Arrival, Part 2: Special Care

Our hospital doesn’t really have a “NICU” per se; it’s a special care nursery for babies born after 34 weeks (we made the cut-off, yay!) or born with some problems that aren’t necessarily life threatening ones. The nursery has lifesaving equipment in case of an emergency, but they couldn’t, for example, keep an infant on a CPAP for a very long time because they aren’t trained for that. If that became the case for someone, they’d have that baby transported down the street to Memorial, where they have a Level III NICU for very sick babies.

So that already makes the place a little different from what I’d expected. I watched videos about babies in NICUs because I knew that twins have this tendency to come early. From what I’d read, 35 weeks was the average, but I was placing money on anywhere from 32 to 36 weeks, regardless of anyone else’s expectations. Towards the end of my pregnancy, the placing money was kind of a “hope” more than anything else because I was enormous and uncomfortable and itching so bad I wanted to peel my skin off with a cheese grater. Of course, nobody ever wants their baby to be sick or to need time in the NICU because, well, it hurts.

But I’ll get to that.

When my surgery ended and I was wheeled back to the eerie room with its pseudo Lovecraftian aesthetic, my twins headed straight for the special care nursery. We got a report later from the nurse who’d taken charge of their care, explaining the treatments they’d received upon arriving there. She explained about babies breathing that it was like inflating a balloon. The first time you inflate a balloon, there’s a lot of resistance, but if you leave a little air in the balloon when you deflate it, it will inflate much easier the second time.

(I don’t know who’s inflating and deflating balloons out there, but I’m here to tell you, friend, that is not how you use a balloon)

Baby lungs are the same way, but when babies are born before their lungs are completely mature, they can just expel all of the air from their lungs, which means that although breathing still happens, each subsequent breath is as difficult as their very first, and they get very tired, very quickly. The solution is a CPAP machine, or one of several other methods of forcing air into the lungs and keeping it from all escaping completely. “But we don’t have a longterm CPAP machine here,” the nurse-or-doctor explained (and apologies that I don’t remember; I was kind of still on a lot of drugs when she talked to us), “so if they do need that–and they don’t yet, but if they do, we’ll have to send them to Memorial.”

She told us other details about the twins’ oxygen saturation and CO2 saturation and how they were working to balance that out, but assured us that they were really strong and healthy for 34-week-old twins. “And big!” she added and laughed. Isaac topped out at 5 lbs, 12 oz and 18.75” long, while Carrie tipped the scales at 6 lbs, 1 oz and 18.5” long. They didn’t necessarily fall into the category of MAHOOSIVE, but for perspective, another 34 weeker came in about four days after they were born and weighed in closer to 4 lbs. So they’re not delicate for their age either.

But the twins were alright; that’s what I gleaned from the entire conversation, even though my head was swimming and I couldn’t feel or move my toes. The trouble was that I’d have to wait to see them for several more hours, as jumping right out of bed after major abdominal surgery isn’t the best idea of all time.

Kyle got to see them first, and I don’t begrudge it of him because he took pictures and videos for me. By the time he got there, both babies were breathing room air and sleeping, as exhausted by the ordeal as I was. They had so many wires and tubes and IVs hooked into them that they looked sort of like they were part of the Matrix, but of course, they weren’t.

And they were so pink, too, healthy and pink. I held onto that quite a lot over the next several hours as my nurses changed shifts and I faced the big requirement for going to see them: peeing.

(I’m going to tell the story of my first time peeing after the surgery later, because I want to write about the twins now. Aren’t you so excited to read about me peeing? I know you are)

The peeing thing happened at around 4 a.m., and I was exhausted and dizzy and my eyes kept closing and I hurt everywhere, but I DIDN’T CARE because I literally would have walked barefoot on a mile of Legos to see the babies at that point. And thankfully, the hurty part ended quickly and with me sitting in a wheelchair and wrapped in blankets, like the sickly character in a novel that takes place in a time when ladies wore really large dresses. And it was 4 a.m. and Kyle was half asleep and I was half asleep, but we still all wheeled down the hall, merry as can be, to go and see the babies and to finally have skin-to-skin contact with them.

