Tia

Mother to two angels

Miscarried April 26th, 2010

and July 26th, 2010

and triplets Cadyn, Adalyn, and Mikayla

Born and lost January 7th, 2011

Burlington, Iowa

My husband and I were high school sweethearts who got married in June 2007 after five years of dating. In 2009, we made the decision to try to start a family. I knew that there may be some difficulties because I had extremely irregular menstrual cycles. I decided to set up a pre-conception visit with an OB-GYN so that I could find out what steps to take to ensure a healthy pregnancy. At the visit, we discussed my concerns about my cycles and I immediately received a referral to a reproductive endocrinologist.

The consult with the RE revealed that I had PCOS and I was started on Clomid in the hopes that it might help me ovulate. The first two doses we tried were a bust. The next dose finally helped me ovulate, but unfortunately we did not conceive that month. Because of some weird side effects, my RE decided to try me on Femara the next cycle. Again, I didn’t ovulate. This lead us to a discussion about getting more serious and trying injectable medications. While I was nervous about this, I was hopeful that this would finally help my body cooperate.

The first cycle of injectable medications ended up being cancelled due to poor response. My RE was a bit puzzled by my poor response so we discussed trying a different combination of medications the next cycle. To my surprise, a week after that appointment, I ovulated! While I was waiting on the results of a progesterone test to confirm that I had indeed ovulated, I got a positive home pregnancy test! My husband and I were so excited. My initial hcg levels were a bit low, but they doubled appropriately, so we scheduled an ultrasound. At the first ultrasound, the baby measured a couple of days behind, but since we weren’t sure of my exact ovulation date, my RE wasn’t too concerned and had me come back the following week. At the second ultrasound, we found a heartbeat, but it was too slow the baby was measuring even further behind. At this point, everyone was concerned. The following week, I had my third ultrasound at what should have been 8w3d and discovered that the baby no longer had a heartbeat.

My husband and I were devastated.

After this first loss, we started back in with the injectable medications again since we had found something that worked. To my surprise, I got another positive pregnancy test with a great initial hcg of 84 that cycle. Unfortunately, a repeat hcg level 48 hours later was only 72. We continued to do hcg levels every 48 hours and they continued to drop. I finally started bleeding at 5w0d and an hcg level that day was finally negative. I was upset that this had happened to us yet again, but I was still hopeful since we got pregnant so quickly. Hopefully, we were finally on the right track and things would work out for us soon.

The very next month, I started on the same medication regime. To my surprise, I was pregnant for a third time! My initial hcg levels looked great and one of the nurses asked me how I felt about twins. I was excited and couldn’t wait until my first ultrasound around eight weeks. However, the next day, I started lightly bleeding and was worried that I was going to lose this third pregnancy. The bleeding continued for almost a week, so my doctor decided to have me come in early for an ultrasound. At 5w6d I walked into the ultrasound suite with my husband, nearly in tears because I thought it was all over.

However, when the screen lit up, I immediately realized that everything looked pretty good…and two gestational sacs were clearly visible. It really was twins! Then, the ultrasound tech moved the probe a little bit and a third gestational sac was found. I immediately blurted out “oh my God, was that just three separate ones!?”. The tech grabbed my hands and nodded. Then she added “and there’s heartbeats”.  I was so overwhelmed by emotions. I was excited, happy, scared…it’s still hard to describe that moment.  I cried and cried happy/excited tears. Finally, I was able to collect myself and we continued with the ultrasound. Everything looked perfect and there wasn’t a source for the bleeding. The topic of selective reduction was brought up, but my husband and I both agreed that it wasn’t something that we could follow through with. Our doctor agreed and sent us home with with instructions to return in two weeks for another ultrasound since there was still a chance that we could lose one of the babies since it was so early.

After being sent home with the news that I was pregnant with triplets, my husband and I were in complete shock. We knew that there was a slight chance of a multiple pregnancy when we decided to proceed with my cycle, but honestly, we never thought that it would happen to us. We discussed all of our fears about things, and finally admitted that we were so happy and thankful for our three little
blessings. I was still cautiously optimistic and couldn’t really let my guard at that point. After two losses in the previous 6 months, I still didn’t believe the fact that I might actually carry a pregnancy past the first trimester.  No sense in getting too attached, only to have my hopes and dreams crushed yet again.

However, to my surprise, our second ultrasound revealed that there were still three very healthy babies growing and I was finally discharged from my reproductive endocrinologist and referred to the high risk pregnancy clinic.

