A Story of Life

Prior to our first ultrasound at 10 weeks, I told my mom and my husband that I was having twins. I just had a feeling, call it a mother’s intuition—call it divine preparation, I just knew. It was the same feeling that had overwhelmed me two weeks earlier when I had tossed that negative home pregnancy test into the trash and then pulled it out 3 hours later to see the faintest, almost invisible second pink line.
We had used natural family planning since the birth of our daughter. Once we decided that we were ready for another baby, this made it relatively easy to conceive since we were keenly aware of the signs that my body displayed upon ovulation. I felt such validation when my OB pulled up that first ultrasound picture of our beautiful babies and my husband Derek almost fell out of his chair saying, “Oh look there’s two of them!” before the OB could even get a word out. After congratulating us she said that she couldn’t take us as patients because we’re “High Risk.” High risk? What does that even mean, I thought to myself. I’m having twins and I’m going to approach this the same way I’d approach a regular pregnancy: I’m going to celebrate, pray, and trust my body and my babies to do what’s right when the time comes for them to arrive earth side.
My OB celebrated with us for a moment, and then, because she couldn’t see two amniotic sacs, suggested that we go for a higher resolution ultrasound to look for that elusive dividing membrane. She reassured us that often times the dividing membrane is a real challenge to find. We left the office and almost lost our minds. How exciting, how shocking, how life changing this pregnancy and these babies were going to be! Derek couldn’t stop laughing, “We’ve gotta get a mini-van!” He exclaimed … a minivan I thought, I wasn’t expecting that transition for a few more years, but three under three, a minivan it is.
The initial shock wore down slightly and I turned to my trusty phone to learn all about twins and making a bohemian home birth a reality for these precious babes.  I sent messages to all my momma friends with twins, and then did a quick search of twins that share an amniotic sac. The results were a little daunting: high mortality rates due to cord accidents prior to 25 weeks gestation; forums set up for mothers to process the loss of their sweet angels, etc. How come I had never heard about this type of pregnancy before? I couldn’t bear to read the loss forums, but I saw the volume of posts, and as I looked for successful monoamniotic monochorionic (MoMo) twins I only found a handful. In some cases the birth of these twins had caused such excitement that they had made national news. I looked at the sweetest ultrasound pictures of our little loves cuddled up next to each other, and I knew in my heart that they were not going to find a dividing membrane. I prayed still for that membrane, but knew that my prayers could not bend the will of God so I prayed for strength, I prayed for informed caregivers, and I prayed for joy.
We went to the second ultrasound. I elected for a transabdominal, as I knew that a more invasive ultrasound would yield the same result and would not change my course of action for this pregnancy. I found myself getting frustrated with the technician and physician that she called into the room as they insisted on a transvaginal ultrasound; but I refused. No need to bother these precious babies to search for the answers that I already knew.  It was confirmed: we were expecting MoMo twins. This means that our twins would be the closest in physical proximity possible aside from conjoined twins. Some of the research shows that this occurs in less than 1% of identical twin pregnancies and is rarer than having spontaneous triplets. We hit the twin jackpot, never mind all the statistics about how rarely MoMo twin pregnancies are successful, these were our babies and we loved them deeply from conception. The length of their physical existence with us had no bearing on our approach to managing this pregnancy.
I wasn’t big on classifying my pregnancy as “High Risk,” even after we found out that carrying past 33 weeks was not going to be an option and I kissed my dreams of a home water-birth goodbye. I was determined to find the best doctor and the wonderful OB I had seen initially went out of her way working on the weekends to set me up with a Maternal Fetal Medicine specialist that could see us and help us plan our pregnancy and birth. We celebrated, we shared with everyone we saw, and we spent every moment anticipating their arrival as we strategically planned how we were going to survive being outnumbered by our three little ones.
