Upon learning that I was not only pregnant with twins, which is already considered a high-risk pregnancy whenever multiple babies are involved, but that I was also pregnant with one of the most rare types of multiple pregnancies known as Monoamniotic, Monochorionic, I discovered very quickly that there would be very little to my pregnancy experience that I could consider “normal” or “typical” from that point forward.
First, some stats, for those of you might not know (and why would you):
* Every year an estimated 4,000,000 infants are born in the U.S., roughly 130,000 of these are twin pregnancies.
* Among identical twins - already quite rare - less than 1% of all identical twin pregnancies are Monoamniotic, Monochorionic.
* Monoamniotic, Monochorionic twin pregnancies are so rare that even within the medical community there is no real consensus on how to handle these pregnancies.
* Among Monoamniotic, Monochorionic twin pregnancies, greater than 50% self-terminate and die in utero.
* Monoamniotic, Monochorionic twin pregnancies are at increased risk for birth defects, disabilities and the typical mortality rate for such pregnancies is usually quoted at greater than 50%.
In most twin pregnancies, there is a thin membrane in the uterus which separates each baby. Without this thin membrane between the babies, the babies share one sac within the uterus. The risk that this poses to the babies comes when the umbilical cords entangle with each other in utero. The greater risk is that one of the cords, or both of the babies cords, become entangled as the babies move in utero pulling tight on the cord(s) and ultimately cutting off the blood supply, oxygen and other vital nutrients to the babies. Another risk posed by cord entanglement is that the cords can wrap around one or both of the babies’ necks causing strangulation. It is for these reasons that most Monoamniotic, Monochorionic twins do not survive.
The Decision to Keep Our Twins
When we learned that I was pregnant with Monoamniotic, Monochorionic twins, the very first OB/GYN that I saw encouraged me to have an abortion due to the high incident rate of the pregnancy self-terminating and the likelihood that one or both of the twins, if born, would suffer from a severe disability. Well, abortion was simply not an option for us. Rather than terminating our twins, we instead immediately terminated our relationship with this particular OB/GYN. These twins were God’s gifts! As a couple, we decided that God had created these babies and given them to us; and it was not within our right to decide what God had planned was not going to be acceptable to us.
Shortly thereafter, God led us to another OB/GYN who, while he too expressed and disclosed to us the same risks as the first OB/GYN, respected our decision to continue with the pregnancy regardless of the risks. And, so it was that we entrusted my pregnancy into the hands of this new doctor and we committed the lives of our girls to God’s provisions and watchfulness over them.
Complications Arise
When I was 27 weeks pregnant, my doctor elected to begin a heart monitoring program of the twins at the hospital. Initially, these heart monitoring sessions were designed to be done on an outpatient basis, however after only two days of outpatient monitoring of the twins’ heartbeats, the doctor observed some irregularities in the heartbeats of the twins.
I still remember the phone call that I received from the doctor informing me that he noted “some distress in the babies’ heartbeats” stating that “cord entanglement is likely an issue now”. The doctor continued, “go home, pack a bag, have a nice dinner with your husband, then get yourself checked into the hospital.”
The hours that immediately followed that phone call remain a blur. I vaguely remember a quiet dinner with very little conversation with my husband that evening. Fears loomed heavy for me and my husband about the fates of our girls and there was very little to say to one another. The drive to the hospital continued in silence, preferring to pray rather than talk to one another.
I was admitted to the hospital at 27 weeks. I was hooked up to heartbeat monitors for the twins 24/7 for 5 dreadfully loooong weeks to help monitor the distress levels that the babies might be facing as their cords continued to entangle in utero. The doctor had informed me that at the first sign of “critical distress” of one or both of the twins, an emergency C-section would be performed. The doctor also informed me that the hope of the ongoing monitoring would be to detect a problem with the cords by monitoring the babies’ heartbeats before it became a fatal issue. The doctor further shared with me that while they will do everything that they can, cord entanglement is a serious issue in this type of pregnancy and there are simply no guarantees. Essentially, we could do all the monitoring of the twins’ heartbeats that we wanted in the hospital and still end up losing one or both of them in utero.
I remained in the hospital for more than 5 weeks until an emergency C-section was performed at 32 weeks when during a heartbeat monitoring session, Baby “A” which is now our Taylor Mackenzie, was noted to have a very depressed heartbeat indicating that she was under serious distress and losing oxygen. The doctors placed me on oxygen to try and flood additional oxygen into the babies in utero; yet even with this surge of additional oxygen, Baby “A’s” heartbeat remained depressed. There was no time to spare and within an hour, I was prepped for the C-section and delivered both babies. It was a totally surreal moment and it all happened so fast!
