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Hi.
I'm Cassenya Lukij and this is Diary of a birth. We've all heard the stories of women not planning on getting pregnant then whoops, positive pregnancy test. But imagine thinking you were done having kids and whoops, twins.
I showed him the photo that had the two sacks on the screen and he just said, no, no, show me the real photo. And I said, this is the real photo, and then we both just started laughing. And we've just sort of been laughing our way through ever since.
I pose. And while we know that pregnancy with multiples often ends in a C section, today's mum was relieved to find out she was cleared to attempt a vaginal delivery.
They basically said because I had had a successful vaginal birth previously and have twin a head down, that I was a great candidate to attempt a vaginal twin birth.
So let's meet today's mum.
Hi. I'm Cassie Jackson and this is my birth story with my twins, Charlie and Luna.
Seeking a quieter life with acreage, Cassie and Scott moved up to Mackay from Brisbane for Cassie's teaching job.
So life before the twins we were going through a massive change within our family. We had just sold our house in Brisbane to move up to MacKaye, taking a bit of a gamble on a opportunity for me to get a teaching position in a rural area where we were very fortunate to get relocation and teacher subsidized housing and those sorts of things in place so that we could work towards our dream of buying an acreage property, which we knew was never going to happen if we
stayed in Brisbane. We wanted to have that slower pace of life for our kids.
With a thirteen year old step son and three year old daughter she shared with Scott, Cassie was looking forward to a fresh start in far North Queensland.
Yeah, we weren't planning to have any more children. Within a space of a few weeks, I lost both of my grandfathers on my side of the family. And it was only a couple of weeks after that, during one of my grandfather's funerals, that I knew that there was just something else sort of going on, And so I took a test that night and it came up very
very strong straight away. And I would have only been about three and a half weeks or so at that point in time, so it was definitely a bit of a shock, but also something that I sort of felt in my bones that there was some sort of other change that was still to come after all of the loss that we had just gone through. When I told Scott, my husband, that we were having twins, we just laughed our way through. It was during COVID time, so I had to go to the dating scan by myself as
he had to stay home with our other children. And I saw those two sacks up on the screen, saw those two heartbeats, and we had had a little joke the night before as well that wouldn't it be funny if there was two heart beats, And so I showed him the photo that had the two sacks on the screen, and he just said, no, no, show me the real photo. And I said, no, this is the real photo. And you know then very sternly, no, where is the real photo?
And I said, this is the real photo. And then we both just started laughing, and we've just sort of been laughing our way through ever since. I suppose.
Given the added risk of multiples, Cassie was monitored closely, but by thirty six weeks and a very hot summer, Cassie was ready to meet her twins.
From about my twenty week scan TWINB she liked to flip all over the place, but that was pretty common for a twin bee, and so they basically said, because I had had a successful vaginal birth previously and have twin a head down, that I was a great candidate to attempt a vaginal twin birth. From about thirty six and a half weeks, I was definitely ready for these babies to come out. It was the middle of a very hot summer in North Queensland. We had set everything up,
the beds, nursery, all of those scenes. We were ready for these babies to come.
Usually twins don't make it to full term, so hats off to Cassie for keeping those little ones in there till thirty eight weeks, but now it was time.
I made it to thirty eight weeks. It was a Sunday. I knew that day that we were going into the hospital to have our next sort of check in. I was not leaving that hospital without them out of me. Really done by that stage. We went with the plan of getting induced, so they started the process of doing the induction. I stayed in the birthing sweet overnight that night, which was really great because Scott was able to stay with me. They set up a little cot for him
in the side of the birthing sweet room. Because it was getting towards midnight. I was getting some really intense cramping pain, contraction type pain, which I think is quite common when it comes to the tape form of action. They were able to give me some morphine and that sort of slowed everything back down, and then the doctors all came in and manually broke my waters and started the whole process from there.
Cassie's team had a loose birth plan, but things don't always go as expected.
