A pregnancy and birth full of surprises

Two weeks ago you got to read the IVF journey of Megan and Ash. This is the second half of their journey. 
Megan woke early hours of the morning having very strong contractions at 27 weeks. Little did she know that a short few hours later she would be meeting her son and daughter?

Megan and Ash had the choice on how there babies would be delivered into the world.. 

Megan shares her ups and downs through her pregnancy and the birth of her twins.

Here is the second chapter of their Journey.

It took a while to sink in. After years of trying, believing that parenthood was something I would never personally experience, here I was… holding a positive pregnancy test! Disbelief soon turned to excitement, then elation, then worry, then fear… and back to excitement. Questions started filling my head thick and fast. How would I tell Ash? Was I really actually pregnant? When would I tell Ash? There was a faint second line; I wasn’t imagining it, right? Would he be annoyed that I found out before him? What and would we tell our family and friends who knew we had started the last IVF cycle? How would we not tell anyone at the wedding we were attending the coming weekend? Was I really, finally, pregnant!

I decided that I would not tell Ash as soon as he walked in the front door. I don’t know why I was holding off, but I felt that I should. We were going to a family dinner at Kerryn’s house (my step Mum) that evening and on the way there I couldn’t hold it in any longer. He was driving and I just blurted out “So, I’m pregnant”. I remember we were on a highway exit, stopped at the intersection; he just looked over at me and said “really?” And that was that. There wasn’t really much further discussion as we were already near Kerryn’s house. We didn’t mention it at the dinner and only spoke about it on the way home later that evening. It was so early (3 weeks and 3 days), my period wasn’t even due for another 7 days. The dreaded “two week wait” in IVF was the longest two weeks, dragging by the hour it would seem… although even though I had a faint second line, I still couldn’t breathe that magical sigh of relief.

We were scheduled to have our blood test confirmation in 5 days. I couldn’t wait that long. I needed to see the words “pregnant” so on the way to the wedding I did the most glamorous thing I may have ever done. I asked Ash to stop at a pharmacy and took a digital test in a fast food chain restaurant bathroom! I should have been embarrassed, but I wasn’t. I stood there in the restaurant toilet gazing down at the most beautiful words I have possibly ever seen. “1-2 weeks pregnant”. My smile was straining my cheeks. I needed to show my husband. So out to the car I walk, with the carefree motion and completely open smile I had been wanting for so long, years. As soon as Ash noticed me, he knew. As I got into the car we embraced and that for us was the moment our pregnancy was real. At the wedding we shared secret moments, stolen belly rubs, childish giggles and it was truly amazing. Our dream comes true.

We had our blood test, which confirmed our pregnancy, with really good HCG numbers (pregnancy hormone). We were scheduled for a repeat blood test a few days later and to see our obstetrician the following week. Our next bHCG had more than tripled, this pregnancy was really going to stick!

At our booking in appointment our obstetrician was kind enough to offer us a bedside scan. It wasn’t a formal ultrasound but we would hopefully be able to see a gestational sac and maybe the beginnings of our little jellybean. I excitedly jumped up onto the bed and unbuttoned my jeans, holding Ash’s hand and looking at the screen in anticipation. This was the first moment we would “see” our baby…. And then we saw it. Without question or doubt. Two little gestational sacs with jellybeans! We were having twins! I looked over to Ash who had the biggest grin on his face. He was elated. Two babies after all we had endured. My heart almost stopped beating. Twins. This wasn’t the plan. Although I desperately wanted a family and multiple children, I had never envisioned having two at the same time. Being a midwife I knew this shattered my dreams of a low risk, natural water birth. I knew my pregnancy would now be classed as complicated or high risk at least. I had watched many exhausted twin parents on the postnatal wards at work and had never thought it was something I wanted. But a few moments later I shook those thoughts from my mind. This wasn’t about me. This was about my precious children, and for the first time we were getting to talk about actual children and not just a fictional child. I may not have planned for twins but by god I fiercely loved them already. And we knew this was a potential outcome with our IVF cycle. So I embraced it. And together Ash and I walked out of the appointment hand in hand with the knowledge that we were now a family of four, and the excitement and love were almost palpable.

The next few months were relatively uneventful. We told all of our family and friends quite early, as most people in our lives knew we had being undergoing IVF and by week 11 I was starting to show. We celebrated each week, each milestone and went about our daily lives. I didn’t do much for those first 16 weeks as by week 6 I was graced with morning sickness. I had waited for the chance to have morning sickness, however when it happened I prayed every moment that it would disappear. It was constant, unrelenting and the most awful feeling I had felt at that point in my life. At the time it felt as though it was never going to end, and for 10 weeks it didn’t let up. Then it almost seemed to disappear overnight. And that was when I truly started to enjoy my pregnancy.

