In my feelings

[I started writing this post a month ago but never finished or posted it. I was going to delete it, but reading it again today, I realize it is still relevant; the first two feelings not as strong, just more nuanced with time.]

guilt:
[gilt]
noun

  1. : feelings of deserving blame especially for imagined offenses or from a sense of inadequacy :self-reproach

Everyone says not to blame yourself for things like this. There was nothing I could have done, they say. There was no way to prevent it, they say. Logically, scientifically, I know this to be true. But it does not remove the feelings of guilt I have around delivering so early. When I look at my tiny babies hooked up to monitors, watching them get poked and prodded regularly, I feel guilty. They are in this situation because of me. If only I could have held them in longer. If only my body had done what it was supposed to do.

envy:

[en-vee]
noun, plural envies

  1. : painful or resentful awareness of an advantage enjoyed by another joined with a desire to possess the same advantage
  2. : a feeling of discontent or covetousness with regard to another’s advantages, success, possessions, etc

It is amazing to me how the sight of a belly bump can bring such longing. I am simultaneously happy for the person possessing it, and envious that they have one and I do not. While it the desire grows weaker as time passes, it does so slowly. I am envious of strangers. I am envious of friends and acquaintances. Envious because I should still be pregnant. Envious because I miss the movements, the kicks, the turns, that I should still be experiencing. Envy feels very ugly to me. I do not want the feeling. I try to pretend it’s not there when I interact with people who are pregnant. I wish it would go away and leave me be. But it seems content to sit with me for the time being.

love:

[luhv]
noun

  1. : a profoundly tender, passionate affection for another person
  2. : a feeling of warm personal attachment, or deep affection, as for a parent, child, or friend

Making daily trips to the hospital, spending hours by their bedsides, looking into their little faces or holding them in my arms. Going home with them on my mind…Clichés hold true when I say I have never felt such love. This love is amazing to me. It is the most precious thing. My love of these two tiny humans…it is what keeps me going when things seem so difficult.

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26 weeks, 6 days

After three weeks in the hospital, three close calls of going into preterm labor, three rounds of magnesium sulfate for 12-24 hours each, and one more steroid shot for the babies’ lungs, I went into preterm labor officially at 26 weeks and 6 days. The contractions had come back and I could feel finally feel them, and feel them pretty consistently. My water had broken a couple days prior, so it was only a matter of time.

The whole thing was surreal. I’d had a feeling that the time was coming. That as much as I wanted to make it to 40 weeks, or even 34, something in me knew they were coming before that. But when the moment came I couldn’t believe it. I wasn’t ready. This wasn’t supposed to be the time.

I’d wanted to have a vaginal delivery, but Baby B was breech and, because they were younger than 32 weeks, they would not deliver the baby breech, due to hospital policy. The risk is too great to attempt at that age. Part of me wondered if, after delivering Baby A (who was head down) Baby B would turn around, but the uncertainty was too much for me, especially knowing that if he didn’t turn I’d have to be whisked away for an emergency c-section. After lots of consideration I just opted for a c-section for both of them. That was a hard decision to make, but I felt it was the right decision, and every time I think about it, I’d still make the same decision, given all the variables at the time.

An entire cascade of events happened the morning of the delivery, from me reporting my increased contractions, to finding out I was 7cm dilated, to the actual c-section delivery. It was overwhelming. I was so nervous and anxious I was making myself ill. Luckily I had my midwife, my doula, and one of my friends who had just happened to stay with me that night at the hospital. The three of them helped me come to terms with what was happening, and I found the strength give the go ahead for the c-section.

Given their age, just shy of 27 weeks, we didn’t expect the babies to cry or move much when they were delivered. But when Baby A came out, he came out screaming. Everyone rejoiced and all I could do was cry out of happiness. He sounded so alive. When Baby B was delivered, he screamed as well. Their screaming brought me so much joy and relief. My midwife was crying as well, and reporting to me what was happening with the babies as they were being taken care of and prepped for the NICU. They were moving and kicking and just so full of energy. They were both around 2 lbs (Baby A a little less, Baby B a little more).

They were ok.

In the weeks since, I have thought a lot about 26 weeks and 6 days. Some days I lament the fact that I couldn’t make it farther than 26 weeks and 6 days. That my body wasn’t able to do the one thing I had dreamed about for so long. That I couldn’t carry the babies as long as they needed. Some days I feel like my body failed me and that I failed the babies. Some days I miss being pregnant, especially because I should still be pregnant. I’m supposed to be pregnant right now. My babies should be with me, in utero, not away from me in the NICU…Some days are very hard for these reasons.

