Monday, July 25, 2022

Discovering Twins: written before their birth



This is tougher to share. I wrote this at various times since February, when I learned that I was carrying two babies. It was such a shock to me and so much to process so I would turn to this document at various moments to track the history, evolution, and also my intentions. I tried to fix my mind on the mantra that I wanted to be part of the evidence of healthy, full term twin births. It's painful now, as I did grow two incredibly healthy boys, but one did not survive birth and the toll it took on me was profound. I still feel like I want to share this as it's part of the journey, even though it's much more complicated now.


It felt different.


I know every pregnancy is different. This was really different. 


I couldn’t track it. Or orient.


But it was so hard to say why. Was it because we’re now living in Virginia after twenty years in New Jersey? Is it because I’m primarily a caregiver, versus an entrepreneur with lots of projects and a full calendar? Is it because we’re in year two of a global pandemic? Because gas prices and inflation and everything else are untenable and frightening? Because we survived walking with the MOVE survivors through a public reckoning last summer? Because the landscape of everything I’ve ever known has radically and irreversibly shifted and still hasn’t taken recognizable form?


Could be.


Also, I got big. Quick.


To the point that people would come up and say, “you’re huge! Are they twins?” (The darlings. FYI, if those words ever form in your head, exercise restraint. No one wants to hear them. They’re not helpful.)


And yet, I measured normally at midwife appointments. The doppler picked up one little swimmer’s heartbeat.


As a low-risk second pregnancy, we were on track for homebirth care and could choose testing. We opted to skip the dating ultrasound that happens in the first trimester (it’s primarily to establish your due date, which you really only need if your provider will only assist you up to 41 weeks or so, not the case with our practice) and just do the second trimester anatomy scan.


Well into week 21 (truth be told, 2 days before 2/22/22 when I was 22 weeks with 2 babies) we went in for our ultrasound. For me, this was going to be confirmation that my fears of twins were for naught, that it was just one baby and a perfectly healthy one. 


As soon as the wand touched my belly we all saw it. The tech said, “you know you’re having twins, right?” I started crying and cursing. Kevin laughed uncontrollably. The tech went outside to check with someone else. Upon return she said, “you know this will cost double, right?”


Yeah.


Both babies perfectly healthy. A crash course in twins: Twin A is always the one closest to the exit (even if they change spots). They each had their own placenta and sac, so they’re considered di/di. There’s a 70% likelihood that they are fraternal, two different eggs that happened to drop at the same time. There’s a 30% chance that they’re identical and the egg split within 3 days of conception. We’ll only know once they’re born and we do genetic testing or if they have different blood types, as even if they’re fraternal siblings babies look alike, so they probably will.


(At birth, they looked fraternal but we didn't get a blood test nor genetic testing so we don't know for certain.)

Di/di are the safest version of twins for me and them. They’re basically two, whole separate babies that I carry and birth at the same time. Because they’re di/di and because it’s legal in Virginia (not the case in every US state nor in every country) I’m still eligible for a homebirth.


For our particular babies, twin A was a biggie– 84% percentile on growth (while the growth estimates are always off and not a good predictor of whether or not a woman can vaginally birth her child based on size, they give some indication of health) and head down. His placenta is posterior, meaning towards my back, so I can feel him and have since week 12 or so.


And now why twin B was trickier– he has an anterior placenta, meaning towards my front and he’s up top. The midwives wouldn’t normally look for a baby under my ribs and his placenta was there– which could have been an anterior placenta for one baby. He was hiding.


B was transverse at scan, meaning forming a T above his brother. He was smaller but still very healthy– about 56th. Were they sharing a placenta we would need to try to shrink their growth differential as one twin can take more than their share of nourishment. As they each have their own placenta it’s basically watching two separate babies– they just each need to stay on their own growth trajectory.


(They switched sizes at birth. A/Wes was 8 lbs 6 oz and B/Trus was 9 lbs 6 oz. We checked them by ultrasound maybe 2 weeks before birth and they were estimated around the same size and closer to 7.5 lbs.)

All parts accounted for. 


