Flip!

In utero, H was apparently a wonderfully compliant little creature. He posed for ultrasound pictures with only limited rambunctiousness or defiance, and he plopped himself head-down almost immediately upon growing large enough for us to even care what position he was in. There was never talk of a c-section for any reason (barring the standard range of potential medical misadventures that can happen during any labor), and his birth was ultimately so easy that I often don't tell other women about it out of fear that they will hate me, and possibly try to steal my uterus.

It appears that my uppance has come. These two lovely ladies have decided to arrange themselves in almost the worst possible position for a so-called natural birth: sideways and upside-down, semi-tangled so neither seems able to move. Due to my defiant nature (and informed but also innate fear of a c-section), R and I have therefore done everything in our power to try to convince them to flip head-down...at least one of them. How have we attempted this, you might ask? Let me share, as well as describing some of the ridiculous crap we haven't bothered with.

1. Therapeutic massage. I managed to find a physical therapist who does "soft tissue manipulation" that my insurance covers willingly, in hopes that she could help get my system aligned and happy. Yes, my hips were disastrously out of whack, and sure, my back was none too chuffed to be carrying around two extra people, but all her best efforts did little more than make me happy for the rest of the afternoon. Her husband, who shares her practice, had another idea...

2. Moxibustion. This is a Traditional Chinese technique that utilizes the flow of qi in the body to motivate movement. We were trained by this local acupunturist, then attempted this stinky, somewhat awkward process at home thrice a day for weeks. Qi in the lower back and reproductive regions is stimulated by holding a smoldering moxa stick - a roughly cigar-sized piece of compressed mugwort charcoal - as close to the outside of the pinkie toe as the mother can stand. The whole experience is meant to be a meditative time for a couple to bond and communicate while simultaneously making their babies dance like Freddie Mercury after too much espresso. R can attest that a matter of minutes into the process, my tummy looked like a scene from "Alien." Yes, it got them moving, but no...they did not actually go anywhere productive. R found it awkward and uncomfortable, I hated the smell, and we were both losing sleep waking up early and staying up late to do it three times a day. Ain't nobody got time for that. So, we added to the mix...

3. The Webster Technique/chiropractic adjustments out the wazoo. Seriously, I had my wazoo adjusted yesterday, and while it kind of sucked, it clearly needed to happen. All the massaging was nice, but apparently I needed someone to just put everything where it needed to go a bit more aggressively. I got recommendations for a practitioner nearby who practices this Webster Technique thing, which is basically focused adjustment of the pelvis and sacrum, with very deliberate massage of the ligaments holding the uterus in place. My chiropractor is a magical fairy princess unicorn superhero whom I adore, but she did admit this week that she really only has about a 50% success rate with twins. At this point, she's helped me feel better enough that I won't hold it against her if this doesn't help them flip, but still...that would have been a nice number to hear before I committed to seeing her three times a week. We'll see. In the meantime...

4. Inversions. This is a fancy way to say "dangling kinda upside-down," which in pregnancy-speak means forcing myself to get heartburn and usually some nasty nausea and weird lower back aching. Some women apparently do this on an ironing board leaning against a couch, which I just can't fathom doing with my current center of gravity (or lack thereof), so I just put a bunch of pillows under my butt and pray that does enough. So far it has been as successful as everything else, which is to say not at all. What's next?

5. Vagina music?!? This seems to be the next thing to get serious about. I did spend a few afternoons at work with my phone between my legs playing some favorite songs, but it sounds like providing as much auditory stimulation as possible to motivate them to put their heads by the music is the way to do it. Some people recommend having the father talk into the mother's vagina, or at least directly at the lowest part of the belly, but neither of us can get past the giggling that would cause. 

6.  Ice 'em out. I've tried this with zero reaction, but might need to try harder. Basically, the idea is to put an ice pack on the babies' heads to piss them off so much that they move away from the cold. This can be combined with chugging an iced drink to cool down the stomach (which is also kind of on their heads), and some even try to put a soothing heating pad on the bottom of the belly to lure them to the warmth, but given how stubborn these girls have been, I feel like this would just all make me uncomfortable while they silently chuckle to themselves about all the dumb shit mom is doing to herself.

7. Totally illicit manual version and absurd positioning. I just rub the shit out of my belly. All the time. Those poor ligaments are going to be like a middle school girl's favorite hair tie by the time these babies are done with me, and even my skin is starting to ache despite my liberal application of coconut and jojoba oil. I push on the sharp bits of baby that stick out (and they push back), I gently nudge head-shaped things southward, and I rarely sit in any way that doesn't somehow encourage some sort of movement. Right now, for example, I've got my belly dangling slightly off to the left while I twist my pelvis open and have one leg tucked under me and the other on a coffee table. Yeah. Try that one at home.

