I had the wonderful opportunity to write a piece for a local magazine called Go Valley Kids. Check it out here:
I had the wonderful opportunity to write a piece for a local magazine called Go Valley Kids. Check it out here:
Let me tell you a story about my beautiful, sweet, tender-hearted three year old son, Roland.
My mom had made me a pie with a graham cracker crust, vanilla pudding, and whipped cream. She brought it over one evening, and of course all the kids wanted a piece right away. As she was serving it up, Roland hesitated, then asked, “does this pie have eggs in it?”
You see, his daddy is severely allergic to eggs, and usually cannot partake in any kind of delicious desserts, much to his dismay. I was pretty surprised that young Roland thought to ask about the ingredients in the pie! My mom informed him that it didn’t contain eggs, and he was pleased.
The next morning when I got up, I checked the fridge and there was only one piece of pie left. I figured the kids – and perhaps Jacob? – had eaten most of it, but I felt justified in taking the last piece, since my mom had made this pie for me specifically, and I hadn’t even tried a piece yet.
I sat down with my cup of coffee and my plate of pie, ready to dig in. It looked delicious! Roland came up beside me and asked if that was the last piece of pie. I said yes, it was. He immediately crumbled to the floor, sobbing uncontrollably.
Oh great, I thought. He’s having a tantrum because he wants the last piece of pie, even though he’d had at least one piece already, if not more! It was way too early for this, and I hadn’t had my coffee yet…
Roland looked up at me, his big brown eyes brimming with tears, and said, “but…if you eat the last piece….then Dad won’t get to have it….and it doesn’t have any eggs!” He began sobbing again.
I called Jacob and asked if he wanted that last piece of pie, because Roland was very concerned about this. Jacob said it was ok. He had already sampled a bite, and it was yummy. We were welcome to the last piece. So I picked up my son, sat him in my lap (pausing to consider how much bigger he seems in my lap now) and we alternated bites of pie until every morsel was gone.
This child is THREE. Three is a very egocentric age. Three year olds do not like to share. But Roland is different than most. His heart is huge, and his heart is pure.
I’m so thankful for this incredible boy.
I’ve been….not ok lately. Like really, really not ok. I’ve cried all the tears. I’ve hated myself and hated my life. I’ve felt – not just thought, but known, deep down to my very core – that I am a failure. If I can’t nurse these babies, I don’t even know who I am as a mother. Maybe I’m not a mother at all.
Then this morning, there was this moment. The love was palpable between these two. It filled the room and it filled my heart.
Maybe the twins don’t nurse. But they never wanted to. I didn’t take anything away from them. Maybe they’re not missing out. Their lives are different. Everything about their existence, from the moment their egg split apart and they became two, has been different from my other babies. Why do I feel things must be the same? They never will be, not for these babies.
They aren’t aware that their mother has failed them. They will not see me this way. All they know is that their mother loves them and takes care of them. They have a good father, and three siblings who adore them. They are surrounded by love. That has to be enough.
I think it is enough for them. The question is, will it ever be enough for me?
You turned SIX a couple of months ago! Sorry for the slight delay in writing you this letter. Life is busy around here right now. A few weeks before your birthday, you acquired two new siblings: your twin sisters, Magnolia and Sunflower! I am so proud of you for being such a good big sister to them.
You have matured in so many ways over the past year. You have gotten taller and slimmer, and you look like a big kid now. You spent the whole summer outside, playing with the neighbor kids, running around barefoot and getting dirty. You’d asked to get your hair cut, so I took you to the salon and you charmed everyone there with your great personality as they cut your hair into a cute shoulder length bob.
Everywhere we go, you win people over. You have this infectious enthusiasm. I love to see your beautiful smile and hear your laughter. You make everything in life more fun.
You and I always talk about how we are “besties.” One of your favorite things to do is lie in bed with me, snuggling and talking about the things we will do together when you are all grown up. I hope we really do stay close as you grow up. I can imagine us going out to dinner, going shopping together, and getting our nails done. Someday perhaps you will have children of your own and I will get to babysit. It’s going to be awesome.
