MoM Elevator Pitch

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Categories Ask the Readers, Pregnancy, PrematurityTags , , , , , 3 Comments

Today, I went into the local Army medical center in an attempt to untangle a sitcom-worthy set of mixups of appointments, referrals and prescriptions. While I was waiting, I got to talking to the visibly pregnant lady next to me. She was 25 weeks pregnant with twins, and wasn’t looking forward to her appointment. Since one of her babies was low on amniotic fluid, she was anticipating being checked into the hospital, something she really didn’t want to have to do quite yet. We happened to leave the clinic around the same time, and she gave me an update. Although she wasn’t being hospitalized, she was being put on bed rest. She lamented not being able to be more available to one of her soldiers whose wife is also expecting twins.

In the few minutes I had, I told her that I also had twins, and that I’d delivered them 7 weeks early. Although it was scary at the time, they spent less than 3 weeks in the NICU, and are now flourishing. If bed rest was what her babies needed, maybe holding on to the thought that she’s doing it for them would help the time pass faster. I told her that I’d be thinking of her, and that I hoped that her babies stayed healthy and in her womb as long as they could.

If you had just 2 or 3 minutes to comfort a scared mother-of-multiples-to-be, what would you say to her?

Sadia is an army wife and working mom of 5-year-old identical twin girls. She and her family live in El Paso, TX, where her husband is stationed at Ft Bliss.

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Ask the Moms, part 17 – bed rest

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Categories Ask the Moms, PregnancyTags 17 Comments

Do you have a question for the How Do You Do It? moms? Then ask away through our Features page!

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Bed rest. Those two words were my primary fear from the moment I considered getting pregnant. And when I found out I was having twins, I freaked out even more. I do not deal well with boredom or isolation, and I knew that having multiples upped my risk of being placed on restricted activity. But in truth, a twin pregnancy is not a guarantee of bedrest. Higher-order multiples, and it’s pretty close to a sure thing, but not necessarily so with “only” two babies. The HDYDI moms, naturally, run the gamut.

The Good

There are people who feel really good throughout their twin pregnancy. I swear! Snickollet even went to the gym at a whopping 38 weeks (and, may I say for the rest of us, “holy crap!”). There are indeed those among us who can keep right on going up to the day of their scheduled c-section. But even if you’re not a pregnancy superhero, you do have the potential to make it through your pregnancy without being placed in lockdown. Can bedrest be “prevented?” I’m not so sure. Whether you know it or not, your body may be prone to preterm labor, you may have cervix issues, or any number of other complications. But to whatever extent you can take care of yourself and help your pregnancy go smoothly, then I’d say go for it.

The key, in talking to many people, is to listen to your body and take it easy. Even if you exercise regularly, by the end of the first trimester, you’ll likely want and need to cut back at least on the intensity level. You’ll likely notice a slight (or huge) decrease in energy and endurance, so don’t push it. If you were a runner, maybe cut back to the elliptical machine. If you did power yoga, switch to prenatal. Low-impact, slow, easy.

I was not exercising much when I became pregnant, and was really too paranoid to start. But I cut back on other things. I noticed myself becoming easily tired around 20 weeks, so I elected to send my husband to the grocery store instead of going by myself, and made him carry the laundry up and down the stairs. Could I have done it longer? Sure. But why not take it easy for a few months? By about 28 weeks, my ankles were swelling and I was winded and getting contractions if I walked (slowly) more than a 2-3 blocks, so I stopped doing that.  I spent more time lying down (on my side, drinking an unnatural amount of water, of course) in my 3rd trimester.  I noticed I was getting more braxton-hicks contractions if I was on my feet too long, if I was too active, or if I didn’t have enough water.

Working is the same kind of thing.  If things are going well, you may be comfortable going to work right up to 38 weeks if you have a low-stress desk job and coworkers who don’t mind that you get up to go to the bathroom every 10 minutes.  If you have a job that requires long hours, time on your feet, or other stress and strain, you may want to cut back sooner, maybe around the end of the 2nd trimester.  I kept working (well, I kept going to work, though perhaps not super productive…) until 34 weeks, at which point it was just too uncomfortable to be in the car for my commute or sitting at my desk.  Plus, I was having twice-weekly NST/BPP at the hospital, so who had time to work?  Some of the HDYDI moms worked longer than that, others stopped closer to 28 weeks or earlier.

There are some doctors who recommend/insist on routine bedrest for all twin pregnancies, starting at a particular week (I’ve heard 28, 30, 32, etc.).  But most of the time, I would say that doctors mainly recommend that you just take it easy as long as things are going well, and only insist on bedrest if there is a particular indication to do so.  One relatively universal restriction, though, is on travel.  By about 24-28 weeks, most doctors will insist that you stop traveling (I traveled at 22 and was plenty uncomfortable), and especially after about 28 weeks, they probably want you to be within 30-60 minutes of the hospital pretty much at all times.  Around 28-32 weeks is a particularly touchy time as far as preterm labor goes, as it’s a somewhat more common time for preterm labor, but a difficult gestational age with regard to NICU times and good outcomes for the babies.  Not the time to be several hours out in the countryside… just in case.

