Twin bump in “Take a Break”

A few months ago I was contacted by a freelance journalist via email. She’d seen me comment on a Facebook post with a picture of the twins tandem wrapped when they were a couple of months old, and wanted to talk to me about baby twins. I agreed to the phone call, and thought initially that she was interested in my twin slinging.

But it turned out she’d seen my blog, liked that I’d taken weekly bump shots, and thought a women’s lifestyle magazine would like a story about a twin pregnancy with some large bump pictures. She’d read quite a bit about the pregnancy already on the blog, and chatted through it some more with me. Then a few weeks later she confirmed that she’d managed to sell the story to Take a Break, and I agreed to it.

A couple of months later I had a call from a journalist working at Take a Break who wanted another short chat with me about the pregnancy, and she’d also already read some of the pregnancy diary on the blog. She went away to write the final story, and a week later she rang me and read what she’d written back to me. I made a few changes (quite hard on the phone with babies around!) and agreed to go to print.

This week the edition of the magazine with our story in is out on sale. I just admit it’s not my normal genre of reading material, but it turned out to be quite a nice little article. The journalists really wanted to push the size of the bump and the weights of the babies, which were good for twins. I wish it didn’t say that “my consultant decided I needed a Caesarean”, I must have missed that when she read it back over the phone. I was the one who made the ultimate decision based on the facts I was presented with by doctors and my own research. But I did manage to correct the journalist’s use of the term “morning sickness” to severe pregnancy sickness, so I count that a small step forward in the media’s reporting of hyperemesis gravidarum.

It also means we got some cash from the story to put towards something the twins need like the next stage (extended rear facing) car seats.

6 months of breastfeeding twins

The last time I wrote about breastfeeding the twins, they were 3 weeks old and things had gotten off to a great start. I’m pleased to say that it has continued to go very well for us. We’re now coming up to six months on Wednesday, which is quite a bittersweet milestone. On the one hand I’m glad that as they start to eat solid food, the amount of formula that we’ll need to supplement my low milk supply will decrease, and that other people will be able to help out with their nutrition intake. But on the other hand I enjoy being the centre of their world, and although I’ll still be that for a long time, this marks another step in their journey to independence. Don’t get me wrong, I do have days when it’s exhausting and I don’t enjoy it so much, but overall I’m happy to respond to their nutritional and emotional needs in this way and will miss it as they need breastfeeding less over time. I plan to let them self wean like the older boys did, so I don’t know how long we’ve got, but I hope quite a while yet.

There have been ups and downs over the past few months, particularly with regards to sleep. The dreaded 4/5 month sleep regression hit at around 4 and a half months. This is a completely normal developmental phase and shows that they are learning lots of new skills, but it was extremely difficult with twins! When all is well I don’t think twins are any harder than two singletons close in age like I had with the boys, but when they’re going through a leap/growth spurt/sleep regression at exactly the same time, that’s definitely the hardest part about twins compared to two singletons.

I have done lots of overnight feeding, though sometimes they’d be awake without wanting milk. Before the regression I used to prefer tandem feeding them as nice sleepy babies at night, so I’d try to wake Naomi to have a go at feeding when Samuel inevitably awoke before her, and she’d sometimes have a bit of a dream feed but was pretty much sleeping through the night (much to my amazement at this age as none of the boys have done that so young!) But once the regression hit I preferred to feed them lying down in bed to maximise my dozing time with all the wake ups, and that’s only really possible for me one at a time, so I would actually be quite thankful if they tag teamed then, as long as they settled again, which wasn’t always the case and my days ended up starting at 3/3:30 am!

A few things really helped us get through the increased night waking. Firstly we have a bed which is set up for safe cosleeping. Next to our double bed is a cot bed with one side off that is attached with cord to the bed frame, and the mattress pushed right against our bed with noodle floats (under the sheet) down the gap against the other side of the cot bed. This means the babies have their own space, but I can simply slide them to and away from me to feed in the night as needed. Tom sleeps downstairs so I have the double bed which allows me to tandem feed safely sat up with the tandem pillow if necessary. I would find it much harder to settle them both, and get up and bend down over in to a separate cot if we had that.

Secondly I have taken any opportunity to nap in the daytime when I can. This means weekends when Tom is around and some weekdays when my parents have come over. I go to bed when the babies settle anyway, so I can’t get any earlier a night, but even just an hour in the day makes me feel better. The babies nap well in the slings for Daddy and grandparents too whilst I nap. Some might say that it would be helpful if others could give them a bottle and give me rest in that way, but unless someone is going to help me all through the night, it wouldn’t really gain us anything. I’d rather Tom got sleep so he can work well, look after the boys and do housework, which I’d only have to do instead if he helped feed the babies. And I’d rather sit and feed babies whilst tired than try to do anything else.

Thirdly I find with breastfeeding that I get back off to sleep much more quickly after being woken than I have done in the past when not breastfeeding. This is down to the hormones involved. So if I’m going to be woken up, I like the fact I drop off again as soon as they settle. I think that aspect would be much harder for me if I wasn’t breastfeeding because I know I find it hard to fall asleep again if woken abruptly.

Thankfully we seem to have come out of this sleep regression now, after about a month of broken sleep, ranging from mildly unpleasant to downright horrendous nights within that month. Naomi is back to sleeping ridiculously well for her age and Samuel is normal for his age with a few wake ups for feeding and relatively quick to settle. I seem to have written a lot about sleep here! It is inherently linked to feeding because most of the times that they wake they want to feed to some extent, though there have been times when they were just wide awake and happy in the early hours without wanting milk. And the fact that they have spontaneously snapped back into each of their “normalities”, without us changing anything, shows it wasn’t that they needing weaning into solids to help them sleep any better, which is still quite a prevalent idea in our society despite the NHS advice to wait until around 6 months to introduce solids.

Before they were born, one of my apprehensions about breastfeeding twins was the logistics of feeding both together or one after the other, and also how that would work with our set up with the supplemental nursing system (SNS). I have been so pleased with my second hand purchase of the Peanut and Piglet tandem feeding pillow. It fits my body shape and size brilliantly and is so comfortable for the three of us. The twins still fall asleep on it sometimes and I usually enjoy the rest I get when trapped underneath it, which is even more comfortable with the addition of a travel neck pillow to rest my head. I can see us using it for several months to come; I think they’ll grow out of it in terms of their arm flailing and whacking each other at the front before they grow out of it length wise! I don’t tandem feed all the time, less so when I have help to entertain the other one, and often even if both are on the pillow with me they’re not necessarily both feeding simultaneously, sometimes I’m just holding the non-feeding one sat up next to me.

