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<p>Hi, my SIL is 18 weeks pregnant with twins.  Her water broke on one baby 2 days ago and she is now in the hospital. Of course, she is very scared, as we all are, as the doctors have told her the outlook for both babies is "grim".  Anyone have experience with this?  I'm the mom of a 31 week preemie due to an abruption, so I'm familiar with birth trauma, but not loss of a child or at least the possiblity of loss.  How can I help her?  Any advice, wisdom, encouragement would be greatly appreciated!</p>
 

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<p>oh hun sorry no advice but i am so sorry you're family is going through this...she's only 18 weeks...<span><img alt="hug2.gif" src="http://files.mothering.com/images/smilies/hug2.gif"></span></p>
 

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<p>Unless a miracle happens the only thing you'll be able to do is to try to understand her.<span><img alt="mecry.gif" src="http://files.mothering.com/images/smilies/mecry.gif"></span></p>
<p><a href="http://www.glowinthewoods.com/how-to-help-a-friend/" target="_blank">http://www.glowinthewoods.com/how-to-help-a-friend/</a></p>
<p><a href="http://brightonwoman.blogspot.com/2010/09/stages-of-grief-in-miscarriage.html" target="_blank">http://brightonwoman.blogspot.com/2010/09/stages-of-grief-in-miscarriage.html</a></p>
<p><a href="http://www.glowinthewoods.com/how-to-stop-lactation/" target="_blank">http://www.glowinthewoods.com/how-to-stop-lactation/</a></p>
<p>I am so sorry.</p>
 

