This birth story starts much differently than my last one.
The effects of COVID-19 can be seen across that world, and Tokyo is no exception. In my third trimester update, I wrote about my feelings on giving birth alone, something I, nor many people I know, ever thought they would have to do. And yet I did. This is my story.
By my 36th week of pregnancy with the twins, I was still undecided about my birth. I was elated to have made it to 36 weeks, the cut off date for NICU, and was hopeful that my babies were of a healthy weight (over 2.3kg) so they could stay with me and again, avoid a NICU stay. My options were to either wait until 38 weeks of pregnancy to go into labor naturally and pursue a vaginal birth (or be induced at 38 weeks if I didn’t) or have a scheduled c-section at 37 weeks 2 days. Ultimately, I decided that my risk of a birth complication with a twin pregnancy leading to a c-section was quite high. My doctor and hospital are also also not the most experienced in vaginal twin births, which also added to my risk. My main goal was to make labor and delivery as least stressful as possible for myself and my babies. I knew that with my birth team, my husband and doula, I could do anything. But without? I wasn’t confident. In the end, I decided to have a scheduled c-section on May 1st, 2020.
The day before my surgery, I checked into the hospital in the afternoon. My husband came and dropped me off and was able to wait with me in the lobby while we waited to sign in. Once it was time to go up to my room, he had to see me off with a kiss and a hug and let this tiny nurse carry my bags. It was a bit surreal, not knowing what to expect from the birth and knowing I would be in the hospital alone for the duration of my stay. This was the first time I really felt the effect of COVID-19 weighing down on me.
We got off at the recovery room floor and I immediately sat down to do some paperwork. They then told me that there were no private rooms available for me to stay in at that time, which was devastating to hear because that meant I would need to bring my twins to the nursery every time I wanted to use the bathroom (shared rooms have shared bathrooms). After a bit of back and forth in English and Japanese with the nurse, expressing my concern about this, she went to check if there were any other options. A second nurse came back and explained that they had a room reserved in case a COVID-19 patient came in to give birth. So far none had thankfully, so they allowed me to stay there with the agreement that I would move if someone needed the room. I felt lucky to have that option, but still couldn’t help feel a bit wary of being in a hospital in general during this pandemic time.
Once in my room, I finished my paperwork and they took my vitals. They also monitored the babies’ heart rate. I was able to eat dinner but had to stop eating by 9PM. My surgery was scheduled for 1PM the next day so I made sure to eat as much as I could beforehand. It felt strange to be in the hospital and know when I was going to give birth. My doctor came in to give me the rundown of how the next day would go and answer any last minute questions. She seemed incredibly confident and comfortable (as she should!) and that put me at ease a little. After she left, I set up my room so I had easy access to the things I would need (nipple cream and water mainly), a luxury I didn’t have in my first pregnancy. Although it was a small moment of appreciation given I wouldn’t have my husband there to help with these things post-birth. I settled in for the night half-expecting contractions to start (they didn’t) and tried to get some rest on that horrendous hospital bed.
By 7AM I had my compression socks and operating room robe on and was instructed to stop drinking water. They hooked me up to an IV and did another fetal heart monitoring session. I had a long wait ahead of me since my surgery wasn’t scheduled until the afternoon. I passed the time video chatting with my husband and 2 year old son, but couldn’t quite shake a sense of nervousness for what was to come. As 1PM approached, my doctor came in again to explain that the surgery would be delayed a little bit because an emergency c-section had to be performed. Around 2PM a nurse came and told me it was time, and we walked together to the LDR floor and into the OR unit.
Walking into the operating room was like walking into a dream. It was quite large and the operating table seemed small in comparison to the wide space surrounding it. My doctors, Dr. Sen (who was performing the surgery) and Dr. Sakamoto (assisting), were sitting on the side looking very relaxed, much more relaxed than me! They immediately had me lay down on the operating table and turned me on my side. After the anaesthesiologist introduced herself, she got started placing the spinal block and epidural. This was, for me, the worst part of it all. There was a large digital clock on one side of the room that I kept staring at and wondering why it was taking so long. They poked and prodded for probably 20 minutes or more all along my back, and at some points I would kick my foot or flinch since they were touching nerves. This was not abnormal, but I have never had an epidural or spinal block before so it was a bit scary. My doctor later said she saw my blood pressure go up at this point! I tried my best to keep using my relaxation breathing I learned from my doula, Stephanie, and that helped keep me calm. The nurses kept asking if anything hurt. After what seemed like an eternity, the anaesthesiologist put in the medicine and I felt warmth in one leg and then the other, and soon I was numb. They turned me over on my back and put up the curtain. My arms were also put out to the side where I think they were monitoring my blood pressure constantly.
