Twin Birth Story, part 2: The Babies

As I lay on the operating room table listening to the sound of my newborn Baby A (Isabel Hope) crying from across the room, I heard someone say, "Three pounds, fifteen point eight ounces."  Immediately, I knew what that meant.  Isabel would not be staying with me--she would be heading to the NICU because of her small size.  It wasn't long before someone came over to tell me just that.  Before she was taken from the operating room, Isabel was brought to me so that I could "meet" her.  My bundled little baby was still crying, but at the sound of my voice she immediately became calm.  I spoke softly to her and kissed her sweet little face and wished that I could hold her and keep her right there with me.  The unfairness of it all briefly crossed my mind--I am her mother, the one who carried her for nine months and the one who just underwent surgery to bring her into this world and the one who loves her more than any other person possibly could, yet I have no choice in this matter but to stay here on this operating table while my baby who needs me is taken elsewhere.  Man, that was a hard moment; but I had to believe that God's grace would see us through.

Meanwhile, our Baby B (Elliana Faith) had been born and was crying just as vigorously as her sister.  How reassuring it was to hear two strong, healthy cries.  As we had suspected, Elliana was big enough (5 lbs. 10.2 oz.) to avoid the automatic trip to the NICU; but due to her low blood sugar, she would be immediately taken to the regular nursery and given formula.  Again, thoughts of the unfairness of the situation came rolling in.  I am the one who has done all the work, and now I don't get to have either one of my babies.  I hadn't even seen Elliana yet, so I requested that she be brought to me before being taken away.  I whispered to her of my love for her and kissed her soft little cheek, and then she, too, left the room.

I don't remember most of the rest of that day thanks to all the medications in my system, but I do remember that Elliana was able to join Travis and me in our room shortly after I arrived back there.  Her blood sugar would be continually checked every eight hours, and she would continue to receive formula until my milk came in; but she would be staying with me!  And four days later, on June 1st, she would be discharged with me, as well!

Over in the NICU, Isabel, who also had low blood sugar (and zero fat reserves), had been placed on an IV through which she was receiving sugar water to supplement the formula she was taking by bottle.  Each day her IV drip was gradually decreased and her formula intake gradually increased until finally the IV was removed and all her calories were coming from formula (fortified breast milk once my milk came in).  She received some phototherapy for a couple days for slight jaundice and remained in an isolette until she was able to maintain her body temperature in an open crib.  Eleven days after her birth--and one week after my and Elliana's discharge--on June 8th, Isabel was discharged from the NICU and came home to join the rest of her family!

The details of my twins' birth story certainly did not go exactly as I had hoped and prayed, but as I sit here writing this post while holding two beautiful, healthy babies on my chest, I can only praise God for His perfect plan.  I may not understand it, but I don't need to....

Twin Birth Story, part 1: The Mommy

Nine days ago, on May 28th, 2009, our precious twin baby girls were born into this world via planned repeat cesarean section.  Because I was so strongly desiring an attempt at VBAC, we had thought to move this date back another week in hopes of buying more time for me to go into labor.  But when my May 26th OB appointment revealed protein in my urine, my doctor ordered a 24-hour urinalysis to screen for preeclampsia.  The deal was that if I passed the urinalysis, I could have another week.  But if not, we would keep the May 28th cesarean on the books.

Travis and I went home from that OB appointment praying that the results of the urinalysis would provide a clear indication of whether or not we should prolong the pregnancy.  When the results came back the next day, we recognized that our prayer had been answered.  I believe the doctor's exact words were, "Angela, you have way way way way too much protein in your urine.  These babies need to be delivered."  With a surprising amount of peace, I responded, "Okay, we'll see you in the morning."

With about 16 hours remaining before the time of my scheduled cesarean, I continued to believe that God would cause my labor to start within that time if it was His will for me to avoid the surgery.  Despite my fears about the surgery itself, I knew that I needed to trust in Him.

That night I managed to get about three hours of sleep.  My restlessness wasn't so much due to anxious thoughts as it was to the discomforts of being 37 weeks pregnant with twins.  At 4:30 a.m. I finally accepted the fact that I wasn't going to get any more sleep and crawled out of bed to start my day.  What a weird feeling it was to know that I was getting ready to go deliver my babies.

About four hours later I walked into the big and brightly lit operating room.  Men and women all dressed in blue were scattered throughout the room preparing for the procedure at hand.  When I saw the familiar face of my doctor I told him I was scared, and he stayed right by my side while the anesthesiologist administered my spinal.  Once I was totally prepped for surgery, the anesthesiologist told my doctor to start making the incision before having my husband brought in.  I felt the tugging at my abdomen begin, and moments later my husband's loving eyes met mine.

