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Birthing Twins at Home
Written by Esther Polden
We found out that we were expecting twins at my twelve week nuchal scan in March 2002. This was my third pregnancy. Yes, I had been sicker, and I was bigger than at the same stage with both our daughters (Rebecca, then aged nine, and Hannah, who was five years old) but I had put that down to this being my third pregnancy and possibly my being an older mother, at 41years. So although my partner, Duncan, repeated over and over, "I knew it, I knew it", I had not guessed that I was carrying two babies, and I stared at the ultrasound image with a sense of bewilderment and disbelief. We went for a walk along the Thames to try to get our heads around this news. Not one, but two babies; we would be parents of four children! So many considerations; the responsibilities seemed overwhelming (and continue to feel that way on and off). One immediate issue was the question of further diagnostic tests. In the end, we decided to go ahead with a CVS (Chorionic Villus Sampling), a technically delicate procedure. Following this, the days passed in a kind of unreal haze until we were telephoned with the results one evening. Both babies had tested negative; we were expecting a girl and a boy. From this point, I began to embrace my pregnancy; this new experience of motherhood.
When I became pregnant for the first time in 1992, we decided that we wanted to have our baby at home. We were influenced by the example of my sister, Ruthie, who had given birth the previous year to her first baby, my niece Hila, at home. Forty or so years ago, my own mother, Margie, had three of her four children at home with the help of one midwife and the local GP. I did not feel especially comfortable with the prospect of being in hospital for the birth, nor did my partner, who is a hospital doctor, see any reason for this. But at that time, local National Health Service (NHS) policy was against first-time mothers giving birth at home. So we booked with independent midwives practising in London at the time, and the births of our daughters were intimate, personal and unhurried experiences, as was the wonderfully supportive antenatal and postnatal care.
Nearly five years on, neither Duncan nor I could imagine my giving birth any way other than in the privacy and calm of our own home, with the steadying support of midwives with whom we had built a relationship. We booked with Mary Cronk, a very experienced independent midwife based in Sussex. Val Taylor, who had been at the birth of my sister's first baby in 1991, agreed to be our second midwife. When we saw one of the obstetric consultants at our local hospital, he listened to our plan to have a home birth but advised us that the Trust's policy was to recommend hospital births for twins because of the risk that the second baby could be breech. However as the months went by, I thought less about the chance of having to go into hospital. As with my two other pregnancies, I was going with the flow, trusting in the natural process of pregnancy and birth, and in our midwives' expert guidance and knowledge.
I went on maternity leave at the earliest possible date just before the school holidays. This was very helpful because it meant I could focus my energy on myself and on my children. One of Mary's oft repeated catch phrases was forward planning. Although some part of me was resistant to planning ahead too much, it was also a relief to know that some parts of the unknown were covered. So, for instance, I knew that our lovely student babysitter, Sally, was going to be around as and when we needed her, and Duncan's mum was slowly filling our freezer with meals. One day there was a ring at the door, and there was Jean, the mother of a friend of ours, with several crates of wonderful looking cakes and loaves. I was speechless at such kindness. Mary had emphasised that the eighth month of a twin pregnancy is equivalent to the ninth month of a singleton and that help in the house and with the children needed to be in place by then.
My expected due date was around 4th October, 2002. During the third and fourth weeks of September, I was aware of changes, period-like pains in my lower abdomen and back. On 25th September, I called Mary and she agreed to visit because I had had Braxton Hicks contractions since the day before. She examined me but there was no dilatation of the cervix. Over the next two days and nights, these mini contractions continued on and off. It was a strange feeling going to bed not knowing if this would be the night I would go into labour, assuming it would start at nightime as it had with the other two. I was anxious to anticipate as far as possible the onset of labour so we could make arrangements for Rebecca and Hannah. Hannah had gone to stay with Duncan's Mum for the weekend, and my Dad was on call for Rebecca.
