One of my fears throughout my twin pregnancy was that I wouldn’t recognize the signs of labor when they came. Every mom that heard me say this laughed at me. “Oh, you’ll know!” Even the nurses I met in the hospital the week I was on bed rest reassured me. “Contractions will stop you in your tracks.”
Well, they were wrong.
I was expecting a c-section up until Liam decided to flip into a head down position in the third trimester. With both babies now head down, a vaginal delivery was an option if I went into labor after 34 weeks gestation, and if there were no signs of distress for either baby.
At 35 weeks 6 days pregnant, I went in for one of my biweekly checkups. This time I was also having blood drawn to check for cholestasis. From Mayo Clinic’s website:
Cholestasis of pregnancy occurs in late pregnancy and triggers intense itching, usually on the hands and feet but often on many other parts of the body.
Cholestasis of pregnancy can make you intensely uncomfortable but poses no long-term risk to an expectant mother. For a developing baby, however, cholestasis of pregnancy can be dangerous. Doctors usually recommend early delivery.
The term “cholestasis” refers to any condition that impairs the flow of bile — a digestive fluid — from the liver. Pregnancy is one of many possible causes of cholestasis. Other names for cholestasis of pregnancy include obstetric cholestasis and intrahepatic cholestasis of pregnancy.
I had mentioned the intense itching I was experiencing to my doctor for a few months now, but she seemed to think it was just my body stretching to accommodate the twins. Never having experienced a pregnancy before, I believed her, but was pretty shocked that all pregnant women were itching this badly and not clawing themselves raw like I was every day.
On Thursday, May 14, I was having an ultrasound done and I kept having to interrupt the technician to sit up and scratch my legs. She said I should mention the itching to my doctor again just in case I had cholestasis. She said they would induce me early if I had it since it increases the risk of a stillbirth. With singletons, they would induce at 36/37 weeks, but she suspected even sooner with twins.
So, my doctor agreed to test me, and as I’m getting my blood drawn, I asked my doctor “So if you had to guess, when do you think I’ll go into labor? Do you think I’ll have to be induced at 38 weeks now?” and she said “I just have this feeling that you’re going to go into labor as soon as I leave the country for my vacation.” She had a trip to Spain scheduled May 15th-25th.
I finished up my blood work, and she said they would have the results by Monday morning, the 18th. She had a note for her partners to be on the lookout for my results. We went ahead and scheduled an appointment for me to be induced the week she came back into town, when I was just shy of 38 weeks. She said she was going to try her best to refrain from logging in to look and see who was in labor each day because she would get sad if she didn’t get to deliver the twins. We loved Dr. Brown so much and knew we would be sad if this happened too, but we were completely understanding and wished her a safe and relaxing vacation!
Friday evening (36 weeks!), I had what I thought was a stomachache. Like seriously, just a tiny bit of cramping. I didn’t think twice about the possibility of it being contractions, because those were supposed to “stop me in my tracks.” Right? These, I just took a few Tums and dismissed it as more of that pregnancy heartburn that had become so common. I slept great Friday night! Other than, you know, being up every two hours to pee…. but that was normal at this point.
Saturday I woke up with the same stomach cramping, but it still didn’t even bother or concern me enough to mention it to Matt even until the evening. About 9 or 10 that night I mentioned it to him, and he asked if I thought they were contractions. No, I didn’t think so, but I was terrified of missing the signs of labor. I kept asking him “Am I in labor?” “Are these contractions?” “No, right? Because they still don’t hurt.” … as if he could possibly know these answers for me.
He said he didn’t think I was in labor, because I was obviously not in any pain, but that I should count my contractions just in case. Well, how was I supposed to do that if I didn’t recognize them? I didn’t feel like there was a clear start and stop to the stomach cramping, it was just a dull ache that was constant.
I lifted my shirt above my belly to watch the babies move around and I saw a contraction! I could see my skin tighten so much that I could make out certain body parts. Matt saw it too!
I decided to go take a bath where I could count my contractions by sight and not by feeling. I downloaded a free “contraction counter” app and went to work. I counted them for an hour and they were nearly exactly 4 minutes apart and 1 minute long like clockwork. There was just one break between contractions that was 8 minutes long, which I assumed maybe I just missed one since the others were so consistent.
I was in labor! Maybe? Right? But why wasn’t I in pain? Not that I was complaining about that part, but I was just second guessing myself.
Matt called the hospital and ran these symptoms by a nurse. She only said “I am only allowed to tell you that if you believe you are in labor, you should come in and be evaluated.” He kept trying to ask her opinion on if it sounded like labor and she wouldn’t help out at all.. I’m sure due to liability reasons, but it was still annoying.
