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Monday, 12 December 2011 18:00

Three Angels Lost

This is the story of Paulina, a woman living in Iceland who follows The Birthing Site.  She shared her story with us and we reached out to her.  I read her story on her website and emailed with her to get to know her and understand her situation so I could help her tell her story to the world so that other mothers who may be going through similar situations know they are not alone, and know that there are many ways to approach a pregnancy with multiples.

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The first time I got pregnant was in December of 2010, but we were saddened when I miscarried in February of 2011.  Little did I know that I had PCOS which could complicate my ability to become and stay pregnant.  We continued to try naturally while my gynecologist tracked my cycles, ran blood tests and eventually gave me Pergotime to help me ovulate.  Almost a year later (December 2011,) he referred us to a fertility clinic in Iceland called ArtMedica.  We made an appointment and got in about three months later.  During this time we were still trying to conceive the natural way, but we didn’t have much hope.

After over a month of hormone therapy, a checkup revealed that two follicles were ready to be releases.  I injected another medication meant to encourage my ovaries to release the eggs and underwent an IUI procedure.  We had to wait two weeks to find out if the procedure was successful – probably the longest two weeks of my life.  I was exhausted and incredibly nauseous and just wanted to know if it had worked.  Finally we were able to take a pregnancy test and it was positive! 

At week 6, we went to the fertility clinic for an ultrasound to check on development.  We saw two precious heartbeats and were overjoyed.  Friddi swore he saw a third heartbeat but at that time, the doctors said there were only two.

I went for another ultrasound at 9 weeks.  After a few minutes of looking at the screen, the doctor began to look worried.  I asked her if something was wrong and all she said was “this is not good.”  I was terrified and asked “Are there three?”  She said “No,” and then  held one hand up, pointed to it and said “There are five.”  I was shocked and overwhelmed; I had so many thoughts racing through my mind I didn’t know what to think now.

After the ultrasound they sat me down to discuss our options.  I wanted to know how this had happened.  Apparently, the doctor noted that in addition to the two follicles that were ready, there were also two more that were approaching maturity, and apparently a fifth that nobody noticed.  When I injected the hormone that was meant to release the two that were ready, it released all five, and all of them were fertilized when I had the IUI procedure.

They began discussing “reduction,” a term I had never heard before and was not sure what they meant.  They explained that carrying 5 babies to term is challenging and possibly risky to all of the babies and the mother and that the safest thing to do would be to terminate three of the five in order to provide the best chance for the remaining two, and me, to make it to term.  They told me that with each additional baby, the average delivery date was reduced by two weeks, (thus twins are usually born around 38 weeks, triplets around 36 weeks, and so on.)  Having five would increase the chances of them being premature and possibly not surviving. 

I was so upset and overwhelmed by the emotional rollercoaster.  First we can’t get pregnant, then when we finally do, we get pregnant with FIVE and the doctors are telling us we should only keep two.  Nobody should ever have to make this decision.  I kept thinking about how we just wanted one baby, and all the other moms who try and can’t get pregnant; now here we were pregnant with more than my body could handle and we had to decide how many to get rid of?  I wanted desperately to keep them all, but the more I researched, the more I learned that keeping all of them was risky for both them and I.  Even with reduction there is still risk to them and I, but at least the risk would be significantly less than if there were all five.  Was it selfish to want to keep all of them, or was it more selfish to only keep a few? What if they all survived but I didn’t?  Friddi would be left with five babies who wouldn’t have a mother.  How fair would that be to all of them?

I went home and tried to call Friddi, but it took forever to get a hold of him because he was working as a fisherman at this time and was out at sea.  When he came to the phone I told him and just broke down in tears.  I felt horrible about having to call him while he was out, but he needed to know.  After I got off the phone with him I called my midwife who told me we could probably keep three, and that she would put me in touch with a nurse she knew who had triplets.  I felt a little better, but I was still an emotional wreck.  I had to get my mind off of things for a little while and focused on work for a while (I have the freedom to work from home if I need to.) 

In the following days, I started reading about multiple pregnancies and selective reduction.  I discovered that selective reduction may increase the chances of survival for the remaining babies, but that the procedure increased the risk of premature labor and miscarriage, something that was already a risk with multiples.  My head was swimming with information, and I was constantly bombarded with everyone’s suggestions about what to do.  Ultimately it was our choice, but I felt it was our responsibility to make the best choice for the babies and to try to give them the best chance of surviving.  We went for another checkup at the hospital at which point all five were still developing.  This came as something of a surprise because with this many multiples, one or two often die early on.  Friddi was now willing to keep all five and we kept reading and talking to doctors to try and sort everything out.  Over the next two weeks, we thought long and hard.   Ultimately we decided to keep three, against the suggestion to only keep two by the Icelandic doctors.

We went in for the reduction procedure and I was a wreck.  Friddi sat next to me and watched the procedure on the screen to make sure they didn’t kill more than the two we agreed on.  The procedure was horrible; it hurt like hell and I felt as though they were taking a part of me.  I felt the loss, pain and anguish as they terminated two of the fetuses.  The worst part was that it felt as though they knew what was going on but were helpless to do anything.  This was the most horrible feeling in the world and I hope nobody else ever has to go through this.

