Mixed blessings: Birthing Experiences

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There is much that can happen during the life-changing journey of creating a family; not all of it jubilant. Three women share their different experiences.

Sarah Brown lost twins Holly and Josh in utero at 23 weeks
Telling an infertile couple that a twin pregnancy is an unwelcome obstetric outcome falls, unsurprisingly, on deaf ears. We were like so many other desperate couples who wanted a family, and twins were the jackpot. We had already been blessed with one healthy daughter, Georgia, via IVF and the thought of having two other children complete our family was wondrous.

So when there were no obvious indicators to suggest I would have problems carrying twins, we put forward a strong argument to our specialist, Dr Mary Birdsall of Fertility Associates in Auckland, for having two IVF embryos placed in my uterus. Although the benefit of hindsight tells us there were warning signs for this being a dangerous decision, we were naive at the time.

From the first blood test it was clear both embryos had implanted and everyone was excited. We were thrilled – our dream of having three children had come true. My blood tests kept coming back stronger and stronger until finally we hit that magical 12-week safety net. Apart from feeling tired and slow, I felt fantastic. Georgia had always been an easy child to look after, and I even continued doing my freelance writing work from home.

I joined the New Zealand Multiple Birth Association in anticipation of the arrival of our twins. Every Monday, Georgia and I went to the association’s playgroups in the hope of gleaning new support from mums of twins and getting Georgia used to the idea of ‘double trouble’.

My pregnancy continued to go well until 23 weeks. I had been feeling a little off one day – nothing obvious, nothing dramatic. I had a feeling of pressure bearing down and a few light Braxton Hicks contractions [sporadic uterine contractions that occur throughout pregnancy and are sometimes hard to distinguish from early signs of pre-term labour]. It was getting close to four o’clock and I was toying with the idea of ringing our specialists before they closed. I felt stupid for phoning, knowing it would turn into a big deal very quickly with me having to go in for a check-up.

Sure enough, I was asked to go to the Women’s Assessment Unit at Auckland City Hospital. I was mortified and instantly regretted phoning. When I arrived the midwives checked me and found no problems, but when one of our specialists came in and performed an examination our world fell apart. My cervix was opening. I can’t explain how everything went so wrong when I had no idea that I was in trouble – I was in shock. I can’t remember what people said to us, but their grim faces told us everything we needed to know – we were in trouble.

We tried to remain hopeful. The next morning a barrage of tests were carried out. My cervix was now completely open and baby Josh could be seen clearly. The risk of infection was the big concern. I was moved into the delivery unit. This was one of the lowest points, as it was obvious that everyone thought the twins were going to be born soon.

Every day the pain got worse, the discomfort was huge; the realisation this was going to end in horror was forever present. The Neonatal Intensive Care Unit staff came and visited us on day three. The news was bad: it was too early for me to have steroids to help strengthen the twins’ lungs, and we were told paediatricians don’t resuscitate babies under the duration of 24 weeks – and we were still a few days away from that milestone. Twin babies don’t fare as well as singletons, and our twins, Holly and Josh, had low estimated weight calculations and had been sitting in hospital exposed to infection with my cervix being open for days. We had no idea what to do.

After enjoying a small period of minimal discomfort for the first time in days (I now believe this was Josh passing away), on day four things drastically changed. A sudden onset of unbelievable pain shot through me.

I felt as if I was being split in two. I have never encountered pain like this before and our room suddenly swarmed with people – everything spun out of control. No form of pain relief worked, and specialists predicted that Holly’s placenta had abrupted. My health was now also in jeopardy and it was time to make a decision. The focus on my health was frustrating as I simply didn’t care; I just desperately wanted the twins and we couldn’t see past that. A message came through from Dr Birdsall that she felt we had done everything we could; we had to let go. That was the turning point for me – I knew Mary would always make decisions that protected our family and she wouldn’t have said this lightly. The truth had finally been spoken.

The distress of delivering stillborn twins will never leave us. Holly and Josh were delivered within a few hours of being induced and they were both black and blue with bruises – it was horrifying. They were tiny. I have only seen my husband, Andy, cry a few times in the 12 years we have been together, and it breaks my heart. We were devastated – our son and daughter were dead. It was simply incomprehensible.