For now, I’m enjoying your “little girl-ness” and hoping you won’t grow up TOO quickly! You are a kindergartner this year at montessori school. You are going all day, which you love, and even sometimes eating hot lunch at school (the things you like are few and far between though). Your teachers love you and the positive energy you bring to the class.
You are a very smart girl. You can read easy reader type books already, and you impress me with your math skills too. You are very inquisitive, always asking really good questions.
We had your IEP meeting in the spring, and you no longer qualified for speech or any other special education services. You also “graduated” from your autism therapy program at the end of the summer. You are still going on Saturdays for the next couple of months for a social skills group, which you are really enjoying. We are very proud of the progress you have made!
This year has brought many BIG changes to our family, but as usual, you have adapted well and are still the same sweet, good-natured girl. You are so special. Please don’t ever change!
Your bestie, Mama ❤
I had sent my MFM doctor a message, thanking him for the wonderful medical care he provided, and his quick decision making when it was time to take my girls out. I also asked for a copy of the placenta pathology report. Mono-di twin placentas are always sent to pathology for examination.
I was disappointed that during their birth, I had forgotten to ask to see the placenta. Once the babies were out, they were my only concern, and I completely forgot that I had wanted to see it. I just thought it would be interesting to see the one huge placenta with the dividing membrane that separated my twins and the two umbilical cords attached.
The pathology report is extremely eye opening. It shows that without a doubt, my twins are 100% identical (although I seriously question it sometimes because they look so different!). It was a monochorionic, diamniotic twin placenta. It states “the dividing membrane consists of a double layer of amnion without intervening chorion.” If there was a chorion in between, then my twins would be di-di and possibly non-identical. So there is no doubt.
Other items of interest:
Baby A’s cord was 10 cm long and Baby B’s was 16 cm. I had heard the doctor say “short cord!” as Magnolia was being pulled out, so this verifies that.
The placental shares for the two babies were not exactly equal. How they determine this is by running two different colors of dye through the blood vessels on each side of the placenta to determine where the division lies, and also see if any blood vessels are crossed (indicating TTTS or TAPS). The report stated that placenta B (Baby B’s share) was larger than placenta A (Baby A’s share).
It also says “many small vascular anastomoses are identified.” What this means is that there were crossed blood vessels carrying blood from one baby to the other. Here’s some more info on this:
“Monochorionic twin pregnancies are at increased risk of adverse outcome because of the vascular anastomoses that connect the 2 fetal circulation systems. The shared circulation is responsible for some unique complications in monochorionic twins, such as the twin-to-twin transfusion syndrome, the twin anemia polycythemia sequence, the twin reversed arterial perfusion sequence, and monoamniotic twinning. Another consequence of the shared circulation is that the well-being of one twin critically depends on that of the other.”
I have suspected that my babies could have been in the beginning stages of TAPS, which is twin anemia polycythemia sequence, where one baby gets more red blood cells than the other. With TAPS, one baby will be born very pale and anemic, often requiring blood transfusions, and the other will be born bright red with too many red blood cells. I was told that both my babies’ blood counts were within the normal range, but looking back on the photos from their birth, Baby A was noticeably pale and Baby B was darker/redder. They still have different skin tones, with Baby B being darker, which could be attributed to this. I’m wondering if their RBC counts were on the high and low ends of “normal” and perhaps it was the beginning stage of TAPS.
There was a pathologic diagnosis of “plasma cell deciduitis” which is inflammation of the maternal side of the placenta. The most common cause of this is from fetal antigens. Remember the E antibody issue that I was being monitored for? Well, most likely, based on this report, the babies DID have the E antigens and it was affecting the health of their placenta. Plasma cell deciduitis leads to preterm labor/premature birth. I am pretty sure I was already in labor when I showed up at the hospital for my scheduled c-section at 34+3, so perhaps this is why.
The last thing of note is “chronic villitis” which is a “pattern of placental injury occurring in term placentas.” Villitis is “an important cause of intrauterine growth restriction and recurrent reproductive loss.” My babies had intrauterine growth restriction!
All of this information is extremely enlightening. I have been really struggling with feelings of guilt and inadequacy over the fact that I had failed to grow my babies well enough, and that they needed to be born early. Their NICU stay was extremely difficult for me emotionally, and I am still trying to process it and move on. I have failed to exclusively breastfeed them, in part due to issues related to prematurity. There have been times I wondered if my medical team had made the right decision in taking them at 34 weeks.
