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More Information:
Please, visit our multiples birth planning page as well
which has valuable outside resources and additional birth education.
Finding ways of honoring your special motherhood:
Many bereaved mothers consider a pregnancy subsequent to loss a “rainbow pregnancy” or “rainbow baby”, being that a rainbow “follows the storm” or the darkest days of loss. Because of this, mothers too, consider a surviving multiple to be a “rainbow baby” or “rainbow multiple”. If you’d like, you might view our rainbow birth plan to find ways of incorporating these ideas into your birth plan. In “vanishing twin” or “fetus papyraceus”, you might also consider including the placenta in a special farewell, including placenta burial or cremation; just visit our farewell celebrations page for more information.
The Birth Plan:
Please also print out the Cesarean birth plan, because there may be a likelihood of your twin birth becoming Cesarean.
This plan is specific to vaginally delivering twins, one that is stillborn, and the other expected to survive.
These options vary, depending on the development of the babies. The options listed often refer to older, more developed babies (one or both).
If one of your babies is expected to survive, please also print the NICU birth plan.
You may be able to labor and deliver your babies in a labor room, but, in some situations, you may be transported to the Operating Room for the actual delivery (this is for your safety, and is in case a Cesarean becomes necessary). This variable will depend on the position of both of your babies (should be vertex), particularly baby A.
What to Pack:
__ camera, stillbirthday.com lists professional photographers at the “professionals/volunteers” page.
__two photos of you and your husband to keep with your babies
__Clinging Cross
__*additional special items: three teddy bears or blankets (one to leave with each of your babies, and one to take home), molds for each of your babies hands or feet
__Music and player
__Favorite candle (in glass jar, for warmer)
__Personal fan
__Several wash cloths, for hot or cold compresses (optional-hospitals have plenty)
__Thermos of hot water
__Massage tools: rice packs, rolling pin, paint roller, oil
__Unscented and scented lotion
__Birth ball
__Pillows (1 or 2) and colored cases
__Change of clothes for labor partner
__Snacks for labor partner
__Gum or mints for labor partner!
__Husband’s cologne, aftershave, deodorant, or other smell preferred by the mother (he’ll wear it)
__Snacks for you: light snacking during birth, orange juice postpartum
__Suckers or other hard candy
__Lip balm
__Cell phone or calling card
__Loose change for phone or snacks
__Phone list for support people to join you for hospital visitation
__Ultrasound pictures, favorite scriptures
__*babiies outfits (for your stillborn baby: for visitation through to final farewell/burial, and for your surviving baby: to be taken home in)
__Toiletries: contact case, shampoo, toothbrush, deodorant, etc.
__Night gown or robe (might get soiled)
__Going home outfit for mom (2nd trimester clothes)
__You will need to bring a carseat
Have at Home:
__people ready to help!
__maxi pads (for lochia)
__nursing pads
Birth:
Natural Options/Information:
- IV, with option of Heparin Lock instead
- Blood pressure cuff
- Electronic fetal monitoring
- No food or drink
- Possible limited natural induction/augmentation and positions, because of risk of placenta pulling from uterus and causing internal bleeding
- Hands and knees on ball or on bed can be very helpful
- Left Side Lying can be very helpful
Ways of creating a soothing environment for birthing include (but definitely not limited to):
__dimmed lights
__soft music
__massage (scalp, feet, legs, back, even brushing teeth)
__inspirational messages and scriptures written on index cards or spoken aloud
__letters written from extended family and friends who can’t attend the birth (read by husband)
__pictures drawn by older siblings posted in room (and left with baby)
__praying
__water therapy (bath until waters rupture, shower, misting spray)
__hot and cold therapy
__intimacy and bonding with husband
Artificial Induction Options/Information:
- Possible cervical ripening agents (Cytotec-tablet or Cervidil-tampon applicator)
- Pitocin (no water breaking)
- Likelihood of Epidural or Narcotic (Stadol, Nubain are examples)
- Even when the deceased baby(ies) have died earlier in pregnancy, such as “vanishing twin” or “fetus papyraceus”, the surviving baby(ies) may still seem to hold space for their sibling, and as such, the pushing stage may take longer. Additionally, there can be a lot of emotions involved that may present themselves during any point in labor, but especially pushing. The fear of an official separation of twins into a singleton, for example, can cause or feed emotional dystocia. Remembering that these things are all possibilities in your own, special motherhood can reinforce that you are a strong and beautiful mother.
