Back to the birthing center — this time, with twins!


Giving birth doesn’t always go as planned. But when Amy Van de Water gave birth to her daughter, Alexandra, at Emerson two years ago, the experi­ence met all her expectations. When she later became pregnant with twins, she knew that her pregnancy and giving birth would be different. Still, she hoped for a similar, positive experience. And that is what happened.

Is it luck, doing all the right things or genet­ics that leads to a healthy pregnancy and happy childbirth? Ms. Van de Water had no morning sickness and felt good throughout her first pregnancy. “I wanted an unmedi­cated birth and used the labor tub to achieve that,” she says. “It was a great birth — really awesome.”

As soon as she gave birth to Alexandra, who was delivered by Avra Jordano-Alter, MD, of Concord OB/GYN Associates, she was able to have skin-to-skin contact with her new­born. With Alexandra placed on her chest, Ms. Van de Water began nursing her imme­diately. Many women request this as it pro­motes bonding between mother and child and helps initiate milk production, which can sometimes take a couple of days.

“It was nice to go right into that mode with Alexandra,” Ms. Van de Water recalls. “Also, I didn’t want her to be whisked away — not after 12 hours of labor.”

Two years later, she was surprised to learn she was having twins. “During the first ul­trasound, I heard ‘here’s the heartbeat. . . and there’s the other heartbeat!’” she recalls.

“I felt great — the same as during the first pregnancy,” says the Shirley resident, “and I started reading a lot about having twins.” It was immediately clear that a twins preg­nancy requires more appointments and extra monitoring. In addition to her regular obste­trician visits, Ms. Van de Water was seen by Drs. Karen Davidson and Rosemary Reiss, maternal-fetal medicine specialists from Brigham and Women’s Hospital who are on site at Emerson.

At week 30, an unexpected surprise

She continued her job as an information technology consultant until around the sixth month of her pregnancy. “I gained the target weight — about 45 pounds — which was good, but I began feeling tired,” she says. At 30 weeks gestation, an ultrasound exam revealed that one of the babies was in a breech position, which would require a cesarean delivery, something Ms. Van de Water had hoped to avoid.

“I tried to get the baby to flip position by swimming, which exerts a safe gravitational pull,” she says. “It was summer, and we were on vacation, so I swam a lot. I even tried a caffeinated coffee, which is also sup­posed to help. I knew it was a long shot.”

“There are a number of safe techniques that are believed to help change a baby’s posi­tion,” says Vlassis Travias, MD, an obstetri­cian who saw Ms. Van de Water throughout her pregnancy. “There’s no strong evidence to support these techniques, but we don’t discourage our patients from trying them.” However, the baby’s breech position re­mained unchanged.

Ms. Van de Water’s cesarean delivery was scheduled for August 10, but her water broke on July 29. She and her husband, Bill, headed to Emerson, where Jamie Bond, MD, delivered Benjamin and Abigail — both a healthy six pounds. “I had asked the nurses ahead of time if it would be possible for me to have skin-to-skin contact with the babies right after they were born,” she says. “One of the things that made me sad about having a cesarean was that few hospitals allow it. I wanted to give the twins what Alexandra had right after she was born.”

In fact, Emerson encourages skin-to-skin contact soon after a cesarean as long as the mother and newborn are stable. Benjamin and Abigail made a brief trip to the warming bed — a traditional stop for most newborns — and, after a quick assessment, returned to their mother right away. Ms. Van de Water began breastfeeding both twins, just as she had hoped.

“The culture in operating rooms has always been to maintain a sterile environment,” notes Dr. Travias. “If the baby is doing well, we can still maintain a sterile environment and encourage skin-to-skin contact during and after a cesarean.”

Benjamin was found to have a low blood sugar level, which can be corrected with supplemental milk — typically formula. Thanks to a program that debuted at Emerson last year, Benjamin was soon re­ceiving donated human breast milk — some­thing his mother preferred. Mother’s Milk Bank Northeast provides same-day delivery for a variety of situations, including when a mother’s milk has not come in or when twins require additional milk.

“It was wonderful,” says Ms. Van de Water. “Since the donated milk was already at Emerson, it was brought to our recovery room, which was reassuring. Right after my husband fed Benjamin, his blood sugar level increased.”

The family was soon home, where Ms. Van de Water’s attention turned to getting the ba­bies on the same feeding schedule. By the fall, things were pretty normal. “I’m feeling great now,” says Ms. Van de Water. “The weight came off quickly; I’m working out again. And the twins are sleeping great — six hours.” They have seen their pediatrician, Mark Francis, MD, at Pediatrics West in Groton several times.

“We have family who live close by, and they love to help out. My mother and grand­mother both come over to fold laundry. Alexandra is a big help; she runs to get baby wipes or anything I need.”

Healthy twins and a birth experience that came pretty close to what she hoped for: Ms. Van de Water appreciates Emerson’s birth­ing center. “Both times, the care was great,” she says. “They listened to us — and we were so well taken care of.”

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