I know now that the right choice had been made. There were several things going wrong with their placenta simultaneously. It was time. I’ll forever be grateful that my babies made it into my arms safely. Perhaps I can lay some of my worries to rest now. Closure is a good thing.
There is so much competition among moms. I’ve come to find out, from hanging out in twin groups online, that twin moms are no exception. While there is a really great sense of camaraderie, an overall feeling of “we’re all in this together,” there is also a lot of bragging that goes on.
Women boast about how far they made it with their twin pregnancy (the longer the better, obviously) and the birth weights of their babies (the bigger the better, obviously). They proudly proclaim it to the world if their twins were born vaginally, or if they didn’t need any NICU time. They wear imaginary badges for things like babywearing their twins, tandem breastfeeding, exclusively breastfeeding (not a drop of formula!), or for the moms who do have to pump and bottle feed, the number of ounces pumped in a session or the total number of ounces of breastmilk in one’s “freezer stash.”
The moms who do everything “right” are touted as “rock stars.” “Wow, you made it to 40 weeks with twins?! You are a rock star!” As if women really have much control over how long their babies remain in. There are so many factors to this: the type of twins, whether they have separate placentas or one shared one, if they have any issues such as TTTS or IUGR (which is what mine developed at the end), if they have an incompetent cervix or go into preterm labor, etc. A mom can do everything “right” and still end up with premature babies.
I didn’t go into my twin pregnancy trying to prove anything, but it’s hard not to feel inadequate for my apparent “failures” at this whole twin mom thing…
My twins were born at 34 weeks. I had a c-section…I CHOSE to have a c-section (gasp!) They were born small for their gestational age. They had to stay in the special care NICU for ten days. We have had nothing but issues trying to breastfeed. I’m now bottle feeding 90% of the time, and struggling to keep up with pumping for them. They have had some formula, my first babies to ever have a drop of formula. When I can manage to get them to nurse, I have found that I hate tandem breastfeeding and it makes my skin crawl (it’s kind of a sensory nightmare for me). I had thought I would wear them all the time, but in reality only have managed to get them both in a carrier comfortably a few times. With 3 other kids and twins, I am not able to practice “attachment parenting” like I have in the past. I am not cloth diapering, although I am thinking of going back to it soon due to the alarming number of disposable diapers we are going through. My twins don’t get held as frequently as my singletons did. I’m often trying to put them down so I can pump (omg the never-ending pumping) or tend to the other kids or do the other 579257 things I need to do on a daily basis to keep my household running.
Basically, I would not be much of a “rock star” twin mom in the eyes of others. I didn’t manage to accomplish ANY of the things that would earn me bragging rights (not that I would have bragged, but perhaps just felt a sense of pride in my own head).
The hardest things for me to process have been the feeding issues. It had never even crossed my mind that I might not be able to breastfeed my twins. Each of my singletons nursed until age two. I even had a brief stint as a La Leche League leader several years ago. Suffice to say that breastfeeding is extremely important to me. Of COURSE I would succeed at nursing my twins.
I wasn’t anticipating preemies. I didn’t know that I would not be able to do skin to skin or attempt to nurse them until many hours after their birth. I didn’t expect that they would be born with lip and tongue ties that would prevent them from latching properly, or that low muscle tone due to being premature would affect the way their mouths move. I didn’t count on them tiring out so easily from nursing that they would burn more calories than they were taking in, causing them to lose weight after we brought them home, and gain very slowly thereafter. And I sure did not think that even after we got their tongue and lip ties revised, they STILL would not be able to latch.
I kept thinking, what is wrong with me? Why can’t I make this work?! I am not a rock star. I am failing.
I had a moment of clarity the other night. It was literally as if a fog around me lifted and I could see clearly for the first time in 11 weeks. I had been so confused as to what to do about feeding my babies. Should I keep trying to pump? Should I do this or that to boost my milk supply? How long should I keep trying to make this work? I would sit at the table, day after day, pumping…always pumping…just feeling completely lost, lonely, and disappointed in myself.