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<p>
HI,</p>
<p>
First of all, I'm SO VERY SORRY for your sister in law and your whole family to be going through this horrible trauma. Pregnancy is supposed to be a time of joy and anticipation, not terror, fear, and grief.</p>
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I can say that I 100% know what your sister in law is going through, and I will tell you my story (as briefly as I can!) to hopefully give her some ray of hope. It is important to know that my outcome is extremely rare, and still "unexplainable" by all in the medical field.</p>
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I was pregnant with twins, found out August 2009. I was so unbelievably excited (pregnancy actually started as quadruplets!!! But two of the babies spontaneously miscarried very early on, so from about 9 -10 weeks on, it was twins).</p>
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I had lots of bleeding/spotting and problems from early on, so I was having a LOT of ultrasound monitoring. At 10 weeks, the twins looked perfect, healthy and right on track.</p>
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Only one week later, at my 11 week ultrasound, it was discovered that my "Twin A" had absolutely no fluid. I had "ruptured" his sac, without even knowing it because they were so little that I didn't notice the fluid I guess.</p>
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I was given a 100% chance of losing Twin A, and a very very very low chance of even being able to save Baby B, because they explained that I would likely go into labor, and they couldn't stop it. If I didn't go into labor, they explained that I would definitely develop a uterine infection because of the ruptured membranes (and Baby A was right on top of my cervix, so they said that infection was certain because of the exchange of bacteria through the cervix).</p>
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I was told to terminate the pregnancy and "start over". Remember, I was still in the first trimester at this point.<br><br>
My DH and I couldn't terminate, because we had a healthy baby in there (well, TWO healthy babies, but we were being told that Baby A would die within days in utero). So, despite the doctor's grim predictions, we just kept going on with the pregnancy.</p>
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I was terrified. I lived for months on eggshells...afraid each day that I would lose one or both of the babies. Living daily waiting for your babies to die, knowing there is nothing you can do to save them, is EXCRUCIATING. Horrifying. Traumatic in a way that I cant even describe.</p>
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I tried to focus on the fact that, TODAY I AM PREGNANT. I sent as much love, peace, happiness, and joy to my babies as I possibly could. I hugged my belly, sang to them, talked to them, prayed for them to stick around.</p>
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I wasn't even in the hospital at this point, because they said that there was no chance that I'd make it to viability (24 weeks), since I ruptured so early. The doctors had pretty much given up on the chances of survival for either of my babies, although as time went on and I was still pregnant with no signs of labor or infection, their hope for Baby B began to increase.</p>
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Finally, at 20 weeks, they put me on strict hospital bedrest, because at this point, they were starting to become somewhat hopeful that Baby B might survive to viability. Their prognosis for Baby A was 100% fetal demise, or if not death in utero, clearly they told me he would die within minutes after birth, because they said that he wouldn't have developed lung tissue that could even be resuscitated. Amniotic fluid is how the lungs develop, and since he lost his at 11 weeks, they said that his lungs would be extremely tiny and hard as a rock.</p>
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So my husband and I prayed for Baby A to live long enough to get Baby B to a place where he could survive. I planned for how I wanted things to go after the birth, in terms of how I wanted to honor Baby A's life, that I wanted my husband and I to hold him, have a photographer from NILMDTS take professional pictures of us with him, and that I wanted my parents and my husbands' parents to see the baby and hold him too. I had a memorial service planned for him , songs chosen, readings chosen...it was important for me to honor that he was ALIVE inside of me (and therefore maintain *hope* for his survival) but also for me to plan for the reality that I would lose him at birth. Meanwhile, I was desperate to stay pregnant long enough for Baby B to survive without horrible complications.</p>
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I reached viability (24 weeks) on New Year's Day. What a day. I was both elated and terrified, because 24 weeks is not when I wanted to have a baby born. The risks are just so high of complications. I think every day between 24 and 26 weeks felt like a year...because 26 weeks was my OUTSIDE LIMIT of when I could even imagine my babies being born.</p>
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Well, unfortunately, I didn't make it, and at 25 weeks 6 days, Baby A's placenta began to abrupt (tear away from the uterine wall), likely a result of slow deterioration over the past 15 weeks I was ruptured with him. Everything happened so fast, and I was just crying and crying...I remember thinking "I'm feeling my Baby A ALIVE inside of me and in minutes, he'll be gone...I'm about to lose my child." :( It's hard to even relive this experience...it was the worst day of my life.</p>
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At the same time, since I wasn't even 26 weeks, I was now ALSO terrified that I was going to lose Ryan (my Baby B). I was in shock, I think...it was like watching a movie of someone elses' life...I was wheeled into the emergency C-section and I remember looking at my husband and crying that we were going to lose both of our babies...I was just devestated., What was supposed to be "the best day of my life", the birth of my first children, felt more like a death march than a celebration.</p>
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Following the delivery, it was so chaotic. The NICU teams kept checking in with us letting us know what they were doing in the room to try to save our babies. They managed to intubate Baby B fairly quickly, so he was hooked up to a ventilator and transferred to the NICU within 20 minutes or so?? Baby A, on the other hand, "coded" in the delivery room. As they expected. He had a very slow heart rhythm and his oxygen intake was extrememly low, and I remember them telling my husband that they were doing everything they could, but it looked like he wouldn't make it. :(</p>
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Unbelievably, the miraculous doctors somehow managed to intubate him (despite how "rock hard" and "undeveloped" his lungs were from lack of fluid the whole pregnancy)...and they somewhat stabilized him, enough to transfer him to the NICU at least. We were still told that he was extremely exxtremely sick and wasn't expected to survive the night.</p>
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Meanwhile, due to complications, I had been given general anesthesia part-way through the delivery, so I wasn't awake for part of this news. When I woke up, the first thing I remember asking my sister (who was with me) was "Did my babies die?" So sad...such sad memories for me.</p>
