Saturday, 14 March 2015

Multiple Birth Awareness Week - Not Enough Hands

“There’s heart beat no.1 and there’s heart beat no.2.”

That’s how the sonographer broke the news to us at the 8 week dating scan. No lubricating our feelings first or checking whether or not either of us had any heart conditions to be aware of. Just straight out with it. My first daughter was 10 months old. We’d spent a year trying to conceive her, becoming sexual dynamos in the process and when we had no luck were about to resort to intervention before I finally fell pregnant on our last attempt. We were away for our wedding anniversary and Manly lost the footy, so my husband and in the end both of us got lucky.

This time I was still breastfeeding and although we weren’t really trying for another baby, we weren’t trying to prevent it either thinking we probably had plenty of time, if it even happened at all, but when I started feeling absolutely dreadful and my daughter was starting to wean off the breast, I became suspicious. A home pregnancy test came up positive and the GP confirmed it and sent me in for a scan to date the pregnancy. I knew exactly how far along I was. I’d had only one menstrual cycle and we had sex once. We thought we had at least 12 months of pressure free humping to enjoy, but it wasn’t to be.

At the scan I saw the two heart beats and the two sacs before the sonographer even spoke, but for a moment I thought it was a split screen; the same image twice. Nup. Twins.

To say we were shocked is a giant understatement. Happy, ecstatic even. We weren’t sure we’d have one child let alone three. We laughed and laughed. Too much. Uncontrollably, at the scan….completely flummoxed and ….  freaking terrified. We spent that night in complete silence, each in our own thoughts, wondering how the hell this happened and the million things we would have to change to accommodate twins. I threw up a lot.

At the 20 week scan we found out we were having two more girls. At least we wouldn’t have to buy lots of new things like clothes. Not that we ever really gender branded our daughter, but others did, giving us lots of pink things, feminine things, supposedly. We also found out that one of the twins had a cleft lip. The sonographer kept saying that it was only superficial, but we wouldn’t know the exact extent until she was born. Just one more thing to worry about. It turned out fine, it is superficial and will only need a day surgery procedure.

The pregnancy went really well mostly. I didn’t have the high blood pressure I had with my first and I was under the care of a private obstetrician. I was a lot sicker in the first trimester, I threw up every day and more than once; had a very short period of the blissful second trimester and then the third trimester crept in and the discomfort really started. Although they insisted I have regular scanning because the babies were measuring small, it felt like I was carrying two baby elephants in my belly. I felt heavy and sore and out of breath most of the time. I couldn’t sleep, it hurt to roll over, I got tired walking and my abdomen, hips, back and knees ached. All the while the babies kept measuring just under the required size on their charts; charts developed in the 1950s that only accounted for a singleton pregnancy. I did what they told me, but took it all at face value, knowing that twins had to measure a little smaller to fit inside me. Most of the medical professionals agreed with me off the record. My obstetrician was incredibly reassuring and just urged me to rest as much as possible. I took her advice on with gusto and it served me well. I was able to enjoy the last weeks of my pregnancy in relative comfort and got them to 37 weeks. They were tiny compared to my first, but were good weights and grew quickly.

The birth was very straight forward. A scheduled caesarean. I knew what to expect sort of, having had one with my first, although with her I laboured for 11 hours and only had the epidural in the last few. I got to 5cms dilation and the baby started to show distress so we all agreed on surgery. This time it was planned. The ob advised against waiting beyond 37 weeks. By that stage I was eager to get them out too. 

On the table everything went smoothly. Like with my first, they took them out all bloody and slimy and showed me and after a quick check, letting my husband cut their cords and wrapping them they gave them to me, laying them across my neck and chest so that I could study and kiss their little faces and hands and heads and meet them intimately. With all three girls they are the moments immediately after birth that I’ll never forget. I will treasure that elation forever. Soon after the twins came out though, I started to feel the procedure. I’d had a spinal not an epidural, which comes on sooner and lasts a shorter time and I found out later from the ob that my uterus wasn’t contracting and so it was taking her longer to finish up. As soon as I told them I was feeling the pain, they placed a mask over my face and knocked me out. The ob finished the job with impeccable expertise and I woke up in ICU. After a day or so I was transferred to the delivery ward and the babies were released to me by the paediatrician and we were transferred to the maternity ward to ‘room in’ for our six day recovery. This period too is one I remember as blissful, with both births. To me, that hospital room became my cottage sanctuary. I barely left the room and just got to know my babies and developed my rituals and routines to start to get them to thrive whilst healing myself. With the twins I had the luxury of a private suite with my own bathroom, which definitely sped up my recovery in terms of how confident I was to nurture my body and its hygiene and functions back to health. In short, I was able to work on pooing without being disturbed; that’s all they want you to do after a caesarean, they want you to poo. I guess to make sure everything is working and back to where it should be and just as well because I was sure my bowels were somewhere near my throat after that pregnancy. 

