Thoughtful Thursday: Know

Happy December! Time for the Intelligentsia (people who have commented on every Thoughtful Thursday post for the month of November).

Wiseguy from Woman Anyone? comes through yet again with an unprecedented 11 Intelligentsia appearances.

Ernessa from Fierce and Nerdy, and author of the upcoming book 32 Candles, is back for the 9th time.

Kristen from Dragondreamer’s Lair is back for #8.

Photogrl from Not the Path I Chose returns for lucky #7.

Jill from All Aboard the Pity Boat makes her sixth appearance.

Lost In Translation from We Say IVF, They Say FIV is back for #5.

Mel from Stirrup Queens three-peats.

A from Are You Kidding Me? makes her first Intelligentsia appearance.

(Note: Birth and children mentioned. The question is couched within the context of my birth experience, but it could apply to all sorts of situations.)

People who have read my birth story know that it ended well, but that it got pretty dodgy for a while. Until recently, I thought I knew everything there was to know about that dodginess.

A few weeks ago, I was talking to a close friend of DH’s, who is also my close friend, about the whole birth experience. He said something about the babies having been in danger.

Me: They were never in danger. I was the only one in danger. They were always fine.
Friend: That’s not what DH said.
Me: Huh?!?
Friend: He said the doctors pulled him aside and said that he could lose you and the babies. They didn’t want to upset you so they only told him.
Me: I have no idea what you’re talking about. I don’t think that’s true.
Friend: Oh. I guess you weren’t supposed to know. Don’t tell him I said anything.

What?!?

When I finally asked DH about it, he said the friend was totally mistaken, and that nothing like that happened. My memory accurately reflected the events of the birth. Phew.

This game of broken telephone raised a question in my mind. If we had all been in danger, would I have wanted to know?

I’ve had general anesthesia three times in my life: when my wisdom teeth were removed, IVF #1, and IVF #2. When you’re unconscious, you have no idea what is going on until everything is over. Good or bad, you are oblivious.

With the spinal anesthesia during my C-section, I was completely awake and alert. I couldn’t see what they were doing, but I could hear — and feel! — plenty. Before the “we need to talk” conversation, I could sense that something was going on. But, never having had a C-section before, who was I to say what was normal. Anyway, I was quite distracted trying to catch glimpses of my babies. By the time I sensed a shift in the tone of the room, Burrito and Tamale were out of my body and reportedly doing fine.

Until I saw the babies and was told they were healthy, I didn’t fully believe that I’d end up with two real live babies. I was prepared for all sorts of contingencies, but I never anticipated a scenario in which information could be withheld from me.

Given how I dealt with the “we need to do a hysterectomy to stop your hemorrhaging” talk, I think I would have handled any negative information about the babies reasonably well. I am certainly the kind of person who wants to know everything that’s going on. Presumably there are times when it seems medically indicated to withhold information: for example, if raising your blood pressure would compromise your health at that moment. Otherwise, personally I’d rather know everything that’s going on. False alarm? No problem. True alarm? I certainly don’t want to be the last to know.

What about you?

Would you rather know that something bad might possibly happen, or would you rather get information only when there’s certainty of a good or bad outcome?

Fertility Massage

Wait, what? Is that title right? Yes it is!

A recent post from Gracie in Brooklyn about uterine massage reminded me that I never blogged about the fertility massages I used to get. Gracie’s post is the first blog I’ve ever seen talk about it. I was always surprised that no one in the entire IF blogosphere ever mentioned it.

I had no idea that fertility massage existed until I saw it offered at my acupuncture clinic. So, as a public service, I’ll tell you what I experienced, and you can decide whether to see if you can find a practitioner in your area. There aren’t many, unfortunately. I suppose that if you have a massage therapist that you already like and trust, you could ask him/her to incorporate some of the techniques.

The “fertility” part combined several massage techniques:

• uterine massage, in which the uterus is massaged very deeply — strangely pleasant, as Gracie describes
• femoral massage, which fans of Randine Lewis’s book The Infertility Cure may recall, in which the circulation in the femoral artery is temporarily blocked to pool the blood in the uterus
• reflexology on points specific to the reproductive organs
• lymphatic drainage, which I’ve never fully understood so can’t really explain to you

These techniques are primarily focused on increasing blood flow to the uterus. Some women do have fertility problems caused by restricted uterine blood flow, and for them, fertility massage would be perfect. Because my fertility problems are unexplained, it’s not clear whether increasing blood flow would do anything, and I can’t say whether fertility massage actually did anything to help me conceive. I can say that I enjoyed fertility massage even more than acupuncture, and infinitely more than anything that involved my RE.

As someone with chronic back problems, it was wonderful to be able to justify spending money on frequent massages. By my skewed logic, I rarely spend money for my own well-being, but with anything that involved TTC, I spent money hand over fist.

