Wednesday, 24 June 2009
First week of being a dad of twins
My wife gave birth to our twins on Tuesday at just after 2pm. It was a 31 hour effort to get them here which started with S. being induced. The purpose of this entry is hopefully to tell other people little things we never thought we would need to know. I'll update as often as I can, but its day four and things are already demanding!
G. and J. both weighed approximately 7lbs each. They were born at Leicester General Hospital at 38 weeks. They were a good weight - aided by the fact the pregnancy went full term. We chose Leicester General Hospital for the parking! However, I would like to state that the staff are incredible, from the cleaners to the consultants.
This is a diary of events that may help dads-to-be.
DAY ONE: S. was induced on Monday at 8am. An induction is a slow process. I did not know this. I was hoping to be home mid-afternoon to catch up on the 20/20 cricket. The day starts with blood and urine tests. If everything is OK then a hormone is placed in the woman's bits (well what else do you call it?) to stimulate contractions which will eventually lead to waters breaking, which would release a natural hormone from the brain and get the whole show on the road. A hormone drug was also to be administered through a tap in the wrist. You will have to forgive my lack of details - I'm just giving people a mental picture of the day. I do not know the Latin name for the hormones etc. By 3pm, contractions had started. They were not strong, nor frequent enough.
S was monitored throughout the day by midwives. By late afternoon the contractions had become quite painful for S. Painkillers were offered (and accepted). S. was keen to have an epidural - a painkiller inserted directly into the spine to anaesthetise the stomach (see I do know something...) This is only possible when the waters are broken. S.'s waters were broken manually at around 8pm, in a effort to increase the contractions and allowing an epidural to be inserted. Once in, the patient can administer her own drug, as long as there is a midwife in the room who gives permission. This is usually granted after a satisfactory blood pressure test.
At about 8.30pm, a decision was made to break the waters manually. This was a relatively simple (and somewhat crude) process whereby a midwife popped the seal of whatever was holding the waters (more science for you) with a plastic stick. It made a quiet 'pop' sound and then surprise, surprise...there was a lot of water on the bed where S. was sitting.
By 10pm. More contractions, not regular enough. More hormone drug inserted in to her wrist. Epidural keeping any pain at bay.
Midnight - new midwife shift the third so far. Handover each time was meticulous. All details noted and explained. Still nothing going on but contractions. The idea at this point is to get the cervix (the baby tunnel - more science) to have widened enough to get a baby through. For us, it wasn't happening. At that point we had four inches dilated (open). The doctors ideally want nine or more. We had a long way to go. It can happen quicker for others. Sometimes the epidural can slow the rate too. To counter act this more hormone drug is given.
We had a long and sleepless night due to monitoring and check-ups.
At 8am on Tuesday, we were told there had been progress in dilation and asked to remain as we were for four more hours. At 12pm we were close to starting a natural birth. However there was a 'cervical lip' preventing a safe passage out for the twins. The doctor recommended the maximum rate of hormone in the arm for a couple of hours.
At just after 1pm the doctor said not enough progress had been made on the removal of the lip. He recommended an emergency Cesarean section, as he was concerned that my wife's energy levels had dropped significantly (they can tell this in a urine test, somehow) and she may not have the strength to push, even if the opportunity came along.
Thirty minutes later we were in "theatre" surrounded by a huge team of people, two of everyone - to help each baby. S.'s epidural worked very well. During the operation I was placed behind a screen, where I could talk to S. On the other side, the surgeon got to work. S. felt pressure on her stomach but thankfully no pain. We spoke throughout the operation, just words of encouragement on my part. S. looked a little scared but coped remarkably well. We then heard the sound of crying, our first baby had been delivered.
They handed him to me in a blanket as the surgeon continued. I was choked but tried to keep a stiff upper lip for S, who was still undergoing major surgery. I could see nothing of what was going on in terms of the medical stuff. I was told not to look beyond the screen. Within what seemed like seconds another little boy arrived. The operation seemed to be over and done with swiftly.
