The Changing Meaning of “High-Risk Pregnancy"

24w5d pregnant
Framingham Hospital, Post-Partum room 357
Belly circumference: 42”

Until yesterday, our high-risk pregnancy meant that we got another doctor, twice the amount of doctor visits, and ultrasounds out the wazoo (7w, 12w, 19w, 23w so far.) Now it means something completely different. It's seemed a bit strange being in post-partum with no babies to show for it. The all-to-real possibility of having babies born way too early (each girl stands about a 50% chance of survival at this rate, according to several sources) at not even 25 weeks hit yesterday like we drove our car into a brick wall.

I suppose I got up about noonish and Paul brought me cereal for breakfast. I hunkered down in my comfy chair on the 3rd floor to watch some TV... all a normal day for me. I was contemplating having Paul bring the laundry baskets down to the basement for me so that I could get something productive done during the day, maybe wrap some of those presents I didn't get to before Christmas for people who won't show up for a week or two anyway. I had plans, albeit calm ones. My typical day lately (except for the Christmas rush when I was going to stores to shop a bit until my back hurt).

About 3:00 p.m. I went to the bathroom and found that I was bleeding quite a lot. I know it looks like a lot more in the toilet, but it was real blood and definitely a flow and a few clots. All the info I have says call your doctor if you see anything bright red or clots at all, so first I texted Paul, who was on his afternoon walk with Jacoby. I asked him – do I contact the old OB I'm transferring from or the new OB, with whose midwife I have my first appointment this Thursday. He said call them both, see who picks up. He was afraid they wouldn't be working normal hours because it was, in effect, Christmas Monday. Turns out my new OB, Dr. Jacobsen, called me back in less than 3 minutes and said I need to be checked out, so go right away to the ER and they'll be expecting me and send me up to Labor & Delivery. He said he'll see me soon. I was ready to go by the time Paul got home from his walk, so he drove me over, and dropped me off at the ER door to then go park the car.

Of course, the ER is never an immediate gratification type of place. I was about 3rd in line. Paul parked quickly and probably almost ran into the waiting room with me. I was shaking at this point from panic about what could be wrong with the babies. I had left the house thinking I wouldn't be back for several days. I pleaded with him to help me (he was a bit calmer than I was at this point) and asked him to get me in right away. Then I saw that the woman checking people into the ER was Dianne, a woman from my movie meetup who is actually a lot of fun to be around. If I ever knew she worked in the hospital, I had forgotten (I ask almost everyone in the group when I meet them what they do for a living, to break the ice) and was so happy to see a familiar face in such a scary situation. I told Paul, “See if her name tag says Dianne. She's a member of my group.” I didn't know if the woman looked like her or was actually her. So he says yeah, that's her. And I go up to the doorway of the room and pop my head in and say, “Dianne, it's me, Dana. I need to get in right away to Labor & Delivery. They're expecting me.” She goes, “Oh, Dana! Come with me right away!” and whisks Paul and I in the back, down a short hallway and puts me on a gurney and gets us a nurse, who wheels me right up to L&D. The whole thing happened very quickly, but I kind of felt like Dianne working here, at this exact time, was one of those things you tell yourself is coincidence if there's not a higher being in charge of things.

I don't really believe that God is manipulating us like pieces on a gameboard. I don't think he arranges our day for better or for worse. But I certainly felt something yesterday when Dianne was the one help us out at the desk and get us back and quickly wheeled up. Call it coincidence if you want to. I choose not to.

At any rate, when we got up to L&D and they found a room for me, Paul in tow carrying my winter coat, scarf, sweatshirt, purse and just as scared as I was, the resident OB, a very kind and gentle woman named Dr. Hernandez, and a very wonderful and calm nurse whose name I got in the beginning but was too panicked to remember, began right away to hook me up to some baby monitors so that they could run a non-stress test on me (ironic naming, considering I couldn't have been more stressed!) and the 2 baby girls. After some maneuvering of the sensors, normally meant for bigger babies, and some repositioning because both babies were kicking and moving around, they got both girls on and both seemed just fine. Heartbeats generally in the 140-155 region and as steady as you can expect with wonky monitors on them.