I’m also really pleased with how our homemade supplemental nursing systems have worked this time. I got into using the homemade version towards the end of feeding Joel with it, having previously relied on the Medela branded version with both boys. Our version is basically an ordinary baby bottle with a thin (size French 4) NG tube pushed through the teat. I find this system easier to clean and sterilise than the branded one, and the flow seems easier to regulate. I found some tubes on eBay – they are puppy feeding tubes – and then got some more through a family member who is a vet nurse. Since we have bottles anyway because I mix up formula in those as it’s not really possible to do it in the Medela SNS itself, this makes the homemade version quite a bit cheaper. I use a Lactaid branded system when out and about because it has a neck strap so I can keep it there under my top to feed as and when I need to when we’re out. I was kindly gifted this by another twin mum, but I wouldn’t buy one myself as it is very expensive to import from the USA, and to use long term would work out even more expensive as you have to buy more disposable bags to refill. I don’t need a neck strap at home because I can rest the bottle on the tandem pillow or hold it in my hand when single feeding.

I’ve found that it’s only practical to feed one at a time with the SNS, because even with the tandem pillow I need both hands to position the tube properly on each baby at a time, and since they’ve been more grabby with their hands and pull it out a fair amount when feeding, it’s impossible to have two tubes – I’ve tried a couple of times and it just ends up a big flailing mess. But it seems to work out that one is happy to suck on bare breast while the other has the tube, and only when they are both really grumpy or overtired does tandem feeding get a bit vocal. I’ve not been able to connect with any other twin mums who have used the SNS long term, so it’s been a case of experimenting with what works for us. Both babies seem to be feeding, growing and developing well, so we’ve not changed things when they’ve worked.

It’s such a good feeling to be able to say that the twins have been fed exclusively at the breast for 6 months! They haven’t had a single bottle in that time, and I don’t intend that they will ever need one now. Of course they have had formula to top up my supply, but it’s all been consumed via the SNS. This means they have maximised the amount of milk they’ve got from me, and we’ve been able to enjoy the benefits of a breastfeeding relationship that go beyond the milk. I know that for twins we are blessed to be in this situation. It’s not unusual for twins to be born early and therefore struggle to feed at the breast for days, weeks or months. Despite my chronic low supply, we’ve had it quite easy in this respect. Strangely I don’t feel that unusual in the twin breastfeeding world compared to in the singleton breastfeeding world. I think it’s because lots of twins end up being mixed fed breastmilk and formula at some point, either short or long term, and for the first time I’ve really felt like I fit into the online breastfeeding community in the form of the Breastfeeding Twins and Triplets UK Facebook group. It took me to have twins to feel like I belong!

It’s apt that in the same week that were marking 6 months, I’m also starting an online course with the Association of Breastfeeding Mothers to become a breastfeeding peer supporter. I’d been thinking about this for some time, but when the opportunity came up to do it with a funded place via a crowdfunder campaign in the Facebook group I mentioned above, I thought it was finally the right time. I think my experience would be useful to share with other mums, in terms of twins and breastfeeding with low supply. I’ll blog more about how I intend to use the qualification when I’ve done more of the course.

I know there will be more challenges ahead, but 6 months feels to me like the hardest milestone to reach, so it’s a big achievement in my mind to celebrate, and the first one I was determined to get to. I’m looking forward to the next 6 months and beyond now!

Surviving the fourth trimester with twins

Since the twins turned 3 months last week, we’re just emerging from the fourth trimester. We survived it! And, if I may say so, the babies are not just surviving, they’re thriving. The linguist in me finds the term fourth trimester slightly awkward (how can a period of time with TRImesters have four parts?); however, I do like the idea behind the term. 

It refers to the fact that human infants are still so heavily dependent on their primary care giver(s) in the first few months after birth. This means the babies like to be constantly close to me (or Tom, though he doesn’t have food for them 😉 ) and won’t settle easily very far from me. This is normal, a survival instinct. Here’s my list of the essential things that have helped us all through this trimester….

Slings:

I would say this has been the most essential one. We don’t have a pram/buggy, so the twins have come everywhere literally wrapped on to me. With two older boys to run around after, we do a lot of walking. And actually the twins nap best when walked outside in the sling, so it’s not just with the boys that we venture out. I have three woven wraps – a size 6, a size 7 and a ring sling. The 6 and 7 I’ve used for tandem carries, and the 6 and ring sling for single carries when one needed holding closer than the other around the house or if I’ve had another adult to carry the other. Babies love being held close and warm to us in this position and moving because it reminds them of the womb, so helps them transition to life outside the womb. It’s no wonder they sleep best here.

Twin breastfeeding cushion:

I’m so pleased that I bought a twin feeding cushion, because it’s such a big help when I’m on my own with the babies. There are a few different brands, but the one that suits my body shape best is the Peanut and Piglet. They don’t always want to feed exactly at the same time, but it’s still good to be able to have them both there next to me, and they both nap well there after a feed. This just means I’m stuck on the sofa for longer – not always practical, but sometimes I do just that, and it’s what I’m doing right now as I type. If there’s another pair of hands around, I do more single feeding as the other baby can be held/jigged as I feed one. 

We made it to 3 months of exclusive feeding at the breast! Our homemade supplemental nursing systems have been brilliant, and the babies have fed well, meaning they haven’t needed to have any bottles. I estimate that they get roughly 50/50 breast milk and formula each on average. I actually think it would be harder to bottle feed twins on my own, at least in a properly paced manner, because it would be hard to hold two babies and be responsive with two bottles at the same time. Instead I can set up the SNS, stand it on the cushion, and let them feed as an exclusively breastfed pair of twins would. 

