Tuesday, August 12th started like most good boring days of bed rest should. Early morning vitals and monitoring, horrible hospital breakfast, “Non-stress test” for an hour where both babies heartbeats looked perfect, within range and with good accelerations and deceleration. I had my usual bi-weekly ultrasound scheduled for 1pm, and the hospital transport was 40 minutes late coming to pick me up. I hadn’t had time for lunch before I thought they would arrive, so I was grumpy and hungry.
In the ultrasound, the technician looked at Baby A first. Not surprisingly, Baby A’s fluid levels were low. I had been loosing more fluid than bleeding over the past two weeks. The doctors though this was preferable to bleeding, explaining that the babies didn’t need as much fluid later in the pregnancy anyway. So I wasn’t too concerned. Baby A also didn’t do her practice breathing- which I understood was normal not to do it every time. She and Baby B rarely both got scores for breathing on the same day, and I was certain I had felt Baby A hiccuping just before the ultrasound (hiccups also count for the breathing score.) But all this meant that Baby A got a score of 4/8 while her sister was 8/8 for the biophysical.
Transport wheeled me back to my room, and I finally ordered lunch and ate at 4pm. The nurse came in and said the doctors saw Baby A’s scores, and wanted me back on the monitors to do another Non-stress test. I was annoyed. If they were worried about the biophysical ultrasound, it seemed like the doctor on call should at least talk to me about the results.
On the monitor, Baby A’s heartbeat looked high, staying around 170 and up, occasionally dropping down to the high 160’s. The TOCO monitor also showed contractions every four minutes, though I wasn’t feeling anything other than what I thought was indigestion from my late lunch.
I’m now so grateful that the doctor on call thought otherwise. Orders were sent down for me to be transferred to Labor and Delivery. I was upset. None of this seemed cause for alarm- and I knew what the routine would be in Labor and Delivery: Magnesium, hooked to the NST monitoring and an IV all night, lots of people coming in and out of the room, and no sleep.
It was 5pm. I told T to come to the hospital.
“Hurry” I added.
T, said later that he knew when I said to hurry, that this was serious.
He left his office and flagged down a cab. Stuck in traffic on the short drive to the hospital, he told the cab driver to do whatever she could to get him to the hospital as fast as possible, explaining our story. Sometimes life is stranger than fiction; the cab driver who picked T up was born prematurely at 30 weeks herself at another hospital in town. With a twin sister who didn’t survive. She refused to take T’s payment for the cab ride, but gave him her card asking T to let her know how things turned out.
When T arrived, I was deep into the magnesium haze, begging for water or ice. I wasn’t allowed anything. The nurses gave me some oxygen to slow my heart-rate, but soon I was vomiting, and then my temperature spiked as I started shivering uncontrollably, my whole body writhing in pain with how cold I felt. I heard the nurses saying the babies’ heartbeats were high. Through my haze, the doctor calmly told me that I had a serious infection from Baby A’s water breaking, and that we needed to have an immediate c-section to the babies out.
I cried, but agreed. I knew I could no longer keep the babies safe inside. I could only hope they were ready.
T called my parents, 3,000 miles away, to let them know what was happening. “Remember to be excited,” my mother said. “This is your babies’ birthday!” Her optimism was just what I needed to hear.
By 7pm, the nurses were wheeling me into the operating room. I clung to T’s hand, pressing it to my face, the only bit of warmth I could feel as my body continued to shudder uncontrollably from severe chills.
It was even colder in the operating room. With all the strength I had left, I willed myself to stop shaking long enough for the anesthesiologist to inject the spinal pain blocker.
I felt the pressure of the incision, and at 7:33 pm, they announced that Baby A was out. My heart fell as I strained to hear her cry. No sound at all. They whisked her into the recovery room and I felt another weight being lifted out of me as her sister was delivered two minutes later at 7:35 pm. Again, no cry and she was whisked away, not even a moment to spare for me to see her. I told T to go with the girls, where he was allowed to watch them in the recovery room.
Meanwhile, I was shivering even more violently as the surgeon was still trying to remove the placentas. The doctor later told me that did his best to stay calm, but he was very worried as my vital signs were failing and my blood pressure was dangerously low. They were placing another IV, trying to stabilize me, promising me a warm blanket as soon as they could get the second IV in. Even with the warm blanket, I was so cold, my body so stiff.
The first placenta came out easily, but I heard the surgeon say that the other placenta wasn’t budging. I assumed this must be the previa placenta, which has a risk of being a placenta accreta. This means it grows into the uterus which was very dangerous and would need an emergency hysterecomy. Another worst case scenario seemed to be coming true. Later I learned it was Baby B’s placenta that was just wedged in at an odd angle, and they got it out.
