When harriet met billy & tommy
CW: This story involves infant loss.
In early 2017, my husband and I decided to try for another baby after our first child, a son, was born in 2013. We were both excited and terrified to discover we were expecting twins. Fraternal (dizygotic) or non-identical twins, I had two sacs, two placentas and two more boys.
I was fortunate to have a relatively easy twin pregnancy, complication-free. Twin one, Tommy, was head down and in the perfect position for a natural delivery; twin two, Billy, was lying transverse across the top of my uterus with feet and hands poking out from both sides as he stretched in there.
As my due date in November approached, I was excited for every week I went past 30 weeks. On the morning of Wednesday 17th October at 35 weeks and 3 days, I woke around 3 am feeling odd. No pains, no contractions, just odd. I walked around the house, had some water and decided to rest on the sofa. I awoke on the sofa at about 5.30 am with mild cramping; I noticed my mucus plug and some watery discharge and thought, this could be something or nothing. By 6 am, I was having regular pains and contracting every 10 minutes. I called the hospital and gave them a rundown of my symptoms, and they decided it would be better to come in straight away, considering it was a twin pregnancy.
The birth plan, as discussed with the obstetricians and anaesthetists, was to come in and get an epidural so that after Tommy was delivered, they would pop a hand in and grab either a foot or arm of Billy and position him for birth. So, I proceeded to wake my hubby, and he got his mum over to get our then-pre-schooler off for the day. Fortunately, she lived less than a km from the road, and we were organised and out the door for the 20-minute drive to the hospital by 6.45.
Thankfully with minimal traffic at that time, we arrived at Canberra Hospital just after 7am; during the drive, my contractions had intensified, and I could tell they were much closer together, although I hadn’t bothered to time them on the drive. I waddled and breathed from the car to the enormous twin delivery room with at least six clinicians ready to go. The anaesthetist was ready and waiting to assess me for my epidural. However, I knew I needed to push. I lay there with my legs crossed over each other, willing my baby to wait for any form of pain relief. Mercifully, one midwife handed me the nitrous gas, and the other helped me out of my leggings while telling me to “open my legs and give baby room”. I recall replying that if I opened my legs, this “baby would come out”. She giggled and suggested a vaginal exam, to which I consented; however, Tommy’s head greeted her awaiting hand, and in two pushes out, he came at 7.11 am.
I looked at the stunned midwives and doctors and said, “But what about my epidural?” Their amused faces fell as the midwife listened to Billy’s heart rate and noted a foetal arrhythmia. Apparently, it’s not an unusual occurrence after a fraternal twin delivery. The second twin suddenly has too much space and becomes distressed. By 7.20, we were being rushed from the delivery room to the operating theatre, and the staff told my husband to walk faster down the hallway. I was wheeled directly into the theatre with staff hurriedly counting instruments and the anaesthetist explaining that there would be no time for a spinal and it would be a general anaesthetic. My husband was informed he would not be allowed to be present during the birth and was redirected to a waiting room.
I woke in recovery sometime later, by which time both my boys had been transferred to the NICU in respiratory distress. I was grateful my husband was with them, and I was able to be wheeled in on my way back to my post-natal room. I could just reach my hand into their isoletts to connect with each of them. I was only allowed to stay a very short time as I had suffered a post-partum haemorrhage (again common after fraternal births due to having double placentas), and had a tamponade balloon inserted intrauterine, meaning I had to stay relatively flat and still for the next few hours.
I was pretty sore; I had stitches everywhere, a second-degree tear from twin one and a caesarean for twin two, without the spinal for extra pain relief. The staff were excellent, ensuring I had appropriate pain relief and was able to get up into the NICU as much as possible. By Thursday evening, I had the balloon removed and was finally allowed to get out of bed. Billy (twin two) continued to improve in the NICU. However, Tommy (twin one) was still struggling with his breathing somewhat. On Friday, 20th October 2017, we were called urgently up to the NICU right as they were starting an iron infusion on me. We arrived to find every parent's worst nightmare; there, several doctors and nurses were resuscitating Tommy; he had lost output after a routine procedure and was no longer responding, and a full code blue with CPR was in progress.
It was the most surreal experience, as a medical professional myself, to watch them working on my child, only described as an out-of-body experience. I knew he was gone; I asked to hold him and did so for the next 8 hours as we were sat in a private room and interviewed by all sorts of people. The staff continued to be amazing, checking on me continuously throughout that harrowing ordeal, keeping my pain relief up and ensuring my vitals were done and stable despite me being sure I was dying of heartbreak. They brought Billy in and waited for our oldest to arrive; they made sure they took photos of us as a family for the first and last time.
The care and compassion continued over that weekend. They organised for Billy to be transferred to another special care nursery as soon as he was stable enough to do so; this was closer to home for us North Siders and meant we didn’t have to keep returning to the same room where we had watched them work on and try to save Tommy. I was discharged simultaneously, and the midwives continued to visit me at home.
Today, Billy is a lively six-year-old with far too much energy; he loves being a twin (possibly because he's never really had to share everything), and our family loves visiting Tommy at Gungahlin Cemetery for a picnic. I recovered well after my double birth and went on to deliver my fourth child, a girl named Elsie, via VBAC in January 2022 at what was then Calvary Public Hospital; I have never been able to return to TCH without the feeling of dread. Elsie was the first of my babies who didn’t go to NICU and was discharged home within 12 hours, a vastly different experience. This birth story is more than that; it is also the life story of my second child; it is a core memory for me and represents the only cuddle I had with him while he lived. The only things I was able to give him were life and a celebration of his two days with us, so this story, while traumatic, is fundamental to our family.
What do you wish you knew before birth?
I was told it would be very unusual to have twins, one vaginally and one via emergency caesarean, so I wish I weren’t told that, but rather that it can and does happen. I also wish there was more emphasis on 37 weeks being a standard viable gestation rather than the general consensus these days that anything beyond 30 or 33 weeks is pretty safe.
If you could, would you do anything differently?
I would have ensured that one of us or another family member was always present with the babies in the NICU, so they were never alone up there. For my final baby, I had everyone on a schedule in case my daughter had to go there and made sure there was always someone available to be with her. She didn’t, fortunately.
What did your partner do that really helped during labour/birth?
He listened to my requests, didn’t argue and did as he was told when the situation escalated. He also really advocated for me throughout my final pregnancy to make sure all my fears and trauma from birth two were not repeated in birth three.
What advice/honest truth would give a mama-to-be about birth?
In my experience, I've had an induced vaginal delivery, a natural vaginal delivery, an emergency c-section and an induced VBAC delivery. I would say that labour and contractions are definitely more bearable when they happen on their own; induced contractions are another world of pain. I found the recovery far faster, less painful and all-around easier after all of my vaginal deliveries than my c-section. I would never choose that recovery unless absolutely required.
For anyone experiencing loss and in need of support, there are resources available to help.
Sands Australia: 24/7 bereavement support for miscarriage, stillbirth, and newborn death. sands.org.au
Red Nose Grief and Loss: Provides support for families experiencing the death of a baby or child. rednosegriefandloss.com.au
Bears of Hope: Grief support for pregnancy and infant loss. bearsofhope.org.au
The Pink Elephants Support Network: Support for early pregnancy loss and miscarriage. pinkelephants.org.au