Our Twin Birth: Deciding on a Birth Place, and The Voice of Love

My maternal grandmother is a fraternal twin—“Joan and Geoff”—so in the back of our minds we knew there was a slim possibility we could one day conceive twins. But when you decide to go for Baby #2, you never really think you might actually conceive Baby #2 and 3.

With our first daughter, we confidently made the researched decision to birth at home. Though Sophia’s 24-hour labor and birth were full of twists and turns, and she was a big baby for my 5’2” frame (9 lbs, 5 oz), our midwives Heather Hilton and Salli Gonzalez handled every element with patience, skill, and grace. In the end, we saw that home really was the safer place for Sophia to be born; we were able to avoid unnecessary interventions and have a healthy birth in the peace and comfort of our own surroundings.

It was a no-brainer for us to return to Heather’s care when we happily found out we were pregnant a second time. At my first prenatal around a sure-of-my-dates-8-weeks, while palpating my uterus, Heather raised her eyebrows and said I really felt more like 13 weeks. Measurements concurred. I’m pretty sure I looked like a deer in the headlights. “What are you implying??” I demanded. Excitement and fear all at once. She calmly and good-naturedly replied that we would just keep an eye on things and see where I was at our next visit.

John and I went together for our 13-week appointment, a couple days before Christmas, and sure enough—I now measured 20 weeks. I was amazed how easily John was taking it all in while I vacillated between joy and panic. Heather asked if we’d like an ultrasound to confirm her suspicion of twins, and we eagerly agreed. Moments later, we were staring at a screen with two tiny babies in separate sacs, active and healthy. I will never forget that moment—John and I staring at each other in disbelief…so much laughter and so many tears. Heather asked if we’d still like to pursue home birth with her and I immediately replied, “Of course. There’s no one I would trust more.” She told me I should expect to go to my due date and counseled me nutritionally to ensure it.

Since our “in-the-caul birth” has gotten a lot of press recently, a lot of people have expressed how impressed they were by our choice to birth twins at home. I’ll be honest, though: while the decision seemed clear at first, I really struggled throughout the pregnancy over whether we were doing the right thing.

Twin pregnancies have the potential for more complications, so Heather wisely sent me to a perinatologist on a regular basis for growth scans and biophysical profiles. Even though the doctor I saw is known for being supportive of home birth for low-risk moms, he was adamantly against me birthing twins at home. He was full of horror stories and worst-case-scenarios about the complications he’d seen delivering twins; he told me that half of his twin moms don’t stay pregnant past 34 weeks and most of the others by 36; and he treated me like an idiot for believing my nutrition had any bearing on the health of the babies or length of gestation. When Baby B turned breech after 32 weeks, he couldn’t fathom how we could be moving forward with our plans. He asked how our midwife would handle the breech baby, and I told him she believed Scout could turn after Toby (Baby A) was born. He scoffed that that would never happen. I replied that if it didn’t, we felt comfortable delivering the second baby breech, since breech presentation is a variation of normal. In addition, Scout was healthy and consistently measuring 2 lbs smaller than Toby, and I was sure he’d “pave the way” for her easy birth. Did I mention I’d birthed a 9 lb 5 oz baby as a first-time mom? I had this in the bag.

Nonetheless, I left every perinatologist appointment feeling defeated and stressed, which was really a shame because each sonogram confirmed that the babies were growing perfectly and thriving, and my pregnant body was supporting them beautifully. To cover all my bases (and probably a little out of self-doubt), I decided to interview OB’s about birthing in the hospital. I am a birth doula and work regularly with many OB’s around town, so I knew that even of the small handful I would agree to delivering my twins, only one might be open to not inducing if I went beyond 38 weeks, and to delivering out of the operating room. Upon interviewing him, he said we would just keep an eye on things, “but twin moms never go past 38 weeks.” Many OB’s, if they even agree to a breech twin vaginal birth instead of surgery, will pull the baby out by its legs or reach in to turn it; this particular doctor said he would break her amniotic sac to speed her birth. In general, he was warm and amenable about most things, and John and I seriously considered switching. My mind wandered to the four midwives who planned on being at our home birth and their vast skill at delivering many variations of normal birth without intervening.

Back at my usual prenatal, I confessed to Heather that I was having doubts about being at home for the birth. I was so afraid she would be offended or that her feelings would be hurt, but she immediately responded with love–“Lindsey, no matter where you birth, I will be right by your side supporting you.” She handed me tissues as my eyes welled with tears and told me that empowered birthing isn’t about where you have your baby, it’s about making an informed choice about what’s right for you and your family.

This woman. What a saint.