I had read about MoMo pregnancies where the mothers were so paralyzed with fear of losing their babies that they did not experience any joy. My heart broke for them. I felt empathy for all the women, like me, that were made to feel that their pregnancy should be feared rather than celebrated. I had to make a choice, a choice that I would not be afraid. I would not be afraid as doctor after doctor talked to us like they were delivering a death sentence to our babies by telling us that they were MoMos. I would not be afraid as I planned for an extended stay in the hospital starting at 25 weeks with continuous monitoring away from my daughter and husband. I would choose to be strong as I saw our twins’ fragile umbilical cords make a delicate “x” on the ultrasound screen, as their cord insertions into the placenta measured less than one centimeter apart. I would choose to be strong when the ultrasound technician scanned the fetal poles for Twin A and Twin B and static silence filled the room at our 16-week ultrasound. I would not be afraid as my doctor typed the words “Fetal Demise,” over the beautiful picture of our babies that had left us too soon.
The  moment the doctor told us our twins were dead, a feeling washed over me that I cannot describe. I looked back to my husband and our daughter, and clung to the memory we had of our twins holding hands in their ultrasound, less than three weeks prior. I knew that every decision that I would make moving forward had to honor the lives that they had. We were escorted into another room, empty and perhaps meant for grieving, but the vacant walls felt crushing. The doctor returned and I asked him what my options were. The doctor described a D&C. You will be put to sleep, he told me, while we extract them and you wake up in recovery. I knew what a D&C was; I knew that countless mothers that had lost their babies before me had D&C as the only offered option.
I remembered a conversation that I had had with my doula weeks prior, where she talked about controlling the language when talking about the birth of these twins since we were planning for a cesarean section. I didn’t want to have our babies taken from me.  So I asked about the alternative, and he indicated that I could have an induction and go through labor and delivery. I didn’t hesitate, I would birth my babies. I knew that I had to say goodbye, especially after seeing so many of my beautiful friends who didn’t get a chance to say goodbye to their precious babies. In this instance a D&C procedure felt medical and impersonal, and while I understand why some women would choose it I knew it wasn’t for me. I was experiencing a silent miscarriage where my body had shown no signs of losing the babies and I didn’t feel confident that I could endure carrying them until my body was no longer in denial and started to miscarry naturally. I told the doctor that I was choosing to have an induced delivery. We left the office, and I cried.
The pain of the loss of a child is a grief that you feel to the depths of your soul.  As I sat in my car in the parking garage I called my Dad. He kept saying he couldn’t hear me, and I told him that was because I wasn’t talking. It was like a bad dream when you’re trying to scream but no sound comes out. I just couldn’t say it, and when I finally told him I lost the twins, he cried with me, and it was a welcomed comfort in a time of sorrow. My husband and I met with my OB to make the labor arrangements. When I was asked if I was feeling any pain I said, “My whole heart.” I was honest and that honesty was too much for the nurse to bear, she cried too. With every tear that fell we were reminded of the equivalent moments of joy that we had shared in having them with us and how many lives they had touched before they were even born.
Induced delivery with Laminaria and Misoprostol was planned with my OB. I asked for the paperwork on Misoprostol and felt sick to my stomach because all the descriptive language on the paperwork was for Misoprostol as it pertained to abortion. My doctor apologized, and I wept. We went to my parent’s house and my mom got off a plane to meet us there. Together we called all the family and with every conversation our hearts broke all over again, we wanted them to celebrate our babies’ lives no matter how briefly, and that came with the price of sharing in our loss.
We had two beautiful doulas Candace and Katie that came and met with us, and honestly I don’t know how we could have gotten through it without them. They offered us emotional support, resources about loss, and talked to us about naming our babies. They explained how we could have our babies released to us rather than disposed of as medical waste, and walked us through burial or cremation arrangements. They were collected for us during the times that we felt as though we would fall completely apart. We headed home and the next morning as our precious almost 2-year-old asked to talk to the babies as she did every morning. My heart sank, I looked at my husband and I told her gently that the babies had gone to be with Jesus. Children are so intuitive, she hugged me tightly, and then said the sweetest words I have ever heard, “Oh, I’m sorry Mama.” Crushing.
