Identical Vs Fraternal Twins

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The thing that struck me about having twins – particularly high-risk twins, since that comes with so many more scans and doctors appointments – is that the whole thing is very, well, mammalian. There are different types of twins, characterised by different placentas and amniotic sacs, and there is a surprising amount of confusion among the non-twin-bearing public about how they work.

So I’ve written a quick guide, and include the usual disclaimer about how I’m not a medical professional, just someone who is surprised by the degree to which people are confused about the biology of twins who’s done a lot of googling.

First, there are fraternal twins. Fraternal twins occur once in about every 80 pregnancies, although the number is going up as maternal age rises and fertility treatments increase the incidence of multiples. Vanishing twin syndrome, in which one pregnancy isn’t viable and just sort of…fizzles….only happens with fraternals.

In fraternal pregnancies, there are two separate placentas with two separate amniotic sacs. They are concurrent pregnancies, but there are no links between the babies in utero; they just happen to be two babies born on the same day. Fraternal twins can be girl-girl, boy-girl or boy-boy, and while many pairs of siblings may look alike, they are no more genetically similar than any other pairs of siblings. There is a genetic component, however: a woman’s likelihood of becoming pregnant with fraternal twins is passed down the maternal line (i.e. mother to daughter), because it relies on a woman’s likelihood of releasing two eggs in any given cycle (though, as mentioned above, there are a number of other relevant factors as well).

The natural world is full of fraternal twins. Every animal that has a litter is, in essence, having fraternal twins.

Identical twins occur once in about every 400 pregnancies, but are (I suspect) less prevalent in the general population because there are some common complications that make fewer identical-twin pregnancies viable. Within the umbrella of ‘identical twin’ there are three separate types of pregnancies:

  1. Dichorionic-dizygotic: two placentas, two amniotic sacs. On an ultrasound, this pregnancy will look exactly like a fraternal pregnancy; in fact, some people do not know until they have genetic testing whether they have identical or fraternal twins even after birth (not all identical twins look alike. Mine don’t!)
  2. Monochorionic,-dizygotic: one placenta, two amniotic sacs. The placenta is divided into two sections, serving each twin individually, but the line can only be distinguished post-partum. This is the most common type of twin pregnancy and occurs in roughly 92% of identical twin pregnancies (though I have also seen reputable websites that claim its more like 60%. Since not all di-di twins will be confirmed as identical there is probably some wiggle room here).
    There are also blood vessels connecting the twins across the sacs; despite the roughly hojillion ultrasounds we had, I was never 100% clear on how that works. In twin-to-twin transfusion syndrome (TTTS), one of the more common and serious complications, the babies’ blood vessels are connected, and one twin receives more blood than the other (donor) twin. Selective intrauterine growth restriction, which is what my girls had, is a similar condition in which one twin has a larger allotment of placenta than the other. Most identical twins are different sizes at birth; sIUGR is diagnosed when one of the fetuses is below a certain percentile (I believe its 10th percentile but I couldn’t confirm that with a quick Google so I’m just going to go with it)
    TTTS affects about 15% of identical twin pregnancies and sIUGR about 10%. If you’re really unlucky, you can have both simultaneously; one does not preclude the other, though the differences between the two disorders are only subtle. Both are not possible in pregnancies without a shared placenta, so do not affect fraternal or di-di pregnancies.
  3. Monochorionic-monozygotic: there is a single placenta and a single sac. This occurs in about 2% of twin pregnancies and is super high-risk. Best practice as of 2017 calls for women with mo-mo pregnancies to be put on bed rest at 25 weeks and deliver at 32. The reason is that there is a risk of the umbilical blood vessels getting tangled within the single sac, which can have really awful, tragic outcomes. Mo-mo pregnancies are also at an even higher risk for TTTS and sIUGR, although I’m not sure why.

The type of twin pregnancy is determined by when the egg splits: if it happens early, you get a di-di pregnancy; if it happens late, mo-mo. Everything in between is mono-di. What surprised me is the definition of ‘early’ vs ‘late’: any egg that splits more than 13 days after conception will result in conjoined twins. Eight-13 days = mono-mono and a split between five and eight days results in mono-di.

