Trust me, I had a birthing plan which definitely included having an epidural, as I had done with my first pregnancy of a singleton. I've always admired women who made the decision ahead of time to give birth naturally, but I knew I was not a woman with that level of commitment to the process of a med free delivery. No thank you, not my tribe. I wanted the drugs. I loved being a mother. I breastfed, used cloth diapers, left the teaching profession to become a stay-at-home mother, but to the core of mybeing I knew I had a low threshold to pain. I had taken classes, practiced guided meditation and had even taken pregnancy yoga classes. Nothing would decrease my anxiety over enduring the pain of labor and delivery. I could not or would not surrender to the process and let my body be controlled by decisions doctors' made for me.
This was my second pregnancy and like my first one, I felt wonderful throughout the pregnany. During the ultrasound, I learned my body was a vessel for twin babies, a sense of being connected to the universe and the feeling of grace and miracles was being bestowed upon me. Once the first trimester ended, I wasn't as fatigued and my 18 month old daughter usurped any pregnancy TLC moments. She needed me just as much as before and I felt compelled to fit in as many unique experiences while she was still an only child. My prenatal appointments were all positive interactions and the feedback from the OB/GYN team was stellar. I was having twins and getting larger by the day, which amped up the attention I received from the doctors to our friends in the community and even complete strangers.All twin pregancies are innately considered high risk, but for me everything was smooth sailing,
Typically, twin pregnancies have the proclivity to go into early labor. My 280 days of pregnancy came and went. I was amorphously shaped; I coud no longer see my feet, sleep in anything except a recliner and I had to wear a belly harness which strapped up and over the shoulders. I was standing in my kitchen cooking dinner when the unexpected happened. A searing pain exploded in my rectum, each time my heart beat, I could feel it in the rectum. This was not any sign of labor I had ever experienced nor read about; however, it was insufferable or at least to a woman with a low threshold to pain. I called the doctor and explained my symptons. I was sent to a colorectal specialist the next morning, which happened to be ona Saturday. I recall thinking how accommodating the world was to a mother of multiples.
When I walked into the specialist's office he looked at the size of my twin belly and asked me how many babies was I housing? I chuckled through my response of, "Just twins." To examine me I had to kneel on a low padded platform and place my arms across an exam table. I saw a roll of plain ole gray duct tape on the exam table. As I pondered this, the doctor was using his calm voice as he explained that with it being a Saturday the nurses were unavailable to help him.
"Now this might feel uncomfortable and awkward, but it's my only option as I operate," uttered the doctor.
"Operate? On what? You haven't examined me, I panicked. He explained that a lot of mothers of multiples develop thrombosed hemmorhoids. An external hemmorrhoid with a blood clot in it. The duct tape was to tape on my butt cheeks to keep them spread apart while he cut open the hemorrhoid and removed the blood clot. I couldn't imagine things could be any more embarassing or just plain awful until I learned that the procedure is typically done under anesthesia, however, due to the pregnancy I would be wide awake and unable to receive pain meds. He pulled long strips of duct tape off and plastered it dead center on each butt cheek and pulled the other end of the tape to the table. What a view and what a position I was in, with my ass on full display, taped down with no where to go. He did numb the area with some lidocaine. He sliced open the thrombosed hemmorhid and quickly removed a dime size clot. He showed it to me and as he explained while stitching me up that I would be delivering soon and with the pressure of pushing, these type of problems can become serious issues in the delivery room by re-thrombosing. He regaled me with stories of being called in the middle of the night as some poor soul was pushing her baby through the birth canal,a thrombosed hemmorhoid would grow to the size of a baseball and he'd have to operate while she was pushing!
I began praying as he tugged at the duct tape on the skin off my buttocks. Oh I knew beyond any measure I could not do this on any level. I walked out into the waiting room where my husband sat entertaining our daughter. I was in a panic and quickly spiraling downward. I saw my husband shaking his head and I overheard some comment about when the lidocaine wears off, use ice packs. On the ride home, the intense searing rectal pain came back. We called him and he asked us to turn around and return to the office. Yes, it had rethrombosed that quickly. He redid the procedure that same day. He explained that he was going to contact my OB/GYN about inducing labor because the babies were getting big and they were putting too much pressure on the whole area.
I was placed on bed rest until arrangements were made for me to be hospitalized. Seventy two hours later, I was in the hospital with Pitossin dripping into my veins. I didn't feel anything changing. I was all wrapped in monitors and had my butt cheeks stuffed with slender bags of crushed ice to manage the pain of the stitches. I was watching televison when the nurses informed me they were going to increase the rate of Pitossin. I started reviewing my medical management plan for pain with them. I want the epidural in, I explained knowing I could not possibly do this without it. They were all nodding and explaining the plan was all in my patient folder. Bob Barker was on the television and Johnny was calling audience members to, "Come on Down!" when I felt an explosion of water between my legs. Not the slow leakage of water I remembered from my first birthing experience. I screamed. It was more than water exploding, my pain went from 0-10 in mere seconds. The nurses came in and examined me. I learned the intense pain was because I was fully dilated. I begged them to get the epidural in fast. Soon, my bed was moving and I was surrounded by doctors, specialists and interested medical students.
Time to start the demands. "I want the epidural now!" I was being ignored. I got louder and more assertive about my prearranged pain managment plan. The doctor got up in my face and said in a firm, matter of fact tone that there was no time for an epidural. My twins were coming now and the epidural would take too long to get in to be effective. I grabbed my husband's arm and was frantically begging him to stop the madness.
"It's okay, honey- I'm here for you."
"I can't do this, I can't do this," was spewing from my mouth until this overwhelming urge to push had taken over. With 3 three intense pushes, the head and shoulders of Twin A had emerged. A raucous applause broke out and it was the first time I noticed that my room was filled with med students and a NICU team. My OB/GYN said to me,"We need to get this baby out now! Twin B is in distress. If you can't push this baby out in one last big push, I'll have to section Twin B." Oh my God, I pushed iwth every ounce of strength I had in me. I was not going to recover from both a vaginal birth and a c-section.
I prayed to God to help me find my source of strength. I begged for my rectal stitches to stay in place when I pushed the last of Twin A out into the world. He screamed loudly and momentarily he was placed on my chest. I pressed my lips to his forehead and alarms started going off. He was quickly removed from my chest. Twin B had floated back up in the uterus and it appeared the cord was wrapped around his neck. I felt like a warrior. I pushed with every contraction, Twin B's water exploded ferociously and splattered all the doctors. I didn't care, he was going to come out. My body tembled with muscle fatigue, but I pushed beyond my fear,my limitations. He came through the birth canal with the cord wrapped around his neck. He didn't scream. The NICU unit rushed in and gathered around him. I couldn't see over their heads, but Iwasn't hearing any noises. Twin A was cleaned and had been brought to me weighing in at 9 pounds. Suddenly, a faint yowl came from Twin B and a cacaophony of cheers. He too was cleaned up and also weighed in at 9 pounds exactly. Both sons were the exact same weight and length of twenty one inches. The separate placentas filled two hospital mop buckets, which the nurses loved lifting up in the air to show me like a trophy. I looked at it in awe thinking of how much my body had actually contained.
No pain meds, no choice. I had to surrender the control and the fear of pain to bring forth fraternal twin sons weighing in at a collective 18 pounds of humaness. I was beyond elation. I had survived what I most feared during pregnancy.
I felt fabulous afterward and the babies were healthy and well. I still believe every woman should have the choce of having an epidural or some form of pain managment, even if the plan doesn't unfold exactly as planned.