"Twin B" . . . Some Sad News

It has been just over two weeks since my last post, and I feel like so much has happened . . . I haven't done a great job of keeping track of everything, but I'm chalking that up to feeling pretty crummy both physically and emotionally. Up until about a week ago, hormones were making me feel like I was always on the verge of taking someone's head off. That combined with feeling extremely tired and being nauseaus off and on every day kept me away from posting. Who wants to complain about how bad they feel when at last, what one most wants has finally happened?

Even with feeling way below my game, I was so, so overjoyed to be pregnant--and with two. What a miracle above and beyond what I thought would happen to us. The first few weeks after finding out I was pregnant were pretty anxiety-ridden, but as each week progressed and I had no symptoms beyond what I have been experiencing with the progesterone injections from the beginning, I began to think we were out of the woods and that this was really going to happen.

Michael had been talking about finding a "new-to-us" car for our soon to be growing family and sooner rather than later, since we figured with twins, I would soon be too big to easily get in and out of our little Civic. We talked about the most vital pieces of baby equipment we would need: the double stroller, at least two car seats, the diaper service, etc.

I continued to talk to the embryos every day, wrapping them in light and love, telling them to "keep growing strong and healthy," assuring them that I could handle all the pregnancy symptoms coming my way. I listened to my pregnancy meditation nearly every day, and held and kissed the little flannel heart that my friend Carrie made for me before we'd even found out for sure that I was pregnant. What a beautiful gesture that was--I'll have to post a picture of it because it helped (s) me so much in feeling connected to the growing life in my womb. I think it would be wonderful for all women going through fertility treatments to have something tangible like that to hold until their flesh-and-blood baby is in their arms. Stitched inside the flannel heart are two smaller hearts, symbolizing the two embryos wrapped in the cocoon of the womb. They can't be seen, but their outlines can be felt with the fingertips. I got in the habit of listening to my meditation in bed, with the flannel heart pressed against my heart, and in that way, feeling close to those little loves.

Beginning last weekend, I began to have a funny kind of feeling that reminded me of a hint of a urinary tract infection. There weren't any really strong symptoms that would immediately warrant getting checked out--just here and there a different kind of twinge or low pelvic pressure than what I had been experiencing. I chalked it up to anxiety and decided to just watch and see how things progressed--if it got worse, I would get tested.

The week before I began to have the strange feeling, I started calling around to see where I could go for prenatal care. I really wanted a midwife, but from what I could find out, the only way that this could happen would be to have the babies at home . . . apparently, midwives (even certified nurse-midwives who have western medical training) are not allowed to care for women carrying twins--at least in a birth center or hospital setting.

It was quite a conundrum for me because ever since serving my friend as a doula at the birth of her little boy over three years ago, I knew I wanted as natural of a pregnancy and birth as possible. But even before getting pregnant, my idea was that I would give birth at a waterbirth center--not at home. I knew that many, many women have had successful labor and births in their homes and say they wouldn't trade the experience for anything, but for me, it felt more comfortable to be in a birth center setting. So it was pretty obvious that I was not going to seek midwifery care with the twins and have them at home. I just wasn't comfortable taking the risk of something not going smoothly and having to get to a hospital quickly since we live several miles away from the nearest one.

I got a recommendation from a friend for the OB she had had with her adorable little girl, and I made an appointment for an initial consultation before beginning care. I wanted to meet him and make sure our relationship would be "a good fit." It was important to me to still try to have as natural a birth as possible with twins, and to at least have a doula in the hospital with me since I wouldn't be able to have a midwife.

I met Dr. Stempel last Monday and we had quite a long chat. At first I wasn't so sure if I liked him, as his bedside manner is a bit more "professional" than nurturing, but by the end of our visit, I could tell that he is kind and that his first concern would be my safety and that of the twins, while his second priority would be my birth experience. He said that some OBs won't even let a woman attempt a vaginal delivery with twins--they think it's too risky and just schedule a c-section. He said he was willing to see how things went and that if all looked really, really well, to proceed with a natural delivery, but that I would need to understand that things could change very quickly and I would need to trust him to tell me if and when an intervention needed to happen. I told him that I agreed--safety was my main concern--hence the reason I was sitting in his office in the first place. After more discussion about vitamins and supplements, he told me to come back in 2 weeks and I would have my first ultrasound since the one at OHSU. I would be nearly 11 weeks along by that point.

I made the appointment for September 30th and hoped I would be able to wait the nearly three weeks to find out how things were going, as waiting is not my strong suit. But as I said, I had already begun to feel a strange feeling off and on and by last Thursday it really felt like a UTI was brewing. I called and got an appointment for the following day. Dr. Stempel wasn't available but I was able to get in with a colleague of his, Dr. Prescott.

Friday morning I headed off to the appointment feeling slightly foolish--figuring I was worrying over nothing and that I probably shouldn't have called at all. Still, I didn't want to take a chance with anything--not after all we have gone through to get to this point. I figured it would be a simple pee test and then I would be on my way to work, maybe with a prescription for antibiotics, maybe with instructions to get some unsweetened cranberry juice and stave off any pending infection that way.

I didn't have to wait long at all before being shown to a room where an assistant took my vitals and asked me about my symptoms. I peed in a cup as expected and then Dr. Prescott came in. He said that my urine looked clear but they could still send it to the lab, although, being Friday, they wouldn't have results until Monday. I told him that was fine--that I wasn't in any huge amount of discomfort and that it was just an odd feeling I'd been having. He asked more questions about the pressure and I also told him that I felt like I always had to use the bathroom--even after I had just emptied my bladder. I think that was what was making me lean toward the idea of it being a UTI more than anything else. He seemed like he couldn't make up his mind about something, kind of heming and hawing for a few seconds, then said, "I bet it would make you feel better to see those heartbeats." I was surprised, as I had not expected to be offered an ultrasound as part of diagnosing an infection, but I wasn't averse to the idea. Although by this point I was feeling fairly confident in the pregnancy because of the absense of any bleeding or heavy cramping, I thought it would still be nice to have the reassurance of checking on the babies.