One note about identicals: in very rare cases, they can be different sexes if one of the babies has Turner Syndrome and the other does not. Turner Syndrome occurs in 1 in every 2,500 births, but its incidence in twins is extremely small – like, five documented cases ever. Still, I was floored to find out there is any instance in which identical twins can have different sexes.

You may think you don’t know enough identical twins for the 1/400 number to sound right; this is because (I think) there have been dramatic advances in maternal/fetal care for twins in the last decade or so, as well as major improvements in neonatology, which is a fast-moving field. In most cases, the treatment for complications is premature delivery, which on average has much better outcomes now than it did thirty years ago (which is not to say there aren’t lots of healthy humans who were born prematurely out in the world, though there is not great data about how they fare in old age).

When we told my parents we were having identical twins, they said ‘but how do you know?’ and the answer is, there was only one placenta, so it was definitely identical. There is no way to increase your chance of having identicals; it just happens sometimes.

 

 

 

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Christmas frickin’ Magic

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The last two Christmases have not been fantastic.

Last year, I finished work on Friday, 23 December, and sat at the kitchen table ready for the holidays. I remember saying ‘I am so excited!’ about an hour before I went to the bathroom and saw blood in my underwear.

For most women, that’s called a menstrual cycle. But I was 23 weeks, 6 days pregnant. I had had an ultrasound earlier that day and it had been positive – it was a high-risk pregnancy but things were generally stable and I left feeling lighter than I had in the past. I was on the cusp of viability! This was HAPPENING!

I was at the hospital less than half an hour later.

The same doctor who had scanned me earlier that day came in, and confirmed that I’d had a bleed but that both girls were still moving. It looked like it might just be a one-off, and then it happened again. And again. And faster and faster.

I chugged water from paper cups in the triage area, running laps between the bathroom and our curtained-off area. A couple hours later, I was transferred to Labour & Delivery – not a positive sign – where I thankfully had a private room with ensuite bath (not all rooms do) and could schlep between the bed and the toilet. I noticed a tiny new stretch mark, running north from my bellybutton, and stared at the blue screensaver on the computer kiosk in a corner of the room, only realising the next morning that I could have turned off the monitor. But by midnight, the bleeding had just…trailed off. The same doctor – bless you, Catherine Aiken – came in to discuss delivery and steroid shots (I got one) and the NICU team came to prep me for the worst. Daphne was 400 grams at that point, and would not have been expected to survive; Fiona, at about 540, stood a fighting chance. Ian went home at about one in the morning and I spent the rest of the night the same way – staring numbly into space, trying to sleep, punctuated with trips to the toilet that confirmed I was mostly not bleeding anymore.

The next morning, a midwife’s assistant brought me tea and toast. I sat on the inclined bed with a Styrofoam cup of tea in my lap and sobbed and sobbed, while my daughters – now an even 24 weeks, and officially Viable as far as the medical establishment was concerned – wiggled and thumped inside me.

I was retrospectively diagnosed with a partial placenta previa, a complication that can be fatal to mum and baby – or can be so minor as to barely register as a complication at all. I left the hospital on Boxing Day, and we had family Christmas two days late. A week later, I had another bleed – a much more minor one – and spent New Year’s in the hospital. And that was last year’s holiday season. Yippee!

That would be enough to feel like I had to bring the Christmas Magic this year, but it turns out there is a theme. Two years ago, I had a miscarriage at 11 weeks pregnant (later diagnosed as having been caused by Graves’ Disease – basically an overactive thyroid), on the 17th of December. It had been an easy, breezy pregnancy to that point – things had gone 100% according to plan with minimal morning sickness, and once we crossed the 9 week mark I thought, ‘well this is fantastic; my chances of miscarriage now are like 2%’

Well, someone has to be in that 2%.