We lost the twins on the 10 year anniversary of the death of my brother Justin. This timing was forever present in the days leading up to losing the twins; we avoided talking about it while in hospital and were shocked when everything was compounded on that day. We now try and believe this is Justin’s way of telling us he will look after Holly and Josh for us. But March 24 has become a very dark day for our family.

We were able to bathe Holly and Josh in hospital and dress them in clothes provided. They were blessed by the hospital chaplain. Leaving the hospital without the twins still haunts us – how can you leave children behind? We had to return to a home that had a nursery already set up. The twins’ names were already on the door of their room. Their clothes were already in their drawers – everything was waiting for them at home.

I needed sleeping pills for weeks afterwards, but even then I spent the majority of evenings awake. Our house filled with flowers and cards. Andy was quiet and sad, while I became obsessed with organising the best funeral we could give the twins. I felt it was the only thing left we could do for them.

I wrote the service, composed poems, organised special hats and booties and had special gowns for the twins made out of the fabric of my wedding dress. I was a woman obsessed, but now we at least have peace in the fact we gave the twins a special send-off.

The shock of not being pregnant was constant in the months that followed. The slow ‘de-twinning’ of the house was heartbreaking. I desperately wanted to be pregnant again, and seeing other pregnant women would instantly make me cry. The twins will always be irreplaceable, so I felt guilty for wanting another child and didn’t think anyone would understand. I felt I was disrespecting the twins, but I couldn’t face not having another baby – the void was too huge and the need for Georgia to have a sibling was paramount to us. I couldn’t face leaving our family with such sadness after many years of fertility treatment; we couldn’t end things like this.

We moved house within months of losing the twins – we needed a fresh space. We commissioned a painting for Holly and Josh that would cement our wish they never be forgotten in our family. We placed their ashes in a garden sculpture we had made especially for them, and have a treasure box filled with special Holly and Josh memories. The Multiple Birth Association gave us two rose bushes to plant in their memory. All these things provide comfort to us.

The five months that we knew Holly and Josh in utero is still better than not having them part of our life at all; we still had a bond and Andy and I still think of them as our children. We constantly regret that we can’t watch them grow up and we get frustrated that life moves on so quickly. Because of this, after only a few months we gingerly took ourselves back to Fertility Associates, knowing we had to be extremely brave to undertake the roller-coaster ride of fertility treatment once more. We knew there were never any guarantees. We didn’t have success straight away, but eventually IVF worked for us again.

This final pregnancy was one of the hardest journeys we had to undertake after losing Holly and Josh – I was petrified. There were endless scans, doctor’s appointments, an operation and a lengthy hospital stay during the pregnancy. Extra stresses of contracting pancreatitis and coping with a house fire were dramas that made the pregnancy surreal at times. We had lost our innocence as we knew things could go wrong at any stage.

Thanks to our clever doctors, Olivia Rose was born five weeks early in June last year. Born at only 1,930 grams, she spent her first weeks in the Neonatal Intensive Care Unit at Auckland City Hospital. With incredibly good luck she was able to come home at the same time I was discharged from hospital.

This good fortune was a huge relief, as I was fearful that leaving another child behind would mean I might not be taking them home at all. I suspected our doctor knew this and was able to work the timing in our favour.

Life is now very simple: it is the little things that matter to us. We will never take our children for granted. We also never take for granted that there are doctors out there who make decisions every day that make a huge impact on people’s lives.

After five years of fertility treatment, four IVF cycles, countless frozen embryo replacements, six operations, three miscarriages and the heartbreaking loss of our twins, we are thankful that we have been privileged enough to have children.

Twins will always have a special place in our hearts and Holly and Josh are never forgotten, always treasured. I still believe I am the mother of twins, as much as I am the mother of our two daughters Georgia Grace and Olivia Rose. Just like part of the verse I wrote for the twin’s funeral, I believe: Now I have a treasure/That I rate above all other/I have known true glory/I am still your mother’.

Andy and I only have a story to tell because of the care we received from three special doctors: Dr Mary Birdsall and Dr Simon Kelly at Fertility Associates and Dr Martin Sowter at Auckland Obstetric Centre. We know they were ‘only’ doing their jobs, but it will always mean much more than that to us.

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