By Candace, Ledyard, CT USA
PROM at 20 weeks + 4 days. Delivery at 25 weeks + 2 days.
Story added: 2009-03-17

I had experienced three years of infertility before becoming pregnant through our first round of IVF treatments. We were absolutely thrilled to be expecting, but our fertility doctor kept stressing "cautious optimism". At our 6 week ultrasound, we found out that I was carrying twins - we had transferred two embryos so we knew that was about a 25% chance. At the 7.5 week ultrasound, we saw three heartbeats. One of the embryos had split into identical twins. I knew I could not carry three babies, and in addition, the identical twins were monoamniotic, which put the entire pregnancy at greater risk. We made the very difficult decision to reduce to one. At twelve weeks, we had CVS done on the two placentas and both results came back normal. At fourteen weeks we had the reduction performed, and found out that we were expecting a baby boy. It seemed like everything would be OK after that point. At seventeen weeks, I started spotting. My OB did an u/s and the baby looked OK but there was "debris" over my cervix. At my level II ultrasound a week later, the baby looked perfect, but I was still spotting and the peri said that she could see "debris" over my cervix. At 19 weeks 2 days, I woke up in the middle of the night to a gush of fluid. I had to wait until morning to go in to see the OB, who did an u/s and saw that the baby looked fine but my cervix was "a mess". He sent me to the peri, who did another u/s and determined that one of the reduced fetuses was in my cervix and was going to be delivered. She admitted me to the hospital on full bedrest, and I laid there until I delivered the fetus two days later at 19w4d. For about four blissful hours, I had no contractions and no spotting and it seemed like everything was going to be OK. Then I started bleeding bright red. The OB thought that it was similar to the type of bleeding that women have after a normal delivery. Two days later, I saw the peri, and she diagnosed me with a partially abrupted placenta. I was discharged from the hospital the next day, at 20 weeks, on full bedrest. A week later I saw the peri for a re-check and she said that my fluid level was down to 3. She then suggested that I could be induced. Next she did a cervix check and found that the second reduced fetus was in my cervix and said that I needed to be hospitalized again because I was down to 1 cm in cervical length and I was going to deliver the second one. I was readmitted and laid there for four days before having another u/s, where they found that my cervix had lengthened again and decided I should go home. The next week, I had my fetal echo, at 22w1d - the results were fine. At that time, the peri discovered that I had no fluid at all, and started discussing termination. It was a dr. I had never seen before, and he sent us home with no plan. After going home and talking to my husband's cousin, who is a doctor, about what we should do next, we decided to ask for a second opinion. We went back the next week and met with a different peri, who had no better news for us, but made sure that we understood every possible option and outcome and that all of our questions were answered. She also made an appointment for us to meet with a neonatologist and tour the NICU. She had us return to meet with her a few days later to make our decision, which was at the 23w3d point. After talking to the neonatologist, we decided not to terminate, but instead to wait until 24w5d for hospitalization and to start steroid injections. If he was born before that point, we would not resuscitate and I would deliver at the local hospital. I had not gone into labor at that point though, so I was admitted to the maternal special care unit at the children's hospital of large academic medical center. I was settling in for a long stay - I was hoping to be there for at least six weeks and there was no sign that anything was happening. I got the steroid shots and reached the 25 week point. It seemed like all was calm, however two days later I woke up at 1AM and realized that I was having regular contractions. I called the nurse and she set me up on the monitors and quickly determined that he was having decels after every contraction. She started flooding me with fluid through my IV and hooked me up on oxygen. The doctors were called in and did an ultrasound to see if he was still breech (I knew he was because his kicks hadn't moved). They then moved me down to labor and delivery, where they decided very quickly that he needed to be delivered by c-section because he was in distress. It all happened very quickly and just seems surreal. I called my husband at the point that they decided that I need to go to L&D, but we live over an hour from the hospital and he did not get there until the c-section surgery was almost over. Our beautiful baby Benjamin Oliver was born and whisked away to the NICU team. After a few minutes the neonatologist came to tell me that his lungs were not developed and that he wouldn't make it, but they wanted me to be able to hold him while he was still alive. I was so numb I couldn't even cry at that point. I held him and his lip moved a little and he just smelled like baby. A few minutes later he was still. I continued to hold him until I started to shake because of the surgery, and then one of the nurses took him and held him close to my face. I had a blanket that I started to use while I was on bedrest. We wiped our tears with it, and it comforted me. I took it to the hospital with me and after Benjamin was born, I asked one of the nurses to have it brought down from my room. They wrapped him in it and that is how we held him. My husband arrived just as they were finishing the surgery and the nurse met him outside the delivery room and told him what happened and then another nurse handed Benjamin to him after he got in the room. It was then that I started to cry. My husband carried him to the recovery room, and we were able to hold him for about four hours until we were ready to let go. The bereavement nurse took him for a little while and took photographs and also made impressions of his hands and feet, and took his footprints and handprints. They gave us a memory box filled with the little gown he wore along with the cap and bracelet and a few other mementos. He was just so tiny that he didn't have a chance - he only weighed 14 ounces. At an ultrasound two days before he was born they estimated his weight at one pound seven ounces, which gave us some hope. But the lack of fluid makes those measurements less accurate. Our sweet Benjamin Oliver was in our arms for just moments but he will be forever in our hearts. Tomorrow we are picking up his ashes at the funeral home and we will take him to our favorite beach when I am physically healed enough to walk in the sand.