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The amazing news is that the answer to that question was "NO!!!!!" No, they did not die. They were alive...literally against all medical predictions. It was a miracle that my Baby B was alive, but it was unexplainable by the doctors as to how my Baby A had not died, both before birth and at birth. They could not, and still cannot explain how he managed to have developed enough lung tissue to support life.</p>
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Our NICU experience was long and difficult. We were there 5 months. The babies experience many complications, including brain bleeds (luckily, none so severe as to cause long-term problems), heart surgery, intestinal surgery, eye surgery to prevent retinal detachment, many infections, multiple blood transfusions...you name it, we had it. It was, hands down, the hardest year of my life...the pregnancy was hard in so many ways, living day to day "waiting" for my children to die. It was horrible. The NICU was horrible in its own way...watching your tiny babies struggle and suffer through so much and daily, not knowing if they will make it or not.</p>
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However, I have not written all of this to depress you or your sweet (and I'm sure terrified) SIL.<br><br>
The good, miraculous, indescribably amazing news is that...BOTH of my boys are home with me, relatively healthy, and will celebrate their first birthday in a month!!!!!!</p>
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I ruptured 7 weeks earlier than your SIL, and wasn't even taken seriously enough to be put into the hospital until 20 weeks, and yet...they are both home with me. The even stranger thing is that my "Baby A" (Noah Peter) who wasn't supposed to be able to breathe outside of my womb...is not even on home oxygen!!! My Baby B (Ryan Matthew) has sicker lungs than his twin, and will require 24-7 oxygen until he's about 18 months or even 2 years old. But other than that, they are happy HEALTHY amazing boys who, according to every person in the medical field, shouldn't be here.</p>
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I tell you my story with caution, because the reality is that our outcome IS miraculous and is NOT the norm. Yes, it is true that in all likelihood, your sister in law will lose the ruptured twin, and may lose both babies before viability. That is the sad truth, and it's a truth that I had to accept for myself as well. But, for ME, it was so critical to have some strand of hope, while remaining realistic.<br><br>
I hope to offer your SIL that small ray of hope...and will pray for her daily and for her precious babies. Please tell her to remain on STRICT bedrest, do anything she can to relax, meditate on the strength of her babies, believe in them, talk to them, sing to them, TELL THEM that she believes in them. Tell her to try to block out any negativity, and inform her doctors that she understands that things are grim but that in order to provide the healthiest environment to give her babies the best shot, she needs to surround herself with healing and positive vibes.</p>
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I had one doctor who insisted, daily, on telling me that my Baby A would DEFINITELY die. He would upset me to the point that I was crying and sobbing, and couldn't eat or drink anything. He was HARMING my chances to provide my babies with the safest womb environment, so I told the nurses that if he couldn't change his attitude/approach with me, that I didn't want him in my room.</p>
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I made it VERY CLEAR that I only wanted doctors to treat me who would at least pretend to believe in my babies. I did not need to be surrounded by their negativity. I explained that I understood the reality of the grim prognosis...but that I had to maintain hope for a miracle, both for my sanity and for the sake of my babies.</p>
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Tell your SIL to advocate for what SHE needs in this situation. I put myself on strict bedrest (even at home before I was hospitalized, I got a wheelchair from a local charity), and just laid around all day doing nothing but reading, meditating, watching TV...anything to get my mind off of death, baby loss, bleeding, etc. I truly believe that so much of this is about maintaining a positive mental outlook, to the best of your ability.</p>
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Please keep me informed as to how things go. PM me if you'd like to have your sister in law be in touch with me directly. I just feel so SO SO much for her right now. I know the horror of what is happening to her...but where there is life, there is hope...and my 11 month boys who are napping upstairs in their cribs, are living proof of that. (And ruptured 2 months earlier than her baby...there IS HOPE!!!)</p>
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Please let me know if there is anything I can do.</p>
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Claire (and Noah & Ryan)</p>
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P.S. One thing that was so important to me was that people continued to speak as though I were having "twins". Yes, I wanted everyone to understand the reality of the prognosis, especially for the baby who had ruptured, but for me, it was SO IMPORTANT to honor both babies, since both babies were alive. I didn't want to discount Baby A, and I couldn't stand for anyone else to discount him either. I decided to prepare for his passing (things like wanting handprints/footprints, pictures, lock of hair, to hold him, songs, etc.) but HOPE for his strength to survive. Everyone who knew me knew that they were to talk about my BABIES, not baby (like Baby B was the only baby who mattered). It is such a personal thing, and was such a delicate balance, so maybe you can ask your sister in law how she feels, and what helps her feel like she is honoring her babies and herself. Just a thought.</p>
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P.P.S. (Sorry I keep adding things that I think of that might be helpful for her to know). Since I *knew* that even if I managed to make it past viability, I would almost certainly be having VERY premature babies, I made it my total and complete mission to grow my babies as much as I possibly could. I am tiny, naturally, and started my pregnancy at 105 lbs. However, when I was hospitalized, I began eating 5,000-6,000 calories PER DAY of mostly protein and fat. The nutritionist told me it was completely unnecessary and that 2,500 or 3,000 was plenty, but I was at the point where I would try anything if it might help my babies grow. I ate 4 fried eggs, 4 pieces of sausage, 2 blueberry muffins, toast and peanut butter, Ensure, cereal with whole milk, and that was just breakfast...then snack, lunch, snack, dinner, and another snack. Plus protein bars in between. I am not a big eater--I get full really easily, and I felt just HORRIBLE the entire time I was eating like that, because I felt like I would throw up all day every day, I was so full. But every bite, I would think "I'm doing this for the babies, to grow them as much as I possibly can before they're born." Every discomfort I endured or put myself through was done to increase the chances that my boys might live or be stronger.<br><br>
And I'm so glad I did it, because at 25 weeks gestation, they were HUGE HUGE HUGE babies at 2 lbs. and 2 lbs. 2 oz. Ultrasound had estimated that they were only 1 1/2 pounds each, but after they were born, the docs were amazed!! I still attribute that to the high protein/high fat/high calorie diet...and TONS AND TONS of water. Just another idea...hope it helps her!!</p>
 

