Whoa: we had a surprise twin double-breech roadside vaginal birth after Cesarean

May 3 | Guest post by Olivia
Red sign on the side of empty road
Photo by Horia Varlan.
I was measuring consistently ahead in fundal height early on and just before the mid-point of my pregnancy my midwife referred me to an obstetrician to have an ultrasound (we'd not planned on having any) to rule out twins, fibroids, excess amniotic fluid, or any other complications. At the ultrasound, we were told there was one baby, no fibroids, and no excess fluid — the doctor said I simply had "a large uterus." So we went with that as confirmation.

At about 2:30 one morning, I had a contraction that woke me from my sleep. This had happened before, so I waited and felt a few more before I grudgingly got up and decided I'd take a bath to help them stop so I could get some sleep. I went into the bathroom and turned on the light. I saw that a little blood was in the toilet from sometime earlier that night, and wiped to see if there was any more… there was.

I woke up my husband, Garrett, and he called our midwife to tell her what was happening. She said it was probably just my bloody show and to take it easy but to call her if anything else happened. I tried to sleep, bathe, and just relax to get the contractions to stop. I was struggling to concentrate on the book I was reading. This was at about 6:30.

I took another bath, a shower, and tried to lie down and listen to a Hypnobabies CD, but the contractions were too strong for me to really relax. I definitely thought they'd stop. In fact, I thought they'd better stop, since I'd just had the home visit from the midwives on Monday morning. I could have a home birth in 5 days at 37 weeks, but not a day sooner!

I was determined not to be in true labor yet. When Garrett got home from dropping off our son (at about 8:30) and saw me in the bed, he said we needed to call our midwife again and so he did — all while packing a bag. She asked some questions and then suggested we come and meet her to assess the situation and see if I was really in labor or see what we could do to slow or stop it.

We left and on the way stopped at the store to get more minutes for our cell phone. I was low moaning for a while, but then that stopped working. About 45 minutes into the trip, my moans got higher pitched and less controlled. We talked about passing a bank, and how we'd definitely make it a few more hours at least and then a couple of minutes later, my water broke — everywhere! I was finally able to accept that the baby would be born that day, and soon, but we talked and I figured we still had at least a few hours. Garrett called our midwife to keep her updated, and she announced a change of plan — she said to meet her directly at the hospital. She asked Garrett if it was me moaning that she was hearing, and he said it was.

As they were talking, my body gave a tiny involuntary push, and I felt something come up between my legs. My first thought was, "Oh, God, the cord." But I knew what an emergency that would be, and thought that maybe, just maybe, I had somehow pooped. So I reached down (with much trepidation) and felt, and it was most definitely cord. I yelled, "The cord is out! The cord is out!" and my midwife heard me yelling over the phone. She told Garrett to pull over immediately and get me on all fours to take the pressure off the cord, and to call 911. There was, oddly enough, some traffic on the rural highway that morning, but after about a minute he managed to pull off the road. He got out and threw Bruin's car seat in the grass (we were, luckily, in front of empty fields on both sides of the highway. It was actually quite a pretty spot) and got me into the back seat, talking with our midwife all the while. She told Garrett to get my chest down and my butt up in the air, and then he called 911.

Somehow Garrett managed to get my shoes and pants off. I could hear him on the phone with the operator and the guy was asking him what he saw, and asking him to feel for a pulse in the cord (he didn't feel one), and telling him to hold the baby in. By now I was really in it… it was all happening so fast, but I truly was my primal self. The pushing and grunting was happening, whether the 911 operator told me to stop or not. I tried to be compliant, but I couldn't stop it. There was literally nothing I could do but work with my body and my baby.

It was the most beautiful feeling I have ever experienced. I wasn't scared — I was totally consumed, growling and pushing.

It was the most beautiful feeling I have ever experienced. I wasn't scared — I was totally consumed, growling and pushing. At some point, Garrett touched what he said was just the cord, which I shouldn't have felt, but it was excruciating. Whether or not the baby made a fluke movement at the exact same time or if for some reason I was able to feel it, I don't know, but I did try to donkey-kick poor Garrett. I tried to kick him off again (while yelling, "GET OFF OF ME!!") when the operator told him to flip me onto my back. That didn't feel right at all, but I tried, and just absolutely could NOT make my body do anything differently than it was doing. It knew exactly what to do, and there was simply no stopping it. I occasionally lifted my head to look out of the window at the trees in the sunshine, and just let my mind feel "universal."