My memories of the miscarriage mostly involve crying: at the ultrasound, when they confirmed there was no heartbeat; in the shower, on the toilet, in my mother’s arms when I found the ‘big brother’ shirt I’d ordered to my parents’ house. Eventually I found a grief anthem: I would sing a chorus from a Ben Folds song and allow myself to feel All the Feels – sometimes I sang it twice – and then I’d pull myself together. All the same, it was a rough few weeks that stretched into months, when we learned that I had to wait until my thyroid was managed to try again.

This year – and every year from now on – I am free from reproductive stress. Our family is complete; this uterus has closed up shop. But as the 23rd of December approached, and I realised that last year would cast a longer shadow than I had anticipated, I felt a lot of self-inflicted pressure to make this holiday special. To start new traditions that would drown out the stress and disappointment of previous Decembers. To celebrate that we had come out of a difficult couple of years with three healthy children. Basically, to create Christmas memories that would drown out the crumminess of the last two years.

Here is the problem: my baby daughters don’t care; my husband doesn’t care (at least not nearly as much as I do); and my son just wants to eat treats and open presents, and will have only the haziest memories of this year if he has any at all. All five of us have colds, except for Theo, who is stuck at home because nursery is closed for the week and is going stir crazy. Holiday perfection has taken a backseat to sleeping and trying not to succumb to our desire to just plop our three year old in front of Paw Patrol and call it a damn day.

Where there has been magic, it has been incidental, which I guess is a good lesson to take from the festive season. Daphne waved at her grandparents and aunts during a Skype call on Christmas, a development that is way ahead of schedule and for which there were many witnesses. In the last four days, Fiona has become an indisputably mobile baby. She doesn’t go fast or far, but she doesn’t stay where you put her, either. Theo’s math skills have taken a step forward – when counting pound coins he received with a piggybank, he got to 8 and said ‘I think I have ten!’ And all three children started playing together for the first time when their new toy, Wobble Bear, was placed between the three of them, which felt like a freaking Christmas Miracle. Some of this stuff was facilitated by Christmas, but its mostly every day stuff that we noticed because we’re all sitting around driving each other a little nuts.

It will take more than one week of bad weather and sick children to erase the scary sadness of the last two Christmases, and an insistence on a CHRISTMAS FAMILY BRUNCH, DAMMIT are probably not going to help. But that’s a lesson in and of itself, and I will take it.

The Tiny Baby Blues

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I met a family last week who had an extremely premature baby. I had two extremely premature babies, but this baby was so premature that I was reduced to saying, essentially, ‘oh, shit, that’s an early baby.’

I have been thinking about that family a lot since. They arrived at the NICU – our NICU – a couple months after we left and stayed for a long time, though they are home now. But I keep feeling regret for them – not that they spent four months with a baby in the hospital, though that sure sucks a lot – but that they left the hospital without the resources that they would have had if things had gone more smoothly. Its hard to make friends with other parents when your experience diverged so sharply from everyone else’s so early, and its hard to settle into a rhythm as a new parent when you feel alienated from everyone else and their robust, healthy, oxygen-free newborns.

When I was pregnant with my first child, my husband and I did a birth-prep class. We had been warned that the content was not especially useful (it wasn’t), but that there was a lot of value in meeting your classmates – classes are organised by neighbourhood, and we live in an extremely fertile area, so our classmates lived around the corner, down the road, up the street – we were extremely geographically concentrated. When one of the babies was born early, the father sent an email to all of us saying how nice it was to meet everyone and he hoped to see us again soon sometime.

We had a good laugh about that at our fourth annual birth-prep group holiday in October. We saw each other almost every day all summer, and are still in regular contact with virtually everyone in the group, which has swelled (with second and, in our case, third children) to 32 people.

My group are outliers; most people don’t end up taking regular vacations with their parenting classmates. But most people do leave the hospital with a roughly shared experience of birth and new parenthood. Plus a baby. Most people leave the hospital and take their child with them.

For NICU families, it isn’t like that. I found it relatively easy to leave my daughters behind, not because I’m a callous witch, but because they were clearly…not finished. They were in incubators and they clearly needed to be. I found it harder at the end, when we were in sight of a finish line that never seemed to get any closer, and the girls looked and acted like babies instead of fetuses.

