And Here’s Another Baby!: Tales of an over-forty twin pregnancy, part two.

We’re pregnant.

These were the words that Ned/Thor/Gunnar and I uttered to ourselves for a week after we got a positive pregnancy test. Over and over and over. By the time we were headed to the ultrasound appointment, I had rearranged bedrooms and furniture in my head a hundred times. I could do this. We could do this. Everything would be okay.

The ultrasound tech was young, and perky. She was chatting with us about our situation, and one or both of us mentioned that this pregnancy was not planned. As she was busy clicking and looking at the screen she said, “You weren’t trying at all?”

NTG gave her a solid, “Nuuuh-ooo. No, no, no, no.”

A few more clicks and she said, “Um, Dad? You may want to sit down for this.” NTG’s head jerked upward, and we looked at each other. “Why?” we asked in unison.

She turned the little monitor towards us and on it, was a little peanut, heartbeat flickering away. The tech said, “Here’s baby,” and she waited a few seconds before she moved the wand on my stomach upward. “And here’s another baby!”

Wait.

What?

Everything stopped.

NTG, I believe, was shaking his head. The tech, delighted that she had discovered twins, because it only happened a few times before, pattered on and on next to me. I felt the dread and awe come over me all at once. As I looked at these two little beings on the screen, I instantly knew they would be healthy and strong. They were here already, after all. Blinked right into existence in my abdomen.

And then she said something else. Almost casually, “So it seems they’re in the same sac, so the midwife practice will give you an OB recommendation, and that doctor will refer you to a Maternal Fetal Medicine specialist.”

I’m pretty sure I said, “Oh. Okay.” I already was aware that a twin pregnancy would boot us out of the midwife practice. I didn’t yet know what was to come.

Stunned, we left the office. Walked out the door. Piled into NTG’s new car. The entire 50-minute ride home, NTG was ratting off exclamations: This is two more college tuitions! Ohmygod, what if they’re girls? That’s TWO weddings! We have to get a bigger car!

I wasn’t thinking in practicality. I was just feeling. And my feelings were that I was in trouble. I was in over my head. I was used to being excessive; it’s part of my personality. This? TWINS? This was too much.

Then I got home and Googled: “Twins in same sac.”

My heart stopped. Twins in the same sac, or monoamniotic-monochorionic twins, are a rare case of twins in which the fetuses share the same sac and amniotic fluid and the same placenta. Basically, when an egg divides and becomes two embryos, if it doesn’t divide all the way, this is what can happen: babies that share a placenta, babies that share amniotic fluid and the placenta, and babies that are conjoined. This handy diagram simplifies it for us. https://en.wikipedia.org/wiki/Monoamniotic_twins#/media/File:Placentation.svg

Now, if you are pregnant and have been to your first ultrasound and are told you have mono/mono twins, and you are reading this: DO NOT PANIC. Yes, this type of twins comes with great risk, but it is extremely rare, and in most cases a subsequent ultrasound will find the babies are in two separate sacs. That little tidbit of information took me a good half hour and ten articles on the internet to find, and was confirmed by a healthcare professional the next day.

I then chose an OB based on my midwife’s recommendation and made an appointment for the next week. NTG came with me, and the first thing she did was recommend an MFM (Maternal Fetal Medicine) practice and told me to call and make an appointment for an ultrasound. I had to tell them yes, I was less than 12 weeks, but we needed to find the membrane and confirm if they were mono-mono twins. And it needed to happen as soon as possible.

This was the scary part. See, the biggest risk to mono-mono twins is cord entanglement. There are a few things that can be done about risks with a shared placenta, but if the cords become entangled, there’s nothing to do but pray and wait it out. It means one or both of the fetuses might not make it.

And it meant if they were mono-mono, we’d have to decide if we wanted to go through all of that, or terminate the pregnancy.

I know. It was heavy. In that week before that first ultrasound with the MFMs, it was all I could think about. I kept telling NTG I couldn’t imagine this was their fate. I mean, they’re here. They exist. Why would that happen only for them to not make it?

The day of the ultrasound, once I was checked in and on the table, the very first thing the tech did when she put that wand on my belly was look for that membrane. And bam! There it was. We ruled out mono-mono twins in an instant.

After the technician was done, I met with my first MFM doctor, whose name was Erin, and she was no nonsense. She told me that we weren’t quite out of the woods yet. The twins were each in their own sacs, but they shared a placenta, which made them monochorionic-diamniotic twins. It meant they were at risk for several things:

1. They could have a uneven placement in real estate on the placenta, meaning that one twin got more space than the other, and therefore one would develop just fine and the other would fall behind.
2. They could have an imbalance in the amniotic fluid, which means one twin would get more than the other.
3. The veins that attach to the placenta could grow into one another, in which then one twin would be “feeding” the other, and therefore have a lag behind in development.

