Wednesday, July 13, 2011

Delivery of our boys.

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This pregnancy has been an awesome first pregnancy for me.  I have not been sick at all, and not until just lately have I really had some of the annoying pregnancy symptoms that most people start to feel towards the end of term (swollen feet, issues sleeping, little lung capacity, etc).  Even carrying twins, my OB has stated that I am extremely healthy, more so even than most single baby pregnancies.  I also have hoped that my birthing experience will be just as wonderful.

I have always planned to have a natural, unmedicated birth (no epidural, no narcotics, no nerve blocks-nada).  I have wanted this to be the case for my birth even before I knew I was pregnant.  People ask me why I am so determined to have a natural birth.  I just like doing things naturally.  I hardly ever take medicine when I'm sick, but instead try to manage symptoms with rest, nutrition and home remedies.  It's just the way I like to do things and it works well for me.  I am completely aware that this style may not work for everyone, and that's ok.  It's just a personal preference of mine.  Sometimes when I try to explain this to people I feel like I may come off as passing judgement onto those who do choose to have medication for their births.  This is not at all the case, and I hope that no one ever takes offense from my opinion.  I believe that it is every woman's own personal preference on how they would like their birth to go, and I am thankful that we all have the freedom in choosing such things.

It was frustrating once I first found out we were pregnant with twins, because I know that usually half (some statistics say more than half) of multiple pregnancies end with a caesarean section.  As you probably have already gathered from the paragraph above, a c-section is not even in my feasible options for my ideal birth.  I did often worry throughout my pregnancy whether or not I would end up having to deliver my boys through an incision in my belly.  Fortunately, my babies have cooperated very nicely and have both been head down for the past few months. With their increasingly growing sizes, we are pretty sure neither of them have room to flip anymore.  This means a natural, vaginal birth is very highly likely! Hooray!

And now we come to the present.  So far, I have beaten a few odds when it comes to multiple pregnancies.  I have one of the rare type of twins (monochorionic, diamniotic, which means one placenta, 2 amniotic sacs, AKA identical twins), and I have been able to avoid certain high risk conditions that are highly associated with multiple gestations (gestational diabetes, preeclampsia, TTTS, low birth weight babies, etc).   And the issue that brings me to write this blog post in the first place...I have been able to avoid the 60% of twin births that deliver before 34 weeks.  I am currently 35 weeks.

During one of my early doctor visits, I was told that if I make to 38 weeks and have not yet started labor on my own, that I would be induced.  I sort of just blew this off, expecting to hopefully deliver on my own around 36 or 37 weeks, or else I would just refuse to be induced unless there was a reason necessary to do so.  Well, we have reached the point again where my doctor is discussing induction.  At first it made me really angry because I saw no reason to make the babies come out until they were ready, since both were equally growing and fluid levels and all else have been normal.  My last doctor appointment scared the crap out of me.  My OB showed me a bunch of research that has been done twins that share only 1 placenta.  Through many studies that have been done, there has been shown to be a greater risk for stillbirth of 1 or both of the babies when gestation goes beyond 38 weeks because the placenta begins to deteriorate.


Stillbirth.

The delivery of a dead baby(ies).  Holy crap.

I then went home and also did research on the topic (not just websites like wikipedia, whom anyone can add their 2 cents to) but actual medical journals and books (Here is one example of an article/study I found).  I have found similar data showing an increased risk.  But then I thought, "well, maybe these  demises happened in pregnancies that weren't very healthy" but as I continued to read articles on the topic, the studies were done on healthy women of child-bearing ages who had very uncomplicated and healthy pregnancies.  The exact cause is unknown (other than placental insufficiency) and it also happens suddenly, without warning, usually within the last few days before delivery.

This is where I am currently:  I would rather give up my perfect birthing experience to have 2 healthy babies, than to be stubborn and selfish and refuse to be induced.  I know that the risk of me actually having a stillbirth delivery is very low, but if it did indeed happen, I don't think that I would ever be able to forgive myself.  I would always blame myself for not doing something that could have possibly prevented the situation.  Jeremy says that if God wants us to have a stillbirth than it will happen whether or not we are induced, that it is all in His hands anyway.  And while I know that is true, I am positive that I would still feel completely responsible for "not trying to prevent" such a tragedy and would probably struggle with it for the rest of my life.

If I do end up having (choosing to allow it, rather) to be induced, I still do plan to have a natural, unmedicated birth.  My OB knows this, and is on board, which makes me feel better.  When I think of induction my mind automatically goes to pitocin which is a synthetic form of the natural hormone that our bodies produce during labor which causes uterine contractions and such.  The fact that it is synthetic, and not organic often causes uterine contractions to be stronger than normal, and thus putting babies in distress.  This often ends in a c-section.  It is also much harder to deal with the pain from pitocin contractions as opposed to natural ones, although not impossible.  I explained all this to my OB and she said that pitocin is the very last measure taken during an induction.  They start with more natural ways, such as stripping of the membranes and things of that nature.  This also made me feel a little bit better.  And the fact that I am already almost completely effaced and have dilated some, that it may not take much to really get my labor started.

However, I still am hoping and praying that labor will start naturally for me here in the next few weeks.  I just have to keep telling myself that no matter how far away my actual birth experience is from my ideal birth experience, the end result will be 2 healthy little boys!  I have started doing some routine things that are said to jump start labor, so we'll see what happens!  I do have a feeling that it will happen before I reach my induction date (August 3rd, 730am).  My "fake" contractions have become more intense and happen more often, and I have noticed more pressure in my pelvis area lately.  I occasionally feel little pings of pain which I hope is me dilating more and/or stretching to get ready!  

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I cannot wait to meet my little boys!  (don't know these twins, just found this cute picture online)



I know this post has been forever long, and if you have read this whole thing and have any helpful opinions and/or encouragement for me, please share!

          

3 comments:

  1. Praying for you Sarah. I know God will bless you in your delivery. I know you are a nurse so you know all the helpful tips but walking helped me in delivering early. Blessing and prayers

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  2. Hey Sarah, remember me? ;) I know I haven't seen you guys in a while but I have been following all of your pictures on facebook and read a couple of these posts of yours. As a pediatric and internal medicine Physician Assistant I am interested in the medical aspects of things and the baby side of things and the "you guys are my friends" side of things. I have been so so SO impressed with your research and knowledge of your pregnancy you have written about, so SO impressed with your cheerful ambitious attitude and so touched by how much you already care for these boys. They are wonderfully blessed to have you as a mama and Jeremy as a daddy, and there is no doubt in my mind that however painful or easy or planned or unplanned this birth goes, God's plan will be played out and you guys have the most amazing attitude to deal with whatever that is. :) I can't wait to see pictures!

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  3. You seem to have a good attitude about it. I, too, was bound and determined to have a natural childbirth. I took Lamaze classes and was fully ready...and then life-threatening circumstances forced me to throw it all out the window. It was hard to let go of that ideal delivery, but all that really mattered was that Noah was healthy. It's good to have a plan, and it's also good to realize that the boys getting here safely is the utmost priority. Love you girl! I know you'll do great!
    Kristi

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