Audrey's Story- 9 lbs., 2 oz.- Hospital

9 lbs., 2 oz.

Hospital

Mother's Height: 5' 4"

I am the mother of 4 children, including a set of spontaneous fraternal twins. My birth experiences taught me a lot about how the OB industry works. I am about 5’ 4” and before each pregnancy I was around 120 lbs. I had no health problems, and very healthy pregnancies. I had post partum depression after my second born, and was successfully treated with Prozac.

My first two children were delivered vaginally by the same OB who was a solo practitioner in the same hospital. They are 18 months apart. My first born was 7 lb. 8 oz., born without any complications and my second was 9 lbs. 2oz. I had no idea my son would be so big, and I delivered him vaginally without any major issues. I had very strong contractions and was 8 cm dilated with my son when I got to the hospital, I thought he would be born quickly, but I personally feel the epidural made it harder to push him out. Once the epidural was shut off, I was still pretty numb but could push him out after 2 hours of pushing and was given an episiotomy and they used the vacuum on his head. He had meconium in the amniotic fluid but he ended up just fine and went home in 2 days from the hospital. The OB that delivered him never even mentioned a c section for his size. I think his birth was stressful mostly because of the fear of meconium entering his lungs, but he was fine. I nursed him like I did my first born, and ended up with mastitis twice with fevers over 103 degrees. He had silent reflux, and woke up every hour at one point to nurse. I ended up on Prozac, after a stressful move and dealing with months of sleep deprivation. If I had to do it over I would have taken the Prozac sooner.

Not an unnecesarean, but an example of no continuity of care during a pregnancy...

My third and fourth children are fraternal twins. I was on the pill and got pregnant with twins even though I never missed a pill, and I was not on antibiotics. I quickly learned that a twin pregnancy is a different ball game. My new OB was a practice of 8 rotating doctors, and I was classified as high risk because of a twin pregnancy. Because of this I was told I had to have my appointments on Tuesday mornings, when high risk patients were seen. I explained that my older children were in preschool 3 days a week, couldn’t I have my appointements while they were in school? I was told no, I had to come in on Tuesday mornings for high risk patients, which I feel was really for their convenience. So I had to bring my two small children to every check up. I was also told I would be going to a different office for ultrasounds every 4 weeks in addition to my regular OB checks. At the ultrasound visits the twins were measured for size and growth. In addition, an ultrasound was used to check for heartbeats at each OB visit. So I would sometimes end up at the ultrasound place on a Monday, then see the OB on Tuesday for an office visit with another ultrasound on a more low tech machine in their office.

From the beginning I told the OB office that I did not want a c section delivery if possible. I was told that a vaginal birth would be attempted as long as both twins were head down, but with twins you cannot guarantee a vaginal birth. If one was breech a vaginal birth could only be attempted if baby A, the lower baby was head down, then the doctor could turn baby B around and deliver it. In addition, only two doctors on staff would deliver a breech twin. I was told no other OB on the staff would do it.

Toward the end of the pregnancy I had to start non stress testing at the hospital where they hook you up to the fetal monitor. They attach two heart monitor devices to me and check heart rates for each twin and check for contractions. Everything was normal, I had weekly visits there in addition to the then weekly OB internal checks.

At my 34th week OB visit I am told I am having contractions. I was told to go to the hospital for non stress testing immediately. Since it is a Tuesday, I have my two older children with me and go to the hospital and call my husband to meet me there. It is confirmed that I am in labor. I am given a shot of steroids to help the babies lungs if they are born premature, and shots of Brethine, which is an asthma drug that is used off label to stop labor. I am sent home with Brethine tablets to take every 4 hours and put on bed rest. The side effects of the medication are shaking, and rapid heartbeat. I am a shaking, nervous mess and spend two weeks on the couch.

The goal was to get me to 36 weeks, and I reach that goal. I hated taking the meds and two days shy of 36 weeks I stop taking it. I am miserable at this point. My ultrasounds that Monday tell me each baby is over 6 pounds, the doctor even double checks the GE ultrasound machine because the measurements are so big for twins at that gestational phase.

