I’d like to apologize, dear readers, for it’s been a month since I posted anything on my little blog. You see, I’ve been working on something else…
About a week prior to Thanksgiving, I had started feeling…different. I felt I might be pregnant, but I knew it was too early to get a positive test. Still, I was certain. I just knew. Finally, the day after Thanksgiving, I got a very faint line on a pregnancy test, confirming my suspicions.
On December 18th, I went to see the newest midwife with my midwife group. When she palpated my uterus from the outside, she said it felt like I was 10 weeks pregnant. That couldn’t be right? I thought I was more like 6 weeks, if that. She sent me for a dating ultrasound. My mother was with me, and we were both excited to see the tiny baby, even though I knew they don’t look like much that early.
As the technician started up the ultrasound, I thought I caught a glimpse of two small white blobs on the screen. I had a split second thought of, “Huh? Two?” But then she moved the wand and there was only one. “Whew,” I thought. “It must have just been the baby and the yolk sac.”
But then she moved the wand again, and said, “Oh look, there are two!”
My mom and I both shrieked and started exclaiming things. I think I may have blurted out, “shut up!” but I can’t be certain. Haha! As the technician moved the wand again, she showed us each baby’s perfectly beating heart, one at 130 beats per minute and the other at 135. At this point I had gone into complete shock, my hands frozen in place up by my face, completely speechless. My mind was whirling a mile a minute. “OMG TWO BABIES?! What would Jacob say? We will need to move into a bigger place. Oh goodness, I will have 5 kids! OMG OMG OMG…” But I’ll be darned if I wasn’t mesmerized watching them on the screen. It was a miracle! There are no twins in my family. How could this have happened to me?!
I’m not certain of the exact order that the next things happened, again, I was in a state of total shock. At one point, they called the midwife I had seen into the room to show her. She laughed and said, “well, that explains your 10 week uterus!” Then she regretfully informed me that I would not be able to see their midwife group through this pregnancy, since they do not handle multiples. That was panic-inducing, since I have been with this midwife group for all three of my kids, and I don’t deal well with change (to say the least).
Then, at some point, they went and grabbed Beth, my favorite midwife who has been so special to me through all three of my other pregnancies. Beth was very excited for me. I told her I was sad that I would not be able to see her, and she recommended an OB through their practice, one Dr. Northshore (later, all I would remember is that his name was two syllables and contained a direction, LOL). She said they refer to him as “the midwife OB” because he is more natural-minded, like the midwives. I said he sounded perfect. So, they went and grabbed him too and brought him in. It was like a party in the ultrasound room at this time, except I was still in a state of high anxiety, barely breathing, yet, as always, staying poised and appearing “normal.” They said they’d never seen anyone so calm after hearing news of multiples. Oh, but I wasn’t calm. No, sir. I was freaking out inside. TWO BABIES? WHAAAAAT?!?!
Dr. Northshore put me somewhat more at ease. He had a gentle bedside manner, and I could tell right away he was kind, empathetic, intelligent, and witty. He would be perfect.
He explained that my twins would be identical. Fraternal, or di-di twins, appear different on early ultrasounds. In that case, you’d see two separate black spaces, with a baby in each one. Mine were clearly sharing the same space (or chorion). What we weren’t able to tell yet, is whether they were mo-mo or mo-di twins. Mo-mo twins share one amniotic sac, which is extremely risky because their cords can become entangled, killing one or both babies. The survival rate of mo-mo twins is only 50%. I already knew all of this, since a close online friend of mine had recently given birth to (healthy, thankfully) mo-mo twin girls. She’d had to go inpatient in the hospital for the last couple months of her pregnancy. I couldn’t imagine leaving my family to live in the hospital, being on continuous monitoring and hoping my twins survived. I was terrified of having mo-mo twins! I was sent on my way, with instructions to come back right after Christmas for another ultrasound. They would look again for a membrane separating the babies and hopefully have an answer as to the mo-mo/mo-di question. I left the hospital in a daze. Had this just really happened?
On the way home, I debated how/when to tell Jacob. He had worked nights the night before, had come home from work in the morning and stayed awake so I could go to this appointment, which had taken an hour longer than anticipated. At this point, he had been awake from more than 20 hours, and was exhausted. I knew if I came home and dropped the twin bombshell on him, he would not be able to go to sleep. I decided to wait.