Other days I feel like it was a feat that I made it to 26 weeks and 6 days. The fact that after being told at 16 weeks that my cervix was extremely short and that I should be prepared for delivering at any moment…the fact that I made it almost 11 more weeks seems amazing. My body carried those babies almost 11 weeks more than the doctors thought I could. My body carried them to the threshold of viability and beyond. Four doctors, at separate times, told me that what happened was a miracle. That, being honest, they didn’t think I would even make it to viability, which was 24 weeks. That the fact that I was dilated to 4 cm, and stayed that way for almost 2 weeks was completely unexpected. Every time they came to check in on me during rounds they were always so excited and happy that I was still pregnant. They genuinely couldn’t believe it. My midwife, who is honestly one of the most positive people I have ever met, told me that while she hoped I’d make it past when I first entered the hospital at 23 weeks 5 days, she genuinely wasn’t sure how long I would go, that sometimes she was unsure I’d make it much past that. She tells me often that this was my doing – the babies being born at 26 weeks 6 days and not before was all my doing. The babies being born at 26 weeks 6 days and doing well in the NICU was all my doing. Some of the doctors have also told me this. On these days I don’t feel so bad, and actually feel good about things.

So now I am a NICU mom. Transitioning into the role of NICU mom has been challenging, and there is a long road ahead for the babies and me, but I am glad that we made it as far as we did in the pregnancy. For how things could have been, I am glad we made it to 26 weeks 6 days.

It’s complicated

I’ve been doing a terrible job keeping this blog updated at regular intervals. I think I’ll just have to accept that and do the best I can. But, part of the explanation is below.

I’m 20 weeks today. Technically just about halfway there. The babies are doing quite well. Both are healthy sizes and weights and, while they are starting to differ in size, their sizes are still close enough to one another that it’s not an issue.

However, around 16.5 weeks I learned that my cervix had become short. Very short. As in .6cm short, when it should be 3cm or above. At that point the MFM doctor who oversees my ultrasounds (since I was seeing midwives) said she was very concerned, but that, at the end of the day, there was nothing they could do, so I’d have to see what happens. She said if it was a singleton pregnancy they could have placed a cerclage (a stitch in the cervix to keep it closed) but that it was not recommended for twin pregnancies. (I later did some research and ultimately agreed with that assessment, as the risks outweighed the benefits.)

I was pretty devastated, especially because no one really seemed optimistic. The common refrain was wait and see. They did put me on pelvic rest and reduced activities, but there was not much else. They don’t prescribe bed rest much anymore, or rather, doctors are moving away from that unless the situation is extreme because bed rest itself can cause a slew of problems. Granted, once I got to the point where I could do some research, I was seeing that people with my cervix length were being put on hospital bed rest, yet my doctors were not recommending it. The discrepancy in recommendations was disconcerting.

One of my best friends did some research after I called her in tears and found women who’d had cerclage pessaries placed instead of the cerclage. The pessary is essentially a silicone ring placed around the cervix to help hold up the uterus and/or alleviate pressure on the cervix caused by the pregnancy. It is also non-invasive; the cerclage stitch is a minor surgery (and runs the risk of infection), whereas the pessary is just inserted like a diaphragm. So at the next emergency appointment I had less than a week later, I asked one OB about it and he didn’t think it would help, but referred me back to the MFM and she not only thought it was a good idea worth trying, but went ahead and placed it. It was painful to me, as the actual pessary is large, but you don’t really feel it once it’s in.

Emotionally, all of this has been very hard. Learning that there is something wrong, something that you can do very little about, is very hard. Learning that my risk of losing the babies is around 80% given my particular cervix length, is very hard. I try to be as positive as I can, but the reality of the situation is too heavy sometimes. When I told my mother, one of the things she said was that I can’t live in fear, that I can’t live in the fear of it. That has been helpful, but again, I still have my moments. The few people I have told all say some version of needing to be positive and then talk about normal pregnancy things. I appreciate that, but sometimes those conversations are difficult. I know they are trying to make me feel better, but I can’t ignore the reality of the situation.