I was lying in bed, trying for the fifth time that day to nurse Magnolia. With each and every suck, she was losing suction and making a clicking sound, getting more and more frustrated and beginning to cry. I cried too. This wasn’t working. She didn’t want to do this.
I looked into her huge eyes, which are slowly turning brown, just like I had predicted. Gosh, she was beautiful. Perfect. And those eyes were pleading with me to feed her. So I gave her a bottle, and watched the look of sweet relief wash over her face as she swallowed. She was gazing at me with the same look of adoration that my other babies had while nursing. Literally the same exact expression. I could see in her eyes that she was loving me, trusting that I would take care of her needs and help her grow. I needed to do that, by any means necessary.
If parenting kids on the autism spectrum has taught me anything, it’s that I can’t – and should not even try to – fit my children into a box. Each of them is an individual. They have different personalities, temperaments, and needs. I am already seeing Maggie and Sunny becoming their own people, which is breathtakingly beautiful to experience unfolding.
Parenting is not about doing things my way. It’s about working with my children to find what works for them. Right now, breastfeeding is not working for Magnolia and Sunflower. And I have been wasting my time, spinning my wheels, in a perpetual cycle of pumping, failed nursing attempts, sore nipples, and more pumping….just desperately trying to make this work. I was so determined to do this – just stubborn, really – because I needed to feel I had succeeded at something. In a way, it would be redemption for all the things that had not gone the way I’d hoped with my pregnancy, their birth, and their early days. I may have failed at literally everything else, but dammit, I would nurse these children if it killed me!
I was looking at this from the wrong angle. Maybe it was my tendency to think very black and white, all or nothing. If I couldn’t exclusively breastfeed twins, well then, clearly I was just a complete failure.
I was wrong. I am not a failure.
I am a rock star.
I am a rock star because I have overcome significant challenges alongside my babies, and I have not given up. I am a rock star because even in the depths of postpartum depression, plus my usual September funk, when all I wanted to do was run away, I have persevered.
I am a rock star because, although it took a considerable amount of pain, suffering, and worry, I have found the solution that is best for Magnolia and Sunflower. I will set aside my own pride and that picture in my head of how things “should” look. This is not about me, and never was. It’s not about proving anything to anyone, other than my children.
I will always be a rock star in their eyes. And that is all that matters.
I will continue to occasionally try to put them to the breast, but if they are physically unable to extract milk, I will not push them. I will continue to pump and feed them breastmilk, but I’m no longer going to allow myself to stress about it. The anxiety I have been putting myself through is not necessary, and it is not helping anyone. I’ll pump when I can, and when I can’t, it will be ok. I’m tired of spending the majority of my day desperately trying to find 15 minutes to pump, pushing aside household duties, and telling my kids that maybe I can play later. I will be a better mom to all five of them if I can just let this go.
My babies will be fed. They will grow and thrive. I have already learned that formula isn’t the villain I once saw it as. As soon as I started fortifying the twins’ breastmilk with Neosure, that was when they started gaining weight. They wouldn’t be healthy, strong, and getting chubbier by the day, if not for formula. So, I will give them breastmilk when I can and formula when I can’t, and before I know it, they will no longer be babies, but full blown KIDS running around energetically and blowing me away with their smarts, just like my others.
All these little things that seemed so important will no longer matter. What will remain is LOVE.
Lucky for them, I have an endless supply of that.
Lucky for them, their mother is a rock star.
I can sense something slowly sneaking up behind me. I hear whispers in the winds, barely detectable at first, but they seem to be growing louder and more insistent each day. I tell myself that it’s nothing. There is no force looming in the distance, threatening to close in on me and bring me down.
I know that I’m kidding myself. There is something coming.
It is September.
Every September, I fall apart. I lose myself in a black depth of self loathing, fear, and despair. My suicide attempt happened in September of 1996 (twenty years ago now!), when I was 14 years old. I didn’t realize it at the time, but it was part of a cyclical pattern for me, something that was occurring each year without fail. I was powerless to stop it, just as the trees cannot stop their leaves from changing colors. The trees though, they start to gain their vibrancy as autumn sets in. I start to lose mine.
