Hang On, I Don’t Want a Caesarean! – Marley’s birth story

It’s not often that I talk about my twin birth story, probably because I had a caesarean and don’t feel like there’s much to say. When I think about it deeply however, there is actually quite a lot to it so I thought I would share. If you are familiar with my posts on social media, you will know that I always make it clear that birth stories are unique, no two people will share the same experience. The woman who was waiting to have a caesarean after me would have had a different experience, and the person next to you in the queue at your antenatal appointment will also have a different story to tell. I say this because even though I am telling my story, it is simply that – mine. You should not make any decisions based on what you read and your journey, if you’re pregnant, will be a totally unique one.

Finding out my baby wasn’t growing

In 2007 I gave birth to twin boys via Caesarean. I already had a 7 year old boy who I had birthed vaginally, and I was a third year student midwife. My pregnancy was pretty uneventful and other than having regular ultrasound scans, and feeling quite heavy, it was as straightforward as my first pregnancy was. At around 32 weeks on a Friday I had an ultrasound that showed one of the twins was a little small, and after returning two weeks later for an additional ultrasound, I was informed he hadn’t really grown at all. I stayed in hospital over the weekend for monitoring and then had another ultrasound on the Sunday morning. This time is showed that some of the blood going towards the small twin from the placenta was actually reversing and flowing in the wrong direction. This is what is referred to as end-diastolic flow and my baby was diagnosed with IUGR (intrauterine grow restriction) as a result. He basically wasn’t getting the amount of blood he needed to grow and flourish properly

Hang on, I don’t want a caesarean!

One of the obstetricians came in my room to tell me the news and informed me that it was quite a severe case of IUGR. His concern was that there was a high risk of stillbirth for that twin if I continued with the pregnancy. I agreed to have the babies, bringing my son into the world so that I could nourish him myself on the outside. The obstetrician went on to say that he would get things organised for me to go into theatre that evening. My response was “Hang on a minute, I don’t want a Caesarean, where did we discuss that?!” The first twin was head down so I had no reason to think there would be an issue with the birth. All I had in my mind was having a vaginal birth, like I had done with my son and my main thought was how on earth could I look after my eldest and twin babies after surgery? I’ve cared for women after caesareans and knew how much help many of them needed just to hold and feed their babies. How on earth would I manage that? I also found the whole labour experience exciting, you may think it’s strange, but for me, knowing my body was working towards bringing me my child meant everything. Being able to get up after the birth, hop in the shower and hold my babies without wincing was how I imagined things would be. I really felt that surgery would take that away from me, especially as the babies would also probably go to NICU as I was only 34+4 weeks gestation. If I had a caesarean, I knew full well it would be hours before I was recovered enough to visit them.

The obstetrician called in the consultant, a more senior obstetrician to speak with me. I knew him well as I was giving birth in the hospital that I was training in and was happy with his care and input. I remember him sitting down and saying “Marley, you know we can’t force you to do anything you don’t want to do, but twin 1 is quite compromised looking at the ultrasound doppler results. I’m not sure he would be happy with us inducing labour and may not cope well with it. Additionally, we have the added issue of it being a twin birth”

I felt I had made the best choice for my baby

I thought about it for a bit, asked several more questions, discussed with my family and then decided I would go ahead with the caesarean that evening. Even though it wasn’t really what I wanted, I thought it would be best for my baby. I guess I knew that if he was struggling for oxygen now, adding the stress of contractions could make it worse. Babies born full term in normal circumstances, generally cope well with labour. They are designed to withstand some mild umbilical cord compression, particularly in the second stage. Having suffered a second trimester loss many years before, I didn’t want to take the chance.

I walked into the operating theatre at around 1am as there had been lots of emergency caesareans that day that were more urgent than mine. Once on the table, the anaesthetist put a spinal anaesthesia into my spine which numbed my lower half completely. The room quickly became full; two midwives, a student midwife, two neonatal nurses, two paediatricians, in addition to the surgical team. After testing my abdomen for completely numbness and making sure the area was sterile, they started the procedure. Within about 5 minutes, my first baby was born; Dillan was the compromised twin but he came out screaming which surprised me! He weighed 4lb 4oz which I thought was good for the gestation. I was shown his face briefly and then he was taken away to be check over and placed in an incubator. Jamie was born a minute later and also came out screaming, he weighed 4lb 14 oz. The neonatal team took both my boys up to the NICU very quickly to assess them and I hated the fact they were away from me. Meanwhile I was busy getting my wound sutured in theatre and was itching like crazy. I also began to get a bit panicky and felt like I was hyperventilating but the anaesthetist was great and calmed me down. The itching continued as I was wheeled into recovery and went on for a good couple of hours, it was awful! Itching after an epidural or spinal anaesthesia is extremely common, its the drugs used that can cause this reaction. One of the most bizarre things I remember from having the spinal is being transferred from the operating table to a bed. As I was being transferred by the midwives, I caught sight of a big brown thing as asked “what is that?” It was my leg. I was so numb, my body didn’t feel mine!

Seeing them in NICU wasn’t easy

I was able to visit my boys after 5 hours. This only happened after I put a heap of pressure on the midwives as many of them felt it was too early for me to get up and they were probably right. The first time standing up after my caesarean was extremely painful for me, I’m still not sure if my reaction was normal or not as I yelped. Many women I have spoken to that have experienced caesarean birth has said that the discomfort was minimal for them when they first moved. For me however it wasn’t a pleasant experience, but I needed to see my babies and 5 hours had been too long. I was wheeled by a lovely maternity assistant up to the NICU and was there for about 5 minutes. As soon as I was wheeled in and saw them in incubators with wires and tubes, I burst into tears. I was still in a lot of pain so the maternity assistant thought it best to take me back to the ward after I manage to hold the boys’ hands for a minute or so.

The next couple of days were difficult as I struggled to move in and out of bed to walk up to see my babies. I was on strong painkillers which helped but caused terrible constipation! The boys didn’t have a suckle reflex so wouldn’t latch onto the breast, pretty common for preterm babies and they were fed via a tube. I had started to hand express colostrum for them so was trying to take it up to the NICU whenever I could. I remember the first 24 hours I practically expressed nothing, not a drop so they had formula during this time. I knew there was colostrum there, I was just rubbish at hand expressing and it showed! I knew the importance of preterm babies having breastmilk so persevered with the expressing, making sure I did it every few hours and soon it started to come.

Finally home

By day 3 I was basically told they were going to discharge me home so I spent the next 3 weeks visiting the boys in hospital from morning to night until they finally came home. I remember becoming frustrated and tearful after I was discharged because I was travelling back and forth every day, my wound was sore for weeks even though it was healing well and I felt it really held me back. By the time I was about 6 weeks postpartum I started to feel slightly normal although the scar numbness was really strange! It’s quite common to feel numb after a caesarean and likely that there will always be a numb patch if you develop one after surgery.

My caesarean birth experience was not really what I had hoped for, but for me it was the best thing to do at the time and am glad I have two healthy 13 year old boys. Having experienced both vaginal and caesarean birth, I decided that any future ones would hopefully be VBAC (vaginal birth after caesarean). I probably felt this was because my first birth was relatively straightforward, not the case for some people who have a traumatic experience first time and feel like a caesarean may be a better option. This is why it’s important to understand that any choice you make should be made because it’s best for you, not because of what someone else did. I did go on to have two successful VBAC’s afterwards and I will talk more about them on another post.

If you would like to share your birth story with me, however you gave birth, please email marley@midwifemarley.com

Dillan & Jamie in the NICU

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