Practical help from family:

We would absolutely not have survived as well as we have done without a lot of help from my parents and Tom’s parents. I give a huge hats off to parents of twins who do it without family or paid support. We are blessed with this extended family village that many families have lost these days, and it helps that 3 of the 4 of them have recently retired meaning they have more free time to spend with us. They have helped in practical ways such as looking after the older boys, cooking, cleaning, laundry, and even planning a garage conversion so we have room for the twins to sleep when they move out of our room! This has meant that I have been able to give the twins so much of my attention, instead of having to split it between all these things. It helps too that Tom has such a short commute and a flexible job, so he too has taken on a lot of jobs around the house that I would usually do, which he’d done when I was so sick in pregnancy anyway.

Acceptance that life is chaotic:

I think my expectations for life with newborn twins were pretty low – I knew it would be chaotic and I knew we wouldn’t be able to attempt to just carry on as normal. So this helped me, even before they arrived, to embrace the chaos and not worry about it. We get by on the minimum of housework, and just work on getting everyone fed, toileted, and to the right place at the right time each day. We have managed the odd day trip out together as a family, but only with extra help from extended family (see the above section!) and I certainly wouldn’t attempt that more than once every couple of weeks or so because even then it’s pretty full on. I know it won’t be forever, and lots of time around the house and just doing plenty of local walks has really helped me feel like I’m enjoying the babies and this time with them so young.

A smart phone:

I’m typing on this right now, in the notes section, and will squeeze in a few minutes on the laptop at some point to publish the blog post. I use it to watch TV in the middle of the night to keep me awake whilst tandem feeding. I use it to do bits of online shopping. I use it to chat with other people via social media, particularly other mums with twins who know exactly what life is like at the moment, at any hour of the day or night (there’s always someone up!) – it’s a virtual “village” of solidarity. I use it to keep up to date with the news and to check the weather (do I need to take my umbrella with us everywhere today?) I use it to keep an eye on how my business is ticking over whilst I’m on maternity leave. One of my favourite features is the camera, so I can quickly snap all sorts of moments I want to remember as they occur, and the pictures automatically appear on our cloud back up so I can do something with them at a later date. All these uses are found in one handy device that fits in my pocket. I didn’t have one when the boys were babies, and used to wonder if it was worth it. My conclusion now is that it definitely is. So I’m very grateful that we are blessed with the means to be able to afford one.All these things have helped us so much over the past three months, and I’m sure they will continue to do so as we head on out into the next three and beyond….

Breastfeeding twins – getting off to a good start despite hypoplasia

I’m sat here typing one handed on my phone as I breastfeed a twin. Sometimes I feed them individually, sometimes in tandem with my trusty preloved Peanut and Piglet tandem feeding pillow – it depends who is awake when. They’re currently 3 weeks old, and compared to the first few weeks of my singleton boys’ lives, feeding is going extremely well. This is partly due to the fact that I know so much more about breastfeeding and about my condition called breast hypoplasia (underdeveloped breasts) and consequent IGT (insufficient glandular tissue), and partly because the twins have fed brilliantly right from the start, with no issues such as low blood sugar or jaundice to contend with.

I was expecting them to be lower birth weights and therefore potentially need a bit of special care where it may have been suggested to top up with formula if they struggled to maintain their body temperature and/or blood glucose levels. But I managed to produce enough colostrum during our 3-day-2-night stay in hospital to sustain them. It helped too that I had managed to express several 1ml syringes worth of colostrum antenatally, so I gave them these in hospital as well as feeding them regularly. As I wrote in the twins’ birth story, I was impressed at the huge amount of uninterrupted skin to skin time and therefore chance to freely feed that we had for about the first 10 hours of their lives outside the womb – I’m sure that this really helped us get off to a good start with breastfeeding.

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When they were first weighed on day 3 at home by the community midwives, Naomi had lost 10% of her birth weight and Samuel had lost 7%. These were both still within acceptable limits, and the midwives were happy that they looked well and that we knew what we were doing in terms of looking at nappy output etc. to see if they were getting enough and topping up with the SNS (supplemental nursing system) as necessary, after I explained our history with feeding the boys. My milk came in on day 3, which is earlier than I was thinking it might do after an elective c-section, which meant I didn’t go into spontaneous labour and therefore didn’t get to go through the hormonal process that occurs for this. My hypoplasia means I don’t really get a huge full feeling when my milk comes in after birth, but I could feel some firmness and could hand express milk that looked mature and white instead of the yellowy colostrum that it had been.

I decided that we needed to start some small top ups with the SNS on day 3, because I didn’t feel that my milk was enough to satisfy them, and nappy output started to dip a little, though soon picked up again. Even with some small top ups, their poo still looked breastfed by day 5 – yellow, loose and seedy rather than pasty like formula fed poo. In fact it still does at nearly 4 weeks old, so I’m assuming that they are getting a decent amount of milk from me – probably around half breast milk and half formula based on formula amounts taken by the average baby as well as the look of their poo! This is not bad going considering there are two of them. They were and still are soaking through a good amount of cloth nappies too.

By day 5 at their next weigh in, both had put on a good amount of weight in 2 days, so this was a great reassurance that we were going in the right direction. The next weigh in was at 13 days, and they had continued to feed well with the SNS in that time. Samuel had gone well beyond his birth weight, and Naomi was only about 80g off it, which the midwives were very happy with. They couldn’t discharge us just yet due to this 80g, but when they came back to weigh them at 21 days old, both had put on a great amount, were well over birth weight, and were starting to look like they’re following a line on the graph. I can’t quite believe how little an issue weight gain has been, after all the struggles we went through with Andrew after his dehydration in the first week and with Joel for his jaundice and related sleepiness in the first month or so. It’s such a relief to not have the battle with health professionals over the dreaded growth charts. And these are twins! And I have low milk supply!!

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The only slight issue that we have encountered is tongue tie. But again this hasn’t impacted on us nearly as much as before, because this time it has been dealt with much more quickly and less stressfully than with Andrew’s. The midwife who did the twins’ health check 24 hours after birth in the paediatric clinic at the hospital picked up on the fact that both had posterior tongue ties when she looked in their mouths. I had noticed Naomi’s myself, now I know what I’m looking for, when she was placed on my chest straight after birth, screaming her head off in my face! The midwife was very helpful and straight away told us how to get a referral to the nearest NHS tongue tie clinic at the hospital in Dudley. It was all done quickly and electronically – Tom filled in an online form, I got a quick phone interview and then an appointment through by email for when they were 24 days old.