I was taken in to an adjacent room for the boys to be weighed and checked out. Everything seemed to be fine. Of course, I felt blessed for that and I have never taken anything for granted. Soon after, S. was taken to a recovery room, where we were reunited. A pair of midwives brought the boys through and S. had her first chance to get acquainted.
By this point, S. was looking exhausted. There were lots of tests now being started on both mum and babies. By 7pm Tuesday, I had forgotten how long we had both been awake. The midwife said it was in everyone's interest that I go home. Mum could get some rest. After nearly 40 hours on the go, I was not going to argue.
I got home, had the obligatory stiff drink and slept solidly. I later discovered that S. had made her first attempt at a breast feed aided by midwives. At this stage, the babies do not receive breast milk, but colostrum, a yellowy substance which gets the babies off to a good start.
Visiting hours started at 11am, although when I got there I discovered S. was still in the recovery room in the delivery ward. She had problem with a blood test and was being monitored. As she waited, S. was again given help on breast-feeding and tried a successful double-feed. She felt hugely encouraged by this. Tip: It is worth asking for the help of the midwives while your wife is in hospital. They are very happy to share their experience and knowledge.
About 2pm S. was allowed on to the main ward. There were mostly double rooms of two mums and babies together. However, S. was fortunate enough to be placed in a single room, presumably because of the twins. The service of the health professionals in the maternity ward remained extremely high. S. at this point could barely walk, due to the op. Midwives encouraged her to try and stand and walk two or three yards if she could.
S.'s parents arrived later in the afternoon, along with her sister Rachel. It lifted a sore and tired S to see her family. Because of S.'s condition I changed the nappies of both the boys several times. Their poo was the colour and texture of marmite. A nurse told me that after a couple of days it would change to become like wholegrain mustard - I discovered on day 5 that this was a very accurate description.
I left the hospital at 8.30pm, feeling incredibly drained - felt it important not to mention this to anyone!
Got up and got in for 11am, but despite getting up early, I almost ran out of time - little jobs were mounting up. Went on to the ward feeling happy with the way things were going. The babies were great, S was showing signs of being on the mend. My mum and dad were due to visit and the boy's seemed to have grasped breast-feeding. Mum and dad were arriving for the last hour of visiting so we had plenty of time to prepare ourselves for more visitors.
It is worth mentioning that at this point, S. managed to walk from her room to the shower in the main ward - 15 yards. To her is was a massive achievement. I have no idea how sore the wound from her op was, however, whenever I knocked the bed she was in she noticed pain.
Also S. had not slept. The boys had been demanding feeds and crying all night. She estimated she slept for one hour. Yet she seemed remarkably positive and undaunted.
My mum and dad came and they seemed really delighted and once again I had to leave when visiting time ended, but not before I changed both nappies.
Arrived at hospital around 11 am and there was a dirty nappy to change. The midwives recommend using cotton wool and water to clean their dirty bottoms up. However, since I have been home I have used a form of baby wipe. It seems far more practical and quicker, with less mess. There maybe be drawbacks but as long as the boys are not at risk, I am happier using the wipes. We are also using disposable nappies. I know there is a massive debate about this.
These are my views in a nutshell:
I am into doing green things. I recycle everything, voted green in the Euro-elections and walk everywhere where I can...
The right thing to do (I'm told) is to have reusable (towel) nappies. However, we are using disposables. This is because meeting the demands of twins is a massive commitment. The washing machine has been on everyday since we left hospital. A dirty nappies wash is another job to add to the long list of things to do. Anything to shorten the list is, in my opinion, recommended.
If I have upset the extreme green supporters, this might only add leaded petrol to the fire but:
Consider the environmental damage of all those extra washing machines going as they wash dirty nappies, all the electricity, all the powder, the powder's packaging, the conditioner and the soapy/dirty liquid that flows away back into the water system. Reusable nappies are not that Eco-friendly.