Skin-to-skin contact is one of the most important things you can do for your baby in the first hours of their life: it helps them to regulate their breathing and body temperature, it helps with bonding, and it’s just an emotionally uplifting thing overall. If the twins hadn’t been preemies, I’d have spent the first two hours of their lives holding them both against my bare chest, letting them feel my heartbeat and warmth, smell my skin, remember me. It’s what I did with Sam, and something we practiced very frequently even after he left the hospital. Kyle did it as well, and I honestly cannot emphasize how much it meant to me, how much good it did, and how much I’d wanted to do it again with the twins.

But I didn’t get the chance until 4 a.m.

Still, at 4 a.m., I took the fucking chance. I was too tired and too eager to really care who was seeing me with my hospital gown flapping down about my waist after the nurses helped me to unsnap it. They closed curtains around the twins’ corner (they have their own corner of the nursery because there are two of them and they’re both in incubators), but honestly, a parade of leering assholes could’ve marched through the nursery and gawked at me and I would not have cared from the second I held each of my babies against my chest.

(this is very sappy and crunchy, like eating a tree)

And then we had to leave. They were too small and delicate to be out of their incubators for very long, and I needed my rest and my medication. Before we left, though, the nurses explained all of their lines and wires to us. The twins each had monitors checking on their heart rate, breathing rate, and the oxygen saturation in their blood. They had IVs in their hands, delivering liquid nutrients and calories to their tiny bodies, since they were still too unstable to try eating from a bottle. They had little thermometers giving feedback on their temperature. They were wrapped in hospital blankets, and they had those funny striped hospital hats on their tiny heads.

Which was something I couldn’t stop thinking about, even after we left: how tiny they were. Now, mind, they’re pretty big for 34 weekers, as I’d said before; but I also have to point out my basis for comparison, which is Sam.

When Sam was born, he wasn’t one of those monster babies that you see on the news where they look like they already know how to drive a truck and sing baritone, but he was still a very respectable 8 lbs, 11 oz and 20.5” long. He’d already mostly sized out of newborn clothes and was definitely too big for newborn shoes, bringing to mind the saddest six-word story ever written:

For sale: baby shoes, never worn.

That was written by Ernest Hemingway, and it’s objectively sad until you realize that the reason the baby shoes were never worn is because the baby had unexpectedly ENORMOUS feet, and that baby was Sam. I still remember reflecting sadly over a pair of fuzzy monster shoes I’d bought right after we found out he was a boy. They were too small. He never wore them.

So that’s my basis for comparison, a baby too big for baby shoes and newborn clothes, not monstrously huge but definitely never tiny.

And here were these little peanuts, big for 34 weeks, but compared to their brother and most newborns I’ve held, absolutely teeny. Teacup sized. Their heads and hands are so tiny, their noses are eensy, their ears are weensy, but what gets me the most is their feet. Their feet are SO SMALL. It’s absolutely ridiculous! Each foot, each of the four baby feet, is the length of my thumb. I do not have long thumbs. In fact, they’re kind of stumpy. And my babies’ feet are smaller than my thumbs.

Their feet also do not fit in the baby shoes, but this time because they are far too SMALL.

Anyway. We had to leave. And the next couple of days became a sort of confusion when it came to visiting the nursery. When you have a healthy baby, you can go down to the nursery and see them and hold them and love on them any time. You can request specifically that your baby is brought to you for feedings; if you’re in a baby friendly hospital, your baby will be there anyway. You can hold them while they sleep, you can hold them while they’re awake, you can change their diaper any time and let their siblings and grandparents and aunties and uncles and cousins hold them, and it’s grand.

You can’t do that with NICU babies.

NICU babies, you see, need to spend a lot of time in incubators when they’re very young because they can’t figure out how to regulate their body temperatures yet. You can theoretically keep the overall room temperature really high and hope that works for them, but it’s usually not high enough, and if they start to get cold, things go downhill quickly.

So they stay in incubators except for brief visits outside when they’re being examined or eventually fed. And in theory, the outside visits happen roughly every four hours (side note: dear nursery, thank you for getting my babies on a schedule long before we could ever hope to do so at home), but sometimes there’s a checkup you didn’t know about or sometimes the babies wake up early or sometimes you’re trying to get there on time but you keep getting cornered by medical personnel wanting to check your incision, and by the time you get there, the NICU nurses just smile apologetically and say, “Oh, we just finished with his feeding and put him back to sleep. He needs to rest now.”

And this also hurts.

Because you want what’s best for them, you want them to get the best possible chance, but knowing that you missed having them in your arms by that much is a bit like a punch to the face.