Matt and I agreed to try to get some rest and go in first thing in the morning if I still had the stomach cramping. Try being the key word here.
That’s when the itching kicked in like nothing I’ve ever felt before. I scratched so hard I was making myself bleed! It was hurting so bad. I’ve never experienced itching that was as physically painful as this was. I was miserable. My back and belly were covered in claw marks from my fingernails. We continued to try to sleep until about 6am Sunday morning when I was nearly in tears from the pain of the itching.
I asked Matt if we could go to the hospital now. He said “Sure, do you think you’re in labor?” and I said “No, I don’t. I’m not in labor, but the itching is too unbearable it’s worth going in just for that.” He got dressed and ready to go and I was already waiting by the door with my hospital bag that had been packed a while now. I had a second list sitting on top of it with the last minute grabs like “toothbrush, cell phone charger, etc.” He asked if I wanted to grab those items real quick “No, they’re just going to send me back home anyway. I’m not in labor, I just need them to make the itching stop.”
I was so angry. I don’t get angry often, but I’ll be the first to admit I was mad! Matt and I didn’t say a word on the way to the hospital. I was in so much pain from the itching and was just preparing myself for them to send me back home.
We got to the check in desk shortly after 7am and the man asked me “what brings you in today?” I said “I just wanted to double check that I’m not in labor, and at least get some medicine for this itching.” I just imagined he was thinking “I’m sure you’re not if you’re standing up straight and having this conversation with me.”
Once I was in my room and being hooked up to the monitors, I explained the mild cramps, the visible contractions, but mostly the itching. I told them I wanted to double check that I wasn’t in labor, but I desperately needed something for the itching either way. They looked at my belly and commented on all the scratches. Yeah, that’s because I was going to make myself bleed out soon if I didn’t get this under control from scratching so hard!
“Well, you’re definitely having contractions! Looks like they’re 2 minutes apart and coming in strong, let’s see if you’re dilated at all… Yep, looks like a 5! You’re not going home again until you have these babies!”
I wanted to kiss her I was so happy!!! I grinned from ear to ear at Matt and gave him two thumbs up! She called the on call doctor from Dr. Brown’s practice to see if I could take any medication for the itching since I was in active labor now. She said no, but that I could have my epidural right away and that might knock it out. Yes, please! Anything!
They rolled me to my labor room, and I eagerly awaited the anesthesiologist. Dr. Graves came in and said she would be delivering the twins as long as they came before 7pm. Luckily, I had met her already! I met all the other doctors during my week long stay on hospital bed rest. And she had actually delivered a good friend of mine’s baby, which was a super high risk pregnancy. So I knew she was a great doctor and very sweet on top of that!
She broke my water (Cherish’s) and checked my dilation again. I was at a 6! I was so happy I had already progressed another centimeter. The anesthesiologist came in shortly after at 9am and gave me my epidural. It just felt like someone pinched me hard for the most part. I felt it more in my chest than anything. But the itching instantly went away, I was one happy girl!
My hospital (and most) required an epidural for a vaginal delivery of twins because there was still such a high chance of emergency c-section. I wasn’t complaining though, that thing was wonderful! And another benefit of an epidural….a catheter. That may be too much information, but any pregnant woman would agree! It’s miserable to get up and pee ever thirty minutes in general, but especially hooked up to monitors and IVs.
Matt had to leave the room when I got my epidural (hospital policy), so he took this as an opportunity to go grab something to eat. Unfortunately, only popsicles were on the menu for me.
I get really sick and throw up when I skip a meal, or a snack for that matter. I like my food. I hadn’t eaten anything since my middle of the night snack – a bowl of watermelon at about 4am. I wish I would have been convinced that I was in labor, because then I would have grabbed a quick breakfast first. Oh well!
I had 6 popsicles over the next 3 hours to try to fill my belly up so I didn’t feel so sick with hunger. It didn’t work, I started throwing up. Matt was sleeping on the couch and I had to wake him up to bring me a trashcan stat! It’s very obvious when you’re throwing up and hooked up to a monitor because your stomach muscles clinch so violently.
My nurse Pam ran in and gave me some ‘barf bags’ so I didn’t have to hover over a trash can anymore. She also cut off my popsicle supply. She was convinced it was the reason I was throwing up, but she was wrong. I understood why she would think that though, so I didn’t argue. I just know my body really well (aside from, you know, recognizing labor symptoms, HA!) and knew that I was throwing up because of my crazy intense pregnancy hormones that took over when I ate too much, too little, or with my hair fixed the wrong way. Basically, just all the time.