They were sort of checking on how bubbs were doing by having both of their heart rates monitored. They did an ultrasound to see where they were positioned to once again make sure that Twin A was still head down and to see what position Twin B was in. At that point in time she was breached. She was feet first. So we had reassessed and made sure that we knew what our plan was, and it was to attempt a vaginal birth for my twins in a way that's called
a trial by theater birth. That basically just means that we were going to have the babies in the theater room so that if anything was to happen, we were already there. As where the birthing suite to the theater at the Mackay Base Hospital is very far away from each other, and they wanted to make sure that we were there just in case anything went wrong.
Coming up. Charlie and Luna have their own birth plan.
So I had the epidural. I am a teacher myself, so I am always open to allowing student doctors or junior doctors the opportunity to learn and practice. I did the same thing with my first pregnancy. He did have a couple of cracks at it and didn't quite get there, so the scene doctor took over and finished off the epidural.
At that point in time they had done a quick dilation check and I was sitting at about three and a half centimeters dilated, and then it was just a waiting game to see how long it would take before I was in active labor and close to that ten centimeter dilation mark for us to move across to the theater rooms.
With her epidural in place but patchy at best, Cassie was moving through labor the best that she could.
After a couple of hours, I suppose my pain levels started to increase quite dramatically. So it turns out that the epidural that I had was patchy. That's the way that they described it, and essentially that just meant that I was feeling the entire body's worth of contractions in one spot, just in my right groin area. So I'm curled over, screaming in so much pain, feeling like this is it. I'm not going to survive this pain, and telling them I've had an epidural before. I know that
there is something wrong here. This is not right. I need the anethesis to come back and have another look. I felt like if I tried to lay down flat, that my body was going to explode or something. It just felt like I needed to stay in that curled up fetal position to stay alive. At that point, the midwives managed to convince me that the anethesis was on his way, that he was going to check the epidural. They said that they needed to check my cervix now.
They managed to get me to lie down and the midwives said to me, look, you're probably not going to be much further past three and a half centimeters looking at the screens. You're only having two contractions every ten minutes. You're not even inactive labor, but we just need to check. I will never forget the midwives voice when she said, okay, so we're ten plus one, and then really all hell
broke loose from there. I don't think anyone was expecting me to be anywhere close to ten centimeters, let alone thinking that I was even going to be five centimeters. So I think the doctors all thought that they had hours and hours and hours before anything was going to happen. And I think that because everything happened so much quicker than expected, it definitely led to a lot of the further complications coming up because we just weren't prepared in the way that we sort of should have been.
I suppose Cassie's medical team sprang into action with the drama worthy of a script written by Shonda Rhimes.
It was absolute chaos. There were people everywhere, So I had the midwives, my doctors, the assistants all getting ready to wheel me up to the theater room and to get up there straight away. It was the quickest way to get to the theater room from the birthing suite at the Mackai Hospital is to go through the public corridors. So here I am legs up, crowning with my boy Charlie and getting run through these corridors while I am still having these intense contractions, you know, screaming in pain.
While there are people who are just going about their normal day to day business at the hospital. I'm sure that they would have had the shock of their lives. And I'm turning to Scott and I'm saying to him, they can all see, they can all see what's going on. And you know, he was turning to me and saying, no, no, they can't see anything. It's all okay, come on, we're going to go. We're going It's all going to be okay now. And it was a couple of weeks after.
He said to me when we were reliving it all, he said, yeah, they probably could see some stuff, but I wasn't going to tell you that then.
And there sometimes lies are for the best.