With the help of my mum, we went to the appointment on Friday. It was such an amazing clinic, run by a midwife who clearly was an expert in tongue ties and passionate about breastfeeding. She assessed them thoroughly with a points-based system, and agreed that their posterior ties meant they weren’t maximising the amount of breast milk they could get out of me, and the fact we have to top up anyway due to the hypoplasia is masking this in terms of their weight gain being ok so far. I’ve not had any real pain whilst feeding, but I have felt that their latches were fairly shallow, and that tandem feeding them in particular was less comfortable than individual feeding. And I’d never had any real pain with Andrew before he had his snipped, but noticed the difference afterwards with a deeper latch.

So we went ahead with the snips, and both fed well from me straight afterwards. There were a few more tears from Naomi than from Samuel, who wasn’t crying at all by the time he was handed back to me. Both were mainly before they were even cut due to the fingers they had firmly holding them in their mouths, but they calmed down whilst feeding and went back to sleep after the feed. I have noticed how much wider their mouths open and therefore the deeper latches they now get, plus tandem feeding has become more comfortable.

As well as the midwife who runs the Dudley clinic, there was another one there who is currently shadowing her with the view to setting up her own NHS clinic in Bolton. It’s so good to see that this is being taken seriously by certain professionals within the NHS. I’m so glad we didn’t have to pay for a private lactation consultant to do the assessment and snip this time like we had done with the boys (Joel didn’t need his snipped).

Both of the midwives were very much in awe of me persevering with feeding like I do, despite the fact I’ll never be able to exclusively breastfeed, and thought I deserved a medal for feeding twins entirely at the breast using a supplementer. For me this was lovely to get recognition for my determination, and a reminder of why I do this despite all odds, something I don’t think of often enough myself. Most midwives I have seen at hospital and in the community haven’t had a clue what an SNS and hypoplasia even are when I’ve explained my breastfeeding story, so it was great to be able to talk about these things with professionals who are experts in lactation and know what I mean.

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So this brings us to where we are now. We’ve been handed over to the health visitor, who said they only need to be weighed once a month now unless I have concerns about their feeding. Having the ball in my court like this, being trusted on feeding and no pressure for weekly weigh ins is such a world of difference from the stress that we felt before with the boys. I’m genuinely enjoying this breastfeeding journey a lot more already, and we’re not even at a month old yet – it took a good few months to get to this before with both boys.

The twins’ birth story

As I had written about throughout pregnancy, I was hoping to give birth naturally to the twins. It turned out that this wasn’t meant to be, and I ended up with an elective Caesarean section. However, overall it was a very positive experience, and I can look back with good memories of welcoming them into the world.

I had spent the weekend trying to walk as much as possible, in the hope that it would encourage the twins to arrive on their own, but to no avail. On the Monday I had a pre-op appointment, to give some blood samples and talk to an anaesthetist about the procedure. I wasn’t feeling very positive about the prospect of a c-section, I honestly thought that labour would have started by now and I wouldn’t be in the position of having to make such a big decision about how the twins would be born. Tom was also getting fed up of being on standby whilst at work, so he decided to come with me for support and start his paternity leave half a day early. I had briefly spoken to the consultant at my last clinic appointment about what the alternative to a c-section would mean in terms of “waiting it out”, but as we didn’t know I’d get to that point, it was assumed that this conversation would come later. We weren’t sure if we’d get to have this conversation at the pre-op, but we were told then that we’d definitely get to have it before anything happened on the day of the operation (Tuesday).

So we arrived at the hospital nice and early at 7:30am on Tuesday. We were called in first (I’d been told that twin mums get priority on the elective list for the day). They did some obs on me, and of course my blood pressure was high. Not only was I in hospital, but incredibly nervous about the prospect of an operation. So this meant I had to stay in the obs room for monitoring – the midwife strapped two foetal heart rate monitors to my bump, took some blood and I did a urine sample. As I suspected, there was no sign of distress in the babies and no sign of preeclampsia in me, as usual.

Whilst I was there, an obstetric registrar came in with an ultrasound machine and asked if I wanted a scan to check the positions. Of course I said yes, and she looked closely at which twin was nearer the cervix. She said it was very close, but that the breech one was just slightly closer. Both were presenting very low in my pelvis, which doesn’t always happen with twins – often one is higher than the other. Without me asking, she then went on to have the conversation I was hoping to have about whether a c-section was necessary or whether I had the option of waiting it out. She was of the opinion that it depended how much I was keen to have a vaginal birth, to which I replied very keen! She talked about the possibility of a gentle induction – no hormone drip, just an internal examination with membrane sweep to see how far off labour I was, and possible breaking of waters if I was dilated enough. This sounded positive to me, and I was glad that she was open to the possibility of not just ploughing ahead with a c-section regardless. However, she said she needed to run this all past a consultant, before agreeing anything with me.

After a short wait, she returned. The consultant had picked up on something that she hadn’t thought of, and that was the risk of “head lock” in a vaginal birth. This is when the breech comes out first, with its bottom presenting first, but as the head comes past twin two, the chin of twin one locks onto the chin of twin two, which is near the cervix as it is presenting head down. As our twins were both so low, the risk of this head lock occurring was higher than if one twin was sitting higher up than the other in the uterus. If this head lock situation were to happen, it would mean a very fast emergency c-section, and even then the outcomes for twin one aren’t good at all. I looked this up myself from respectable sources I found on Google, as well as taking the doctor’s word for it. I decided that I didn’t want to take this risk, and that a planned c-section was the best option for us in this circumstance. I felt that it was meant to be that I hadn’t gone into spontaneous fast labour with them in this position, because if we had have found ourselves accidentally staying at home, or worse still in the car, the consequences of head lock could have been far worse than at the hospital with an operating theatre down the corridor.

Once the decision was made, it was time to get prepped for the operation. The midwife took the monitor off my bump, and I got changed into a gown and compression stockings. We then had a short wait in a delivery room until it was our turn to go into theatre. Tom also had to get changed into scrubs.