At 16 weeks we had an appointment with our obstetrician who confirmed the genders of our jellybeans. We were having a son and a daughter. Our Son was Twin A and our Daughter Twin B. We knew we were so blessed. Not that it would have made a difference to have two boys or two girls, but we knew our family was complete and that it was a blessing to be able to have the opportunity to raise a son and daughter. Although I must admit that I was a little nervous as I am not particularly girly and the idea of doing girly things in the future had me a little apprehensive (and still does in all honesty).

At week 20 I felt the twins moving for the first time. It was such a surreal feeling, I wasn’t aware of which baby was moving, but the flutters were incredible. I had one placenta at the front and one placenta at the back, the anterior placenta made it harder to feel the movements sometimes, but there was definitely a lot of moment all the same. And I loved every second of it. I was fortunate to be a midwife and have access to ultrasound machines. Sometimes at night I would have a quick peek and see the jellybeans moving about, bouncing around in their sacs. I could have watched them for the remaining of each shift!

At 21 weeks we went in for our routine morphology scan. The one where they count ten little fingers and 10 little toes (or in my case, 20!) they also check all of the organs and measure growth. It is an extensive ultrasound and one that I was never able to enjoy. The scan started at my cervix, I am not a trained sonographer but have been looking at scans for years and as soon as I saw my cervix on the screen I knew something was very wrong. He said he would come back to my cervix and continued on with the scan. But I couldn’t pay attention to what he was showing us. My heart was beating so loudly I could hear it in my ears. I couldn’t breathe. I knew something was wrong and so did the sonographer. Half way through the scan he excused himself and that was when I turned to Ash and told him with tears streaming down my face that something was wrong, my cervix was opening well before it was time to. We held each other and all of my worst fears swam in my mind. The sonographer entered the room and asked to do an internal of my cervix, he confirmed that my cervix was in fact shorting and told me he would phone my obstetrician. I informed him that I would be heading straight to the obstetrician’s office once the appointment was over.

We drove to the Obstetrician in silence. I didn’t have words; just my own thoughts running through my mind at a million mines a second. How was this fair? How could we come so far only to possibly lose our children? Why was life so cruel? We hadn’t even picked names yet. We met with our obstetrician who felt that I was now too high risk to be managed alone and decided I needed to be monitored by the hospitals foetal medicine unit also. I was booked in to see the consultant the following week and given instruction for bed rest at home. My pregnancy wasn’t yet viable; there was nothing that could be done.

We went home and I spent the next 36hrs agonizing hours in bed, then I started to have tightening’s. Ash drove me straight into hospital. I was given panadine forte and had a speculum exam and foetal fibronectin test done (which gives you an indication of pre-term labour). My cervix didn’t seem to be changing and the Ffn test came back low. With nothing more that could be done, I was sent back home.

We met with the Consultant who said that a cervical stitch was not an option in my twin pregnancy with a very short cervix. During the appointment we were told that I only needed to have modified activity, not bed rest, and that basically there was nothing that could be done for the babies until I reached 24 weeks, so we just needed to go home and that we would be better off if we lost them now.  I was given a script for progesterone pessaries to insert vaginally every evening and booked an appointment for the following week. We never made that appointment.

At 21+3 weeks I started having contractions. I had not been happy with the consultant that I had been referred to so I made the decision to go to another hospital. The best hospital in Victoria when it comes to premature babies in my opinion. I knew my rights as a patient and I was doing everything I could to advocate for the babies I so desperately loved. Ash was at work so my mum came to drive me into the hospital. I had another speculum and Ffn test. This time the results were slightly higher, but my cervix had still remained slightly closed. Ash arrived and a few hours later we were told we could leave, only to have a call on the way home asking that I return to be admitted as an inpatient. I was elated that they were going to try to get me as far along as they could but simultaneously devastated and shattered that this was how my pregnancy was evolving.