We're at thirty six and a half weeks...so now what? Medical science (for what that's worth) says that if a baby hasn't flipped by thirty six weeks they probably won't, but internet message boards are filled with women whose twins flipped as late as thirty eight weeks or later. I'm trying to maintain any hope that this is just their first attempt to mess with me, and that they will happily pop their little heads down at the last minute so we can all avoid a c-section, but it's been tough to stay positive. The idea of making babies do anything is absurd, but making not-yet-born twins in massively cramped quarters go anywhere other than where they are does feel pretty ludicrous. We shall see. 

Permission.

When I was younger, I had it in my head that doctors made decisions and patients followed their directions. Period. No negotiation, no questioning, and definitely no suggesting other alternatives. Part of this might have come from my frustrated anger at the fact that shots - the most dreaded part of the already-dreaded doctor's visit - couldn't just get squirted into my mouth for me to painlessly swallow. What kind of sadistic jerk was my doctor to refuse my completely rational suggestion for how he could get immunizations into my system without the needles that just made me hate him? Now that I'm old enough to understand (rationally, at least, though emotionally I still disdain the process) that shots are just necessary sometimes, I still have to pause and question medical decisions that strike me as overly dramatic.

Like a c-section.

Up until maybe 32 weeks, the girls didn't stay in a consistent position for more than a few days at a time. After that point, both decided to hang out either breech (hard little head smashed into my ribcage) or transverse (butt jabbing out the front of me, feet kicking wherever the hell they seem to want to). By now, almost 36 weeks along, R and I have tried basically everything there is to try to get them to flip. Moxibustion, inversion (i.e. dangling my massive pregnant self upside-down and then flailing like a turtle on its back until someone helps me up), cold packs by their heads, playing music into my lady-parts, chiropractic manipulation, massage, and now, just flat-out begging them to comply. If at least one of them flips head-down, I will be allowed to attempt a vaginal delivery, but if not, it's a c-section for me.

Now, let's note the language in that last sentence. I will be allowed to attempt a vaginal delivery if the girls are in a position that makes the doctors comfortable. This whole pregnancy has been on other people's terms: which doctors are comfortable taking care of me, when I need to be checked up, what I need to eat/drink/do to take care of myself and these babies, and even when and how I can give birth. Up until this week, I had a c-section scheduled for 38 weeks on the grounds that it is easier and more convenient to do the surgery (not the birth - the surgery) at a pre-determined time so that everyone needed could be present. Even just having a date on the books was driving me insane. How dare the medical world tell me that I needed to have my completely healthy babies by means of a massively traumatic process just because it was convenient for them not to give them more time to potentially be ready for a natural birth?

After all the bullcrap I had to go through while pregnant with H (up to and including my "induction," to which I arrived already in labor, apparently out of stubborn defiance of doctors' desire to pump me full of drugs), the idea of having so little ownership of this birth made me want to flip a table. In what world is a child's birth dictated by the needs and comfort of medical professionals, not those of the parents? Sadly, the answer is "this one." I've been researching twin breech births, and really...it's not that it can't happen, but that doctors are just not trained in how to help it happen safely. If I showed up in a hospital somewhere in Northern Europe in labor next week, I would be "allowed" to pop them out as they are. Sure, it might be more painful and difficult, but isn't birth kind of a bitch to begin with?

It took a fairly blunt conversation with one of the OB/GYNs I'm working with (part of a practice that everyone in the area describes as "okay, I guess, if you NEED to go to an OB/GYN and not midwives...") to have her cancel my scheduled c-section. According to her, it's standard practice to deliver twins at 38 weeks, and to have the surgery scheduled in advance so everyone they need can be available. What this translates to, as I have learned, is that doctors prefer to avoid the potential complications of large twins past that point, and that they like to be done with surgeries early in the morning. I was originally scheduled to be at the hospital at 6:00AM, which would have meant not giving H a kiss before we left, which was just insult to injury. Beyond that, even though I don't necessarily expect these girls to hang in for that long (who knows?), having a c-section scheduled for before I am in labor just feels like the doctors are cheating. There are so many good hormones and other healthy stuff that babies get being part of their birth process...so why deny that if everyone is healthy and otherwise doing well?

Long and short, I've at least temporarily reclaimed some of the ownership of my birth experience. I know that I might walk into the hospital in labor and still have exactly the birth I don't want, but I also know that having the time and space (mentally and physically) to let the girls settle out where they want to be and choose their own way out is going to let me accept whatever their birth needs to be. It scares me so much to hear other women talking about their birth experiences - heck, their entire pregnancy experiences - in terms of what their doctors wanted or would let them do. Self-advocacy is so critical that I want to scream and flail around uncontrollably and publicly until every woman planning to give birth knows to walk into her OB/GYNs office wearing brass knuckles and a chip on her shoulder...or better yet, to just work with midwives and never let a trained surgeon anywhere near this utterly non-medical life event unless there is a real need. Leave your IV ("that we're going to put in now just because it's easier than when you might need it later") at the hospital, go to a birth center, cop a squat in your living room, and just have a damn baby on your terms. 

