This is loooong, unlike my pregnancy. My girls were born Tuesday, January 10th, 2006 at 29 weeks gestational age.
I had been having some braxton hicks contractions over the Christmas holiday, but they were very scattered so not a worry. Monday morning (12/26) they started coming every 8-10 min for about an hour. I had trouble reaching my doc (his service wasn't answering -xmas hangover?) and almost went to the hospital, but on the way I got the service, he called right away, and he said lie down on the left side,drink water, wait 2 hours, call if no change, but either way please call the office in the morning and make sure he sees me that day. They stopped. Totally. I felt fine.
Got ready to go Tuesday morning to the doc, felt fine for woman carrying 27-week twins. I had one contraction when I stood up in his office, but I wasn't worried. He does a fetal fibronectin test and internal exam, my cervix is closed. Then he does the transvaginal sono and my previously "long and closed" 3.5 cm cervix is down to 1.3 cm. Do not pass go, do not pick up husband, go staight to Labor & Delivery, he will call ahead and be there later.
They admitted me and put me on terbutaline, and put all the monitors on - 1 for contractions, 1 baby a, 1 for baby b. I was covered in monitors. I got 3 doses of injected terb, followed by oral every 4 hours. I started breaking through with contrax before 4 hours was up, so they went to 3 hours. That seemed to work. Kept the monitors on all night, etc. Nothing exciting recorded. Next day they sent me down for a sono with the maternal-fetal-medicine specialist, and although the babies looked awesome (2 lb 9 and 2 lbs 13 with fat bellies!) I was now 70% effaced, fingertip-1cm dilated. Within an hour I was in an ambulance, lights and sirens, on my way to North Shore University Hospital, because they have a better NICU in case my babies were going to be born.
Once I got there, they went through terb, indocin, and finally had me on a magnesium sulfate pump from Thursday evening to Sunday afternoon, I believe it was. Mag sulfate is satan's drug but it stopped the contractions. I was in a labor and deliver room from Wednesday night to Thursday night, and then they moved me into their high-risk antenatal unit. I sat there, 90% effaced, still fingertip-1cm and on strict bedrest for 2 weeks (I did get bathroom privileges after a few days - whee!) They tried me on a terbutaline pump but it made me tachycardic (heart rate too fast) so I ended up on nifedipine for the duration. I had a few episodes that sent me back to L&D with the thread of more mag, but everything always stopped.
At 2:30 in the morning on January 10th, I woke up out of a sound sleep. I felt kind of wet and weird and thought maybe my water had broken. I stuck my hand down there and found it wet and immediately rang for the nurse. When she came I turned on the light and realized it wasn't water, it was blood. Had to try really hard not to panic. She called for the resident to come in, and in the meantime tried to keep me calm. I was afraid I'd had an abruption, but she told me if I had, I would be in constant pain and I was not.
The resident came in, checked my cervix and said I was now at 3cm (before I was 1-2) and that the blood was probably bloody show. OK, um, I thought bloody show was just a little blood. This was a LOT. Like a whole period at once, and it kept going. I called Ryan and told him to get up and get there, because it looked like we'd hit our expiration date. They took me down to labor and delivery again, put all the monitors on, and I was contracting every 1-2 minutes. Some of them I felt really strongly (and painfully) and some I didn't even notice. In came the bag of magnesium sulfate, which I didn't try to fight because I knew it was my only hope.
The mag slowed down the contractions considerably. They got as far as 20 minutes apart, though each one was quite painful. Around 11 they brought me down to maternal-fetal medicine and the doctor who usually does my Level IIs did a biophysical profile. He was very concerned when he saw how low Baby A was and asked when I had last had my cervix checked. I told him 3am and he said OK, he was going to call up and make sure someone checked my cervix when I got back to L&D. While we were waiting for the perinatalogist, I told Ryan I thought this was it. He was still in denial. But the contractions started coming closer together and were really really painful - enough that I couldn't really talk through them anymore.
I watched the doctor's face while she checked my cervix, and I saw her eyes get big. I was 6 cm, 100% effaced, and Baby A's membranes were bulging. That was it, she told us there was no way to stop it at this point, so we would stop the magnesium and have babies today. She reminded us how we had gotten two more weeks out of them and told me she highly recommended an epidural because both twins were head down and they were going to let me try vaginally (very important to me and that made me feel a lot better), but if I needed a c-section, having the epi on board already would save valuable time. I was fine with that, given the circumstances, and I could not believe the change in my personality outlook after I got the epi.
I suddenly realized I had been in some level of pain for two weeks!
