Friday, April 12, 2013

Twin Birth on the Farm ...excerpt from Spiritual Midwifery by Ina May Gaskin, 2002 Book Publishing Company with permission. Chapter on Twins, pg. 130.

Stephanie: Our first birth was in a hospital. It was wonderful. We worked for months choreographing this event with our doctor. We would bring our midwife with us, we'd have a lovely, homey birthing room, no equipment, no extra nurses, and we'd go home when we wanted to if all went well, and it did. It was a short labor: one hour and eighteen minutes. The doctor never made it to the birth. We ate, napped and went home. We appreciated the hospital staff so much, especially for their respect of our wishes. We weren't treated like freaks. In our conservative state (Minnesota), in 1980 we couldn't find any doctors doing home births and although we found a very small group of midwives who were, they had no hospital support at all. I expected a little resistance to my wishes in the hospital, and I was prepared to fight, but I never needed to. I was used to the raised eyebrows and shaking heads by the time I was pregnant again two years later. We had kept our baby, Abraham, in bed with us, and I was still nursing him at two years of age. We had dozens of offers from people to buy us a crib after they came to visit and were denied a tour of "the nursery," because we didn't have one! When I was three months along this time I was twice as sick as before, twice as big, and twice as pregnant. It was twins! I went back to my doctor, an ex-home-birther who had "reformed" because of the sanctions lowered on his kind by our state. I told him I would have the babies in the hospital with the birthing room arrangement that we were so satisfied with before. My joy and excitement at finding out I was carrying two babies was totally dashed as I listened to him describe his hospital's policies on twin deliveries. High-risk pregnancies (which included all twins) were a whole new picture. To begin with, birthing rooms and midwives didn't touch high-risk cases. It didn't matter that both of my babies were in a head down position. It didn't help that my blood pressure was wonderfully low during the whole pregnancy. It made no difference that this wasn't my first delivery (Abraham had been almost ten pounds) or that the twins weren't coming prematurely and appeared to be gaining well with strong heartbeats. I talked to every hospital in the entire metro area. Twins were normally delivered in operating rooms after the mother was prepped for a C-section, "just in case," we were told. Both babies would be electronically monitored, and ultrasound would be used during both deliveries. An IV was required to facilitate a speedy transition to surgery. Often the first baby was bom "naturally," but the second "required" a Cesarean if things didn't "progress." The babies would also be professionally observed in the hospital nursery for twenty-four hours, another regulation, regardless of their birth weights. The list went on. I read voraciously. Studies. Statistics. Nothing seemed to prove that the precautions were vital. My husband David's support of any decision I would make gave me comfort. Over and over I was told, "This is a special problem. You need the best care. I felt that the "best care" often posed the best risks. Hasty interventions have their own horror statistics too. I had never before felt the weight of bearing so much responsibility for one decision. I would have to fully assume the consequences of my ultimate choice. I prayed a lot and cried a lot and felt like all the joy had gone out of what should have been a time of wonder at the miracle of two precious babies growing inside of me. I considered a home birth then but soon found out that because of the high risk screening factor none of the midwives in our area had even observed a twin birth. In desperation I wrote to the authors of a book on birth that my doctor had given me a couple of years before. It was Spiritual Midwifery. I knew nothing about their community, but after my first call to relay the information they requested, I felt peaceful for the first time in months. Above all, I trusted their skill and experience and was warmed by their understanding and compassion. 
           During this whole time, David simply continued to assure me of his support: "I want you to have these babies wherever you are going to be the most comfortable. That's where I want you to go." We finally agreed that I would go to Tennessee and he would come later when he had vacation time a week before my due date, stay, and then we'd all go home together. Of course, we took the chance of the babies coming early before he could come, but we resigned ourselves to that possibility.
            I spent my first three weeks on The Farm in bed. My checkup found a thinning cervix and I was dilating slowly, possibly from the weight of the two babies. The midwives suggested bed rest, hoping the babies wouldn't come prematurely. They guessed that they were around five pounds each at this point in time. They brought me lots of books and lots of snacks, which kept me occupied and gaining about two pounds a week. It was hard to eat. During one particularly active kicking session by Baby Number One, a lower rib cracked. My five foot, four inch frame wasn't exactly designed to carry this kind of load for long. Baby One's head was engaged at this time and Baby Number Two seemed to be face up, although the head was down near my left hip. The next week's exam found I was dilated to five centimeters! Back to bed. It was still three weeks before my due date, and I wanted to fatten them up a bit more. A common complication with twins is prematurity and breathing problems. The greater their birth weights and the closer to term they are carried, the better.
            Two whole weeks later, while I was bathing Abraham, with my dilation at seven centimeters, my water broke. Three minutes later—rushes! I grabbed Gerrie Sue, one of the midwives who was staying with me, and off we went to join the other midwives, the nurses, and the video crew at the larger birth house. Then she washed up and examined me. Eight centimeters. I wanted to slow everything down a little because it was happening so fast now. She sat next to me on the big bed and helped me relax. Then Judith came, smiling so sweetly, and massaged my legs. She had become such a good friend during the time I was living at her house. Everyone came in very quietly, so as not to disturb me. This was very calming. No one felt like she had to chat or joke or distract me. Twenty minutes passed, and Gerrie Sue could see the first baby's head. I could push slowly. Isaac came first—seven pounds and fifteen ounces. Everyone cheered. They clamped his cord, and I held him, completely overwhelmed by this little boy. Then Ina May prepared to catch Baby Number Two. The bag was ruptured, and her hand was starting to come first. Ina May tucked it back up inside, which took a few minutes, and finally, I could push again. Just after Isaac was born, I had completely forgotten there was another baby. Ruth popped out, weighing seven pounds seven ounces, only six minutes after Isaac's birth. She was even pinker and much louder than he was. More cheers. The huge placenta came six minutes later, with two sacs. My whole labor was only fifty-nine minutes. I nursed both babies, kissed the cameraman, and called David. We ate some supper, (I felt like a bottomless pit and ate piles of pancakes!) and everyone went home except for a couple of nurses who stayed all that night with me. I slept soundly, waking only to feed the twins. 
            Our whole family was reunited that weekend. I counted each second until David would drive up to the gate. It was so good to see him. He climbed up on the big bed and spent the weekend there, getting to know his new little son and daughter. It was hard to say good-bye. We had become part of this big, loving family. We'll never forget them. We came away with much more than just two healthy babies. I hope we can pass on some of what we learned about giving to others now, too.

See "Twin Vertex Birth", 1982, DVD from the Farm of the twins' birth: http://www.inamay.com/natural-delivery-vertex-twins-dvd
Also see the new movies, "Birth Story" and "More Business of Being Born" both with footage from "Twin Vertex Birth."  
For more information about the Farm see http://www.thefarmcommunity.com

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