The business.

Okay, internet, I get it.

Women in the so-called, problem-riddled "first world" get pregnant, and most of us immediately run screaming to the internet like our panties are on fire in search of answers to queries like "what's that weird feeling I get when I don't eat, and what can I do about it?" (it's hunger...eat something) or "help! I'm six weeks pregnant and I can't feel my baby moving!" (that's normal; savor the peace). Especially when something gets funky, the internet seems like a safe - nay, desirable - place to roam about in search of wisdom and comfort. For some women, it really does seem to do the trick. I won't lie, I am often jealous of people who actually get something out of message boards and leaving comments on blogs. How nice is that?

When I first found out that I was pregnant, way back in the spring of 2011, I did as my upbringing and environment had trained me to do. Before even telling my husband that he was going to be a father, I spent most of a day online (granted, I was supposed to be teaching seventh grade at the time, but that's another story entirely) researching early pregnancy symptoms, exploring two dozen webpages with virtually interchangeable graphics of seven-week-old fetuses, and almost instantaneously getting fed up with message boards on which everyone uses confusing acronyms that made reading potentially thoughtful comments an act of disappointing futility. I did tell my husband, R, later that day (in the form of a cake - also a good story, also for later), and as we hugged in the kitchen basking in the relative shock of the situation, I whispered sweetly in his ear: "don't bother going online; I already read everything there is to read, and none of it's good." Somehow, he believed me, and didn't bother.

My first pregnancy and first baby, H, were both arguably riddled with complications, given how wonderfully everything turned out. Here it is in such a small nutshell as to be annoying: 

1. I had morning sickness, and it sucked.

2. At 19 weeks, we learned that our son (yay, a boy!) had a pile of congenital heart defects. After a hellish weekend waiting to see a cardiologist the next Monday, we learned that he would likely be fine after three stages of open-heart surgery concluding roughly when he was three years old.
3. I had a metric crap-ton of ultrasounds, both otherwise a fairly normal, healthy pregnancy.
4. Hudson was born with zero medical interventions, healthier than anyone expected.
5. He had his first surgery, crashed twice, recovered, got a staph infection, recovered, then ended up in complete heart failure at not quite two months of age.
6. We were transferred to Children's Hospital Boston where he was listed for a heart transplant, waited exactly one month for the right heart to show up, and he recovered and was released from the hospital in record time.
7. Now H is just over two, and awesome.

R and I joked through the whole ordeal that we'd end up with our second pregnancy being healthy, normal, and completely okay...except that there would be two of them. Apparently we joked too loudly too close to some snarky gremlin or minor deity. Here's my second pregnancy to date in a similarly tedious nutshell:

1. I had even worse morning sickness, and it sucked even more than before. I also cried a lot before I even knew I was pregnant, and could smell EVERYTHING.
2. At 13 weeks, we learned that my already getting kind of huge and feeling as sick as I did was because we had (as I gently termed it) a "double-occupancy situation."
3. My glorious midwife practice had to break up with me - again - because they don't manage twin pregnancies. It was really sad, but I already knew the more "mainstream" practice from being pregnant with Hudson, so I resigned myself to things just not going as planned...again.
4. At 20 weeks, a previous ultrasound tech's suspicion was confirmed. Two girls.
5. At not quite 24 weeks, I stood next to a coworker who was due in about three weeks, and we were the same size.

6. At 35 weeks, one girl is breech, the other is transverse, both are growing beautifully, and while I feel like I am the size of two whales, my doctors have me drinking milkshakes to catch up on weight gain. We're doing everything we can to get them head-down to avoid a c-section.

So, what's my beef with the internet? It turns out that when one is pregnant with twins, the internet is about as terrible a place to be as it is for anyone pregnant with a child with known heart defects. Everything sounds like a medical disaster waiting to happen, and every website preaches their position or advice to be 100% accurate and medically approved. This is not so. Major websites (I shan't name their terrible names here, but you know what I mean) have tiny little sections devoted to multiple births, most of which give so little actual information as to be more threatening than helpful. Personal blogs are sometimes great, but few are truly informative, and many are so riddled with scary stories as to be even less helpful in the long run than the shamefully outdated books in my local library. 

I know I can't fix the internet, or the creepily cultish obsession women seem to have with reading about nightmarish things that twin pregnancies and births can do to them, but I'm going to start to try. I might get gory from time to time, but I promise I'll try to keep it as productive as possible.