This really only stayed a problem while I was still at the hospital, and even when I couldn’t hold them, the nurses gave me all the news of their progress. Carrie has been progressing the fastest, but Isaac hasn’t been far behind, except that he has a fondness for what they call “bradys.” Bradys, where preemies are concerned, are times when the baby’s heart decelerates, and they can happen for any number of reasons. Isaac’s preferred reasoning is that he’s hungry and drank his bottle too fast, and that somehow makes his heart rate drop, which in turn makes his oxygen saturation plummet (this is called a “desat”), which in turn makes his mother freak the fuck out when she’s trying to feed him, even after the nurses easily get him back to normal and tease him for being such a brat.

Not that this, you know, happened to me yesterday or anything.

Now that I’m out of the hospital, we plan our visits and coordinate with the nurses, so they’ll know that we’re going to be there for the noon feeding or the 4:00 feeding or something along those lines, and they’ll make sure to try and postpone the feeding until we get there. Even if they can’t (read: Isaac is screaming and Carrie is kicking the walls of her incubator), they make sure to put off as long as possible so that we have a chance to at least hold them and rock them and change their clothes for the day.

(changing their clothes is illogically one of my favorite things because it makes them seem so normal and so like they’re just at home, and I need that)

They’re showing real bits of personality, too, different on some levels from what I got used to when I was carrying them, but familiar as well.

Isaac has two modes: enrage and asleep. If it’s taking too long to get him his bottle, if he feels like he’s not getting enough attention, if he needs a diaper, he’s enraged. And oh, that boy can scream. He goes from zero to RAGING in about 0.04 seconds flat, and he’s got lungs on him. Usually, the incubator walls muffle the babies’ crying somewhat, but not Isaac. He has a problem, and you WILL know about it.

But then when the problem is solved, he mellows out so easily and reaches this incredible state of peaceful bliss, especially with me or Kyle. He wants to be comfortable more than anything, so if he’s getting the attention he wants and snuggled up with someone he loves and has all his needs met, it takes another 0.04 seconds for him to fall right asleep and sleep so soundly and deeply that, yes, he occasionally had bradys in his sleep.

He also belches like a trucker.

Carrie, on the other hand, doesn’t really scream or cry that often. She’s more of a fusser, kind of like Sam was. If she’s not happy with her circumstances, she’ll give her own little cries, which are more of polite protests than anything else, but will immediately stop once things stop being weird. She’s far more interested in looking around and taking in the world around her, as much of it as she can see. When you hold her, her eyes just stay WIDE wide open and drink in everything, especially you.

She vacillates with how she does on feedings, and her feedings have a lot more variety than Isaac’s. Sometimes, she’ll just sip at 25 ml and be done; other times, she’ll chug 45 ml before you know what happened. She’s not a belcher, nor often a burper, which gets frustrating at feeding time, because you need her to burp in order to make room for more food, but nope. She prefers to just look up at you and will actually use what little neck strength she has to pick up her head and turn it to face you if it’s not already doing so (e.g., when you’re holding her forward and getting her to burp). And when the nurse can’t get her to eat anymore and I can’t get her to eat anymore, it seems to help a great deal when we get Kyle on the phone. She’s a daddy’s girl already.

They’re both such delights, honestly, and leaving them is the worst part of the day, even when you know that it’s just another day closer to when they’ll come home. When it’s time to leave, I’ll have packed up their dirty clothes and picked up their diaper bag, and they’ll both be tucked sweetly back in their incubators. They have blankets from  home now, muslin ones, that I slept with one night so that they would be saturated with my scent (which sounds creepy and weird, but scent is pretty much the only reliable sense they have right now). They’ll both be asleep or mostly that way, but because they’re in the incubators, I can’t really touch them, so I tap the glass and tell them to be good and that I love them and that I’ll see them tomorrow.

And then I go, and I thank the nurses on the way out, and I make jokes even though part of me is staying behind. I press the silver buttons that let me out of the maternity ward, after I have one of the nurses validate my parking ticket, and I ride home with Kyle because I can’t drive yet.

And sometimes, like yesterday, I go home and I cry and I cry and I cry because I know they’ll be home soon, but goddamnit, soon isn’t now, and I’m very childish and temperamental when it comes to having all of my babies under one roof and within easy access of my arms.

