Abram & Asher's Birth Story
August 15th, 2018
Story shared with permission, written by Gina Conley, the doula, following a birth interview with Lansingh and Jon Hange.
Lansingh, a mother of four, had already given birth twice prior to her third pregnancy with twins. The first two pregnancies and births were drastically different from her most recent experience with twins. Births one and two both culminated in inductions with epidurals. The road to postpartum recovery in each case was prolonged due to complications resulting from medical intervention. For example, Lansingh developed spinal headaches from her second epidural. The thought hadn’t even occurred that there could be an alternative to medicated birth or that women even had the option to forego an induction or epidural for birth.
I asked Lansingh to compare her experiences between births one and two. Despite receiving induction and epidural during both, she admitted that her experiences were significantly different. Lansingh’s second birth was far more relaxed than her first, as she recalled feeling more comfortable throughout the process. In contrast, the atmosphere of her first birth was one of stress and anxiety. She delivered with an OB which felt very clinical. During this birth Lansingh was not only directed when to push, but also when to breathe; never fully finding the ability to appreciate the moment or find comfort as the doctor and nurses: kept all the lights on; paced around the room; and persistently yelled birth commands at her. The second birth took place with a midwife. Also, during delivery the lights were dimmed while the traffic in the room was limited to the midwife and at most one or two nurses. While the birth felt more intimate, the recovery was more difficult due to the spinal headaches caused by her epidural.
Lansingh desired a natural birth with her third pregnancy. After watching a friend’s home birth video, she was initially inspired to pursue the same experience of intimacy and privacy with the birth of their next child. A roadblock occurred once the Hanges were notified that their insurance provider would not cover a home birth, so the family decided to tour a local birth center in search of a comparable and intimate, birthing environment. After the tour, Lansingh knew that she had found what she wanted for her next birth, so she booked her first appointment with the birth center.
The midwife performed an ultrasound for Lansingh during her first appointment. Not knowing how far along the pregnancy was, the Hanges were eager to find out the estimated due date. They had not planned on getting pregnant again quite yet, but the news was a lovely surprise. During the ultrasound, the midwife paused at discovering Lansingh was in fact carrying twins! She and Jon were completely shocked to find out that they were expecting twins! Neither Lansingh nor Jon have a history of twins in their family, to which they soon learned that twins do NOT need to run in a family to occur. Unfortunately, the birth center could not take multiples, so Lansingh redirected once more and found prenatal care at a local hospital.
After discovering she was pregnant with twins, the combination of excitement for twins and disappointment that she could no longer have her birth at the local birth center prompted the Hanges to seek out a reputable OB doctor in the area who was willing to support Lansingh’s birth desires.
All research regarding modern twin births found online seemed to be immediately followed with the words scheduled c-section. Lansingh grew frustrated and knew there had to be potential out there for twin births without a scheduled c-section. All Lansingh and Jon wanted was an OB that would support her birth desire to deliver vaginally and not immediately resort to schedule her for a cesarean. They finally located a doctor who was on board but only under the stipulation that both babies were head down. A safety concern was posed as Baby B (the higher baby) was currently in breech position. Ultimately, the doctor agreed to support a vaginal birth.
Lansingh still wanted to deliver naturally and without medication. The doctors initially insisted that an epidural would be necessary in case of an emergency cesarean but ultimately supported her desire to labor without an epidural; accepting the risk that in the event of an emergency, she would need general anesthesia. But first, Baby B needed to flip head down!
Lansingh attended MamasteFit prenatal fitness classes throughout her entire pregnancy, and when she approached me about Baby B being breech I began conducting research on various positions for her to try to help encourage Baby B to flip. Spinning Babies has been a vital resource for me as a trainer, and now doula, and I recommended Lansingh try the Forward Leaning Inversion everyday for a few minutes at a time. Lansingh was diligent in her Forward Leaning Inversions and performed them daily. In the gym, we worked on balance, mobility, and strength in the hips.
