second support system of my choice the next day despite making all the necessary arrangements one month ahead of time. And while Mike supported me amazingly I know it would’ve been nice to have someone to support us both.
Induction Day 2
We woke up around 7:30 am on July 29 to breakfast arriving and then they started me on the oxytocin drip again around 9:00 am. As my contractions started up again they never progressed past a 2 on my pain scale. They decided to break Baby A’s (the presenting twin) water around noon. Which promptly ramped up my contractions from a 2 to a 10.
The contractions then came in continuous waves. I was trying to breathe through and relax into each one but there was no break in between. I couldn’t catch my breath and the pain seemed to go from 2 to 10 in no time. I decided at this point to go ahead with the epidural. As part of our birth wishes, I had agreed to have an epidural sighted but have nothing running. When we reviewed this with my OB in the months leading up to the birth she said that wouldn’t be a problem. But upon discussing with the anesthetist it wasn’t an option and a test dose would need to be run to ensure it was placed properly.
In my birth wishes, I did not want an epidural. I had really wanted a non-medicated birth for the following reasons. As Mike and I have only wanted 2 kids, this could be my one and only pregnancy. I really wanted to experience childbirth and all that comes with it fully. In addition, I live with MS. At the time of my MS diagnosis, the entire right side of my body had gone numb and I never wanted to feel that way again.
But as the pain increased and my inability to breathe and relax through them I chose the epidural. Which in hindsight was a smart choice based on what would happen during the birth. So as the epidural took effect, I surrendered to the fact that my lower half would go numb. I could still feel the contraction waves but they were barely there and I would put them at a 1 on my pain scale. And as my body went numb, I battled with the feelings of fear to feel that way again and pushed them aside for the moment to focus on labouring.
As the epidural took effect I was able to rest for a bit. The OB came back in and asked if he could do a cervical check. I said of course as we hadn’t checked me before the epidural. He exclaimed, oh you’re fully dilated. To which I asked “so I’m 10cm?” which was the only reference point I had to be ready to push. He confirmed.
Mike had gone downstairs to get a coffee and to call his parents and I sent him a text. “I’m 10 cms. Get back here!!” From there, I think they let me labour for another hour in the L&D suite before wheeling me to the OR (something that is a non-negotiable for hospitals and twin births) to begin pushing. One positive is that they let me stay in the L&D bed instead of shifting me over to the cold OR slab. That was really nice because I had come to terms with the twin OR birth policy. I’m glad the OB let me stay a bit more comfortable instead. A small win.
After we arrived in the OR, chaos commenced. There were so many people in the room. At one point as they were setting up the bed with stirrups, OR staff began coming in and lining the wall in front of me. I asked my L&D nurse to ask them to move to the sidewall so I didn’t have 4 people in my vagina line of sight as I started pushing.
Can we discuss the amazing Marge Simpson hairdo I had going on with the hair net?!
And while I wish I could’ve moved around more in labour and pushing I made the most of it due to the epidural and birthing options for labour with it in.
The OR staff was only there in case it became an emergency c-section. But it definitely made it seem like there were a ton of people in the OR. After about an hour of pushing the OB came in and said let’s get these babies out. It was then explained to me that Baby A wasn’t in the right position and that they would need to try and turn her. He tried to turn her manually but that didn’t work. At this point an episiotomy was performed without my consent, forceps were inserted to try and turn her and when that was unsuccessful the OB used another set of forceps to deliver our baby girl. This happened so fast. Mike witnessed the episiotomy happening but it happened so fast he didn’t have a chance to say anything. I spoke about it with the OB post-birth and he said “oh yeah I forgot that was on your birth plan”. I was truly disappointed he didn’t discuss it with me before doing it.
After Baby A came out she was immediately placed on my chest. The nurses started vigorously wiping her down which I had asked not to happen. I had simply asked for a towel to be placed over her as we had a moment for skin to skin. But I was overwhelmed with everything that had happened and just wanted to look at her so I didn’t say anything. It’s weird how hard it can be in the moment to remember to advocate for oneself and this is where a Doula would have come in handy to remind me. Instead, I focused on welcoming her into the world, telling her how much she was loved and saying her name and kissing her.