The tugging continued as I tried not to think about what was happening to my body.  Then came my doctor's voice from the other side of the blue drape.  "Angela!  You have a hole in your uterus!"  "Yeah?  I could feel the tugging," I replied.  "No... you have a hole in your uterus before I made an incision.  The only thing holding those babies in is the amniotic sac."  At once my husband and I knew what he was saying, and with tears streaming from my eyes, I looked up at him and whispered, "God knew.  Praise God, because He knew."  Travis closed his eyes, and I could see the emotion on his face.

Not too much later we heard the cry of the first baby followed by that of the second a couple minutes later.  My husband left my side to be with the babies and to take pictures while the doctor sewed me back up.  When the doctor was finished, he came around to my side of the drape, eyes wide with an emotion I can't describe, and said, "Your old scar was completely separated.  If you would have labored or your water would have broken, we would have probably lost you both."  He went on to say, "That scar should not be tested again.  There is virtually nothing left to the bottom of your uterus.  The lining down there is as thin as cellophane.  I repaired it and double stitched it, but that scar should not be tested again."

Those of you who know me or who have been reading my blog know that I prayed for months that I would be able to avoid having a repeat cesarean section.  I never knew whether that was God's will, but I did know that His purpose would prevail; and I prayed unceasingly that whatever the outcome, God would be glorified. Though I believe I had truly surrendered my desire for a VBAC to Him, I think it seemed from my human perspective that God would be best glorified by doing the impossible and answering my prayer.  Instead, God has glorified Himself through what appears to be an unanswered prayer.  He did not grant me my desire for a VBAC because He knew what the consequences of that would be.  It is in this unanswered prayer that the extent of God's mercy and love is more real to me than ever before.

Still, nine days later, all I can say is, "Praise God, because He knew...."

Birth Announcement: A Double Blessing Realized!

On Thursday, May 28th, 2009, at 36 6/7 weeks gestation, Travis and I welcomed into the world our precious twin baby girls.  Isabel Hope (Baby A) was born at 9:11 a.m., measuring 3 lbs. 15.8 oz. and 17 3/4 in. long; and Elliana Faith (Baby B) was born at 9:13 a.m., measuring 5 lbs. 10.2 oz. and 18 in. long.  Both babies were born in good health; but Isabel, because of her small size, was admitted to the NICU (where she remains) soon after birth.  The picture below was taken in the NICU the day Elliana and I were discharged.  It was the first time I was able to see my babies together and the moment at which I began to fully experience the reality of what I have called from the beginning a double blessing.

Stay tuned for more on the birth story of Isabel and Elliana!

Reflecting on His Faithfulness

Tomorrow is another big day for us, as we have what is possibly our last regular OB visit of this pregnancy.  Despite Thursday's amazing appointment with the perinatologist, our OB has put us on the books for a Thursday, May 28th, cesarean; and tomorrow's office visit is our last chance to discuss his decision with him.

I've spent a lot of today thinking about what questions I want to ask of my doctor while simultaneously clinging to the instruction and promise in Philippians 4:6-7:  "Be anxious for nothing, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.  And the peace of God, which surpasses all comprehension, will guard your hearts and your minds in Christ Jesus."

As I think about my questions/concerns/fears regarding this May 28th deadline and the passing of yet another day which brings us closer to it, I can't help but think about the many prayers regarding this pregnancy that God has already answered.  I went back tonight and read a couple of my older blog posts and was greatly encouraged as I revisited--and realized--some of the things that God has already done.

I hope that anyone reading this tonight will also take the time to visit (or perhaps revisit) these posts, and that as you do so you, too, will see God's hand at work.  Below are the links.

God's Purpose Will Prevail
Making My Requests Known

"The Magic Formula"

Praise God from whom all blessings flow!  Tonight I am sitting at home, 36 weeks pregnant with healthy, growing twins!

This morning started with a mix of emotions as Travis and I added last-minute items to our hospital bag, loaded the van, and headed to our ultrasound appointment prepared to stay and have our babies delivered this afternoon.  While I felt prepared for whatever the ultrasound might indicate, I warned my husband that I was sure I would cry no matter what the results.