Still, from the moment they were born, I thought they were perfect. I wanted to tell people about my gorgeous twin daughters as much as any other new parent. When I was two weeks postpartum, I took my son to a birthday party and people asked how I was. It was only as I watched their eyes widen that I realised I had to adjust my rhetoric a little. ‘I just gave birth to tiny, perfect, extremely premature babies!’ isn’t exactly cocktail fodder. No one knew what to say. I skipped the next preschool party.

Of course there are families in the NICU who are going through something similar to what you’re experiencing. When people ask if I made friends in the NICU, I say ‘well – Facebook friends.’ I did meet people whose acquaintance I value, but none of them live within a twenty mile radius. Catchment areas for Category III (most intensive) NICUs can be huge; there are only a few in the UK. There are always families coming and going, and there is a hierarchy. One woman took weeks to warm up to me, presumably because her kid was having a rough go and she didn’t want to deal with another baby having an easier time than hers.

So I’ve been thinking a lot about this family I met recently, who had four crummy months in the hospital only to find themselves starting from a different place than everyone else who has a baby the same age (actual or adjusted) after they got discharged. I’ve wondered what could be done to make it easier for them, and I’ve wondered what I could do without coming across as an overzealous weirdo. I haven’t come up with much so far.

 

 

I Hate Santa.

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My paternal grandmother invented the Elf on the Shelf about sixty years before you ever heard of it. She didn’t profit from it – but she created a household elf, McGiffiny, who would come to Shorewood, Wisconsin around Thanksgiving, spy on my dad and aunt and uncle, and have little tete-a-tetes with my grandmother about her children’s behaviour. To say she cultivated a belief in Santa would be an understatement. When my dad found out the whole thing was an adult fabrication – from a friend of his older brother’s – he felt duped and betrayed. And while he’s not exactly losing sleep over it at age 67, it was sufficiently unpleasant that he and my mother went out of their way never to endorse Santa mythology to me or to my sister.

When I was in first grade, I asked my mother where presents came from if Santa didn’t bring them. And she told me. I have been grateful since then that my parents never tried to bullshit me about Santa or about various other imaginary creatures – the tooth fairy, the Easter bunny, etc.

Now that my son is old enough to understand the narrative about Santa, I appreciate more than ever the way my parents never endorsed the myth. Because it is a difficult fricking line to walk. This year, Santa has made appearances at nursery and my husband’s office do, and my son is a firm believer despite the fact that my husband and I have gone out of our way to avoid encouraging him.

And so we find ourselves hamstrung: when Theo met Santa last week, he looked completely star-struck. There is no doubt in his mind, despite the fact that he met two different Santas on two consecutive days, that the whole shebang is real. If, come the 25th, there aren’t presents from Santa under the tree, we will have to have a reckoning. But if there are, we are playing into this weird fantasy about a fat man who breaks into people’s houses every year that is perpetuated by adults for their own amusement. I know some people argue that its fun to believe, but I don’t think anyone enjoys learning that they have been lied to. Stop deceiving your children because you think its cute!

And McGiffiny notwithstanding, don’t even get me started on that damn elf on the shelf. Creepy AF.

World Prematurity Day 2017: Reflections

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Last week was World Prematurity Day, and I took the girls back to the Rosie Hospital & Addenbrookes NICU – the hospital where they were born and the ward where they spent the first two months of their lives – for a reunion with the staff and some of their old roommates.

The event was 100% totally sweet. We paraded through the halls of the hospital with little tea lights, wearing purple (the colour of prematurity and also, I recently learned, of pancreatic cancer), and then convened in a hospital seminar room with a table of cakes and tea and coffee for a reception that lasted about 45 minutes. And then we left. It was perfect.

Many of the NICU staff had provided baked goods and there was a great turnout from consulting doctors and a few of the nurses (many, of course, were working and not able to come). Seeing the staff, the people who literally saved our children’s lives, was fantastic, and while I appreciate it wasn’t at the top of their list of things to do, I wish I’d been able to see more of them. Sarah and Sophie from room 7 or Denise and Ben from room 12…I get a little emotional thinking about it, even now. The NICU staff made it possible for me to go home and sleep every night even when Fiona’s oxygen needs were going up or when Daphne had green goo coming out of her stomach. They took care of my daughters when I couldn’t, and I will never be able to say thank you enough. I hope they know that.

