Most of the time, I write blog posts because I feel particularly inspired to write – I have an abstract idea I want to get across, and a concrete fertility or pregnancy update that goes with it. This is not one of those times. I’m not sad to be sharing this update, but it’s not going to be funny or even particularly clever. I should also add: the topic of this post is probably going to be touchy for some.
About seven weeks ago, we learned that there were four fetuses growing inside me. You can read about that “holy crap” moment here. We met with a team of doctors and nurses who shared their expertise about the likelihood of successful (i.e. healthy) quadruplet delivery. They did not paint a pretty picture. So just over six weeks ago, we made the decision that at 12 weeks, we would reduce the pregnancy to twins. And then, we waited.
The first trimester of pregnancy isn’t really easy for anyone: ask any pregnant lady who’s spent the last eight weeks kissing the porcelain throne, anyone who’s stressed about an early miscarriage, or trying to hide an early bump for their own personal reasons. My nausea wasn’t bad, I’m not one to stress about things I can’t affect, and writing a blog about making a baby doesn’t really give you much of an opportunity to hide anything. Instead, this was my gripe: we spent almost seven weeks growing four fetuses and trying our damnedest not to get too attached to any one of them or all of them together, because we only had hope to be safely bringing two of them home as babies.
I don’t mean to complain about the repercussions: It was our decision; a choice we made based on medical information and we are confident we did the right thing. But the time between was tough in ways that a typical many might not experience with a typical pregnancy. For a number of reasons, I often felt compelled to explain what we were doing, and this elicited a variety of responses – mostly supportive. But it still wasn’t happy baby news we were sharing all the time.
It seems like a backwards sentiment, but I am happy to be able to say that we’re now past that point of my pregnancy. Wednesday Michael and I took the day off work, went to breakfast, relaxed a little at home, and then met with a team made up of our doctor, two nurses and a sonographer to reduce my pregnancy from four to two fetuses.
I spent a lot of time reading and researching selective reduction before our decision and in the weeks before the procedure to make sure I fully understood what would be happening, but there’s not a lot of information about how it works online. I would have liked to have learned more about the procedure from a personal standpoint when I was looking around for info. So here comes one of those trigger topics I mentioned earlier: I’m going to describe what it was like for me.
Yesterday’s procedure actually started on Monday, with a full evaluation of each fetus. The sonographer took dozens of images to measure their arms, legs, heads, bellies, bladders, placentas and umbilical cords. They did a nuchal translucency screening to test for genetic disorders like trisomies and looked for heart defects. We asked a few questions and the doctor wrote me a prescription for Valium to take a half hour before the procedure. We signed some paperwork, and went on our way.
The reduction itself was scheduled at the same office where I’d been seeing the reproductive endocrinologist who helped us get pregnant. Most of my infertility treatment has happened through the University of Kansas Hospital, and their get-me-pregnant clinic works closely with their oops-I’m-too-pregnant-now clinic, in this case even sharing an workspace. I never totally loved being in that office on a regular basis for obvious reasons, but it actually felt quite comfortable to be in their waiting room. While we waited, I visited with a nurse I saw on a regular basis during my initial treatment and she reminded me that their whole team is cheering us on. It was nice.
We went back to an ultrasound room and the sonographer and the doctor repeated a quick version of Monday’s screenings to confirm what they had learned earlier about the health of each fetus, and most importantly, the health of the fetuses that would not be involved in the reduction procedure. I’m a firm believer that when taking a step like this, you should fully understand what it is you’re doing and own up to it as much as possible, so I asked to have the overhead screen turned on so we could see the procedure as it took place. The sonographer nicely, but firmly, told me no, and I didn’t fight her.
Then, the prepping and sterilizing began, and it took… a while. Reduction procedures carry a small risk to the remaining fetuses, because of the risk of infection involved with doing any invasive procedure on underdeveloped babies. If any bacteria were to get into my uterus during the procedure, it could cause serious problems for me and the remaining fetuses.
After that, the doctor told me not to watch – to keep my eyes closed or watch the ceiling. I think he didn’t want me to see the needle going into my own skin for fear I would squirm. I get it, fetuses are very small at this stage and millimeters made a world of difference between hitting the target and not. I’m not a needle-phobe though, and I wanted to be as aware as possible about what was going on. So I kept a side-eye on the primary sonogram screen as the needle pushed through my uterus (that did NOT feel good) and then again through the fluid sac, and into the fetus. For a moment… it was quiet in the room as the doctor and sonographer watched the screen. I couldn’t see, but I think they were monitoring the heart rate as it slowed and any fetal movement. Then, the doctor said “I think we’re done now.” For the most part, the process was the same with the second fetus.
When it was said and done, they showed us the two remaining little ones, the now Ralph twins:
All in all, I’m relieved it’s over. I’m glad we did it, because it means a better chance for the two babies we will have, but I’m relieved it’s over. Now we can move forward.