TJ* & L* are a loving couple with three children.  TJ has a strong history of twins on her side of the family.  At around 20 weeks she was measuring ahead.  I asked her to monitor her growth during the next couple of weeks and my mouth dropped when I next visited her, she visibly looked almost term. Ultra sound confirmed what we suspected, twins, boy & girl.

TJ has a large tummy muscle separation that preexisted this pregnancy.  This separation lent itself to an ability to feel these babies in a detailed way, (feeling knees, feet hands etc early on). However this separation also lead to some challenging concerns about babies lie.  They were able to make complete roll over movements in front of your eyes at 38 weeks.  Each visit lead to new positions, (36 weeks transverse, transverse, 37 weeks vertex, transverse, 37.3 wks, oblique, transverse, etc...  TJ & L had a strong commitment to homebirth and assumed personal responsibility for this pregnancy and this homebirth in numerous ways.

Friday night TJ called around 6:30 to report ctx q. 10 min and some bloody show.  My heart skipped.  I had made three trips out in the last 10 days for some patterned ctx  but with no bloody show.  I asked her to continue on with her normal activity and I would call in 1 hour.  Called Marj*, (fellow midwife,who had agreed to travel three hours to assist me) and we decided to recommend that she hydrate her self and get to bed.  It had been very humid that day and knowing the typical family routine, the parents had been up since 5 a.m.  So when I called TJ back, thats what we recommended.  Also of course asked her to call back if the ctx became 7 min apart, srom, or ctx changed in strength.  Mean time I put everyone else on call and settled down with my resources.  Reviewed my Shoulder dystocia, OFP, Breech Wise, Hemorrhage handbook and all my collected twins materials. Read, reviewed and centered myself for what the universe had awaiting us this night. 

Interesting enough the day was full of symbolism:two period of 15 min rains in full sunshine; a brilliant rainbow; a full moon.  I also have a personal symbol related to births I will have some significant growth from, I always see a deer, (day or night).  So sure enough, I saw a deer on the way to the birth and a deer in the middle of my town that morning as I returned home.

So at 9:40 that night L calls to let me know it is time to come.  Ctx are 4 min apart.  L explains that TJ had just gone to the bathroom and the ctx went from q. 10 min to q. four min.  Marj lives three hours away so I call and prepare myself for thoughts of receiving one or both of these babies before my trusted cohort can arrive.  Jay*, a new assistant, arrives just as L calls.  We head out and great the full moon. I ask L to have TJ lie down until I arrived, I did not want gravity working to have these babies arrive before I did. 

Jay & I arrive at their home by 10:45.  TJ is side lying in her & L bed working beautifully through ctx's.  We quickly acclimated ourselves to the relaxed peaceful environment of there home.  I take TJ vital signs, listen to babies and gently try to palpate babies positions from a side lying position.  Yeah, one of the babies has a pole in the pelvis.  Upon asking about TJ comfort, she shares that she has quite a bit of back discomfort, so we show L how to apply some massage and counter pressure to her back.

We start to set up for the birth and then I ask TJ if I may check to see how she has progressed internally, and also to see if I can assess what we have presenting.  TJ & L agree to this request.  So the assessment reveals a large bulging bag of waters with a very hard presenting pole and 5-6 cm dilatation.  Because the BOW was bulging so far out of the cervix, it did not permit me to palpate any details on the presenting part, ( just average length fingers for me).  We continue to set up for the birth and support TJ, about 10 min later her membranes release.  Cl fluid and babies heart tones are great. Within ten min., TJ is overwhelmed with an urge to push and I support her in this asking her to push just at the peaks of the ctx and only if it is asking her to.  She tries and I ask her if it felt like the right thing to do or did it hurt to push.  She reports that it felt good to push.  I ask if I may assess her internally to see if I can better feel her baby (I do not typically feel I need to do internal assessments unless I am going to get information that will be important to the birth.  So having twins, my midwifery partner not being there yet and the fact that these babies were moving so much up to the moment of labor I wanted to assess how close we were to birth and what baby part was presenting in the pelvis).  So as I assessed I first found a complete cervix and the presenting part was now low in the pelvis,  I started to assess the presenting part and found my fingers trying to find fontanels and they couldn't.  TJ got a ctx and I waited until she finished and informed TJ & L what I had and had not found and asked there permission to assess once again to further decide what I was feeling.  As they consented and I began my assessment TJ got another CTX and a swollen scrotum began to crown in my hand.  I though thats why I could not find the fontanels!!!!!!!!!!

At this point I truly could feel & understood that all the ancient birthing mothers and midwives were protecting this birth.  I felt such a calmness surrounding this birth, a complete sense of serenity and that these births were going to open up as planned and all was well.