Lansingh had heard about doulas from a friend who had given birth in January. Her friend’s baby was breech, but because her doula advocated for her, she was able to move through positions to help encourage the baby to flip head down and ultimately delivered vaginally; avoiding the cesarean that her doctors had demanded was necessary from the get go. Lansingh heard this success story and told Jon that she needed a doula. He looked at her and agreed that whatever she needed she would have for this birth and asked where he could order one.
Does Amazon Prime have them?
After several weeks of research, Lansingh and Jon read statistic after statistic, story after story, of how beneficial doulas were for birth in reducing the number of unnecessary medical interventions, and how doulas significantly contributed towards the positive birth experience of the family. It was settled, they needed a doula. Unfortunately, Amazon did not have any in stock.
We began to incorporate labor recovery workouts during Lansingh’s third trimester, and after trying to coach her husband through a double hip squeeze, she slapped his hands away and looked at me stating that she needed me at her birth as her doula. I told her I wasn’t a birth doula, but I would go to the next course I could and become one. I signed up for a DONA Birth Doula Workshop that evening.
At Lansingh’s 32-week appointment, Baby B was finally head down! The doctors now fully supported her desire to birth her twins vaginally and without an epidural. She spent the next several weeks listening to positive birth stories on podcasts, reading them on blogs, and talking with other twin moms on social media that she had never even met before. She surrounded herself in positive stories to help her believe that she could deliver her twins in the way she desired.
At 35-weeks, Lansingh finished a book called “Christ Centered Birth,” and she felt that she was ready for an unmedicated birth. She texted me stating that she knew she could do this unmedicated, and she was ready for it. However, the anxiousness started to catch up as she worried she would have to be induced before she went into labor as each week passed.
Her 37-week appointment came, and she was scheduled for induction for the following Tuesday. The doctors discussed with her how it would be beneficial to be induced around the 38 week mark, as the risk for cesarean increased if her pregnancy progressed past that mark. Lansingh and Jon did research on their own and made the informed decision that supported their family’s desires and supported the idea of induction if she had not gone into labor by then.
She did everything she could to try to induce labor naturally: she walked; she squatted; she lunged; she drank all the raspberry tea leaf and had to be restocked by her doula who happened to have an entire bag left over from her pregnancy. She did it all.
However, at her 37-week appointment, the doctor could not determine a Baby A or Baby B! The twins were side by side and competing with who would be the first baby out. They determined this competition restricted one baby from being able to push effectively on her cervix and was preventing labor from happening.
I recommended they try out the Miles Circuit, suggesting that it could help the twins readjust in her pelvis. Sunday afternoon, Lansingh did the circuit, and immediately afterwards felt so different; she felt more pressure and felt as if Baby A had moved down and Baby B had moved upwards. The contractions started that evening.
The contractions came but were still not close enough together to head to the hospital. Lansingh went to sleep, and the contractions slowed. They continued for a few days, but all the walking in the world was not helping them get stronger or closer together. She decided it was time to just relax and surrender to this process after days of trying to get labor going.
Tuesday morning came, but the hospital was full, so they were delayed another day. I told her to enjoy her last day of pregnancy and having her boys all to herself, as soon they would be earth side for the rest of us to admire and love.
They went in Wednesday morning at 5AM for the induction. Lansingh has a huge fear of needles, and she needed to get stuck four times before they were to find a vein for her IV. She blurted out that this was a good start! But immediately stopped herself from continuing down a negative rabbit hole and refocused her mindset to be more positive.
In the late morning, the doctor came in to check Lansingh and discuss the induction options that were available for the birth. At least that is what they were told he would be doing. Instead, he walked in, introduced himself, proceeded to check her, broke her water, got up and then left without saying a word. Lansingh and Jon stared at the nurse, who informed them that he had broken her water and we would wait to see what happens now.
Shortly after her water was broken, I walked into the hospital room and could feel the tension still present. They were frustrated because they wanted to be equal partners in this birth. They wanted to be a part of the decision making. They didn’t want to be difficult for the doctors, they were in a hospital after all, but they felt there should at least be enough courtesy to have a discussion and let them make the final decision on what happens during their birth. We worked through what had happened and decided to focus on what would come next instead of lingering in that frustration; we knew the doctor would change shifts soon, and a new doctor would be on call for Lansingh.
