Change of Plans

May 21, 2012
Daphne Abigail

Daphne Abigail

I had a plan. I wanted two children. My first daughter was a winter baby, and after a gloomy postpartum period, I decided my second should come in the spring, so I could be out and about during maternity leave. When Lucy was two and a half I got pregnant, with a due date in late May, according to the plan. Pregnancy symptoms came fast and furious, which I had heard was normal for a second pregnancy. By my first prenatal appointment at seven weeks, I had violent morning sickness and my pants were tight. Within the first few seconds of the ultrasound, the reason became clear: two heartbeats.  The doctor smiled and I hyperventilated. My husband, perched on a chair across the dark room, tried to understand what was happening.

“There are two in there,” I barked. This was not part of the plan! The doctor was quiet, and said she needed to call in a colleague to “determine the twinning.” The MFM came in and uttered the words that would scrap the plan: “This is not good.” There was no time to get used to the idea of twins before we had to be scared for their lives.
Our twins were monoamniotic, which means they shared not only a placenta, but also the amniotic sac. In their little tub, they were free to swim around and tangle their umbilical cords. Without intervention, I had a 50/50 chance to see them come out alive. The protocol would be to check into the hospital in the second trimester for fetal monitoring. That way, at the first sign of trouble, the babies would be delivered. The goal was to make it to 32 weeks, when they would be safer out than in my uterus. That was the plan.

I was admitted at 26 weeks. We allowed ourselves a giant exhale. Of course, it was stressful leaving behind my 3-year-old, my job, my life, to sit in the hospital and monitor watch. The babies were still small enough to move around, and kept escaping the monitor. Each time, the nurse would try to find their heartbeats. If she couldn’t, a resident came in with a portable ultrasound machine. I would hold my breath until one flickering little heart appeared, then another.

One afternoon, less than a week into my stay, I had just finished eating a homemade lunch that my husband had brought. We tried to reposition the monitors, which had slipped while I was sitting up for lunch, but could not find Baby A. That was highly unusual, as she was usually calm and easy to find, near my cervix. Baby B was incredibly active and bouncy, evading the monitor several times a day. This time, A was missing. The resident came in and again, the ultrasound ended the plan. She touched Baby A with the wand and I knew it. My daughter was gone. “I am so sorry, I don’t see a heartbeat,” she said. Her eyes filled with tears. Baby B’s heart rate was erratic. “Please save the other baby,“ I begged. My OB rushed me to the OR, anesthesiologists put me to sleep, and when I opened my eyes in recovery, I was empty.

The neonatologist approached me, larger than life. He said he was sorry for my loss, but congratulations on my new daughter. She had lost a lot of blood, so they gave her a transfusion. She was moving all around, he said, so he was “cautiously optimistic.” I was numb. The pain from the C-section distracted me from the other kind of pain. My husband rushed to the NICU to visit wiggly Baby B. At 27w 4d, she weighed about 2lbs. That night, after I had been moved to a room, we named her Daphne Abigail. Her angel twin, Leah, was not named until days later. We will never know why we lost her. It was not a cord accident. It may have been a case of acute TTTS, but as my MFM explained, it is hard to know if it happened before or after her death.

Daphne’s NICU stay was long – five months. She suffered permanent kidney damage from the blood loss at birth, and will likely need a transplant. She had a congenital heart defect fixed when she was 6 months old. At three years old, she continues to face many long-term effects of her prematurity. She is a bright, beautiful little girl who approaches everything in life with gusto. We follow Daphne’s plan.