At the time of the ultrasound, we were still team green. We found out Twyla’s gender shortly after the anatomy scan. I knew this was my last pregnancy and birth so I thought it would be fun to one time have the experience of discovering gender at birth. But given how much was new, we asked the tech to put the gender in an envelope in case we wanted to look later.


It took a long time to process.


I’m still processing.


Some things that I learned: twins are all due to Mama. Apparently, I was a perfect candidate for twins. I conceived at 40, which ups my chances. I conceived right as Twyla weaned and apparently breastfeeding while conceiving also ups your chances. My grandmother had siblings who were twins. Apparently that matters.


And then my hair brained theories: I was conceived when my Mom was 38 and born when she was 39. They thought that I had a twin but it was later discovered that it was a cyst. Now I’m like, did I eat my twin and this is revenge?


Also, I had Covid in March of 2021 was fully vaxxed as of May 2021 and conceived at the beginning of October 2021. In the interim, my very regular cycle became irregular (a very common vax side effect, we’re discovering). I know this makes me a conspiracy theorist to even wonder, but I’m curious if it supercharged my ovulation given the other impact on my cycle. I've also heard that Covid itself has impacted many people's cycles and I had Covid in March of 2021. There is a twin boom right now.


Obviously, IVF and birth support up your chances of conceiving twins. That’s often an invasive question that twin parents receive (again, if you’re tempted to ask someone, exercise restraint. It’s really not your business and something for them to disclose only if they chose). Because I know everyone wonders: no, we didn’t use IVF. We’re broke. And in our case, we luckily didn’t need support to conceive our children but I’m very grateful those practices are in place for others to grow their families.


A few days after we found out that we’re having two more kids, we decided no more surprises. Our inlaws took Twyla for the day so we could drive to Richmond. We hiked around the James River and found a quiet inlet with two white birch trees extending into the water. Kevin opened the envelope and laughed. 


“Two boys.” 


Again, I developed tourettes and shouted obscenities into the air.


I meticulously packed all of Twyla’s baby gear to move it from New Jersey to Virginia, knowing we’d have another child. Come to find out, baby gear for one kid is largely useless with twins. I kept two years worth of her clothes in case we had a second daughter. Two boys.


If we had one more daughter we would have only needed diapers. I thought we were good.


We had nothing.


Of course, I went through all of Twyla’s clothes and kept what’s gender neutral (and now is not the time for gender lectures. I’m aware. It’s all considered. I have my reasons). I have to say, not the best practice when you’re pregnant. I always say that parenting is grieving. You have to give your child room to grow and become, but that means you also have to let go of who they were. There were so many times when Twyla would graduate into a new size of clothes or a new developmental phase or whatever and I would be so excited and simultaneously bereft at losing the little baby I knew and loved so well. The first time, I got through so much by telling myself, “this isn’t the last time. There will be another baby.”


And then I folded up yet another beautiful bubble romper and knew that was the last time. That was the last time I had a little baby girl. That little baby girl. 


I’m in a thousand groups of expecting parents and twin parents and the like and someone said something so sweet about gender disappointment (a very real thing): you’re not sad about the child that you get. You’re sad about the child that will never come.


That was it.


I always wanted a son (can’t say I counted on two!). But this was saying goodbye to any more daughters. 


I’m grateful for the daughter that I have. She’s incredible. She makes me want a thousand of her (though, with the addition of a willingness to sleep). And now, I’m expecting two sons. At the same time. Something I never even imagined.


None of this was on my radar. I’m not someone who ever dreamed of twins or thought dressing two babies the same was cute or anything like that. I’m a pretty individual person and really believe in allowing others to be individuals too. In so many ways, this feels like the greatest challenge.


And yet.


I could fight my life or trust it.


I love Tami Lynn Kent. She writes about mothering as a yogic practice. She writes about those of us who have studied in ashrams, purposefully given ourselves deprivations and challenges so we can see our own shadows and work with ourselves with greater awareness. To her, parenting is the most intense of those practices. 


Having both parented Twyla to this point and studied in an ashram, I concur. In an ashram, I could hide in my own fantasies or duck out to a quiet corner. There was still escape.


