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Natural Birth of Twins

Wendy’s Story (written by Belinda Tran-Lawrence) 

Most of us tend to look on birthing one child as something of a challenge – how about two?! This is Wendy’s story about the experience of birthing twins, and is a lesson to all of us that a multiple birth need not be any harder than one!

The beginning

Wendy herself is adopted, and this led to a great desire to have her own child in the usual way. However, after eight years of trying in the old-fashioned way (and some not so old fashioned methods), with much regret and disappointment, Wendy and her husband finally turned to the IVF program to help them conceive their wanted child. Wendy had never liked medical technology, so was very disappointed when she discovered that they were unable to get pregnant naturally.

Finally, after an exhaustive process, three viable eggs were implanted and, although the medical prognosis was not encouraging, Wendy and her husband went to the first scheduled scan positive that there would be twins. And, much to the surprise of the fertility specialist, indeed there were. In his words - “Oh my god – there’s another!”

“Ha, ha we were right!” Wendy and her husband were thrilled, although they were warned not to get too excited, as it is apparently common to lose a twin without even knowing that you had a multiple pregnancy to begin with.

The pregnancy

The experience of having undergone infertility treatment, while resulting in the longed for pregnancy, had involved a lot of medical invasion and so had, in turn, led to a desire for an ‘as natural as possible’ pregnancy and birth.

Wendy was determined to enjoy her pregnancy as much as possible since she knew that this would be the only one she would ever have. A normal pregnancy did follow, with an emphasis on eating well, exercising heaps, and resisting all suggestions that she had a high risk pregnancy just because she was having twins. Wendy did not experience any morning sickness, which is unusual for someone who is carrying twins.

It certainly helped that Wendy was very fit when she conceived, since an applicant’s BMI (Body Mass Index) has to be within a certain range to get on the hospital list for the IVF programme. Through concentrated exercising and diet, she had gone from 121kg to 89kg prior to being accepted onto the programme.

Wendy decided to follow a two-step program during her pregnancy:
Step 1 – refuse to read anything on labour. Then you won’t get scared by the ‘what ifs’!
Step 2 – keep fitness up by aquaerobics, walking and stretching exercises.

Some spotting occurred at 10 weeks and this was rather frightening – but Wendy just went straight to bed and concentrated on positive affirmations, which seemed to do the trick.

During the first half of the pregnancy, the couple were living in Auckland, so they attended multiple birth ante-natal classes there. These were very helpful and, even though they were very focused on intervention-type birth, the emphasis was on having the confidence to speak up and go with your gut instinct. Wendy felt that it was good to have all of the information on the possible medical intervention aspects of a multiple birth; however, it only increased her determination to do it the natural way. As part of the ante-natal classes they were taken on a tour of National Women’s Hospital and the multiple birthing suite - Wendy did not feel that this was an environment that she would wish to birth in. It was also stated at the time that the staff at National Women’s prefer to do caesareans for the second twin and for mothers of multiples to have epidurals.

The birth plan

Wendy felt that it was extremely important to write a birth plan – it was three pages long!! The birth plan comprehensively covered how the couple wanted everything done relating to the birth and care of both mother and babies directly after the birth. It dealt with such issues as that Wendy’s husband and sister would both be present, if Wendy had to go to theatre for a caesarean for the 2nd baby her husband would stay with the first baby, in event of neo-natal care at least one parent was to be involved at all times if possible. It also stated that Wendy did not want pain relief but was prepared to consider drugs if necessary.

The birth plan was worded carefully to try and plan for all eventualities while also trying not to alienate the doctor or obstetrician who happened to be on duty. Interestingly enough, when the birth plan was completed Wendy sent a copy of it to the antenatal coordinator in Auckland to get feedback. Her response was that it never would have been accepted in Auckland.

In New Plymouth, however, Wendy was blessed with a very supportive obstetrician (Jeremy Smith) who was happy with the birth plan and very supportive of Wendy’s desire for a low intervention birth. Jeremy never gave the impression that the twins’ birth had to be one of high medical intervention simply because it was a multiple birth.