We helped TJ get into her hands and knees and I began to prepare for receiving this baby boy.  I shared with TJ & L what I had found and how a birth of a bottom first baby typically progressed.  I asked TJ to pant through these contraction explaining that we wanted to make sure the cervix was completely out of the way and that we really wanted to try and have another midwife present because we were having twins and sometimes bottom first babies need a bit of help getting going. 

I asked Jay to call Marj on my cell phone and  I updated her on what was happening.  Even though I was calm and at peace, it was so wonderful just to here her voice because I knew she knew exactly what I was feeling.  She suggested I try putting TJ back in a side lying position, that this may help slow the progress.  Marj was 37 miles away.  So for 40 minutes every person in the room panted rhythmically with TJ through every ctx.  We helped this strong loving mother work the hardest she has ever worked in her life, holding back when every cell in her body was telling her to release.  She was so beautiful, I love her and her strength.

We heard the front door and soon I saw my sister midwifes face, she never looked more beautiful to me.  Marj, emotes pure confidence that radiates to those around her, it is one of her many  gracious gifts.  Even though I held the space in peace, calmness, belief and readiness, Marj's innate radiating confidence completed what we needed for this birth.

We set immediately to the work before us.  We assisted TJ to sitting at the side of the bed and placed L behind her on the bed so she could relax into him.  Jane*, the other assistant, & Jay sat beside each leg ready to lift and support them with each ctx.  Marj & I positioned ourselves in front of  TJ ready to receive this sweet baby boy.  Three ctx later we watched the bottom crown without retreating then Marj gently freed each leg and we sat on our hands and watched this baby danced and kick his legs down and watched him turn his body from presenting posterior to presenting anterior, ( I feel I am truly seeing the work of the ancients before my eyes, something so sacred I can not possibly describe it in words).

Then one arm is out and Marj gently releases the second arm, the nape of the neck emerges and then he releases himself and is gently released and lifted to TJ waiting arms.  Vigorous and awake he looks around and to his parents.

We helped TJ recline to meet her son and listened to second baby.  This babies cord was to short to permit nursing as planned.  After several minutes we noted some blood and a large mass at the base of TJ abdomen, (released placenta, distended bladder)???  TJ gets a ctx and we decided to cut the cord, L, did this, and takes his son.  Now I can not find FHT.  I checked internally and find a bulging bow and what feels like a vulva.  We decide to AROM and then a silent girl shoots into my hands before we can move TJ to the side of the bed.  She is limp and makes no attempt to breath.  HR is great so we bring the heated cookie sheet up to the bed & I begin mouth to mouth PPV (five slow inflations). I could feel the second I placed my mouth over the [baby's] face her life force link with mine.  I can't truly explain it but it gave me an ability to read [the little girl's] spirit in a way I have never had with any other baby I have recessed before (I worked in a neonatal ICU for years).  I knew [this little girl] was staying here.

As I was doing this Marj grabs the readied O2.  We rub and stim to no avail.  We apply PPV, no response,  we suction, no response.  We apply PPV and Marj Delees getting 4cc clear fluid.  We get a gag, her first motion & effort.  HR still great, (we had not cut the cord and were right beside mom & dad on the bed, baby on a cookie sheet covered with a heating pad).  More PPV, another gag & effort, more Delee more secretion.  Eight minutes of recess and we had her present in her body.  The thing that kept running though my mind the whole time was a question, Why isn't she coming back into her body, I know she is staying I felt it, what is taking so long.  I still don't know the answer but she came into her body fully.  Her HR never wavered, her lungs were just so full of fluid.  Marj gave a great homeopathic to [the little girl] to help dry & clear her lungs and she really perked up after that.  Mom and dad sat quitely and waited, I had shared with them earlier that evening that sometimes a second baby needs some help just getting started.

Then [the baby girl] went to her parents and brother.  We began to feel, in our bodies, the miracle of this evening.  I grabbed the Rescue Remedy, dosed myself and handed it to Marj. Marj noted the placentas at the vulva and received them, now merged, while I continued to give [the baby girl] a bit of blow by O2.  We noted some bleeding and remedied this. Then we began tidying up.  TJ began nursing babies with help from Jay. 

[The boy] was 6#12 oz and [the girl] was 6#10 oz.  Mom's bottom was intact.  TJ nursed both babies then she & L went to the tub. We tuck mom and babies in bed ate homemade bars and left.

TJ & L and babies are well today.  Babies nursing, mom having after-cramping and back pain but quite happy and proud of there new little ones.

This is plenty for now.  Thanks for the interest and support, smiling and grateful to the universe,

Name Withheld

*name has been changed , and story has been edited by request.

The persecution of midwives