Anxiety started to build as we sat in the waiting area of the perinatology office.  I looked around the room at the other couples waiting to be called back for their ultrasounds, and I wondered if we were the only ones with reason to feel anxious.  They all looked so calm and worry-free.  I probably looked the same on the outside.  But on the inside my tummy was doing flips as I wondered what outcome a few simple measurements would determine for us.

We didn't have to wait long before we were called back, and the ultrasound itself seemed to go rather quickly, too.  Measurements completed, the technician at last reported our babies' weights:  Baby A, who measured 3 lbs. 14 oz. ten days ago, is now measuring 4 lbs. 7 oz (which happens to be the cutoff point for avoiding an automatic trip to the NICU!); and Baby B, who measured 4 lbs. 12 oz. ten days ago, is now measuring 5 lbs. 8 oz.!  Pleasantly surprised by our babies' growth and praying it would be enough for the perinatologist to grant us more time, we headed to another room and waited for her to join us with her decision.

After what seemed like forever, the perinatologist at last knocked at the door and announced as she entered that she was going to let us pick our date--she was not going to make us have our babies today!  (I think this is the point where my promised tears appeared--tears not of fear or disappointment but of relief, thankfulness, and awe of my God.)  We discussed the babies' measurements and the fact that while they are both still small (Baby A is in the 1st percentile and Baby B in the 26th), they are growing and doing well!  She felt that waiting even two more weeks (until my 38th week) would be safe as long as my health, fetal movement, and non-stress tests remain good.  At some point during the conversation she made the comment, "Every thing is just going your way today!  You guys must know the magic formula."  I looked at my husband and smiled with thanksgiving in my heart as I thought to myself, Yes, we do.

As we were heading out the door at the conclusion of our consultation, the perinatologist added, "You know, you've made all the cutoffs for the NICU.  You'll take your babies home with you at 37 weeks."  To this I replied, "Praise the Lord!" and I watched as her face lit up.  She broke out in a smile, lifted up her eyes, and started waving her hand in the air in a praise to God as she said, "Oh, yes!  That's right!"  My new-found Sister in Christ gave me a hug, and I said, "That's the Magic Formula."  We both smiled and headed down the hallway together in an attitude of praise.  You see, I knew that no matter what happened today, it would be for the glory of God; but I didn't know it would be so apparent.  Today was a true testimony to Him, and I am so blessed that I got to be a part of it.  As this story continues to unfold, I pray that God will continue to receive the glory due His Name!

A Tentative Plan

Yesterday, a week after learning that our Baby A's rate of growth seems to be dropping off due to her having a two-vessel cord, we were finally given a tentative plan for the timing of our babies' births.

After yesterday's routine non-stress test (which went well!), I stopped by the perinatologist's office to inquire as to whether she had consulted with my OB.  To my surprise, I got the opportunity to actually speak with her briefly and found out that she had indeed passed her recommendation on to my OB group last week, but the information had apparently not yet made its way back to my specific doctor (which is why he didn't know anything at Friday's appointment).  I told her that my doctor would probably be contacting her to discuss the possibility holding off on the c-section another week, and she said that depending on what this Thursday's ultrasound shows, that could be a definite possibility.  She went on to say that she suspects we will be able to hold off another week, but she needs to see another ultrasound to make sure.  Basically, we need to see an adequate amount of growth in Baby A since the time of our last ultrasound to ensure that waiting another week is in her best interest.  I left the perinatologist's office both encouraged by her optimism and a bit confused by her change of tune.  After all, last week she had been dead-set on ending this pregnancy at 36 weeks (this coming Friday) and had even said that nothing would make her change her mind.

Later in the day I got a call from the perinatologist's nurse and found out that she had called my OB and that they had come up with a tentative plan.  They had agreed that if this Thursday's ultrasound looks okay, we will schedule a c-section for next Thursday, May 28th (my doctor's closest on-call day to me being 37 weeks).  But if the ultrasound shows cause for concern and indicates the need for an as-soon-as-possible cesarean, our babies will be delivered this Thursday after the ultrasound.

For the past week we have been praying for wisdom and clear guidance; and when Travis and I talked yesterday about how my upcoming days should be conducted, we agreed that between now and Thursday I should be resting and eating lots of protein in hopes of boosting Baby A's growth and thereby buying us another week.  However, we are praying that if our babies do indeed need to be born this week that labor will start on its own (before Thursday!) and in spite of my not taking measures to naturally induce it.