None of the midwives or maternal consultants were there, which is a shame – because as critical as the NICU nurses were, the only people I wanted to see more were Kasha and Catherine, the doctors who watched over my uterus week after week and then ultimately delivered the girls by emergency C-section. Catherine came to debrief me before she left the hospital, as I was coming down off the heroin derivatives you get when you have a c-section, too, which was awfully kind,

There were probably about fifteen families, mostly with children under a year old, including at least two women casually slinging oxygen for their baby and a six-month-old three-month-old who looked like the tiniest old man you’ve ever seen.

A number of our girls’ NICU contemporaries were there. In December of last year, there was a family of quads born at 27 weeks at the Rosie, and the smallest of them ultimately spent over five months there. They were all there and were, naturally, like visiting celebrities. There was another family of twins born two weeks after mine who were our roommates for a couple of weeks and two other single babies whom I hadn’t actually ever seen in person – I’d just seen their mums in the pumping room.

It was a funny thing. I know these women (it was mostly women, because the milk kitchen was where the bonding happened) from one of the most difficult phases of  our lives. Our children spent months occupying the same rooms and our breastmilk sat side-by-side in little purple trays and we passed each other in the halls wearing pyjamas, or swallowing tears en route to the toilets. We chatted through the beige curtains to  background music provided by Medela breast pumps and then swore at the bizarrely hot tap water we used to wash our pump parts, exchanging small talk as we each microwaved our steriliser bags for three minutes.

I liked a lot of the people I met in the NICU. The super-religious family; the family with a silent husband and a wife with more than enough personality for two; the couple with a dad who was always dressed in expensive loungewear; the French woman who showed up two days postpartum with perfect hair and makeup; the ones who always ate tinfoil-wrapped sandwiches in the parents’ room and the American military man who thought my excitement over Teddy Grahams was hilarious (I mean, it was). But when people ask if I made friends, I say ‘well…I made Facebook friends.’

It was so good to see these families again – with parents looking less wan, mums looking slimmer, and babies looking chunky and normal. I’m so pleased I got to go, and to show off the girls a bit too. But it is also funny to think – given all the solidarity I got and gave with these people – that actually, half an hour of shmoozing turned out to be just about right. I walked back through the hospital and packed the girls into the bike, grateful to have seen everyone and even more grateful to be leaving the hospital behind for a while.

Poop.

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Theo has discovered toilet humour. So that’s awesome.

He’s actually a little late to the poop party – most kids discover it around the time they get toilet trained.

I understand. I am a thirty-four-year-old woman and I love a good fart joke. But most of the time, I don’t want to listen to a preschooler sing ‘poop poop poop!’ at the dinner table. Some of the parents and carers I know are really keen to shut it down, but to be honest, I’ve been surprised by how little I care.

What I HAVE been surprised by, on the other hand, is how vehemently I care about my kids’ ability to read the room. I don’t mind if he talks about poop. But my line has been ‘I’m not interested in talking about poo, Theo, so let’s please talk about something else.’

It turns out toilet talk isn’t an issue for me, but instilling in my kid the sensitivity to change the subject definitely is – in fact, it is one of my Core Parenting Values. Talk about poop with your friends, kid. Don’t talk about it with me.

Most of my revelations about parenting have come that way: I establish a policy about a fairly prosaic part of everyday life, only to realise that it stems from something deeply held. For example: you can go up the slide instead of down, but not if someone wants to use it properly. Not because I care about slide etiquette, per se, but I care about having a child who is aware of other people and will be respectful of other playground users.

Broadly speaking, I came to parenting with my Core Parenting Values fully fledged: I want my child to be kind. I want my child to be respectful. I want my child to be feminist and generally anti-discriminatory. And there were a few specific things I felt strongly about, mostly drawn from my own childhood: I wanted girls to have my name, for example, because I have my mother’s. I felt strongly about not propagating ideas about Santa Claus, because duping children for the amusement of adults seems gross to me. I didn’t want my son to have clothes with cars on them, because I think that’s weird, sexist, outdated and unfortunate: I hate cars (I’m an urban planner).