The Bad

Things can and do happen to indicate bedrest, either modified, complete, at home, or in the hospital.  LauraC had her first pre-term labor scare at 21 weeks, and was on some version of rest for the remainder of her pregnancy.  Cynthia already had a history of pre-term delivery, so was watched extra carefully and when pre-term labor hit at nearly 28 weeks, was on full bedrest for the next 7 weeks until her boys were born.  Our resident triplet mom (a new contributor you’ll be hearing from soon!) takes the cake, with modified bedrest at home at 16 weeks, and hospital bedrest at 21.  Others had bouts of restrictions after an episode of bleeding or contractions, or were otherwise just told to stop going up and down the stairs, or lifting heavy things (like a toddler!).  “Modified bedrest” is a tricky phrase, and can mean anything from “stop working 12-hours shifts as a nurse” to “only use the stairs once a day.”  Often the restrictions are just an important illustration of how “easy” you should be taking it.  Complete bedrest generally means that you have to be lying down nearly the entire day, only getting up to go to the bathroom (or sometimes not even that, if you’re in the hospital).  The range of possibilities is all over the map.

While there are arguments to be made about the effectiveness of bedrest in some situations, our general feeling is to err on the side of caution.  Is it fun?  No.  But if it means your kids have a chance to be born at 35 weeks instead of 32, then we’re all for it. I’ve heard it said that every extra day they can spend in your belly is worth 3-7 days in the NICU.  It’s worth it to keep them in there as long as you can. You can survive bedrest.  Make sure you have a good stash of food and water.  Plenty of books and trashy magazines.  A laptop and wireless internet access.  A TV, DVD player, and a subscription to Netflix.  Call old friends, hit the Babycenter bulletin boards, start a blog.  Have a schedule of friends and family to come visit you and bring lunch.  Just try to restrain yourself from shopping online all day long.  It can get expensive. :-)

The Ugly

A word on multiple-pregnancy intimacy (yeah, it’s not a pretty image).  Unless your doctor has instructed you to be on “pelvic rest”  (boy, do I love that phrase!), there’s often no reason that you have to avoid sex during pregnancy.  There are sometimes reasons to avoid it, such as cervical issues or placenta previa.  But if your pregnancy is going smoothly, it is not generally recommended that you must avoid sex.  If you’re feeling good and are game for a some interesting physical logistics (what with the enormous belly in the way and all), more power to ya.

You never know how this one’s going to go.  Some people are hideously uncomfortable and the thought of sex could not possibly be less appealing.  Some people are all aglow with life, and discover the fabled 2nd trimester sex drive (I swear it’s a myth, but my friend said it happened with her, and my husband kept waiting for it to happen with me… and waiting… and waiting…).  Some men are a touch freaked out by the fact that there’s a person (or two or three) inside your belly, or have conflicting feelings about this new body of yours.  Some think a pregnant wife is the most gorgeous and appealing thing he’s ever seen (and might be kind of grateful for the pregnancy boob fairy).

We’ve all heard the stories of women past their due date being advised to try sex to stimulate labor, which is generally enough to freak out those of us who lived in fear of going into labor too early.  Every respectable thing I’ve read, though, says that sex itself will not spontaneously bring on labor if your body isn’t already inclined to do so. Though I will say that I… know someone… who was late in her twin pregnancy, whose body was clearly changing and getting ready to deliver for a week prior, and who may or may not have knowingly agreed to sex with her husband half-hoping it would get the show on the road, and and who may or may not have immediately afterwards started contracting every six minutes, and who may or may not have delivered her babies the next morning.  As I said, sex won’t just start labor if your cervix is closed and you’re not contracting and all of that.  But maybe, if you’re near the end, and have been contracting for a week, and the babies have dropped….

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What about you, dear readers?  Were you on any kind of bed rest or restricted activity?  Did your doctor have a set date at which (s)he’d send you to the couch, or more of a wait-and-see attitude?  If you did spend a lot of time lying around, how did you survive the boredom and loneliness aspect?

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Aaron & Brady's Twin Birth Story

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I have posted my loving version of the birth story here shortly after it happened.  But I know “Birth Week” on HDYDI is more about sharing the nitty-gritty for you moms-of-twins-to-be who want to know “what’s it really like”. Here is what is was really like for Cynthia, Aaron & Brady:

First, a little background. When my singleton was born she arrived very quickly and unexpectedly at 33 weeks. I had not prepared for this possibility and delivered her at our local hospital – without a NICU. Subsequently, she was taken immediately from me, stabilized and transferred 50 minutes away. The doctors said I had an incompetent cervix which led to me having a very quick and relatively painless labor. So by the time I got the idea into my head that perhaps I should get myself to the hospital, I was pretty far along and very active; they couldn’t stop me.