We're getting closer and closer towards the theater room and exiting I suppose the public section of the hospital, and it really was a scene like straight out of Grey's Anatomy. So Charlie was twin a he was head down, he was good to go. He had engaged, so they were really ready for him to come straight out. As soon as we got up there, I come into the theater room and there are just people everywhere. Now I'm talking
forty to fifty people in this room. Because we had my whole team of doctors, we had the theater team of doctors. We had two sets of pedutricians for each baby and their teams. So I've got all these people coming up to me, putting their faces right up close to my head. Turns out that there was some miscommunication
between my doctor team and the theater doctor team. In the theater's mind, I was coming up for an emergency C section for both twins, so in their head they needed to replace my epidural with a full spinal tap. They did do the spinal tap on me. My midwife all of a sudden appeared Scott was next to me, thankfully, and my midwife, she was the first one to put two and two together that, oh, they think that she's
here for a C section. She literally body blocked me when the doctor was coming in ready to cut twin a out. So my midwife turned to them and said, she's here to push. She's here to push, And then it was put two and two together. Oh, well, she's had a spinal tap, so that's going to make things extremely difficult. But we're going to try this. We're going to try to push him out. We will use fourceps if we need to, but he is ready to go.
Let's see if we can get him out still in the way that we wanted to with having a full spinal tap. I could not feel a single thing from my neck down. I could have been just grinning a ginormous smile. I can't feel a single thing. I don't know if I'm even pushing. Then they decided to get the forceps out and were able to get Charlie out with forceps and they put him straight onto my chest. When he was on my chest, he was quite a
bluish color. He wasn't crying. They ended up taking him off of my chest and straight over to his pediatric team, where I then didn't know what was happening. No one gave me any updates of whether he was okay. I still couldn't hear him crying. There was a lot of commotion, and I kept saying, is he okay? My husband, Scott kept turning to me and saying, okay, we need to get our girl out now. We need to focus on getting our girl out and making sure that I was
ready to go again. Could get Luna to Quinn b out safely, But in my head, I was petrified, and I think more than that, I was so overwhelmed with everything that had all happened and everything that I knew was still to come. I felt like I had that tunnel vision of just needing to know that he was okay. The doctors were saying to Scott, we need to get her to refocus now. Scott ended up turning to me and saying, like, yep, they gave me the thumbs up. He's fine, He's good to go. Let's do this now.
He told me again later that that was the second time that day that he lied to me because he had absolutely no idea, but he knew that I wasn't going to be able to focus on getting our girl out safely if I thought that there was anything going on untoward with Charlie.
And just like that, baby Charlie was born, but Cassie wasn't done yet.
He had been told the morning of that the plan was once Charlie was out, that we would have an ultrasound done to locate and see what position twin B or lunar was in. If she was still feet first, we would be attempting what's called a foot extraction, where the doctor puts their hand up through the vagina and into the uterus and will grab the baby by the feet and pull them back through the canal to deliver safely.
There are a couple of risks involved with that. The main one that we were told was that they could not break her amniotic sack because twin A's placenta and his sack and all of his fluids and his maconium, all of those things would be in there with her, and that could lead to serious complications and serious risk of infection and all of those other types of things. If she had flipped around and was headfirst, that chances are she would engage on her own and just come
on out. The doctor put his hand up and started searching for her feet. He is searching around, and he turned to the other senior doctor and said, I can't find it. You have a go. So the second doctor came in and she went on up and was also you know, attempting to locate Luna's feet, which they still initially thought was feet first. The midwife, my saving grace,
my guardian angel. On that day. She was like, get that old rasound machine over here now, and so we did that and found that she actually had flipped around, as she quite often did anyway, and she was head first.
I have nothing but the utmost respect for midwives. They are heroes.
At this point in time, though, the senior head consultant, she was starting to get a bit worried about how things were progressing, and decided that she was going to be the third doctor to attempt a foot extraction. She had done it previously and said that even with her being now head first, she was able to get all the way up and be able to essentially pull her around and down, so she was elbow deep in me.
We had no curtain up or anything like that because it wasn't a C section at this point in time, And so I could look down and see this woman's face as she is searching around for my daughter's feet inside of me. I could see the panic in her eyes when the monitors were going off saying that baby was in distress, and she said, I just need one more goal at this, I just need one more goal
with this to try to do the foot extraction. But unfortunately, during that process, her amniotic SAP was broken, her stats plummeted, her heart rate was down into the sixties, and my midwife said to me the next day she knew at that point there was absolutely no other option. We had to do the emergency C section straight away as Luna's life was in danger.