Dr. Graves had been in and out over the course of those 3 hours checking me, each time I had progressed even more. Things were moving along quickly!
At 2pm she came in and said I was at a 9, almost pushing time! She also got an alert on her work phone and laughed, she looked up and said “Well, your blood work came back… looks like you have cholestasis!” Haha! You don’t say?
2:30pm, I was a 10 on one side and a 9 on the other, so she had me lay on my left side.
2:45pm, Sunday May 17th, I was a 10 across the board and crowning with Cherish, it was pushing time! Well, almost. With twins you have to deliver in the operating room even if you’re going to attempt a vaginal delivery because of the high risk of emergency c-sections.
So, they start to roll my hospital bed down to the OR. I was so nervous, I thought I would have a c-section this whole time. I was on bed rest by the time Liam flipped so I didn’t have the opportunity to take any child birth classes. How would I know how to push 1 baby out, let alone 2?
Once we got into the OR (3pm) there were about 10-12 staff members on my delivery team. Anesthesiologists, my OBGYN, a pediatrician for each baby, and nurses out the wazoo! I felt so well taken care of. They were all so kind to me and encouraging, telling me I’d do great, this would be quick and easy.
They transported me from my hospital bed to the operating table. They made me and my pregnant belly feel light, they lifted me so effortlessly. But again, there were like a dozen people in that room!
They got all my monitors set as Dr. Graves started telling me how the pushing would go. She asked if I could feel my contractions, “I think so, yeah…maybe” “Well, you’re having one right now, pull your legs to your chest and push as hard as you can.”
I didn’t realize how quickly and easily this part would go, it was nothing like the movies! Each contraction they had me push 3-4 times for ten seconds each. “That’s it!” “Perfect!” “Just like that! Here she comes!”
3:08pm and Cherish was here!!!! They had told me all along how calm and positive I was for being in labor with twins, both before and after my epidural. I warned them that I was a sap and would cry the second I saw my babies. They said they would be worried if I didn’t!
I was right, the tears started streaming. Wow, she was here! My firstborn. My daughter. Baby A. Cherish Grace. Weighing in at a whopping 5 lbs 6 oz and 18 inches long. A full head of dark brown hair, and perfectly petite little facial features. Bright eyed and staring straight at us. We were in love.
One of the nurses grabbed the camera from Matt and asked if she could take pictures of us as a family of 3. I’m so thankful she thought of that, because those will be so special to our sweet Cherish one day.
I completely forgot I was still pregnant. There is just so much relief that comes from pushing out a baby. It feels like it’s time to rest, but not with twins. Little Liam was still inside me and working his way down.
They had been monitoring his position via ultrasound the whole time we were having our moment with Cherish.
“Okay, it’s time to push again!”
Oh yeah… Liam! We’ve got to get him out too!!! They took Cherish back and I got into pushing position again.
My first contraction came and I pushed 3 times then rested, just like I had done each time with Cherish. My second contraction came shortly after. I pushed once and something popped. “What was that?” “Your water broke, keep pushing… again… again… again… keep going…. again… you got this… again…. don’t rest… push…. harder…. again…. one more…. almost there…”
I had forgotten I had a second water until it broke. I had really high fluid levels so it didn’t just break, it exploded. Everywhere. But Cherish’s membranes were ruptured while I was pushing too, and they allowed breaks between contractions. Something was wrong. I knew it. I didn’t panic, but I knew without a doubt that something was definitely wrong. I pushed as fast and as hard as I could to get my son out, because I could read it on everyone’s faces… he was in distress.
They didn’t tell me at the time (thankfully), but later I learned he had a prolapsed cord. It happens in less than 1% of vaginal deliveries, but there’s a slightly higher risk with twins (baby B specifically), and with high fluid levels – which I had extremely high fluid levels my whole pregnancy. So, when I pushed and broke his water, his cord shot out first. Meaning, his oxygen supply was instantly cut off because of the pressure on the cord from the cervix. Dr. Graves and her staff acted quickly, calming, and efficiently. She later told me that if I didn’t get him out within another minute she would have ordered an emergency c-section.
He came out purple and limp. But there was a peace inside of me. I somehow knew he was okay. Months prior, I had a conversation with a good friend asking all my questions about c-sections. During that conversation she warned me that her daughter came out blue, and that it doesn’t necessarily mean they aren’t okay. God brought back that specific conversation to my mind right in that moment and filled my heart with peace. Liam was okay, I just knew it.
Matt didn’t though. He thought he was stillborn. He heart was breaking until they were able to get that first cry out of Liam. Once he started crying his color slowly came back to pink! We were so happy to see he was going to be okay.