When Wendy was admitted into Taranaki Base hospital, she was very impressed when it was immediately evident that the hospital staff had indeed read her birth plan.

The labour

Wendy got to her due date (Monday) intact with the attitude of ‘Ha, I did it’. But then she started to worry through a thoughtless comment from another twin mother. She arranged for a foetal assessment on the Friday at which Jeremy informed her that everything was fine. She could choose to go home or to do an induction then.

An immediate induction was decided upon, since Wendy felt that she had already made her point by going to full term and she was concerned about birthing over the weekend. She did not want to have to give birth with another obstetrician who would not be familiar with her or what she wanted. She was happy to accept the prostaglandin gel since it would only work if her body was already ready to begin labour.

3pm: Nothing happening although feeling a bit restless – more gel.

5.30pm: Plug came away on loo. The midwife went to check and Wendy’s waters broke in a big flood.

Throughout the labour, Wendy did not have any pain relief – she says it never got that bad. She hated being on the bed and felt most comfortable sitting on the toilet.

Wendy remembers thinking - “why haven’t they got the Doctor (obstetrician) yet?” Jeremy only came when he was needed, towards the end – he was playing it Wendy’s way!

One of the midwives at the birth had never attended a multiples birth before and Jeremy remarked to her “don’t think they’re all like this”. There were only three staff present at the birth and this is very unusual, as it is common for each twin to have its own neonatal team. During Wendy’s labour the neonatal unit kept ringing to see when they would be needed (assuming that they would be needed). Jeremy told them they weren’t needed and they would be called if necessary.

11.46pm Out came the first baby – a boy, Connal – and he was put straight on Wendy’s chest as per birth plan, with the umbilical cord left intact.

Wendy: “Don’t tell me I have to do all of that again!” – She didn’t know if she could go through all the pushing a second time!

Obstetrician: “I would like the other one born now”. – He could see that the cord was wrapped around the 2nd baby’s neck but did not want to worry Wendy.

Midwife: “Or the next one could be born tomorrow!”

Wendy: “Stuff that – birthdays on two different days!” A few more pushes and then Azaria made her entrance into the world, seeming to glare around at everyone!

After Jeremy had breathed into her face briefly she was placed side by side with her brother on Wendy. Connal was already feeding to help with the release of oxytocin, which aids the delivery of the placenta, since Wendy had said that she did not want an oxytocin shot.

Wendy’s husband cut Connal’s cord, and his sister Azaria’s. The staff then left the family alone as was specified in the plan – there was no need for anyone to hang around.

Breastfeeding

Wendy and the twins stayed in hospital for nearly a week to help get feeding established. Initially the twins were fed one at a time at first and then graduated to tandem feeding during the day and one at a time at night. Her husband took the big step of staying home for the first few months to help her out and support her in breastfeeding. One of the hospital midwives, Mary Shepherd, also provided wonderful support – she felt her main job was making mum feel strong and confident and not about telling her what to do.

Wendy had thought that she would breastfeed for 3 months, as it was hard to feed two at once on her own. However, after one year she decided to let the kids decide when they wanted to stop - they ended up continuing feeding for 3 1/2 years!

The first year passed in a bit of a sleep-deprived haze but the twins are now healthy and happy little people. They are very close and although they fight a lot between themselves – woe betide anyone who gets between them!

Wendy’s advice to other mums of multiples:

  • Do your own research and don’t automatically accept that you are having a high-risk pregnancy unless you have other risk factors.
  • Enjoy your pregnancy because you won’t have any time to enjoy anything after!
  • Don’t be afraid to ask for help.
  • You need a strong support network that is willing to help even without being asked.
Azaria and Connal are now 4 ½ years old and their favourite things are Playcentre, Mum and Dad, their friends and lots of cuddles. Mum’s favourite things are Playcentre, Azaria and Connal, running, friends and lots of cuddles. Azaria wants to be a Star-Angel when she is bigger and Connal wants to drive an ice-cream truck.