Like any parent, many of my strongly held beliefs have disintegrated in the face of, well, reality. My daughters DO have my name, but Santa Claus is a losing battle: I haven’t endorsed the myth, but Santa made appearances at nursery, at my husband’s office party, the Christmas market, and pretty much everywhere else, too. And cars – well, yeah. That didn’t happen, either. I’m hardly the first parent to give birth to a kid thinking I can control some aspect of their life, only to find myself proven fundamentally, laughably wrong about five minutes after the kid was born.

And as someone parenting a preschool boy and baby girls, I find myself navigating new territory in terms of gender expression and identity. The onslaught of sweet frilly things has proven way harder to resist than I expected, because it turns out I like sweet frilly things way more than I expected and I like NEW frilly things even more than that. I thought that putting my kids in gender neutral clothing would be an expression of Core Parenting Values – but actually it turns out, what I care about is that my children not feel oppressed or constrained by their gender, or frame their sense of self-worth in terms of their private parts. I don’t think the adorable pink overalls I inherited from a friend are going to factor in, long term.

I let this post marinate for a while now – I started it back in October – because, you know, who cares, right? In parenting, you learn by doing. Shocking surprise twist. But I think the takeaway for me is that in parenting, the personal is political, in that everything is a proxy for a more deeply held belief that I often have not thought to articulate until it is expressed via a stupid or seemingly trivial rule.

Don’t talk to me about poop, kid. Talk about it with your friends.

 

 

So we’re sleep training now.

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September has been a rough month: the girls went from being pretty solid sleepers to, well, the opposite. I felt like they were trying to break me (and a couple times, I think my husband would say they succeeded).

I don’t remember being this tired the first time around, although I’m sure I was – in fact, I had undiagnosed Graves’ Disease, so from months 4-6 I had brutal insomnia most nights and ended up taking long naps in the morning to try to get to a point where I could function. This time, though, the morning naps haven’t happened; the girls’ daytime sleep hasn’t aligned well enough.

Sleep deprivation isn’t a good look on anyone, but I’ve had a couple of weirdly unhinged moments – like once when I got so frustrated I threw my giant feeding cushion across the room, or another time when I ended up lying on my stomach on my bed and kicking my feet like a tantruming toddler. Most of my symptoms have been more prosaic, though – incidents when I’m so tired that I can’t remember a word, or I start a sentence, forget where I’m going, and then think ‘oh eff it, nevermind, I can’t be bothered to formulate that thought after all.’

So we decided to start sleep training. We used Ferber with Theo and it worked so well that we are trying it, with some trepidation, on the girls. They feel too young. It seems too soon. But I am damn near catatonic, so last night I gave Daphne extra squeezes and lots of apologies, put her in bed, and walked away.

And….she just stayed asleep. I’d let her fall asleep on the boob, like an amateur. Fiona, on the other hand, started squawking almost immediately. With Ferber, which is a method of controlled cry-it-out, you go in every few minutes to reassure the baby. But it doesn’t calm them down at all; I just felt crummy for failing to comfort my child, and in the end I ceded as much of it to Ian as I could.

With both girls, their first experience of being left to self-soothe lasted about 25 minutes. The second took about ten. And then I fell asleep feeding Daphne and screwed it up AGAIN. But still. We have begun. We are on our way.

I am a sleep-training evangelist. I know the internet (and the world) is full of people who say ‘oh but I just couldn’t.’ And that makes me angry. I appreciate that sleep training is not for everyone, but it is not something I take lightly. When we did it with Theo, it was by far the hardest thing I had done as a parent, and it was 100% the right thing for all of us. When people say ‘oh, I can’t,’ what they are implying is that they are more sensitive or empathetic or more devoted to their children’s wellbeing than I am. And maybe they are, but if so, it has nothing to do with their willingness to engage in sleep training. I believe in sleep training as one of my core parenting values, because I will parent better if I can formulate complete sentences and deal with frustration without throwing things (even cushions) across the room.