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The midwife showed us down the corridor and into theatre. Everyone in there introduced themselves. There were lots of people, mainly because with twins they need two of some types of staff! But is was a bigger room than I was imagining, so it didn’t feel overcrowded. Everyone started to get their bit ready, and soon the anaesthetist asked me to sit up on the operating table and curl forwards over a pillow so my spine was rounded. She sprayed a cold local anaesthetic on me, then apparently put the spinal block needle in, though I didn’t feel a thing. Pretty soon my feet started to feel warm and fuzzy, and she checked that this was the case. They then pulled my legs up onto the table and I lay down. The obstetricians set up the screen in front of me, whilst the anaesthetist talked through what she was doing with me – attaching a drip and BP cuff. She then got a cold water spray, and sprayed some on my arm, then down on my abdomen, and asked me if it felt cold like on my arm. It didn’t feel as cold, which showed that the spinal block was starting to work. She also checked that I couldn’t move my legs, which was really weird – like my brain was trying to do it as I thought about it, but I couldn’t actually make them move! At the same time, one of the theatre staff put a catheter in, which I couldn’t feel. After a few minutes, the anaesthetist did more of the spray tests, until I could feel no cold right up to my chest, and also some pinching tests on my abdomen – I couldn’t feel a thing. We were good to go, as she put it.

It wasn’t long before I could feel the doctors rooting around inside me. A very odd sensation, I could tell they were in there, but felt no pain at all. The next thing I knew, there was a loud cry from a baby! We had made sure they knew that we wanted to discover the sex of each baby ourselves, and the midwives were brilliant in this respect. The baby was passed to them, given a very brief check over, and within a minute was brought around naked, still attached by cord to the placenta, to our side of the screen. A boy! He was taken back over to the baby table, weighed, wrapped up in a towel, and Tom was asked if he wanted to cut the cord. He didn’t want to, so the midwives did it.

Meanwhile I could still feel the doctors rooting around inside me, and pushing quite firmly on my bump. Then, two minutes after the first cry started, we heard the second cry. Again the baby was quickly brought naked to us – a girl! I couldn’t quite believe that! What was more shocking though was when we were told her weight. It was in metric – 3.3kg, and although this doesn’t mean much to me, I did remember that the boys had been roughly 3.4kg and 3.5kg, so i knew she must be about 7 and a half pounds! I was not expecting a girl twin to be almost the size of my boy singletons. But then I thought maybe in my anaesthetised state I wasn’t computing that properly. The midwives confirmed though that she was big for a twin, as they cut the cord and wrapped her up in a towel.

Whilst the doctors stitched me up, the babies were brought to us to hold. Tom held the boy whilst I had the girl across my shoulder in my arms, supported by the anaesthetist who had remained by my head throughout and was great at explaining what was going on. Once I was ready, it only took a few minutes to transfer me to a bed. Meanwhile Tom went with the babies and midwives to the recovery room first, followed shortly afterwards by me. Within 10 minutes of birth, the midwives were encouraging us to unwrap the babies and get them skin to skin with us. At first we had one each, and I fed the one on me. They both latched brilliantly straight away and had a good suck. I was really expecting this to be an issue if they’d been born smaller, so I was so happy that they were able to do this pretty much as quickly after birth as the boys had done.

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The babies had routine tests of temperature and blood sugar done, and the little boy was a bit cold and had one low sugar reading, so the midwives got me to do skin to skin with them both at the same time, and wrapped us all up together in several blankets, whilst we continued to feed. They continued to monitor them, and they warmed up as well as maintained good blood sugar levels, so they didn’t need admission to special care.

I was monitored for about an hour, and was offered some toast and lunch in that time. It felt so amazing to want to eat again! I don’t think I remember exactly when the sickness left, like when I delivered the placenta after Joel was born, probably because there was so much going on in theatre. But I knew I wanted to eat, and simple white buttered toast never tasted so good! Then I enjoyed a tasty pasta bake a little later.

I was losing quite a lot of blood, which is pretty normal for twins because the uterus has a long way to contract back down. But as a precaution the doctor who reviewed me wanted to keep me down on the delivery suite in a room so that I could have one to one midwife care for a few hours or so rather than going straight up onto the ward. I felt fine in myself, and my BP was stable in the normal range (not too high or low).

We spent the afternoon just the four of us with occasional midwife visits to check all was well and to do obs. It was a really lovely time to be able to chat about names and enjoy those first hours uninterrupted. We weren’t sure that we’d get to have this in a busy hospital. And we hadn’t had this time after the boys were born because it was the middle of the night and we were both tired so tried to rest in the birth centre. So in the end we managed to come up with our final name choices more quickly than we’d imagined. They are called Samuel John and Naomi Grace.

The boys came to visit with Granny and Grandad in the early evening. They were very impressed with their new brother and sister, and seemed to enjoy their brief trip to see us all. Not long after they’d left we were moved up onto the postnatal ward. We had our first glimpse of what it’s like to have twins in public, as the midwives wheeled me on the bed holding the twins in my arms through the reception area to the lift, and we turned lots of heads and got several “ah twins” comments.

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Tom stayed with us in the ward into the evening until around 10pm. The night shift midwives on the ward introduced themselves and told me to call if I needed any help lifting the babies to me. The cot was right next to my bed and at the right height, so actually I found it quite easy to reach across. The effect of the spinal block was wearing off and I had most movement back in my body and legs. Not that I was able to get up out of bed yet, mainly because I had the catheter attached to me and the bed still, so I tried to rest as much as possible in between feeding the twins who were quite sleepy now. It was the other noises on the ward keeping me awake, like snoring, other babies crying, monitor bleeps etc., then it got completely light by 5am.

All in all it was a very positive experience, and one that I can look back on and feel that the twins were born in the best possible way for them given the circumstances. I still would have preferred a vaginal birth like my previous experiences, and I can’t deny that the unavoidable positions of the twins means I’m a little disappointed at this, but I’m glad that modern medical techniques like the c-section exist to help in cases where natural birth may lead to seriously poor outcomes. We don’t know, we might have been alright, but I was glad that I’d been through the surgery in a calm and planned manner than having to do the same in an emergency.

I was especially pleased with the amount of uninterrupted skin to skin time we got, which is important for babies born via c-section in terms of seeding their microbiome – vaginally born babies get their seeding of “good bacteria” as they pass through the birth canal, whereas c-section babies don’t, so we should try and make up for it in other ways such as being skin to skin with mum and breastfeeding. I’m hoping that both these things will have given the twins as good a start as possible despite the c-section.

37 weeks – still pregnant, again!