Alora Jade Anne Pineault was born at 7:32 pm on July 29th weighing in at 6 lbs 7 oz.
From there the NICU nurses took her to the next room to be weighed and looked over and Mike went with her, while I believe I was instructed to start pushing again so Baby B (our little boy) could arrive. The OB chose to use forceps again and I don’t think it was ever explained to me why. So our baby boy was placed on my chest and then our baby girl was brought back over all swaddled up and placed back on my chest.
Ryland Desmond John Pineault was born at 7:44 pm on July 29th weighing in at 7 lbs 1.4 oz.
From there, things became a blur. Our baby boy was removed by the NICU nurses and Mike held our little girl and went with the NICU nurses while the placenta was birthed. Mike said he believes he remembers watching the OB vigorously remove it when he came back into the room so I’m not sure he gave it adequate time to birth. We had to remind everyone several times that the placenta was to remain with us as twin placentas apparently always go to pathology.
I am not sure of the order of things at this point but the OB started stitching up the episiotomy that he had created. I was told I hemorrhaged at one point and this may have been why the placenta was birthed quickly. I also remember puking as they started wheeling me back to our L&D room. They had given me medication at this point to start contracting the uterus and stop the bleeding which also caused uncontrollable diarrhea. As I arrived back in the L&D room I had asked to shower and so the nurse and Mike attempted to get me out of the bed and into a chair to wheel me to the washroom and as I got out of the bed I became increasingly dizzy and light-headed and ended up passing out in their arms.
I don’t remember much but apparently, there is an emergency button that was pushed and a stream of nurses flew into the room to resuscitate me. I’m not quite sure about the timeline but later I proceeded to lose consciousness again while lying in bed. It was explained to me that my blood pressure had become extremely low and that I was passing clots. The OB came back into the room and started pulling grapefruit-sized clots out of me. I woke up a bit out of it with an oxygen mask on and being asked questions like where was I? Etc. I also remember the diarrhea being non-stop at this point and I would alert a nurse would you sweep the bed pad away and clean me like a newborn to which I kept apologizing. I seriously don’t know why I think I had to.
So in hindsight, I may question our birth but I do believe that we had the best birth experience for ourselves and our family. The babes came out healthy and ready to take on the world. The complications that then happened I’m not sure can be linked back to how the birth happened or anyone could have prepared for it. I’m choosing to stay focused on the fact that we made the best decisions presented to us as things progressed. But my birth story doesn’t stop there.
Birth Complications
As mentioned, the OB who performed our birth believed that I either had a bruised or broken coccyx based on Baby A’s position during birth. I was sent for an X-ray to which we discovered it wasn’t broken. My sacrum is just extremely sore and will take a while to heal the bruise. So grateful that I’m not contending with a broken coccyx on top of everything else.
From the initial hemorrhage after birth, I continued to bleed profusely. So when I was sent for the X-ray I was also sent for an ultrasound to which the OB let me know that they found a 7cm size mass inside my uterus. The OB on call that day provided us with options but recommended a manual extraction in the L&D room using fentanyl to numb my pain. This was way more painful than birth and I screamed in agony and clutched Mike’s hand as she shoved her hand inside my uterus and removed bits of retained placenta and blood clots. We even took a picture of what was removed but I’ll spare you to gore.
Every day the nurses would check my uterus manually by pressing on my belly and I was still in incredible pain and the bleeding, to me seemed excessive but I had no reference point. A few days later another OB on call came in and said he’d like to do another ultrasound before discharging me. He performed the ultrasound in the room with a mobile unit to which he found even more material inside me. I was terrified he was going to repeat the same procedure and as a larger man, there was no way I was going to be able to endure another manual extraction with his arm inside me. Instead, he recommended a D&C procedure where I go under general anesthesia and they would use a suction device to remove the retained material. I had no idea why this wasn’t recommended previously or can’t remember if it was. I do believe the previous OB was trying to keep me out of the OR and with my babies but that pain was so intense I would’ve opted for the D&C in the first place.