Postscript (mentions pregnancy and babies): I had so many fertility massages that the massage therapist and I became friends. I continued to see the same woman for prenatal massage. When I was hospitalized, she drove almost an hour to visit me in the hospital and to massage me for free. I have seen her for massage a couple of times since giving birth, and in addition to the usual, she has been massaging the site of my C-section to reduce scar tissue (which never would have occurred to me; I thought I’d just have a lumpy scar forever). We also brought Burrito and Tamale for a class she taught in infant massage.  At the class I saw a woman from my old infertility support group. Her baby is a month older than B & T, and we traded parenting tricks and massaged our babies. Full circle.

Perfect Moment Monday: Reversals of Fortune

Over a year ago, I wrote about a woman I know solely because of infertility, and I wondered whether I should pursue a friendship. Following that post we continued to talk when we happened to see each other, but I didn’t end up specifically pursuing that friendship. After many failed IVFs, she is no longer pursuing treatments. Because of that, it felt like we were in different places in the process, and it just didn’t feel right to talk to her about my continuing treatments (whether more failures or, hopefully, an eventual success) while she had no possibility of conception. When I became pregnant, she was genuinely happy for me, but I felt awkward about having left her behind.

I haven’t seen her since early summer. Between bedrest and having newborns at home, I have barely left the house/hospital at all since mid-summer. Last week, during a rare outing, I ran into her. She has been pursuing international adoption, and since the last time I saw her, she has been matched with a child. In a couple of months she will have the baby in her arms. I am absolutely thrilled for her.

The Perfect Moment came when I realized that her baby is just two months older than Burrito and Tamale — close enough that they might become buddies. Somehow, in less than a year, we went from two nearly-hopeless infertiles, weary from years of failed treatments, to two mommies on the brink of planning playdates. It really can happen.

Find more Perfect Moments at Weebles Wobblog.

Thoughtful Thursday: Role

In honor of many of you who have just sat through an awkward holiday meal with extended family…

People in families end up with roles. Among children, there’s often The Smart One, The Athletic One, The Pretty One, The Fuck-Up, etc.

As children grow, roles change into adult versions. The Successful One, The Unemployed One, The Dutiful One, The Drunk One, The One Who Never Grows Up, The One Who Ages Too Fast, The Fuck-Up, etc.

Family-building also seems to play a part in forming the roles. A friend of mine comes from a blue-collar family. He is the only person in his family ever to have gone to college, and he went on to obtain two advanced degrees. Formerly The Smart One, he grew to become The Successful One. His siblings all had children at a young age and all work at make-ends-meet jobs. For a while, it seemed like my friend would focus on his career and might never get married or have children. When he met his now-wife and announced that they were getting married, his parents panicked. They were afraid that The Successful One, on whom all of the family hopes had been pinned, would give it all up and become “just” a family man. Their fears were unfounded, and he now has children and a successful career. He doesn’t make his siblings look very good by comparison, but the roles remain intact.

In DH’s family, several of his younger siblings are too young to have fallen into adult roles yet. The oldest sister, about whom I’ve blogged extensively both before and after she got pregnant, has taken on the role of The One Who Can’t Make Up Her Mind. By age 30, she’d had several careers and gotten several degrees in different fields. But, even before getting pregnant, she made it clear that her real intention was to become The Stay-at-Home Mother. This is not the role that the family would have selected for her (including her future husband, actually), but it is the role that she has chosen for herself. This explains some of her overzealous rush to get pregnant: you can’t be a SAHM without a kid.

In my immediate family, since I have no siblings, I am the conduit for all expectations and holder of all roles. Among my extended family, as I’ve mentioned before, there is a split between breeders and achievers.

The cousins who have not been successful (poor or no job prospects, little education, debilitating mental illness, serious substance abuse) all have children, and all are divorced. Those of us who have gotten educations and pursued big-shot careers are all currently childless (actually, now that I think of it, all of them are divorced too except for me – my family doesn’t do marriage very well). In my family, my job is to be educated to an unprecedented level, and extremely successful, and well-traveled to places that others can only dream of, and fabulously happy in my marriage.

(Don’t get me wrong. My “unsuccessful” cousins are mostly really good people, and by no means are their problems related to having had children, and in fact I think most of them are better at parenting than they are at the rest of their lives. My “successful” cousins are even better people, some of the very kindest people that I’ve ever met in my whole life, in addition to being smart and ambitious and athletic and unbelievably attractive and humble… the kind of people that you would hate except that you absolutely can’t because they exude goodness yet are also wonderfully sarcastic.)

