BOGO Babies, or Getting Knocked Off My Low-Risk High Horse

Everyone loves a good pregnancy story, right?  I figure I should record it for posterity before it is overwritten in my memory banks by the actual birth.

I found and had three meetings with a wonderful CPM.  We decided to have just one ultrasound - my feeling being that if you are going to have a home birth, there's no harm in ruling out easily-spotted problems.  I was not going to find out the sex.  (I know ultrasounds aren't perfect, but I still feel that the risks of intervention are outweighed by the benefits of information in this case).  So on January 4, 2012, The Husband and I happily drove half an hour to the practice of the OB the midwife works with to have an anatomy ultrasound performed.

Back to the ultrasound room we went, lighthearted enough, even though I always get a little jittery before things like this.  I hopped up on the table, and the guy told me I needed to empty my bladder, and that it was the fullest one he had seen that day.  So I went and did so and hopped back up (I can't believe I was that nimble just four months ago).  Within about 30 seconds, he said, "How many babies were you planning on having?"

"Just the one," I said.

"Well, there are two in there."

I laughed, in a probably mildly unhinged manner, for a couple minutes, then had to be still so he could look at a few more things.  He couldn't do the full anatomy scan on both twins due to scheduling, but he checked their hearts, brains, and also identified the type of twinning.

Thence began a happy, but difficult, January.  I immediately, if sadly, ruled out home birth - just too risky, especially with monochorionic twins, even diamniotic ones.  (No, I didn't know the terms before, but here's the important thing:  they share one placenta but have their own amniotic sacs).  I picked an OB/midwife practice; it was terrible, and I cried at the first appointment.  I then switched practices and it has been great.

The first OB said some pretty terrible things.  Like:  no option of a vaginal delivery unless both twins were vertex; he would induce me when I got to 38 weeks; oh, and in the ever-so-likely even of a c-section, would I like them to tie my tubes "while they were in there?"  Hence the weeping.  My OB now?  Vaginal delivery as long as the presenting twin is vertex (and they are about the same size, not distressed, not preterm, and other reasonable stipulations); no one will say "induction" unless I go to 41 weeks (pretty unlikely); and, in general, a c-section is not the preferred method of delivery.

I had a very hard time admitting I am a high risk pregnancy.  Unfortunately, there's simply no getting around it; monochorionic twins ARE high risk.  They die in utero more often than singletons, whether it's early or late in the pregnancy, even more often than dichorionic twins (twins that do not share a placenta).  They can have Twin-to-Twin Transfusion Syndrome (TTTS), where their mingled circulation can cause one twin to have too much blood, urine, and amniotic fluid while the other has too little of those things.  Placental abruption is more of a danger during delivery.  Heart defects are more likely.  Preterm delivery, and especially very preterm (before 34 weeks) is more frequent.  Going past 40 weeks appears to be more risky with twins than it is with singletons as well.

Having said all that:  I'm happy to say I am being treated as normally as possible, while being monitored very closely.  My midwives (CNMs) have been amazing and are respectful of my general hippie-ness.  I even detect a touch of excitement from them!  Their plan of action has so far included: an in-depth ultrasound that checked for uneven blood flow, heart problems, and a bazillion other things (it took over an hour, and I nearly passed out from being on my back, but at least now I have an iron-clad reason not to be on my back during labor!); twice-weekly non-stress tests staring at 32 weeks; once-weekly biophysical profiles starting at 34 weeks; and growth ultrasounds at each midwife appointment going forward to verify that growth is equal and not slowing too much.  (Unequal growth is a very obvious sign of the previously mentioned TTTS).  Is this a lot of stuff going on from now until birth?  Absolutely, but it's "stuff" that actually improves outcomes, and that's all I ask.  Poke me, prod me, strap three monitors to me twice a week, but improve my chances of having healthy babies!

So, here I am, 34 weeks pregnant with monochorionic/diamniotic girls who are creeping up on 5 pounds each.  Yes, I am uncomfortable, huge about the belly, tired, and I sleep alone because I get up all the time due to a full bladder, heartburn, hunger, or some combination thereof, but I'm awfully close to bringing some kick-ass healthy twins into this world, as close to "the old fashioned way" as possible.  I am controlling what I can, which is mostly what I eat and how much I rest.  I still think those things, especially the eating, are incredibly important.

I realize that I've left out all my feelings about the actual having of two babies thing.  In short, the idea of going from one kid to three so quickly was an incredible shock, but we have mostly processed it.  I don't think we will fully comprehend it until they are here.  But just know... it could happen to you!

Goodness!

It's a good thing I take better care of my family than I do this blog.  Truth is, it's been a weird couple of months, with a wonderfully happy ending(s).  I hope to start writing semi-regularly again now that we are settled.

The Husband finished his first year of graduate school with flying colors and so much stress.  However, things began to break down over the summer and it was ultimately decided that he would quit.  That certainly took awhile for me to process, but I did my best to be supportive.  I was, in some ways, quite disappointed, almost to the point of grieving - that PhD was the !thing! that was going to solve all of our problems.  (Wait - looking at it from this side, I can see that we don't really have that many problems).  So a job hunt began, and as the end of August, and the stipend, approached, I finally had a solution.  I wanted to go home.  Home being central Pennsylvania, mountains and all.

For a few days, I put it forth as our worst-case scenario.  The cost of living in central PA is such that one of our incomes (TH actually started working remotely for the same place I do again; he worked there first and they are always glad to have his help) would be sufficient for rent, a car, everything (if necessary).  Then TH had an interview for a job in Nevada, and I realized that Nevada sounded god-awful and that I was severely freaked out by the idea of going that far away from the East coast and all my family.

So, the decision was jointly made.  The more we talked about it the more we liked it.  We found a house and started packing (we had actually started earlier, because we knew one way or another we weren't staying in the cave).  We arranged our move-in for September 25.  On September 20, my grandmother died.  She had been living with my parents.  They tried to take their first non-camping vacation in years, and my mom's first real break from caretaking in at least 9 months.  They had a nurse/friend stay with her, and while sitting in a comfy chair, she had a heart attack and died almost immediately thereafter.  She was 93.  The nightmarish practical side of it was that the Bee and I had to rent a car on the 22nd to drive up here for the funeral, leaving poor sainted husband to finish packing himself.  My parents and I drove down to fetch him (and of course the moving truck!) on the 25th, then back to Williamsport the same day.

We've been in Williamsport for nearly a month.  My immediate family (parents, brother and his family) and a good chunk of my extended family (aunts, uncles, my bazillion cousins) are within 30 minutes of my house.  And it is wonderful.  The city has its charms, it's so close to beautiful outdoorsy adventures, and having family makes having a two-year old so much better.  I was so resistant to the idea of ever moving back to this state, and I feel like doing so and being able to successfully interact with my family on a regular basis was a real growing-up experience for me.  The house, while modest, has 3 bedrooms and an enclosed porch for laundry and playing, which is a real improvement over a 600 square foot English basement (and at half the expense!)  But best of all?  TH found what is quite nearly his dream job working for the county.  He starts next Monday.

Wait.  Maybe that's not best of all... I found out on September 12th that I am pregnant.  Not unexpected, and very welcome.  I've already found and met with an experienced CPM in the area.  She is wonderful and we're having this one at home!  I am nearly 10 weeks and doing well, already a little pouchy, I kid you not.  So, yay!  I am so looking forward to having actual support during the postpartum phase.