Casey’s Birth Story

May 22, 2013

I can’t lie and say that I was thrilled when I found out I was pregnant with twins. I had just rekindled a romance with an old flame, had just been diagnosed with PCOS (on top of already having endometriosis , and was a single mom to a five year old girl. Getting pregnant threw me for a loop, but I was ready to take responsibility, and my boyfriend (fiance now) was ready as well. I can’t say that I was ever over the moon excited though, and I’ve felt more guilt about that than I ever thought possible. The pregnancy was fraught with complications from the start. I was put on progesterone very early and it made me horribly sick. My fiance moved in to take over my bills because I was no longer able to handle my extremely physically demanding job.

At 15 weeks, we found out that both babies were girls, and we began picking names. We started buying clothes, and diapers, and everything we would need to prepare ourselves for these two babies that we both already loved. At 18 weeks, I started cramping and having some spotting. I went to the emergency room where the ER doctor told me I was 1-1.5cm dilated and baby A, Samantha’s, amniotic sac was funneling into my cervix. He told me to follow strict bedrest until I could follow up with my own OB-GYN. This is where things really got rocky. I have wished a million times I had switched doctors. The ER doctor had recommended a rescue cerclage and bedrest. He faxed the paperwork to my doctor. My doctor was of a differing opinion. He assured me that this was all ‘normal’ for a twin pregnancy. He didn’t feel a cerclage was necessary because my cervix was only dilated and not really effacing. He also felt that bedrest wasn’t necessary.

I spent 90% of every day in bed anyway. I knew something didn’t feel right, but I didn’t question my doctor’s decisions. He had been in the baby business for almost 40 years. He came highly recommended to me by other moms of multiples. I can’t really tell you why I didn’t just trust my gut, but I didn’t, and ultimately my babies are the ones that had to pay for it.

The morning of November 7th was extremely uneventful. I was 26 weeks exactly, and I had felt better than I had in a long time other than nagging constipation, which I know to be normal in a lot of pregnancies. I had the same problem when pregnant with my five year old. I know this is too much information, but I was trying to relieve myself when I felt something gush out of me. I was terrified to check, thinking it was my water breaking, but when I wiped, the toilet paper was completely saturated in blood and there was blood in the toilet. I think I went into a state of shock, because for someone bleeding while pregnant, I was incredibly calm. I asked my fiance to look between my legs, because I thought I had cut myself wiping or that I had a fissure or hemorrhoid. When he looked, he saw my amniotic sac bulging out of me. I remember on the way to the hospital telling him to slow down and not drive so fast. I was calm and collected, thinking we would go in for simple monitoring, everything would be fine. But when I was describing my issues to the nurse, the fog started lifting, and I started getting nervous. I remember her telling me that there was so much that could cause bleeding in pregnancy, and I shouldn’t worry.

When she checked me, I saw her features change. And then she lied to me to try to keep me calm. ‘I can’t really feel anything because the baby is so low, so I’m going to call the doctor.’ She smiled at me and walked out. I looked to my fiance and told him that she was lying, that something was wrong. He tried to reassure me, but my heart was already racing. The doctor came in, and he checked my cervix, and told me in a grim voice that I was 9cm dilated, and that baby A was in my birth canal, feet first. I lost my mind at that very moment. I can only hope there was no one in the rooms beside mine, because my screams would have scared them to death. I couldn’t help it. It was too early. My babies weren’t due until February 13. It was November 7th, and they were coming that very day. The nurse and anesthesiologist were trying to ask me pre-op questions, and keep me calm, but my water broke, and it was time to go right there. There were no more questions asked. The grim faces of every nurse and doctor and my own mother and fiance swam in my head, reminding me of the severity of the situation. As I was being wheeled out, I looked at my daughter (it was an emergency and we had no choice but to bring her) and told her that mommy loved her so much, and she broke down crying as I was taken out of the room. That was the last thing I remember until the babies were born.