At 9 weeks, we met with my maternal fetal medicine physician (MFM) for the first time. He informed us of the high-risk nature of this pregnancy but told us that everything looked great so far. My blood pressure was perfect, the bleeding had completely stopped and I was experiencing some pregnancy symptoms, which was reassuring. He sent us on our way with a return appointment at 14 weeks. Wait, that’s just over 4 weeks away! How in the world was I going to make it that long without some reassurance that everything was ok?

Well, I did survive those four weeks and by my next appointment was starting to notice that I was definitely beginning to get a belly. Yikes, if I was only 14 weeks at that point, then the next several weeks could get interesting. Again at that appointment, everything looked great. All three babies were wiggling around on the ultrasound and had great heartbeats. Also, I had made it past the first trimester!

Really, I had been pretty lucky with pregnancy symptoms too…only an occasional bout of nausea and vomiting, nothing like it could have been with all of the hormones that were surging through my body.

To my relief, my next follow-up appointment was scheduled for just two weeks later. At that appointment, we would check length of my cervix on ultrasound. If it was starting out too short, then we would do a cerclage to hopefully avoid an extremely premature delivery. If everything looked ok, then we would be sent on our way and just keep on eye on things at the next few appointments.

My 16 week appointment went great. Again, the babies looked good and my cervix was measuring 3.3cm long…a good enough start. More exciting news….I went to have an elective ultrasound done and it looked like we were expecting two boys and a girl! Christmas was the following week and we received so many nice gifts for the babies. Clothing, blankets, car seats, a diaper bag…we had a nice start on the list of things that we were going to need.

At 18 weeks, everything still looked great. The babies were all getting so much bigger and my cervix hadn’t changed a bit. By this point, I was also starting to feel the babies move every so often and loved it. I wasn’t feeling anything consistent, but it was an amazing reminder of the lives that were growing inside me. Our big 20 week anatomy ultrasound was scheduled and I went home to count down the days again. I’d pretty much been living my life in two week chunks up to this point…two weeks into a cycle until I would ovulate, two weeks after that to find out I was pregnant, and then appointments every two weeks with my doctor. I was hoping the next two would also fly by without any problems and we’d get to see the babies for a good hour or more while they measured and examined every last part of them at the anatomy scan.

At 19 weeks, I was starting to get a bit uncomfortable. My belly was measuring well ahead of where I was at in my pregnancy.  Heartburn and indigestion had set in again big time as everything inside of me was squished and pushed out of place. I hadn’t been this sick in my whole first trimester…what was the deal? I was getting worn out easily and was starting to get pretty sore if I was on my feet for too long. It was looking like my time of working 12 hour shifts as a nurse was coming to an end pretty quickly. In fact, it looked like everything was changing pretty quickly…

I had just gotten up for the day and was getting ready to head in to work when I went to the bathroom and noticed that I was spotting. I immediately panicked. I knew that this was a sign that my cervix might be starting to shorten and called my MFM’s office. Since it was after hours, they wanted me to come in to be seen in the Labor and Delivery unit. My husband and I made the hour and fifteen minute drive up to get things checked out. As I was laying in the bed waiting to be seen, I thought that I felt some very mild cramping. It wasn’t bad though and after the long drive I thought that it must just be the ligament pain that I’d been getting for the past few weeks. The physician came in and did an exam and told me that it looked like the bleeding had stopped, but that they did see a small clot right up by my cervix that they removed. Hopefully, the spotting would stop and wouldn’t continue to worry me. Other than that, my cervix still felt thick and closed so I was good to go home unless I wanted to be monitored overnight. I really wasn’t feeling all that bad and was actually kind of embarrassed about getting so worked up over a little spotting, so I said that I was fine with going home and trying to get some rest. My appointment with my MFM was less than a week away, so surely they would be able to tell if anything fishy was going on then.

At home, I really didn’t sleep at all. I just couldn’t find a spot that I was comfortable in and the events from earlier in the night still had me a bit worried. The bleeding had stopped, so I kept trying to tell myself that I was getting worked up over nothing. The next morning, I headed in to meet with my employee health coordinator to let them know that I likely would not be working anymore after my next appointment with my doctor and got the necessary forms filled out to take a pregnancy leave of absence.

When I got home, I went to the bathroom and noticed a ton of mucus discharge with a little bit of spotting again. In addition, I was feeling a lot of pelvic pressure. Instant panic set in so I called back up to my MFM’s office and told the nurse that I really felt like I needed to be seen again. She informed my doctor about what had been going on, and he agreed that I should come up to the office as soon as I could.

My husband reluctantly left work to make the long drive for the second time in 24 hours. I wasn’t willing to let on just how uncomfortable I was becoming during the drive, so he didn’t realize that anything that serious might be going on. By the time we got to the office, I recognized that I was cramping pretty regularly. Then, when I stood up and got out of the car, I felt a bit of a trickle. I wasn’t sure what was going on so I went to the first bathroom we came to. I was horrified to find out that my panties were saturated with bright red blood. We walked over to the clinic as quickly as we could, but by that time, I was starting to lose my composure. The cramps were getting painful and I just knew that things were not going to end well.