In the time since I wrote that over a year ago, my role has now been expanded to Mother of Twins, an over-achiever variation on breeder. Can you call someone a breeder if they are married more than a decade before having children in their mid-30s? If they endure 7 years of infertility? Perhaps not. So, apparently, my role is Achiever Who Achieves Career Success and Just Barely Achieved One Successful Pregnancy and Now Gives the Impression of Juggling Everything Better Than She Actually Is.

What is your role in your family? How does family-building (or lack thereof) affect your role?

Thoughtful Thursday: Experience

(Note: Pregnancy and babies discussed.)

In addition to breastfeeding difficulties, the other big component of the hard time I’ve been having is some sort of hormonal baby blues. Much of the time I’m fine, but every few days for a few hours I’m not fine at all.

Right after giving birth it was more obviously hormonal, and I’d burst into tears at the slightest provocation. For example, almost any song. Or a particularly nostalgic Sesame Street clip on YouTube. (Seriously, when that happened, I knew I’d totally lost my mind.)

After the first week, there has been less crying. Instead, I either feel fine, or I feel desperate and forlorn. Thankfully, much more of the former than the latter. The main things that have been setting me off have been:

• Breastfeeding difficulties
• Being overwhelmed, generally by my inability to manage more than an hour of work per week or by dealing with two screaming babies on my own (which rarely happens — the alone part and the both screaming part — but oh boy, when it does…)
• And, shockingly, thoughts of pregnancy

Before becoming pregnant, I wanted to have biological children but pregnancy itself wasn’t that important to me. When I was finally pregnant, I was so thrilled that I cherished every moment I could; even the difficulties like debilitating fatigue and hospitalization were special in their own way. Both before and during pregnancy, I reserved the right to consider additional children later.

Now, simultaneously I want nothing to do with future pregnancies or children and I also burst into tears mourning the absence of those pregnancies and children. Pregnancy kicked my ass, birth almost killed me, and I can’t even manage the two children I have. I have no business trying for or having more children — if I could even get pregnant again, which is almost impossible without treatments, which we’ve sworn never to do again. I’ve shed more than my share of tears over BFNs. TTC turned my life upside down for 7 years. Yet…

The yearning hits me at random times. Tidying up papers and finding an ultrasound photo, and realizing that I’ll never have a 3D ultrasound image of any baby because the Burrito and the Tamale were never in the right positions in the womb. Watching one of them move their legs now, thinking about how the kick would feel if they were still inside, and realizing that I’ll never feel another fetus kick. Jiggling the jelly that is my new abdomen, and remembering my beautiful pregnant belly. Looking at my now full-term babies (39 weeks gestation!), and wondering how it would have been to carry a baby anywhere close to full term, to hold that baby right away instead of touching it for a minute through a window in an incubator, and to go home with that baby instead of spending weeks in the NICU.

I think what gets to me most isn’t that I won’t experience these things again (or for the first time).

What gets to me is that I don’t have the option.

Most of the time now I couldn’t be happier, but sometimes I couldn’t be sadder. Who knew.

How important was/is the experience of pregnancy, as opposed to the baby itself, to you?

Thoughtful Thursday: Quitter

Welcome to November. Wow, what an October I had. Anyway, here are the Intelligentsia (people who have commented on every Thoughtful Thursday post for the month of October).

Wiseguy from Woman Anyone? still holds the record with 10 out of 10 Intelligentsia appearances.

Close behind is Ernessa from Fierce and Nerdy, back for the 7th time.

Photogrl from Not the Path I Chose makes her 6th appearance.

Jules from Just Multiply by 2 and Lost In Translation from We Say IVF, They Say FIV are both four-peating.

Two-timers include Elana from Elana’s Musings, Mel from Stirrup Queens, and Stacie from Heeeeere Storkey Storkey.

(Discussion of infertility as well as baby issues ahead.)

I’m a big advocate of cutting losses. People tend to stick too long with things that just aren’t serving them well. For example, spending more on car repairs than the car is worth, or staying in a bad relationship because of all the years you’ve already invested. You started eating a cookie and you don’t like it? Throw the rest away!

Simultaneously, I refuse to be a quitter. Sometimes I take on challenges that are beyond me, then I have to keep going until I’ve seen them through. Household repairs, for example — I don’t even enjoy them, and in the four hours it took me to do that plumbing repair, I could have earned enough to pay a plumber to do it in half an hour.

Or, to use another example, infertility. I never got close to that point, but I think that if treatments hadn’t succeeded when they did, I would have kept going with IVF cycles until I ran completely out of money, the physical ability to continue, or time.

Now I am faced with a similar situation. A few days ago I alluded to having had a hard time lately [and many people were kind enough to comment or email with support, thank you]. There’s a lot of things contributing to it, but probably the biggest one is breastfeeding.

Put simply, breastfeeding is not going well.