From here, it was a haze. I don’t remember them stitching me back up, only vaguely remember them rolling me back to my L&D room. The warmth gradually started to return to my body. They wheeled in Baby B so I could see her. She was so tiny and beautiful, and seemed calm despite what she had just been through. They assured me she was doing well. They told me that she was smaller than her sister, just 2 pounds 7.5 ounces while her sister with the compromised placenta and amniotic sack was surprisingly much bigger at 3 pounds 5.6 ounces.
I was afraid to ask where my other baby girl was. T came in from the baby recovery room. Looking at his face I knew it wasn’t good news. He told me she was fighting hard, but she was struggling. He bowed his head so I wouldn’t see how scared he was, but he was crying.
“Go be with them,” I told him. I felt numb. This couldn’t be happening.
I will always be so grateful for my nurses who took things into their own hands and decided I needed to see my baby girl. As soon as they confirmed I was stable, they wheeled my hospital bed down the hall and up to the NICU. It looked like a party in our room- a huge crowd of people and all the lights on. Everyone surrounding the isolette where my daughter was. I overheard the doctor telling my husband that they had tried all the ventilators, that she was refusing them all, that she wasn’t breathing on her own or taking in the oxygen she needed with the support. The last resort was to administer nitrogen oxide, something they didn’t usually use on preemies, due to the risks of bleeding. It was a “Hail Mary” approach at this point. I’ve never seen T look so shaken.
My nurses wheeled my bed in right next to my daughter’s isolette. I expected to see her lying there, limp and motionless. To my surprise, she was kicking her feet and waving her hands around. My husband was right- she might be struggling, but she was fighting hard. The nurses opened the door of her isolette and encouraged me to reach in and touch her, to talk to her.
It hit me that this might be the only time I would see her, the first and last time I might hold her hand. Tears streaming down my face, I reached in and stroked her tiny arm gently, holding her little hand and told her how much her daddy and I loved her. How she had a wonderful big sister who couldn’t wait to meet her. How much her little twin sister needed her. How loved she was. How she had to hang in there, that we all needed her. T came over and we held each other and cried.
“I’m so proud of her- she’s fighting so hard,” he said through his tears.
The nurses took me back down to my room, leaving T behind with our daughters. I was dazed and exhausted. I started to pump milk, getting only a few drops, every few hours, but feeling good that there was still something I could do for them. Each time I dozed off I’d wake with a start when I heard the door open, afraid someone was coming in with the news I feared to hear. T came back to let me know that the doctors were able to place the ventilator. He was going to sleep in the NICU room with the babies, and he’d let me know if anything changed.
When T came in the next morning, I could see the exhaustion in his face, but it was mixed with relief. He brought me across the hall to the NICU to see our tiny babies. Our tough little girl had made it through the night and was holding steady on the ventilator. The NICU doctor was standing by her isolette, explaining that they were already starting to turn down the nitric oxide and supplemental oxygen. That if all continued to go well, our tough baby girl would soon be exubated and moved to the less invasive CPAP instead, which just exerted gentle air pressure to make breathing easier.
Our youngest daughter was continuing to do well, sleeping as peacefully as she had the night before, letting her twin get all the attention she needed.
We began to let ourselves relax a little bit. We marveled over their tiny toes and fingers. Their matching dark hair. Most of all, their incredible determination to be here.
Yesterday we finally decided on names, choosing middle names from each of our families and first names that were all their own.
I’m so grateful to be able to introduce them to you all: Sylvia Grace (Sylvie, meaning from the woods in Latin) and Carina Eleanor (Carina meaning dear little one in Italian.) Grace after my great-grandmother and for all the grace she had coming into the world so early but so calmly, allowing her sister to get all the attention she needed in those critical hours. And Eleanor for T’s grandmother who died when he was very young, who was always said to be his guardian angel.
The nurses in the NICU already have commented what little personalities they are. That Sylvie is the talker and Carina is the active one. We held them today for “Kangaroo” time- the girls were calm and seemed happy snuggling in warm and cozy against us. All the wires seemed to disappear for that moment, and T and I finally were just parents holding our babies. It felt wonderful.
I get to go home today. It seems surreal, that I’ll be home for the first time since July 10th, sleeping in my bed with T, playing with E and walking around without the constant worry of my difficult pregnancy. My bed rest marathon is over, but we are just beginning the NICU marathon. Our girls as well as T and I need to stay tough, and once again, take it just one day at a time.
While I still wish I could have protected them for longer, our little Carina Eleanor knew that she and her sister needed to come out that day. I also wish this was the end of our story; that I could wrap it up here with a happy bow. But as the doctors like to remind us, there are no guarantees in the NICU.
Thanks to you all for your love and support through all these chapters; through the long struggle with infertility to my hospital bed rest pregnancy and now the NICU. I’ll continue to share updates here about Sylvia and Carina. And hopefully one day, the happy ending to our story.
PS: For everyone who is hoping to see a photo- forsome reason, WordPress is not allowing me to post photos. I’ll try and share one later.