Once admitted we were told that a paediatrician would not be able to visit to discuss prognosis until I was close to 24 weeks, at the time this felt so far away. I wished the days away just to get closer to that all-consuming milestone. I was placed on bed rest with my head slightly lower than my trunk and given daily shots of clexane to prevent clots and continued on my progesterone. I couldn’t think, I couldn’t focus. I spent my days looking for stories of hope on the internet. I also let the realist in me start to think about the alternative. Ash couldn’t stay with me overnight, so after work he would come to sit by my bedside. We would talk about the day and also plan the children’s funerals, so if the time came we didn’t need to be blindsided making decisions in a moment of absolute grief. We picked names and bonded as much as we could with our cherubs, as we knew we were not guaranteed the coming day. We had a calendar next to my bed and every evening Ash would cross off one more day. Over the course of this time I was fortunate enough to have some incredible nurses who shaved my legs, washed my hair in bed, gave me extra chocolate milk and tried as hard as they could to be positive and make me more comfortable and I will forever be thankful to them for that. We even had one lovely nurse who included us in the nurses take out run for dinner and got us Thai food. Small gestures were absolutely the biggest actions at the time, and I don’t even think they realised how much that truly helped us. We had frequent scans and tests, each one with worse news. At 23+5 the paediatricians came to talk to us about resus of the babies and the prognosis at that gestation, the odds were not great, but we would take anything we could get and as long as our children fought, we would fight with and for them. That night I was given my first steroid shot to help mature their lungs for their impending arrival.

A few days later we were able to celebrate making the viability milestone of 24 weeks. One that had seemed so elusive a few weeks prior was finally a reality. A moment that we cherished by having a quick moment to stand and have a belly shot. My children now had a fighting chance. But the celebrations were short lived as at 24 weeks I was 3cm dilated, with bulging membranes and also had an infection in my sons’ sac. My son seemed to be doing ok and was still growing so we just continued to monitor the babies, but I was told that this also made his prognosis poorer should he be delivered this early. I was commenced on a trial antibiotic to see if we could reduce the infection. Given that I was now also dilated the risk of breaking my waters and getting an infection were also increased so my progesterone was ceased. I was now just a sitting duck. I still could not breathe easy.

At 26 weeks I was given my glucose test, which came back normal and at 27 weeks I was given as iron infusion as I was too anaemic. Ash and I had begun to relax a little. We played cards in the evenings. I had begun to attend (in my bed – which the nurses so kindly pushed into the day room for me) an arts and craft class 2 times a week (still not outside in fresh air but I would take what I could get and it was 2hrs a week out of my 4 walls that I had become a prisoner in). At 28 weeks there would be the possibility of getting out of bed, I wasn’t even sure that my legs could bare my weight, I didn’t even know what I weighted at this point and I didn’t know what carrying twins truly felt like as I hadn’t really experienced it laying down. It’s an I’ll now sadly ever have.

At 27+3 I woke at 5am. In labour. I knew it was labour, it was so different to the times I had previously had contractions. They were every 2 minutes, and they were not just tight but they were painful, enough to make me gasp to catch my breath. I held my stomach and asked my sweet children to be strong, I spent a few minutes alone with my children before the inevitable chaos and then I buzzed the nurse. She sat with me a few minutes with her hand on my stomach and tried to talk to me calmly; before 10 minutes had passed she got up and told me she was phoning birthing as she too felt I was in labour. While she was gone I called Ash to tell him that I was contracting again, I was trying to be optimistic (or in denial, maybe both) and told him to still get ready for work and I would let him know what birthing said, he told me not to be ridiculous and headed straight into the hospital. The contractions continued every 2 minutes and their intensity was increasing at a rapid rate. I was trying to remain calm but there just wasn’t enough time between contractions to collect my thoughts. Ash arrived and almost as soon as he did we were transferred to birthing. There were countless people waiting for us when we arrived. I was examined and found to be 4cm, which they didn’t think, was a change so tried to stall the labour and would check me again in a few hours. Several attempts were made to get a drip in to start magnesium sulphate and I was given oral tablets to also try to cease the contractions. I was so uncomfortable on my back but the twins needed to be monitored and the only way they were able to monitor both twins well was if I was on my back slightly propped up. Before long the pain, which had not dulled or subsided, became too intense and I asked for the gas, which did help with the pain intermittently. It was so hard for Ash and I to be together at this time, I know in hindsight he wanted to support me and I desperately needed his support also but there were so many people that were surrounding my bedside. At one point he tried to get close to me to offer me a sip of water for my dry mouth from the gas, but in his nerves and with everything going on all he managed to do was spill water onto me.

Through all of the madness there was one sweet nurse who sat near my head and tried to reassure me as well as she could. She spoke quietly and calmly and really helped me through the moment. Her name was also Ash and she was an absolute godsend for me in labour.