Right after birth, I couldn’t nurse for quite a long time because the babies weren’t able to feed by mouth. Then, once they could start practicing, their level of prematurity meant that nursing did not come naturally to either of them. Tamale has nursing down quite well now, but for a long time her little cheeks got tuckered out very quickly. Burrito’s problems have improved but still continue even now that he’s in the full-term range. I love that little guy with all of my heart, but nursing him is not my favorite time together: biting, blocking his mouth with his tongue, and flailing his arms for several minutes each time before he can nurse properly really pushes me over the edge sometimes.

The biggest problem, however, is my milk supply. The culprit, apparently, is losing almost half of my blood volume during delivery. Plus, who knows if I ever would have had a full supply — many women can’t make enough for two babies, and some women’s bodies never make enough milk for even one baby. Sometimes I do everything right and pump every 2-3 hours. Sometimes I get frustrated and pump just a few times in a day. Either way, the amount of milk doesn’t seem to vary. I’ve seen many lactation consultants. I’ve tried fenugreek, which doubled my supply — but 2 times a tiny number is a slightly less tiny number. I’ve tried power pumping, which doesn’t seem to trick my body into making more milk the way it should. Nursing the babies directly doesn’t seem to make a difference, so at this point almost all of their feeds are by bottle, either formula or, once a day, pumped breastmilk. I produce enough for about 5% of their total intake. The only possibility left is to try to increase supply using strong drugs, but my emotional functioning is already so tenuous that I’m afraid I couldn’t handle the side effects.

I believe strongly in breastfeeding, for all sorts of reasons. I always envisioned that I would nurse for a long time (and that it would be idyllic, like people say). I’ve long ago given up on the hope of exclusive breastfeeding, and I’ve accepted that it’s not always fun, but pumping nonstop to yield only 5% is really frustrating. Several people have suggested that I give up, reclaim those many hours a day, and spare myself the heartache.

But, right now, I can’t. My body took so many years to create them, and my body couldn’t gestate them as long as I wanted, can’t my body at least feed them? Plus, I’m too wedded to not being a quitter. I should know better. I should be willing to cut my losses. Right now, I am stuck. My head and my heart both want to continue, but my head and my heart also both know that I should move on.

At some point, perseverance becomes stubbornness.

What are the limits of your perseverance — with family-building or with other realms of life? How much do you value not being a “quitter”?

Thoughtful Thursday: Stickler

By nature I am a detail-oriented person, and I take a lot of care with every kind of detail. I am well aware that not everyone else is so concerned with precision. When other people make an error, sometimes I can be quite a stickler, and sometimes I let things go. Strangely, the issues that get to me the most aren’t necessarily the ones that matter the most. Here are some examples.

Perpetual stickler:

• My name. My real name is impossible to spell and pronounce, and I have spent far too much of my life correcting people. The only times I let people use the wrong name are when I’m about to never see them again, as when my order is ready at Starbucks. Otherwise, I just can’t let it go. When I first met DH, he mangled my name, and I was so intent on correcting him that he thought I couldn’t stand him, and our relationship almost never got off the ground. Good thing we worked that out.
• Misinformation. Especially as it pertains to my profession, there are issues that I just can’t let slide when I hear someone say something horribly wrong. I try not to be bossy and know-it-all, really I do, but sometimes I can’t help myself.

Sometime-stickler:

• In the hospital both pre- and postnatally, the babies’ conception came up frequently. Quite a few times, a health care worker stated that the babies were conceived through IVF rather than IUI. Sometimes I was careful to correct them, when it seemed like the misinformation might make its way into the chart or otherwise stick around. Other times, especially when it was one practitioner talking to another rather than to me, I bit my tongue.
• Also on the topic of fertility, sometimes I hear people say outlandish things about infertility problems and treatments. Sometimes I feel the need to educate them, and sometimes I shrug and move on.
• The name of this blog. There is no “the” in the name. As I explained when I first started blogging, the blog name is a line in a Radiohead song. I realize that it doesn’t look quite right unless you know the song. I’ve seen lots of people add a “the” in their blogrolls, links to my blog on their blogs, etc. Occasionally I send someone an email with a friendly correction, but usually I don’t say anything because I don’t want to go around the blogosphere bossing people around. (But, if you have the name written wrong somewhere on your blog and now you would like to correct it, that would be lovely.)
• “Are these your first?” As in, “Is this your first pregnancy?” or, other times, “Are these your first children?” To health care workers, I carefully explain my two miscarriages. To everyone else, I evade the pregnancy part of the question and simply say that these are my first children.

