Friday, December 7, 2012

The Birth of the Surrogate Twins


  • This Blog Post was written by Tiffany, Surrogate Mother

    Warning, readers beware: I don't have a filter when it comes to birth stories (or much else for that matter). I love birth, I love hearing birth stories, and nothing about birth grosses me out - I think all of it, even pooping on the table, is a beautiful process. Yup. I have tried to class this up knowing it could get back to my grandma, but no one's perfect and some potty talk has slipped out in order to keep the story authentic. You have been warned. If that does not bother you, grab your tea, sit down, and have a nice read about how I welcomed my two nephews into this world.
    They say there are two sides to every story. Well, with over two people being present during the birth of the surrogate twins, I have a feeling there will be more than two sides to this story. In the meantime, this is my side.
    Thursday November 8th 2012
    Time for my 34 week check up! Technically I was 33 weeks and 6 days, but it was time for a check up. I went in feeling fine, a few daily contractions (as it had been since about week 20) and the typical swelling that started very early in this pregnancy. My ankles looked like I had Shrek feet! My doctor had been keeping an eye on me for Preeclampsia, so I was not too concerned with my swelling, plus I have lovely blood pressure. The babies sounded great, everything seemed good except for... my blood pressure! This time, it was about 160/108. My doctor asked me what I was doing this weekend, I said "Working, photoshoots, I'm still working and will be... why... I'm working." I was set on working apparently. He said that I might need to go to labor and delivery for a work up since he was concerned with the blood pressure. Then he said if it dropped before the end of the appointment he would let me go to the lab for blood work and head home with the 24/hour urinalysis. Sounded fun! My blood pressure cooperated and the bottom number dropped to about 94 and he sent me to the lab. As I was leaving, I remember he said, "You just have to make it to tomorrow." That day would mark exactly 34 weeks, which meant I could deliver at our local hospital instead of being transferred or having the babies transferred since our hospital only goes to 34 weeks for the NICU.
    Friday November 9th 2012
    I don't want to wake up. I am still so sick! So I try to wake up, I putter around the house, I check client emails, and then I go throw up and frown about it and go back to bed. Oh, and I started to collect my pee like a hoarder. I started at 9 am and sat on the toilet and collected in the "pee hat" and then poured it into the big jug. Falling back asleep after being sick is hard, because you feel so sick that you almost can't sleep, although it's your only real escape! I finally fall asleep and because I am pregnant with twins, I'm up 2 hours later having to pee again. And, back to sleep I go.
    By 2pm, I was feeling like I should wake up and I feel like I have wasted yet another day, but I DID feel less nauseous around this time of day and I needed to go edit photos. I went to collect my pee in the hat again, and then stand up and dump it into the collection container and BAM, my water started breaking, all over the bathroom floor. Since my water broke with both my previous pregnancies, I knew exactly what it was. Panic set in for some reason and I just started yelling for my husband. He came running into the bathroom as fast as he could, he found me standing there, naked, with the pee jug in my hands and amniotic fluid dripping on the floor (and yes, he is still married to me). I told him my water broke and he says, "Oh shit!" then we both sort of stand there and don't know what to do. He went to get all the camera gear ready for filming, and I continued to leak water. Suddenly I had a thought. When my first son was born, my water broke at home and by the time I arrived to the hospital, they told me it was not amniotic fluid, but that I had just peed my pants. I said, "I pee my pants ALL the time, I know the difference!" I did not want this to happen again, so I decided to collect my amniotic fluid in the pee hat and then I stored it in a small Tupperware container (pictured below with my swollen face as well) and packed my pee jug and amniotic fluid for the ride. I called the doctor's office and they transferred me to the triage nurse and she said I needed to go straight to the hospital. I asked her if I could take a shower first (I would have liked to have semi pretty hair when I started birthing and maybe some freshly shaven legs). My request was denied. She reminded me I was 34 weeks with twins, and to head to the hospital! I knew she was right, so I put on some deodorant, sprayed some smelly stuff all over my body (Febreeze?) and called it good. Sorry in advance hospital staff.
    I called Natalie, and my heart was racing! I told her my water broke and she replied, "You're joking!" I said no, and in fact, it was still happening! She seemed as frazzled as me, unsure what the next step was. Obviously we both had to get our butts in gear and husbands in tow! James and Natalie live two hours away from us and it was a Friday afternoon around 2 pm. We hung up and I went to pack my hospital bag. Yup, I had not packed it (even though I made Natalie pack hers weeks ago!). I threw random items in there (none of which were useful later on, wrinkle cream, a spork, undies that did not fit, yeah, I was a packing champ) and worked on getting a babysitter for our boys, then Sean and I were on our way.
    We arrived at the hospital a little after 3 pm, and the hospital staff was ready for us! A quick history for those that don't know; my first son was born within 3 hours of arriving at the hospital and 20 minutes of pushing (just 4 hours after my water broke). My second son was born 6 hours after arriving at the hospital, and 45 minutes after my water fully broke, it took about 4 pushes. My births go fast and the staff did not want to take any chances. At this point, I was not having any big contractions, still just the every 20 minutes or so, nothing exciting. I began to feel very nervous. I had been so confident that I could have a vaginal delivery with the twins, epidural free, and as I walked through those hospital doors, I started to think I was a little crazy for signing up for all of this! I also began to feel a little sad that the journey was coming to an end. Even though I had been sick the entire pregnancy, and wanted my body back, I still enjoyed being pregnant with them and enjoyed being a surrogate. I was unsure how I would feel after all of it and that made me nervous and sad. I went inside to check in and I gave the nurse my amniotic fluid so they could test it (it was a first for them!) and that bought me an automatic trip to Labor and Delivery.  Since I was exactly 34 weeks to the day, they would allow me to birth at my local hospital - no transfer necessary! 


