The Prelude
In late 2009 we decided that in the new year we were going to try and provide our daughter with a sibling, this is a decision that wasn't taken lightly, our first daughter was born at 33 weeks, while in the prem world isn't particularly early, she arrived in a big rush, her birth story is here, and while her time in SCBU was reasonably smooth, with minimal breathing issues, sepsis, low bls, jaundice and took a few weeks to learn how to feed, she has long term respiratory issues and had required numerous hospitalisations and is on a raft of medications to keep her out of hospital. Something we were desperate to avoid this time round. We knew that going into this pregnancy that before we even started I was classed as high risk of having another prem as the reasons she arrived early were a combination of maternal on and other pregnancy related complications.
The Pregnancy
We were extremely blessed to discover that we had become pregnant during the first month of trying, and estimated our EDD to be about the 27th of October 2010. I made our announcement on the forum and it was with gusto that I stated we were going to avoid the premmie rollercoaster and grow a full term take home bubba. We wanted to experience giving birth and taking your baby home with you, not leaving them behind in the hospital after discharge in the care of others, a baby should be with its parents..... not isolated in a plastic box surrounded by machines that go "ping" and constantly being poked and prodded by with needles and tubes, wires and lines.....
For the first couple of weeks everything went smoothly, very few tweaks and twinges it was certainly different to my first pregnancy, but as everything had "stretched" before it wasn't surprising. On the March long weekend we had a photo shoot which had been postponed from January due to DD having been in hospital, it was a beautiful crisp Sunday morning, wandering aimlessly through the east of the city, looking for those unusual creative locations to capture our family of three (plus bub tucked up safely inside my belly), we were so happy so carefree, I look back at the photos now and am touched by the pure joy that resonates from the images, knowing that that are the only photos which include all of us....
The following evening I was cooking dinner, Roy was in the office and Nakita in her highchair eating dinner, and out of the blue was a gush, I stopped in my tracks, bolted for the bathroom, wondering what had just happened, it was at this moment that our lives started what was to be one hell of a rollercoaster ride... I was bleeding, bright red fresh blood; it had soaked my underwear and jeans. I was shaking, horrified and scared, I yelled out to Roy, he came running, tears were pouring down my face... I had bleed while pregnant with Nakita but it was never to the extent I was experiencing this time. Roy ran and grabbed the phone book and my mobile and I called the WCH, as I hadn't been to my OB yet and wasn't sure who to call, and thought the WCH would be the best option. They said to come in immediately and would see what they could do; I was 7 weeks 6 days. I went upstairs got cleaned up and changed, grabbed my handbag, phone and car keys, gave Roy a kiss and a warm hug and blew a kiss to Nakita trying to hold myself together so she didn't see me upset.
I drove into the hospital and was seen quickly, they checked my loss, undertook a blood test to check my HCG levels to see if they were high enough to warrant a scan, and I went back to the waiting area to wait for the results. Within 1/2 an hour they asked me to start drinking water and a while later they came and got me for a scan. The Dr on call was lovely, and went through what she was going to do, she was then interrupted to take a call from a country hospital where they had a mother labouring and the staff needed assistance, 10 minutes later she returned and we went through it all again. She started the scan, I was desperate to see the screen, but I could only just see it, she was quiet for a majority of the time, will a lovely MW held my hand. The Dr confirmed that there were two sacks, one slightly behind the other, and that she thought that there might have been a HB in one of the sacks, I was pretty certain that I could see she had picked up a HB but couldn't confirm if she had seen as HB in either and that I would have to get a scan on the Rolls Royce Machine in the next few days to confirm either way... My HCG levels were 32,000 @ 7 weeks 6 days
So I left the hospital in a daze not really taking in what she had just said and doing what I needed to do to get home and back into the arms of my Roy. We both cried, we didn't have a clear answer, nothing could be confirmed.... So I went onto my forums and asked for support and prayers for the next few days, this was not something that I was going to be able to go through alone or just with Roy, I needed to know that there were people out there who had been through something similar or who just understood what I was going through and to give us hope... and the community was there for us for the next few days and weeks and months... supporting us and praying for good news.