Non-stickler:

• Tamale’s name. Burrito’s name, like the word burrito itself, is rarely mispronounced or misspelled. Tamale’s name, like the word tamale, has a few potential proper pronunciations (such as ta-MAH-lay and ta-MOLLY…) and many more mispronunciations (TA-muh-lay, TA-mail, ta-MAIL…). When I chose her actual name long ago, I had no idea that people would consider it as exotic as they do, and I had no idea that anyone would think to pronounce it any way other than the “right” way. Already in her short life, I have heard an incredible number of guesses as to the pronunciation. So far, I have been saying it properly to each person once, and then letting any subsequent mispronunciations go. As she grows up, I don’t want her to have the same visceral reaction to hearing her name misspoken that I do for my name, and I don’t want her to have to waste so much effort making people get it right. So what if a restaurant hostess or substitute teacher doesn’t say it right? I certainly don’t want her to be such a stickler about her name that she risks shooing away her future husband like I almost did. Some things are more important than the details being exactly right.

When are you a stickler? When do you let things go?

Thoughtful Thursday: Partner

As I mentioned in last week’s BBBB post, one of the biggest surprises since the Burrito and the Tamale were born has been the changes I’ve seen in their father.

Normally, DH is a highly emotional guy — mostly when it comes to unimportant things. When he watches sports on TV, his yelling has been known to send pets and neighbors running for cover. He shows uncommon enthusiasm in response to new flavors of ice cream and sunny days. Don’t even get me started on what happens when he sees a puppy.

In terms of negative emotion, he is usually very even-keeled. He gets worked up over abstract issues like government encroachment on civil liberties, but if something unpleasant happens to him personally, it’s like water off a duck’s back.

He is fiercely loyal and effusive when it comes to me and his friends, but less so with family.

His high levels of energy and emotion have made it all the more bizarre that over 7 years of infertility, he was almost always calm to the point of being blasé. He’d get riled up about the money or about minor inconveniences, but the big picture didn’t seem to bother him the way that it got to me. There were hints, but, like the physical toll of the treatments, most of the emotional toll seemed to fall on me.

During the pregnancy, he was phenomenal as far as helping me during the months of 1st trimester immobility and 3rd trimester home and hospital bedrest. But, when it came to the babies, I was disappointed at his lack of enthusiasm. The correct response to, “Do you want to feel the baby kick?” is “Yes!” Instead, he often answered, “I guess,” or even, “No thanks, not right now.” Instead of cooing at cute baby items, he questioned the cost. During every minute of each ultrasound my eyes were as wide as a kid’s on Christmas morning. Being in a dark room for an hour made DH sleepy.

I didn’t question what kind of father he’d be nor the kind of husband he’s been all along, but, during a supposedly happy time for which we’d worked so long and so hard, I found his reactions (or lack thereof) disheartening.

And then the babies were born, and all of the emotion burst out. Not the screaming-at-the-TV emotion, but the sweet, joyful, loving emotion that I fell in love with, a decade and a half ago. He marveled at the Tamale’s resemblance to me, chuckled at the Burrito’s antics, told them sweetly about the cat waiting for them at home, made up songs to sing to them in the NICU.

When I pointed out the contrast between his pre- and post-birth reactions to the babies, DH said, “We weren’t counting our chickens before they hatched. I didn’t want to get too attached. Now they are here, and I can love them.”

When I pointed out the contrast between his effusive reaction to the babies and his stoicism during infertility, he said, “Infertility was depressing! If I’d showed emotion then, it would only have been bad emotions.”

7.5 years of DH’s guarded emotions during IF and pregnancy in exchange for singing and dancing through the house for the next couple of decades? Not a bargain I expected to make, but I’ll take it.

How has your partner reacted to infertility/loss? Is this consistent with your partner’s typical style of emotional expression?

Thoughtful Thursday: Emotion

Quick health/baby update before we begin Thoughtful Thursday: I am feeling better and better every day; the percentage of the day in which I feel Human has gone from 0% for several days post-birth to 80% today. The Burrito and The Tamale are developing incredibly well — so well that we’ve been discussing discharge with the NICU team. Looks like just a few days until they come home!

Today’s topic follows from a question I submitted (and then subsequently answered myself) for this week’s Barren Bitches Book Brigade on It Sucked and Then I Cried by Heather B. Armstrong of dooce.com. Since only a few people participated in the book club, I’d like to open the topic up for discussion more broadly.

On your blog, how much emotion do you express? Is that more or less emotion than you tend to express in real life?

From my BBBB post:

In real life, I am very guarded with emotional expression. On BabySmiling, I am considerably more expressive.

For years I have enjoyed Dooce’s monthly newsletters about her daughter. They combine snapshots of Leta’s growth, snarky humor, and pure love. I think that I will be comfortable expressing emotion directly to my children, but it feels strange to think of writing emotional public newsletters under my real name for friends and family (and strangers) to read. Do I save the emotion for BabySmiling, even though it goes against the mandate of the blog as an infertility blog? Do I write the letters privately? Do I remain guarded and let the emotions go undocumented? Probably not the latter, but I’m still figuring this one out.

