Back story:

For various reasons, involving staving off the approach of uterine or ovarian cancer as a result of polycystic ovaries, Elysse and i decided two years ago it was time we start multiplying. We tried for a year with no success, and turned to fertility treatment in early 2003. She got pregnant a month or so after moving into our new house, on the second Clomid treatment.

Rather early on, she decided adamantly to go with a home birth and no ultrasounds or drugs, and we chose an experienced midwife who saw Elysse regularly and advised on diet, activity, and holistic health in pregnancy. As things progressed, Elysse's belly grew in a way that indicated a due date of early January rather than early February. We checked many times for a second heartbeat, knowing that Clomid increases the chances of multiples, but never found anything beyond an echo.

In early January, Elysse started what turned out to be a very long false labor.

Sunday, 25 January 2004:

After a long and rather sleepless night, Elysse spent the day cleaning, doing laundry, and making chicken soup. We couldn't really go out, as there had been sleet and freezing rain all day, resulting in a quarter-inch of ice on everything, freezing my car to the driveway (among other things). Elysse slipped and fell flat on her butt on the icy front porch, and i dropped an armload of firewood on myself when i slipped on ice coming around the house.

Sunday night is TV night, and we watched the Simpsons, Bernie Mack, Malcom in the Middle, Arrested Development, and the Fox 10 O'clock news. Around 10:30pm, Elysse started timing contractions, which were about five minutes apart, lasting a minute. Recalling what had happened a few weeks ago with the false labor, we tried to make sure it was the real thing. She got in the bath, but the contractions did not weaken; in fact, they had grown closer and stronger.

Shortly after midnight, we called Linda (the midwife) and asked her opinion; she offered a few more suggestions, and said to call back in an hour. We timed the contractions, which were growing steadily stronger, at an insistently constant three minutes. Around 1:30am we asked Linda to make the one hour drive in the sleet and ice.

When Linda arrived, Elysse had just run to the bathroom for the first of what would be many stomach-emptyings. Despite our original plan to do it all in the living room, we set up the "birth nest" in the bedroom -- vinyl undersheet on the bed, water pans and towels and rubber gloves and all sorts of birthy paraphernalia. After this, the contractions grew much stronger, and doubled her over in pain. Linda told us that loud, high, wailing cries of pain actually cause the cervix to contract, and that focused, low moaning sounds were the way to go. We tried to remind Elysse of this all night, but the pain was too much for her; by the time the assistant, Kendra, arrived around 3:30am, Elysse was a basket case.

Remember, we hadn't had much sleep at all; Elysse had been up since 7am Sunday, twenty hours at this point. She wanted nothing more than to rest, but there would be no way to rest with the intensity of the contractions. The best way to move labor along is to walk around and move the hips, but this caused searing pains through her back that made her plead with me to make it stop (which of course i could not do). She wound up lying on her side on the bed for long periods of time, so dilation took a pretty good while.

By morning, her cervix was fully dilated, and only a small lip remained on the anterior edge, probably the result of premature pushing. The baby's head was in the right place, but appeared to be face-up, or posterior, which is not a poor presentation, but is more painful than normal. With all of this in mind, and the fact that Elysse's mother had to have her water broken to induce labor, we broke her water at 9:30am.

And then, there was nothing, for a very long time. We waited and waited and waited and waited... we feared that Elysse just wasn't dealing well with the pains of labor and was prolonging the process by trying to make it hurt less.

Finally, at 8:00pm, Linda said that the best thing to do at this point was going to be to move to a hospital so they could finish the job. We shuffled around the house quickly, bustling to get everything ready for a transport; find my wallet, find Elysse's social security card, get the clothes for baby and mom, which hospital, get the stories straight, hustle, bustle... finally, we stood Elysse up to get her some clothes (she'd been wearing nothing but a bathrobe for twenty hours), and Kendra says, "hrm, look at that pile of vernix on the floor!"

Linda stopped cold and decided it was time to do another exam, rather than have the baby in the car on the way there. I went upstairs to get her another pair of gloves, and when i got back, they had Elysse on the floor in front of the loveseat, head pointed towards the kitchen, feet aimed straight at me, breathing hard and making lots of noise. And then i saw the head poke out for a moment.

