Location: St. Vincent’s Southside in Jacksonville, Florida

OB: Dr. Yeykal of Full Circle Women’s Care

Doula and birth photographer: Dallas Arthur Birth Stories & Support

After supporting Victoria through her first son’s birth, she put the due date for her next baby on my calendar earlier than any other client ever had. Because she let me know the date of her embryo transfer, happening a few months in the future! Then I got the “pee on a stick” picture (one of my very favorite kinds of texts!) and then a few weeks later the…”OMG it’s TWINS” ultrasound picture!

I was thrilled to support Victoria and Chaz through another birth as their doula and birth photographer. They were having twin boys, and Victoria had a fantastic, medically “boring” pregnancy (though very uncomfortably, particularly at the end!) She made it to 39 weeks pregnant (quite the achievement with twins!), and this is their story.

“We had a scheduled induction from the get go. Well, maybe ‘planned’ is better as we were supposed to start one day but didn't until the next day because of lack of space. I gave them the one day but we showed up whether they wanted us there or not on Friday. I was so done! 39 weeks with twins was plenty far enough along for me at that point.

At my appointment on the Wednesday before, I was already 4cm dilated. Since we were already at that point, we skipped the Cervadil and Foley and went right into a low dose pitocin when we were admitted on Friday.

I hate to be braggy but it was easy peasy while just laboring. The pitocin took forever to actually cause contractions to start dilating further. One of my big goals this delivery was to avoid magnesium and preeclampsia like I had with my first. Since we had a sense of how my body would cope with things, I elected to get an epidural once my blood pressure started climbing despite my pain being minimal at best. Immediately after receiving the epidural, my blood pressure began to normalize and held steady. We called it an experiment with a resounding success.

With twin pregnancies you are required to be on constant monitoring so it greatly limits what you can do while laboring. Keeping one baby on the monitor is difficult enough. Keeping two is a lesson in patience. You aren't able to get up and move around. Even just rolling to your side can mean losing both on the monitors and having to spend time finding them all over again. Most of the time was spent with a nurse coming every half hour to try to find the babies back on the monitor. Being stuck to the bed was not one of my hopes for my second pregnancy but it was just one of those things you don't get to choose with twins.

My husband took a lot of naps while I was just laboring. Since I was stuck in bed there wasn't much he could do and we both knew delivery and post partum was where he'd need his energy. We've been this route before and knew this was the time for quiet and rest as much as possible.

I went from 4cm dilated to 9.5cm within a span of about 4 hours all while taking a very lovely nap with the peanut ball.”

“It was go time quickly after that point. We were all very surprised it suddenly went so quick. I called Dallas and she was able to get there in record time after finishing another birth only a few hours before.”

Victoria’s birth was my third in three days, despite being the only scheduled induction. We kept in touch through the day while I was with another client (read her birth story here!), echoing the birth preferences and plans we had discussed in our prenatal visits. When I got the call at midnight that she was ready for me, I flew out the door, grateful for a quick nap and some now-cold coffee still in my driver’s side cupholder!

“Another fun thing with twins is the requirement to deliver in the operating room. So when it was go time, it was a whole parade from the L&D suite to the OR. The OB, nurses, me in the bed, the IVs, the monitors. It was a whole shebang.”

We knew from the very beginning that even vaginal births would be happening in the OR, as per hospital policy, so we had reviewed what comfort measures would be most effective and readily available. But a vaginal birth in the OR was new to me, so we walked in with curiosity about the logistics.

“In the OR, you're very limited by what any of us can do. It's full of stuff and people.”

Victoria transferred from the L&D bed onto the operating table, and the staff (and Chaz) worked together to get it assembled for pushing.

They asked what kind of music she would like, and set the radio to an oldies station. That clunky boom box in the corner ended up being a source of entertainment and subtle dance parties for the birth team through the night!

“Everyone has their place, and unlike the beds in the regular L&D, it's basically one position and that's all you got. The bed sucks. 0/10 recommend for long periods of time.”

“When baby A was ready to launch, it was a long four hours of pushing for him to make his princely arrival. I'm glad we'd rested during the dilation phase because we needed it.”

“During pushing, it was just like a zen zone between pushes.”

“My contractions weren't super steady even on high doses of pitocin (these boys did NOT want to come) and it took a combination of the monitor and feeling my own body to determine if they were strong enough to warrant pushing.”

“The down time between pushes was pretty relaxed thanks to the epidural. The anesthesiologists were on their A game that night.”

Because Victoria was on a surgical bed, we were very limited in what pushing positions she could use. We did some knees-in-feet-out pushes and tug of war, which helped to change the shape of her pelvis and bring her baby lower and lower.

