Majella Clare and Rosie Patricia – 6 December 2005
40 weeks + 1 (3kg & 3.1kg)
Justine Caines is the former secretary of Homebirth Australia and a respected advocate of natural birth. She gave birth to twins at home in December 2005, and tells their story below. Justine has also written an article on risk and birth which elaborates on her informed decision to plan a homebirth for her twins.
At 18 weeks I attended a routine GP appointment in order to have a blood screen and get a referral for an ultrasound (even though I had not decided if I was having one). I was planning another homebirth (all my 4 children have been born at home). These experiences have been the most exquisite of my life and I would only birth in hospital if proven to be absolutely medically necessary.
The GP asked if he could feel my belly and I agreed. He said I was presenting higher than my dates. I quickly replied that “I was certain of my dates” and he then said he would put the scanner on (which was a very small unit that I had not noticed at the end of the bed). ”Just as I suspected he said”. ”What?” I replied nervously fearing a problem. He then said, “See that little one” and although it was small and birdlike it was surprisingly clear. ”Yes” I said. He then moved the scanner to the left and said, “Well there´s another”. At this stage I believe I reinacted the shampoo commercial where the woman becomes hysterical. I left in a daze forgetting to pay or have my blood test! I already had 4 children and the idea of 6 aged 6 and under was a little daunting.
My pregnancy progressed without real incident I was happy and healthy. I was quite nervous about growing 2 little people (I was confident about 1 but 2 was different). I had an anterior placenta and did not feel either baby until 22 weeks, and then one baby was far less active (due to the position of the placenta).
My plans for a homebirth were undeterred. I did however choose to have the 3 ultrasounds recommended by an Obstetrician I trusted, one at 20 weeks, 28 wks and 34 wks. This was the only interaction I had with medical care. We found that the babies each had their own sac and which was a good thing (no chance of them entangling in each others cords). Like all our babies we chose not to find out their gender. The ultrasound also provided a crude weight estimate (as ultrasound is only accurate + or – 20%) but it was useful, as we knew the estimate was similar for each baby.
I put on very little weight and close to the end of my pregnancy felt that I was ‘all babies’. Despite some wonderful advice to rest everyday I was unable to do this (with 4 other children!). Perhaps stupidly our family also moved house when I was 35 weeks pregnant! Some of those close to me feared that this might bring on the babies. I was quietly confident and told them they needed to wait so they could be born in their home free of boxes and wait for their brothers and sister to calm down from the big move.
Sadly the greatest challenge was finding 2 midwives to support me to have twins at home. Unfortunately I also have the extra impediment of living in rural NSW. I needed to find 2 midwives that would travel to me and support my choice to birth twins at home. I did not find these 2 angels until I was 34 weeks pregnant. Betty Vella and Robyn Gasparotto not only had the courage to truly be ‘with woman´ they also drove 600 kms round trip for each visit. Well and truly beyond the call of duty I would say! When we all met I felt an instant calm and knew all would be fine.
By 38 weeks I thought I might meet by babies. Although I refuse to accept obstetric hysteria and fear mongering there is a pervasive view that few women get to 40 weeks with twins. Also it is a very common practice for women to be induced at 38 weeks. My midwives had faith however and were game enough to say they thought my body would grow these babies to 40 weeks!!! (My bladder heaved at this comment). My pregnancy was really beautiful, my back held up well and even the nagging symphis pubis pain of previous pregnancies was seldom felt. My bladder did however feel the pressure of the additional weight. I only got up once per night however (from about 30 wks).
Like many women I felt fed up and ready to give birth and around 38 and a half weeks. I had a lot of pressure on the cervix in these last weeks (obviously doing great preparatory work for labour). As I approached 40 weeks most people (other than my faithful midwives) were astounded I could ‘go this far! The mindset that twins come early is firmly ingrained. The fact that the vast majority of women giving birth in the system are pressured into unnecessary induction at 38 weeks gives weight to this perception!
On the Sunday evening we decided to watch a DVD, ‘Meet the Fockers´ (something I would never watch!!). I found it so funny that I believe I laughed my waters to breaking point! It was a hind water leak, but as I had also had a ‘show´ that day I called my midwives. They had to travel from Sydney (4hrs) and I wanted them to be with me in time. For someone who wanted a ‘sign´ to forewarn us, this proved to be it. Both midwives and my friend and doula, Margie Perkins arrived in the wee hours of the morning. I slept through their arrivals and woke at 8.30am feeling like a huge fraud, nothing had happened!!!
The next day was very hot and with 4 young children I knew nothing would happen in the day. Betty and Robyn did some wonderful reflexology, massaging the point in the foot for the uterus and massaging a relevant pressure point on the inside of the ankle. This worked well, giving me some nice tightenings. We shared a nice meal and all went to bed. My midwives were very confident that it would happen that night. On reflection this was a lovely time as Margie, Betty and Robyn got to meet and we all shared a day (kids included), before our babies arrived.