    I had been seeing the same doctor for my whole pregnancy, and had been very spoiled. I hand picked him from tons of great recommendations for his expertise in twins and loved seeing him during the pregnancy, he is an incredible doctor. Well, guess who was in a class in Seattle that day? So, in walks a doctor I have never met before, she introduces herself as Dr. Russo and I am already very suspicious of her. I was afraid she wouldn't let me try an epidural free birth, I was afraid she would make me get on it right away, or decide that a C-section would be the way to go. Of course, I would have done any of those things if they were safest for the babies and myself, but I really just wanted to try at having another natural child birth and I really believed my body could do it. I have had some experiences in the past where a doctor's first instinct is to put you on the drugs and move things along, and not knowing this doctor, I feared the worst for some reason. Thankfully, I could not have been more wrong. She told me that she knew I wanted to try this without an epidural and that she fully supported it! We talked about my hope of trying, and how I also would let her guide me and tell me if I needed to stop being stubborn and start accepting the fact that it might not happen. I immediately loved her.
    With twins, it is normal hospital procedure to give birth in the operating room, in case you do need an emergency C-section for some reason. For example; if you vaginally deliver Baby A (who typically is born first and named baby A because he/she implants closest to the cervix) and then Baby B is not head down, you might need an emergency C section. In the mean time, you labor in the labor and delivery room and then when it is time to give birth, off you go to the OR. When we arrived, the ultrasound showed both babies were head down, which was great news because it meant that meant I would get to try for the vaginal birth! At some point after checking in, it became apparent I had preeclampsia. I think they dipped a stick into my pee that I brought in and then checked for protein. I was VERY swollen and my blood pressure kept rising. I was put on magnesium and told it might be pretty miserable sickness wise. After being as sick as long as I was, I doubted this magnesium rumor would have any affect on me! In actuality, I could not tell if my nausea was from the morning sickness (can it have a new name please?!) or the magnesium, but it was not too bad and very manageable. The magnesium would prevent me from having seizures and other things I can't remember and am too lazy to Google. My contractions were starting to pick up slightly, becoming a little stronger and more consistent, but still nothing where I thought it was time, and I was only 3 cm dilated.
    I remember asking several times where James and Natalie were, I was very afraid they were going to miss the birth. While we waited for them, I met the anesthesiologist. I have never met one before and I sassed him and let him know I wouldn't be needing his services. He was a good sport about my joking and he was very informative about the risks of my choice (if for some reason Baby A came out and Baby B got stuck, they would have to knock me out to perform an emergency C-section, or if the Dr. could retrieve the baby, she would do so by going up my vagina, up my cervix and into my womb without the epidural and I would wish I had one). I understood everything and he also told me that if I needed him, he would be by my side the entire time we are in the OR. As much as I sass about the drugs, this made me feel calm.
    During all of this, my sweet husband was taking care of me, filming, staying in touch with people on the phone, and being amazing. I kept looking at him in wonder from time to time and was so astounded by how calm he was and how much he was juggling.
    James and Natalie arrived at 4:30 pm, I could not explain the relief I felt to see them and that they made it. Just typing this sentence and reliving the memory gets me almost teary eyed at the thought of them making it on time. My contractions were not too bad so we were able to enjoy a few moments together in the labor room. During all of this, the nurses were working hard to get the babies' heart rates on the fetal monitor. Baby B really was not cooperating. Both babies were moving too much and after several attempts by different nurses and too much time going by, Dr. Russo recommended we monitor the heart rates from inside. What?! That did not sound like a fun time to me. She explained the take a small catheter type thing and insert it up my lady parts and attach it to the babies' heads. It is a tiny clip on their heads, it does not hurt them or me, and we can safely get a reading. She suggested it so we can keep monitoring their heart rates to make sure the babies were not going into distress (internal fetal monitoring). This sounded like it was what was best for them, so I let James and Natalie decide what they wanted to do, since it's their babies and all! They decided yes and I feared the pain of something more going up there, however, it was not bad at all! I think it brought us all relief too, being able to genuinely monitor them after that.
    As my memory goes from here (correct me if I am wrong readers who were there, I know there are some of you!), my contractions started to pick up for the next 2 hours. From 4:30-6:30 I could tell they were getting stronger, harder and I felt as though I was getting close to delivering. I was checked around 6:30 pm and I was about 5 cm dilated. Wait... what? How could that be!? That did not seem like much at all and I really felt like I was getting close. So I spent some more time contracting and around 6:45 I wanted to go to the O.R. This was hard for me to ask for. I felt confident that the babies were coming soon, but only being 5cm dilated, there was a part of me that felt I could possibly be wrong and would waste everyone's time and hold up the O.R. if someone else needed it. I also was concerned my doctor would not believe me when I said I felt like I was getting close, and that I would deliver the babies in the wrong place. She came in after hearing my request of wanting to go and guess what? She believed me and was all on board for heading to the O.R! It felt incredible to be validated for my intuition and that she trusted me enough to move us.
    James, Natalie and Sean all got in their little blue suits and head pieces. They looked adorable. I was wheeled down the hall and at this point, time started to go by much faster as I was shaking during each contraction and they were no longer peaceful. Meaning: I was being loud during them! We arrived in the O.R. at 6:50 and I immediately felt out of place. I have never been in an O.R. and it was a little eerie to me. I remember getting on the new (tiny/made for Kate Moss) bed and looking up at the big lights and I began thinking of all the women who came in here to deliver their babies. I was not thinking of people in surgery, or anything like that. I thought of women who were scared to be cut open, who maybe planned a different birth. I thought of the women excited to come here and meet their babies, I just thought so much of all the women and babies who were here and then a contraction hit and I thought no more.