Rumor has it, though, that we’re just a few days out. Rumor has it that Isaac is getting off the monitors, and that afterwards, he and Carrie can both try sleeping in cribs instead of incubators. Rumor has it that we need to bring their car seats in for a car seat safety test (where the nurses make sure that they have the neck strength to not suffocate themselves in a car seat), and rumor has it that once they’re in cribs, it’s only another couple of days until they’re home with us.

And I really hope that rumor is true.

Arrival, Part 1: Actually Arriving

In retrospect, I could probably write a long blog entry about the signs of early labor I’d been dealing with for several weeks by the time I went into the hospital on the morning of Wednesday, March 14, because as it turns out, I’d been dismissing a lot of things that I shouldn’t have been: actual contractions, loose stools, pelvic pressure, the works. For as much as I fancy myself knowledgeable on topics of pregnancy, labor, and delivery, I actually was completely clueless when it came to recognizing that I’d been in early labor for several weeks.

BUT this is already going to be long, so I’ll just fast forward to Tuesday.

Tuesday, March 13, we had a nor’easter here in the Commonwealth of Massachusetts. It was the third in less than three weeks, and everyone had a feeling of fatigue when the forecast called for a whole bunch of snow on top of the stuff we’d gotten the week before. Sam’s school was closed for the day, Kyle was working from home, and I was adamant that I absolutely would not go into labor that day.


Not that I had a lot of reason to believe I’d go into labor so early, of course. Despite my immense discomfort, my pregnancy had been smooth and healthy, and the twins were growing steadily enough. I itched like hell and was begging for my bile acid test to show that I had ICP so that I could start receiving treatment for it, and of course I had the aches and pains to be expected with carrying twins, but I had no reason to suspect that I’d be delivering them any earlier than overall vague guestimates of 36-38 weeks. I expected Easter babies, I expected several more weeks of misery, and I expected my body to listen when I demanded that it NOT go into labor in the middle of a snowstorm.

And, well, I didn’t, but I was uncomfortable. The discomfort was nothing new, but I just felt overall unwell, tired and full of malaise. Both were easy to chalk up to late pregnancy misery, but late pregnancy misery or no, I was relieved when it was finally time for bed.

I’ve mentioned before that falling asleep while so enormously pregnant is a difficult process, and on Tuesday night, it was no different. I rolled and I shifted, I stretched and I turned, and eventually, I fell asleep on my side, facing a gently snoring Kyle. And I’d been sleeping pretty well, too, until around 2:30 a.m. Kyle’s hand must have fallen from wherever it was resting as he slept, and it gently thwacked me in the belly, jolting me out of sleep (as even a gentle jolt against that belly is enough to shock me into consciousness). I sleepily berated him and then began the difficult task of walrusing myself out of bed to use the toilet.

Because when you’re that pregnant, you always need to use the toilet.

When I got back to bed, I settled down in my sleeping nest and was immediately greeted by hip-to-hip pelvic pain. It was pretty bad–a six or seven on a scale of 1-10.

a-better-pain-chart(per Allie Brosh’s fabulous chart, I saw Jesus coming for me)

Still, I dismissed it as round ligament pain for the most part. The entire team who’d cared for me throughout my pregnancy had warned that, especially when you’re carrying twins, round ligament pain can be excruciating. I’d just gotten up and shifted my position, which logically had shifted the twins’ position and thus the position of the pain. The fact that I managed to fall asleep within ten minutes seemed to further my conclusion that I wasn’t really in labor, that it was just regular aches and pains, that I’d be fine by morning.


Morning came as it always does. Sam woke Kyle up, and the two of them started to head downstairs in order to let me sleep a little longer (until 8:30; it was 7 at the time). The trouble was that I couldn’t fall back asleep because the pain was still there, just as bad as it had been at 2:30 in the morning. I shifted and rolled and tried to calm it down with positional changes, but it persisted. Still, I didn’t want to call it “labor” because it didn’t feel like contractions–the pain wasn’t coming in waves or intensifying and releasing. It didn’t take breaks; it just hurt. At that point, I thought I’d just really aggravated the muscles, but I still wanted to call a doctor, just to be sure.

So I called Kyle up. “Don’t start freaking out,” I told him, “but I’ve been cramping since 2:30 a.m., so I’m going to call the doctor if moving around, eating breakfast, and drinking water don’t help.”