This is a selfie I’m pretty proud of! I put my camera on a 5 minute self timer and set it on the counter across the room while we did tug-of-war.

“Baby A made his way into the world and we were able to do some skin to skin before he was handed off to my husband.”

Baby A was teeny, and a spitting image of his big brother.

Chaz cut the cord and accompanied him over to the warmer for a checkup.

“We had names picked beforehand, but hadn't assigned them to which twin, as we wanted to see them first. It was pretty obvious right to my husband that Baby A was now Rodney Phillip.”

“He got to hold him while we prepared for the next stage of our birth plan.”

“Baby A (Rodney) had been head down pretty much the entire pregnancy, but Baby B was breech. Because of his size and being larger than Rodney, Dr. Yeykal and Dr. Adams didn't want to deliver him breech.”

“They weren't sure an ECV would be successful but it was a risk we were willing to take.”

They did a quick ultrasound to confirm his position, and found that he was still breech, as predicted. They performed an ECV to try to flip him head down.

“Once again, I am so thankful for a good epidural. ECVs are not pleasant, they are using their hands on the outside to make the baby shift positions into a heads down one. That takes a lot of pressure and pushing.”

The did a second ultrasound to see what his position was now…

…and we were overjoyed to see a sweet little head! (Those are his eye sockets on the screen!)

“We all celebrated the win of getting Baby B head down with some rest.”

Baby B was head down, and a few “practice pushes” showed us that he was still really high up. Because Victoria had pushed for four hours to get baby A out, she needed some rest, and time for her body to continue contracting and bringing baby B lower.

In the meantime, dad got his first snuggles and feed in with Rodney, who was content and peacefully blinking at the bright lights of the OR.

The staff dimmed the lights, everyone but us and one or two nurses remained, quietly charting. I tucked Victoria in the best that I could so that she could get a well-earned nap! I wheeled a stool over to her and bent over for a little seated nap right next to her. I had only 4 hours of sleep in the last 3 days, and I knew we might be in for several more hours of pushing.

“Both Dallas and I took a nap after it was over to let my body labor Baby B into position. I was able to get about two hours of sleep before it was time to start pushing with Baby B.”

Chaz and Rodney got lots of father-son bonding time and some sweet pictures during Victoria’s nap!

After a nap, Victoria got right back to pushing. She pushed just as strongly as she had before, using every ounce of strength for about two hours.

“While we'd hoped for two vaginal births, Baby B tolerated about two hours of pushing before he started struggling.”

“We attempted to use the vacuum to assist pushing and get him out quickly and safely but all three attempts failed.”

“After the third attempt, his heart rate slowed too much and it became a race to get him out.”

Baby B just wasn’t tolerating pushing. Victoria had given it her all, and a fighting chance at a vaginal birth, but the decision was made that a Cesarean birth was the safest option for him at this point.

“The shift from vaginal delivery to emergency C-section was a quick one. Things are a bit more fuzzy for me at this point with all the meds.”

“They did have to push Baby B back up and out of the birth canal. I was mostly able to zone out and just let things happen as they happened.”

“My birth plan has always been ‘we all leave alive’ and this fell under that, even if it wasn't necessarily my preference.”

“In a C-section, there's so much less left to your body. It's more a series of tugging sensations as they work their way through to get to the baby. Not pleasant by any stretch but entirely worth it.”

“Baby B arrived safe and sound in the careful hands of Dr. Yeykal.”

“At that point, Baby B finally got his name of Carson Thomas.”

Chaz had the opportunity to trim the cord over at the warmer.

Carson was almost two pounds heavier than his brother! Chaz sent an update to their family via text, “He stole all the food!”

Soon Victoria had her two boys within eyesight, a welcome distraction to the sensations she was feeling.

“Chaz was able to stay with the twins, who thankfully needed no assistance or NICU time, while Dallas stayed mostly with me while getting stitched back up. That took far longer than normal as they had stitches in more than one place.”

“Then, finally, we were able to go back to our room to recover.”

“I'm not going to lie, the pain was nearly unmanageable and my pain tolerance is generally pretty high. It was extremely rough for awhile. I couldn't comfortably hold either of my boys for days.”

“While it wasn't the birth I'd hoped for, it was the one we had and we made the most of it. I joked that we got to check all the boxes of things that could happen in a delivery. So if nothing else we got to go out with a bang!”

What a whirlwind! Victoria handled every twist and turn like a champ. She is such a strong person with a sense of humor and a powerful go-with-the-flow attitude that served her so well in this complicated birth. To say it was an honor to support her and document her journey with all three of her precious boys is an understatement! Congratulations, Victoria and Chaz! You did AMAZING!

Thank you to Full Circle Women’s Care for working so closely with this family to honor their birth plans and bring their boys safely into the world.

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