The doctor wheeled in a small ultrasound machine and did the test himself, using a transducer very low over my uterus. There was quite a lot of pressure, which was a bit worrisome to me, but I figured he knew what he was doing. The picture on the screen was pretty fuzzy, but after a few seconds, he was able to show me the beat of one embryo's heart. Then there was more pressure as he slid the wand back and forth across my belly. He didn't say anything and I tried not to be concerned. Then he turned to me and said, "I can't find a heartbeat on this one." Needless to say, I was stunned. How could that be? I had been so focused on the fact that I hadn't had any miscarriage symptoms that it hadn't even occured to me that one of them could just stop growing.

Dr. Prescott said they could squeeze me in with their ultrasound technician and do a transvaginal ultrasound in order to more clearly see what was going on. He asked if I wanted to call someone. I said that no, I would wait until after the second ultrasound as I didn't want to alarm Michael over nothing. He left the room and I curled up on the examing table, trying to hold it together.

"Please God, let him be wrong," I whispered over and over, hoping that by saying it aloud, it would prove true. I just couldn't believe that this could be happening. It had to be a mistake.

After about ten minutes, the ultrasound tech came to get me. We went to the room with the big ultrasound machine and I hopped up on the table. At first she just had me pull my pants down a little and used the transducer over my abdomen, but I think it was just to see how full my bladder looked. She sent me off to go pee and when I came back, had me undress for the transvaginal test.

When she came back in the room, Dr. Prescott followed her and watched as she checked the first embryo. I could see its heart beating, but they did not turn on the sound. The doctor said the embryo measured just the right size for almost nine weeks gestation. Then they looked at the second embryo, "Twin B," as I later saw it was named on the screen. I was struck by how different the embryos looked after only two weeks since our diagnostic ultrasound. Then they were mostly just dark circles on a screen. Now they looked like tiny babies, with their heads curled to their chests and tiny arms and legs forming. I could not see any heartbeat on the second embryo, but that had been the case at OHSU as well--Dr. Lee had seemed to lock and unlock the action showing on the screen, so I just waited to see what they would say.

The ultrasound tech measured the second embryo and hovered over its chest with her cursor. Then Dr. Prescott turned to me and said, "I'm so sorry but there's no heartbeat. I'm sure."

Of course I was completely devastated and started sobbing on the table. The tech left the room and the doctor wrapped his arms around me for a few seconds. He had told me after the first ultrasound that this kind of thing happened all the time in twin pregnancies and that it wasn't anything I did. Now I asked him if exposure to chemicals could have caused it (the first thing that popped into my mind), and he said that no, if that had been the case, neither of them would have made it.  He also said that the second twin was slightly smaller than the first and I asked if that meant everything had just recently happened. He said yes.

I just couldn't wrap my mind around what was happening. The doctor let me get dressed then led me to an empty office and told me I could use the phone to call someone if I wanted. I just used my cell and called Michael. I asked him to tell our boss that I wouldn't be coming in today and told him that one of the embryos had stopped growing. I couldn't bring myself to say the word "died." He didn't say very much in response--probably just as shocked as I was. He said he had planned to come home anyway because he had caught a bad cold and it was getting worse.

I left the office after that call, stopping at the front desk to ask the receptionist to thank the doctor and the ultrasound tech for me. In my peripheral vision I could see that the waiting area had filled with more pregnant women. I could not look at them. I left feeling like I was back at square one--back where I'd been going through fertility treatments: scared, hopeless, alone. I kept telling myself I was still pregnant, but it didn't feel that way. I felt a tremendous sense of loss and grief for that tiny still form on the ultrasound screen, who had been alive inside me and now suddenly was not.

When I got to the parking garage, I sat in the car and called my mom. I cried and she said she was so sorry, but that maybe it was a blessing in disguise. Maybe I would not have been able to carry both. I know she meant well, but those were not the words I needed to hear right then. Honestly, I don't know if anything would have really helped. Only, "We made a mistake. Your baby is fine." Other than that, there wasn't anything that could have comforted.

I drove home in stunned shock. I can't even remember now if I was crying. I do know I missed my exit and ended up in farm country out in Hillsboro. Eventually I found my way back to a main street and made it home, but I was definitely out of it.

The house was quiet when I got home and I figured Michael was upstairs sleeping. I wasn't sure I was ready to face him yet anyway. I talked with my best friend and told her how unfair it was, how angry I was and how I just could not understand why this particular aspect of my life (becoming a mom) has to be so difficult. I told her that now I am terribly worried about the other embryo. What if it too stops growing? What will I do? The doctor had said when this happens usually it means there was something wrong with the embryo--the egg or the sperm didn't have the right number of chromosomes and so the heart just stopped. I wondered if this meant my eggs were too "old" and that my other little embryo would not make it either.

Mostly I grieved and I am still grieving. It is a feeling I can't even describe to you--feeling the loss of a tiny child whom I already loved; at the same time knowing there is at least for now, another living child still there, depending on me to be strong. I cannot completely fall apart, but I am close. I ask God why, and there is no response. I do not know what lesson I am supposed to learn from this, or if there even is one. More and more I think it is just Life, in all its unfairness and impartiality. Just as in gambling, some people are luckier in life than others. And at least in this aspect of my life, I feel that I am one of those poor souls who have invested all they had, lost a sizeable part of it, yet are still at the table playing.