September is cunning. September is a sneak. September is a liar. September whispers to me with its winds, which creep up on me, and begin to send chills through my body and mind. I don’t even remember that it is coming until it’s nearly here, and I start to realize I’m feeling the same old way.
September whispers that I am a failure, that I am a bad mom, that every other person in this world has it together more than I do. It reminds me of specific times in my life when I’ve done things wrong, playing the memories back to me in my head like video clips. It tells me that I’m not enough – for my children, for my husband, or even for myself. It berates me for my social shortcomings, the fact that I can’t even make a phone call without an anxiety attack, that a simple social interaction can render me useless for days, holed up in my house with my shades tightly drawn, pretending the people with their smiles and the trees with their leaves on the verge of change and the near-September winds don’t exist.
I can’t escape it though. It comes annually, bringing with it the old feelings of worthlessness and apathy. It saps me of all energy, making every necessary action feel like an impossible feat. It renders me unable to compose my thoughts into sentences, and pull those words from the depths and send them out of my mouth. It causes me to want to desperately cry out to everyone to just leave me alone, because I can’t. I can’t do any of it anymore.
September wants to bring me down, to turn me into a darkened, saddened version of myself, like a tree in winter that misses its leaves and colors.
This year, it will not succeed. Because I am stronger than the cold and the wind.
I’m going to seek help. Screw you, September. You won’t beat me this time.
At 34 weeks 1 day, Jacob and I went to our weekly MFM appointment. Originally Jacob was to stay home and watch our youngest while I went to the appointment with my mom, but at the last minute we switched it around and my mom babysat while Jacob came with me. In hindsight, I was so glad he was with me!
We arrived at the hospital, checked in, and waited to be called back for our ultrasound. As always, I was excited to see my babies. There had been times when I was filled with anxiety before ultrasounds, but strangely, this wasn’t one of them. I was looking forward to seeing my girls, and finding out how big they’d gotten. Their growth would be measured this time, something that was done every 3 weeks.
Our ultrasound tech was one of the midwives, and she is always so wonderful to talk to. She complimented me and told me I’m the “poster child for twin pregnancy,” which made me laugh. I certainly didn’t feel like a poster child, waddling uncomfortably down the hallway to the ultrasound room!
As she started the ultrasound, we chatted about a number of things. My other kids, how summer was going, whether we were ready for the babies (how can you ever really be ready for twins?!). As we were talking, I was simultaneously keeping a close eye on the ultrasound screen. I watched as she measured the deepest vertical pocket of fluid around each baby, pleased to see that as usual, their fluids were equal and in the normal range. Everything was looking great so far.
She began to measure the size of the babies. As she measured Baby A’s head circumference, abdominal circumference, and femur length, I watched the bottom of the screen where it estimated the gestational age of the baby based on those measurements. I was 34 weeks 1 day, but the measurements were coming up as 32 weeks, in some cases 31 weeks. My heart started to pound. Something was not right.
I sensed the midwife’s apprehension. She knew. I could see her hesitate and then quickly decide to continue the charade of happy small talk with me, as if nothing was wrong. As if EVERYTHING wasn’t wrong. Knowing that ultrasound techs are not allowed to give much information, and also that my MFM would explain everything to me after the scan, I decided not to address the problem right then either. The tension in the room grew.
She took each measurement three times, as carefully as possible. I’m sure she was hoping it was simply a measuring error, rather than a growth problem. As she finished, she murmured, “the doctor will want me to check cord flow.” This was another red flag for me, since this wasn’t something they normally checked at every ultrasound. She checked the flow of blood through Baby A’s umbilical cord, and then moved onto measuring Baby B. Again, I watched the measurements pop up on the bottom of the screen, and this time, the gestational ages were coming up even earlier. This meant that Baby B was even smaller than Baby A, who was clearly smaller than she should have been. By now I was approaching panic.
After the ultrasound was over, we were lead into an exam room to wait for the MFM to meet with us. Once we were alone, I looked at Jacob and told him that something was wrong, with tears welling up in my eyes. The anxiety that had built up during the ultrasound was in danger of pouring out. I had to hold myself together! It might sound silly, but I didn’t want the MFM to see me cry. He’s always spoken to me like an equal, like he respected my intelligence. I didn’t want to appear like a weak, emotional little girl in the presence of this man whom I respected so much. I pressed a wadded up tissue firmly into the corners of my eyes, took a deep breath, and somehow managed to stop the oncoming flow of tears before the doctor entered the room.