Now, i will freely admit that i was not interested in watching the birth proper. I was planning to sit behind Elysse and give her physical and emotional support. However, here it was, happening right there before my eyes, and i couldn't look away. It was fascinating, like a train wreck.

Linda was similarly fascinated with how adept Elysse was at pushing when it came right down to it, so much so that she remembered suddenly -- "oh crap! first-time mom! i need to stretch her perineum!" I have never seen anybody stretch that delicate skin so much, and watching that i realized that there was a bulge in E's bottom quarters that wasn't there just twenty minutes ago. When E seemed to get a bit disheartened, Linda said "put your fingers down here and feel your baby's head!" and when E's fingers touched the tiny cranium, a change came over her pain-riddled face.

And another scream. And another scream.

"Is the head the biggest part?" she gasped.

"Yes", Linda replied, almost laughing.

"Oh... good."

And another scream... and another scream...

...and out came the head! I imagine my eyes bugged out quite the same. In one swift motion Linda caught the baby's head and redirected the whole bloody mass up onto Elysse's stomach, trailing a bright white and blue spiral-twisted cord.

By the time i had worked my way around the mess of furniture, the newborn had already found a nipple and latched on.

Linda announced, "It's a girl!" at 8:32pm EST, 26 January 2004.

Kendra started taking pictures, and Elysse and i were very happy and amazed and relieved and things were going just great. Linda pulled on the cord to see if the placenta was already unattached, and it didn't appear to be. She felt around on the belly to see if she would be able to get it loose, and an odd look crossed her face. "Kendra, would you get my doppler?"

Nobody said a word. There was a loud and strong heartbeat in Elysse's womb.

"It looks like you have another baby in there!" Linda said softly.

Elysse's face changed instantly. "You're kidding me."

I felt a little faint.

Linda probed a bit to see the lay of the land; the second baby appeared to be breech, as she could feel a toe. We were going to have to try to rearrange the baby, but first we'd have to get the first-born out of the way.

I got to cut the cord. The cord was very cool. It looked completely fake, like a prop from the alien autopsy scenes in 'Independence Day'; there was a blue vein twisting around the rubbery white substrate, and it throbbed with the placenta's heartbeat (a whooshing sound in the doppler) over the two or three feet of its length. We started by using some silky ribbon to cinch the cord about an inch from the navel, and then used a funky looking pair of scissors, a circular shape in two bits, with semicircular blades, to cut the cord on the mom-ward side of the tourniquet. It was tough and rubbery, like calimari.

The next order of business was to get the other baby out. Linda tried a few things to see if she could flip it upside down, but nothing worked. We'd have to break its amniotic sac as well -- both sacs appeared to be made of rip-stop nylon. At this point, Elysse was slouching on the loveseat, with Yvonne and me to her left; she was still wearing the robe, which was protecting the unsuspecting couch from birth goo. We knew that the only thing that would really start contractions again was to get her up and walking, so Kendra and Linda tried to pull Elysse to her feet, and i pushed with my free arm from behind.

Elysse slipped to her knees at the edge of the couch and let out the most blood-curdling, gut-wrenching scream i've ever heard... some goo dropped out, and Kendra jumped to get a towel. When she got back, she saw a foot... and then a butt cheek... and another butt cheek, then another foot... and with another final push, the other baby dropped into existence.

Of course, i was still on the couch, and didn't see any of this. "Low sounds..." i said, mechanically, as i'd been saying all night.

"It's another girl!" at 9:32pm, exactly one hour later.

"Oh crap, we don't have two girl names! We'll have to split the one we have!"

So the first is Yvonne and the second is Zella.

The midwives made the first phone calls, bragging to their friends. "Twins! At home! One posterior, the second a surprise, footling breech! I *know*! And get this -- a first-time mom who didn't even tear!"

With hindsight, we realized that Elysse hadn't been handling labor badly; she'd been in extreme pain beyond what we'd expected. Twins are almost never born at home; even experienced midwives leave twin births to hospitals, where they are invariably born by C-section. The risk of complications from breech birth is just too high.

Sat Jan 31 21:31:38 EST 2004