Well if I wasn’t sure I’d get to write last week’s post, I definitely didn’t think I’d get to write this week’s! We appear to have somehow got to the start of 38 weeks. I feel this is quite an achievement for twins.

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I’m pretty desperate for them to arrive now though. They will be well and truly developed, and we’re only about two weeks earlier than when the boys were born at 40 weeks. I’m still holding out for a natural birth, even though we don’t have long left, because I know my body can do it and the thought of surgery I find pretty scary. But I know that there’s always the possibility that this is for the best, so of course I am willing to go down that route if needed.

I was supposed to have a c-section booked for early this week, and I was in the room when the consultant rang the booking office to request a date over two weeks ago. But when I’d heard nothing by Monday earlier this week, I rang up to see what was going on. In a moment very much like the Little Britain sketch “compu’er says no”, the receptionist I spoke to said there was no record of my name or number on the system for c-section bookings. Gotta love the NHS for admin efficiency! In this case I’m actually not bothered, because it’s given us an extra week to wait for them to arrive spontaneously. But what would have happened if I didn’t chase it? Would I just have been left to my own devices until I turned up in labour, whenever that might be? Thankfully I’m clued up on the risks of later pregnancy with twins, and what to look out for in terms of reduced movements and rising blood pressure, but would everyone be the same? She said that she’d ask one of the midwives what to do, and I made sure she knew it was twins and therefore she may need to speak to the twins specialist midwife or consultant.

I’d still not heard back by the next day, so I tried to chase it, but couldn’t get through to the antenatal clinic where I’d spoken to the lady the day before. Eventually, later that morning, whilst I was in the swimming pool, I got a call and then voicemail from one of the twins consultant’s secretary, saying she had a date and could I ring her back to find out what it was and other details. So I did, and was pleased that it’s not until Tuesday, which is 38 weeks and 4 days, so that still gives the twins time to come on their own.

I haven’t yet had any signs of labour, but then I never do get much warning, so it’s perfectly possible that they will be born this weekend. I’m doing as much walking as I can manage, in an attempt to bring on labour. It’s fairly uncomfortable on my hips – not really pain, just pressure. I’m also eating large amounts of pineapple, which might help the cervix to soften, but I would probably have to eat even more than I am for a real effect. I love pineapple anyway though. I’m bouncing on my birth ball when sitting down, and spending as much time as possible on all fours with my arms over the birth ball for support. Both of these positions are supposed to help.

Of course I don’t actually have to have the c-section on Tuesday at all – I could “wait it out” for longer. The consultant had said that this would involve daily trips to the hospital for monitoring, though as I said, goodness knows who in admin would actually follow up on that, but for my own peace of mind I think I’d want to anyway. However, I’d also experience anxiety and high blood pressure every day at the hospital, which isn’t good for me or the babies, so I’m not sure overall that this would be a good idea. They might even insist I stay in with high BP, which I would really hate.

I feel like we’ve come so far, and the icing on the cake for waiting this long would be the natural birth that I’d really like to have, so why just cut off at 38+4? But equally I have a sense that if they haven’t come spontaneously by then, then it’s probably not meant to be, and I’d rather have a calm, planned c-section than an emergency one once I’m in labour. Maybe the breech position of twin 1 would require intervention, and the bigger they get, the more likely this is, even though I believe it is perfectly possible to birth a breech baby, particularly with the help of skilled doctors and midwives at our hospital who are used to assisting delivery of breech twin 2s.

It’s still very much not in my hands, and I trust that the right birth will happen at the right time, even if I still don’t know what that is!

36 weeks – still pregnant!

I wasn’t sure if I’d get to write a post this week. But as it’s Saturday morning and there’s no sign of the twins arriving yet, I thought I’d do a quick post!

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There’s not that much to report, other than I’m very pleased to be able to say that we got to full term! Friday was the start of 37 weeks, which is the official day that any baby is no longer classed as premature if they are born on or after it. I think this is quite an achievement for twins, who tend to come earlier on average than singletons. I do think that ironically the sickness has helped us – I’ve had to rest loads to keep it at bay, and I think rest is one factor that helps a twin pregnancy get to term. I am, however, still looking forward to delivering those placentas and being able to eat and drink normally again!

I’m very grateful this week that Tom’s parents have been here for half term. We thought they may be needed to look after the boys at any point if the twins arrived, but instead it’s been lovely for me to just take some time for me and rest some more. I have done a few things with them, like swimming and a visit to the Botanical Gardens (which are nearer to the hospital than our house!), but mainly they have taken the boys out to places of interest further away like the Think Tank and RAF Cosford whilst I stayed at home.

I was supposed to hear from the hospital this week to confirm the elective c-section date and pre-op appointment. I haven’t heard anything, so I’m guessing there’s been some kind of admin slip up. As I’m not that keen on having an elective c-section until we’ve waited a bit longer anyway, I haven’t gone out of my way to chase them. If I’ve had no signs of labour by Monday, I will chase it up and probably try to set a date for Friday (38 weeks). Maybe this is a sign that we won’t need the elective c-section anyway?!

So we’re still waiting, but we must be very near the end now! I am still fairly confident that they will come spontaneously this week if we give them chance until the end of the week. If I say it often enough, it has to be true, surely?

35 weeks – hospital trips

After an uneventful few weeks of plodding on, this week has seen quite a bit of action. No arrival of twins though!

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Over the weekend I noticed in my home monitoring of blood pressure that it was starting to rise a little. Still it was within normal range, but until that point it had been so consistently on the low to average side, so I kept an eye on it. The doctors had always said in all our chats earlier in pregnancy about blood pressure that it’s quite normal for it to rise in the third trimester, particularly with twins, and have trusted me to go in and see them if it got to the threshold of being too high. By Monday morning it had indeed just breached that threshold, so I went in to triage – thanks to my mum for keeping me company and to my dad for looking after the boys. In hindsight, I think some of the rise was down to me worrying that it had suddenly risen a little, even though I know this is normal, and the trouble with that is the worry makes my BP rise even more.

