Tuesday, October 5, 2010

Mom to twin boys
Jonah Harrison, Born and died February 5th, 2010
and Noah Daniel, Born and died February 10th, 2010
Fort Worth, TX

Here’s my story of the pre-term births of our twin boys, Jonah Harrison and Noah Daniel, born 2.5.10 and 2.10.10 due to an unforeseen complication called incompetent cervix.

After experiencing severe nausea and morning sickness the first 17 weeks of my twin pregnancy, I had little energy or urgency to prepare for their arrival. I was told multiple times to make sure to start early since I would start feeling badly in the 3rd trimester. On the afternoon of Thursday, February 4, I experienced a severe urge to get things together for them. I asked for suggestions on a message board of the boring things I could buy for myself that I maybe wouldn’t get at a shower. I got home and tore apart my kitchen with the notion of reorganizing and deep cleaning. I even posted it as my Facebook status and many people commented that I was “nesting.” Apparently there’s some truth to the old wive’s tale. I only worked for about 20 minutes before I started feeling very badly. I was having some cramping (felt like gas pains), an increased urgency to urinate, and lots of mucus discharge. I tried to lie down after dinner to see if it would help me feel better, and at about 10 pm I experienced bleeding. I screamed for my husband and we were on our way to the ER. In the car on the way, the pressure feelings got worse and more timed. I still wasn’t aware that I was having contractions, as this was my first pregnancy.

In the ER, I was immediately hooked up to an IV with fluids, given some morphine and Zofran and had an immediate ultrasound. The ultrasound showed that Twin A’s amniotic sac was bulging and that I was 2 cm dilated. In other words, I was going into premature labor. The ER doctor was not hopeful and said we needed to “let nature take its course.” A second doctor, an OB/GYN, came in and said we’d give it the “old college try” and invert a bed (trendelenberg position) and see if gravity would help get the baby to push back up where he was supposed to be and pray that my cervix would close on its own. I was wheeled to labor and delivery and immediately hooked up to a magnesium sulfate drip. It was to help with the contractions, and it’s the strongest medicine available to stop them. I had to sleep with my head low and my legs above and see if it would work. Hourly, I had vital checks (blood pressure, oxygen, contractions, etc) and every 6 hours I had a blood draw to check the level in my blood to make sure I wasn’t getting too much. By the end, my veins were blown and my arms looked like those of a heroin addict. They had to start using the veins in my hands, which was super painful. Thursday night was incredibly terrifying but we were hopeful that we caught it in time. On Friday morning, I had another ultrasound that showed that I was 10 cm dilated and ready to deliver. Around 11:30 am, on 2.5.10, our first son Jonah Harrison was born at 17 weeks, 4 days. He was so tiny (about 8” and 6 oz) but so perfect. He was beautiful and perfectly formed. Our pastor made it in enough time to baptize Jonah before he passed. Jonah lived for less than a minute, but he made such a huge impact on so many people. My husband took one picture, however awkward it was at the time, but it will be treasured forever.

After this devastating event, we still had hope that we could save Twin B (whom we didn’t have a name for). The plan was to try an emergency surgery called a transvaginal cerclage that literally sews the cervix closed. I was quickly taken to an OR to perform the surgery under general anesthesia, but it was unsuccessful. The doctor saw what she thought was an infected placenta, and stopped the surgery. She sent the pieces to the pathology lab to determine what it was, cleaned everything out and waited. The ultrasound the next day showed that although our doctor thought she saw infected placenta, both placentas were actually fully intact. Everyone was confused, and the hope was that we could get back in and try the cerclage again if I made it a few days without infection. It also showed that Twin B was definitely a boy, and so in the midst of a long night of hourly vital checks and painful needle sticks, I yelled out “Noah Daniel” to my exhausted husband as a name for Twin B. It gave us hope to name him and refer to him not as Baby B, but as our little Noah. At this point, the worry was infection. Jonah’s placenta was still intact and his umbilical cord had been sewn closed and put back inside my cervix. For the next few days, I was monitored for infection and at one point was transferred from labor and delivery to an antepartum unit to be with all the other bed rest ladies. It felt like a graduation to me. Unfortunately, my stay in the little room didn’t last long, as I started having regular contractions again around Tuesday, so I was moved back to labor and delivery with another round of magnesium and trendelenberg. Our spirits were low yet again. My body was trying to reject the placenta and Noah. 
My doctor assured me that I needed to pass the placenta to avoid infection, and that ideally, the placenta would come but not Noah. Again, we held out hope that this would happen. I had an awful night Tuesday night with painful contractions. At this point, I had been taken off magnesium and allowed to sleep somewhat normally. All day Wednesday I was actually feeling much better; I had a lot of visitors, and was in good spirits. Around 5:30 in the evening I started feeling more contractions and was using a marker (button) to time the contractions on the computer so the nurses could see how far apart they were. At one point, my doctor told them to make me stop timing them and stop stressing, that whatever was going to happen was going to happen. At 11:15 pm, the contractions were about 3-4 minutes apart. At around 11:30, I had 3 incredibly strong ones, and my water broke. We screamed for the nurses, called our family and pastor, and prepared for the birth of our Noah Daniel. At 18 weeks, 2 days, he was born at 11:48 pm on 2.10.10 and was immediately baptized by his father. While his cord was still attached and he was lying down near my legs, I could feel his little kicks, letting me know he was alive. He lived for quite a few minutes, so we got to enjoy him during his short stay. I won’t go into detail about the delivery of both placentas, as it was the most painful thing I had to endure the entire week, but thankfully, both were removed naturally and I was able to avoid another surgery that could have scarred my cervix. Just like his brother, Noah was unbelievably perfect and so beautiful. This time my husband was prepared and we got lots of pictures and although incredibly difficult, celebrated the miracle of this little life and his birth and baptism.
I am currently 14.5 weeks pregnant with a singleton and elected to have a transabdominal cerclage (versus a traditional transvaginal) placed in-pregnancy.  It was performed at 10w6d and it has given me a bionic cervix.  The success rate is in the high 90% for full-term births.  For more information, see my blog (pregnancy mentioned) or join Abbyloopers.org.


Danelle said...

Hello Trisha. Thank you for sharing your story. I delivered my triplets on June 2, 2010 at 23 weeks due to an incompetent cervix. I gave birth to two boys and a girl. On day 3 and 4 I lost my boys, Elliot and Gabriel, to severe brain bleeds. I am fortunate enough to have my daughter, Gemma, with me today. She is still in the NICU fighting. I am so sorry for the loss of your sons. I feel your pain and sadness. I wish you nothing but the best with your new pregnancy!

Trisha said...

Thank you Danelle! Your words mean a lot. I'm sorry for your loss as well but happy you are mom to a living baby girl. (((HUGS)))

Anonymous said...

Hi Trisha,
Thank you for sharing your story. I am a true testament that yes, cerclages do work. I had 2 losses due to IC, one at 19 wks and one at 22 wks. The worst worst times of my life. I decided to try again, and this time I had a stitch put in at wk 13. My daughter is now 14 months old, healthy and happy. So there is hope for you.

Danielle- hugs to you, and I pray that your little girl keeps getting stronger... Lord be with you.
Thanks ladies,

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