To his credit, he kept his freak out internal as I shuffled downstairs and slowly ate breakfast. He got in touch with his boss and said that he might not be in that day. I gently urged Sam away from my lap and ate, still not noticing any ebbs and flows in pain like you’d expect from contractions, but instead noticing that the pain was lessening the longer I sat. Not lessening, however, were the number of Braxton Hicks contractions I started feeling.

Braxton Hicks contractions, for the uninitiated, are painless “practice” contractions the uterus goes through in the last several months of pregnancy. The uterus tightens and releases, but the contractions do nothing in terms of thinning or shortening the cervix, so these contractions don’t require medical attention. They’re annoying and can be pretty intense, but they’re not a sign of anything going awry.

And I was having them Wednesday morning, but they weren’t at regular intervals, and they certainly weren’t painful. Intense, yes: the way the muscles in my abdomen tightened left me entirely breathless and unable to do much until they relaxed. But painful? Not even close. It was like involuntarily trying to deconstipate or lift a heavy object; again, not painful, just a lot of effort.

I finished breakfast and excused myself from the living room, where Sam was pretty engaged with his movie (Moana, maybe? I was a little focused at that moment). I intended to sit at my computer and google my symptoms while calling the nurse line and making sure that my phone had some good labor playlists on it, which was one of my last checklist items. To my annoyance, my computer had decided to install updates overnight, so I watched it balefully while chatting with the nurse line and coming up with a plan of action.

Initially, the on-call nurse suggested that I go to an appointment at their Westborough office to get checked out. Because the pain wasn’t strong and rhythmic, she said, it didn’t sound like labor, so a quick appointment would probably help me figure out what it was and end with me going home to rest and drink water. She’d talk with the physician assistant on call to make sure, but she said it just sounded like I needed a quick once-over and that I’d be fine. My appointment would be at 9 a.m.

I got up and started pulling myself together, texting my mother to ask if she could watch Sam for a little bit, telling Kyle that he should probably hold off on going to work for at least the morning, and planning to just drive myself the half hour to Westborough and get checked out on my lonesome. Five minutes later, the nurse called back after speaking with the physician assistant. “She thinks you should go straight to labor and delivery,” the nurse explained. “It’s probably nothing, but since you’re expecting twins and since you’re 34 weeks along, she just would rather have you there, just in case.”

Alright, cool. I got off the phone and told Kyle and my mother (over the phone in a different conversation) of the change in plans. We’d drop Sam off at my mother’s house on our way to the hospital, in Framingham, and then pick him up later today or tonight, depending on how long they took to monitor Isaac and send us home. “Just in case,” I gave Kyle a list of things to pack in a labor bag, like our chargers and a bathrobe for me and so on. I went to help get Sam get dressed.

Five minutes later, the phone rang again. This time, it was the doctor at the hospital where we’d planned to deliver. “How far are you from here?” she asked. “Because the roads aren’t great, and if this is an emergency, we don’t want you to have to travel far. I see that you have two hospitals closer, Saint Vincent’s and Memorial. Saint Vincent’s is actually our affiliate, so why don’t you go there?”

COOL. I told Kyle about the new change in plans, passed the information along to my mom, and bundled everyone up in the car. I kept my phone in my hand, just in case they called again, and we sped along the highway for the ten minute drive between our house and Saint Vincent’s.

(you may wonder why we weren’t going there in the first place, and in fact, I had Sam at Saint Vincent’s, and it was a great experience. This time, I’d been more interested in following my OB-GYN, even though it meant a longer drive to an unfamiliar hospital, so heading to Saint Vincent’s again was… off-book, to say the least)

My mom met us up at registration, where the Braxton Hicks contractions hadn’t really let up and were keeping me from concentrating on the questions at hand: things like emergency contacts, insurance, and so on. We hadn’t planned to deliver at this hospital, so we weren’t preregistered or anything, and every question and signature only served to make me appreciate the preregistration process more. After what seemed like hours of paperwork, but was really only a few minutes, the registrar set me free and found me a wheelchair, which Sam desperately wanted to ride in. We denied him this and instead distracted him with the fancy glass elevator between floors.

Once off the elevator, our motley crew wheeled through the hospital’s grand atrium (complete with birds, trees, and a working waterfall) until we reached the Center for Women and Infants. Our party split there–Sam and my mom went to the waiting room while Kyle and I continued on to one of the labor and delivery suites, the one in the farthest corner of the hall.