So how did Cassie feel after her emergency sea section?
For all intents and purposes, the sea section was done flawlessly. I have recovered really, really well. I didn't have any issues in regards to infection or scarring and all of those sorts of things. But when Luna came out, her at birth Apgar score was two. One is the lowest that you can go. So they got her out. They put her straight into the incubator. Her pediatric team said we need to go now. They turned to Scott who was right by my side, and they said to him, Dad,
are you coming. He turned to me and he said, what do you want me to do? And I said, go with them. So he got up straight away, gave me a big kiss, said you've got this, and he went off with both Charlie and Luna straight down to the special care nursery, so that he was there with them, and it made me feel obviously a big pang of jealousy that he was with them, but I knew that they weren't alone, and they had one of us there, and that was the most important thing to me at
that point in time. Charlie had recovered. I suppose by that stage he's doing really, really well, but it was Luna that we were worried about.
After a truly traumatic and dramatic birth. Cassie was eager to spend time with both her babies and make sure they were okay.
I knew that Luna was not doing well at all. They had told me that they needed to get her down straight away and get her onto the cepat machine, the bubbles and all of those other things, because her life was still in grave danger. She had been deprived of oxygen for a period of time throughout the birthing process, and I was being, let's just say, a bit of a pain in the ass, saying, how are my babies? Can we get an update on the babies? Are they okay?
Is Luna okay? They kept telling me to just have a rest. Your body has been through so much. Have a sleep, You'll feel so much better. Just kept saying, I'm not going to rest. I need I need to see them. I need to know that they're okay. There was one nurse in particular. She turned to me, she said, you're not going to sleep, are you? I said, no chance.
So she went and got me a yellow zoopa dupa to get my sugar levels back up because she could see how hard I was fighting the sleep when my whole body was obviously just craving it, but my mind was never going to let that happen. So eventually, after I'd say a couple of hours in the recovery ward, my beautiful midwife came back up, and she was up to get me to take me back down. I had gotten enough movement in my feet and my body at that point for them to be happy for me to
leave the recovery ward. And as soon as she turned the corner, I could see the smile on her face, and I just knew that everything was going to be okay. And she told me that Charlie was doing fantastic, that he was having some skin to skin time with Dad, and that Luna was off the bubble machine, but she was just staying in the incubator for a little bit longer, just to make sure that everything was still going okay. But she was definitely out of that mortal danger side
of things by that point in time. So she wheeled me down, wheeled me down to the Special Care nursery, and Charlie was still having some beautiful skin to skin time cuddles with Dad, and he was right next to the incubator with Luna in there. They had said that she was a feisty little thing and ripped the dummy out of her mouth and threw it straight through the little hole in the side of the incubator. They said, she's got to be a basketball player or a netball
player or something when she gets older. Once I was down there and they had given me those little updates that it was time for Charlie to come over to have some skin to skin cudd all time with me, and that Luna would be ready very soon. They just wanted to do one last check on her. So I had some cuddles with Charlie and it was just so beautiful, you know, having Luna right there next to me. I was still able to put my hand in and touch
her and everything like that. Obviously she was fully cooked, I suppose at thirty eight weeks, so it was fully safe to do all that had Charlie on me, and it just felt so much relief that after everything that we had gone through over those past couple of hours, and really there was thirteen minutes between the two berths, so what felt like hours and hours and hours of all of these crazy things happening was really over only
on the space of you know, half an hour. The doctors came and did another check on Luna and they said that she was fine to come out to the incubator. She was put on my chest as well, so I had both babies on me, had Scott right there by my side. The midwife came in and she took the most beautiful photo of the flour of us. I look absolutely wrecked in this photo. I am yellow in color in comparison to the babies. Just the amount of stress that my body had gone through had obviously caused this
yellowing sort of color. It looked like I had one epic spray tan. But it was all good. It was all for the best. I look back at that photo with such immense pride that we not only survived, but thrived from such an awful experience, and where we are now to that point in time, never thinking that would be in the position that we are now to have two such beautiful, healthy babies or toddlers. I look back at that photo with just such immense pride in myself and joy that I achieved that.