Samantha was born first at 4:28 pm (less than an hour after we arrived at the hospital), as she was baby A, and she was born silent. The doctor had pushed her back into my uterus to be able to pull her through the c-section incision. My baby B, Alexandra, was born 30 seconds later. Samantha Gabrielle weighed 1lb 12 oz, and Alexandra Noelle weighed 1lb 11 oz. When Alex was born, she let out a bawdy, hearty cry. My fiance brought me pictures to the recovery room. The hospital broke the rules for us, and allowed him to be with me. He told me they were blonde, that he had held them for a second and kissed them, and that they fit into one of his hands. He told me that Samantha was on oxygen, but Alexandra was breathing on her own. The NICU team was on their way, and they would bring the babies in before they transported them to the bigger hospital almost 2 hours away. When they brought them by for me to see, they were bundled up, so they didn’t look *that* tiny to me. I was so morphined out though, that I wouldn’t have known either way.

After the c-section, I spent less than 48 hours in the hospital. As soon as they discharged me, we made the 86 mile trip to the hospital, and nothing in this world could have prepared me for what I saw. Samantha and Alexandra were the tiniest babies I have ever seen. They were intubated, hooked up on the monitors, and had umbilical catheters. Alexandra’s eyes were still fused shut. I remember nearly collapsing when I saw them. Ashamed as I am to admit it, I never in a million years believed that either of them would make it. How could something so small survive what they were going to have to endure.

The next week was a blur of hospital, pain meds, and car rides. Alexandra was showing classic signs of brain bleed, and Samantha was still significantly bruised from the chest down from being stuck in my birth canal. Other than that, they were okay. Alexandra was down to 21% on her ventilator, and breathing over the vent, and Samantha was on about 33%, but letting the vent do the work. All okay, all was fine and dandy other than Alexandra being fidgety, and restless. On November 18th, at around 3AM, the nurse called to let us know that Alex’s belly was distended, they had started blood and antibiotics, and would we be coming in the morning? I told her we would be. I stayed awake, and eventually woke everyone else up, telling them it was time to go. I was worried about my baby girl. On the way to the hospital, they called, telling us that her vitals had dropped, and they had to do chest compressions to bring her back. We sped like demons to get there. When we got there, they said she was stable, and they were going to try to get her in for surgery soon. I needed to pump, so I went to the pumping room. The nurse came back to get me, and Alexandra was crashing again. The doctor came by, and told us as bluntly as possible that there was nothing more to be done, and Alexandra was going to die that day. I don’t know how I stayed on my feet. I just looked at her. So tiny, so precious, and wished I could die for her. I wished I could take it all away from her. I prayed for God to take me instead. I prayed for a miracle. But there was no miracle for us that day. We held her for hours as her vitals plummeted farther and farther, and finally made the decision to take her off the ventilator. I just wanted peace for my baby at that point. At 2:25pm, Alexandra Noelle took her last breath.

As ashamed as I am, again, to admit this, I gave up on Samantha that day. I gave up on living that day. But Samantha had other plans for me. She hit a turning point. She started breathing better, digesting better. Her color was better. Her apneas and desats and bradys fewer. She was nearly 5 weeks old when I held her for the first time. She was still on a ventilator. I will never forget the feeling of her skin on mine. I will never forget the way she fidgeted to find her comfy spot, and drifted off to sleep.

After 97 days of ups and downs, of blood transfusions (9 of em) and ROP, of the NICU abc’s, we walked out of that NICU for the last time with a 5lb 14 oz baby girl in tow. Things have not been easy since we have been home, but I wouldn’t trade a single second of my time with her for anything. There are still days when I don’t want to get out of bed, but I’m driven by two tiny girls that came feet first into my life weighing less than two pounds. They had the strength to fight impossible odds, and that is my driving force. I miss Alexandra every day, but I know she is constantly lending strength to Samantha. And me.

I haven’t felt strong from this experience, but I am finding a certain strength in my weakness. And I know that my strength isn’t because my daughter died, or because my twins were in the NICU, or because they came early. My strength is because my daughters fought, because Samantha overcame the odds of being a micropreemie. Because Samantha came home with no oxygen and no meds. And because Alexandra, if only for 11 days, lived and showed me the meaning of true strength and determination. The will a preemie has to thrive is nothing short of amazing. I’m inspired and astounded at the strength of my two tiny miracles each and every day.