28 weeks: preparing for the transition

*WARNING* this post is about pregnancy progress. If you are not in a good place, PLEASE skip this post. As always, there will be others. Take care of yourself first. In the meantime, you can help Grey and me answer a question that's been plaguing us for the last few of years: 

Do we praise him or scold him?

Yes, there's a piping hot pizza under there. And the delivery guy's vote is to praise him.

Today marks the beginning of the 3rd trimester; yet another milestone that has me in complete disbelief. This past week has been a busy one for myself and the Beats. Last Thursday we had another ultrasound to check my cervix for a final time and to talk about the next few appointments. Seeing as our MFMs are at the university, it was also the first time that I had a medical student in the room with us. As the resident who's been following me since 14 weeks asked me the usual questions, I could see the medical student nervously nodding along. It was as they brought in the ultrasound machine that we learned that I was the first twins case she was sitting in on and she was worried I wouldn't let her do the ultrasound. The look of relief on her face when I assured her that I was completely comfortable taking a look at the Beats brought a smile to my face, as I know all too well that many people are not comfortable with medical students yet how important it is that they gain exposure and practice prior to going off to residency.

Here's where the fun part happened: as the resident stepped out of the room to find the attending MFM, the medical student was scanning the twins, commenting on the boxing match that was happening. It was then that she turned to Grey and asked him if he wanted to try. Without missing a beat, he said "sure" and got his first lesson with the ultrasound machine.

Anyway, the Beats are doing well and seem to be on track. We'll find out more next week with our first growth scan as to how well they are progressing. In the meantime, my cervix is holding at 3.5 cm. Outside of a severe case of constipation which landed me in L&D over the weekend to rule out preterm labor (another story for another time) and a prescription of daily Miralax and Colace, all is looking good.

With all of this news comes the beginning of seriously preparing for the Beats' arrival. Last Wednesday we did our tour of L&D, learning about what to expect during birth and post partum. I was especially pleased to see a breast pump in each post partum room as well as know that we would have immediate access to lactation consultants because of the twins.

In addition to doing the tour, we also had a weekend long crash course about pregnancy, delivery and managing multiples. The instructor for this course is an OB nurse at the university who has been teaching this course for 16 yrs. Though she is not a mother of multiples, she saw a need for this course after she found herself modifying topics for couples expecting multiples during normal birthing classes. Needless to say, the course was jam-packed with lots of great information, starting with how to recognize the signs of preterm labor, diet/nutrition and how important it is to gain the recommended weight (i.e. 38 lbs by 28 weeks), birthing multiples and what to expect in the delivery room (and that an epideral is almost required for the experience), breastfeeding multiples and where to find help (and why not to beat yourself up if you need to supplement) and finally tips for surviving the 4th trimester. The two most important things I relearned over the weekend where 1) that we're going to need help, hence I need to put aside my stubbornness and really begin cultivating where this will come from and 2) the term "Braxton Hicks" is misleading, especially for preterm labor.  I won't spend much time with this, as there's a whole post one could easily draft on this topic, but I will say that a contraction is a contraction and the ones to be concerned about are those that happen regularly (6 or more an hour). In addition most preterm labor contractions are painless, meaning that many women who aren't aware of the signs and symptoms will easily miss this warning sign and assume all is okay until it's too late. We actually had one couple who are at 29 weeks and are currently on restricted has bedrest because of preterm labor 26 weeks. Initially they said it came on without warning, but as we learned about the signs and symptoms, she kept saying "OMG, I had that!!" and by the end of the class they made the decision to switch from their midwife to the MFM that was recommended.

Since the course, Grey and I have been planning. I had already planned on stopping work by the end of July, but now I'm reducing my hours so I'm only working 3 days a week. We also now know that there's a limited amount of time left where I'll actually be able to help with acquiring the materials we'll need for the Beats, so we've begun transitioning our bedroom and the office area into living quarters for 4 human beings (we've actually been advised to skip a nursery as it's likely we'll be moving within a year). In addition, we joined one of the many multiples groups located in the Seattle area and have already been connecting with the group. The theme of babies after fertility treatments is a common one and many are more than happy (if not relieved) to share their journeys when they learn about our journey.

The short and the long of it is that though I'm still nervous and worried about the worst happening, I'm also embracing that we have to prepare. To not do so will only lead to stressful consequences for all of us. Besides, I learned long ago from David that bracing one's self for the worst doesn't make that trauma any less and I owe it to the Beats to embrace the positives of this pregnancy.

So begins the countdown. We're hoping for at least 9 more weeks of gestation. 9 more weeks means these guys will be full-term and no NICU. Come on, little ones: grow!