With parenting, there is none. It is relentless and utterly all consuming. I know reading that many (women especially) have a kneejerk reaction that who I am as an individual woman gets consumed by the martyrdom of motherhood. That potential is there, and I think it’s largely there in a culture that so deeply undervalues mothers and leaves so little room for support and self-definition in that terrain. I don’t think that’s my personal struggle. I’m pretty clear on who I am, my passions, curiosities, and that I deserve support. And I’m also clear that babies and small humans are labor intensive. The two are both true. And it’s a short-term season. Babies grow into children and part of their growth is the need for more room and freedom. So again, if I do my job, they need me less, I grieve and miss the littles that they were, witness who they are, and make it my own responsibility to fill my time without them defining me. So it is all consuming for a time. It doesn’t mean that I give myself to the cult of motherhood indefinitely. It does mean that I redefine motherhood and let it change me as well.


Here, entering another ashram. Another rite of passage. Another journey into the underground. Like Inanna, I feel like I’m being stripped of everything I know. You birthed a baby unmedicated? Cool. Try two. You made choices to keep your baby safe through pregnancy, birth, and infancy? Now double that and raise the stakes. You breastfed your baby for two years? Try two while caring for a toddler or shift to formula during a shortage and inflation. You bedshare with your now toddler and have since birth? Now think of safe sleep with 3 kids under 3. You love your Honda Fit? Jokes on you. Trade that thing in for a van that can fit 3 car seats. You planned to baby wear all the time to keep up with your toddler? Get ready for double the baby weight strapped to you as your body heals from a twin pregnancy. Have a tiny house with one bathroom? Get ready to share it with the 3 children you accidentally made.


So many of my own past statements are coming back to haunt me. I remember, pregnant with Twyla, when friends would ask if I planned to have more. We hoped to have more but we’ve always kept children close to our vest. It just feels private and sacred and not like something that I wanted to talk about with anyone beyond Kevin. I did say to those that asked that I worried if we opened the door to one more child, a sneaky third would pop in. I meant, like an accidental third pregnancy. But now I wonder, on some level did I know?! Cause that’s exactly what happened!


And I remember reading about how for some the transition from 0-1 child is the greatest challenge and others from 1-2. Here we are going directly from 1-3. 


I read that many parents report the greatest level of challenge and frustration with 3 kids because you’re outnumbered. You don’t even have enough hands for them to help cross the street. (And then parental satisfaction balances again at 4 kids because people just give up, ha!)


Here we are. As a child, I wanted 3 kids. We started late for many reasons and I felt like 2 would be plenty. And somehow: 3. What feels like in so many ways the biggest challenge. And yet, what do I know? These boys are pushing me to have faith. I’m not good at that and yet, people are showing up and helping us. Somehow, we’re getting all the gear we need to care for them. And as Kevin says, maybe this will give us a dose of healthy neglect in our parenting. All kids need a little breathing room. We have to let go. They’ll get it. Maybe this is how I become a better parent: by giving up on control. Trusting that they know the family they want. Being their family.


Now the task is trying to live through the healthiest twin pregnancy that I can. It has been a BALL BUSTER. I loved being pregnant with Twyla. I definitely had hard to handle pregnancy symptoms but overall, I felt better than I do when not pregnant. I was full of life, my hair was great, my mood was balanced, it was a good time. I was so excited to be pregnant again.


I don’t know if I did better with girl hormones versus boy hormones or if it’s just because there’s two of them but this has kicked my behind from day one. Round ligament pain out the gate. Instant acid reflux. Insomnia from the get go. Way more nausea (often while dealing with Twyla’s gastrointestinal woes).


And yet, it’s been healthy. I haven’t had nearly the struggles that many twin moms do. I entered this pregnancy with pubic symphesis dysfunction from two years of sidelying nursing. I immediately started up with mamastefit’s prenatal strength training program, which has a lot of input from pelvic floor physical therapists. I’ve been at the gym with all the bros 4 days a week until the third trimester. When I was able to go to the gym, it completely managed my pain and I think gave me the strength I need to manage the intensity of this pregnancy.