Over the following weeks John and I wrestled with this incredibly difficult situation together. We felt a lot of social pressure to birth in the hospital. If something goes wrong in the hospital, you get a free pass that “you did all you could,” even if it’s the result of negligence or some unnecessary intervention! But if something happens at a planned home birth, you’re an ill-fit parent. This phenomenon is disturbing and unfair, and yet we were dealing with its reality. We talked. We prayed. We researched. We sought trusted friends’ opinions. We talked some more. Suddenly I was 36 weeks and had to make a decision… Nothing.

And then, for some reason, it was just clear to me. I was driving home from another wonderful, encouraging prenatal at Heather’s birth center, and I found myself praying that I could become more like this humble, intuitive, pure-hearted midwife. I realized that of all the offices I’d been to, of all the birth professionals I’d met with, I only felt peace when I was with Heather. She knew me. She knew our babies. She even knew upon first touch that we were having twins! In my heart, I believed that she could be trusted to deliver our children in not only the safest way, but the most beautiful. And once I committed to that decision, there was peace in my soul. John agreed and was completely supportive.

Sure enough, I went past 38 weeks. In fact, I went past 41 weeks. And there was no pressure from my care provider about induction! Of course, the perinatologist had been on my back since 36 weeks about getting these babies out (for no apparent reason), and at my 40 week sonogram expressed concern that my uterus was getting overextended. The uterine lining was indeed beginning to thin, but when I asked how thin was too thin, of course there was no definitive answer. The worry was that I would lose the ability to contract effectively.

So, just in case, at 41 weeks and 1 day, on July 6th—after virtually no signs of labor—I made a good old-fashioned castor oil root beer float for a post-lunch dessert. Yuck. But sure enough, I started getting a little crampy around 6:30 p.m. John called on his way home from work to see what I wanted for dinner and I had to put the phone down to focus on my contractions. I could hear him frantically calling through the receiver—“Are you in labor?!” In a surge of hormones, not really knowing why, I just started crying (even as a doula, I wasn’t recognizing active labor!). He told me to call Heather and rushed home. Thankfully, Heather did recognize active labor and headed right to our house with her skilled assistant Summer. John and our doula Rebekah quickly lined our mattress and filled the birth tub while I labored in the bathroom.

Within minutes, it felt better to bear down with the contractions. Back on our bed, in the same place Sophia was born two and half years prior, sweet Toby began to crown. Since the labor was so fast and he was a good-sized baby, I was a little overwhelmed and almost felt afraid. But I remembered that my body was capable of doing this, and I settled into the stretching sensation of him moving down. With each surge I prayed (pleaded) aloud for God’s mercy. Then, at 8:00 p.m.—after only an hour and a half of labor (!)—he was born, and I cradled him in my arms in wonder and disbelief. He was a big boy: 8 lbs, 13 oz.

For a moment, I actually forgot I still had another baby to deliver. But the urge to push quickly returned, and Heather did her first cervical check to determine Scout’s position. She felt a bulging bag of waters but said with surprise that she thought she was feeling a head! At 8:07 p.m., in one gentle push, Scout’s 6 lb, 1 oz body drifted toward us (head first), completely enclosed in her bag of waters. She had turned, just like we’d hoped. Amazing. Heather gently opened the bag with her hands and little Scout took her first breath before being handed to me.

Arms full of healthy babies, I was in awe. I looked up into my husband’s eyes, and together we were deeply grateful. What precious little souls! We felt so blessed. I was overcome with the beauty of our abundance.

Now that it’s all said and done, I see how we were protected in our decision to stay home. Scout really needed those last weeks to grow as much as possible, and how wonderful that she was born so peacefully in the caul. How pleasant to birth out of the bright lights of an operating room—to welcome our babies surrounded by quiet, love, and respect. We just held them and held them…they didn’t have to go anywhere else.

And yet, I wouldn’t advise every twin mom to do things the way we did. I wouldn’t advise at all. It’s a very personal, very complex decision that will be unique to every family. And if I may quote my God-sent midwife—it’s not about where you birth; it’s about making the right informed choice for your family and your situation.

I remember hearing once—“There are only two reasons for ever doing anything; one is love, and the other is fear.” For me–after weighing all the pros and cons, asking a million questions, and searching my soul–I ultimately had to tune into that quiet voice of Love, rather than the pervading voice of Fear. And I pray that will be the voice that guides the parenting of these three beautiful children.

*We are forever indebted to our beloved midwife Heather Hilton for her patient and pure heart, her great generosity and her friendship. Summer Kirchner for her enthusiastic votes of confidence. Midwife Salli Gonzalez for her calm, strong spirit and motherly presence. Midwife Alisa Voss for her trust in normal birth and vast experience. And our doula Rebekah Galloway for listening to us, supporting us, and getting that plastic sheet on the bed in the nick of time.

More beautiful pics of this birth (by Leilani Rogers, birth photographer) at http://www.photosbylei.com/birth-photography-2/twins-and-in-the-caul-birth-austin-birth-photographer