At 1.30am I awoke to the horn of the freight train passing through and a huge gush of waters. 15 minutes later my first contraction, and boy was it real. I only waited for another 2 before waking the three wise women. I was conscious that we needed to fill the pool and that would take an hour. As I predicted once labour started it really ‘kicked in´. Within 30 minutes I could feel our first baby moving right down and that pressure on my tail. I have birthed 4 children standing up and yet I have always wanted a waterbirth. When it came to labour I was not comfortable sitting or kneeling. I still clung to the water idea, as I so much wanted to ‘catch´ my own baby. Interestingly this time I found it very intense in my usually preferred standing position leaning on the kitchen bench.
As soon as the pool was nearly full enough to give birth I got in. The pain relief was amazing. I kneeled and lent over the side (the pool was semi rigid with a support ledge around it, perfect!) Our photo record reveals I was only in the pool for 7 minutes before B1 (Majella) arrived. To my astonishment I calmly placed my hand on her soft little head and felt her shoulders rotate before being totally born into my determined arms! I lifted her up and welcomed her (without knowing her sex). I was overjoyed to have a girl (after 3 boys in a row) and a photo captured my expression. It looked like agony but it was ecstasy!
Majella´s cord was not overly long. Very soon after her birth I began contracting with B2. My husband, Paul got into the pool to hold Majella. Although he was very gentle I found it very hard to contract with a baby still attached. The cord had stopped pulsating so I asked that it be cut. Our daughter, Ruby cut the cord. I got on with birthing B2. Betty announced that she ‘saw a foot´. B2 was in a breech position all of my pregnancy. At about 38 weeks we thought she had turned. I never felt a movement and was not surprised to hear she was still breech. I remember thinking “oh this bit will be easy but I´ll then have to brace myself for the head”. I know I had just birthed a baby but I must say this birth was very easy. Betty gently moved Rosie toward me (so she didn´t bob up behind me as her head was last and the weight would of naturally taken her behind me not in front) and I again received my baby. Rosie was born 13 minutes after Majella. She was very alert and in good condition for a breech babe. She took a couple more minutes to be calm (compared to Majella) but was essentially fine from the moment of birth. I gently welcomed her and soon after started a very literal motherhood ‘juggle´ as I held a baby in each arm. At this stage I said, “I don´t know which way to look”. What an amazingly gentle and beautiful experience. The room was full of warmth and love. What an end to our birthing experiences. What a triumph to be holding two babies that I had caught myself.
I wanted to change positions to birth the placentae (two placentas fused). I actually had another few good contractions before I birthed it. I was surprised that this was quite hard work! As planned it was a physiological third stage. I had minimal blood loss, less I believe than with some of my other children.
My recovery has been extraordinary. I felt healthy and strong, a bit of a bonus as I embarked on feeding twins and caring for 4 other children!
The birth of Majella and Rosie was very straightforward and beautiful as I imagined. Essentially it was no big deal; Just a wonderful family event. When we take a look at what my options would have been if I had birthed in hospital one realises it was extraordinary in its ordinariness. I am so very grateful to my midwives for enabling this. In Hospital, at best if I was ‘allowed´ to birth vaginally I would have been pressured to have an induction at 38 weeks, with constant monitoring removing the ability to use my body to its best advantage of an active birth. I would also have been pressured to consent to an epidural and a forceps removal of the second twin. Why? Because of fear from medical practitioners who have no faith in birth being normal and women´s bodies having the innate ability to birth.
My dream of a water birth would have been right out the window, and as for our 6 year old cutting the cords! Wouldn´t the hippie detector have been in overdrive!
Recently I was in a major shopping centre and as I have learnt twins, especially month old one´s are fascinating to many. A woman approached me and we started chatting. When I revealed that these were baby 5 and 6 she asked how the other children were. I told her that they were all very happy, as birth was such a normal event in our house. I told her that Ruby was present and cut both cords. She was naturally surprised, but to my surprise she was really happy to hear such a positive story. She left saying ”What a wonderful bond Ruby will have with her sisters. What a wonderful gift.”
Every birth is a gift, and they each teach us something. I did not learn any more about the wonder and strength of a woman’s body (well perhaps a bit as I grew 2 babies!), this time I learnt of the amazing bond that surrounds birth. The relationship between women, in what is so very much women’s business.
I do not underestimate the unfaltering love and support of my husband, Paul. When I hear of how so many men try and control birth and have little faith in women´s power I am reminded of how lucky I am. This was the gift of our first birth.
So as I hang up my ‘birthing boots’ I will cherish the love and faith of what the word midwife means, “with woman”. To Betty, Robyn, and Margie, Thank you for all the intangibles: the courage and wisdom to step outside the square. Also for the very practical things, all the driving, and the time it took to support me through this wonderful journey. The following quote sums up my 6 beautiful homebirths
Somewhere ages and ages hence: Two roads diverged in a wood, and I – I took the one less travelled by, And that has made all the difference.
Robert Frost- The Road Not Taken