The room itself embodied the unsettling sort of Lovecraftian aesthetic that’s so familiar in our part of the state, for better or for worse. The walls had a sort of mauve-and-seafoam Victorian border against beige “texture,” broken up only by a large picture of babies in hats. Jesus stared down at us from a silver crucifix–after all, it’s a Catholic hospital–and something about the decor gave the flavor of a turn-of-the-20th-century asylum more than anything else. The view of bricks and snow and the grey light from outside the frosted window only added to the eeriness, and I laughed with Kyle at the sight. Wouldn’t it be funny if I really was in labor and this was the where of it all?



Every trip to labor and delivery begins the same way. Once you’ve been admitted, the nurses send you into the bathroom, where you pee into a cup, take off all your clothes, and change into a gown that is in no way large enough to cover you. You’re lucky if it ties at all, enormous belly considered. You’re also lucky if they remember to give you a plastic baggie of slipper socks (I was not lucky on Wednesday, at least not to start). Once this is all done, the nurses return to you and place monitors the size of whoopie pies all over your belly to monitor your kids and your contractions. This is uncomfortable, but definitely not the most uncomfortable experience of the day.

It’s even more uncomfortable when you have one twin who is just completely disinterested in being monitored ever, ISAAC.

The nurses found him eventually, though, and I explained my situation to about 50 people coming in and out of my room to do various things–take my blood pressure, give me an IV, ask me what was going on, ask me how far along I was, introduce themselves as Nancy (I had three Nancys helping me at one point). At length, the nurse midwife on call came in, introduced herself, and performed a pelvic exam, which felt like the fist of God. I figured this would be the thing to send me home–that she’d have reached up into my tonsils and come down with the conclusion that I wasn’t dilated at all, that I just needed to poop, and that I could go home.

As I writhed on the bed and grimaced and Kyle watched me and eventually remarked, “That didn’t look like fun,” the midwife hummed and finally withdrew her hand. “You’re about 60% effaced and at a -1 station, and you’re also about 4 cm dilated.”


And now, a lesson on dilation, effacement, and labor.

In labor, the muscles on the sides of your uterus contract to thin out, or efface, your cervix while simultaneously opening, or dilating, your cervix. The goal is to reach 100% effacement and 10 cm dilated, which can take anywhere from hours to weeks. Over the course of this process, your muscles also ease your baby, or babies, into the birth canal–their station is a determination of how close they are to birth, with -5 being “nowhere near the birth canal” and +5 being “actively being born.”

Dilation is the number most people are familiar with, and it’s also the number doctors use to determine whether or not you’re in active labor. Most won’t send you home once you’re past 4 cm dilated, and suddenly, there I was, having no idea that I’d been dilating at all and being told that this, this was it. I was 4 cm dilated, and because of the twins’ gestational age, they weren’t going to do anything to stop it. I was having two babies, and I was having two babies on that day, Wednesday, March 14.

This is, I believe, the third time during this pregnancy that a surprise revelation has caused me to say, very loudly, “Holy shit!”

Knowing that I was in active labor, everyone picked up the pace. I got a bag of fluids to start my IV adventure, and the doctor on call wheeled an ultrasound machine into the room to double check Isaac and Carrie’s positions, the latter of whom remained breech. The midwife also came back to do my test for Group B Strep, which I’d not had done yet because, again, 34 weeks pregnant. Nobody really expected me to go so soon. While I was being poked and prodded and having my dignity slowly removed (it’s kind of a burlesque routine), Kyle took charge of calling and texting everyone to let them know that hey, babies were coming TODAY, surprise!

Partway through the tests, the doctor came into the room with me and sat down next to my legs on the bed. “So we have a few options here,” she said. I liked her a lot from the get-go; she was young, with a broad smile and the most gorgeous dreds I’ve seen in my life, dyed a golden ombre. She also had the matter-of-fact attitude that I appreciate about doctors, and a sense of humor about the whole thing. “Because Baby B is breech, we normally wouldn’t be able to give you much–you’d have to delivery by Caesarian. We do have a doctor here today, though, who specializes in breech deliveries. So we could let you labor through and try to deliver Baby B breech. We could also have you labor through and then attempt an external cephalic version after Baby A is born–that would just mean me pushing on your stomach to try and get Baby B to turn head-down for delivery. There’s no guarantee either of those would work, and in both cases, that would mean a C-section. You also have the option of just going for the C-section from the get-go. It’s all in your hands; whatever you want to do, we’ll support you, because the babies are both healthy and responsive, and you’re young and healthy as well.”