At my latest appointment three days ago, I learned that my cervix is at about 1.2cm. So the pessary has helped a little. The cervix is still quite short, but it is something, and at this point I will take anything I can get. I am still on pelvic rest and significantly reduced activities. No prolonged standing, no lifting. I can walk around the house, but need to sit as much as I can, laying down is better (though not for too long). They also put me on vaginal progesterone when this started (to support the uterus and prevent contractions), and I still take that.

At those last appointments (I meet with a regular OB and an MFM, no midwives anymore, which is another story) both doctors said that the goal right now is to make it to 24 weeks because that is the point of viability. There were lots of “if we can make it to 24…”, “we want to get to 24…” etc. That hit me really hard. That, and how one of the doctors felt almost 100% certain these babies would be born quite early, again, if I made it to 24 weeks. It’s one of those things where, I recognize the reality of the situation, but hearing it put so plainly struck me, and I’m still dealing with the impact. There is so much uncertainty on whether I will even make it to 24 weeks. With each week that goes by, another hope, dream, and desire for this pregnancy goes out of the window. No homebirth, no midwives, dwindling chances of natural delivery, no normal. At this point I just want the babies to stay in, but instead of hoping for 39-40 weeks, I’m at “let’s just get to 24, anything past that will be a bonus.” The NICU is now very likely to be in my future, and, realistically, it’s likely to be a long stay for the babies, which comes with it’s own risks and consequences, health-wise and developmentally. I just want two healthy babies and it’s not clear whether that will be the case.

I feel them move often. It used to fill me with excitement, but now it is mixed with a bit of anxiety. The lowest baby, Baby A, is very low, and their head is constantly rubbing against what is now the open funnel of the top of my cervix. I was told that the bigger they get and the more they move up against it that the more stress there will be on the cervix. I want moving, active babies, but every time Baby A is very active it makes me nervous. I hate feeling that way.

The rest/reduced activities is hard too, especially because it is just me. I have to rely on others so much more now, and I realize I don’t have as many people as I thought I did. Or maybe I do and I just can’t see it. I don’t know. But simple things like washing dishes, making food for myself, picking up something I dropped, I can’t really do. Cleaning is not often. Laundry is not often. I know in normal pregnancies these actions can become hard, but they are especially hard in this case because of the added stress they place on the cervix. I have to be strategic about which days I shower (since daily is too much) and when I wash my hair because of the prolonged standing. I order food far more often than I used to, which helps in terms of staying off my feet, but doesn’t help my budget that is getting tighter and tighter as I’m still in the process of closing on a condo (which has hit another delay).

I had a fleeting moment where I wondered if I’d made a mistake in not waiting to do this with a partner. The moment was in passing, but it was very real. When you think about having a baby on your own, you know that there’s a chance things might not go smoothly, but I don’t think you think about it seriously, or you do and think you can handle it. I knew there was a possibility things could not go smoothly, but I assumed the chances were small. But here I am.

I’m actually still staying with friends at the moment because of the last-minute condo debacle from two months ago when the last one fell through at the very last minute, leaving me homeless. They have been helping me a lot, but that is not forever. They’re actually out of town currently and all the things I can’t do or need help with seem magnified, and representative of what it will be like once I move into my new place.

I’m fighting the urge to just withdraw from everything and everyone because this situation feels so isolating. I don’t feel like I can talk to a lot of people about it, for the aforementioned reasons. Telling people about the situation also takes an emotional toll on me, constantly recounting the issue. That and, on the flip side, it feels like I’m being a burden when I express concerns about the realistic aspects of this. Some days I’ve considered joining an online forum, but some days I have a hard time reading other people’s experiences. It’s a mix of hope and heavy that I’m not ready for yet, though I feel I would find support there. I’ve read that working on your registry or continuing with baby planning can really help during this time, as it gives you something positive to focus on. I’d started working on my baby registry and buying some clothes around 16 weeks, but both of those have been on hold because they are emotionally taxing right now.

On the flip side of all of this, I am happy that I have made it this far. I’m 20 weeks. A little less than 3 weeks past when I first learned about the short cervix. I’ve made some progress. The babies are healthy. I’m committed to doing whatever I need to maximize my chances. Their chances. Every morning I tell myself that I can do this. Every morning I say out loud that we are all going to make it through this. Sometimes my resolve is shaken and my faith in those statements is thin, but I say them anyway.

So that’s where I am now. Just counting every day that goes by as a success and one step closer to my first goal of 24 weeks.