From the 1st trimester I was pretty sure I wanted to opt for a cesarean section. It is by no means the 'easy way out' and I had done a bit of reading around the subject for the delivery of MCDA (MoDi) twins.
There is no right and wrong way, and it seems that the choice solely lies with the mother. Although some consultants may persuade for a natural delivery if both twins are presented head down.
I was nervous about the discussion with my consultant, as both of my twins had been head down the whole pregnancy. My reasons behind opting for an ELCS was the reading I had done about acute twin to twin transfusion that can occur during delivery. Also the fact that twin 2 could flip around to the breech position, complicating delivery, or resulting in a C section anyway. I know the risks are small, but the risks were still there and it wasn't a chance I was prepared to take! Having to potentially heal two areas of my body didn't appeal to me one bit!
So, the choice was made, and I was booked in for October 18th at the Norfolk & Norwich University Hospital, at 36 weeks + 3 days gestation. As the babies were to be delivered early, a course of two steroid injections was advised a few days before the surgery, to help with the maturation of their lungs. I had also read into this a bit, and know there is mention of links to autism and so on. It is the general feeling that the benefit of proceeding with the steroids outweighs the risk in this instance.
D-Day
I arrived at the hospital before 7am on the day of the surgery. I had followed my fasting instructions, and taken a ranitidine tablet the night before and the morning of as instructed.
I was first on the list that day. However, there was no NICU beds available at the time,in case the twins should need them, so they had to sort that out. I was nervous as I didn't want to go home to have to come back again later in the week as I had prepared myself. But, things like this cannot be helped. I got moved back on the surgery list slightly and two NICU beds became available while we were waiting.
I met my anaesthetist and surgeons first thing, and signed more consent forms and got told the risks of surgery again (not for the faint hearted listening to these). I had a theatre gown and compression stockings (the compression tights reduce your risk of blood clots after surgery) to put on. My husband had a set of scrubs to change into also.
We got called at 10am , and walked down to theatre (take your dressing gown- the theatre gowns are backless don't forget!). In the anaesthetic room that is when everything started to become real. That is really when I became nervous.
Theatre
Everyone was so friendly and the atmosphere was great. A lady held my hand and spoke to me whilst the spinal block was done, and a cannula was inserted into the back of my hand (you get local anaesthetic before it gets put in, but they never gave mine enough time to work first! It just pinches a bit).
My back was sprayed with a cold solution which makes you jump a bit, and covered with some plastic sheet to prep the area. Anaesthetic was injected into my back which was fine, just stings a tiny bit, and the spinal block was injected into my spine. My experience of this wasn't amazing- the injections were fine and you don't feel the spinal block as pain at all, just a very strange pressure feeling in your spine. The young anaesthetist who was doing mine took 8 attempts and 40 minutes to complete , so I was slightly uncomfortable. To check you are numb they run an ice cube down your side and ask a few questions, also they ask you to raise your legs, which you cannot do. It was a bizarre feeling.
Straight away after this (at 10.45am) I was wheeled into an adjoining room which is the operating theatre. Straight away the lights get put on you, and the screen got put up. Little did I know that they got started straight away!
During surgery my blood pressure dropped quite low so that made me feel a bit funny, but was soon fixed by some fluids injected into the back of my hand and goodness knows what else they gave me.
At 10.56am we heard a cry, and baby Thomas was shown to me and placed in a cot to be checked over quickly first, while this was being done another cry was heard and baby George was born at 10.58am, I was amazed by how quickly it all happened once they had got started. They were both checked over, and daddy cut the cord before the babies were given to us for skin to skin. We spent possibly 15 minutes with them at first before they had to be taken back over to be weighed and so on. I thought they were going to be bigger, going by scans at 34 weeks.
Twin 1 (Thomas) was 5lb9oz and twin 2 (George) was 4lb7oz. They were so teeny and so perfect. We were so delighted that they were with us safe, I think I was in shock the whole first day! It went by so fast.
After 40 minutes of putting me back together again, I was wheeled onto recovery (they monitor your blood pressure/ any bleeding and monitoring for post partum hemorrhage and your general well being). I felt very nauseous (I'm guessing from the morphine) I was wheeled back onto the maternity ward (Blakeney at the N&N) after about an hour on recovery.
We had nurses from the NICU come and assess the babies. They were found to have low blood sugar, and low body temperatures. This is quite common for little babies as they use so much energy to try and maintian their heat. It was recommended they bring the babies to the NICU to be checked over. So dad went with them and I stayed on the ward (I had no choice, I was stuck to the bed with numb legs and a catheter attached!)
I was suprised thinking back how out of it I felt. I wasnt prepared for the side effects of the pain relief I was on, and I barely noticed the babies being wheeled away.
I hadnt taken one paracetamol during my pregnancy at all, so I guess drugs take their full effect with me !!
I later found out that the babies were placed on a heat mattress in the NICU , and feeding (nasogastric tubes) inserted to assist with getting some milk into them as quickly as possible. Breast feeding, or bottle feeding uses huge amounts of energy for teeny babies , so this is quite common to need assistance for their first few days I later found out, and keep their energy output as low as possible.
I wished I had known this before as it was something I wasnt prepared for at all. I'll discuss this in another blog post.
I'll also discuss C section recovery in another blog post.
Here are a couple of photos from the theatre when we first got handed our boys!!
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| Twin 1: Thomas |
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| Twin 2 : George |