Dr. Sen was performing the surgery and Dr. Sakamoto was assisting. Sakamoto reassured me a bit in English, telling me I shouldn’t feel any pain but maybe some pressure. I couldn’t even feel that to be honest and I was surprised when the anaesthesiologist told me about five minutes later that Baby A was born at 3:05PM! I didn’t get to see her right away, the nurses took her instead. Then, one minute later, I get another announcement that Baby B is now born at 3:06PM! I also didn’t get to see him right away, but about five minutes after they were born (apparently, I couldn’t see or feel anything which was strange) they brought each baby over to me by my head so I could see them. I wasn’t allowed to hold them or breastfeed in the OR however, as many people in other countries seem to commonly do. The meeting was short, about one minute per baby. Dr. Sen finished the surgery which took an additional 15 minutes or so. Afterward, they took down the curtain, moved me to my bed (the one from my room I later realized) and wiped me down before taking me to the OR recovery room.
Dr. Sen stayed with me the entire time which I was grateful for. In the recovery room we called my husband to let him know that the babies were born and everything was all good from her personal phone. I remember once we got there she asked me, “So what did you think?” (because she knew I didn’t want a c-section and she also was my OB for my vaginal delivery) and I said, “I don’t know why anyone would sign up for that!” (she agreed with me ha!) Then she went up to the nursery to take pictures of our babies and sent them to my husband and brought them to me as well. I stayed in the OR recovery room for about 30 mins to be monitored before being wheeled to my personal room. At this point I still couldn’t feel anything and wouldn’t for another few hours. I waited in my room while the nurses continued to monitor me and after a while, they brought me a baby!
I was confused at first why they only brought me one baby, and the nurse didn’t really say anything. I remember also wondering which baby it was! I only got to see them for such a short time after birth, that I couldn’t recognize who was who yet. Soon I saw on the bassinet that it said baby #1 so I knew it was our girl. When the nurse came in again, she explained that our boy was on oxygen for a little while but didn’t say when he would be able to join us.
The effects of the spinal block were still full on, so I couldn’t move. I also had a monitor on my arm for blood pressure (I think) and another on my finger. I had an IV and a catheter as well, so basically I was feeling completely wire trapped. Regardless, I got to hold my little girl and also attempt to breastfeed. She was very sleepy however and didn’t latch. Slowly I regained feeling in my feet and legs and was able to move slightly, however sitting up and adjusting my position was impossible because of the incision. I felt breastfeeding was also quite uncomfortable because of all the wires attached to me and I was unable to sit up enough to get a good angle. I was a bit sad at this because my first son had been able to latch within a few hours after birth and was breastfeeding well almost right away, so I worried I would encounter problems with my twins if they didn’t latch right away.
The night after the surgery I still had the epidural line in, which I could control the amount of medication given. If I felt pain, I could push the button on the device and it would release more medication for me. I had watched many videos and talked to many people about how to make my c-section recovery more comfortable and everyone said to make sure you take as much medication as you need. This is so true! It’s already very uncomfortable, even with pain relief, so taking your meds is necessary. It’s not the time to try to be a hero!
Over this first night, the nurses were very attentive and helped me put my baby girl in and out of her bassinet. I would use the nurse call button when I wanted to breastfeed and they would come and give her to me plus help with positioning. When I was ready to put her back, I would push the button again and she would come help once more. The nurses also did all the diaper changes for me until I could stand, which wasn’t until the following day. At about midnight on the first night, my baby boy was brought to my room which was a huge relief! I wasn’t sure how long he would be on oxygen and was about to ask the nurse if I could be wheeled to the nursery to check on him if it was going to be an extended thing. Luckily, his time spent there was relatively short at only about nine hours. I attempted breastfeeding with him as well when he came to my room, but he was just as sleepy as his sister and wasn’t able to latch. The nurses reassured me that this was common for babies born early and also via c-section and not to worry too much. I also felt extremely sleepy at this point and was actually falling asleep sitting up. I think possibly from the epidural?
I was really fortunate to not have any negative side effects such as shaking or fever from the epidural or the surgery, and overall my recovery has been really smooth. This was incredibly fortunate because even with the help of the nurses, I still found it difficult to take care of two babies at one time. I knew that going home ASAP was the right choice for me and luckily the babies were of healthy weights and I was recovering without issues so we were able to go home on Sunday May 3rd, two days after the surgery. It was such a relief to be home with family even though I was still quite sore from the birth.
One difference I felt after this birth compared to my first was the feeling of being a mom to these two humans from the very moment I saw them. With my first, I remember feeling quite strange after delivery and almost like it wasn’t real or it didn’t happen. But this time, probably because I am already a mom, I felt connected to them right away. At the time of me writing this, they are nearly two weeks old and doing very well! We are breastfeeding around the clock and trying to get into a routine with three kids under three years old! I am so lucky to have a lot of help at home right now from my husband and mother in law, I couldn’t do it without them!
To all the mamas to be who are about to go through this experience alone, please know that you can do this. Mamas are the strongest humans on the planet and your natural internal motivation to protect and nurture your child(ren) will be enough to get you through this time. If you want to read more about how I prepared to give birth alone, you can read my blog post about it here.
Mirai Rose Saito
Born May 1, 2020 at 3:05PM / 2944g / 47.5cm
Taishi Ander Saito
Born May 1, 2020 at 3:06PM / 3044g / 50.5cm