It was induction day. We asked for one last ultrasound. I needed confirmation, and wanted to have a last look at their little bodies untouched by this world in my womb. The technician was wonderful; she printed us several pictures and took her time to show us our babes in 3D. I knew they were gone, but seeing it again before the induction began was reassuring, and a grieving family deserves to be reassured.  I had the Laminaria placed and the thought of inducing my body to expel the life that we had created together made me feel physically ill. I held Derek’s hand and prayed for that moment to end.
When we checked in, the nurse at the register could not see me from behind the counter and said she didn’t have my registration date.  She asked me what my due date was and I told her that my babies had passed away. I didn’t mean it harshly but I had said it with such a flattened affect that she fell silent. What is there to say in a situation like this? Nothing, there is nothing to say. Each time I had to deliver the news I felt like I was breaking another heart, and the burden of so many broken hearts was difficult to endure.
As I was wheeled down to Labor and Delivery, I was hopeful that they would place me in a room in the back, but fortunately I couldn’t hear a thing from the Laboring mothers around me. My dear friend who was a Labor and Delivery Nurse at the hospital arranged for me to have the sweetest nurses who were knowledgeable about loss. They hugged us, they listened to us, and they encouraged us. This experience was healing for me, too, as I was apprehensive about labor at the hospital following my daughter’s birth, but this time I felt heard and respected. My husband and I picked names, two for boys and two for girls.
In the morning, our doulas Candace and Katie arrived. My doctor came in at 7:40 and we talked about the plan for the day and about Misoprostol. Misoprostol was originally used to treat reflux but doctors discovered it also induced contractions in pregnant women, so now it is commonly used for the purpose of inducing labor.  The goal is for the medication to bring on cramping, but the time it takes for delivery to occur is variable. I prayed fervently for a swift and uncomplicated delivery. I knew that my body could transition quickly and was designed to birth and recover. We talked about pain management and I considered it. I thought about how nice it would be in this moment to feel nothing. While I knew that pain medication may assist with the physical burden, it would not mend my soul. I am a fighter, and I have always been a fighter; I knew I would be able to endure the trial of this labor without mitigating the physical pain.
I received a gift the morning of my labor that made an imprint upon my heart that I will carry forever. My sister-in-law Michelle Tucker wrote and recorded a song the night prior. I believe that this song had been divinely orchestrated to capture all of the things that I had been feeling about our babies but had not been able to say. It was the most beautiful song that I had ever heard and the lyrics play through my memory often and each time it brings tears to my eyes.
We are one and two
It’s just me and you
Hands held in our room
And then we’re gone
We never climbed the trees
We never felt the breeze
We just knew Mommy
And then were gone
But God gave us wings
Real toes on real feet
We play in dirt, on swings
And in heaven sing
Jesus loves me this I know
For the Bible tells me so
Little ones to Him belong
We were so little but He is so strong
We were so little but He is so strong
We still love big sis
Play with toys we missed
We send a big twin kiss
And then we’re gone
We miss Mom and Dad
Cuddles we never had
We heard them cry, talk, laugh
And then were gone
But God gave us a spot
On the roof where we could watch
Our family grow up tall
‘Til they join our glory song
Jesus loves me this I know
For the Bible tells me so
Little ones to Him belong
We were so little but He is so strong
We were so little, it seems wrong
We were so little and now we’re gone
We were so little but He’s still God
We were so little, goodbye Mom
 
Goodbye mom, the saddest words ever spoken. At 8:15 AM I had the Laminaria removed, thank God–that part was awful. I had already reached between 2 and 3 cm dilation and wouldn’t need much more given the gestational age of our babies. Derek and I called our daughter, I told her that I loved her, and felt peaceful as she left to be cared for by our dear friend Barbara.  I would have loved for Barbara to be there with us, as she is an excellent advocate and so caring. She offered to help us out with whatever we needed and in this moment she was there to care for our daughter. In our time of grief there was no greater blessing than to know that our children, all three of them, were safely tucked in the arms of those that loved us and them.
