I did the best with the information I had at the time.

I should have noticed the signs. But how would I have known? This was the furthest I had ever been along in a pregnancy. I did see my OB/GYN and complained of all the symptoms a week prior to the diagnosis: rapid weight gain, despite morning sickness all day long, heavy lower abdomen, frequent urination, and a pain on my side that just didn’t feel right. The terrifying thought that you did something wrong, that you caused this because of your actions or inactions, runs through the mind of every woman who has suffered a miscarriage, a pregnancy loss, or a stillborn. I did the best with the information I had at the time. I loved (love) my children and did everything within my power to save their lives. That’s what O. tells me and I believe her.

May 4, 2010 – 17 weeks pregnant

The perinatologist tells us that he is transferring me to another doctor. One who is at the practice more often than he is. He’s only part-time, he reports to us. Sort of semi-retired. In the meantime, I’m informed I should continue to work. I should go home and do some research, and return to see the new doctor next week.  My husband asks, “So there’s a chance we’ll come back next week and…and there will be no heartbeats?” 

"Oh yes," he replies in a matter-of-fact voice.

The online search for TTTS reveals a dismal picture. All of the experts strongly recommend you go on immediate bedrest, drink protein drinks, and inquire as to whether or not you are a candidate for a laser surgery to correct the disease. The semi-retired doc casually mentioned something about a surgery. I latch onto the success stories that are highlighted on all of the websites. I put myself on strict bedrest and medical leave from work.  I will do all I need to do to save my boys.

The following morning my feelings of despair morph into anger. I am livid that I am not being seen by a doctor for another week! I assert myself, and put the lives of my boys first as I bully my way into an emergency appointment with the new doctor that day.

Dr. S. is compassionate and direct. A difficult combination to achieve, but he does so gracefully. I feel at ease with him. He is my advocate. More importantly, he is my boys’ advocate. He is optimistic that I am a candidate for the laser surgery, and will send along my files to the specialist in San Francisco. He gives me hope that I will be that person that beats the odds, that I am a survivor not a victim of TTTS.

May 11, 2010 – 18 weeks 3 days pregnant

Almost a week has passed since the diagnosis when I trek to the suburbs for a follow-up appointment. Dr. S. is monitoring the amniotic fluid in the twins’ sacs. The fluid must increase in Baby A’s sac in order for the laser surgery to take place. It was last 7 mm and it needs to be at 8. Only 1 mm. Such a minute amount, but so large in terms of the difference between a life-saving operation and not.

Ultrasounds are meant to bring pleasure, not the anguish that invades my soul as Dr. S. turns on the monitor and glides the wand across my belly. Baby A lies still. No kicking, no heartbeat. Tears well up in his eyes. “I’m so sorry,” he says. “I never imagined this was what was going to happen.”

My mind immediately jumps to the question, "What did I do wrong?" Dr. S. hears my inner thoughts. "You didn't do anything wrong. This is rare, and completely arbitrary. No rhyme or reason." 

I did the best I could with the information I had at the time. That's what O. tells me. I say I believe her. But I can't help but wonder, what if?

Intuition and hope sometimes clash.

I wish I was writing the birth story of how two beautiful twin boys were welcomed into the S. household. Instead, I am facing a quickly approaching due date, October 11, 2010, with no babies to hold in my arms. Although carrying twins meant I would have delivered at 38 weeks instead of 40, the date still remains significant. Thus far my entries have been filled with how I am dealing with my grief. I’ve yet to share the story of my losses. Some days I have to remind myself that this truly happened to me, that it wasn’t a nightmare. Other days it feels like it was just yesterday that I received the news, a fresh wound that won’t heal.

May 4, 2010: 17 weeks pregnant

The day is filled with anticipation. An anatomy scan will take place at our appointment later in the afternoon. Throughout my day my students take bets on whether or not the twins will be boys or girls. Some contemplate what names would best suit these little ones, and others lay claim to names that have a nice ring and complements my last name.

