5:30 a.m. June 3, 2005. Getting ready to go give birth. I still can't believe how VERY pregnant I was!!
Welcome to the world Abigail Elizabeth!
Welcome to the world Noah Christopher!
Abby's tired...it's been a long day.
Noah all tuckered out after his grand entrance.
Aaaaah, together again. Check out the size of Noah's head..no wonder they thought he was bigger!
A picture of small part of the birth team (just
my nurses), taken after all the chaos was over.
They always slept like this, cuddled together nose to nose.
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-Two years ago today two new souls entered in to the world and our lives – I remember most of it like it was yesterday.
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It was a long and stressful pregnancy, much more taxing on my body and emotions than I ever would have guessed. First came the question of whether or not my cervix was competent, which involved 6 detailed ultrasounds over time by a specialist. I had cervical cancer the May beforethe August I got pregnant, which thankfully did not penetrate beyond the lining of my cervix and spread, but which did require laser surgery removing a large portion of the outer portion of my cervix. Because I was carrying twins, there was a high probability that my cervix would be “incompetent” leading to an early miscarriage or premature delivery. Luckily, that wasn’t an issue, but it was a constant looming worry every time they measured the length of my cervix through ultrasound and discussed the possibility of surgically inserting a cerclage, which is basically a procedure where they sew your cervix shut.
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Next came gestational diabetes at 20 weeks. I’m not prone to diabetes and have never had an issue with it in prior pregnancies, but my pancreas just couldn’t handle the added demands of twins. This meant an excessively strict diet and blood sugar testing 8 times per day. I did not want to go on insulin, so I religiously followed the diet. It got confusing, so I just resorted to eating the *same* exact balanced diet, spread over 6 “meals” every single day. Different things tended to throw my sugar off in weird and unexpected ways. A roll with a hamburger would throw me over the limit, as would half a banana, but for some reason an occasional square of a Hershey bar would not. I ate the *same* breakfast of exactly one cup of whole wheat Cheerios and ¾ cup of soy milk every single morning. Real milk also threw my sugar over the limit. I lived on sugar free popsicles to quench my sweet tooth. Knowing that gestational diabetes slows down lung development and twins already meant a high risk of an early labor was a constant motivator to stick religiously to the diet. By this time I was also on “modified bedrest” which meant I could get up to drive the kids to school and do little things, but couldn’t say, go baby shopping, carry Mikailey, or do much of anything. Also, around this time the peri-natologists were also getting concerned about Abby’s growth, and upped my growth scans at the peri’s office at Uconn to twice a month. As time went on, it seemed that Abby wasn’t growing properly. At the same time, Noah had polyhydramnios, which is excess amniotic fluid. This can mean many things that they can’t diagnose on the ultrasound, including kidney problems. Life from 20 weeks on was an odd mixture of caution, worry, endless doctors appointments, bland food, back aches and indigestion, days running in to nights, and hours upon hours of lonely boredom. I made a calendar for myself and counted down the days to a safe delivery, which for twins is 36 weeks. I surfed the internet while lieing on my left side for endless hours and tried, with little success, to sleep.
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By 30 weeks the “growth discrepancy” (you’ll read why this is in quotes later) was getting more and more concerning. In addition to weekly growth scans at Uconn, I had to add in twice weekly non-stress tests at Rockville Hospital. Growth scans, for those who are wondering, are sort of like the detailed 20 week ultrasound most people get once. They usually took up to 2 hours with the twins, and more than once I passed out on the table. How the high risk peri-natologists haven’t yet caught on to the problem with leaving a hugely pregnant woman flat on her back for two hours is a problem and cuts off blood flow, is beyond me. Non-stress tests are another adventure. You go and wear the monitors around your belly that they normally use to monitor babies’ heart rates during delivery, and you push a little button every time you feel a kick. On the print out, they compare the heart rate when the babies are moving to when they are still, to make sure they are still OK in there. Sounds simple enough, right? Not with two!! Most women getting NST’s were in there because they were past their due date. They’d come in and leave within 10 minutes. With me, it was a whole production. They’d get both monitors on, and without fail, the babies would change positions, or fall in to a deep sleep and refuse to move at all. Usually it took two nurses holding the monitors by hand, and forcing me to drink caffeinated soda with ice to wake the babies up (guess what, they feel cold when you eat ice!). This whole production took anywhere from 30 minutes on a good day to two hours on a bad day.