Somehow, despite all the uncertainty surrounding us, God has given me peace that surpasses all comprehension (Phil 4:6-7).  My desires for a natural childbirth and for babies too strong and healthy for the NICU have not changed; yet somehow, in the face a possible cesarean and the birth of a baby too small to avoid the NICU, God has given me peace.  I don't understand it, but I have it; and I am thankful.  I continue to cling to the certainty of His character and to His promises, knowing that nothing is impossible for Him, knowing that His purpose will prevail, knowing that He is not bound by my circumstances, and knowing that He hears my prayers and cares for my concerns.  Instead of being anxious, I have purposed to continue to make my requests known to Him and to thank Him.  Instead of worrying, I have purposed to believe Him.  Instead of trusting in our plan, I have purposed to trust in His plan, whatever that may be.  No matter what happens, may God be glorified.

05/15/09 OB Appointment and Prayer Requests

This morning was my first OB appointment since Monday's ultrasound, and it didn't go quite like we expected.  Better or worse than we expected?  I guess I'm not sure!... :-)

We didn't get far into the appointment before it became apparent that everyone was not on the same page.  Right off the bat, the nurse informed me I would be getting my Strep B test done today.  I told her I had already had that done last week and was expecting to get the results today, so she looked it up and recorded the result in my chart (Negative!  No penicillin during labor this time around!).  I then told her that I would like to have my cervix checked (I decided on doing this after receiving the news that we would be planning a cesarean for next Friday), and while I could tell she wasn't convinced this was necessary, she noted my request and handed me the lovely white "sheet" before leaving the room.

When my doctor came in he expressed approval of my "skinny ankles" and of my making it to 35 weeks.  He then checked my cervix and, upon detecting no dilation and only slight thinning, he exclaimed, "You're gonna do this!  You're gonna make it to 38 weeks!"  (Thirty-eight weeks is the point past which they don't like to let twins go because of increased risks and higher infant mortality rates.)  Pleased but confused by his comments, I asked, "Have you talked to the perinatologist?"  "No..." came the response, so Travis and I proceeded to summarize what she had told us following Monday's ultrasound (the results of which had not even been sent to the OB office).  We told him of the perinatologist's concern that Baby A is not growing well because of her 2-vessel cord, of the 18% weight differential between the two babies, and of the admitted possibility for error in Baby A's measurements due to her position (the full circumference of her head can no longer be measured because she is vertex and super low) and due to the tendency of the technician who did the scan the time before to over-measure (thus creating the appearance of insufficient weight gain).  Based on this information alone, our doctor seems to be thinking that there is not a strong enough indication for taking the babies early.  He said he would call the perinatologist and then call me, and we went on our way, more confused than ever.

I got the promised call from my doctor not long after returning home from my appointment.  He said he had been unable to reach the perinatologist thus far and was going to keep trying throughout the afternoon.  I told him that I really hoped he could reach her yet today because I was feeling so much in limbo--confused by the differing opinions and hoping his opinion is the right one since I want to carry these babies as long as possible.  We had a little further discussion about the fact that ultrasounds done so close together are not reliable, that our NSTs and kick counts show that both babies are doing well, that these are two babies in two separate sacks who should not be compared to each other, and that I tend to have small babies anyway (Abel was 7 lbs. 1/2 oz. at 40 6/7 weeks, and Amariah was 5 lbs. 13 oz. at 39 4/7 weeks).  He suggested that we talk to the perinatologist about waiting until 37 weeks to take the babies (sort of a compromise between her 36-week suggestion and his 38-week "limit"), and I told him I just want to go as long as is possible and safe for the babies.

A second phone call from the doctor later this afternoon informed me that he still hadn't been able to reach the perinatologist, so it will be the beginning of next week before we know anything more.  In the meantime, we wait and wonder whether or not we should be employing some natural methods of induction; and as we wait, we pray that God will grant us wisdom and clear guidance for the coming days/weeks.

If you would like to come alongside us in prayer, these are the specific requests we are making known to God.

• Lord, please allow our babies to remain in the womb until they are both truly ready for life outside it.
• Please cause labor to start spontaneously and in Your time so that we might avoid having a planned cesarean.
• Give us divine wisdom and clear guidance as we make decisions concerning the (natural) induction of labor and the selection of a cesarean date.
• God, please cause Baby A to grow at the appropriate rate in spite of her 2-vessel cord so that both she and her sister would be born at a sufficient and healthy weight.

In conclusion, I just want to say that the entirety of this pregnancy has been to me a source of absolute joy.  I view my babies as nothing less than a double blessing, and for that blessing I praise and thank God with all of my heart!  May God finish the good work He has started, and may He alone be glorified!