The doctor returned a few hours later and the examination results were much as I was expecting. I was now 8cm dilated and my son was sitting very low. There would be no success with stalling the labour. Our children would be born today. We had not informed any of our family that I was in labour. We didn’t want anyone else to be aware of what was going on yet, we didn’t want to deal with the questions, worry and support other people may have wanted/needed. So there we sat, the two of us and a room full of people we had never met making the decision of how our children would enter the world. Would we try for a natural delivery given that I was almost fully dilated? Would we go to theatre? The choice was placed in my hands, it wasn’t my Obstetrician in the room with us that day and so the decision really was ours to make alone. I had previously considered this scenario though and decided it was safest to have a c-section. Statistically there was less risk for brain bleeds for premature babies born via c-section. There would also be more organization, less chaos. I didn’t want to have one baby born in birthing and have to be rushed to theatre and have one born in theatre and two different resus attempts happening in two different areas. I just felt that I needed some control over the safety of my children, and for me, that decision was to elect to have an emergency c-section. Who will ever know if I made the right decision, certainly not me? But I feel that I made the best decision with the knowledge that I had at the time and I would make the same decision again.

I was prepared for theatre, placed in a gown, a catheter inserted and most likely given a shave (although I truly don’t remember that being done). Ash and I held onto each other and then I was wheeled into theatre to have the spinal inserted. I was virtually alone. I didn’t know the staff that were working, the amazing nurse that had been in the delivery room had not come to theatre and Ash was out in the waiting room. I felt so alone and so frightened. The pain was still so intense that I didn’t have a lot of time to focus between contractions, but fear doesn’t need to be concentrated on, it is innately felt. And I could feel it in every bone and muscle of my body, every fibre of my being. I was so afraid for my children. Would they survive? Would the ever forgive me for failing them and not keeping them safe when that was my only job? Would we watch our children grow? Within moments the spinal was over and the numbness soon took effect. I was laid down and Ash was brought into the room. He sat down to hold my hand and at this point I imagine that the surgery was already underway (I couldn’t feel it to confirm).

It felt like an eternity before Aiden Cooper entered the world. But at 11:32am he silently did. There was no meagre cry to be heard. I was very quickly given a glimpse of my son before he was whisked away to another room next to theatre where the paediatric teams were waiting. A long 2 minutes later at 11:34am my daughter Abigail Grace entered the world in the same fashion as her brother, in complete silence, not an audible sound to be heard. I don’t recall being given the opportunity to see my daughter before she too was whisked away to the adjoining room. I don’t recall how long it was before an isolette was wheeled past my face, a doctor (or nurse) telling me I could place my hand in and touch my son briefly. I tried to peer inside to see my son properly, but the angle I was on and him being covered in so many wires, leads, bubble wrap. I couldn’t see him well. But I touched his sweet, very red and fragile hand and cheek and then he and his father were heading off to NICU. And then I was alone. I began to feel tugging on my abdomen and pins and needles in my feet. I told the anaesthetist but he assured me the surgery was almost over. I still didn’t know my daughters condition and I was becoming more anxious by the second. I needed to know how she was, I needed to see her. Abigail was not able to stay close by me to have a private moment together before being taken to NICU. She was not as stable as her brother had been and was just slowly walked past my view.

I wanted the surgery to be over, I wanted to see my children and I wanted the pain that was getting more intense to subside. By the time I was wheeled into recovery I was in agony. I felt as though my insides were on fire, actually, worse than that but I struggle to define exactly how it felt as it isn’t a feeling I can compare in reality. I had told the anaesthetist several times that the feeling was coming back but the speed with which it returned was quite shocking to me. I desperately wanted to see my children and know how they were, but in this moment I was completely overcome with pain and was able to focus on nothing else. I had to be stable and have my pain under control before I could leave the recovery are. I was given morphine, endone, and tramadol, a morphine PCA and in the end a ketamine infusion. It turns out I metabolize anaesthetics at a rapid rate (or something like that, was the explanation I was given – I had told him that I had previously woken while under a general anesthetic as a child) I remained in recovery for 5 hours. On the way back to my room (the same one that I had spent the previous 6 weeks in) the nurses were wonderful enough to take me past the NICU to meet my children. I knew what to expect, but seeing it, and it being your own children is something completely different. The first feeling I had was complete shock. These two tiny beings were my children; they were so small weighing in at 1.1kgs each, so red but almost see through. They had so much hair but hardly looked like babies at all. The second feeling was absolute and total love.


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