The following day I booked in for my scan at the WCH which the earliest appointment I could get was Thursday morning, 2 days time. I then rang my OB's office to see if she would like to see me and she made a space for me just over an hour to see her. I remember sitting in the waiting room and seeing some beautifully pregnant mothers, close to the end of their pregnancies and how I would love to be in there position to skip what was to come in the following days, weeks and months....
I didn't wait long and went in to see my OB, went through what had happened and she was shocked that they hadn't done an internal scan as at this gestation an external US wouldn't show a lot. She then commenced the scan and turned the screen so I could see it clearly, confirming that I had a septate uterus, there was a septum down the centre of the uterus, dividing it into two halves, this alone puts me at risk of Pre Term Delivery. Immediately we could see the two sac's, she was able to confirm that in one sac (Twin A) we had a precious little baby with a strong beating heart 125BPM, Flickering brightly, stronger than it was the night before, she then went over to the second sac (Twin B) there was no heart beat :cry:.... To complicate things further the two sacs were joined just above my cervix, so we were at risk of Twin B actually dragging Twin A with it during the miscarriage..... She then did a check of my cervix length and it was 2.1cm, very short for this early in a pregnancy, and may indicate that I had a Incompetent Cervix, so would be on fortnightly scans to check the length, but we couldn’t put a stitch in until the 12-14 week mark, and I need to pass the twin, clots and blood before she would be able to do the stitch. So from here it was going to be a waiting game, there was little we could do except hope and pray...... I was to still go to the WCH for the scan and also get another HCG result to see if that is giving us any indication as to what the future holds for us and our babies...
The following day was emotional, I just didn't know what to think, I was scared... I named Twin A... Flicker...
That night I was woken suddenly at 1am, excruciating pain, and another large gush of bright red blood, I was terrified, I didn't know what was happening... was I losing Flicker as well.... I lay in bed talking to Flicker...I am sending you all my strength and courage Flicker, my little fighter, I have no idea how many times I repeated this to myself and Flicker, but eventually I fell asleep.....
Later that day I went into the WCH for my next HCG Blood Test and then over for the scan, the first thing the sonographer did was zoom in and pick up Flickers HB, it was up to 135BPM, our precious little buba was getting stronger.... but now there were no longer two complete sac's, Twin B's (Firefly's) had ruptured, I believe that this is what I experienced at 1 am that day... the scan continued with numerous measurements taken, the Sonographer then called in the OB, who sauntered into the room, saying hello and soon followed with "You are not going to get to Full Term"... wow.... I was blown away, such a negative comment so early....
The following afternoon we received the HCG results from the day before, they were not great 38,700, they were supposed to double in approximately 90 hours at this stage, and they were no where near doubling... it had been more than that since the first BT.... We could only hope that the slowing of the levels was due to losing Firefly and not indicative of the strength of Flicker.....
Over the next 5 weeks I experienced a number of large bright red bleeds, went for numerous scans and checks, it was tough emotional and scary. I never felt safe, or was able to relax, I had to rest, I worked from home and kept activity to a minimum only doing what I needed to do...
By the 12 week mark my list of complications was growing....
History...
PPROM (Preterm Premature Rupture of the Membranes)
Spontaneous fast progressing labour
Dilation with very little pain or length of contractions
Amniotic Band (although unlikely that it should occur in this pregnancy)
Maternal...
Septate Uterus, heart shaped uterus, known for PTL (Pre Term Labour)
Possible IC (Incompetent Cervix)
A twin pregnancy, which is now a singleton pregnancy
Prolapse, of the Uterus or Vaginal Wall, started to occur at 14 weeks.
Low Platelets
Location of the Placenta, being over the top of the septum, where there is no blood vessels to feed the placenta, so relying on the outer reaches of the placenta to draw oxygen and nutrients in to help the baby grow.