At 19 weeks things had been going fine until we went in for a checkup.  I was told that I had an incompetent cervix and it was “funneling” which means that it was beginning to dilate too soon.  In the U.S. when this happens, a cerclage is performed (a stitch to hold the cervix closed) but the doctors in Iceland felt that it was too risky with a multiple pregnancy.  They sent me home for strict bed rest and told me that there was a high chance of still birth or miscarriage.  The following week my cervix had shortened again, leaving it only 3cm long, and I was beginning to have contractions.  I was terrified because I knew that if the babies were born now they wouldn’t survive.  At 21 weeks I was admitted to the hospital for preterm labor and they couldn’t stop the contractions even with medications.

After 19 hours of labor Ársæll Leo was born. At this time the doctors tried to stop the other two from being born but it was too late when the amniotic sac from Annelise broke. She stayed without any fluids for many more hours, and the contractions slowed down.  At this point, we wanted to try to save the last one, but for it to be possible Annelise had to be born and we did not know how long this was going to take. After so many days of being with contractions, and so many hours of being in labor, we tried to speed up her birth with medication.

Annelise was born shortly after the medication was started.  Unfortunately, the placenta from the first two did not come out, which meant keeping Finnbjörn inside longer became impossible. The placenta needed to come out in order to close the cervix, and avoid infections. We did not want to make this big decision, but it was necessary.  We felt that if we were to have any hope of having a healthy pregnancy in the future, we had to do this.  The doctors broke Bjössi’s sac and he was born very quickly.

All of our triplets were so perfect, so beautiful, with a strong heartbeat and willingness to breathe in our world. However, their bodies were too small (25-28 cm) and underdeveloped that the only thing we could do was to hold them until they passed away. We cradled them in our arms and told them how much we loved them and how precious they were to us. One of the hardest things to do in life is to see your kids die without even being able to spend some years with them, teaching them everything you know and appreciating everything they do-- even the naughty stuff.

We had a traditional Icelandic burial ceremony. We went to the cemetery where a priest said some words, with our closest friends and family members.  We decided to cremate them, not sure why but that was the first thing that came into my mind. It was a good decision because while being in the cemetery I would have never wanted to let them go away, and I would have wanted to kiss them and hug them again.

We placed them above Friddi's grandmother who is buried next to her husband. We wanted them to be in between but that was not holy ground, so they had to be placed above her. We wanted the great grandparents to take care of them because they were really good with children when they were alive.

People keep saying that time will help me heal, but I certainly don’t feel that way.  I keep on thinking about them every day. The pain is so hard that the few words, hugs and emotional support is not enough to get over it. After losing three babies people need more than a month, (which is what is given by law to parents who lose children from stillbirth here.) We know that there are people around the world who have had it worse. While it doesn’t make it any easier, it helps us to remain hopeful that eventually the pain will not be so bad, though I can’t imagine it ever going away completely.

We’d like to start a family as soon as possible, but right now we are focusing on trying to heal and spending some time with my family in Mexico.  Friddi wants to finish school first so he can support a family without worrying, but that means we would have to wait another 3 years and I don’t know if I want to wait that long.  It’s hard because I am a mother of three, but all of my babies are in heaven rather than here with me.  Every time I do anything, I think about how I should have my babies with me and what they would be doing now. 

For the full story on the site Paulina built to share her story, please follow this link: http://www.apmedia.is/triplets/

 

 

          

Published in Birthing Stories
Thursday, 13 January 2011 18:15

Symptoms of Polycystic Ovary Syndrome (PCOS)

  • *Amenorrhea (cessation of period) or infrequent periods.
  • *Irregular bleeding Infrequent or no ovulation.
  • *Cysts on ovaries.
  • *Increased levels of male hormone, like testosterone.
  • *Infertility.
  • *Chronic pelvic pain for six months or more.
  • *Increase in weight or obesity.
  • *Diabetes; over production and inefficient use of insulin by the body.
  • *Lipid abnormalities (high or low cholesterol, high triglycerides).
  • *High blood pressure Excess facial and body hair growth.
  • *Male-pattern baldness or thinning hair.
  • *Acne, oily skin, or dandruff.
  • *Dark-colored patches of thick skin on neck, groin, underarms or skin folds.
  • *Skin tags in the armpits or neck. 
Published in Fertility
Thursday, 13 January 2011 16:48

The facts of Polycystic Ovary Syndrome (PCOS)

  • *1 out of every 15 women world wide has Polycystic Ovarian Syndrome (PCOS).
  • *It is an endocrine disorder, meaning the hormones are not balanced with in many cases there being too much testosterone.
  • *About half of women with PCOS also have diabetes.
  • *Symptoms of PCOS.
  • *PCOS is one of the most commonly under-diagnosed conditions.
  • *Diet and exercise can help alleviate symptoms.
  • *Fertility can be affected by fibroids on the ovaries affecting ovulation (release of an egg), giving an irregular cycle and can lead to infertility.
  • *The condition is accompanied by intense abdominal pain and cramping.
  • *There is a higher chance of miscarriage in women with PCOS, although many women report once they first are pregnant it's easier to become pregnant again.
  • *Surgery has only a 50% success rate of removing tumors and can impact fertility from scar tissue left behind inhibiting ovulation.
  • *Genetics and environment can contribute to the development of PCOS.
Published in Fertility

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