Around 17 weeks, during the Omicron surge, we got it. My second bout of Covid and this time while pregnant. Do not recommend. I was exhausted and tired for a bit beyond that bout, but we’re fine. I bring this up in case it happens to others: it’s not always drastic. I needed examples of people who had it pregnant and made it through ok. I’m not making any claims about Covid in pregnancy beyond my own experience. If you need hopeful stories, let me be one. I tried to avoid it. I was really sad that I got it. And, I can’t control the world. I got it. And the babies and I are ok.


(I know one of the fears is that Covid will impact the placenta. My boys were born at 42 weeks 5 days and 42 weeks 6 days, when many worry about the quality of the placenta. Their placentas were some of the healthiest that the ultrasound techs, doctors, and nurses had seen. So again: covid and late term don't always mean a deteriorated placenta. I'm not making any claims, just offering one hopeful example.)


At 27 weeks, with GERD like I’ve never, I turned to drugs and got prescription strength treatment. It induced something like pregnancy asthma where I often can’t breathe or have coughing spasms that make me feel like I can’t breathe.


As we discovered they’re twins, my midwife recommended the Brewer’s diet and other twin moms sent me books on eating to support healthy twins. Basically, everyone recommends protein every 2-3 hours. Twins tend to grow and develop earlier as they often get evicted sooner. Best case scenarios are getting them big and healthy early so that if they do come quick they’re ready for the world. So my job was to eat and drink. And twin B has been stationed in my throat.


I keep kefir on hand to swig when I’m not hungry (which is most of the time). I’ve always been good about drinking water so thankfully that’s not hard. We are putting collagen in EVERYTHING. Like, in my eggs. My nails are growing so fast it’s ridiculous. But, this is my job. Get these kids healthy.


When the third trimester hit, the exhaustion really slowed me. I couldn’t go to the gym anymore and couldn’t walk far distances due to SPD pain. Thankfully, my inlaws came most afternoons so I could take a nap (given that Twyla no longer did). Rolling over in bed was agonizingly painful. Around this time, Twyla started sleeping in her own bed of her own accord, which helped. She’s still a typical 3-year-old mix of sometimes sleeping with me and sometimes in her own bed, but more and more, I have my bed to myself (for a minute). 


On week 36, our household contracted Flu A. Since then, my right ear has been clogged and I can’t hear out of it. I think I’m just so swollen that that eustachion tube likely won’t open until I give birth. That was an incredibly painful week. My midwives consoled me by saying that babies are generally kind and wait to be born until their mother is well. It was true for me.


The day after I reached 40 weeks full gestation— a completely unexpected milestone— I developed Bell’s palsy. We went to the hospital where doctors surmised it developed from the earlier Flu virus. While they had never seen a full term twin Mom & urged me to deliver, they confirmed that I & the babies were healthy & we all went home. Albeit with my melting face.


Everything is swollen. I hobble. My feet have to be elevated as much as possible. I put on compression socks and usually wear braces for carpal tunnel. I’ve tried gua sha to reduce the swelling in my face and neck. 


I can’t do anything– Kevin has taken up all other tasks. He cooks, as I can’t stay on my feet (I often become breathless). I can’t bend over to pick up Twyla’s toys or fold laundry. I can’t clean. I pretty much try to eat and rest to keep baking our sons while Kevin takes care of everything else. 


I have enough trauma in my life. I don’t need anymore. And collectively, I don’t think we need any more stories of birth nor baby trauma. Things happen that none of us can control and I recognize that. And, I’ve set my intention to be a part of the evidence of healthy, full term twin birth. We need more examples of healthy moms, empowering births, and healthy twin babies. I’m a part of that. While this pregnancy has busted my hump, I write this full term– with healthy twin boys.


Given that we lost Trus at birth, it's hard to read this last paragraph. He was healthy until an hour or so before we lost him. I have so many wishes or what could have happened so that he could be here with us, and so many unanswered questions. For now, I'm focused on healing, helping healthy Wes continue to grow and thrive, caring for Twyla as she adapts to the new normal, and continuing to learn and love Trus in this configuration.




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