This was objectively refreshing. There are a lot of stories around the internet as a whole telling of forced C-sections, cascades of interventions, and painting doctors as pushing women into unnecessary C-sections for a variety of reasons, depending on how conspiracy theory you want to go with these things (liability, money, the Illuminati told them to, etc.). And I’m not saying that sort of thing never happens; I’m sure it happens plenty and in plenty of places around the country.

But. Having a C-section presented as my choice, having it be my choice, was really refreshing amidst those stories. It set the tone for the entire experience: even though a C-section is a situation in which you literally have no control over a lot of things, the medical team made sure I had control over this one thing, and that helped so much.

So I chose the C-section. I love delivering vaginally; it’s a huge rush, and I’m damn good at it. With Sam, it took me all of 45 minutes of pushing and he was out and home free. I know I could probably do a breech delivery, especially of a pre-term baby, and I know that I could cope with the discomfort of a version if I had to. But all that said, the idea of going through all of that, of laboring and laboring and trying these methods and having one fail and needing a C-section anyway? I hated it. A C-section was never my ideal, but in that moment, I knew it was the right choice for me, and I told the doctor as much.

And thus the prep began.

My C-section was tentatively scheduled for somewhere between 2 and 4 p.m., leaning closer to 4 p.m. so that (a) my breakfast would digest, and (b) the steroid shot given to help the twins’ lungs mature even a little bit more could take effect. A steady stream of people flowed in and out of my room, everyone doing something different, having me sign a different form, telling me details of a different facet of the procedure.

(Kyle sneaked out to get a slice of pizza and some coffee somewhere in there as well)

I got bags of antibiotics, both because of the surgery and because we didn’t know if I was positive for GBS or not. I got more fluids. I got another cervical check, confirming that I’d dilated to nearly 5 cm. I got a nice shave–of my bikini line. I got to meet Joe, the nurse anesthetist, who had me sign an entire book of papers. I signed that book of papers. I signed some more papers about surgical consent. I signed more papers about drug testing (standard procedure for preemies). I had a third cervical check, confirming I was at 5.5 cm.

Around 3:45, another nurse anesthetist (Nancy, not to be confused with Nancy the admitting nurse or Nancy the baby monitoring nurse) brought me a cocktail of drugs to stave off the nausea I’d normally have experienced with anesthesia. I choked down something impossibly bitter while another nurse gave Kyle his own set of scrubs, complete with hat and booties. Another nurse rolled a pair of slipper socks onto my feet, and another wrapped a sheet around my shoulders like a robe. I heard another woman give birth across the hall, and I applauded, though I don’t think she heard me.

Nancy the Nurse Anesthetist and another nurse (possibly also another Nancy, I lost track) served as my escorts as we left the labor and delivery room and made our way down the hall to the operating room. I’ve been in my fair share of operating rooms before, especially considering my history with IVF, but this one came as a pleasant surprise to me. Sure, the table and room overall were cold and sterile, but something about the two radiant warmers set up and covered with blankets settled my nerves. They seemed to say, nothing bad will happen here today. Today, this room is a room of life.

At Nancy the Nurse Anesthetist’s instructions, I heaved my walrus body up onto the operating table, my butt as far back as I could manage without actually falling off (wouldn’t that have been an adventure?). Once I’d settled, she introduced me to Sergei, another anesthesiologist, who would be monitoring me. Sergei’s job, at that point, was to keep me from moving or being too uncomfortable as Nancy gave me my spinal block, a sort of epidural on steroids that essentially turned off my entire body below my stomach. Sergei didn’t completely succeed: the spinal block still briefly felt like someone driving knuckles into my vertebrae, but at length, a warm sensation flooded down through my back and legs, and I felt insanely dizzy. Sergei and Nancy lowered me onto the table, and my legs disappeared from existence.

Well. That’s not true. I felt my legs. I felt my entire lower body. It just felt like instead of existing as things that could be moved on their own or used, they were all wrapped in a heavy blanket, warm and comfortable. The weird part was that I couldn’t move my legs or wiggle my toes, no matter how hard I tried. A lot of people would logically find this weird or frightening; I thought it was hilarious that I was putting so much brain effort into something so simple, mostly because I knew it was temporary.

