Prepare for a confident birth – The Birth Class

Episode 503

Bron – endometriosis, triplet-pregnancy, miscarriage, induction, TENS, positive induction

At her first dating scan, Bron found out she was pregnant with triplets; one singleton, and MCDA twins who shared a placenta. A few weeks later she attended her first appointment with the head doctor of the specialist multiple birth team, who outlined the risks and complications of her pregnancy and suggested selective reduction of the twins. Bron and her husband, Ryan, were completely blindsided by the pessimistic perspective of the doctor but their overwhelm soon turned to grief when an ultrasound showed the twins had already died. Bron takes us through the remainder of her pregnancy, the coexistence of grief and joy, and her positive induction.

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“I was diagnosed with endometriosis when I was 15. My brother and I were one of the first 500 babies conceived through IVF in the early eighties and my parents had to do IVF because she had very aggressive endometriosis. When I started menstruating, mum recognised symptoms straight away. I was always honest with my husband about the fact that conceiving could take a long time. We started trying and a few weeks later I was pregnant – it was a huge shock.

“I’d spoken to family members who were quite well-informed about maternity models of care. I waited till I was referred to the hospital but I didn’t really know what to expect. I was bedridden most days but I’m lucky to work rom hoe so I often dragged the laptop into bed with me. Once the nausea subsided at 18 weeks, I felt really well.

“At the scan, the senior sonographer went quiet and then she told me I was pregnant with triplets. I burst into tears and I reached for Ryan’s hand and clung to each other for the rest of the scan. There’s no multiples in our family at all so it was such a shock.

“Everything became quite urgent all of a sudden. We were referred to a specialist multiple birth team in Melbourne; a triplet pregnancy is automatically classed as ‘complex’. At ten weeks we met with the head of the department and it was really overwhelming; we were given information on the risks and complications and the different conditions the triplets could develop.

“We had a singleton and a set of MCDA twins who shared a placenta which is complex and risky. She started talking about selective reduction of the twins for the benefit of the singleton and I said to her: ‘I’ve been adding up the risks, and from what I can tell, there’s about a 30 percent chance that any of these situations can eventuate, and that doesn’t seem like enough of a risk for you to be making this recommendation.’ It didn’t feel like we were given balanced information and statistics. I was in tears by the end of it, it was pretty awful. She told us we had a certain amount of time to make a decision – it was about 2-3 weeks.

“I requested an ultrasound at that point. And that was when she told us she could only hear one heartbeat; the twins hadn’t made it. It was like the wind was knocked out of me again. The grief felt very complicated because we’d had a loss but we were still pregnant and that felt so fortunate. We were extremely grateful but it was hard to talk about; I didn’t feel like I was in the miscarriage club because at the end of the day, we were still going to be parents. I swung between feeling grief for the twins and joy for the baby we still had.

“There wasn’t any follow up…they just explained it to us as having two separate pregnancies in my body at the same time, so Alex wouldn’t be affected. Over the months, the twins got smaller and smaller….I never had cramps or bleeding. I gave myself a few weeks to grieve and then I really switched my perspective but I must admit, I was really careful to always sleep on my side and not do anything risky.

“The hospital called us a couple of days after the confirmation scan to ask if we wanted to transfer to our local hospital. Because the hospital already had our history and they’re quite highly regarded, we were happy to stay with them. They recommended a blended form of care where we saw both obstetricians and midwives.

“I was very anxious about miscarrying Alex. I started feeling movement at 16 weeks but it wasn’t consistent – I wouldn’t feel anything again for a few days and that was really hard. We had a reassurance scan and found out the sex and we had already named him so that helped me connect with him and the pregnancy.

“Ryan wanted to be a really active birth partner so we did a lot of education and preparation together. As I started to show and Alex’s movements were more regular, I felt more reassured. I wanted to go into spontaneous labour but at 40+3 I had a routine appointment and she said they were happy for me to go to 42 weeks before induction. But then she measured my fundal height and it was small and she went ahead and said I’d be induced the next day.

“We spoke to a midwife later that day and she reiterated that we had options and she encouraged us to return the next day for further monitoring. We went in with an open mind but the obstetrician reiterated that it was a sign we wouldn’t want to ignore. I also hadn’t been sleeping well and I was worried that I wouldn’t have the energy to labour so I agreed to an induction. They inserted the balloon catheter and then I got to go home and we had a lovely, relaxed night and morning together before we made our way to the hospital.

“The catheter had done its job and I was 2 cm dilated. An obstetrician came in and broke my waters and then they waited an hour to start the syntocinon IV. I spoke to the midwife about what I wanted – dim lights, no offers of pain relief. Soon after the syntocinon started I was having really intense contractions so I hooked up the TENS machine and Ryan held my hand and coached me through; he really was the best birth partner. I realised very quickly that labour is a mental game.

“I was most comfortable on my side with a peanut ball between my knees. About five hours after the drip started I was feeling the urge to push. My body took over and I told the midwives I couldn’t stop it. Alex was born at 9:43pm and they handed him to me through my legs. I was really shaky but once I’d rolled over he was on my chest and I remember thinking: ‘I know you”. It was amazing, I’ll never forget it.

Topics Discussed

Endometriosis, Induction, Miscarriage, Positive induction, TENS, triplet-pregnancy

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