To elaborate on what I wrote earlier this week…

I have never felt more emotion than in the past couple of weeks. Part of it is attributable to fluctuating hormones, sure. Some is attributable to having babies, the same as anyone. But a big part has to do with the realization of 7 years of infertility plus months of more-difficult-than-usual pregnancy. I am so filled with love, but there’s also a good measure of disbelief, overwhelming retrospective sorrow, hope, worry, wonder… And there you go. I am expressing emotion here on this blog. Emotions which most likely will never be expressed anywhere else, certainly not in writing.

I just don’t see myself writing gushy love letters to my babies under real name for my friends and — gah — family to see. But I am feeling that gushy love, so where do I put it? Here, where I never set out to mommyblog? Some sort of BabySmiling annex? Privately, for only my babies to see someday? I didn’t have an answer on Tuesday during BBBB, and I don’t have one today.

On your blog, how much emotion do you express? Is that more or less emotion than you tend to express in real life?

The Birth Story — or, And I Thought Getting Pregnant Was The Hard Part

Note: Here is the birth story people have been requesting. It also involves a major infertility turning point. And, it is very long — you may want to grab a snack and get comfortable.

So it looks like the magnesium did its job.

Recap: A week ago Tuesday, rehospitalized at 33w0d due to further cervical dilation (5cm). Given another course of steroid shots for the babies’ lungs, and put on mag to hold off labor until the steroids could take effect. Tuesday night, had lots of very strong contractions (up to 7/10 pain level, which is almost unheard of for me) 4 minutes apart, but cervix didn’t change further.

Wednesday, contractions slowed then stopped. No notable contractions or cervical change through Friday morning when mag was discontinued.

Friday morning, mag is stopped. Friday morning and afternoon, no contractions. Lower back, which has been hurting steadily for quite a while, starts hurting more.

Friday early evening, contractions resume. Not wanting to be deprived of food and drink for no reason, as I had been on Tuesday night for half a day, I decide to eat my dinner first then report contractions. The model patient rebels a bit. Hungry + thirsty + contractions = crankier than I intend to be.

I ate dinner, then reported the contractions. Monitor showed contractions 4 minutes apart. They weren’t as painful as those on Tuesday (more like 5/10 pain), but I definitely felt them. Cervix still at 5cm.

Throughout the past month+, DH had slept in my hospital room only the first night of each hospitalization, then visited during the day every 2 or 3 days. Most recently, he’d slept over on Tuesday night, left on Wednesday, then hadn’t returned until Friday night. He thought that the discontinuation of mag was as good a time to stay over as any, because I was at higher risk of delivering. This would be the first time he’d voluntarily slept in the hospital with me. He worked late on Friday and arrived well after dinner and the start of contractions. Because my cervix was unchanged, “contractions! come here right now” became “finish your work, see you later.”

He arrived, we hung out for a few hours, and we decided to go to bed around midnight. We wanted to watch a bit of TV before going to sleep. Halfway through the show, I had to pee.

I peed.

Then something else started coming out. Something pink. Something that was not urine.

The nurse and resident quickly concluded that it was amniotic fluid. Baby A’s water had broken. Fluid continued to trickle then flow then pause then trickle then flow over several hours — such a bizarre feeling. How much fluid could there possibly be in one amniotic sac?

Previously, the perinatologist had told me that further cervical dilation would buy me a quick c-section, but that breaking my water at 5cm dilation would buy me an even quicker c-section. Once my water had broken, urgent could become emergency very quickly. (Remember this part.)

DH packed up my room and we were whisked away to Labor and Delivery.

They said that the resident and attending were occupied with another birth, but that we’d deliver soon.

We waited.

My contractions got stronger and closer together.

We waited.

Stronger and closer together.

We waited. What the hell?

A second vaginal birth jumped the queue. Hmm, remember how my water breaking was supposed to constitute a near-emergency?

We waited. Both very sleepy, but it was no time to sleep.

Finally, with my contractions 2 minutes apart and extremely painful (no pain meds on board, some combination of my being a trooper and it being “any minute now”), the nurse announced that both births were finished. I didn’t get to the pushing part, but no one can ever say that my c-section didn’t involve full-blown labor. When contractions are 2 minutes apart, that means that it’s 2 minutes between the peak of each contraction. The respite between the end of one contraction and the start of the next was less than a minute. The limits of my iron pain tolerance were being tested and pushed to the limit.

