Tuesday, June 7, 2011

Birth Of A Mother

My twin girls turn 8 years old today and like all mothers I have spent the day recalling their infancy, what I did while in labor, the delivery and all the special moments that we have spent together.   Being pregnant now is making me SUPER sentimental soooooooooooo you get the pleasure of revisiting with me one of the most painful and beautiful times of my life.
When I found out I was pregnant, I was very not ready to be a mother.   I was 21 and in college but I determined that carrying the pregnancy through was something that felt right to me.   It was not until I was 17 weeks along that I discovered there was not just one baby in there but two! The anxiety and restlessness of accepting that you are carrying twins is something for another post entirely.  The pregnancy was normal and went very well until I hit 24 weeks.

  One night, I felt some light contractions and was not sure what they were really because, well, I had never felt contractions before.   I knew something was not right though.   The contractions continued to get stronger and closer together until I finally decided that I would need to visit the hospital to make sure everything was okay.   My partner drove me to the hospital where I was promptly admitted, strapped with a contraction monitor and thus began my 8 week stay in the hospital.   At first they gave me shots of a medicine called terbutaline.   This medicine is used for asthma but one of the noted side effects was stopping pre-term labor.   How this connection was established is beyond me. Hey, your asthma attack is gone and look here!   Your uterus isn't contracting anymore!   What luck!   Anyhow, it helped mildly with my contractions but the nurses and doctors thought that giving me a shot of this medication in my arm every few hours was a good idea.   By day two, I had been injected so many times that my entire arm was bruised and swollen.
This was in 2003.   Here is what the FDA said just this year regarding terbutaline and pre-term labor:

In February 2011, the Food and Drug Administration has ordered to put a boxed warning on the drug's label. Pregnant women should not be given injections of the drug terbutaline for the prevention of preterm labor or for long-term (beyond 48-72 hours) management of preterm labor, and should not be given oral terbutaline for any type of prevention or treatment of preterm labor "due to of the potential for serious internal heart problems and death."
The American College of Obstetricians and Gynecologists also discourages the use of terbutaline for preventing preterm labor.

Once it was determined that the terbutaline wasn't going to do the trick alone, I was started on an IV of magnesium sulfate.   When introduced to this medication you feel like your entire body is burning from the inside out.   You cannot walk, talk, think or otherwise do anything remotely human.   It basically relaxes every single muscle in your body (including your brain).   Look up the term "mag brain" you will see what I mean.   So, this was going to be my life......   terbutaline shots and mag sulfate and a hospital suite all my own for the next 8 weeks until my twin girls were born at 32 weeks.
Living in the hospital is about as horrible as any stretch of the imagination can muster up.  I lost myself in that hospital bed.   I became a ghost.   Endless meals on trays, television, visitors, the smells, the nurses, the other women laboring, delivering and going home..... and me?   I remain.   I lay and I wait.   Ultrasounds, cervical checks, IV beeping for some button to be pushed, waiting and waiting and waiting.   I watched spring arrive from my hospital bed.   Fresh air a memory, an idea.
At 32 weeks, everything gave out.   My contractions continued to gain purchase though the heaviest possible doses of mag sulfate and turbutaline shots.   My cervix was dilating.   Things were moving along and to top it all off, I had preeclampsia (basically rising blood pressure with risks to the babies).    They bumped all possible medications to the max until I was basically a puking, crying, groveling mess.   This stupid doctor, I will always remember him, said to me, "you've got to calm down, you are making things worse."   The look I gave him was something like this:

During my stay in the hospital I had a weekly meeting with a neonatologist to discuss the risks my babies faced if they were to be born that week.   I knew from these discussions that my children, although very tiny, would be considered "viable" outside the womb and had a near 100% chance of surviving with the help of the NICU.   I was ready.   It was a difficult internal decision to make.   Knowing that your babies would be best kept inside but keeping them there was killing you....
I was prepped for c-section and my family was called.

Hearing the cries of my babies for the first time is by far the best sound I have ever heard in my entire life.   Every cell of my body was on a pivot....a pause....until I heard.   They cried and they were alive and they can breathe!   Clara was born first and the doctor waited a minute to deliver Ellie so she would have her own separate birth time.  I was quickly shown their faces before they were whisked away to the NICU for immediate care.  The remainder of the c-section (sewing up) and the recovery room are a blur to me.   When I woke up, I was brought up on my gurney/stretcher thing to see my babies in the NICU.   I was so weak, I could not hold them but my partner and nurses helped support them as they were brought close so I could meet them for the very first time.
Seeing my children so small, so real, so in need of constant care was quite a startling reality and one the would continue to unfold for the entire first year of their lives.   The machines, IVs, tubes, wires, the beeping, the measuring all merged together to be the backdrop to my new role as a mother.   I felt like an outsider looking in, useless to my babies when every fiber within me wanted to just scoop them up and hold them.  

They stayed in the NICU for a month, which is very good for infants born at 32 weeks.   What took the longest was their ability to regulate their own temperatures.   Being a new parent through the NICU is an experience that you would not want first hand experience with.   The alienation, fear and anxiety that ride your back everyday is overwhelming and terrifying.  You worry about everything from the way you hold them, to the possible germs on your clothes, if your voice is too loud, if that beeping you hear means your baby is in danger, the nurses are hovering around you like vultures making sure you aren't going to fuck something up.   Even something as simple as the desire to hold your baby must be only at specific times and if permission is granted, otherwise, your interaction is simply viewing them from outside their incubator.  
We brought them home on July 4th, Clara and Ellie's personal independence day.  And as much as I would love to narrate the tale of their life at home, this is the story of their birth and my birth as a mother.   We three have grown so much in these eight years we have had together and I honor their existence every day.   They truly are my little miracles.
Ellie (left)  Clara (right)   4 months 
Ellie (left)  Clara (right)   5 Months

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