When I got home, Jacob was indeed exhausted. He said he was going straight to bed. On his way down the hall, he paused, and turned back toward me. “How was your appointment? Did the baby look good?”
“He said BABY. Singular,” I thought deliriously, almost bursting out with laughter. I hesitated and said in a strained voice I barely recognized, “Yes, everything was fine. I’ll tell you all about it later. Goodnight!”
I proceeded to spend the rest of the day googling, obsessively reading all about the different types of twins, and trying to process what had happened. Luckily, I had an easy evening with the kids, who all went to bed early without a fuss.
When Jacob woke up, we finally had time to spend together. He asked, “Is there anything else you want to tell me about your appointment? You seemed weird when you got home.” I hesitated and said, “Um….yes?” He asked, “What? Twins?” I said again, “Um…yes?” He exclaimed, “You’re joking!” I showed him the pictures. He was happy, hugged me, and said this was wonderful news and everything would be just fine. Thank goodness for Jacob. He’s such a good man. 🙂
Somehow, I made it through Christmas. Morning (all day) sickness was in full force. I was still stressed about the mo-mo twins possibility. The holidays are difficult for me in general: the change in our typical routines, all the social events that I’m obligated to attend, it’s all just very hard for me. I think I have a harder time than my kids, even! But somehow, I made it through.
The Monday after Christmas, I went back to the hospital for another ultrasound. I kept picturing only one baby popping up, and hearing that there had been a mistake. But no, we saw two perfect little ones again. They had grown so much! We saw their two hearts beating away again, this time up to 165 and 170 bpm. And – best of all – we could easily see that each baby was encircled by its own amnion. This meant they were confirmed mo-di twins, which are still high risk but not nearly as risky as mo-mo. That was a huge relief! Here are my pictures from that ultrasound. The babies were 7 weeks 6 days based on my due date, but they were both measuring 8 weeks 2 days.
Shortly after that, I had another opportunity to take a peek at the babies, only on a portable ultrasound machine this time. They had grown a lot more, and the baby on the left was moving! I could see his/her arm buds waving at me. The baby on the right was just chilling or sleeping. Two perfect hearts beating yet again.
So, that’s my twin story, so far. I will be utilizing this blog to chronicle my twin pregnancy journey, so expect many more detailed updates and ultrasound photos. I will be monitored very closely by my wonderful OB, Dr. Northshore, and also a Maternal Fetal Medicine doctor (special high risk pregnancy doctor), whom I have not seen yet.
There are serious risks with monozygotic (identical) twins, the main one being Twin to Twin Transfusion Syndrome. This is something that occurs in 15-20% of monozygotic twin pregnancies. The problem is that the two babies share the same placenta, and as Dr. Northshore quipped, “babies don’t tend to share very well.” Blood vessels can be unevenly distributed amongst the two babies, and what ends up happening is that blood gets taken from one twin (called the donor) and ends up as an excess of blood in the other twin (the recipient). This can lead to a whole host of problems for both babies, and is often fatal to one or both. Here is a link to information about Twin to Twin Transfusion Syndrome (which you will see me refer to here as TTTS).
Another possible complication that I may experience is due to an issue with E antibodies in my blood. I tested positive for E antibodies in the routine blood work I had done at my first midwife appointment. What this means is that if the babies have E antigens in their blood, my immune system could attack the babies’ blood. The main risk with this is that the babies could be born with anemia or have severe jaundice. My blood will be tested once a month throughout the pregnancy. Right now my E antibody level is at 1:1. If it stays low, there is most likely no reason for concern (although I have read case studies of mothers whose number remained low and their babies were still born severely anemic). If my numbers rise above 1:16, then there is serious cause for concern. At this point, I am choosing to push this potential issue out of my mind, as it’s completely out of my control. I’m just hoping my numbers stay nice and low.
As you can see, there are many reasons for me to worry throughout this pregnancy. Carrying twins (especially monozygotic ones) is a whole new ball game. All I can do is be as healthy as possible, trust my medical team, and hope for the best outcome for my babies.
I will post another update after my next appointment, which is with the MFM on January 28th.