The atmosphere in the room was very calm, which helped Paul and me settle down a bit. I met Dr. Jacobsen shortly thereafter, or so it seemed, and it turns out he's super nice, funny, and easy-going. You can tell the man smiles a lot in his life. I had a speculum internal exam by Dr. Hernandez with Dr. Jacobsen peering in (all looked fine, I had stopped bleeding probably a few minutes after I got to the hospital), and then Dr. J did an internal manual exam that didn't hurt nearly as bad as he warned it could if I tensed up (I was sure not to!). He found my cervix to be tight, long and closed. All signs that are wonderful news. If pre-term labor had started, it would be thinning, shorter and starting to open. Just in case, though, he ordered a 2-shot, 24-hour-apart regimen on steroids to mature the babies' lungs so that if they were delivered in the next day or two, they'd have a fighting chance. I asked what would happen with the drug if the babies stayed put? Nothing bad. The drug would still take effect, but they'd just have a jump start on their lungs.

He also said that he'd want to keep me in the hospital overnight, until the next shot on Tuesday (today) at 5:00 p.m. The nurse later said that in the morning they may decide to send me home and then come back again for the shot.

Dr. J said I'm on “modified bed rest” for at least a few weeks, which means I can get up to go to the bathroom, but nothing else. I wasn't allowed to shower yesterday (too bad I didn't sneak one in before all this started yesterday afternoon, as one of the lovely side effects of this pregnancy for me is that the lush hair the other women claim during gestation just has manifested itself as oily hair after about 12 hours for me. Lots of ponytails lately!). I had to stay in bed. I'll ask about showering today when Dr. J stops by this morning at some point.

Paul asked about his trip to Florida next week, which is a belated trip for Alice's high school graduation. He's planning on leaving on Saturday the 1st, at which time my parents are coming up to help me, feed me, walk Jacoby, do whatever I need to get ready for the baby shower weekend, which is the next weekend. Paul was planning on returning from Florida on Thursday, but that may be bumped up a bit now. Then my mom's coming in Friday afternoon (the 7th) and will be staying for a few days into the next week to help me organize things like wash baby clothes, etc. We were going to shop for baby stuff, but that's out now. Thank goodness for online shopping, which may be my option now. At any rate, the doc kind of said, “Let's see how things pan out tomorrow.” That is, if the bleeding returns, maybe not such a great idea. He offered to write letters to get out of reservations, etc.

Paul and I talked today a bit about it and realized that as long as he gets Alice and her friend down there and checked in, he could come back like the next day or in two days and just tell them to ride the Disney buses to where they wanted to go. He would have served as chauffeur, but there are other options for their transport. I'd rather have him home than not now that something's happened, but we'll see what the doctor advises. At least I'll have all the help I'll need with Dad and Jannine coming up in Paul's stead.

The doc said that if I “behave” (I said it's the babies who have to behave!), this bed rest could get more lenient in the next few weeks, but he'd keep an eye on things and let me know. I think I'll probably have more appointments with him and his midwife than maybe normally, but that's not a bad thing.

I asked him, naturally, about the baby shower. I said it could just be a matter of me driving to the restaurant and sitting there for a while. He said that should be okay.

The nurse, in a calm moment, told me that they wouldn't necessarily be able to explain why this happened. They'd look, but sometimes there's no structural reason it happens. It appears that this unexplained bleeding is what I had.

She took blood, gave me the steroid shot in the arm (intramuscular – yay), and took a urine sample. All routine tests. So far, everything's come back okay, including the tests the docs performed. It's good to know they have a system in place for this scenario, that they know the routine even if I don't, that no one's panicking about anything. That's reassuring.

A bit into the evening, I got moved to a post-partum room, when it was apparent I wasn't going to be delivering these babies in the very near future. It's a double room with no roommate, so Paul slept on the other bed last night. He keeps running home (2 blocks away from the hospital) to walk the dog, get food for us, bring me more things. I just left with my purse yesterday, which I had packed with phone and charger and iPod and charger, but that's it. He's been trying to make me more comfortable (and less bored, as it's totally boring here without anything to do). He brought a few movies, one of which we watched last night (Flash of Genius with Greg Kinnear), my laptop (hospital WiFi!), stuff for a shower, should I be allowed to do that today.

