In December, my twins, Reid and Madeleine, will turn 4 years old. I hadn't thought it would take so long for my husband and I to be ready to consider having another child, but then again, I also hadn't thought we'd ever have two babies at once. Now that the kids are in school though, and are a little bit older ad a little bit more independent (and also super enthralled by anything to do with babies), having a third child no longer seems like quite an outlandish idea. Unfortunately, getting pregnant again will probably take a bit of work, and if I do get pregnant again, I won't be able to have a VBAC (vaginal birth after cesarian section) like I'd hoped. And honestly, that bothers me more than it probably should.
Before I got pregnant for the first time, it never really occurred to me that anything could go wrong. I knew, of course, that some people have miscarriages, and I guess I had a vague notion of pregnancy complications. But when I saw that little plus sign on the pregnancy test, I figured I'd just have the same kind of long, mostly-happy pregnancy that I assumed every other woman in the world also had, and then I'd scream through my hours-long labor like they do on TV, and end up with a healthy, fat baby I'd take home a day or two later. But these days, I realize that the world is actually full of women whose pregnancies and deliveries were awful experiences. I now know that there is virtually an infinite number of horrible things that can go wrong when you're expecting, and I know that because some of those horrible things happened to me.
The first four months of my pregnancy were a blur of constant nausea, overwhelming exhaustion that left me unable to do anything other than lie on the couch all day long until it was time to go to bed, and a general feeling of misery. But little did I know that was actually going to be the good part. At 21 weeks gestation I learned I had an incompetent cervix, which an emergency room OB promptly stitched closed in a bid to save my twins' lives. I was put on bed rest at home, only to return to the hospital at 24 weeks with contractions and threatened pre-term labor. Then, after being transferred to a different hospital with a higher level NICU and spending a week on strict hospital bed rest, my twins were born at 25 weeks and five days gestation, weighing less than 2 pounds each.
As much as I was terrified, as much as I absolutely did not want to giving birth so soon, and as much as I've actually blocked out a lot of the details from that night, pushing my daughter out into the world was easily one of the greatest moments of my entire life.
Their birth was straight-up terrifying, mostly because no one knew whether or not they would actually live. And if they did live, we knew babies born that early were at a high risk for all kinds of complications. Madeleine and Reid spent almost four months in the NICU, and the memory of those days still weighs heavily on my heart in a way I'm not sure I'll ever come to terms with. But the twins came home, and they've thrived. And as much as the thought of trying again feels scary and daunting, and like perhaps I'm asking for far more than I really deserve, I really would like to have another baby. I really would like to expand our family, even despite all we've been through.
For a long time, having another baby was a thought I pushed to the back of my mind. I'd resigned myself to the belief that my body was clearly not cut out for pregnancy, and there was nothing I could do about it. But then I learned that might not actually be true. My husband, Matt, and I always assumed that our only option for getting pregnant again would pretty much involve crossing our fingers that I'd only end up pregnant with one baby, and then getting my cervix stitched up again early in my pregnancy (a transvaginal cervical cerclage), and praying that it would hold for longer than it did the first time around. It turns out though, that for women with a history of pregnancy losses or failed transvaginal cerclages, a permanent kind of stitch, called a transabdominal cerclage (TAC), can be placed through an incision in the abdomen — and it can also be done prior to conception, which would reduce the risk to the fetus. While it's not a guarantee of a healthy, full-term baby (no one can guarantee that), the odds are pretty great: according to The University of Chicago Medicine, more than 95 percent of women who have had a TAC deliver at term.
The one major downside? You can't deliver vaginally. Although I'm fully aware that a c-section is a very small price to pay for a full-term pregnancy, honestly, the thought is pretty disappointing. Firstly, I've already experienced a c-section before – my son, my second twin, was born via emergency c-section 20 minutes after his sister was delivered — and it was not a pleasant experience. Recovery was painful, and after I realized about a week later that I was feeling worse instead of better, it was discovered that I'd developed an infection and a hematoma. To say I wouldn't want to repeat that again would be an understatement. But more than that, there is the fact that I really, really loved giving birth to my daughter.
It was as though I'd had my first moment of actual clarity in what had otherwise been a night of overwhelming fear and sadness. Pay attention, Alana, I remember saying to myself. This is the moment your daughter is going to be born.
For obvious reasons, there wasn't a lot about my delivery experience that I look back on fondly. Tensions were high, no one was excited, and everyone knew that it was entirely possible one or both of the babies would not survive the birth. It was, in other words, a total sh*t show. And yet, as much as I was terrified, as much as I absolutely did not want to giving birth so soon, and as much as I've actually blocked out a lot of the details from that night, pushing my daughter out into the world was easily one of the greatest moments of my entire life.
Because I wasn't very far along, Madeleine was so small that it wasn't a huge effort to deliver her, and my body was making it easier by refusing to remain pregnant. It wasn't long after my water broke that I felt the strong urge to push — something I remember my OB telling me not to do under any circumstances until they'd manage to at least wheel me into the operating room. But when she finally gave me the go-ahead, it was as though I'd had my first moment of actual clarity in what had otherwise been a night of overwhelming fear and sadness. Pay attention, Alana, I remember saying to myself. This is the moment your daughter is going to be born.
As I pushed, I could feel her coming out, and over and over I told myself, do not forget this; do not forget this feeling. I knew I might not get to have anything else after this, might not get to ever tell her the story of the day she was born. But at the very least, I wanted to make sure I had the memory of bringing her into the world.
Even though everything had been going at what felt like breakneck speed, as I prepared to push, I could've sworn time stood still. And, for the first time in my scary, emotionally-detached pregnancy, I let myself picture Madeleine, my little girl, and made myself remember exactly what it felt like to have her safe inside of my body. Soon she'd be born, and no one knew what would happen next. But right then, at least, she was alive, and she was OK. And I wanted to marinate in every single second of it for as long as I could, so that I would never, ever forget it.
I pictured her in my mind while I was pushing, envisioned her making her way into the big, scary world far before she was ready. And I thought of us, together, me and my sweet, perfect girl, inadvertently tag-teaming this insane, heartbreaking experience, the very first thing that truly connected me to my very first child. As I pushed, I could feel her coming out, and over and over I told myself, do not forget this; do not forget this feeling. I knew I might not get to have anything else after this, might not get to ever tell her the story of the day she was born. But at the very least, I wanted to make sure I had the memory of bringing her into the world.
I'm so lucky that that wasn't the end for us, that Madeleine and her brother survived and are now healthy, happy, kindergarteners. But for me, Madeleine's vaginal delivery was literally the only positive experience of my twins' birth. And knowing that I'll never get to go through that again, even if I do get to have a full-term, healthy baby who can breathe and cry and who I can hold right away? That feels like a major letdown.
Then again, if we do opt to try for another child, I know it's going to be exactly what I'll choose. My doctor has reminded me that it's entirely possible my cervix would be fine the second time around, and that's it's entirely possible I could get a normal transvaginal cerclage early on in pregnancy that would last until my due date — and I know she is totally right. But I also know that I couldn't handle taking that risk. So, as much as the idea of having another c-section scares me and also makes me really, really sad, it's what I'm going to push for. And in the meantime, I'll just try to be grateful that the beautiful memory of Madeleine's birth is something no one can ever take from me.