I woke up on the Saturday morning feeling very disappointed that the mini contractions I had experienced during the night had not developed into full-blown labour. Duncan and I went for a long walk on the South Downs in the warm sunshine, and that evening the quality and frequency of my contractions changed. I spent the evening feeling a sense of urgency about finishing arranging some old photos while sitting on my gym ball, and then rocked the night away, breathing through the pain of the contractions, and using a TENS machine. I had gone into the pool several times in the previous week, to have a float and quiet reflection, sometimes listening to a tape with positive affirmations and comforting music that I had got from one of my active birth yoga teachers. Duncan telephoned Mary around 6 a.m. and helped me go down to the pool. There would be three midwives. The first to arrive around 7 a.m. was Andrea Dombrowe, whom we had not met before. Her arrival was the opportunity I needed to let go of my feelings of fear and loneliness that had been building up inside me, and my sadness that my own mother, who died in 1998, would not be at these births. She had been at the births of our first two daughters and I had always known that her absence would be very difficult for me. Val and Mary arrived in the next twenty minutes and I was aware of the three of them setting up their equipment in a quiet business-like manner. I have looked back at my maternity notes to help me remember the details of the next four hours. Only four hours! It seemed a lot longer!
I have strong memories of the three women, especially Mary, helping me to relax and focus and guiding me at every stage so that I could birth our two babies. As with the other two births, I relied heavily on Duncan's quiet, calm and relaxed presence. Rebecca kept out of the way, preferring to watch the TV until my dad arrived, and together they went to a café by the sea. She told me later with some indignation that they had only just got their food orders when they received the call from Duncan that our babies had been born, and had to leave the café in a hurry!
Just before 9 a.m. I wanted to get out of the pool, and after resting had the urge to push at the height of a contraction. But after an hour of pushing, sometimes in an upright position with one leg raised on a stool, and with the most unbearable back pains, Mary asked me to walk to the stairs and walk up and down sideways to try and shift the first baby's position. She suspected that he was lying in a posterior position, with his back to mine. Mary also asked me to stand with my legs wide apart and bend my knees several times, which transported me momentarily back to years of dance classes and pliés! Mary wanted to examine me again. I lay on my back with my feet off the floor and my knees bent up around my ears in what she has told me is called McRobert's position. She managed to rotate Adam's head, and as she did so I felt him descend into a better position. She then asked Val for a second opinion. Val had noted that at this point I was feeling "despondent and tired", lying on my left side and attempting to get my back to loosen and relax. I suppose it seemed to me that I still had such a long way to go. Hannah was a posterior baby and it had been a long stop-start labour. The back pain and prospect of still more pain was also very hard to bear. Although Andrea's massaging, the use of the TENS machine, and walking about and up and down stairs had helped ease it, the pain was almost constant. I coped because between them, Mary, Val and Andrea helped me to try different ways of moving Adam into an optimal position and to manage the excruciating pain, and I felt reassured by this and it helped me to remain focused.
Forty minutes later, Adam was born weighing 7lbs 8oz. I had the urge to push and, after two or three slow pushes, with Mary talking me through these, Leah arrived weighing 8lbs 4oz. I was lying on my left side, with Duncan holding my right leg up, Andrea supporting me around my back, and Mary guiding Adam's head. I just had time to cuddle Adam, and to marvel at this beautiful little person and feel elation that he was out. I was apprehensive that Leah was posterior too but her descent was far easier and she was born around nine minutes later. I held her and gazed at her, marvelling some more that both our babies were now with us. Duncan by this time was holding Adam. Adam started to feed soon after Leah's birth, and almost immediately I had another urge to push and my placentas were delivered.
The twins, who have just turned two, were born at home on 29th September, 2002. They are both still breast-feeding and are wonderfully chatty and active little people with a very deep-felt love for their two older sisters and for each other. Leah loves and needs a lot of sleep, in a cot at the end of our bed, while Adam sleeps less and feeds more and is in our bed at night. We have all grown into our new family constellation. I am amazed by Rebecca and Hannah's maturity - it has not been an easy journey for them. For me, certainly the first month after Adam and Leah were born is very hazy, and I felt on and off for some time that I was simply getting by and surviving each day. I remember thinking early on that there was no time to feel real joy and pleasure because days often felt too busy and frantic. I also had some feelings of guilt and sorrow that I could not give uninterrupted time to either twin, because the other also needed me to feed them, hold them, change them. But we have worked it out. I can see what fantastic companions they are for each other, and must have been almost since conception. I feel proud and joyful that I was able to birth them at home and have been able to breastfeed them all this time. I could not have done so without Mary, Val and Andrea. Chloe Fisher, a specialist breastfeeding consultant based in Oxford, convinced me that twins can be breastfed just when I was feeling I could not carry on. These are all remarkable women, and we are very lucky to have benefited from their great wisdom, intuition and experience. And so lucky to have our four beautiful children.
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© Juno Magazine 2007 |
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