    My contractions were getting closer and closer and a few were coming on top of each other. By 7:15 pm I insisted on being checked again. I knew I was close and this would help me through the rest of the pain knowing I was at an 8 or a 10. Nope. I was checked and I was maybe at a 6. WHAT!!!!! In the video, Dr. Russo checks me and tells me I am at a 6 and I say very calmly, "No... that's wrong." And very calmly back she says, "No... it's not. " I laughed at the video but at the time, I was devastated! I told her to go get Dr. Pitch and to give me the epidural. You know what's silly? At this point I was thinking to myself, "Great. I mouthed off for months about how I was going to give these babies a natural birth into the world with no epidural and of course I can't do it and I have to let down Natalie and James and THEN I have to face all my readers and tell them what a failure I am."
    First of all, I know I would never let down James and Natalie by asking for the epidural. Second of all, why would ANY of you think I was a failure for needing an epidural and why would it bother me if you did? I certainly don't think that about any of my friends who have had epidurals, so I have no idea why I thought this would be a thought directed towards me. Such a silly and fleeting thought because my next thought was this: "Oh my God. I am going to get the epidural and for the next 4 cm I am going to have a fun time! I won't be in this shaking pain, I will get to enjoy the birth and relax and pee into a catheter whenever I feel like it instead of all over the table. Score." Dr. Russo brought me back to reality by saying, "Now Tiffany, I just want to remind you that you told us if you call down for the medicine, it means the babies are coming and not to give it to you." I replied with, "Well, you're telling me I am only 6 cm so I am pretty sure I can't keep going, I want the meds." She was so supportive of whatever I wanted to do and she brought me Dr. Pitch.