As soon as she came off the monitors, we requested she be taken off the IV and insisted she would drink water. The nurse happily agreed, and Lansingh had a new-found freedom of movement that she had not yet experienced in the hospital. We walked the halls; swaying through mild contractions, performing a few lunges and squats, and then started to incorporate the Spinning Babies Abdominal Lift and Tuck during contractions in an effort to encourage Baby A to engage in her pelvis. She was still able to talk, so we used the time to joke and laugh, discuss their birth plan, and reinforce that Lansingh could do this and that she had our support for her birth.
Jon later stated that he didn’t know what actually worked or didn’t work to help Baby A engage, but he knows if it had not been for a doula, they would have just walked in circles hoping that something would happen. He stated that they wouldn’t have done any squats, or lunges, or the lift and tucks, that they wouldn’t have known what to do. He stated that the doula brought up options he didn’t know were options; they were able to ditch the IV tower, and she was able to walk more freely; Lansingh didn’t have to be restricted to the bed during monitoring, and she could labor in a position she preferred during the ten minutes of mandatory fetal monitoring. He felt that having a doula helped them navigate this early labor, and also helped Lansingh avoid additional interventions in an attempt to start her labor.
Slowly, Lansingh started to become quieter during contractions, and there was a visible change in her demeanor as labor began to progress. Eventually, she needed more and more support during a contraction.
Around 4PM, Lansingh had her final vaginal exam prior to pushing, and Baby A had engaged in her pelvis. It was time to adjust the physical environment to accommodate Lansingh’s labor. We made sure the diffuser had been restocked with her favorite oils: Orange and Peace & Calming II; I turned all the lights off, to include the computer screens, and we used the diffuser’s candle light feature to subtly light the room; we put on her favorite Pandora station and let the music quietly fill the room and cancel out the outside traffic. We created a birthing cave, and within a few minutes, labor really began.
Later I would learn that they had created a similar environment, dimly lit room, same essential oils, same music, each night before bed. They had inadvertently created a ritual of their own that supported a feeling of peace and safety when we mimicked this environment during the birth.
Lansingh leaned into Jon’s chest for support during her contractions, each one bringing her twins closer into the world. Initially, the two swayed together, repeating short prayers and phrases, encouraging her to relax through the contraction as best she could. I would massage her low back with a lavender blend massage oil in between contractions. As the contractions grew in intensity, I began to squeeze her hips through them, coaxing her to relax in a methodical fashion starting from her face, her jaw, her neck, all the way down to her toes; just as we had practiced during our labor recovery workouts. Exhale, let it go.
Jon whispered prayers, and told her he loved her, and that she was doing so great. We all swayed together through every contraction. We rubbed Peace & Calming II into Jon’s shirt, where Lansingh had buried her face into each contraction. The smell soothed her, and she began to recite her own powerful prayer as her contractions peaked.
There were moments in between contractions where she would pull back, stating she couldn’t do this anymore and that it hurt a lot. But she would immediately refocus and bury her face back into Jon’s chest; swaying together through the next contraction.
Nurses would tiptoe into the room, respecting the space we had created for Lansingh. They would whisper questions to Jon or me, and we worked together to continue to support her labor. We would gently move Lansingh closer to the monitors, so she could continue to stand and lean into Jon during contractions but also let the twins be monitored for a few minutes. The nurses found their labor to be so beautiful, that they held back their tears each time they came in to monitor the twins.
Around 9pm, transition had started, as a shift in Lansingh’s demeanor suddenly occurred. She pushed back, demanding that she needed pain medication and that she didn’t want to do this anymore.
The aggression was so sudden, and unlike her previous laboring, that I grabbed her by the face and demanded she look into my eyes. I told her to breathe with me; inhale, exhale, let it go. You can do this, we talked about how this might happen, you are doing so amazing. Inhale, exhale, let it go. Look at me. Look at me. She pushed me away, lunging into Jon’s chest through the next contraction. In between contractions, we worked to try to calm her, even if for only a few moments.