Anyway, back to events of day four:
From the minute I got to the hospital, the boys were grisly. Mum tried to breast feed. They settled for ten minutes maximum. Still grisly. Nappies checked, nothing to worry about. After half an hour, both screaming. Back on the breast. Settled for five minutes. Grisly again. A few minutes later, screaming again. This continued pretty all day. I was stressed out, S. was stressed, tired and getting upset. Eventually we asked for the midwife (something we should have done hours before really).
The midwife explained - and this is important to be aware of - that the colostrum had finished, but the breast milk was yet to arrive. The breast feeds which S. had done that day were of little benefit to the boys, only they were getting more used to attaching themselves to the nipple. The attempts to breast feed also helped to 'draw' the milk through, which we were told could take up to three to ten days to come through. (Sometimes a Cesarean can distort the creation of the milk).
The boys were angry all day because they were hungry. The solution was to attempt the breast-feed first to continue to draw the milk through and then top up with formula milk (which comes in a carton, or in powdered form to add water to).
S. felt guilty at first for being unable to offer solely breast milk. But you have to be practical. After hours of stress and concern, crying and screaming, the boys were soundly asleep after just half a bottle of formula. It felt like heaven. Mum wanted sleep, I left them sleeping to prepare for them to come home the following day.
It takes a little while to be granted the chance to leave the maternity ward. There is a little bit of administration to do. During that time, it is useful to think of all the questions you can ask a midwife about your babies and your wife's condition (which, by day five after Cesarean is dramatically better than Day two).
Make sure your baby car seats are fitted properly and that you have got the hang of taking them out and putting them in.
Start taking all the bags/presents your wife has used/been given to the car and get them out of the way. Carrying twins to the car in their car seats takes its toll, so you don't want extra baggage to worry about. You will need to carry both twins too, as your wife will be too sore and tired.
We got home, fed the boys, put them in their Moses baskets, wrapped in two blankets, and they did what they do best - sleep. We ordered a massive takeaway curry to celebrate being home. Warning to dads, do not have a load of beer. You will not be able to sleep it off!
The twins are awake for feeding every hour and a half to three hours absolute maximum. Mum will need your help, with everything that you have been doing on the hospital ward, but now at home. This includes cooking - hence the takeaway!
A midwife gave me a tip - mum should do nothing other than give feeds and you do the rest. It sounds like a big commitment but it has worked very well for us so far. Also your wife appreciates living with a changed man!
Did not get much sleep. Had no idea how often S. was getting up to feed in the night - at least three times and its a long process feeding two - one wants more than the other, one wont get back to sleep. S. was doing all this in hospital when I was at home, hence I was a bit ignorant. I was there each time throughout the night, helping with bottles and nappies.
I was shattered the following day but surviving! The community midwife paid a visit (even though it was Sunday). This was prearranged at the hospital. She checked that everything was OK, and answered a couple of questions.
S.'s mum bought her a post-Cesarean belt from Boots. It is simply a comfortable strap to offer support near the surgery wound. The midwives were a little dismissive of the idea, but S.'s mum bought it anyway and I have to say it has been a comfort to her and offered her some protection when moving, lifting and feeding the boys.
After S. fed the boys at 10pm she went up to sleep. She was in the main bed and the boys in their baskets on the floor, tilted at a slight angle so she could see their faces from where she lay.
She had a couple of solid hours before the boys were wanting to be fed again. There is no concept of day and night for tiny babies!
At 3am, S. booted me out of the room so she could get some more sleep. I went to the spare room, where she would call me if necessary. S. did not want to be woken if I moved, snored etc... Sleep is now a precious commodity!
We are starting to settle into a pattern of feeding and sleeping now, we had another check from a community midwife and things seem to be going well. I'm still doing the cooking and cleaning, changing nappies and helping with bottle-feeds. S.'s breast milk is also coming through. Things, for now, seem to be under control!