    Now, here's where it gets exciting! Around 7:20, Dr. Pitch, the anesthesiologist, came in to go over all the protocol for the epidural. I really did not care. I just wanted the drugs and wanted them stat. I have never had one before and just assumed it would be heaven sent. James and Natalie had to leave the room for this, so they stepped out. I finally turned onto my side and curled up in a ball (how familiar does this sound to many of you?). He said he was first going to administer some Fentanyl into my I.V. to help take the edge off. Once that entered my system, I felt as though I had had two glasses of wine. It actually felt rather nice, rather fast! Literally within moments, I felt a little "fun" inside. Right away he went to work on getting my back cleaned as I felt two glasses deep on a nice Cabernet I could feel him cleaning it and then within about two minutes of receiving my "wine in a line" drug, and Dr. Pitch was preparing the Epi (pictured below), I began to feel the need to push. In fact, my body decided to push whether I wanted to or not!

    At 7:27 pm I suddenly yell, "The babies are coming! UGHHHHHHHH I'M PUSHING!" and I start to grunt and want to be on my back right away. They helped me onto my back and Dr. Russo is at the receiving end of my claim that babies are on their way. Within about 30 seconds I hear her say very calmly but matter of factly, "Peds, someone call peds." I start to realize this is actually it. It's really happening! My body pushed and pushed for 26 seconds (I just watched it on the video and timed it, cause that's how I roll) and suddenly, there is a baby born! I remember the baby coming so fast and not being able to help but push, my body was working on it's own with this baby. I also remember feeling him being so very small as he came out (remember my last baby was 9 lbs 4 oz) and at first, I thought I delivered the placenta first (why I would think this, I don't know). Then you hear the most beautiful noise ever; a new born baby's cry. I realized then that I did give birth to a baby after all and the first sentence out of my mouth was "Where's Natalie?" I was so afraid they had missed the birth because they had to step out. I am not sure what happened, but I think a nurse went and grabbed them and they made it just in time to see their son, Parker, born. Looking back on the video, you see James and Natalie crying with joy and staring at this beautiful little human (picture below of their reactions... warning, get tissues). As Natalie sobs and looks to me saying, "He's so beautiful... he's so beautiful!" James is waving a little baby wave and saying, "Hi! ... Hi!" to his new son. He then cuts the cords and you can hear him cry with joy as they both stand together looking at their new baby. I am so happy to have this footage because the whole birth is a blur. Life is a blur, but birth really is and this was one of the most amazing moments of life ever, ever. Ever. In fact, I am crying as I write this part. Parker was born at 7:28 pm weighing 4 lbs and 13 oz.











    As Parker headed over to be checked out by the pediatric doctor and nurses, I lay there calmly, realizing... I have to do this one more time. I had heard it could be minutes or hours until the second twin is born. Not to mention, we didn't even know if Baby B was still head down or if he had flipped. Dr. Russo called for the ultrasound machine and checked on little Baby B. Sure enough, he was still head down. Major score! I was still feeling a little happy on my wine in a line drug right then and had had about 2 or 3 contractions but nothing too big. Dr. Russo went in to break Baby B's water (remember, the twins each have their own sac and placenta and it was presumed that Baby A's water broke at home, which ended up being true). After she broke his water she told me the next time I had a contraction I should push. This was a very new feeling to me since my first son, my second son, and baby Parker all came on their own with my body deciding when to push. So I felt very proud that I was able to do as told. After 22 seconds of pushing (yes I went back and timed this one too), out came Levi! Born at 7:40 pm and weighing 4 lbs 3 oz. He was all wrapped up in the cord from head to toe! He cried a beautiful healthy cry as well and was whisked off to be checked out.