When the nurse called me back to check my blood pressure and do a quick exam I broke down crying. I was terrified and the look on my husband’s face told me that he was feeling the same way, even though he kept trying to tell me that things would be ok.

After the exam, I was taken back to the ultrasound suite. They checked the babies and took a quick look at the placenta first. Everything looked great….what a relief! My MFM started telling me that if my cervix looked good, then I would be ok to go home and just take things easy. I was starting to get to the point in my pregnancy where I probably would be uncomfortable and that was normal. Great, I was fine with being uncomfortable as long as it meant the babies were growing appropriately and looked good.

The minute that they switched ultrasound probes to get a better look at my cervix I knew that something was wrong…very wrong. One of the babies’ heads was right up against the opening and there didn’t appear to be very much cervix left. The tech took several measurements, but they all came up about the same. There was only 0.9cm of cervix left. My MFM said that they could try to put in a cerclage, but they wouldn’t be able to while I was still cramping and bleeding. I was completely devastated. They brought a wheelchair into the room and sent us over to L&D again for monitoring and medication to hopefully stop the contractions. On the walk over we saw three angels up on the wall of the walkway from the office building to the hospital. My husband quickly looked back at me and said “I hope that’s not a sign”.

In L&D I was given indomethacin in an attempt to stop the contractions, however, they were still coming about every 2-5 minutes. I begged them to increase the dose or try another medication, but I was told that it wasn’t possible. My husband left to make a quick trip home to grab a few things. While he was gone, I got up to go to the bathroom and noticed blood running down my leg and dripping onto the floor. I pulled the emergency cord in the bathroom as I started to feel myself passing some larger clots. I thought that this was the end…and I knew that at just 19w4d there was no way that my precious babies could survive being born.

Oddly enough, after the whole episode of bleeding and passing clots, the cramping stopped completely and the bleeding let up significantly. By the following morning, I was feeling relatively good and my MFM doctor was hopeful that we would be able to go ahead with the cerclage as planned that afternoon. Later that morning, a resident stopped by to check on me and informed me that I was now about 1cm dilated and my cervix felt like it might be a bit thinner. Because of this, she wasn’t sure if they would be able to do a cerclage or not. I tried to tell myself to take what the residents say with a grain of salt…after all, they haven’t been doing this for as long and might not know what they were talking about.

When my MFM came by that afternoon, he agreed that I was 1cm dilated, but this wasn’t much change from where I was at the night before, so they could still try the cerclage. I was relieved, signed the consent forms, and was taken back to the OR. The anesthesiologist put in a spinal block and everything was ready to go. Just as my MFM was getting started with the procedure, he noticed some fresh bleeding and had to scrap our plans for the cerclage. I was told that since they couldn’t tell where the bleeding was coming from, it could do more harm than good to proceed. Feeling my hope start to slip away, I was taken back to my room to recover. Our new plan was to start progesterone, keep me on bedrest for the weekend, and try the cerclage again on Monday.

I was nervous, but physically was still feeling good and was finally allowed to eat (I wasn’t allowed to eat the entire night before the procedure since they knew they were going to have to do a spinal) so my husband went to my favorite restaurant and brought back dinner. Since I was stable, they were going to transfer me over to the antepartum unit. All of this was great news and I tried to stay optimistic… until things suddenly took a final turn for the worst.

As the spinal was wearing off, I started to notice that I was contracting again…and they were painful.  Everything still felt a little funny so I wasn’t completely sure about what I was feeling. I called the nurse in and told her that I felt a little crampy again and that I was feeling a weird pressure sensation. She also thought that it was probably an upset stomach and gas from eating a big meal after being on an empty stomach for so long, but told me to let her know if it got worse and left the room.

My husband and I were talking and watching television when I went to roll over to my other side for a while. As I did, I felt a ton of pressure and then just knew what had happened. I was hysterical and pleading with my husband to get the nurse in the room as quickly as possible, but to not look under the sheet. When the nurse came in, my fears were confirmed…the amniotic membranes for one of the babies had started to come out and there was no way to stop the baby from being born at that point.

She called in some help and shortly after, my water for the first baby broke and he was born alive on January 7th, 2011 at 7:22pm. It felt like my heart had just been ripped out. I wanted someone to tell me that none of this was real and that his was all just a bad dream. Unfortunately, it was all very real. They laid my tiny son, Cadyn, up on my chest so that I could hold him. He was squirming around and attempted to take a couple of breaths. Everything about him was so perfect. It was amazing how he shared a lot of the same facial features as my husband. Then, at 7:42pm he passed away peacefully with my husband by my side.

