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.
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.
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.
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.