As I’m driving to the appointment, a sudden fear infiltrates my mind. “What if something is wrong?” It's a thought that I haven’t had since I passed the first trimester marker and glided into the next phase of pregnancy.  I dismiss this silly notion. Just last week the doctor and I saw strong heartbeats and two little tykes wiggling about on the ultrasound. I remember what M., another of my spiritual healers, has said to me. Trust your intuition. I wonder for a moment, barely a second, if this thought is intuition or simply fear playing with my emotions.

My dear husband has joined me for this appointment. We are nervous, but excited to catch a glimpse of the babies. We have playfully debated about whether or not they are female or male. I hope they are girls. He, of course, wants boys. As I settle onto the table, my dear husband places his hand in mine and gently squeezes it. The technician easily navigates the ultrasound wand across my protruding belly to find Baby A. "It’s a boy!" she writes on the screen. My husband cannot suppress his grin. We watch Baby A fling his tiny limbs about the womb.  He is perfect, announces the perinatologist.  He’s measuring where he needs to be, his anatomy is all in check, and we have a healthy baby boy.

The technician then sets out to uncover Baby B. Husband and I are beaming, unaware that the mood of the room has abruptly changed. The doctor clears his throat, pacing back and forth in front of the ultrasound monitor. I’m so sorry, he says. This looks like a classic case of twin-to-twin transfusion syndrome.

My stomach clenches, and I gulp for air. Wait? Is he talking to me? I want to turn around to see who he is addressing. He continues to speak, but I’m not listening. My eyes are fixated on the screen as the technician tries to take Baby B’s measurements. I perk up when I hear him say he’s never seen someone have this rare placental disease so early on in pregnancy. I swallow the lump that has formed in my throat, and sputter, “So we could possibly lose not one, but both boys?”

Intuition and hope sometimes clash. I knew why I was asking the question. Earlier in the car it hadn’t been fear. I knew the answer, but was hanging onto the hope that my intuition was wrong.

Moving Forward Fearlessly.

“I’m surprisingly okay,” I announce as I settle into a chair in S.’s office.  After this loss, I thought it was over, that this would be it. It’s only been a week since it happened when I make this statement, but I really am fine. I’m not pretending. I am confident that I can move forward. S. is not surprised by my calmness. A holistic fertility specialist, she chose this profession because she has followed this path too. The same history: an early miscarriage, and a late pregnancy loss followed by another miscarriage. She was expecting me to say exactly those words.

I secretly think S. is really an angel sent by my loving relatives in heaven. She’s here on earth to hold my hand on this reproductive journey. Her spiritual guidance has taught me to honor my emotions. Because of her, I’ve learned that I cannot control what has happened to me, but that I am the driver of my emotions.

I’ve been told to not dwell on my loss, to move forward. Others tell me that “it’s just a miscarriage” and that I will have other children. I listen patiently, nodding and smiling, while they recall stories of those that have had similar experiences and of so-and-so who now has one, two, and three children. I know this support comes from the goodness in their hearts. Not knowing what the future holds is uncomfortable, and seeing a loved one hurt for whom you have no answers must be even harder.Could you tell a friend who lost a beloved member of their family to get over their grief after four months? I think not. I hope not. This is a trauma that will play a starring role in my life that cannot be overcome in a short period of time.

I’ve been through a miscarriage, two in fact, and this was not one. While a miscarriage is not to be easily dismissed, a late pregnancy loss, in my experience, is different. The loss of my twin boys according to the medical field, and is duly noted on my record, is a fetal demise. The words sting and I shiver every time I hear or read this clinical term, but it clearly indicates this pregnancy loss was a death. A miscarriage can absolutely be categorized as a death, but the ones I endured were the end of a future that I had imagined. I did not know their genders, nor did I have the opportunity to hear their little hearts beating or watch them kick each other inside my womb on the ultrasound machines. With the boys we had passed the point of an imagined future, and were making plans of a reality. I felt them, I saw them, I love(d) them.

In order to look toward the future I need to feel in the present. I wouldn’t have made the announcement to S. that I was okay if I hadn’t acknowledged my sadness and let myself cry uncontrollably; if I hadn’t recognized my anger and broken plates in the back alley (ok, that’s a dream I had, but it did make me feel better); if I hadn’t allowed myself to feel hope that one day I will be the mother of a living child. 

So for now, I will continue to feel in order to honor today’s mantra: moving forward fearlessly.