Our hope at this point was that we leave Cadyn’s placenta in and tie it off without disturbing the other two babies. Hopefully, this would buy the time that we needed to make it to viability. I was trying my best to remain as calm as I could because I didn’t want to stir anything up. As we were waiting, I was told that the physician and nurses were starting to get concerned about how much I was bleeding. They were getting ready to start a second IV just as I started to tell them that I really wasn’t feeling well and thought that I was going to pass out. I remember hearing that my blood pressure had dropped to 70/31 and knowing that that was not good at all. I was rushed back to the operating room, leaving my poor husband alone in the room holding our tiny son fearing that he was about to lose everything.

In the OR, they set one bag of IV fluids wide open and then started to run in two units of blood in my other IV. I started feeling better shortly after that and frantically asked if someone could please go let my husband know that I was doing ok. After this, the details got a bit fuzzy. They did an ultrasound to see what was going on and found out that both of the remaining babies had heart rates in the 60s. This finding, in combination with my bleeding and status, forced them to start pitocin to induce labor and deliver the remaining two before I bleed too much more. My body had completely failed me. My husband was allowed to come back to the OR and we waited. At 9:55pm our daughter, Adalyn, was born sleeping.

She was followed by the third baby at 9:58pm, whom we thought was our second son that was also born sleeping. The nurses took them over to clean them up and asked me to remind them what we thought we were having again. I told them two boys and a girl and the one replied “Oh, honey…there’s no boy parts here.” My husband and I couldn’t believe it and actually got a bit of a chuckle. All of the planning we had done wouldn’t have mattered anyways. So we named the baby that we had been calling Mason all along, Mikayla. The hospital chaplain came back to do a quick blessing with us as we were still stuck in the OR waiting on the placentas to deliver. Finally, at 12:10am the placentas delivered. The physician had been getting a bit impatient and worried so he was just coming back to say that they were going to have to go in to manually remove them. I was so relieved that I was able to avoid this.

I was stable enough to be discharged the following morning. We left the hospital with the babies to take them to a funeral home in our hometown. I still could not believe that everything had just happened and that now we had to make funeral arrangements for our children. All kept thinking was “this cannot be real”. Then next couple of days passed and we met with the funeral director to make the arrangements. I was so thankful that at least we were going to get the opportunity to say good-bye to our babies and have their short lives recognized. However, I don’t think that any parent should ever have to go through picking out a casket for their child. That’s just not the way that things are suppose to happen.

We had a beautiful service and buried the babies together next to my grandfather. We also bought the cemetery plots next to the triplets so that we could be buried there with them one day. It’s so hard to think about your own death when you’re still this young, but at least this one detail is already taken care of.

Since losing the triplets, my husband and I have started trying to conceive again. We’re not giving up on the hope of having a healthy baby, however, it’s a very nerve-wracking process trying again. My MFM doctor plans to monitor me very closely and do a cerclage around 12 weeks with a future pregnancy. I hope this plan works, but sadly I’ve learned that nothing is guaranteed to help me bring home a healthy baby.

Tia blogs at http://ttcwithpcosrpl.blogspot.com/

You can contact her at tmm164@hotmail.com

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Comments

  1. Tamara says:

    Praying for your family. We too lost multiples. I was pregnant with 6 babies after taking IVF treatments. I lost the babies in the first trimester. I was sent to a fertility specialist in Atlanta. It was determined that when I get pregnant my estrogen level bottoms out. This was causing my miscarrages. Please have them check this for you. Happy ending for us….I couldn’t have our own children so we adopted a boy and a girl. They are now 11 and 10. It’s pretty amazing. You can tell God made these babies just for us. Adoption is a wonderful thing. Will keep you in our prayers.

  2. Maggie says:

    Tia, Thank you for sharing your story. I am sorry that you have lost your babies… it is never easy, no matter how far along you are. I pray you and your husband are able to conceive and carry to term a healthy baby!

  3. Michelle says:

    I wish you and your husband the best of luck. I lost my daughter at just 19 1/2 weeks. Loosing one was hard enough, I couldnt imagine loosing five. Your a strong mother to keep trying. I hope one day your miracle baby will bring much joy to your lives.

  4. Tia says:

    Thank you all so much for the supportive comments. Unfortunately, my husband and I had another early miscarriage when we starting trying again after the triplets. However, we are pregnant for a fifth time and found a wonderful MFM who is being very proactive with things. I had a cerclage placed and will be starting 17p injections in a couple of weeks. Hopefully, this combination along with very close monitoring will finally bring us our take home baby.

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