Pitocin Info:
+ Can start labor
+ Can speed up a slowed labor
+ Can increase intensity of contractions
+ Can stop a postpartum hemorrhage
+ Can be regulated and monitored closely
+ Can be turned off if necessary
– Difficult to produce natural progression of contractions
– Pain from Pitocin is often more difficult to deal with
– Requires IV and constant monitoring
– Mom small chance of hyptertensive episodes
– Mom small chance of titanic contractions
– Mom small chance of uterine spasm
– Mom very small chance of coma
Epidural Info:
+ Catheter into epidural space in spinal column (1st space)
+ No need to repeatedly puncture: catheter can re administer or continue dosage
+ Given during Active labor (3-7cm)
+ Does not alter mom’s consciousness
+ Can relax mom
+ Can help lower blood pressure of a PIH patient with high enough blood platelets
– Goal of 80% relief, not 100%
– Completely immobilizes
– Not administered promptly: same anesthesiologist for entire hospital
– Chance of longer second stage/ More difficult to push
– Mom chance of hypotension (drop in blood pressure)
– Mom chance of itching in face, neck and throat
– Mom chance of nausea, vomiting
– Spinal headache healed by patching hole with mom’s blood
– Postpartum headache/backache
– Uncontrollable shivering
– Uneven, incomplete or failed pain relief
– Loss of perineal sensation: inability to push: increase cesarean chance
– Mom need catheter
– Mom chance of fever
Narcotic info:
+ Given IV in Active labor (3-7cm)
+ Increases pain tolerance (doesn’t eliminate pain, but takes “edge off”)
+ Can be given ASAP
– Barbiturate derivative: anticonvulsive and hypnotic properties (“I feel drunk or something.”)
– Wears off/ ACCLIMATION, need for increased dosage
– Can either increase or decrease labor (unpredictable),
– Can cause mom vomiting
– Can still feel highest peak of intensity, just not building up or let down
Crowning/Delivery:
__I would like the use of a mirror to see each of my babies heads crowning
__I would like photography
__I would like to be reminded and encouraged to touch my babies heads while crowning
__forceps, vacuum or episiotomy may assist in final delivery of babies
__Umbilical cord(s) cut by doctor *Can be cut “long” so that dad may “trim” it later
__Placenta(s) expelled
After the Birth
__*Have the photos you brought placed with your babies (if your baby that survived visits the NICU, and one photo to remain with your stillborn baby).
__*Ask if babies (both) can be swaddled in the blankets you brought.
__*Ask how long your stillborn baby can remain with you, and if they can be placed in a special refrigerator in the labor unit until you may like to see them again.
__*Ask if you can give both of your babies a bath.
__*Ask if your labor room or your postpartum room can be in a quiet location on the floor, where you have less of a chance of hearing other babies.
__*If your stillborn baby has hair, ask for scissors to cut a lock off.
__*Utilize all of the special plans you have, including saving mementos, holding both of your babies, capturing your stillborn baby’s smell with a blanket you will take home with you, dressing both of your babies, naming both of your babies, taking photographs, and including a pastor and friends and family. See the “Professionals/Volunteers” link at stillbirthday.com for additional services to consider.
__If you are staying overnight at the hospital, have someone planning on spending the night with you. Perhaps consider having a friend spend the night with you, so that your husband can go home, prepare the house, and rest.
__You will still have lochia (the remaining blood from inside the uterus, which will be shed for the next 4-6 weeks).
__*You will have breastmilk come in immediately after the birth.
__*Mentally prepare for going home. The first few days at home can be very difficult.
__Watch for signs of postpartum depression (PPD) or secondary vaginitus
__Remember to pray and ask others for help and for prayer
__Be easy on yourself, your body, and on your recovery
__Talk to God, your husband, and trusted mentors and friends about all of your feelings
__*Visit stillbirthday.com for “Farewell Celebrations” and for “Long Term Support” resources
*are specific to stillbirth
