I remember every moment from our first ultrasound scan in my second pregnancy, my partner remembers only the ultrasound technician typing in the number two in the column marked fetuses. His mind completely blacked out from the shock and he remembers nothing else from that appointment. Sometimes, you experience infertility for years, then finally fall pregnant after a year of seeing a fertility specialist, fertility medication, and a procedure. Sometimes you have surprise twins with no interventions. Life is anything but boring!
Once you are expecting multiples, you learn a lot very quickly. You are immediately labelled a high risk pregnancy, and are sent for more ultrasound scans to determine what type of pregnancy you are experiencing as well as the subsequent risk associated. There are 4 types of twins, dizygotic, monozygotic, dichorionic, and monochorionic.
Dizygotic are formed from two different eggs and two different sperms, these are known as fraternal twins. Fraternal twins are the only type of twins that are hereditary, and then only on the mother’s side, as the woman must release two eggs, an inherited “skill”. Fraternal twins experience the lowest rate of complication, as each baby has their own placenta.
Monozygotic twins are known as identical twins, they are formed when an egg and sperm meet and then spontaneously split. Despite the most common question I get (after the ever original, “are they twins”), no, I do not have twins in my family as identical twins are not hereditary. Depending on when the fertilized egg split, you then fall into the categories of monozygotic, dichorionic, and monochorionic. My boys were mono-di, which means that the egg split late, but not late enough to be monochorionic, which is when the babies share both placenta and amniotic sac. This is the most dangerous of twin pregnancies, as sharing a placenta is dangerous plus the logistics of two babies and two umbilical cords together in one sac can be deadly.
Our boys are identical, they shared a placenta, they also shared an amniotic sac with a thin membrane between them. I was immediately referred to a specialist in Twin to Twin Transfusion, a disease of the placenta that causes one twin to have increased blood volume, as my boys were high risk.
At my first appointment, my doctor explained to me that, “the placenta was not made to be shared,” and often the fetuses do not share equally, resulting in loss of life if measures are not taken. Our boys were given a 50% chance of survival with a high possibility of health issues if they did pull through. After explaining the risks and procedures, we were offered an abortion. We were told that they hospital would fully support our choices.
Thankfully, I had my partner with me, he did not blackout this day, but listened to all our options and together we made the best biggest decision of our lives. It was very emotional, but we decided to go ahead with the pregnancy. I had weekly and biweekly scans including doppler readings to measure the amount of blood flow to each baby. I was privileged to see my babies frequently on the grainy screen and get to know them before they were born. I am so grateful for this. I knew that Mr. L was prone to kicking Mr. G in the head and enjoyed his unfair share of amniotic fluid. I knew that they had adorable button noses, and I wanted to meet them so badly!
If the twin to twin transfusion had begun before 24 weeks, I would have been flown to Toronto (I was living in Ottawa, Canada at the time) to undergo Placental Laser Surgery, to hopefully reverse the uneven blood flow between the babies. Luckily, our particular case of TTTS did not become chronic until nearly 34 weeks gestation. At my routine appointment, I was told that the transfusion between the twins had reached dangerous levels and that the babies would need to be born as soon as possible via emergency caesarian section. My father-in-law had just arrived to help us out (watch our 2 year old son when needed), we had purchased a minivan 2 days prior (as 3 baby seats would not fit in our compact car), and it was suddenly TIME.
The delivery went well. Luckily, I only know how to make humungous babies, so the boys were born at 6 lbs 6 ounces and 6 lbs 5 ounces, despite being born a day shy of 34 weeks. Mr. L (the donor twin in the TTTS scenario) enjoyed a short stay in the Neonatal Intensive Care Unit, Mr. G (the recipient twin) had complications and difficulties regulating his breathing, temperature, and a case of possible hydrocephalus that needed to be monitored. He stayed in the NICU for a long 16 days. One of the happiest moments of my life was when I finally got to hold him! The nurses who work in the NICU were absolutely wonderful and occasionally hilarious as required. After a follow up scan a month after being sent home, Mr. G’s health was in the clear. I believe we celebrated with another sleepless night.
My beautiful twins are now four years old. They are bright, they have taught themselves how to read, they know far too much about the solar system, they love playing pretend and making art. They are inseparable. Frenemies for life. I am very grateful that they joined our family, they were definitely worth the stress and the trouble early on, although I would argue that the stress and the trouble continues as they have just received a scolding from their father whilst I sat here writing.
They are playing outside and have been spraying water at each other resulting in a massive muddy mess. Mr. G and Mr. L drive us crazy in a magnified way that only parents of multiples can truly understand, they bring an energy and a zest for life that I didn’t know I was missing. They are both a perfect team and two very different and distinct people. So if you have twins or are expecting twins, though it might not seem so at this very moment, you are the luckiest!
A Guest Blog from Danielle Deschenes
Danielle is a Canadian living the dream in the Cotswolds with her handsome husband and three adorable sons. She is a writer, painter, singer, musician, decorator, child herder, adventure seeker, autism mom, twin mom, and cheese connoisseur. In her free time she is a classical music teacher specialising in voice, piano, and theory. You can read all about her adventures on her blog you can also follow her on Instagram or on Facebook.
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