I was given Misoprostol to induce labor at 9:10 AM. Katie and Candace were amazing. They ensured that I had eaten breakfast and was staying hydrated. Candace gave me a foot massage to help progress labor and to help me relax as the cramping was increasing. Derek constantly remained positive and spoke words of truth over me about how this was beyond our control and that these miracles were just too good for this world. I needed him close, he was carrying me and he knew that. At 10:05 my mom arrived and I was so thankful for her. You can’t replace your mother, and I needed her to be there. I knew that she could relate to me in the most intimate way. I labored for her as well, as she had lost two babies that she had never had the chance to meet, and I hoped that this labor would honor them and bring healing to her as well.
With every surge I felt sick at the thought of enduring the physical loss of my babies. At 10:38 I had the same feeling that I had before my daughter was born and told everyone that they were coming. Two perfect angels Enoch and Elijah, our sons, were born at 10:39 am on June 3, 2016 sharing an amniotic sac, and holding onto each other. Enoch, 11.5cm 33 grams 1.2 ounces. Elijah, 11cm, 34 grams 1.2 ounces. We chose the names Enoch and Elijah because they went straight to heaven without experiencing death in the Bible. They were so fragile and perfectly formed, even at just over 14 weeks old their humanity was undeniable. I remember staring at their tiny hands and feet we were so proud. Our doula Candace took beautiful photographs for us of our sons, something that we will cherish for years to come.
Normally delivering the placenta is a step unnoticed due to the joy that you feel holding your newborn baby. In this instance I was hyperaware. I almost passed out and instead threw up, was physically exhausted and just wanted it to be over. The Lord is sovereign and gave me only what I could tolerate. My cramping all but ceased following the delivery of the twins, and although two hours elapsed between the birth placenta delivery, during this time I felt little pain. I was given an IV and Katie fanned me with a cool cloth and I felt blessed to have such strong women surrounding me and lifting me up. At 12:47 my OB manually detached the remaining placenta, and to say that it was excruciating is an understatement. Manual extraction of remaining placenta is not something that I would wish on my worst enemy, although it brought relief. It was finished.
Overall my labor experience was short, induced but otherwise unmedicated. It was peaceful. The boys were wrapped in a beautiful blanket our doula Katie had made and placed in a box provided by the hospital. We had the twins’ bodies released to us, contacted a funeral home and my husband transported the twins together. In life they were always together and in death we felt it should be the same. It was a bittersweet moment being separated from them, but we knew when we looked upon their faces that they had gone to heaven and they were forever safe from experiencing the pain of this world.
In the weeks that followed, recovery was tough as I didn’t have a baby demanding all my attention to distract me from the physical symptoms of recovering from labor. It took me four weeks to feel what I would consider to be normal, and they were agonizing. I remained hopeful with every passing day, and slowly felt stronger as my body functioned intricately to recuperate from the trauma.  During this time, we had many difficult events from the day we picked up our babies from the funeral home following cremation to the day that I returned to work and we received reminders from friends that we were loved and being upheld in prayer. We were shown pure grace through hardship which was a gift we were not expecting to receive.
Miscarriage is a challenging subject, but even when circumstances are tragic, birth can be beautiful. For so many years families were made to experience the loss of a child in silence. Sharing your grief can be a healing experience not only for you but for those around you. If we had chosen not to share the news of the twin pregnancy and therefore the loss, the outcome would not have changed. Our babies would still be gone and I would have still felt the weight of heartbreak; however I would not have had others to lift me up when I was experiencing my darkest moments. Although it was not what we had planned when we found out that we were pregnant, Enoch and Elijah’s birth was made beautiful because we chose to honor life as did the caregivers that supported us.  Enoch and Elijah taught me about the fragility of life and the depth of grace. Knowing them for a moment in time is a gift for which I would endure their loss a thousand times.
 
This is a  guest post from Elise Verwers.  Elise is a wife, mother, and employee who loves exploring the gorgeous Pacific Northwest with her family and reminding people who much they are loved.