The Birth of Noelle Elise and Evelynn Rose 7/21/21

Rebecca and Jason, repeat clients of mine, welcomed their twin girls, Noelle Elise and Evelynn Rose on July 21, 2021! Their arrival was a far cry from the birth of their big brother, who came barreling into the world quickly via an induction at 38-weeks. Rebecca knew that carrying and birthing twins would be different, but she maintained her desire to birth them vaginally with as little intervention as possible. She was hopeful for the chance to birth them without pain medications too, just as she had done the first time.

However, this pregnancy required a lot of changes for Rebecca. The providers who had taken such excellent care of her during her first pregnancy, were unable to take care of her this time due to a recent type 2 diabetes diagnosis. Rebecca switched providers but was left feeling unheard and unsupported. But that wasn’t even the half of it because a month later, Rebecca and Jason learned that they would be welcoming twins! This catapulted Rebecca’s pregnancy into a completely different high-risk category. Her pregnancy was riddled with extra ultrasounds and NSTs, not to mention elevated concerns that were voiced simply by virtue of the fact that she was growing two babies. Rebecca did not let the risks get to her and she continued the journey of awe and wonder at two new lives, while also feeling the shifting and stretching of her own body to accommodate her girls. There was her firstborn to take care of too, still a toddler himself. Rebecca’s aching body was stretched thin with the daily tasks of mothering in addition to the pregnancy. Jason was a huge help, but he couldn’t carry the babies for her.

Continued red flags inspired Rebecca to switch her providers again. She was 6 months into her pregnancy, but she felt much relieved after making that change. (It’s never too late to follow your instincts, mamas!) Unlike her first pregnancy, Rebecca’s cervix remained closed, a herculean task considering it dilated significantly before labor for her singleton pregnancy! It was especially critical since her uterus housed two babies. Her cervix really stepped up this time and held those babies in nicely.

Then Rebecca was hit with another surprise. Her babies were in the breech position. Both of them. She tried to do everything within her power to encourage them to rotate head down, but they simply wouldn’t budge. And the more time passed, the bigger they grew, and the less likely they were to turn. Rebecca had to face the reality of a c-section for the birth of her girls, a very different birth than the one she imagined for them. She did great job of embracing the change in plans and marveled in the miracle of growing and birthing two babies, by whatever means. Her cervix remained closed for the twins, unlike with her first, and she managed even better bloodwork too. As the weeks ticked by with no change in position, the c-section was scheduled for July 21.

Just prior to 37-weeks, Rebecca’s blood pressure was high at a prenatal appointment. Thankfully the labs came back fine, and she went home to wait out the last couple of days before the scheduled c-section. She was left waiting all the way to the end! Then on the day of the c-section the labor and delivery unit was hopping. It was a popular birthday! And another woman requiring a more urgent c-section cut in front of Rebecca, leaving her waiting even longer to meet her babies. But she was so patient. After all, she had already waited months, what was another couple of hours?

Finally, the OR was available, and it was Rebecca’s turn. Baby A, Noelle Elise, was born first at 3:57 pm. She was smaller but very strong. Evelynn Rose, Baby B, was born second at 3:59 pm. She was larger but had some breathing struggles at first. And the babies were two very different weights! Noelle was 5 lb. 12 oz. and Evelynn was a whopping 7 lb. 12 oz.! Turns out there was a very big reason why their weights were so disproportionate. Noelle’s umbilical cord was attached to the placenta by a velamentous cord insertion, which means the veins were attached to the membranes of the amniotic sac before they joined the placenta. This meant that Noelle was close to potential danger the entire pregnancy with her lifeline extremely vulnerable to a kick or really anything, and it also helped explain the 2-pound difference in their weights. It was a very good thing she was born by c-section and there were no attempts to rotate her externally. In the end, it was a godsend really, because it kept one more risk factor out of the picture and out of Rebecca’s (and her providers’) mind. And as if that wasn’t enough, Evelynn’s cord was a marginal insertion to the placenta, which isn’t the sturdiest by any means. Two babies. Two miracles for so many reasons!

Noelle snuggled with her mom in the PACU while Evelynn got the breathing support she needed in the special care nursery. She remained there for several days but made it home with her family that first week. The first night at home with everyone was an experience indeed. Family support and flexibility would be their best resources in the early weeks, much like during the pregnancy.

Rebecca struck a balance between advocating for her preferences and making decisions for the safety of her babies. She relinquished control and let go of a lot. She sacrificed so much growing two babies and even ended up with a very different birth experience. But at our postpartum visit, she was tired but happy. She had family at home to help, and her babies were thriving—all three. And to this day she is still breastfeeding. I am so proud of this mom! And I will not soon forget her story and how both of her babies were miracles who were protected from potential grave harm the entire time. Now that is a true miracle!