I wrote about my pregnancy for the
Denver Post. Here is my story.
Bittersweet emotions attend birth
Grief, joy spring from in vitro twins
By Daisy Whitney
Special to The Denver Post
Jan. 28, 2001 - It either works or it
doesn't.
At least that's the conventional wisdom
among couples trying to conceive a child
through in vitro fertilization (IVF).
That was my only thought when two eggs
harvested from my ovaries and fertilized
by my husband's sperm were transferred
back into my uterus last May. "It
worked!"
In fact, IVF worked so well that I was
carrying twins. It seemed like the
simple, lovely miracle my husband and I
had prayed for. At the time, we did not
face squarely the risks of carrying
multiples. Ultimately, we faced them as
we had to.
With IVF, the goal is to make possible
and then maximize the odds for a live
birth, and that means many couples and
their doctors - including us and our
infertility specialist, Dr. William
Schoolcraft - choose to transfer at
least two of the embryos to the uterus,
to begin the journey toward birth.
In April I wrote about our quest for a
"miracle."
Today I report the results. One baby
died and the other was born 11 weeks
premature.
My husband, Jeff Brooks, and I had tried
to have a baby for more than a year when
we learned that my fallopian tubes had
been damaged during childhood in the
aftermath of a ruptured appendix. IVF
was our only hope. It was a risk and a
gamble - a $12,000 gamble - and there
were no guarantees we would be
successful.
To boost our chances we did opt to have
two embryos transferred. We were
thrilled to learn that both embryos had
settled in for what we hoped was a long
winter's nap inside me.
After a year of trying to conceive,
numerous ultrasounds, endless fertility
shots and thousands of dollars, we had
thought getting pregnant was the hardest
part.
We were wrong.
On July 23, 2000, after 14 weeks of an
idyllic twin pregnancy, my water broke,
26 weeks before my due date. The
sterile, protective sac full of amniotic
fluid that my lower twin had been living
in had ruptured. Most women go into
labor anywhere from 12 hours to 10 days
after the water breaks.
If I did go into labor, my doctors said
they would not stop it. When the water
is broken, they explained, the body
usually goes into labor for a reason,
most likely to protect the mother from
the risk of infection.
The prognosis wasn't good for Twin A,
as we began to call the baby in that
sac. It was very unlikely that I would
be able to carry him 10 more weeks, the
earliest point at which he could be
considered viable. Even if I did made it
to the magic 24week mark, the outcome
for babies who have endured a prolonged
time in a ruptured sac is poor. Weeks 18
to 23 are crucial for lung development,
and amniotic fluid is needed for that
development.
My doctor, maternal fetal specialist Dr.
Greg Lindsay, told me about a rare and
controversial procedure known as a
delayed interval delivery. Doctors use
it when one baby in a multiple pregnancy
needs to be delivered early and while
the other, or others, would benefit from
being kept in utero as long as possible.
If the first delivery occurs before 24
weeks, the first baby will die. A
delayed interval delivery is a risky
procedure, with the mother and remaining
babies at risk of infection, and it
doesn't always work. Only a few hundred
have even been done in the United
States.
I was 21 weeks and three days pregnant
when I went into labor on Sept. 10. The
contractions came fast and furious that
evening.
My husband drove as quickly as he could
to Presbyterian/St. Luke's Hospital,
where my doctor on call, Dr. Richard
Porreco, performed an amniocentesis on
twin B, the baby in the intact sac. The
baby was free of infection, which meant
that we could proceed with the interval
delivery and, hopefully, keep him inside
me.
That also meant my first twin would die.
My husband and I were alone briefly
after the amnio.
"We need a name for the baby," I
whispered. We tearfully picked a name
for a girl and a boy. The nurses then
took me to the operating room, where I
was given an epidural to eliminate the
pain. I didn't know labor could hurt so
much when the babies are so small.
My husband held my right hand and the
anesthesiologist held my left while I
pushed. As soon as I heard Porreco say
"nitroglycerin," a drug he gave me to
calm my uterus, I knew the first baby
was born. I looked over and saw him on a
table.
"Is that my baby?" I asked.
"Yes," the nurse told me.
"What did I have?"
"You had a son."
I asked to hold him, so she wrapped my
firstborn son in a hospital baby blanket
and handed him to me. We named him Ben
Russell Brooks. I held him in my arms as
Porreco performed a cerclage, stitches
designed to keep the cervix closed.