I hadn’t been sleeping so well for a few nights, partly being so warm, and partly because it’s uncomfortable lying down, even with extra pillows (which add to the warmth!) So by Monday morning I was just very fed up, tired, and worried about what might be happening. Would it be the start of preeclampsia and therefore I’d have to stay in hospital until they’re born, and would that completely scupper our chances of a spontaneous vaginal delivery? The midwife who saw me in triage was lovely, very reassuring and understanding of my white coat hypertension. She fixed me up on a foetal heart rate monitor – complete with two sensors 😉 and took some blood and urine samples. Everything was fine, with no signs of preeclampsia (no protein in the urine, liver and kidney function normal from blood tests). That in itself made me feel better. So basically it just seemed to be a bit of late pregnancy induced hypertension, not helped by my worry, which should be controllable with a drug.

The midwife did warn me though that the doctor would probably want to keep me in overnight just to check that the drug would indeed stabilise my BP. And that’s what he said when we saw him. I recognised him as the consultant who did my first scan at the hospital to check that I had two placentas. So I was admitted, first to the delivery suite, which was slightly unnerving, because I didn’t think there was any kind of rush to deliver that day! But it turned out that was down to staff ratios – they wanted me to have a couple of hours of one to one midwife care to check the drug was having an effect, before moving me up to the antenatal ward where they only do obs about every 4 hours. They also suggested it was a good idea for me to have a steroid injection at that point – this is to help the babies’ lungs mature a little more before birth, and is often given to mums who may end up delivering early for whatever reason, apparently it’s common for twin mums to have it, though at the end of 35 weeks, our babies should be pretty mature by now.

Thankfully I did respond well to the drug (which I knew from before), and I was moved up to the antenatal ward just before tea time. It was absolutely sweltering up there – the sun was coming directly through the window next to my bed and creating a hot greenhouse effect, with only a small openable window available. After tea it appeared to be “foetal monitoring hour”, and everyone in the room got strapped up to a machine. The sound of various heart beats going all at once, including two from us, was quite an experience!

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Two heart rate sensors strapped to my bump!

The ward seemed to be quite a mixed bag of ladies in terms of what we were in for. Two in my room were clearly there as the start of induction. As I tried to get some sleep later into the evening, it became clear to me that one of them was dilating much more quickly than the staff realised, which is what happened in my labour with Andrew, as all I could hear were her screams with each contraction. This was not exactly helping me sleep or keep my blood pressure down! I felt like shouting over to get her down to delivery! Eventually they did, with what sounded like not much time to spare. I think I got a bit of sleep once she was gone, but it really wasn’t the best environment to spend the night. The night shift midwife did, however, help direct a cool breeze from the window on to my back when I asked for a fan but there were none left for me.

In the morning I saw a doctor, who was lovely and agreed that I didn’t need to be in hospital if I was monitoring at home, and my BP had been stable overnight so was clearly responding to the drug. She wanted me to have some repeat blood tests just to check again for preeclampsia, and a few more obs in the day, but I needed to wait around until the afternoon anyway, to have the second of the two standard steroid injections 24 hours after I’d had the first. All was fine during the day, so I got home that evening after a rather chaotic discharge. I enjoyed a long sleep in my own bed that night! The next day my BP was consistently low, lower than it had been even in the second trimester, but I’m happy to take the small dose of drug and deal with low BP for the sake of only another week or two.

Then the following day I was due to have our final growth scan anyway, so I was back at the hospital for that and clinic. All was well at the scan. The twins are continuing to grow well and at a similar rate. They are still average size for gestation, and there’s about a 5% difference in size between them. Estimated weights are currently about 5 1/2 lbs each, though as I’ve said before, this has to be taken with quite a pinch of salt because scans aren’t always that accurate in this respect. It does seem plausible from my point of view, because I look/feel much bigger than I did with 7,11 lbs and 7,9 lbs worth of baby in there before! Unfortunately twin 1 is still breech, though twin 2 is head down. This may make delivery more complicated, if he/she doesn’t turn in time. And I have to say there seems so little room in there now from what I could see on the blurry scan!

In clinic I saw the same consultant as last time. We chatted a bit about BP, which was of course high in clinic, but she commented that I’ve now proven that I will go in if I’m concerned, so I’ve definitely won their trust in me on that one now! She was happy that it’s under control and I know what to do if I see changes again.

The conversation about birth options was pretty much the same as last time. If they come spontaneously in the next week or so, and if everything goes as fast and smoothly as before, then the doctors/midwives at the hospital are experienced enough to assist me with a breech vaginal delivery. I just need to go straight in at any sign of labour and we would assess from there the best course of action depending on how labour progresses. If I quickly get to full dilation then there’s no point working against nature and doing a c-section just to pull a baby back up and through my abdomen! Of course if there are concerns about it not going quickly and smoothly then they would recommend an emergency c-section.

However, if they don’t come spontaneously soon, I need to make a choice as to how to proceed. She suggested that we book in an elective c-section date now, so we know it’s there if needed, and if not then great. I’m waiting to hear exactly when this is, but it should be on Monday 5th June or soon after as that was her request, depending on availability. This is half way through week 37. She did make clear that it is entirely my choice, I don’t have to follow her advice, I could decide to delay, but the risk of stillbirth increases beyond the end of 37 weeks, so it would mean daily trips to the hospital for monitoring if I wanted to wait it out for a spontaneous labour and possible turn of twin 1. Having looked at the stats myself, the increased risk of stillbirth is there, though it’s still not very high at all, so depending on how I’m feeling by then, I may decide to wait it out, though I’m not sure what my BP would do if I spent an hour or two at the hospital every day!

If twin 1 does turn to be head down, then I would be able to opt for an induction rather than c-section, they just don’t do this for a twin 1 breech presentation, because that’s too high a risk of complications, which I can totally understand. She did say that I would be offered a presentation scan on the morning of the elective c-section, to check their final positions before going ahead, and if twin 1 had turned then I could indeed opt for induction that day instead.

Although I would rather avoid a c-section in terms of recovery, I think this seems like a reasonable and sensible plan for now. I’m still hoping and praying that it’ll all happen quickly and safely like when the boys were born and I won’t have time to think about it, I’ll just get on with it! But I think it’s a good idea to think about the alternatives in advance and be prepared for them. So it’s still a waiting game, and a rather hot one at that.

34 weeks – name decisions and rainbows

It’s been another uneventful week really. I have a little spiel prepared for when people ask me how long I’ve got to go, which happens a lot as the bump is so huge! Not that we know exactly how long there is left, and I’m very grateful to have got to the start of 35 weeks, because whenever they are born now, they should be big and strong enough to not need much (if any) special care.

