When determination and advocation get together, magic can happen...
I will never forget the anxious feeling radiating off of Victoria the first time I met in her person. She sat on a couch across from Lisa and I explaining how her plan to birth at home, got flipped upside down at 20 weeks into her pregnancy. She found out she was having twins that shared a placenta. This type of birth is often considered "high risk" and it meant she could no longer be cared for by her midwives.
Many practices told her that this type of pregnancy, monochorionic, meant she would have to deliver via cesarean. The first practice that agreed to let her deliver vaginally, had a lot of rules too. She would have to deliver in the operating room, she would have to agree to have an epidural placed just in case, because of all of the things in the operating room, she would have to be confined to only moving on the operating table, and they wanted to induce her at 35 weeks.
The other two providers that I thought might give her a chance to deliver vaginally, were out of network for her insurance, and both practices told Victoria no, when I had her call. It kept me up at night to be honest. This was a woman, who was having a perfect pregnancy and while I know the risks involved, herself nor the babies, were showing any signs of distress.
At 31 weeks, I started begging, calling doctors on my own, and eventually asked for a meeting with Manchester OB. They asked for me to have her send over her medical records and for me to write a referral letter. When I was dropping it off, one of the doctors saw me in the office and she said, "oh is this the doula who is calling for the twins?" When the nurse manager replied yes, she said, "I'm a yes then." It was the first time in my career, that anything like that had happened. While I've always felt respected, knowing that one of my clients had a better chance of getting what she wanted from a provider because she had me, was certainly career affirming.
A few days later (felt like 100), they agreed to take her on. Victoria was excited, but still a little skeptical. I think after hearing so many people tell you no, a yes felt a little unimaginable, or perhaps that there must have been a catch.
Over the next two months, they gained her trust. They respected her choices, listened to her when she spoke, and anytime that we knew there was potential for a big conversation, I joined her for her appointments.
Victoria was having prodromal labor on and off for the entire last month of her pregnancy. She was done, but the practice never offered up an induction. While that was ultimately what she wanted, I think there were times, where she had hoped they might tell her today was the day. At her appointment midway through her 37th week of pregnancy, her blood pressure started climbing up a bit. They discussed an induction for her at 38 weeks. 38 weeks! The fact that any practice let her go to what is considered term, really is probably bigger than what many of you reading this can understand. It was HUGE!
We arrived for her induction on Tuesday night at 5:30pm. They checked her and she was barely 1 centimeter dilated, despite all of the contractions she had been experiencing. They decided to place a cervical ripener on her cervix overnight, to help her to dilate and thin out her cervix, if other interventions were needed.
I stayed with Victoria for a few hours, but then returned to my home to sleep overnight. At 4am, she called me and asked me return. When I got there she was having some consistent contractions, but they then spread back out. A few hours later, they decided to give her another cervical ripener orally, because she was having contractions on and off on her own. That would be the last artificial thing, they would offer up.
Lisa had also decided to attend this birth, in order to gain some twin experience. I had to leave early morning to go to another birth, and Lisa stayed and supported Victoria. I returned early afternoon, and Victoria was starting to have some consistent contractions, but nothing to intense. Her belly though became hyserically distorted during each one.
Early evening, is when things really started to progress. Just the little bit of ripeners, had helped Victoria kick into labor on her own. Lisa and I began helping her with physcial support and comfort measures. Her husband Derek, was exceptional as well. He helped her manage through every contraction, talking to her when she asked, stayng quiet when she insisted, and helping us, to help her dilate, by using positional changes.
This picture in particular is my favorite of all the ones that I took. Laughter is such a huge part of coping with a long labor combined with limited sleep and exhaustion. We all laughed a lot, until baby a's water was broken.
At 9:40pm, things became insanely intense. This was what we were waiting for! Again, Victoria's wishes and wants had been respected the entire time by the hospital staff and her provider. She was only being monitored intermittently, the nurses and doctors were doing mental and visual checks only, no one ever offered her any medication, and her support team was surrounding her.
I have never seen a woman (who struggled to walk! 38 weeks with twins is no joke!) have so much determination and perserverence. She was an absolute force to be reckoned with. She stayed in control (excpet for the few times she pulled Derek's hair bahaha!) She let us help her speed through this active part of labor and transition, by changing positions every time we asked, and breathing and rocking through the new intensity each time.
Then it was finally time to meet her beautiful little babies. Victoria began pushing and of course not to long later, baby a, who is now named Aero, was earthside and placed skin to skin on his mamas chest. I will never forget the look on Derek's face. He loves his wife fiercely and while I had seen it at every moment during this labor, you could feel it. He was so proud of her, he was beaming.
Quickly the midwife, Jen Loomer, mentioned that baby b was coming right behind his brother. Victoria, is such a darn rockstar that she started pushing with baby a, still on her chest. She asked for him to be taken for the next push and baby b, now named Indi, came out riding a wave of fluid from his sack (while monochorionic twins share a placenta, they do have their own amniotic sacks). His head and body came out in one pass, and was also immediatley placed to her chest, once again with Aero. Victoria and Derek, with their eyes welled up, stared lovingly at each other and those little boys. It was absolutely one of the most amazing moments in my entire career.
Victoria grabbed my hand tightly, looked into my eyes and we both started crying. She mouthed thank you and I realized that she was still in disbelief that she had gotten the exact birth that she had hoped for, and me in total awe of her power and strength. Her body was capable of so much more than what many others thought was possible. She grew two humans, with one GIANT and hearty placenta, she fought for herself, she always asked why, she reached out for support when she needed, she stayed up two nights in row allowing her body to build up it's own contractions, and she was so fierce.
SHE EVEN TANDEM NURSED THEM WITHIN THE GOLDEN HOUR!
I know that I will forever feel bonded to Victoria. It was such an honor for her allow me (and Lisa!) to be part of such a wonderfully incredible, labor and birth.