3:25 pm, 6 lbs 12 oz, 19.5 inches long. Liam David Kramp had arrived! Our first son. We were now a family of four!
We had our time with Liam, holding him close and thanking the Lord for his life! For protecting him in delivery!
As I passed him to Matt, I noticed Dr. Graves was still working on me. “Did I tear?”… “Oh yeah. You’re a mangled mess. I wouldn’t put a mirror down there anytime soon.”
Unfortunately, I suffered a 3rd degree tear, which meant a 6-10 month recovery process. If you don’t know what that means, google it… if you have a strong stomach. Less than 4% of women get 3rd and 4th degree tears, but trust me… you want to be in that 96% for sure. There was no pain at the time (thank you, epidural!), but the lengthy recovery time isn’t painless.
But that didn’t matter! The twins were here and they were healthy!
They didn’t go to the NICU right away, but at 2am I was woken up by one of the NICU pediatricians saying “Mrs. Kramp? I don’t mean to alarm you, but I need to inform you that your daughter was just rushed to the NICU with dangerously low blood sugar levels.” Newborns are at risk of seizures when levels reach below 20, her’s was at 20 on the dot. He went on to share that in terms of seriousness for NICU stays this was about a 2 out of 10. That was reassuring to hear, maybe he should have led with that! He said to get some rest, she was in good hands now, and that we could learn more about her length of stay tomorrow morning.
Monday, May 18th, 2015… what would have been my grandmother’s 91st birthday! She went to be with the Lord the previous November, shortly after hearing the news that we were pregnant with twins. She herself was a twin, she also had twin daughters (one of which is my mother), twin grandbabies (my cousins), and now twin great grandbabies! It was special to me that my twins’ birthday was so close to my Gramman’s.
At about 8 that morning, we had another pediatrician come and tell us that Liam had just been placed in the NICU for low blood sugar readings alongside Cherish. She assured us that this was “out of abundance of caution” since his levels never read below 40, as well as “to make things easier on you logistically”. Something we would be even more thankful for as the next few days in the hospital unfolded.
So, we made our way up to the NICU each day during every feeding time and wake time. We were so thankful to have such an incredible hospital facility here in Louisville where we could just be a few floors away from the twins. What a gift!
I was still being closely monitored because of a potential blood transfusion due to major blood loss during delivery. Not to mention, I was still vomiting regularly – something we later learned was just my high levels of pregnancy hormones STILL working their way out of my system. Ugh! So, in between pumping sessions, sleeping sessions, vomiting sessions, ultrasounds (checking my liver functions) and blood draws, we enjoyed our first days with our babies finally in our arms. Hooked to wires and machines, but safe and healthy nonetheless.
On day 4 (Wednesday), Liam and I were officially discharged. Thankfully, there was a charity house on site where Matt and I could stay to be with Cherish still. Unfortunately, you couldn’t have any minors in the charity house with you, so Liam wouldn’t have been able to stay.
So, as we were debating who to send home with Liam and who to stay with Cherish (because my breast milk still needed to be in two places at once somehow), another amazing NICU pediatrician came up with a plan. She said she was willing to keep Liam again in the NICU for monitoring another night (fudging a little paperwork to do so), if we were okay with that option financially.
Thankfully, we were covered in full 100% with no deductibles or ANYTHING, so we were fine with this option if it meant we all got to be together tonight. She even said we could stay for free in the “care by parent room” directly across from the NICU instead of the charity house. So, we would actually get to care for our babies together overnight while they were still on their monitors and their amazing medical staff was right across the hall if we had any concerns.
It was such a good transition for us. Looking back on it all, I’m very thankful that our twins had a short and non life-threatening NICU stay. We didn’t know how to take care of premature newborns, especially not two at once! They were so helpful in giving us just the confidence boost we needed as parents. We learned so much from them and will always remain grateful for that brief NICU stay, even if Liam did projectile poop on Matt that first night.
Thursday, May 21st, we were all three discharged from the hospital and got to spend our first night at home by ourselves as a family of four. And we survived!
Matt went back to work on Saturday, and I slowly but surely learned to navigate the waters of this whole twin mama thing, relying on lots and lots of grace every day!
And then a few weeks later, we were having dinner at a friend’s house when she offered to take our picture. We laughed when we realized this was our first photo as a family of 4. Real classy, right?
Looking back on our twins’ birth story, from conception to delivery, from NICU to now, we are flooded with thoughts of God’s graciousness showered upon us once again. We are so undeserving of all the good gifts our Lord has given us, the greatest of these not being our own children, but His.