Thursday, July 29, 2010

Mom to Nicholas, February 1st, 2008, lived for one hour
Sophia, February 16th, 2008, lived for five minutes
and Alexander, November 23rd, 2009, lived for five minutes
Harleysville, PA

After nearly a decade of infertility, I was diagnosed with Polycystic Ovarian Syndrome (PCOS) and treated with ovulatory drugs to facilitate getting pregnant. On our first medicated cycle, we conceived our twins, Nicholas and Sophia. My pregnancy was textbook; and, joys of all joys, we found out we were having a boy and girl at thirteen weeks.
Three weeks later, our world collapsed. After a relaxing day, I was making dinner when I doubled over in pain. Feeling the need to go to the bathroom, I sat down and, almost instantly, delivered my son, Nicholas, into my hand. He was moving, and, as my husband called 911, he reached for his father's finger, wrapping his tiny hand around as much of his father as he could.

Within moments, the EMTs arrived and did their best, and, at the time, the thought that my sweet little boy could die never crossed my mind. In retrospect, I know that sounds insane, seeing as he weighed a little over an eighth of a pound and was the length of an ink pen. But he was moving and breathing; surely that meant they could save him. The Fire Department Chaplain had heard the call of a woman in premature labor and had responded as well; on that cold, rainy, February night, he collected water in a used coffee cup and baptized my son shortly before we were airlifted to Children's Hospital.

While in the Medevac, the EMT gave Nicholas an APGAR of 2 and, as we touched down in Philadelphia, 12 minutes later, my son died en route to the emergency room. Laying on the gurney as doctors who were used to working with children tried to stop my labor and stabilize me for transport to the hospital next door, that kind EMT appeared and when I asked, as I had for our entire time together, if my son was alright, I saw a tear roll down his cheek. He closed his eyes and shook his head no, before he touched his forehead to mine. I can still remember my sharp intake of breath... The knowledge that my firstborn son was gone... That my son had died... I couldn't breathe; I couldn't even begin to catch my breath. The doctors and nurses continued to their work, as I watched a nurse explain to my husband that our son was simply too young to save. She wrapped him in a blanket and I saw Peter clutch that little bundle to his tearstained face.

How? How could this happen? I had had a perfect pregnancy; my scans were outstanding. My cervix was "beautiful" and long. Hadn't I paid my dues, with a miscarriage early in our marriage followed by 9 years of infertility, and medications to even conceive? I'd followed every recommendation from what not to eat to how to sleep. I never missed a prenatal vitamin or doctor's appointment. I ate organic food. So why? What happened?

Our OB had no real answers. My pregnancy had been textbook since conception. There were two options; either I simply couldn't carry more than one baby or my cervix had prematurely dilated for no reason. And then, sometimes, women lost their first second trimester pregnancy just because... and then went on to have perfectly healthy, normal ones. But, he insisted, we would be proactive "the next time" and place a cervical stitch called a cerclage. His specialty was a Shirodkar, which he felt would bring me to viability and beyond.

Three months later, we were blessed with a pregnancy that, heartbreakingly, wasn't meant to go beyond the first eight weeks. After one missed cycle, we conceived our son, Alexander, and opted to keep our pregnancy a secret until the cerclage was placed. But as our ultrasounds progressed, we were given the news that the risk of miscarriage from the cerclage would be 50% because of how low Alexander had implanted and based on the partial previa of my placenta. Weighing our options, we decided on ultrasounds every 2 weeks and to postpone the cerclage until the risk factors had decreased. At my 16 week ultrasound, things looked good; my placenta was migrating into a more advantageous position and Alexander was playing soccer with whatever internal organs he could find. I finally breathed a sigh of relief; we had crossed the threshold of Nicholas's birth. We would be alright. I would have the surgery (if it was even needed) and Alexander would be an Easter baby.