    Both babies had no problems breathing and were very strong for how little and early they were. Parker looked just like James and Levi looked just like Natalie and they both looked just like Hunter. Genetics is such an amazing thing to me. It was such a high delivering them and I could not have been happier at how fast it all went! The babies were then taken to the nursery for their work-ups and vitals with James and Natalie in tow. Sean stayed with me as I still had to deliver the two placentas. Unfortunately, after 30 minutes, the placentas were on strike and decided they did not want to evacuate. Dr. Russo had to go up with her hands, into my uterus, and retrieve them and check for debris. It took four times. Ask me how happy that was? Overall, yes, it was not a day in Disneyland, but the Fentynal did help and I'm happy to know I will never have that done to me again. After that thrilling time with my new-found best friend and doctor, it came to be that I was bleeding a little more than I should have been. Dr. Russo suspected it was cervical and after further investigation, she was correct. My cervix had torn and I guess tears in the cervix are very sensitive and can cause some good blood loss, which is what was happening to me. I remember getting some numbing shots in my lady parts so she could stitch up my slight lady part tears as well as cervical tears and the next thing I knew, after about a minute or two, they were done and I was being wheeled into recovery. My husband told me later that that "minute or two" was actually 45 minutes. Dr. Pitch gave me a nice cocktail via my IV and I went nighty nights. Every now and then I would wake up and ask if my placentas were out and go back to sleep, I have no recollection of this. Sean said I asked about 4 different times! When I heard that, I assumed my husband had left for those 45 minutes to get footage of the babies (he had to turn the camera off at this time.). He told me that in fact he stayed, they brought him a chair and he held my hand and petted my hair while I was asleep and they stitched up my bleed. Yup, tearing up again as I write this.







    I was wheeled into recovery around 10 pm or so, I think. I wanted to see the twins so my nurse helped me to the bathroom and then said she could wheel me to the NICU. Well, I was a little too sick. I had lost 1,000 cc's of blood (typical vaginal delivery should lose around 300 c's of blood) and was very weak from that and the pre eclapmpsia/magnesium. I almost passed out and had to go back into bed and was there until the twins were 3 days old and I finally was able to see them. They were beautiful. I just wanted to see them breathing and moving and it was a miracle.
    I was released three days after the birth and with the blood loss it I was obviously a little weaker than normal, but I felt amazing given the physical circumstances. Also, I did have a severe case of preeclapmsia, my numbers were crazy high and my blood pressure was not interested in calming down so I was sent home with blood pressure meds to help out. The twins had to stay until they were 3 weeks old and were then released to go home from Bellingham to Tacoma with James and Natalie. They were lucky that they had no respiratory issues, and just had to work on feeding and getting strong. It was beautiful to watch James and Natalie jump right into the role of mom and dad of their sons without missing a beat. They have done a wonderful job of loving their sons, all three of them, and making this family whole.
    The first the babies were home, I received this sweet message from Natalie: "My heart is beyond full right now!! I honestly have not been so happy in my whole life!!! Thank you thank you thank you!!!!" This is why I became a surrogate. This makes it all worth it.
    I have so many feelings to share on all of this and will blog about my recovery and the big question I keep getting "How are you dealing with not having the babies and are there any attachment issues?" I will cover all of that honestly and openly in my next blog post in a few days. But I will say this, I could not be happier with what has taken place. All the ups and downs and the new found love for so many of life's precious gifts. Surrogacy was harder than I imagined, but it was also more beautiful than I ever imagined. We have learned so much, come so far and now we are celebrating the lives of two new people in this world where the possibilities of who they might become are endless. Anything really is possible and with the love of family, you can overcome so much, even if it isn't always peaches and cream the whole way. We are blessed and I feel I was given a bigger gift than anyone, an amazing outlook on life, and the joy of watching happiness that two people may never have had otherwise.
    In the meantime, James and Natalie will be taking a step back from blogging and sharing their story as they focus on their new family and life at home with three boys. They are excited for some privacy and I will still be blogging about surrogacy for the time being and some small updates of the twins. We are all so grateful for all the support, comments and prayers that have come our way during this crazy journey that took forever to start and is over in the blink of an eye. Without our readers and your supportive words and personal stories, this would have been a very lonely journey. We are stronger and wiser because of what you have taught us while we openly shared our story. We are forever grateful.

    Also, all the images above are screen shots from our documentary. They are taken from the raw footage my husband filmed during the labor. We still have a lot more to film on the movie, doctors, other surrogates and even someone who was a surrogate baby!  Stay tuned for updates on the movie as we continue to film.
    "May your trails be crooked, winding, lonesome, dangerous, leading to the most amazing view. May your mountains rise into and above the clouds."
    - Edward Abbey
    Warmly,
    Tiffany Burke, Surrogate Mother