Two of these are treatable. The first one is not (again, pray and wait).

So we prayed. And waited. I didn’t want to tell anyone until we had hit another milestone and could see they were developing. And we sat on this news: surprise pregnancy, twins, high-risk, for months.

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We Weren’t Trying to Get Pregnant: Tales of an over-forty twin pregnancy, part one.

I got pregnant when I was 42 years old, and I quickly discovered there were two camps when it came to pregnancy over 40: Those that wanted to know how I got pregnant over 40, because they are trying to get pregnant, and those who wanted to know how I got pregnant over 40 so it will never, ever happen to them.

I’ll ruin the surprise for you. It was a surprise. I was completely and utterly, totally NOT trying to have another baby.

I’d always wanted three kids. Three seemed perfect. So my husband, Ned/Thor/Gunnar, aka NTG, and I had baby number one three years into our marriage. A few years later, after a big move and when Max was two, I had to convince NTG it was time for another. (This is not limited to children. I have to convince NTG of most things. He is the opposite of me, The Doer. He’s the Non-Doer.)

We had Andy, and right after, Max received his Autism diagnosis. As you can imagine, our lives changed drastically, raising a child that was on the spectrum, and then raising one that wasn’t.

It was a lot. And NTG didn’t want a third. And the more I watched Max and Andy, the more I thought we’d lucked out. I honestly was afraid if we had another, we would have another child on the spectrum, and that was scary. At the same time, I thought it would be nice for Andy to have another sibling (one that didn’t bully him) and then when he was an adult, there would be someone else to lean on.

I always had a feeling I would have a “surprise.” On top of that, my gut also told me I would have twins. I mean, most women that ever consider becoming mothers also consider what it would be like to have twins. But I just had … something more than a feeling. But after we had Andy, I left it up to fate. Well, as much as I could. I was on birth control.

As women, we all have a “scary” age. A mental line we draw and think, “No, I wouldn’t want to be pregnant then.” That age, for me, was 40, and it came and went with no shock, no twins. Nothing.

It surprised me that parts of that really hurt. I looked up at the Universe and thought, “Well. That’s that.” But I didn’t feel complete, and it seemed everywhere I turned there was some lovely mom I knew in town, or followed on Instagram, who was YAY! PREGNANT! NUMBER THREE! (And not just pregnant with a third, but with a girl.) I was taunted.

On the flipside, it still felt like: If it was meant to happen, it would have happened, right? So I accepted it. I threw myself into work. Into therapies for Max and play dates for Andy. I started really moving out of the labyrinth of motherhood and doing unheard of things like being social, and joining the church council and taking my mother on a beach trip for her 70^th birthday.

Awesome, right? In the midst of all of that, the low-dose birth control I was on stopped being effective, so I took a break from it and had The Talk with NTG about our future birth control plans. He wasn’t fond of his options, but my options were far more complicated. And my lovely, husband, the Non-Doer, sat on his option and did the thing Non-Doers do best. Nothing.

Now, I was a good little cycle tracker. I used OTC birth control. But NTG, or me, or both of us are historically very, very fertile. (Up until that point, all three of our pregnancies had happened very quickly.) A few more months go by, and I kept bringing up to my Non-Doer that he wasn’t doing the thing he needed to be doing.

My beloved Walter.

And then, my cat died. (That’s another post). That grief is actually something I still carry with me, because that whole process was interrupted by a little pregnancy test that upended our whole lives. After several solid days of crying, it dawned on me that my period hadn’t started. I actually said to my husband, out loud, “I’ve heard of grief affecting a woman’s cycle, but it’s never happened to me before.”

Ha.

Ha. Ha. Ha.

Honestly, I don’t remember why I took a pregnancy test, but it was a week after my period should have begun. I had some in the house, because this was not the first time since I dropped the pill that I had taken one. And each one of those times, instead of being ready to welcome a surprise, I held my breath. Each time the negative result was an exhale.

When this test turned positive, it took a nanosecond. (I now know this is hormones. Lots and lots of extra hormones.)

My first thought was, “My mother is going to kill me.” Honestly, I felt very much like I was a wayward teenager than a 42-year-old married woman. How could this be? How could I do it again? What about my job? Ned/Thor/Gunnar is going to freak out?

But he didn’t freak out. Instead he took the test and said, “Okay. Well, why not us?”

So I called the midwives and made an appointment for the following week. The first would be an ultrasound, and what an ultrasound it would turn out to be.

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