Having gone through that kind of heart-wrenching experience, I vowed to be much more prepared this time. I was determined that there would be no surprises; no circumstance I had not considered. I researched, I read, I spoke with other MOTs and played out every scenario in my head. I prepared for the worst case and then…was pleasantly surprised with how it all went down.

I had my regular weekly appointment with Dr. M scheduled for 2:15 on Friday the 13th. Earlier in the week I had said the boys would be born on this lucky day but as the time for the appointment approached – and I still felt fine – I gave up on that theory.  My internal exam showed that I was slightly further along than I was the previous visit. Meaning, I had gone from about 1 cm to 1.5 (or so) cm and was now almost 90% effaced. He gave me the option to go home and see how I felt for a while, or go directly to the hospital and be monitored. At 34 weeks – and after 6 weeks of bedrest – I was getting anxious and decided to go down to L&D for some monitoring.

When my husband and I arrived at the hospital about 35 minutes later (no time to go home and get my carefully packed bag with our CAMERA!), I was checked in without any delay and immediately examined. The resident’s face shows a little surprise and she says “You’re more like 2-3 cm. Welcome!” As Emomily said in her post, all I could think was I’ve waited for this moment – now I’m not ready!

I am asked if I am planning a vaginal or C-section delivery. As the babies were mono-di, I had decided ahead of time that if they were presenting anything but Vertex-Vertex, I’d get the C-Section. However, when they presented Vertex-Transverse, I balked. Did I really want major surgery? I’ve never had a “real” surgery before. why would a choose to go through that. OMG, someone…TELL ME WHAT TO DO! My husband gently reminded me that the only thing I’ve truly wanted to avoid this whole time was a one of each type of delivery, so I consent to the C-Section. And I start telling anyone who will listen that I am TERRIFIED. Thankfully, they take me seriously and put on the kids gloves to deal with me from that point on.

The attending arrives and examines me. His announcement is “we’re having babies tonight!” I am now more like 5 cm dilated.  BTW – have a mentioned I still don’t feel any contractions? Good thing I didn’t go home to wait it out, I’d still be waiting for a signal to make me call the doctor….

Into the room we go. The spinal is put in with relative ease. Thank God I didn’t faint which is what I was sure was going to happen. Next thing I know I see hubby coming into the room and they tell me we’re going to start. They ask me if I can “feel that” and I can! Oh no! STOP! But I guess whatever I felt was high enough up on my torso that they decide to proceed because before I even know they’ve started, I hear a cry. WHAT? ALREADY? Aaron Denis emerges screaming his lungs out. Where was all the pressure I was supposed to feel? The tugging? What is going on down there…and…

Here comes the other one! 6:36 and out comes Brady Roy. Except, no cries this time. I start to panic. After an eternity (or 30 seconds) I hear a little cry. Whew. Turns out, his cord was wrapped twice around his little neck and it needed to be untangled.

And just like that, it’s over. But where are the babies? I heard people talking about them. Isn’t everything okay? You said they looked good, can I see them? They both needed to be taken immediately to the NICU so the best that they could do for me was to wheel them by me in their incubator. They slowed down, but didn’t stop. If I hadn’t mentally prepared for that possibility, I would have been devastated. Thankfully, I knew it was a real possibility and I made myself okay with it. I prepared to heal myself so I could get to them as soon as possible. 

Daddy accompanied the babies to the NICU and I set about getting settled in my new room. Fortunately the combination of shock, delirium and good drugs got me through the night pain-free. At some point during the night the nurses came in to stand me up. No one thought to put a pad on me and I was greeted with a nice rush of blood down my legs and all over the floor. Whoops. Of course the sight of that had me whoozy, but otherwise the night was uneventful. I slept for approximately 7 consecutive minutes while I was anxiously awaiting the first meeting with the boys which would take place the next day.

The next day was when the trouble began. There was mix-up with my pain meds and I was undermedicated for a great portion of the day. So that upset me. I was only physically able to get myself down to the NICU one time that day. So that upset me. There was entirely too many visitors in and out of the room and I was an emotional wreck. The nurses offered me a sleeping pill for that night – which I gulped down and the day after that, things began to look up.

Healing was slow and staying on top of the pain was key. On the day I was discharged, I swelled up like a balloon and was very uncomfortable. Apparently there isn’t much you can do for that except drink a lot and try to pee it all out. The Vicodin gave me flash headaches so after my first night at home, I stuck with just Tylenol.

The boys started nursing on Day 3 and really got it by Day 7. They were released on Day 14. Thankfully we had been through the NICU experience before with our firstborn so we were prepared for what to expect. Aaron had the CPAP to start and was then under the lights for jaundice. Brady had two apnea spells on Day 3 and hospital policy dictated he couldn’t leave until he went 10 days without one; he had no other issues.

They are happy and healthy now, 25th percentile for actual age. As for me, I am pregnant again and hoping for a VBAC this time. All said and done, I’m glad I had the C-Section for the boys but the recovery WAS hard. Especially with other children at home. I’m glad I had lined up help and, honestly, I’m glad the boys stayed a little bit longer because I needed the time to heal.

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