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Andrea is a mother of nine children, five of whom were born at home. Her last two babies were twins, born in hospital at 40 weeks' gestation.
I gave birth to dizygotic twin girls in September 1999 and had very much wanted to have them at home, where I had birthed five of my other singleton children. My personal 'rules' were that I would stay at home if they were both head down, born close to term and estimated to be good weights. However my second twin presented transverse, so I choose to give birth in a hospital.
I'd rejected the care of the secondary care clinic, a multidisciplinary team, and stayed under the care of my midwife, Sandra.
I was walking around and trying to get the babies to decend (as the contractions were too far apart) before Rose's birth.
Rose was born weighing 7lb 2oz, She was caught by Sandra, 3 hours after the epidural!! Contractions slowed to 1 in 30-45 after epidural was inserted.
Pushing the first twin out was very different from my other births. All my pushing efforts went onto Milly (second twin), who was on top, and Rose (presenting twin) got this weakened second-hand push to help her out. Needless to say, it took much longer than I was used to, to birth her.
I had one consultation with an obstetrician after the birth of the first baby, as twin 2 remained high and transverse. He performed an internal and external version that, upon reflection, was completely unneccessary. For the internal version, he reached in to pull the baby down, but couldn't reach her because she was too high, despite using his other hand to perform external version at the same time.
The attempt at version failed and the obstetrician left in a panic to call the anesthetist, as I had been given a light epidural for pain relief during the maneouvre; he wanted to see if this could be topped up with something stronger for pain relief for a caesarean section.
While he was gone I had some good contractions which turned Milly to the oblique (head over right hip). I kept my hand on her bottom and gently pushed her up and over. Between contractions (which were very far apart because of the epidural) I kept my hand on Amelia's rump keeping up pressure so she wouldn't slip back.
When the obstetrician came back in and saw the second twin was at the oblique and her heart rate (by hand-held Doppler) was good, he decided we could have a while longer to get her right around. We continued to push her bottom up and over until she was fully vertex, and then I pushed her out. It took nearly and hour and she was born face up, but it wasn't a panic or a drama. Amelia weighed 8lb 8oz
A lot of blood is visible in my birth photos after Amelia was born, but it wasn't a haemorrhage - it was clots from Rose's placental site. Rose's placenta birthed before Amelia was born, and as my uterus wasn't able to contract the site (plus it was in the lower segment), a few clots built up. Amelia's placenta birthed after she was born, then I had syntometrine IV. Interestingly, I started to feel dizzy after this - it made me feel worse than the blood loss. All up I lost about 500mls, which evens out at a pretty normal 250mls per placental site.
What makes me fume is the fact that I had the epidural just to allow the obstetrician to attempt internal version. To try to turn the baby, he broke my second bag of waters. This immediately increased the risk to my babe as her cord could have slipped down. The epidural slowed my contractions, which again put me at risk of a floppy (atonic) uterus postpartum, and meant the contractions were too far apart to turn my baby without help.
I am so pleased I kept my midwife as my lead maternity carer as I am sure I would have ended up with a caesarean section (or, worse, vaginal birth and c-section) had I gone under the care of the 'team'. I am eternally grateful to her for her commitment to my babies and myself. It was no picnic for her either - she was under pressure to relinquish my care, and if anything had gone wrong she most likely would have lost her access agreement with the hospital.
In hindsight we could have stayed at home even though the second twin was presenting 'abnormally'. If I am ever blessed with twins again I am most definitely considering homebirth for them, head down or not.
Cuddling both babies, just after the birth.
Andrea
AH updated 30 December 2001
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