 I loved having my own bathroom, but even at the public hospital with my first, I found this time of rooming in with my baby to be absolutely exquisite. I enjoyed every minute. Ok I was off my face on pain relief drugs both times, but it was just me and the babies.  I was being fed well and checked on and fussed over, especially with the twins and I stayed in bed all day; although I did force myself to have a shower and change my clothes every morning. That is one thing I have continued and which has helped me to maintain my sanity. With both births I made sure that despite having to care for newborns, I had a shower every morning. Then I had a blank and not so sweaty slate to begin the day. It was a really healthy ritual to adopt and when it is threatened by an unruly baby, I knuckle down and get what I need to done to make that shower happen.

I went home with the twins after six days, heavily medicated. I was cruising; so happy to be home with my oldest daughter who I’d missed terribly and her two new baby sisters. My husband was off work for a few weeks, it was over the xmas period and suddenly we were a family of five. Together we established some patterns, an extension of the rhythm I’d developed in hospital and everything seemed to fall into place. With two adults caring for three children, one of whom was rather independent and comfortable in her routine, we found that things were going really smoothly. We mostly dealt with one baby each. I directed my husband, he was my extra set of hands. We had this.

Then my husband went back to work and I’ll never forget that first day completely on my own with three children under two. To my surprise, I coped. It was a good day. Bit rough around the edges at times, but I’d survived and was confident I would be ok. As time went on though, things started to slip from my grasp. The medication ran out. I went from being heavily sedated and pain free to depending on over the counter stuff that didn’t even touch the sides. I was eating them like lollies with little to no effect. The surgery scar and my uterus ached, especially with each feed which was happening every two hours now. In hospital I was on a schedule. You can do that with newborns, but as they get bigger and start to demand feed, it starts to get more frequent. Soon I was exhausted and I found it really hard to keep up with them all during the day. The oldest one still needed my attention and her routine observed and the babies were on a constant feed, change, settle pattern. I needed to eat and drink often and I was in pain. I was a little sleep deprived, but was resting during the elder’s nap. It was tiring and hard, but I was still pushing through. My parents visited regularly so I wasn’t always coping on my own. They were an extra two sets of hands and evened up the ratio; one adult per child. It was always harder to go back to doing it by myself. 

Then the breastfeeding issues started. Suddenly I was having excruciating pain. It coincided with me trying to cut down on analgesics. My surgery pain was dissipating, but my nipples and breasts were killing me. I’d had absolutely no issues breastfeeding my first. I tried to understand what was happening and put it down to having to feed two babies so frequently.  With my first I gave her one breast at a time until she became expert and then offered her two. She was content and fulfilled and slept well in the day, feeding every three or four hours. These guys got a boob each and became accustomed to snacking. By the time I fed both, changed and settled them, they were almost due for another feed. There was no time to recover from feeding injuries either. If they latched poorly and my nipples cracked, tough luck, I had to feed them again in two hours and there was no giving one side a break. It became a vicious cycle. I’d feed them and they’d latch badly, my nipples would be sore and cracked so I’d take them off early. They’d wake up sooner as they quickly digested the milk they drank and caused more damage at the next feed, especially if I made them wait too long and aggravated them with my hesitancy; it made them suck poorly and aggressively. I used balms and ice and gel pads. I tried different positions, but nothing worked. I was reluctant to pump, formula was out of the question if I wanted to stick with the breastfeeding, I bought shields, but couldn’t work out how to use them. I was a complete mess. The lead up to every breastfeed was riddled with anxiety and the aftermath was utter shock. 

