Life can change so quickly, my last post talked about my ultrasound, seeing my little twins moving around in my rapidly growing belly, their little feet pressed outward giving us the best pictures and hearing their rapid little heartbeats, we were so excited to be having a baby, but just ecstatic about having twins. We couldn’t wait to be parents to these two little lives, if we had just known…
On August 30, at 4:15am my water broke. I woke startled and Nathan asked me what was wrong. I said, "I think my water just broke!" He said,
"Are you sure you haven’t just wet the bed?" I was certain and started crying. I was so scared. I was only at 22 weeks and had just read in my journal before bed that babies at this stage couldn’t survive outside the womb. Nathan was scared, groggy, and a bit panicked, but managed to call the after hours number for the doctor and the labor and delivery charge nurse at the hospital and since that is only 5 minutes away we were at the ER being admitted very quickly and taken to the Labor and Delivery department.
The first thing they suspected was an infection, but since I wasn’t running a temperature, wasn’t achy, tender, feeling ill, my doctor was hopeful. My white blood count was slightly elevated, but some women have naturally occurring high white blood counts during pregnancy. He didn’t have my chart to see what my last one was, but he was positive. He was talking to specialists and the hope was to keep me pregnant, hope that the rupture would seal enough so that Twin A would have enough fluid around him again, and then at 23 1/2 weeks I would be transferred to Swedish (TG wouldn’t take me until 25 weeks) where they have a NICU where I would probably still have to stand on my head (that was the worst part, I still have a sore spot on my head from the bar on the bed because I kept sliding down), while they started steroids to help boost the twins’ chances of lung development at delivery which probably would have happened at 24 weeks, but hopefully later. 23 weeks was just around the corner, that wasn’t so long I kept telling myself. We can do this, they can make it. I kept rubbing my belly and telling the twins to hang on, be strong and stubborn as all hell. As the morning progressed the leaking slowed, they started me on some preliminary antibiotics and I think we all started to think it was going to be ok. Some women have a rupture, but go on to carry their babies to term. Nathan went home, packed me a bag as well as most of my unread books and magazines, we were in this for the long haul. Bed rest sucked even at that point, but I just knew it was going to be worth it. Anything I could do to protect the twins would be worth it. Even peeing into a bedpan uphill, which is a talent I mastered quite well. That night Nathan went home to get some much needed rest. I slept off and on and just kept thinking positively.
The next morning our high of the previous day was shattered. My white blood count was higher again. This was not a good sign. Then we got a preliminary report stating I had a Group B Strep infection, it is a naturally occurring bacteria in the va-jay jay (as Oprah puts it) of about 30% of pregnant women. Usually it is not a problem and they routinely check for it just after 30 weeks and if present wait until about two weeks before your due date for a round of antibiotics. Since the bacteria is in the vagina and the amniotic fluid was collected from there, there was a small chance that the fluid was contaminated before collection, but since the sack surrounding Twin A had ruptured and the bacteria is highly dangerous to infants the chances of survival for Twin A were dropping. Our doctor wanted to wait for another test result and to confer with the specialists again. Nathan ran back home, dropped off the dog, called our parents, and our Doula, Barbara, and came back quickly. We were expecting the worst.
Barbara got there shortly after 5pm and we waited. The test results again came back saying it was indeed a Group B Strep infection the concentrations were higher, and my white blood count was higher again and the doctor had consulted with the NICU at Swedish, and their opinion was that if we waited trying to let the twins have more time because the infection was so fast moving, we would certainly be putting my reproductive health at jeopardy, and possibly my life. The likelihood of Twin A surviving was very low (less than 5%) the rupture wasn’t sealing and Twin B wasn’t much better because of the infection. They swapped my antibiotics to a two medicine mix that were much stronger. Based on advice from everyone, Nathan and I decided to induce labor, knowing that the twins wouldn’t survive, but my body started having contractions on its own. I really think that my body and the twins knew what was going on and they were just waiting for us to come to terms. It wasn’t an easy decision at that point, I don’t think it would have been at any point, and as soon as my body started having contractions it wasn’t really a decision for us to make any longer. In my yoga class we used to say, "I trust in the infinite wisdom of my body." I really believe that, my body knew exactly what it needed to do, and when it needed to do it, even when I didn’t.