At my 36th week I have my OB visit and show them my hugely swollen right leg, and new horrible rash that developed in the new stretch marks below my belly button. The OB doctor says nothing about the rash, no explanation, and does not think my swelling is that bad. After the OB visit I go directly to the hospital for my weekly non stress test and the OB nurse tells me I have PUPPP(Pruritic Urticarial Papules and Plaques of Pregnancy) rash, which is common in twin pregnancies. The OB doctor said nothing about it, she basically ignored it. The OB nurse also looked at my leg and said to get off that leg, sit down and raise it. The OB nurse seemed more concerned about me that the doctor I saw that day.

I made it to the 37th week, and at my OB visit they said I was 3 cm dilated. I was in agony at that point, and even more swollen and rashy on my belly. I asked to be induced and the doctor I saw that day had to call another OB to discuss my case. They decided to induce me the next day and we were told to go to the hospital at 6:30 am. That night I had strong pains which I thought were contractions.

We got to the hospital and once I was hooked up to the fetal monitor it was determined I was in labor, having regular contractions. An internal exam was not given. The nurse who hooked me up to the IV said she thinks if they break my water I will not even need Pitocin because of my regular contractions. They take blood from my IV line and come back saying my platelets are very low, there could have been a mistake, they need to re do the blood test. They take another blood sample and determine that my platelet level is very low. At my first blood test in the beginning of my pregnancy my platelet count was over 200,000. That day it was under 80,000. Suddenly everything changes. The OB doctor (one that won’t deliver a breech) on call that day rushes in and says because of my low platelet count I cannot have an epidural, because if I hemmorage that I could be paralyzed. I later learn from a nurse that doctors do not like to deliver twins without epidurals. I wanted one, because I did not think I could take the pain. It ends up that I must have a c section, with a spinal block. The pain I felt overnight was baby B turning, she ended up being breech.

Prior to surgery I was shaved and catheterized and wheeled into the operating room. I was so upset by the sudden turn of events that I start to cry as they put in the spinal needle in the OR. I was in shock because all along both babies were head down and I thought I could deliver vaginally.

My baby boy was pulled out first, he was 7 lbs. 12 oz. and my baby girl was 6 lbs. 10 oz. After the surgery is complete, I am wheeled to recovery, on another hospital floor in a haze. I thought I would be on the maternity ward with my babies. I am not told where I am going and I am so out of it I don’t really know what is going on. Once my legs are not as numb I am returned to the maternity ward where I finally see my babies. I am still catheterized and have pressure bandages that inflate on my legs so I don’t get blood clots. I cannot get out of bed until the next morning, and can’t eat until then either. I am a mess. The babies had no complications and were sent home with me after 3 days in the hospital.

Once I was home, the PUPP rash became much worse. It spread all over my body, up my legs and onto my buttocks. It erupted all over my hands. As it spreads it feels like bugs biting you, with a horrible painful itch. I end up on oral steroids, and it took a full month to go away.

Looking back I think my body was telling me at 35 weeks that it could no longer handle the twins growing inside me. At 37 weeks I was crashing, and no one would have done anything if I had not pushed to be induced. I also realize now that a vaginal delivery of twins is a joke. None of the doctors wanted to do it. I was foolish to think I would have a vaginal delivery. I was even told by one of the OB nurses that new doctors are not even taught how to deliver a breech baby. If your baby is breech it is an automatic c section.

I feel that the common practice of having many rotating doctors does not benefit patients. Every week I met someone different, and not one of them really knew me other than the nurses. Each doctor would speed read my chart and check me and the babies heart beats in a matter of 5 minutes or less. The nurses communicated better and seemed more knowledgeable than the doctors.

I feel like I was tramatized by the c section experience. I thought I knew what a c section was, but no one told me all the details of what to expect. My recovery was much harder than with my first two pregnancies. I cannot imagine anyone electing to have a c section.

After all of it, my babies are healthy and that is what counts. But I think some things could have been handled differently.

Comments

[Tina]

Having a vaginal delivery of twins is not a joke...it sounds like this "team" of doctors and the hospital you were at are the real joke. They ignored your concerns and were ill-equipped to deal with something outside their realm of 'normal'. It is a very sad state of the world and maternal health in general when we've gotten to the point where doctors aren't even taught how to deliver a breech baby anymore.
"Doctors don't like to deliver twins without an epidural" that statement alone from the nurse is just agonizing. Exactly who is giving birth here? I am glad that your babies turned out healthy despite the chaotic hospital environment and unplanned c-section. I hope you continue to recover from this traumatizing experience. <3