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By 28 weeks, I was measuring 40 weeks, by the way, which is the size I would normally measure on the day of delivery. By the time I gave birth, I measured 52 weeks pregnant, which is kind of like being pregnant with a 3 month old!! Anyway, by 32 weeks, they were getting more and more concerned. How do people get through twin pregnancies without help? Luckily, Mikailey was in daycare after I was put on bed-rest. I had a weekly OB appointment, a weekly peri appointment at Uconn, and 5 weekly NST’s from 32 weeks on! They diagnosed Abby with Intra-uterine growth retardation because she didn’t seem to be growing. But… they could never get good measurements because Noah, with his extra fluid, was all spread out like he was in a recliner and poor Abby was so squished, with her head in my left pelvis, that they could never get a good head measurement (which is the main one they use to estimate weight). Every appointment at Uconn was stressful, because each time I knew they might admit me and take the babies out early if Abby wasn’t OK. It didn’t help that I simply couldn’t get in many calories on my diabetic diet, with my stomach in my throat. I’ll also add that I’ve never been so uncomfortable in my life. Everything hurt. Fraternal twins, or identical twins in separate sacs, simply weigh more than two babies in a single sac (which is more dangerous, so that's not good either) because you have two separate amniotic sacs with fluid. Also, Abby felt like she might just fall out at any time, while Noah was actually under my rib cage (they had to ultrasound him through my ribs, and ultrasound Abby from my groin looking up towards my pelvis.) They also only seemed to fight when I tried to sleep, which I gave up trying to do laying down by 28 weeks (full term sized for a normal pregnancy). I felt like I had a huge octopus inside me, with 8 limbs poking out in every direction! The skin on my belly stretched so much it burnt and actually would get raw and bloody! I also had strong Braxton Hicks contractions from about 28 weeks on. Fun stuff.
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Anyway, back to the story. At 36 weeks after extensive testing, the doctors were confident that the twins’ lungs were fully developed. Since twins are under extra stress, their lungs develop early, which is a good thing because a full term delivery for twins happens at 38 weeks instead of 40. They always induce at 38 weeks because the placentas just stop functioning properly around then. Because of Abby’s growth problem, they decided to induce me at 36 weeks and 6 days, on a Friday morning. I have never been so ready to deliver in my life!!
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Exactly two years ago today, we all packed in to the car at 6 am. Chris dropped me off at the hospital, brought the kids to school and then came to be with me. Jordan, being the quirky guy that he is, felt that the car ride to the hospital would be a good time to relay all the research he had done on twin births. Of course I knew all the risks, but I didn’t feel like hearing them listed on the way to the hospital!! The poor kid was so worried! He also was in 6th grade, and had to take the 7th grade honors algebra placement test that day (he managed to ace it, so at least that’s good!).
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The labor and delivery was indeed stressful, but not incredibly painful. By the time they got their act together and got my IV’s and stuff in it was after 9 am. They started the Pitocin, and Noah’s heart was going crazy. From then on, not only was I not allowed to move, but I had to lie perfectly still on my left side to reduce his stress. Privacy wasn’t part of the deal, like with normal labors. I had 3 nurses with me the entire time, usually two hand holding the heart monitors because the babies just wouldn’t stay still enough for me to wear the belt thing. By 10 they stopped the Pitocin because Noah was in serious distress, and broke my water to see if that would progress things. Noah recovered a bit, although talk of a c-section was constant. They started the Pitocin at a lower dose again at 12. I barely felt the contractions which were 8 minutes apart, but still Noah wasn’t tolerating them well and I was stuck in a weird uncomfortable position on my left side. The contractions got regular and strong by 2 and I got my epidural. For those of you who don’t believe in epidurals, they aren’t optional with twins. I had to have one in before going to the OR for delivery in case of an emergency, so they could just quickly up the dose and do an emergency c-section. I was lucky enough to find an OB who would let me try for a vaginal birth at all, as most prefer just to do c-sections with twins.