I've been keeping all my parents up to date on what's going on. Jannine apparently flew down the stairs to Dad, who was in the basement working on the 1st crib, in a panic last night when I had time to call them. She goes, “Dana's in the hospital!” and they both sounded pretty freaked out. I had to tell them everything seemed okay so far and they seemed to calm down a bit for the story.

Mom listened calmly after I told her it all seemed to be okay so far. We all wish there was an explanation, but maybe no explanation means no real problem, too, so even that's not bad news.

I'm so glad I got to get through Christmas on my own two feet. I got to buy Paul's gift, we got to go to church on Christmas Eve, we got to celebrate Christmas Day like we normally do – a nice breakfast, present-opening, then a low-key day with a great dinner. True, I had a migraine most of the day, but that mostly meant that I lay on the couch (with Jacoby – that was cool!) by the Christmas tree and napped on and off while Paul did some house work that needs to be done. He feels crunch time now with only a week (as of Christmas) to get the projects done for the shower weekend. My dad will help with anything he can't get done.

I'm amazed every day how much Paul has gotten accomplished the last few months. It seems like his baby-planning isn't taking the form of buying things for the babies, and planning what we need, strategies for twin baby care, etc., like mine is, but rather he's nesting in a way that I can't – home improvement. I wish I could help with painting, and holding doors for him as he installs them and fixing up the 2nd floor bathroom (which has been transformed from something barely useable to something I'm actually proud of, baring the new floors we'll get done in late January). He's been completely busy from morning to night each weekend since early October fixing up the house. For our baby shower weekend (less than 2 weeks away!), when 3 of the rooms on the 2nd floor will be occupied by Jannine and Dad, Mom, and Sara (my sister-in-law) and little Reed. For our babies, who won't tolerate too well Daddy drilling the holes for the closet door in their room or down the hall or paint fumes.

Oh, some good news: My back won't hurt at all if I'm not allowed to walk anywhere! Looking for silver linings here.

Something nice about being in Post-Partum: It's comforting and wonderful to hear a baby cry down the hall. These rooms are surprisingly sound-proof. Or maybe it's just that there's no one next door to us. But Paul left the door open when he left to walk the dog and to shower this morning and I can finally hear a baby down the hall doing what babies do.

All the pain and discomfort of being pregnant with twins is made up each time I feel one of them kick. But I know that that joy is about 1% of what I'll feel when I finally get to hold Lillian and Blair and see Paul hold them, too. I think that's when the magic will hit. For all the trauma of delivery, the possible months of bed rest, the scary situation yesterday, the three and a half years of trying to make our babies, if we finally get to hold two healthy daughters, then it'll all be worth it.

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Dr. J just came in to talk to me. He had looked at my non-stress tests and said everything looks great, that he was really happy the bleeding stopped on its own yesterday, that it tends to happen again if it happens once (but not always). He said I should be on bed rest (with bathroom and shower breaks) until 32 weeks (7 weeks from now), then as the babies get more viable, I can do more things. He said at 36 or 38 weeks I can go play basketball if I wanted to. :-) At that point they try to make labor start on its own, so anything “risky” now would be welcome then. He also said I should keep all my doctors' appointments, including Garian, our chiropractor.

He was in no rush with me. He commented that he liked Paul, that he seems like a fun guy. I had to agree, of course! Paul is a fun guy! I told him how much he's been helping me out. About showers/bathing, the doc said they're good for me, that standing for 20 minutes wouldn't hurt, but I may be more comfortable with a shower chair (which, incidentally, we have because it came with the house and our steam shower) or having Paul help me in the bath. Both are good ideas. :-)

He vetoed sex, because it seems that any messing with my cervix makes it angry, even though nothing really bothered it yesterday. We kinda figured on that veto. He said it's time to get creative. I'm all for that! :-)

Dr. J is obviously a very personable guy! He commented on what a nice room I had, what a great view over the lake, which is beautiful with newly fallen snow.

He also said I should stay here until my shot at 5:00 this evening. Which I prefer, actually, because going home and coming back seems not exactly like bed rest to me.

So here I am, with Paul, in this nice room for the day. With nurses to come give us whatever we want. They really are wonderful here.