By Michelle Bar
About a year and a half after having our identical twin boys, my husband and I started talking about expanding our family. I knew I really wanted a third child to, as they say, “round out our family.” What I wasn’t so sure about was whether I could go through another delivery.
My boys were born at 35 weeks, after I had developed preeclampsia. Until that point, my pregnancy overall had been okay, considering carrying twins made me high-risk. After we hit 23 weeks’ gestation, my OB and maternal-fetal medicine doctors closely monitored me with weekly scans, which is typical when you have mono-di twins—meaning the babies share one placenta but are in separate amniotic sacs. They had planned for me to have a C-section at 36.5 weeks, but my doctors decided to admit me at 35 weeks after a few days of high blood pressure and extremely swollen feet and hands.
What was supposed to be a relatively routine Cesarean turned into a medical emergency. I was bleeding internally, and I fell in and out of consciousness as my blood pressure continued to drop. I needed six blood transfusions and spent the first 48 hours of my sons’ lives recovering, unable to see or hold them.
It wasn’t until much later, reading through my medical records on MyChart, that I learned I had had uterine atony and a postpartum hemorrhage (PPH), and went into hypovolemic shock due to losing half my blood supply. All of that was likely caused by an overdistended uterus from carrying twins.
Not exactly the birth story I’d imagined.
After my sons spent eight days in the NICU, and I spent five in the hospital, we all eventually came home. Settling into life with newborn twins left me very little time to fully process anything beyond whose turn it was to sleep. And for a while, I didn’t think too much about what had happened—until we started talking about having another baby. I wasn’t afraid of being pregnant; I was afraid of giving birth.
My fears were different this time around. With my first birth, I was terrified I might never hold my babies. The second time, I was terrified I might not get to come home to the children I was already raising. I had two little boys who relied on me. They still had no idea what happened when they were born, or why their mother was suddenly so preoccupied with the possibility of it happening again. I’d be doing something completely ordinary, like getting my boys ready for bedtime, and suddenly find myself thinking about what would happen if I didn’t make it home from the hospital next time. My mind had a way of turning ordinary moments into worst-case scenarios.
I kept thinking: Was I being selfish for wanting another child when I already had two who needed me? Was I pushing my luck? I hated that these questions even crossed my mind, but they did. I didn’t have a clean answer. So for better or for worse, I did what I tend to do when faced with something that scares me: I researched.
I read about postpartum hemorrhages, recurrent uterine atony, and what could be done before I ever entered the operating room. I came across an article about the Jada System, a medical device used to help control postpartum bleeding, and asked my doctors whether it would be an option if I hemorrhaged again. I wanted to know what my options were, what questions to ask, and what safeguards could be put in place. My husband and I got our wills and estate planning in order. Not exactly the kind of baby preparation you imagine, but it gave us some peace of mind and gave me a sense of control. I wasn’t leaving anything to chance.
There was something about saying these thoughts out loud to people I trusted that was freeing. It didn’t make the fear disappear, but it took away some of its power.
At every OB and MFM appointment, with every new doctor I met, I brought up my previous delivery. I asked them to review my records, not just glance at the summary, but actually read what had happened. I’m sure I sounded like a broken record, but I didn’t care. I wasn’t going to assume that because something was in my chart, everyone had read it. What would happen if I started bleeding again? What was the plan? I wanted answers. I became my own biggest advocate. I wasn’t looking for someone to tell me delivery would be fine, because I’d heard that before. I wanted to know what the plan was if it wasn’t fine. I’d already been on the wrong side of the odds once.
I also spoke with my therapist about the anxiety surrounding another delivery. As much as I wanted to believe I could research my way out of being scared, I knew it wasn’t going to erase what had happened. I spoke openly with my husband and close friends about my fears, even the ones that felt irrational to admit. There was something about saying these thoughts out loud to people I trusted that was freeing. It didn’t make the fear disappear, but it took away some of its power. That was just as important as all the medical preparation I’d done.
The first time, I’d gone into surgery with a playlist of our favorite songs and very little understanding of what could go wrong. This time, I knew exactly what could.
Last February, I delivered my daughter via a scheduled C-section. After months of researching, questioning doctors, reviewing medical records, and talking through my anxiety in therapy, the entire delivery was remarkably uneventful. What a welcome change. I got to hold her. I got to feed her. I got to experience those first few hours I’d missed with my boys.
And for once, there was absolutely nothing interesting to report. I’ve never been so happy to have a boring birth story.