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Anyway, after getting the epidural at 2, when I was only 3 centimeters, I let the nurse know at 2:35 that I was delivering THEN. She didn’t believe me. I’d done this before, I knew!! After getting the epidural with Mikailey at 4 cm. I gave birth 45 minutes later. Anyway, she seriously didn’t believe me, and Chris was down in the cafeteria getting lunch because he thought he had time since I was only 3 cm. and comfortable with my epidural. The nurse finally humored me and checked, and sure enough Abby’s head was coming out!
They paged Chris over the intercom and a nurse went running to find him. Everything snapped in to high gear right then. They tell you to be prepared for a lot of action with a twin delivery, but I still wasn’t, lol. Chris came running up and he and my sister were quickly and dressing in to scrubs while I was already wheeled in to the OR. I was shaking, as often happens at the very end of labor, and arrived in the OR to a scene I hadn’t predicted….a tiny room packed with a large group of people running around in what seemed like pure panic and chaos!! I had 3 nurses with me to begin with, but I got to the OR to find at least 12 people in full surgical apparel. So much for modesty! They just kept shouting at me NOT to push because they weren’t ready so I focused on not pushing and checking out my surroundings. At each baby station there were 2 nurses for each baby, and a neonatologist, with resuscitation gear and all sorts of stuff I had never seen in a regular delivery. Our pediatrician, Dr. Parnes, was also there at my request. For me, there were at least 6 nurses, 2 anesthesiologists (I guess there was a back-up in case of emergency?) ready to up my epidural or knock me out at a moments notice, and there were also 2 OB’s – mine and a helper. All these people ran and materialized out of what seemed like thin air in less than 5 minutes, and all were breathless from the rush! Gawd, I told the nurse the babies were coming.... she should have believed me, lol.
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When Chris and my sister got to the OR, breathless and squished in to weird places (we all simply did NOT fit), they finally gave me the OK to push. I tuned out my large audience and got to work. Abby came out in about 4 minutes, after only 2 pushes. After all the worry about her, she was just fine, with a healthy set of lungs. Next, the real fun began:-) The biggest risk in a vaginal twin birth is to baby B. Any number of dangerous things can happen, including the placenta detaching after A comes out. My OB told me from the beginning that if B turned breach I was going to have to have an emergency c-section and this was a risk I was assuming by insisting on a vaginal birth. Noah, who has been mischievous since he was in the womb, took the brief opportunity of more space (a short window after Abby came out before my uterus could contract and squish him) to flip himself in to a breech position. The anesthesiologist was ready to put me under a using general because Noah’s heart rate was going crazy and there didn’t look like there would be enough time for my epidural to get me numb enough for a c-section that way. She was holding the mask over my face, and I pushed it out of the way, sat up, looked my doctor in the eye, and begged her to flip him if she wouldn’t deliver him breech. I made the most pitiful face ever and said “I just went through labor and birth; you can’t do a c-section without at least trying to flip him!” She sighed and said she’d try to flip him, but only through one contraction and only if his heart rate didn’t’ get dangerously low. Thank God I had an epidural, because what came next was kind of like a horse birth. The other Dr. worked on flipping him from the outside, while my doctor grabbed his feet, shoved them back in, and literally had her arm all the way up in my business. She wrestled with slimy feet and arms, finally got his head down, and then the other doctor and two nurses pushed on me as hard as they could to make sure he couldn’t move again before my next contraction. I pushed once and he was finally lodged in the birth canal and crowning but didn’t come out (I was no longer dilated to 10 cm, and he had the bigger head). His heart was decelerating dangerously low, and with the next contraction the Dr. vacuum extracted him. I was moved to the OR by 2:40, allowed to push at 2:48, delivered Abby at 2:52 and delivered Noah exactly 8 minutes later at exactly 3:00 (in only 8 minutes he flipped, they flipped him back, I pushed, and they opened the vacuum kit and used it to suck him out…not bad, eh?). So, while it was an uncomfortable labor, it was a short one… my real contractions started at 1, they got really painful by 2 and two babies were born by 3. When I got to the OR, it all went so fast it was just amazing and overwhelming. I couldn’t believe the crowd of people cheering, or the feeling of looking over at TWO screaming, completely healthy babies!!