Originally we hadn’t planned on any pain meds for delivery, especially because an epidural really scared me and made me uneasy. But because of the delivery being what it was everyone thought it was best for me to have an epidural so I wasn’t in as much pain physically, but still mentally with it so I could be all there when they were born. The anesthesiologist was really good and answered all of my questions and was quick and nearly painless, it hurt less than having my IV put in. So after the epi was in, Nathan and I rested while my body and the pitocin did its job. I woke up at about 5am and could feel contractions on my left side, we tried a boost on the little button but it didn’t work and as they were trying to find the doctor to adjust the epi I started to have pressure and upon a check they found out Charlie was on his way.
Our son, Charlie, was born at 5:49am, September 1st. In my family all the boys are born on the 1st of the month, they were just following tradition. We got to hold him and cuddle him for about 10 minutes before the doctor had to break the sack around Jackson. Jackson was born at 6:18am. While I was delivering Jackson, Nathan was holding both Charlie and me. Then after Jackson was born they were both laying on my chest until after the placenta was delivered which detached on its own and came out whole, which was another worry the doctors had. We both just stared into their peaceful little faces and cried. We touched their faces, hands, and toes. We gave them kisses and hugs and rocked them. We took photos. I was so proud to be their mom, and so sad because I knew they weren’t really with us, even then. Seeing Nathan hold them just made my heart ache.
The nurse, Linda, (who was good beyond words) took them both to get cleaned up and weighed and measured and she dressed them in their little hats and shirts. Charlie was 1lb 2.2 oz and Jackson was 1lb 2.8oz. I can’t remember how long, Jackson was longer than Charlie though (no worries we have all the measurements in little memory boxes the nurse put together for us along with hand and foot prints). We spent several more hours with the boys, our doctor, Dr Bell, came in from the office to see them and us (his partner, Dr. Sears, was the one who delivered, but they are both amazing and would refer anyone I know to them) as well as the midwives that we started out with and the hospital photographer came down too, really when I say everyone was so great I mean it, if it hadn’t have been that group of people who were with us I don’t think it would have gone as well as it did for what it was. We also had hired a Doula, Barbara, about a week before all this, and she was with us the whole time and was exactly what we needed, and I think we will use her the next time too.
They did cultures on the placenta and sent that to the lab and sent the placenta to an off site lab for an exam. Usually they said it can take a couple of days for the cultures to come back, but they already had called back after about two hours with the results, it was a very fast growing infection, the nurse said it was almost unheard of to hear back so fast. That actually helped us knowing it was the best decision for all of us. Just after delivery my white blood count went up, and all this time I had been on antibiotics so the doctors were still a bit concerned for me, and they kept up with the antibiotics and monitoring my white blood count.
The next morning my bleeding was minimal, my uterus was contracting down to normal size, I hadn’t taken anything for pain, and my white cell count was down, though slightly elevated, lower than when I was first admitted. I was moving around normally (a bit sore, but tolerable) and everything else was "functioning". They did another round of antibiotics and gave us the option of staying in for another 24 – 48 hours for continued IV antibiotics or going home on an oral. We really wanted to not be there at that point, not that we wanted to come home, but I was tired of lying in bed sequestered in my room (we were still in labor and delivery so there were lots of women in labor as the windstorm was about 9 months ago). The doctors and nurses understood fully and they discharged me.
Sunday and Monday were very emotional days for me. Yesterday was a bit better, and today is actually pretty good, being outside has helped a lot and talking about them and what happened helps tremendously. Today I could even say their names out loud and it makes me smile. It was a very sad event in our lives, but at the same time it was absolutely wonderful to meet them and spend the limited amount of time with them we did. So I am still on a really strong antibiotic to make sure that that the infection is indeed under control and gone. My next pregnancy will be considered a higher risk, especially if it is twins again, but the chance of this same thing happening again is 1% or less, and we like those odds. I have been taking my temperature as that would be a sign of the infection spreading but so far I have been normal, in the hospital the nurses were even taking their temperatures to make sure the thermometer was working because I was exactly the same every time! My blood pressure is good, no tearing, no "issues" at all down there, I am back into my pre-pregnancy clothes (my choice), and have a really huge rack. Oh come on…laugh, its ok! It is the first time in my life I have been able to say that.
The boys had an autopsy scheduled for yesterday, and we found a funeral home here in town that is going to do their cremation for us, and my friend Jen’s (the kayaker/author) husband makes prayer wheels and he is going to make one for us to put their urn in. Even talking about that isn’t too upsetting for me today. They are safe, happy, and only ever knew love.
If you needed to cry, it’s ok. I understand and hope you can all feel the love we both have for all of you and all of your support, it is so great to know that you are there for us. And yes we are in a new club, one of them is a club we never thought we would be in, the other is a club we wanted to be in together from the beginning, we are parents! And I say that with a smile and a little tear.