I was completely dilated, of course,
having just delivered a baby, so it was
no easy task. While the doctor worked, I
held Ben. He had Jeff's nose and dark
hair. He weighed 1 pound. We told him
how much we loved him.
Ben was perfect in every way, except
one. His heart wasn't beating.
But his brother's was. Porreco
attempted to stop my labor with
magnesium sulfate, indomethacin and
other drugs, but it wasn't easy. I was
still contracting every two to three
minutes shortly after midnight as I was
wheeled into my hospital room.
During the night, my contractions slowed
and I began to stabilize. I figured I
was home free the next morning when I
was only contracting once or twice an
hour. But I needed to get through that
crucial first week, when the risk for
infection is highest, before my doctors
could breathe a small sigh of relief.
After seven days in the hospital, I was
sent home on bed rest, anti-contraction
drugs and antibiotics.
No one could predict how much time I
would have in between Ben's birth and
the birth of his twin brother. My
doctors, at Obstetrix in Denver, had
done 31 delayedinterval deliveries prior
to mine. The average time span between
babies ranged from 38 to 45 days.
We got 52 days, long enough to pass the
28-week milestone. Babies born after 28
weeks gestation have a greater than 90
percent chance of survival and less than
10 percent chance of long-term complica
tions.
Walker Ben Brooks entered the world on
Nov. 1, weighing 3 pounds, 1 ounce. I
had been pregnant 29 weeks.
We knew we had passed the scariest time
for a premature birth, but we were not
out of the woods. Walker spent eight
weeks in the intensive care nursery at
Rose Medical Center.
Some people ask if childbirth was easy
because he was small. It wasn't,
physically or mentally. Preemies aren't
just small. They can have a host of
complications such as blindness,
deafness, mental retardation and
cerebral palsy.
Some people asked if I was happy to be
back on my feet after 101 days in bed. I
wasn't. I would gladly have endured six
or seven more weeks with only bathroom
privileges if it meant that Walker had
more time in the womb.
But instead, I spent every day, all day,
with my son in the intensive care
nursery. The early days were emotionally
difficult because of the extremes of
opposing emotion - the devastating grief
for Ben as well as the overwhelming joy
for Walker.
When I watched the other mothers of
twins in the nursery holding two babies,
I felt a longing, an aching. One of my
arms was empty. Having a survivor does
not erase the pain. Ben and Walker were
and are two separate beings, and I
wanted them both.
Some people think that when you lose a
baby, you can just have another one to
make up the difference. But Ben was the
one I wanted, and he is the boy who will
never be. When I see the life before me
in Walker, I sometimes see the shadow of
his twin brother. Now there is one when
there should have been two.
But what should have been is really
irrelevant, I try to tell myself.
After all, we could so easily have two
dead babies. We would have if it
weren't for the extraordinary medical
intervention and expertise of Drs.
Porreco and Lindsay and their partners.
We are more than lucky to have the one
baby we have.
And while we are fortunate that Walker
hasn't had any complications that
portend long-term health or
developmental problems, his time in the
intensive care nursery was often
frightening. Walker needed surgery when
he was 8 days old to close a blood
vessel that did not close properly. He
also had initial trouble gaining weight
and frequently endured drops in the
level of oxygen saturation in his blood.
But we knew, despite those problems,
that we were the fortunate ones.
During Walker's stay at the intensive
care nursery, I saw tiny babies who
needed blood transfusions as well as
babies with severe hydrocephalus, water
on the brain that can cause brain
damage.
Even worse, a baby died while Walker was
there - a little boy three months
premature who lived only three weeks. I
have since come to know his mother and
have learned that healing is possible
and often comes through sharing.
I tell people embarking on the IVF
journey my story - that I spent 101 out
of 202 days of my pregnancy in bed, that
one of my babies died and that the other
was born 11 weeks premature. I try to
share with them the risks of multiples,
the potential for premature birth and
great loss.
Then again, when I look at Walker, I
don't know if I would have done
anything differently.
Though the IVF experience has been
bittersweet, I haven't closed the door
to trying again. The bitterness of
Ben's death gives us pause, but the
sweetness of Walker's life gives me
hope for another. Jeff, however, isn't
sure he can do this twice. I do know
that if we try to conceive another
child, we will transfer only one embryo.
Our story isn't just about infertility
anymore. Back when I was trying to
conceive, all I knew was the pain of
possibly never having a child. Now I
know a much greater pain - that of
having lost one. But I also know the
greatest joy - my living son.
You can e-mail Daisy Whitney at
pepr@att.net
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