Finally, it was time. I headed to the OR first for anesthesia while DH was asked to wait. The anesthesiology resident attempted to place the spinal in the midst of my almost constant contractions. Just sitting up in the right position was reeeeally difficult. I got seriously pissed when I heard the anesthesiology attending tell the resident, “You blew the space.” I remembered reading that nowadays, the dreaded spinal headaches are rare and usually only happen if they keep blowing the space and have to do multiple sticks. Luckily, the second try worked. If he had blown it a second time, I was prepared to tell the resident he was incompetent and should step aside. I was also prepared to tell him that I liked the other two anesthesia residents I’d met before much better, and that he was ugly.

With the spinal in place, they started to prep me, and I lost track of the dozen people in the room. I’d never met the OB attending before, but I knew the OB/MFM resident well.

Eventually DH joined us in his gown, shower cap, and mask. He is not the type to peek behind the curtain, but he could still see plenty.

More than 3 hours after my water broke, the babies emerged quite quickly. A, the boy, Burrito, came first. He had the most fabulous loud cry. They showed him to us, and he looked big and perfect. A real baby. A real baby! The neonatologists went to work on him, but not much was needed. From the first moment he was breathing room air and was just perfect.

B, the girl, Tamale, came two minutes later. Her cry was weaker. They bagged her, but she seemed to be doing okay. Also a real baby. We had two babies! All of my Dead Baby Thoughts had been unfounded, and all of the fears of severe prematurity at 26w and 28w had not come to fruition. They were alive, and apparently healthy, and so beautiful.

From my vantage point, I could see Burrito’s station very well, but couldn’t see Tamale. DH was able to see Tamale quite well, as well as some of what the doctors were doing to me. As the doctors started to work on putting me back together, I was so grateful to be distracted with views of Burrito and DH’s reports about Tamale. When I met with the neonatologist at 29w, he’d said that they might immediately whisk the babies away. The fact that the babies were still in the room seemed like a very good sign. It exquisitely seemed like forever, but was about 10 minutes, that I just watched the hustle and bustle and caught glimpses of my baby. DH, despite declaring years ahead of time that he wouldn’t feel comfortable, cut both of their cords. I was proud of him.

According to the time stamp on the photos, 13 minutes after Burrito’s birth, they brought him over to me to look at and touch for a few moments — longer than I was expecting. Was this really my baby? I knew they hadn’t smuggled any babies into the OR, and there were witnesses who saw these babies come out of me, so they must be mine. After I touched and kissed Burrito, DH held him for a minute. They said that Tamale wasn’t ready to be held, but that we could see her soon in the NICU.

Meanwhile DH could see the activity level around my abdomen growing.

Here comes the part relevant to infertility.

The babies were still in the room and I was still wonderfully distracted when the OB attending interrupted. In a very calm but clear voice (thereby telling me that the situation was serious but that he was trying not to freak me out), he said:

BabySmiling, we need to talk about what’s going on. We’re trying to finish up, but it’s not going as planned. B’s placenta was what’s called accreta. Her placenta is attached very deeply to your uterus, and it is so deep that it even goes beyond the uterus. This is very rare, but it is more common with multiples. We have been trying to remove the placenta and control the bleeding, but it’s not working. We may need to do a hysterectomy. This would mean that you couldn’t have any more children. We will try everything we can, but right now it’s looking like we will need to remove your uterus. You will still have your ovaries, so you won’t go into menopause, but you won’t be able to have more children. You have also lost a lot of blood, so we will need to transfuse you.

Here is the golden moment when 7 years of infertility came to a head.

DH and I looked at each other. In one split second it felt like three things occurred as we made eye contact: taking in what the doctor said, asking the other’s opinion, and simultaneous agreement. It felt like we both shrugged with our eyes. Here is what went through my head.

• Oh. Wow.
• Hey, it’s like Abby on ER. She lost her uterus during childbirth too.
• I guess this settles the conversation about having more babies.
• It’s fine, I can live with that. At least we don’t have to use contraception, and I never have to wonder or take a pregnancy test or cry over a BFN.
• This will make a really good blog post.
• Huh, I bet most people would be really upset right now. Abby on ER was really upset, even though she didn’t want that baby in the first place. I’m fine with it.
• DH looks fine with it.
• Those pesky placentas! First A’s was previa, and now B’s is accreta.
• Technically I could have more children via surrogacy, but I know what the doctor means.
• No surrogacy, these two are enough.
• Thank G-d the babies are okay. They both seem to be doing so well!
• Little does he know, even if I have a uterus I probably can’t have more children.
• I’m so glad the babies are still in the room for me to have something to watch while this goes on.
• The doctor probably wants an answer.

The way it looked to everyone else: Doctor finishes speaking, DH and I look at each other, and we both say something to the effect of, “Whatever you need to do.”

The doctor said, “Thank you.” In my mind, the unspoken full sentence was, “Thank you for not freaking out like most people do, thank you for not making my job harder while I’m trying to do this, and thank you for not requiring me to convince you that this is the only way to save your life.”