Eventually, she was able to alert the staff that she wanted pain medication. The nurses slowly walked into the room, and casually told her if she wanted any medication, she would need to get in bed so that they could check her. They respected that she was trying to give birth naturally and wanted to support that desire, but also understood plans could change.
When they checked her, she was at 9cm and was complete. She didn’t have much more to go! They hit the call button to alert the doctor and staff. It was protocol for twins to be delivered in the operating room, in case of emergency. Lansingh so desperately wanted to deliver in their labor room and did not want to be carted to the OR when it was near time to push.
The energy of the room intensified as we waited for the doctor to arrive; 15 minutes had nearly passed! The nurses continued to hit the call button, alerting the staff it was time. Other nurses were starting to fill the room with assorted carts and trays, they were beginning to get things ready to move Lansingh to the OR. Finally, the doctor walked in, and casually walked over stating that he was going to check her.
She was 10cm! And Abram was right there! The doctor immediately began to put on his gown, and alerted the nurses that they would be delivering the twins here. The nurses scrambled to adjust the room to accommodate the birth of the twins. Jon and I moved to Lansingh’s side, as he held her hand and brushed her face telling her how proud he was of her, and that the twins would be here soon.
After a few minutes of pushing, Abram was born! The nurses rushed him off to the warmer for his newborn exam, and Jon followed shortly after some conflict on who he should stay near. I encouraged him to go with Abram, and I would stay right here with Lansingh. I began to tell Lansingh what was happening to Abram, relaying to her what procedures were being done, how much he weighed, and whatever else I could hear so she felt included.
The doctor began to focus on Asher, as the nurses were having some difficultly with monitoring his heartrate. The doctor checked on the ultrasound, and Asher was still head down! He informed Lansingh that Asher was still head down, and they could continue with the vaginal delivery of the second twin!
Shortly after the good news, the doctor paused. He leaned in towards Lansingh, and calmly stated that Asher’s cord had prolapsed and they needed to do an emergency cesarean. Lansingh and Jon immediately asked what other options were available, as the doctor paused to hear their concerns and provide them space to speak. He kept his composure, and calmly told Lansingh that there were not other options.
Lansingh looked directly at me, and I held her hand tighter as I reassured her that this was the only option available right now. Her shoulders released their tension, and she nodded as she told the doctor okay.
Lansingh later told me that the doctor’s calm demeanor helped keep her calm; had he been panicked, she would have fed off that energy heading to the OR. She greatly appreciated that he acknowledged her fear and provided her space to make a decision and come to terms with what was happening. She told me when the doctor told her they would need to do an emergency cesarean, that she trusted no one else in the room but me. She knew that if there was another way, I would have recommended it and advocated for her and her family. When she looked at me, and I told her that this was necessary, she felt relaxed and accepted that this was how Asher had to be born. She felt safe as she headed towards the OR because of the doctor and my reassurance that this was the necessary option.
The staff quickly moved Lansingh out of the delivery room towards the OR, as Jon followed her. The nurses near the OR offered to take Jon’s phone into the OR to take photos of Asher being born, since he was not allowed in the OR. He greatly appreciated the nurse’s kindness in providing updates on what was happening and reassuring him that his wife and child were doing great. He later said it felt like much longer than ten minutes as he waited.
I stayed with Abram and held him in my arms until Asher was earth side. Roughly ten minutes later, the nurses announced that Asher was born, and Abram seemed to stop crying. Maybe it was all in my head.
When Lansingh woke up in recovery, each baby was latched! Jon had one twin on one breast, and the nurse had one on the other breast. She asked if everything was okay, and the nurse reassured her that everything was great!
Lansingh and Jon had the birth experience for their twins that they desired, even if it didn’t all go according to plan. They had a doula that supported them throughout the pregnancy and birth. The staff was incredibly supportive of Lansingh’s birth desires; the nurses advocated for her and the doctor was very respectful of her birth desires but was able to calmly reassure her when an emergency arose. As they reflected on the experience, they are happy and would do it all again. They welcomed their handsome, twin boys on August 15th within twenty minutes of each other; each born into the world in a completely unique and beautiful way.