From here I saw my OB every 2 weeks, we were planning longer gaps between appointments but it wasn't meant to be... At 16 weeks the Braxton Hicks (BH's) started, 6 weeks earlier than they had with Nakita... At 17 weeks my fluid levels were low, it appeared that we are looking at the opposite I had with Nakita, where she had a swimming pool of fluid, this time we only had smaller pockets of fluid, Flicker was breech and we need to look at getting Flicker to turn and stay turned, with the low fluid levels and shape of my uterus we needed Flicker to be head down as early as possible.... My cervix had lengthened nicely around the 12 week mark, but as we moved to the late teens and early 20's, my cervix started to shorten, I was losing length and it was looking as thought a stitch was going to be needed.
At 22 weeks the BH's had grown so intense, were lasting for so long and not relenting that I was put on Nifedipine to reduce or try and stop them, as with a shortening cervix the last thing we needed was anything to aggravate it further. My cervix continued to shorten, by 20 weeks we were down to 3.2cm, the previous three scans it had reduced by 1cm, 1cm and 0.8cm, if we lost that length again, we would need a stitch, but we were absolutely thrilled to discover that at 23 weeks my cervix had grown in length and was out to 3.6cm!
For the next few weeks things remained relatively stable, we were having to increase the Nifedipine to combat the BH's, but we would get them back under control within a few days and I was able to "relax" a bit.
At my 28 week appointment my fluid levels had risen and were into the normal range, and Flicker's position was optimal, so my OB attempted an ECV, they generally aren't contemplated until 36 weeks or around that mark, but we had to take the opportunity while it was there. She attempted it twice and Flicker did move into a better position but then decided nope not interested and immediately went back to the lovely breech position, during the ECV she had to stop a couple of times as I was contracting. A few days later the BH's were getting out of control; I had increased the Nifedipine after the ECV as my OB said it would stir things up for a day or so. But now they seemed different and I didn't feel comfortable with them anymore, so I ended up in my OB's office on a Friday afternoon on the CTG and we discovered that I wasn't just having Braxton Hicks, I was actually having contractions, regularly 15 minutes apart, not just sporadically like she had felt a few days earlier, and in between a very irritable uterus that just wasn’t resting this is not want you want to hear at 28 weeks! I was put on a constant dose of Nifedipine throughout the day, with the hope that we can slow things down.
It was at this point I was put on Bed/Couch Rest, no more working in the office, no more shopping or getting out and about, I was now limited to lying on the couch and only getting up to eat meals and go to the bathroom. From here Roy had to stop going to the gym, he picked up and dropped off Nakita to day-care each day, took her to her swimming lessons on the weekends. He did the cleaning, food shopping, helped with meals, washing and just getting things done. Family and friends made meals, helped clean, ran errands and helped look after Nakita on Fridays when she was home with me for the day.
Then to throw a spanner in the works at 29 weeks we received a call that no parent expects... the results from our 12 week scan were incorrect, we had to return to the place where we had the 12 and 20 weeks scans and have an urgent growth scan and meet with a genetic counsellor.... I won't go into all of the details but you can read them News that a parent never expects to hear..., but we went from being low risk to high risk for having a baby with Down syndrome. It was a very stressful and emotional few days as we took in all of the information and made some big decisions, I truly hope that it doesn't happen to anyone else again.
Over the next few weeks, we would get the contractions under control, then they would ramp up we would play with the dosage of Nifedipine and timing and get a few days grace where they were more spread out and less intense, before we would go through the cycle again.
At 32 weeks they got completely out of control, I was contracting less than 10 minutes apart, it was going on for hours, the Nifedipine wasn't working, I was on the maximum dosage a combination of slow and fast release, taking the fast release when the contractions got out of hand, but it was no longer working, I was exhausted and struggling to cope mentally and emotionally. I was worried that we wouldn't get them under control again. At my OB appointment I was shattered, my OB decided that we needed to try a new course of action, she ordered steroid injections two 24 hours apart, in case we weren't able to stop the contraction, she then put me on Progesterone cream every night, and we had to limit the Nifedipine to 140mg a day, as my BP was dropping too low. The new combination worked, it took about 4 days for the full effect of the Progesterone to work, but it did calm things down again and I finally was able to relax for a bit. My next appointment I was bright and bubbly, contractions on a good day were 30-40min apart, and on the bad days they would get under 10 minutes apart, but were bearable. My OB said that she was about to admit me the week before, I am glad that we were able to get through it without the admission and looking back I am not sure how I did it to be honest....