Anyway. I couldn’t wiggle my toes, and soon, I couldn’t see anything below my chin, as the medical staff placed a huge blue sheet so close to my face that I kept inhaling it. Nancy the Nurse Anesthetist clucked her tongue at this. “I always tell them to put it a little farther down; it doesn’t need to be in your mouth,” she scolded nobody, moving the sheet away from my mouth. Meanwhile, below the sheet, someone remarked to me, “Abigail, this is going to feel like sandpaper, alright?” And then I felt no sandpaper, just someone rubbing my belly a lot. The rubbing didn’t stop and eventually turned into more of a rocking as my doctor arrived.

“Are you going to pinch me to make sure I can’t feel anything?” I asked nobody in particular, remembering what I’d seen in educational videos on C-sections. My doctor smiled at me over my sheet; or I assume she smiled, because she was wearing a mask.

“I have been,” she assured me before returning to her work. A moment later, Kyle came in, though I couldn’t really see him because of his placement and my position. Still, I gave him a cheerful smile.

“Hi honey!” I said. “I can’t feel my feet!”

“I saw your guts!” he answered in as cheerful a tone. “They’re yellow!”

Because, as it turned out, they’d already begun the surgery before he came in. I was mildly disappointed–he’d brought my phone with him so that I could play my C-section playlist, which started with Weird Al’s “Like a Surgeon”–but hey, it meant he got to see my guts. That’s a privilege not many people have experienced.

(and as he said saccharinely later that night: “Now I can say with all honesty that I love you from the inside out.”)

Someone warned me of pressure and tugging, but I didn’t feel anything different, and then before I knew what was happening, I heard a cry: angry and small and demanding to be heard. “Isaac,” Kyle confirmed, and I started to choke up.


“He’s crying,” I said. Hearing your baby cry right when they’re born is such a relief, especially if that baby is being born early. Crying means breathing. Crying means that air is coming into and going out of their lungs. Crying means that, even if just for this moment, your baby is alright.

And Isaac was crying.

And before I could get over that emotion, I heard another cry, this one an angry kitten. “Carrie,” said Kyle, and I cried again. Carrie’s warmer was within my field of vision, and I watched a half dozen nurses surround her, rub her, and start to care for her.


I couldn’t look away, even though my neck started protesting the position after only a few minutes. I didn’t know or care what was happening below the blue sheet. I didn’t mind at all that my upper abdomen was being used as a repository for tubs and tools and the like. I just wanted to see my babies and see that they were alright. Someone placed a mask over Carrie’s face, and I knew that she was receiving oxygen, and that was good. The doctor poked her smiling head over the sheet again. “We’re about 75% done with you, alright? You did a great job, just hang in there.”

And then came the twins, Isaac first and then Carrie, both bundled up in blankets and hats, both amazingly pink, even pinker than Sam had been when he was born. I kissed them both on the cheek, touched their soft skin, told them I was there and that it would be alright. And then they were gone, off to the nursery, and Kyle and I sat in the OR and waited for my stitches to be complete.

“You did a great job,” everyone kept saying, and I wanted to laugh. A great job at what, lying immobile on a table? If I’d known that was all I had to do to get such high praise, I’d have started inviting observers to my naps a long time ago.

They took the blue sheet down, and I could see the doctor fully now; she was spattered with blood, but she looked pleased. “Everything went really well,” she said. “Great job, mama. Those are some really healthy babies, especially for their size and age.”

A handful of nurses concurred. One said that the twins had the healthiest umbilical cords they’d ever seen: “so thick and coiled and full of nutrients. Good job mama!” I thanked them for this, though again, I had NO idea what I might have done to construct such awesome umbilical cords. I still don’t know what I did, but if I ever find out, I’m 100% going to market it and get super rich in a Gwyneth Paltrow GOOPy sort of way. Shoot, I might just pretend that I know what I did and market it anyway, like maybe I’ll say that it was because I ate so many Milano cookies and I’ll sign a deal with Pepperidge Farm and everyone will buy Milanos because (a) delicious and (b) really healthy umbilical cords!


The nurses rolled me out shortly thereafter, and Kyle trailed along behind on the path back to our eerie room, where I took my first steps of recovery and we started to learn how the twins were doing.

But that is another blog entry altogether.