So what is life really like with twins?
It's a total cliche when they talk about double trouble, and how much on the other side of it, twins are an absolute blessing. There are days that you think, how on earth am I going to survive another day raising these twins, because they're just crazy. But other days we look at them and just think it's a miracle that they are here, and watching them giggle at each other and laugh and play with each other is just so beautiful, and it's just amazing being a twin mum.
I can't describe it any other way. When you talk to people about having twins, it's the same reaction that I would have had to years ago or three years ago, saying, oh my goodness, I can't imagine that would be my worst nightmare. I've had people say that to me in front of me. It's such a journey to go on to be a twin mom or a multiple mum. But you know, really, at the end of the day, you wouldn't have it any other way. They are just they
are just amazing. And Luna still has her struggles. Obviously, she was born in a very traumatic way. She has low muscle tone because she was deprived of oxygen at birth. She has been diagnosed with a global developmental delay, so she's currently receiving therapy in physioot and speech. Who knows what would have happened if her birth wasn't the way
that it was. Will never know whether or not she would have had the same issues, but she is thriving in all of her therapies, and she's just doing amazing. When she has her moments, she definitely has her moments, But when she laughs and giggles, she's a big cuddler. She just wants all of the culors in the world.
This week, we're lucky enough to have obstetrician Bronwin Devine, who delivered both my babies, to explain the medical perspective. If you're committed to a vaginal birth with twins, why do we often need to pivot to an intervention?
The problem with twins is they're quite unpredictable and can be really tricky. So while vaginal birth is definitely the preferred mode for lots of women, sometimes you'll find with twins what can happen is the first twin can come out vaginally, and then once the first one is out, the second one can do all sorts of funny things. It can turn itself upside down, It can decide that the right way to come out for it is to come out shoulder first, or it can let its own
unbeliable core drop out. Sometimes the placenta can come away quickly, or sometimes it can just take a very long time for the second twin to get itself into a position to be able to be borne easily. So there are sometimes occasions with planned twin vaginal births where the first twin comes out vaginally, and no matter how hard we want the second one to come out vaginally, it just
isn't gonna happen that way. So we always say to women who are planning a vaginal birth with twins, we would aim for both bubs to come out vaginally, but if the second one does something strange and unpredictable, it may be that we have to go and do a Caesar for the second one.
And doctor Devine wants to ease people's fear of forceps.
I do get a lot of people who say to me, look, whatever you do, I'd really prefer you not to use forceps. They sound terrible, they look scary. And I went to my birth classes and they show you know, they showed us a vacuum, they showed us the forceps, and I definitely would not want to have those people. Do think it's some relic of the eighteen hundreds, where.
It was a question of just you know, doing whatever you can.
And you know that sort of thing. Having said that, there are definitely instances where forceps are a very useful instrument to use, and they're a very good instrument to use, and some babies really dislike the pushing stage where their head's coming down. They find that it's causing them to have reductions in the amount of oxygen that they're getting and they really start to complain. And if we leave babies in that situation, they can be born in a
very bad state. Indeed, so as long as you've got someone who's comfortable using forceps and is experienced using forceps, and he's gentle with the forceps, then there are times in childbirth where forceps can be the absolutely right instrument to use.
Thank you for joining us on Diary of a Birth, where we celebrate all the amazing ways that we as women bring life into the world. If you'd like to share your birth story with us, we'd love to hear from you. Details are in the show notes. Diary of a Birth was hosted by me Cassena Lukitch, with expert advice from doctor Devine. This episode was produced by Tom Lyon and myself Cassena Lukitch, with audio production by Scott Stronach.