At my 34 week appointment a few things didn't go to plan, the growth scan highlighted that we now had asymmetrical growth, bubs head was growing at a greater rate that the abdominal, with the femur being right on dates, this was not good, while we are able to accept low growth, when things become asymmetrical it indicates that the baby isn't receiving enough nutrients. My BP had risen and while 120/80 is not particularly high, the fact that I was on a lot of Nifedipine which lowers BP and previously I had been sitting around the 110/60, it was a big jump in a very short amount of time. We were reaching the end of what my baby and my body were able to cope with. I was sent off for a series of blood tests and monitoring, another dose of steroids was ordered for a few days time, and in four days we were going to make the call as to when our precious little Flicker was going to arrive earthside....
35 weeks.... the end is nigh..... it was the title of my last post on my blog, and my final message on my forums and FB. The decision was made within seconds of entering my OB's office, she asked how I was feeling and I said buggered. I was mentally, physically and emotionally I was at my limits I was questioning my ability to go any further, where could I find the strength to go on for another few more weeks, I wanted to dig deeper, but I felt like I had nothing left. She said that she was amazed that I was still going and that we had reached the end, she wasn't comfortable with pushing it any further I was maxed out on medications in attempt to stop things, but my body was now fighting the medications, we knew the day would come where there is a point that the drugs would no longer work....my baby needed to come out. So we booked in the C-section, we had hopes that a Breech Delivery would have been an option and my OB was fully supportive of it, but we were now in a situation where both bubs and I were going to be put under too much stress going through a natural delivery, we were going to have to stop the drugs and with my BP already high, we knew that if we stopped the Nifedipine it was highly likely to skyrocket and would likely end up with an Emergency C Section, and I was at peace with the decision, I felt calm as I didn't chose my baby's birth date, my baby had been trying to chose its own for months and we had done everything we could to stop it. I just wanted my baby to arrive safely....
From here we went into preparation mode, I was administered a further dose of steroids to boost Flickers lungs, we planned for the last dose of Progesterone that night, but not the following night in preparation for the section the following morning. I was to continue taking the Nifedipine right up to the C-section. Paediatricians, anaesthetists, theatre, hospital were called and booked, another set of blood tests were to be done the following day. We filed out paperwork and I signed where needed, I was glad I didn't have to write why I was having a CS, because it wasn't by choice it was by necessity. She then did a scan, and within seconds we knew the right decision had been made, there was no more black left on the screen, I had no amniotic fluid left, bubs growth had stopped, and was fully engaged. I was then taken out to go back on the CTG again, I had the little button waiting to press it each time I felt a kick. I was concentrating hard on waiting to feel a movement, but there were none, I drank so ice cold water and still no movements, I was ignoring the contractions, just focussing on that little kick, finally after 35 minutes we got movement, a short while later, the CTG was stopped and I asked the MW how far apart the contractions were. I had stopped timing them in recent weeks as I felt it was taking over my ability to keep a positive frame of mind.... so you can imagine how shocked I was to discover that they were 3-5 minutes apart with a break of 2-3 minutes apart... no wonder I was exhausted.... That was it, it was over, I had a finish time and date... I had fought long and hard and I know that there was nothing more I could do.... I sense of relief came over me as I knew that I only had to hold out for less than 48 hours... this was the start of my time...
I became invisible, I hid away from the online communities, forums, FB and Messenger, I prepared my final post... we were not going to reveal when Flicker was arriving, that was our secret, after bearing my soul throughout this pregnancy we were keeping the grand finale to ourselves and a very select few who "had" to know, but all were sworn to secrecy.......
This was my time to reflect, to make final preparations, to take time out; I had shared so much of our journey this time was now mine, one day before I would meet the most precious little baby. I didn't want to speak with anyone unless I chose to, I didn't want to be quizzed or questioned and most certainly didn't want to be asked numerous times when Flicker was coming...
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