About five minutes passed and I could hear the ambulance coming down the road. Garrett said he felt a tap on his shoulder and walked around the back of the car to come be by my head, and by the time he got to my side of the car, the baby's body was born (they had managed to flip me on my back during that time span, too). I will never forget the feeling of her body coming out all at once. There aren't words to describe it. I heard the EMT say, "We've still gotta get the head out!" and, from all my reading, I knew that it would come and that we weren't in any immediate danger as heads rarely get stuck. But I can understand why they freaked.

I waited patiently for my next contraction, and out she came, easily, quietly. Calliope Ontario Isis slipped gently from my body into the October sunshine. No one was yelling, and it was actually quite ideal for a birth. She was technically born outside, and I love that, and they immediately sat her on my thigh. She weighed 6 lbs. 3 oz. She was whitish gray and completely floppy. I knew some babies are slow to start, and I wasn't scared, so I asked, "Boy or girl?" and was told girl. I thought my heart might explode I was so happy!

Garrett helped push the stretcher to the back of the ambulance and I was lifted into it. The contractions had stopped and I was feeling euphoric, even though I wasn't home, wasn't in the tub, and wasn't even holding my girl… but I had DONE IT! I had naturally VBACed a breech baby with a prolapsed cord! So I just laid there and watched Calliope's chest rise up and down, and listened to the chatter of the EMTs. Someone told Garrett to go ahead and meet us at the hospital, that we'd beat him, so he left.

I told him it almost felt like the contractions with the baby, and that I thought the placenta was supposed to hurt less.

Then I started contracting again, and we all assumed it was the placenta. One EMT in particular was talking to me now, and assuring me that Calliope was out of danger, and said, "Well this is a day of firsts. I've been doing this a long time and I have never delivered a baby." The younger guy had delivered one, but not breech on the side of the road. The older one asked the girl to start massaging my belly to help my placenta separate and at about the same time I asked him if delivering the placenta was supposed to hurt so bad. I told him it almost felt like the contractions with the baby, and that I thought the placenta was supposed to hurt less. I was vocalizing low moans at this point. He said, "Yeah, probably."

A few contractions later he said it sounded like I was ready to deliver the placenta, and moved down to check. I was involuntarily pushing again. He lifted the blanket and said, "Oh! There's feet! Did you know you were having twins?"

Imagine my shock now! Refer back to earlier in this story and note that we had an ultrasound at 18 weeks with an OBGYN at the insistence of our midwifery team. My weight gain was normal for one baby. No one had ever felt the second baby when palpating, and we never heard a second heartbeat. But the day before the girls were born we'd had our home visit with the midwives and they left unsettled. They were actually going to call on Tuesday to tell us that they were no longer comfortable doing a home birth and that we should plan on a birth center birth. They all knew something wasn't quite as we suspected, although no one could pinpoint just what it was.

Twin love!
Io Rumina River was born in just a few pushes, feet first. Unlike her sister, she came out yelling! I got to experience that first cry that everyone wants to hear. I was told, "You have another girl!" About eight hours from start to finish, and I'd VBACed two babies. The ambulance pulled over and the doors opened to another ambulance — they said since Mina was perfect and in good health (weighing in at 5 lbs. 13 oz.) that she would travel on her own. I held her for just a second before they put her in the next vehicle and we drove on. I delivered the placenta en route — I asked the EMT if there were any more in there, and he said no because there were two cords coming from the placenta (it was actually two placentas fused together).

When we arrived at the hospital, they took everything off of Calliope and placed her on my chest for transport up to the NICU and labor and delivery. I remember frantically trying to rub as much of her vernix into her skin as I could because I knew they would bathe her and wash it all off. I got some into her chest and shoulders and I just loved touching her sweet little body. They unloaded us, and Mina was shortly behind, but I was only holding Calliope when we got to the elevator, which is where we met up with my husband. He was quiet, and an EMT said, "Does he know yet? Oh, man! He doesn't know yet!" and I looked over and said, "There's two. It's twins!" Garrett didn't say anything, just looked completely overcome. It was a beautiful moment.

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