Twins pregnancy transforms Akron Children's employee into patient

2014-10-02 11:04:51 by Michelle Dickstein, as posted on the blog.


When I first started working at Akron Children's Hospital, I never thought I would become a patient. I'm an adult, so what place do I have as a patient?

Well, everything changed in fall 2013 when I learned I was pregnant with twins.

The moment the ultrasound tech put the transducer on my belly and discovered there were 2 babies it felt like the world stopped turning. I burst into tears and laughter simultaneously as I tried to wrap my brain around the idea of 2-for-1.

I had my first experience in motherhood 2 years earlier with a healthy pregnancy and delivery of my first daughter. I was looking forward to reliving all those magical moments and bond with a baby while nursing once again.

I never thought there could be 2 babies in there.

Learning I was having twins put me in a state of giddiness and sheer panic. What do I do now? Carrying multiples means this is a high-risk pregnancy. Where do I go for the very best care, because this is a whole new ballgame?

Thinking of the resources available to me, I reached out to my colleagues, who are also the experts.

I have the great fortune of working with Akron Children's Maternal Fetal Medicine Center on a project focused on reducing prematurity by promoting progesterone.

I suddenly identified with every mother at-risk for a preterm birth, a position I never thought I would see myself in. My colleagues advised me to get my prenatal care here in maternal fetal medicine.

Ilana (left) and Miriam at 10 days old. Ilana (left) and Miriam at 10 days old.

From day one, everyone was beyond amazing. Every person from the front desk secretary and ultrasound techs to the certified nurse lactation consultant, nurses and docs are worth their weight in gold. I realize this is just what the team does on a daily basis, and it's what they are trained to do, but being on the other end of the relationship as a high-risk mom... it's just an entirely different experience.

The entire staff always put me at ease and encouraged me to call or come in if I ever needed anything, or even felt a little bit anxious. Most twins are born prematurely, and realizing this pregnancy had a lot of unknowns made me even more determined to breastfeed regardless of when or how the babies arrived.

The general notion around multiples is they are born early via caesarian section and spend time in the NICU. I wanted to deliver my babies full-term (37 weeks), vaginally, and if they needed extra care in the NICU, I would pump breast milk for them around the clock.

Josh holding Miriam and Ilana. Josh holding Miriam and Ilana.

Liz, the lactation consultant, met for a one-on-one session with me and my husband. During this 2-hour meeting, we discussed not just different feeding techniques and holds, but she explained what we could expect if the babies were born at 26 weeks, 27 weeks, and so on.

Her weekly Mother's Group offers a lot of support too, which I attended a few times while still pregnant. When I think about it, Liz had spent over 7 hours with me talking about nursing before my babies were even born.

The team of doctors all partnered with me to feel empowered to make the best decision for my babies. They shared the latest research and publications regarding the type of twin pregnancy I had (Dichorionic-Diamniotic), some articles which they authored themselves.

Moreover, Dr. Melissa Mancuso is the mother of twins, so I immediately felt at ease because she understood exactly what I was experiencing.

The day I delivered my twins, I went to the maternal fetal medicine office in the morning and learned I was indeed in labor and about 5 cm dilated. Dr. Mancuso said I was to go to the hospital and she would be there later in the day to deliver me.

In the delivery room I felt completely calm and ready to welcome my babies. Dr. Mancuso exuded cool confidence in her ability to deliver them vaginally despite Baby B often turning transverse or breech. She knew avoiding surgery was important to me and Baby A was cooperating by presenting head down.

After Baby A came out, Dr. Mancuso quickly checked the position of Baby B and told me, "I think you should go for it." Baby B was going to be delivered vaginal breech.

I watched as Dr. Mancuso pulled the baby out feet first and my husband announced it was another girl, but I only saw a blue baby who was not breathing.

Why isn't she crying? This was another moment the earth stopped moving.

After cutting the cord the team quickly took her to a warming table for examination and oxygen. Without missing a beat, Dr. Mancuso approached me and my husband to explain what was happening and to provide reassurance. She comforted us by saying her delivery was a shock to her system (typical of a breech delivery) and she just needs a bit of oxygen to get going.

Miriam (left) and Ilana at 2 months. They were born April 16, 2014. Miriam (left) and Ilana at 2 months. They were born April 16, 2014.

A moment later we all heard a small cry, which quickly became louder, and a huge weight was lifted. We had 2 healthy little girls!

Dr. Mancuso's presence kept me relaxed because I knew my daughter was in the very best care possible. I am certain any other doctor would have advised me to go for a caesarian, but instead I was able to hold my babies and nurse them right away in the recovery room.

The expert training and skill set of the maternal fetal medicine (MFM) team meant I could have the pregnancy and delivery I had hoped for while keeping safety and the health of me and my babies as the top priority.

I feel like I honestly owe the health and life of my girls to MFM, and my gratitude for their care goes beyond words. My patient experience truly speaks to the mission of the hospital and it makes me so proud and thankful to be a part of the Akron Children's Hospital family as an employee and now former patient.

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