At this point, my angel of a nurse came in. I was sitting with Mike on the window seat as he released tension in my back. She wasn’t our nurse at this point but had heard about all the complications and just popped in to visit. She placed both hands on my arms and said genuinely “how are you doing?” to which I broke down crying. It was a lot. I was overwhelmed, scared for my health, trying to breastfeed the babies with boobs that had barely started producing milk and I was now going in for a procedure that I knew nothing about. Since then the tear flood gates opened fairly consistently once a day and I would just release the pain from each day.
So I was wheeled up to the OR and the procedure was completed. I found out after that the suction device wasn’t enough and that they needed to use a tool to manually scrape more placenta and clots out. The OB also redid my episiotomy sutures as they had come undone. We were assured at this point that everything was removed.
Throughout the week and due to the bleeding and multiple procedures my hemoglobin had dropped from the 100s to the 50s and was cause for concern, I was put on multiple blood transfusions and iron transfusions. We were finally discharged on Aug 5 (one week and one day later than when we checked in) and headed home. It was perfect timing as Mike’s parents were arriving that evening to help us out.
One thing that became evident as our stay kept extending was there were some days that the OB coming on call hadn’t reviewed the notes from the day before and we were having to educate them on what had occurred the day prior. I totally get that an OB is busy but I think my care warrants knowing what’s going on. I never had to worry about the nurses. They always knew what was going on and I never had to update them.
Complications Continue
Unfortunately, our hospital journey didn’t end on August 5. My bleeding started getting heavier and heavier after we got home. I passed a significant clot and sent a picture to a new friend in town who’s an L&D nurse at the Port Alberni hospital and she wasn’t too concerned about it but said we should go to the ER should it continue. The next day I passed an even larger clot. I put the pad with the cloth on it in a ziplock bag and we decided to go to the emergency department here in Port Alberni. They informed us that they didn’t have capabilities for an ultrasound so we’d have to drive back to the hospital in Nanaimo.
We returned home to pack our bags again and bundle up the babies and headed back to Nanaimo. After a longish wait in emerg, more blood work and another ultrasound they readmitted me to the L&D ward and proceeded with rounds of antibiotics to combat a potential infection (found by elevated white blood cell count). I also received medication to contract the uterus and expel whatever other clots may be inside.
I passed another significant clot that evening and from there the bleeding slowly lessened.
The OB who performed the D&C was back on shift and after looking at the latest ultrasound he believed that since the D&C a uterine fibroid had developed. He then ordered an MRI to confirm.
After having an MRI, the OB that performed my manual extraction said that it doesn’t look like a uterine fibroid but potentially an AVM. Since my uterus is still so inflamed we are going to wait 2 weeks before performing another ultrasound. So while this part of my birth story isn’t over, there are still some unanswered questions.
I was also told that when I’m ready I can review the OR recording (everything is recorded in the OR during delivery) and all the doctor’s notes. There is a part of me that’s curious to dig into the why’s of what happened (although post-partum hemorrhaging is common in twin pregnancies). However, right now I need to focus on healing and taking care of me and the twins.
What I’ve learned from writing this all down is that there is a fine balance of pre-planning your birth so you can be prepared for what might happen. However, nothing can truly prepare you for dealing with complications. And there is no need to live with worry regarding all the aspects that could go wrong. I’m grateful for conventional medicine for saving my life after birth and I’m also frustrated with the lack of continuity of care and potential miscommunication among the OBs as they switched shifts.
So where do I go from here? I am currently looking for a therapist who specializes in birth trauma so I can speak to someone about what happened during my birth story and start to process the trauma. Otherwise, I’m in the midst of the fourth trimester. My responsibility lies in taking care of the twins right now, in figuring out breastfeeding, supporting my body to heal so I can produce more milk and taking care of myself so my body can heal from all the complications. From there I will ensure my mental health is also fully supported and while I have coping tools in the meantime I know I’ll need to dedicate time and energy to healing emotionally as well.