My little distractions weren’t in the room long, and they soon went upstairs to the NICU.

The doctors kept working, and the anesthesiologists started getting really busy.

DH made a joke/offer about the transfusion being convenient because he is a universal donor, and rolled up his sleeve.

I asked him to tell me everything he remembered about the babies to keep me busy, and to show me the photos he’d taken.

DH, normally rather squeamish, was quite fascinated as the surgeons worked and told them as much. “This is so cool!” “From a medical standpoint, this is so interesting.” Usually I would be the one filled with intellectual curiosity for my own surgery. We weren’t entirely ourselves that day, in lots of ways.

DH didn’t tell me at the time because he didn’t want to alarm me, but there was a lot of blood. He later said that it seemed like an awful lot of blood, between the huge tub of suctioned blood and the giant puddle of blood on the floor that everyone kept having to step around. No one ever mentioned the word hemorrhage.

Later, DH asked how much blood I’d lost, because he thought he’d heard an amount mentioned but it couldn’t possibly be that much. They confirmed that he’d heard correctly. I had lost more than 6 units. My loss was 2/3 of the normal human blood volume, though because blood volume increases during pregnancy and even moreso during twin pregnancy my percentage was lower, closer to half of my total blood. That is still really a lot.

With a spinal, you don’t feel pain but you do feel “pressure.” The pressure got stronger. The way they were throwing my body parts around felt a lot like Thai massage.

Eventually the doctor said, “The bleeding is slowing down. We tried [a drug whose name I don't remember] and it worked. We aren’t going to transfuse you right now, and it looks like we won’t need to do a hysterectomy.”

DH asked, “Is that drug commonly used for placenta accreta, or did you just try that drug on a whim?”

Everyone laughed.

As the doctors continued to work, they started talking to us more. Several times, DH or I made them laugh quite a bit. I don’t think either of us was trying to be funny.

The OB attending said that it was lucky that B had been breech and required a c-section. If I’d had a vaginal delivery, the bleeding would have been harder to control, they might not have had time to open me up, and I might have died.

After a while, they were done. With all the genuineness I could convey, as they were wheeling me to recovery, I told the doctor, “Thank you so much.” Thank you for saving an organ that I probably have no use for but would have missed, thank you for doing such an incredible job, thank you for saving my life.

As they wheeled me out of the OR, I started feeling pins and needles in my legs. This meant that the spinal was wearing off and they had finished surgery just in time. If it had taken longer or if they had needed to do the hysterectomy, they would have switched to general anesthesia.

Recovery did not go so well. It was supposed to be “an hour or two” but ended up being more than 3 hours — among other things, we had to wait for a shift change in the NICU then in the mother-baby unit. In my altered state, I had it in my mind that I shouldn’t go to sleep because I needed to be alert when they wheeled me to the NICU to glance at the babies. I really should have gone to sleep. I dozed off here and there, but mostly I lay there being agitated.

The nurse appeared periodically to tell me it wouldn’t be long (sound familiar?) then would disappear for far too long. During that time, they had a post-op conference to discuss my case. A Morbidity and Mortality meeting, without the morbidity or mortality. A “here is what went right with this crazy case” meeting.

I was also terribly thirsty even though I was hooked to an IV for hydration.

And I was itchy, so itchy, from the anesthesia.

Unprecedented sleepiness + agitation + impatience to see my babies + thirst + watching DH eat and drink + itchiness + not knowing how much longer + severe nausea + almost dying = a bad combination.

I remember so much about the birth, but the NICU trip is pretty hazy. I thought I’d just get wheeled by each isolette momentarily, the way that a tour bus pauses to look at a monument, but we stayed in each room longer than I’d expected. They told us that the babies were doing wonderfully. Tamale had disagreed with their recommendation for breathing assistance and had pulled out her tubes, so she was breathing room air like her brother by the time we saw them.

The next days were a weird combination of highs and lows. I’ve already talked about the contrast at Show and Tell earlier this week.

To preempt an inevitable question: They didn’t transfuse me because the preference in that hospital on that service is to avoid transfusion below a certain very high limit. I was actually kind of glad that they didn’t, because even screened blood carries a certain amount of risk, but dealing with that level of blood loss has made the recovery much more difficult.

My next post will have pictures of both babies, as well as some processing of the events I’ve just told you about. This post is long enough.

Birth details (in metric or disguised to reduce Google-ability):
Born one week ago exactly (on Sat.) around 3:30 a.m. at 33w4d
Burrito weighed 2.15 kg, Tamale weighed 2.25 kg
Burrito was 47 cm long, Tamale was 44 cm
APGARs 8 and 9 for both
Off the charts in terms of being loved