During the whole contested adoption, I was also carrying my twins. I am not sure how all twins pregnancies go, but mine was a difficult journey indeed. So with the adoption in full force it was difficult to focus on my pregnancy, but soon it became all-consuming.
The next time I went to see my OB, I was measuring just shy of 11 weeks. My OB looked a little concerned. She said she thought that there was only one placenta, but that her machine was not good enough. She wanted me to go see a perinatologist who could do a more detailed scan. So at 12 weeks I met my new specialist. When I went in, he read my charts and showed very little emotion. It was his bad news face. He looked at the ultrasound and told me he was looking for separate placentas and amniotic sacs; then we would measure each baby to check growth, and measure the amount of fluid around each baby.
After a 30 minutes ultrasound, he concluded there was only one placenta (bad news), but two amniotic sacs (slightly better news). This meant that they were identical twins that split between days 3-8. Furthermore it meant we were at risk for Twin to Twin Transfusion Syndrome, which was what my OB was concerned about. The perinatologist wanted me to come back in the following week for another ultrasound. He told me to try not to look at the internet and we would talk next week when he could measure the changes, which would give more information that just one day’s measurements.
Of course I could not stay off the internet, and the statistics were not what I wanted to see. The problem when twins share a placenta is that the blood flow is shared between both twins, and one can pull more than the other. They are then labeled as the donor and the recipient twin. The donor twin has a reduced amount of blood flow that reduces urinary functioning, therefore reduce the amount of amniotic fluid surrounding it. As a result, the fetus may also have delayed development. The recipient twin will get too much blood flow, which can lead to heart problems, possibly even failure. If they were to get to the point that intervention was needed, there would be a 90% chance that one would survive and a 60% chance that both would survive. (I looked at some statistics lately and it looks like that number has been increased to 70%.)
We went back in the following week, week 13, and the perinatologist measured each baby again. He checked the growth, the amniotic fluid, the blood supply through the cords and the urinary tract functioning. He looked at me and said “Well this week they are stable. The good thing is if you need intervention, USC (which is close to us) is one of the best hospitals around that does the surgery you would need.”
He proceeded to tell me about a procedure that is done in-utero to separate the placenta by cauterizing some of the large shared blood vessels. In an ideal situation then each twin would have their own blood source. The part that stuck in my head was that 60%. It was not much better than a flip of a coin whether I would see both of my twins alive. He told me that what we would do for now was come in every week to take the same measurements. If we made it to 27-28 weeks, I could just be delivered. The risks of premature birth is a better option than the risk of letting the twin to twin transfer continue.
I went home and cried. These babies that I was carrying might not come to be, my adoption was a mess, and I was devastated. It was an instant switch from being completely freaked out by having so many babies, to being fiercely protective of my unborn children. I was no longer overwhelmed by having the twins and DS just 9 months older. I prayed that I would be able to hold each of my babies alive and well.
Each week I returned to my perinatologist. It took 30-45 minutes to get each of the measurements that he needed, and each week he simply said, “They are still stable this week, but not any better.”
At 16 weeks he did a brief anatomy scan, and we found out that we would be having two little boys. I still wasn’t letting myself feel much. I was so far away from that 27 week mark. Every time he would tell us the differences in size and weight. Baby A was taking more food than Baby B. Baby B was stuck up on my left side under my ribs with hardly any fluid around him. I was literally counting the days. At any given time I could have told you the weeks and days I was pregnant. I counted every day just hoping to make it to 27 weeks.
I wouldn’t talk about names, figuring out sleeping arrangements or getting things we would need for three infants. I just couldn’t bear the thought of coming home to a house we had prepared for our twins if we lost one or both of them. I did allow my husband to talk about a new car. With three backwards facing car seats, we would need a bigger car. I gave in and let my husband figure out buying a mini van, but I would not talk about their strollers or car seats. I figured that could all wait until I knew what would happen.
I struggled each week with all of the “what ifs.” I went in every week, sometimes for more than an hour, and every week was the same. “Stable but no improvements.”
Finally it came to 27 weeks. I had made it to my goal and my babies had remained stable. Now at any given time if they took a turn for the worse, I could just be delivered. My perinatologist even told me he was relieved we had made it this far, and that he had his doubts early on. Thank god he didn’t tell me that at week 12. I was a mess as it was; if I had known he didn’t think we would make it, I don’t know how I would have coped. I still had to go in every week for my ultrasound to make sure they remained stable. Now instead of aiming for 28 weeks, we were just hoping to keep them in as long as possible. The longer I had them in, the less issues we would have at their birth.
As the twins grew, it became increasing difficult to get the measurements the perinatologist needed, which resulted in me being on my back for longer and longer. Finally at 33 weeks he said he felt confident with letting me go two weeks before coming back in. I know that might seem like a lot, but to me it was a miracle.
At week 34 my OB started doing heart monitors twice a week. She was also watching my blood pressure, which had started to go up. I was developing preeclampsia. The monitoring was a pain. Baby A did not like the monitors and would kick at them whenever they were in place. That made it very difficult for my doctor. I ended up being admitted to the hospital three times for extra monitoring. I was getting so tired of being at the doctors and the hospital, I just wanted to get it over with and meet my twins.
Finally at 36 weeks and 6 days, my doctor told me not to eat before I came in in case we needed to do a c-section. I was so glad. I knew that my blood pressure was going higher and I just needed it to be over. I was retaining so much water (30 pounds in 3 weeks), I just knew I needed to be delivered. When I went in my blood pressure was up, and this time there was protein in my urine. I would be delivered that night. My original hospital was full and had no room for a nonemergency c-section, so I had to go across town.
It was a fairly straightforward procedure, except there was two full delivery teams in the room with me. Each baby required its own set of nurses, plus I had two OB’s doing the surgery and each of them had a nurse assisting. That is a lot of people to be around when your hospital gown gets opened up, but I was over it. I just wanted to meet my boys.
At 8:02pm, my boy Joseph was born at 6 lbs 8 oz. At 8:03pm, his brother Nicholas was born at 5 lbs 12 oz. The nursing staff told me they had never seen a healthier pair of twins. They required no special medical treatments, except one of them needed some formula when their blood sugar dropped and I was still in recovery. I was overjoyed! Months of worry and I had two perfectly healthy little boys.
Three days later we went home as a family of five. We had quite an adjustment period. It took some getting used to juggling three little ones under a year old. My husband stayed at home for two months, and I spent most of it sitting on our couch nursing the twins. But after that we did pretty good with getting out and taking the boys different places.
My husband is a saint. I don’t know many men who could handle the jump from 0 to 3 with as much grace and patience as he did. Both sets of our parents are also a huge help. They are constantly helping us and playing with the kids. It’s a life saver. Even though our family had a rough start we are doing great. We even welcomed a little girl into our ranks. Now we are a family of 6, and I wouldn’t have it any other way.