Birth story - Lauren and babies Lewis and Imogen

When I found out I was pregnant with twins, it immediately became apparent that my birth choices were going to be relatively limited compared to most. Prior to that I was considered a low-risk pregnancy and was hoping to give birth at a new local unit. Unfortunately this isn't an option with twins and early on I made my peace with having a relatively medicalised birth.

A bit of background: Twin births can come with a lot of complications, and over 50 per cent of twin births are by C-section, either planned or unplanned. Occasionally the first twin is born vaginally but the second twin requires a section. As such vaginal twin births are recommended to have an epidural as early as possible. All of this means that a hospital labour is recommended. During labour full monitoring of both twins is required and so a water birth is out of the question. Twins are considered full term by 37 weeks, and over half arrive before this point. Beyond 38 weeks the risks when carrying twins increase dramatically, so I was strongly advised to have an induction before the 38 week point if I had not gone into labour. The date for this would be decided at the consultant appointment following my 36 week scan.

Despite all this, I decided to try the positive birth pack as a way to feel in control of the situation and to find tools to help me through a medicalised labour.

My pregnancy was mainly straightforward, if tiring. I was scanned every 4 weeks after 20 weeks, and both twins remained head down from 24 weeks onwards, so things were looking good for a vaginal birth.

From 32 weeks I began experiencing occasional mild Braxton Hicks and generally feeling like things were stirring, so I was confident that I wasn't going to make it as far as needing an induction. I was happy at this thought, as I was desperate to avoid being induced and was seriously considering requesting a C-section if if came to that.

In the final weeks before the twins were born my feet began to swell quite a lot and I would spend the evenings with them propped up waiting for them to go down. An out-of-hours GP having dismissed my concerns, I discussed the issue with my midwife, 4 days before I went into labour. She was a little concerned by my blood pressure at this point and told me to be alert for other symptoms that might point to pre-eclampsia.

1 April was the date of my 36 weeks scan. I was 36+2. I went to bed the night before feeling very uncomfortable (though that was normal at that point as I was the size of a house) and only really dozed on and off until the early hours. At 3.30 am my waters broke in a huge gush. The whole of my side of the bed was soaked. I ran for the toilet where they continued to gush. We rang triage who advised that because I was having twins and needed to be monitored I should go straight in. While I was on the phone my contractions started. They were averaging 6 mins apart from the start, although there would occasionally be longer or shorter gaps. We arrived at the hospital at 4am - me waddling in with my bottoms soaked and a towel between my legs, as my waters continued to gush with every contraction I had! The up breathing was very helpful at this point and I felt very much in control.

I was in triage hooked up to the monitors and the babies were scanned. They were both doing well. However, I was diagnosed as having pre-eclampsia.

At about 5am I was offered an internal examination. It turned out that my cervix was still closed. I was surprised considering how close together my contractions were, but decided to accept that I was going to be here for a while. I initially declined the offer of paracetamol and dihydrocodeine as I was managing fine just breathing through them, but at 7am accepted as it was becoming a bit more intense, though still very manageable with the up breathing. I was surprised when they moved me to the delivery room - at about 8am I think - as I was still not officially in active labour.

The frequency of my contractions remained at about 5 minutes apart for some time and I continued to manage them using the up breathing technique. At about midday I asked whether I could have any more pain relief, but was told that I still had an hour until I could have my next dose of painkillers. I asked whether there were other options and was told no, as I wasn't in active labour yet they couldn't offer me anything else. They then offered to do another internal examination to see how I was progressing, which I agreed to.

I was hoping for some sign of progress, that I might have at least reached a couple of centimetres. I wasn't expecting the midwife to inform me that I was in fact fully dilated! And neither was she - she actually fetched another midwife to check she was right! My response was 'Can I have the gas and air now?' - it materialised very quickly! It was only at this point that they mentioned that pre-eclampsia can cause you to labour quite quickly, but I don't think even they were expecting it to be so fast!

Then began the discussions around my delivery and specifically the epidural. Although I was happy overall with this, I was a bit worried about not being able to feel when I needed to push and the fact that this might result in unnecessary intervention. The midwife said that given how well I was doing and that both babies were also doing well, she thought I could do it without the epidural, but that the downside would be that should I need to go to theatre they would very likely have to give me a general anaesthetic. Using BRAIN my other half (who really got on board with the birth pack and was awesome throughout) helped us to reach a compromise where they put the line in for the epidural so that I was prepared in case surgery was needed, but we wouldn't use it unless we needed to. They administered an initial test dose only, to check it was working. Getting the line in didn't go smoothly, and I found that process the most difficult part of my labour, but was happy that I had it there as a back up.

The pushing part of the day is a bit more hazy - I think because that's where the gas and air kicked in! There were a lot of people present, as they have a team per twin, and my bed seemed to be surrounded by people cheering me on! I don't think I had mastered the down breathing very well, and so the midwife had to coach me in my pushing a lot. My son was born first, and he proved difficult to birth. He has quite a big head and he got stuck in the 'u-bend'. I exhausted the window for pushing so they had to cut me and use the ventouse to deliver him. The ventouse was uncomfortable but I was happy to go with it because I was conscious that any delay could put my daughter at risk. Throughout my contractions remained manageable, and it was really only the crowning that I found very uncomfortable - it was only at that point that I had my 'I can't do it' moment.

Lewis John was born at 5.15 p.m. I had a brief period of skin to skin before he was handed to my other half to continue with this while they prepared for my second delivery. Imogen Margaret was born half an hour later, without intervention (she has a smaller head!). There was a brief moment of comedy when they announced that they were going to break her waters, as I had assumed that the vast quantities of liquid I had been producing were because it was both babies. I couldn't believe there could be any more water in there!!!

We had a short period of skin to skin with both babies before they were put into the incubator, as due to being slightly early and on the small side they struggled a bit to maintain their temperatures for the first few days. Unfortunately because of this I wasn't able to breastfeed straight away. I lost quite a lot of blood which left me feeling very weak and as my blood pressure remained elevated I found my recovery from labour quite difficult.

Nonetheless, overall I remain proud of my birth experience. Thanks to PBC (and my excellent antenatal class) I approached my birth feeling positive and prepared, despite the challenges, and was able to deliver my twins using only gas and air - a rare feat.