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After all that stress, it turned out that Abby did not have any growth problem at all. They estimated that Noah was over 7 pounds and Abby was barely 3 pounds, but they only had a weight difference of 5 oz.! It turned out that Noah had benign external hydrocephalus (extra fluid on the brain) which caused him to have a huge head, and led them to over-estimate his size. Abby, on the on the other hand, had short legs. They could never get good head measurements on her because of her position, so the main measurement they used was her femur. So Noah had a big head and Abby had short legs, but they were both almost the same size and they were both healthy!! Since I was induced early, they were a little small, but they were perfectly mature and didn’t need the neonatologists, oxygen, or (thank God) an emergency trip to the NICU at Uconn! Abby was 4lbs 11 oz, and Noah was 5 lbs 4 oz., and they were both absolutely perfect!!
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I was back in my room, all cleaned up and nursing two babies by the time my mother picked the two big kids up from school and got them to Rockville Hospital. After having gestational diabetes and religiously following that strict and miserable diet, I was finally free to eat whatever I wanted. I demanded that all visitors bring at least one food item with sugar or carbs. I ate an entire Paul’s pizza for dinner that night and spent my time in the hospital balancing two babies with cake, cookies, French fries or candy.
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My other two pregnancies were uneventful. This one was filled with worry from 12 weeks on when they started talking about the possibility of an incompetent cervix, and then the gestational diabetes, risk of premature delivery, the suspected growth discrepancy. They made us tour the NICU at Uconn, and had us prepared for the worst -most twins aren’t born at term. They told me to expect a c-section – most twins don’t cooperate and both position themselves head down before birth (Noah kept changing positions until the day of birth.. and even after Abby’s!). I discussed the risks at length with our pediatrician and the peri-natologists and understood that if anything went wrong, if either of the babies needed to spend time in the NICU, they would be transported to Uconn immediately without me. I believed it was all going to go right and so decided to give birth at my hospital with my own OB. And in the end, after all those weeks of worry, everything went just fine.
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Two years ago today, I left for the hospital feeling more pregnant than I imagined humanly possible and then I sat holding two beautiful new babies in total shock and awe. I couldn’t believe how perfect they were. I couldn’t believe I just had TWO more children, that I was now a mother of four! I couldn’t believe that I could already tell their cries apart, or how often at least one out of the two of them was crying! I couldn’t believe the rollercoaster pregnancy was over and the real adventure, which I still couldn’t imagine, was just beginning. I couldn’t put them down and send them to the nursery to take a much needed rest. Two years ago today, I sat staring at two beautiful babies. One journey had come to an end, a new journey, their journey through life, our journey together as a family of six, had begun. Already I couldn’t imagine my life without them.
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Today I type with two rambunctious toddlers at my side. Noah is zooming around on his little car and Abby is using him as target practice to hone her Elmo throwing skills. In a few minutes I’ll start to get the dining room cleaned up for their second birthday party. Honestly, this might have been the longest two years of my life. Suddenly it seems like it’s all flown by, though. I can’t believe they are two!!! I can’t believe my last two babies are no longer babies!!
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Abby and Noah – I love you more than more than I could ever express in a little blog entry. I love you both differently and infinitely. Have a wonderful second birthday. Your lives are just beginning guys – the future is wide open. As much as I sometimes wished that I could freeze time and keep you as tiny babies for just an extra little while (your first year was a blur!!) I can’t wait to watch you grow and see what your future holds.
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Oh, and just for the record guys, you only get to go through the “terrible twos” once, so live it up while you can. By this time next year, I expect you both to be potty trained, sharing your toys, and never having dramatic “throw yourselves on the floor” temper tantrums. OK, maybe that’s not realistic, but potty training would be nice – your diapers cost a small fortune guys:-)
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I know it’s still just beginning, but all I can say about these last two and a half years is: “What a long strange trip it’s been”….
Jordan and friends (yey!!)
Preparing for a lecture at the university
Lots of nasty microbes live in the Mississippi river - that's my professional scientific opinion after looking at the squirmy living things under the microspope
My little scientist
Please Mikailey... don't break anything expensive!!
If you want to know why Jord has that scared look on his face while examining his specimen under the microscope, you'll have to ask him what grew in his petri dish after he swabbed the keyboard of the public use computer in the hotel lobby (yucky... you might want to wash your hands after using public computers!!)