I rang the hospital, but by this stage the babies were over six weeks old and the hospital couldn’t help me. I saw the nurses at the baby clinic, but in their haste to support me ended up dismissing my issues telling me that as long as they put on weight and pooed and peed, there was no issue. But there was an issue; a big one. While the babies thrived because I was pushing through the pain to feed them,  I was in agony and my emotional health was deteriorating. Finally I read up about vasospasm and someone suggested breast warmers and I called in a private lactation consultant. She confirmed the diagnosis and after wearing the warmers for one day the pain was completely gone. It was the magic solution I thought didn’t exist. They still don’t latch as well as they should, but we’re working on that. I can’t believe I was using the gel pads OUT OF THE FRIDGE instead of warming my breasts. I was actually contributing to the narrowing of the vessels in my breasts  - insane!

So everything is now starting to align. As they get bigger, they are more settled and we as parents are more confident, especially me when I’m by myself with all three. I’ve even been out on my own a few times, although I do feel like a bit of a circus freak. There is genuine fascination with twins and people literally stop you to see them and talk to you about them. It’s mostly very sweet and polite and people are really sensitive about the cleft too; they don’t mention it, but I do. I’m not ashamed. She’s beautiful. In fact I’m a bit in love with it and will miss her mangled bubble blowing grin when it’s gone. 

The twins are now 3 months old and are still on a very tight feed, change, play and settle schedule during the day, but are mostly sleeping through the night, waking once sometimes for a feed. I know this will change with teething and illness and the dreaded move into the big girl’s room. I can’t imagine how I’m going to get them all to sleep in the same room. 

The hardest thing I find is that I only have two hands and after sort of attachment parenting my first, I’ve had to let these babies cry a bit more, simply because I can’t get to them in time or pick both of them up at the same time and soothe them. I grieve the cuddles, the baby wearing, the sitting on the couch for ages playing with one baby, the feeding and rocking a baby to blissful sleep, one on one. There’s not a lot of time for that and it’s physically impossible. Like I said to my ob when she told me she imagined it was like triage; it’s actually like spinning plates. You pick up the baby that is crying the hardest, calm her, put her down and pick up the other one should she need you too. You use your feet and your teeth when you need to; to rock bassinets, to hold onto bibs or nappies, to pick stuff up off the floor. You push doors closed with your chin, nudge things with your elbow and bum and you move a lot; constant activity. All. The. Time.  I have swinging rocker chairs and high chairs and play cots and mats and toys and music boxes, but babies want their mum to pick them up and cuddle them and gaze into their eyes exclusively and tell them they’re safe and you can only do that one child at a time. So in this house, one or two children at a given time are sometimes screaming in distress and a mother is physiologically programmed to respond to a crying baby, it triggers an emergency response in your brain and until you learn to interpret the cry and you develop over time the ability to stay calm and respond rationally, you go into extreme panic mode when that baby starts screaming. It is evolution, it’s how the baby survives. 

Sometimes I see them all competing. One baby will start to whine and she gets my attention. The other baby will eye ball me and start to call out, so I go to her. The other baby cries a little harder, I soothe her. The other escalates. Before too long the bigger one joins in because if the babies get mum’s attention by screaming she figures she should do it too and it’s a symphony. So I shout with them, I sing loudly or just match their tone and volume like a mad woman. I try to reason, to bargain WITH INFANTS, “Please wait, I’ve only got two hands, I’ll be with you in a minute. If you just be patient, I won’t be long. It’s alright sweet heart, I’m right here. Hang on a minute….for Pete’s  sake just wait…oh far out just WAIT…. JUST WAIT….I’M COMING.” I try to resist escalating and cursing myself.

When it’s bad, it’s pretty dismal. That few weeks when I was in constant pain and finding my feet, frustrated that the breastfeeding was failing, confused about finding a solution, feeling completely isolated and alone, being screamed at constantly by irrational newborns and a completely unreasonable toddler nearly broke me. However, when it’s good, it’s bliss. Three beautiful smiling faces, all content and settled beaming up at me, gazing at each other. The prospect of these three girls growing into women side by side fills me with sheer joy, the scale of which I never envisaged I’d experience.

I’ve only got two hands and three babes. I can’t hold them physically all at once, even though I’ve tried and we ended up in an awkward heap on the bed. I can certainly hold them all though; in my eyes and with my gaze, in my mind and thoughts, in my heart with all my being.