At that point, we called my parents, and invited them to come sit with us and wait for my water to break. They were allowed to hang in the delivery room until that point. Once we had time to get over the initial shock and fear, we started to get excited to meet our girls and to have the PTL ordeal over with. My parents were really great and supportive, and it was surprisingly nice to have them there. I was super-sleepy and drifted off a few times while they all chattered, which was fine.
Mostly we sat and watched the monitor to see how close the contractions were. They got to 3 minutes and incredibly regular, and the doc sent my parents out so she could check me. 10 cm, ready to rumble. Mom and Dad came in to kiss me good luck, and suddenly the medical parade began! Our quiet little room was invaded by neonatalogists, neonatal nurses, anesthesiologists, pediatricians oh my! I think there were a dozen of those people, plus the attending perinatalogist, my L&D nurse, and the two resident physicians who did most of the work.
They broke my water, which felt kind of cool - like a little internal "poink." The contractions started coming closer together, and it was time to push. They told me to push like I was constipated. LOL! With each contraction, they had me push 3 times. They were awesome, because they didn't count or anything - they just said OK...PUSH! and told me what a great job I was doing. I think we repeated that over 5-6 contractions, and then I got to see my Lillian's head emerging below - what an incredible feeling. They took her and cleaned her up, and let me hold her for the most amazing 15 or so seconds of my life. She was beautiful, with the sweetest little lips I had ever seen. I fell in love with her instantly, and it was heartbreaking to have to give her up. But, we had more business to attend to.
While I was falling in love, the doctors were locating Kate. Unfortunately, she must've seen her sister going down that narrow hallway and decided she wanted none of that. She didn't actually flip, but even more dastardly, she folded herself in half so that her head, hands, and feet were all right in the same spot. They said there was no safe way to get her out at that point but a c-section. I suppose if she'd been full term I might've wanted to wait and see if she moved, but although her vitals were good then, I wasn't willing to take any chances anyway.
They wheeled me next door to the OR, and pumped up my epidural. The section was a piece of cake, especially after all the work of pushing out the first baby. I didn't get to hold Kate, because one arm was in restraints, but Ryan did for about as long as I held Lillian. I got to look at her sweet little face, and fell for her just as I had her sister. She was so beautiful. I was so exhausted after that I nearly fell asleep while they closed me back up! Spent about an hour in recovery, and they brought me up to my room, which was about twice the size of the one I had lived in for the previous 2 weeks. They left the epidural in and gave me a PCA pump, which was very helpful. I couldn't sit in a wheelchair that night, so I couldn't go the NICU, which was awful. It was around 9 by the time I got to that room.
Ryan and my parents went to see the girls, and I was stuck just lying in bed with the phone and TV for distractions. That was the hardest part. Knowing that for 7 months I was everything to these babies, but now I couldn't even get out of bed to see then.
Having them in the NICU was amazing motivation to get moving. I started pumping the morning after they were born, and hauled myself or was hauled in a wheelchair to the NICU constantly. Being discharged without my girls was the worst night of my life, but I was back early the next day and every day for the next 2 months, except for one blizzard that stuck us at home.
The girls did well in the NICU. They were big fighters. Lilly was 3 pounds even, and was on a CPAP for 10 days, then moved to nasal cannula and then nothing. Kate was 2 pounds 13 ounces and stayed on a ventilator for 2 weeks, then moved to CPAP and to nasal cannula, which she eventually had to take home with her. She was on the supplemental oxygen until sometime in May. Both of them had a PDA (patent ductus arteriosis - a common preemie problem) which resolved with 2 courses of indocin. Their head sonos were all clear, and they had no issues other than normal preemie things - a little bradycardia but mostly problems holding their O2 saturation. They learned to breathe, suck, and swallow, and we did as much kangaroo care and breastfeeding practice as we could.
I never managed to get them fully on the breast. With the oxygen, the two babes, thrush, painful latch issues, nipple shields, and the pumping to maintain supply and to supplement them after BFing, I couldn't keep up. I ended up EPing for them and still am, nearly a year later. I intend to go to their adjusted age birthday - 3/27.
My girls had a truly harrowing entry to this world, but they have thrived. At nearly 1 year chronological age, they are healthy and strong and have only had 2 colds the whole time. They are on track for their adjusted age, and a little ahead, even. They are both pushing 19 pounds and are the most delightful little babies in the world. So, take heart and know that even a scary, medicalized preemie birth can result in something wonderful.
ETA some photos:
Lilly's first photo - http://i99.photobucket.com/albums/l2...abies_0047.jpg
Kate's first photo - http://i99.photobucket.com/albums/l2...abies_0053.jpg
First babies ever to co-bed at our NICU - http://i99.photobucket.com/albums/l2..._kids20014.jpg
A few weeks ago - Lilly on the left, Kate on the right - http://i99.photobucket.com/albums/l2...wknd_06056.jpg