Three days after that ultrasound, I was admitted to the hospital for premature dilation. The following day, my water broke. But Alexander was a fighter; it wasn’t until I had a placental abruption two days after my water broke that he had no choice but to enter this world too premature to survive. Having lived through this twice before, we asked the nurses and on-call doctor to leave us alone and to let us birth naturally and together. A priest was called, and he prayed over us. We took our last family nap together. And, a few hours into seventeen weeks, Alexander made his entrance into the world as his sister had, as Peter delivered our second son. He was breach and his feet kicked out first; after three pushes, he arrived in a perfect, peaceful birth. He kicked and his little shoulders moved back and forth as he stretched his limbs. A kind nurse we had called baptized him, and, as they wrapped him in a blanket, his little arms slowed and his muscular legs relaxed. By the time he was placed in my arms, he had drifted off to sleep, never to wake again.

We spent the morning, napping as a family... knowing that we would leave the hospital with a memory box instead of a baby. Peter's parents came later in the morning to see their youngest grandchild, and our priest drove up after Mass unexpectedly, as our son was being prepared and delicately wrapped for the undertaker. He prayed over him and comforted us in our grief while we prepared to leave the hospital. After a bout with postpartum eclampsia, we planned our second memorial service and prepared to introduce our third child to family and friends, as we asked them to say good-bye.

At my postpartum appointment, we made the decision that, should we get pregnant again, we would place the stitch at 11 weeks, regardless of the risks, and follow it with strict bed rest. In addition, I would take weekly 17-alpha hydroxyprogesterone injections (also known as P-17 shots), to try and prevent a premature rupture of membranes. My doctor was devastated that we had delivered Alexander early and vowed to do whatever he could do to take us beyond 24 weeks in our next pregnancy. We gave him the chance six months later. After a 6-weeks miscarriage, we conceived our second set of boy/girl twins. I resigned from work at ten weeks, and had the stitch placed at 11 weeks. Immediately I went on bed rest, but, at my 20 week ultrasound, fundal pressure caused part of Bobby's water bag to slip below my cervix which, even with the stitch in place, had dilated to one centimeter. I was admitted to the hospital, placed on inverted bed rest to relieve the pressure from my cervix, and told by the nurses and residents to prepare for another severely premature delivery. And my twins were born premature. But, in addition to being a face of loss, I am also a face of hope; after 7 weeks of hospital bed rest, my 27-week twins were born with a 90% chance of survival and health. They were taken to the NICU, where they spent the first two months of their lives on earth, before coming home without assistance of any kind. Their initial follow-ups showed them in the developmental range of their birth age. At nine months old, our son, Bobby, was 30 inches long and 20 pounds, and our daughter, Maya, was 24 inches long and 15 pounds. Both behaved like full-term 9-month olds. And both continue to bring new days of sunshine into our lives.

But no child replaces another, and Bobby and Maya can't fill the voids left by their older siblings. Nicholas, Sophia, and Alexander will always be missed; there will forever be gaps in our family photographs. Our laughter will never quite be what it was before and our arms will never be full enough. But they are a balm to the raging wounds in our souls; their little hands hold the shattered pieces of our hearts together. And they give us the desire to live on, to make a life on this earth that their older siblings would be proud of.

This isn't the way we thought our lives would be, but we wouldn't give up the opportunity to have known all of our children for anything in the world. And, if this is the only way we could have had all five of them, then we will take that and be grateful for every second we've had the privilege to be their parents.
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Dana said...

This is have been through so much. I am so glad you got your rainbow twins and they are doing so well.

That EMT who cried and touched his forehead to yours...I wonder if he knows what a difference he made by showing how much he cared and was affected by what happened. I love hearing stories of rainbow babies and of medical staff who really cared.

one-hit_wonder said...

i didn't know the whole back story, michelle. wow.

Jo said...

Even though I know your story and follow your blog, it still makes me bawl to read this.

I'm thinking of you, and ALL of your babies, today.


Anonymous said...

Beautifully written, and so very heartbreaking. I couldn't help but cry too when you talked of a tear rolling down the EMT's cheek. How wonderful to have someone that truly cared. Thinking of you and your babies.

Once A Mother said...

beautifully written and so, so powerfulxx

princessputter said...

Michele I follow your blog have for quite sometime.. still I cried reading this.. Thank you for sharing this

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