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<p>Wow. I think I remember parts of that from around the board but had no idea about anything since they were born. Truly miraculous. I hope this mama has as good of an outcome <3</p>
 

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Discussion Starter #6
<p>Thanks to everyone for the wonderful replies.  Claire -- what a wonderful and truly uplifting story!  As a former NICU mama myself, I can sympathize with your fright and your determination to advocate for yourself and you babies.  I remember how scary it was watching my DD in the NICU.  Definitely not how you expect a pregnancy to go. But, what an amazing story of hope you have offered when things seemed so bleak!!    Congratulations to you, your family, and your little (well, I guess not so little!) babies!  That is just truly amazing.  When she feels she is up to it, I will definitely pass along your story to her and let her know that you have amazing words of encouragement for her!  Thank you so so much!  You have made my day!!  <span><img alt="joy.gif" src="http://files.mothering.com/images/smilies/joy.gif"></span></p>
 

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<p>Claire that is remarkable. I am speechless. <span><img alt="grouphug.gif" src="http://files.mothering.com/images/smilies/grouphug.gif"></span></p>
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<p><span><img alt="hug2.gif" src="http://files.mothering.com/images/smilies/hug2.gif"> Sierra. How is it going?</span></p>
 

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Discussion Starter #8
<p>Babies are still stable at this point, but the doctors are still concerned. Otherwise, no word yet as to why this happened or outlooks for the future.</p>
 

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Discussion Starter #9
<p>Unfortunately, some bad news in the latest update.  Baby A's (the one without water) umbilical cord slipped through the cervix last night and into the vagina.  Doctors are urging her to induce both babies as they are afraid of infection at this point.  SIL is also having contractions and the doctors are trying to stop that.  They are really just taking it a day at a time at this point. Doctors have said they will check her blood every day, but, at the first sign of infection, they will have to induce.  They are also entertaining the idea of delivering Baby A to save Baby B.  Just when we thought things were stabilizing, now this happens.</p>
 

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<p><span><img alt="praying.gif" src="http://files.mothering.com/images/smilies/praying.gif"></span></p>
<p><span><img alt="hug.gif" src="http://files.mothering.com/images/smilies/hug.gif"> I'm so sorry. I hope they can hold out a few more weeks.</span></p>
 

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<p><span><img alt="hug.gif" src="http://files.mothering.com/images/smilies/hug.gif"> I am so sorry hun</span></p>
 
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