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Twin rainbows

I’ve become famous at the local swimming pool, where I’m keen to do some gentle non-weight-bearing exercise to keep me moving whilst I feel so big – the staff refer to me affectionately as the twins lady. Mums in the school playground and at toddler groups seem impressed that I’m still going, but life has to go on with older children. That’s not to say I’m not resting loads too though, it’s still a balancing act to get the rest to activity ratio right.

This week Tom and I had a recap on the list of names we’d come up with as possibilities a couple of months ago. During each pregnancy with the boys, we decided on a boy’s name and a girl’s name (first and middle name for each) and said that unless we really felt it wasn’t right when they were born, that’s what we’d use. And so we did. We decided not to tell anyone our girl option, in case we wanted to use it in future. This time we started trying to decide on various combinations of names, but quickly came to the conclusion that it was actually quite tricky – there are so many factors to take into account this time. For example, they’ve got to sound good as a pair, they’ve got to go with the boys’ names as a four, they’ve got to suit our surname, we both have to agree on them (and although we have similar ideas of what we like, we don’t always totally agree on individual names).

So instead we thought it best to wait until after they are born, and at least then we’ll know their sex, before making decisions. This cuts down on the possible combinations that we have to prepare in advance. It also seems much more laid back than we were previously! We do have a list of boy names and a list of girl names to work from, so it won’t all be from scratch. They are stored on Tom’s phone, so we’ll definitely have them in hospital with us. Basically, don’t expect our first announcement to contain names, these will probably follow a few days later. They will still be known as Thing 1 and Thing 2 for a while outside the womb.

To finish, I thought I’d just write a bit about rainbows. As you probably know if you follow the blog or are friends with me on Facebook, these twins will be born following the miscarriage I had in July last year. The term “rainbow baby” is now popular for a baby born after a previous loss. The idea is that the new baby is a bright and positive thing to happen after the pain and difficulty of the storm. It doesn’t mean the rain has gone completely, but it does offer a glimpse of hope for the future. As a Christian, a rainbow also symbolises to me God’s promise that he will never leave us through difficult times. In the Bible, we read how a rainbow was given in the sky to Noah and family after the great flood, as a sign of God keeping his covenant, or promise, with His people that He would never again send such devastation in response to their turning away from Him.

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Last year was really hard for us, and I still get upset writing about our baby whom we never got to meet, but when I think of these two rainbow babies, I trust that God has a plan far bigger than I can ever understand, and that He is always with us, in the hard and the happy times. I don’t often see double rainbows in the sky in this country, but I did see one in the week I did a test for this pregnancy. I was sat watching Andrew’s tennis lesson, the nausea had just started a few days before and I was beginning to wonder if I was pregnant again. The kids playing tennis pointed to the sky behind where I was sat, so I looked around and saw an amazingly clear double rainbow. In hindsight this was a brilliant sign, though it was only weeks later that I saw the significance of double! I didn’t get chance to take a photo, because soon afterwards it started pouring with rain, so we all had to gather inside the club hut to keep dry. I did, however, get to take a photo of the other double rainbow that I’ve seen in this pregnancy – this one was in the second trimester when we knew about the twins. It was a lovely reminder, on a difficult day when I was lying feeling very sick and tired on the sofa, that this will all be worth it. And that’s something I have to remind myself of quite often as the weeks go on and I get more fed up of feeling sick.

33 weeks – writing a birth “plan”

There’s not been much to report this week. As I wrote at the end of last week, I’m trying to get the right balance between resting and keeping active.

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I am getting lots of comments from people I see regularly saying how well I look and how big the bump is getting. I don’t feel particularly well but glad I come across as not looking as rough as I feel. I do feel like my body is very out of proportion with the bump being all at the front – people say I don’t look pregnant from the back. It’s hard to believe it will get any bigger, like how is that physically possible?! But I have seen photos of twin mums who got to 39/40 weeks whose bodies look like they are defying the laws of physics by not just toppling forward. It must be a huge strain on the back, though I don’t have any pain there, yet.

My hospital bag is now completely packed and ready to go whenever. I think we have everything sorted at home, and we have car seats sorted to bring them home in. We got some lovely new hand knitted cardigans this week from Tom’s aunt in very small sizes, so those have gone into the hospital bag. I’m not convinced they need to be wrapped up loads in the boiling hospital, especially in May/June, but better to have them in case any staff insist. I’d rather do skin to skin with them for temperature regulation, but I guess this may be harder with twins if they have different needs.

The one thing that I’d still like to get but haven’t actually bought yet is two sets of milestone cards. I’ve become aware of these since the boys were born, and I think they’re a great idea to easily record developmental and age milestones with a photo. So for example, at 1 month old you take a photo of the babies with a card saying “I’m one month old today”, and then I can go back later and make an album easily without having to remember how old they were on a particular date. I was going to get a twin set – they say “we are….” instead of “I am….” – but actually I’ve decided that two sets in different colours will be better, in case the twins are difficult to tell apart, particularly if they are identical or just look very similar as babies. When we look back at the photos we will definitely have a way to tell who’s who if we assign them a colour of card from the start. I’ve heard some twin mums say that they can’t always tell who’s who in early photos! There are some lovely sets of cards on Etsy, I just need to decide which ones to get.

After the chat I had with a consultant about birth options last week, I decided to write a birth “plan”. I wasn’t sure whether to do this because I’m not entirely convinced that the word “plan” can be used next to the word “birth” – there are so many permutations of what could happen that it’s pretty impossible to predict entirely how it will happen. However, having read the Positive Birth Book, Milli (the author) convinced me that it is worth doing and showing to your care providers. She actually says it’s more like “birth plans”, so A and B, and even C, D, E etc. A is how your perfect birth would go, the others are contingency plans. I see it more like a list of desirable points, which express my general wishes for how I and the babies are to be treated, as far as possible depending on the circumstances we find ourselves in. I’ve written a list of desirable points for option A – vaginal birth, and for option B – c-section. I’ve also been through it with Tom, though he knew most of it already, so he can be ready to advocate for me/us if necessary. It will be interesting to see if the babies have turned to be head down by the next scan in a couple of weeks, if they haven’t arrived by then anyway!