As usual, he didn’t waste any time with pleasantries. He looked at me and said, “well, everything has changed. Your twins’ placenta has reached its limit.” Right at that moment, the doctor’s cell phone rang. He said, “I’m sorry. I have to take this,” and ducked out of the room into the hallway. Jacob and I turned and stared at each other. What awful timing to get a phone call! We needed more information about our babies!
Luckily the doctor wasn’t gone long. He came back in and explained that our twins had developed IUGR, interuterine growth restriction. They were measuring at 4 lb 7 oz and 4 lb 0 oz, which were the 11th and 2nd percentiles. Baby B had only grown 6 ounces since our last growth scan three weeks prior, and at this stage babies should grow about a half pound each week. All of this indicated that their shared placenta was failing, and they were no longer getting enough nutrients to grow. The babies needed to be born soon.
The good doctor recommended that we get steroid shots, which would be administered over the next two days, and the babies would be delivered at 34 weeks 3 days. We were to get the first round of steroids before we left that day. This would help the babies’ lungs develop quickly. I’d read all the statistics about how effective steroids can be, often reducing NICU time by 50%. My concern was whether it was safe to leave the babies in for two more days to wait for the steroids to work. The doctor felt that since the babies’ cord flow dopplers looked good, they weren’t in immediate danger, but they still needed to be born very soon. They should be ok for the next two days, and the benefit of the steroid shots outweighed the risk.
The next thing we discussed was which hospital location would be best for their birth. Our preferred hospital doesn’t have a level 3 NICU, only a level 2 NICU (aka special care nursery) which takes babies 34 weeks and beyond. Since I was right at that cutoff point, the doctor wanted to make sure the special care nursery would be equipped to handle their needs. If not, we would go to a different hospital further away. I told him that we would go wherever he recommended. We wanted our babies to be well cared for. The MFM told us that before we left that day, he would have an answer for us as to where we would deliver. He was just waiting on a call back from another doctor.
He told us that in the 5 minute span of time after our ultrasound, he had already gotten the ball rolling on everything. That ill-timed phone call he’d received was part of that process. I was pretty impressed with how quickly he had acted! He literally must have taken one look at the ultrasound report, said “yep, they have to come out,” and immediately started making arrangements. He’d scheduled us an appointment to see him again the following morning, to get the second round of steroids and another ultrasound to check on the babies and look at their cord blood flow again.
We were led to a room in the labor and delivery ward, where a very peppy young nurse administered the first steroid injection. I felt pretty awkward bending over and getting a shot in the butt, but it wasn’t too bad. It burned a little as the steroids entered my bloodstream. The whole experience felt very surreal. Was I really preparing to meet my twin babies in just two days time?!
We went back and spoke with the MFM again. He had talked with several other doctors and pediatricians, and they had determined that the special care nursery could definitely handle the needs of 34 week preemie twins. Everything was all set up for delivery at our hospital closer to home. The next thing we had to do was meet with the OB doctor who would be performing my c-section. My regular OB, Dr. Northshore, was unfortunately on vacation that week.
The OB was a young woman with a very kind demeanor. She looked about my age, and I couldn’t be sure, but she also looked to be pregnant. I didn’t want to acknowledge it and be wrong though, so I kept my mouth shut! She went over all the details about what to expect with a c-section delivery. It was scheduled for that Friday at 7:30 am, so we would need to arrive at 5:30 am. The surgery itself would not take long, and once the babies were out, there would be a separate team of doctors ready for each baby. I was scared to have a c-section, but at the same time, I knew it would be the quickest and safest way for my twins to be born.
After meeting the OB, we left the hospital. As we went through the big revolving doors, a flash of garishly bright sunlight hit me. Everything felt too real. I was dazed and in shock. My brain was having trouble processing everything. It reminded me of the day I had first found out there were two beating hearts inside of my womb. My womb that would be cut open in two days time. The two beating hearts would be taken out of me, and the two identical people I had given life to would begin to exist outside of my body.
It was time. I wasn’t sure if I was ready, but it was time.