So we’re sleep training now. It was a little sooner than we meant to, but it turns out its time. Wish us luck.

Fertility & Social Media

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I look cute, but also, this pic makes me feel like kind of a jerk.

During my second pregnancy, I trawled Etsy for the perfect ‘Big Brother’ shirt and spent a while composing the pregnancy announcement in my mind. I had it ready to go. And then I lost the pregnancy.

When I started writing about my experiences as a parent, I fully expected to write about my miscarriage, which happened in December 2015. But it turns out I don’t have that much to say about it. It happened. It was awful. I do still occasionally think about what life would be like if we’d had that one baby, though I think about it less and less as I get to know the two I ended up with.

Anyway. The ‘big brother’ tee shirt never got its day, and I began a year of uncharitable crankiness about other peoples’ pregnancy announcements. Like many people my age, I’ve been on social media for over a decade, and have hundreds of contacts with whom I have minimal actual contact in real life. That woman I met at a wedding? Or the  conference? Or the person I hung out with for four days straight at Bonnaroo and then never again? Check, check, and check. And in the time between miscarrying and receiving the green light to try again, I think all of them got pregnant.

Announcements obviously run the gamut: some people post ‘btw internet, we had a baby’ while other people go full-on Beyonce. But when you want to be pregnant and haven’t had any luck, it is hard not to interpret all of them as preening: ‘#april2017! #soblessed!’

So when I got pregnant again, this time with twins, I put a lot of thought into how to tell the world. Because TWINS! Right? But on the other hand, I knew of a few friends who have had trouble conceiving. Perhaps more importantly, I knew there were even more people I didn’t know had trouble conceiving. I didn’t want to be THAT girl.

In my period of infertility, there were a few friends – not Facebook friends but real-life friends – who got pregnant. Hurray! I did not begrudge them their reproductive success. Even so, it meant the world to me (it still does, more than a year later) that they spoke to me or emailed me and said ‘this probably sucks for you to hear, and I’m sorry to cause you emotional turmoil, but I’m pregnant.’  It didn’t actually cause me much turmoil; it was easy to just be happy for them, and grateful to have such thoughtful people in my life.

And then – finallyyyyyy – it was my turn. A friend took a picture of me with my beloved Peugeot bicycle in her front garden. My pregnancy hair looked amazing. My bump (about 18 weeks at that point) looked sweet and compact. My thighs looked enormous, but can’t win’em all. And so almost without thinking, I posted it. #Frannyhavingtwins #goodhairday

And that is how, in a minute, I became the thoughtless jerk whose posts had made me glower for the better part of 2016.

Its hard to know what the right balance is. Its not like people should keep their children secret. The world is full of babies. That’s a good thing. Babies bring joy and light and hope into the world.  But I think maybe we should all agree, collectively, to put a moratorium on the following: #soblessed, #blessed (those two don’t need to be used by anyone, for any reason, ever again. Google it. I am hardly the only person who feels this way), #fitpregnancy, heart-on-uterus pics, and ultrasound images. I don’t need to see inside your body, Girl from Middle School.

I know how hard it is to resist. As soon as I got pregnant, I thought: tee shirts! Chalkboards! Balloons! Glitter! Tiny baby shoes! ALL THE PINTEREST! But thank goodness my laziness was stronger than my hormones, because I know how hard it is when you want to be pregnant but are not.

Prematurity on TV: Black-ish Season Finale

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I’ve seen a few episodes of the American sitcom Black-ish, which will be returning for season4 on 3 October (in the US. in the UK, who knows? I saw the finale at 10 am in the morning on ITV. I think.).

Season 3 had centred on the late-in-life pregnancy of the female lead, Rainbow, and the finale gave a mostly-accurate depiction of a sudden, scary turn: she developed pre-eclampsia and delivered the baby two months early (so about 32 weeks gestation).

I wrote about prematurity as depicted by Pampers  a couple months ago – in general, I would say, pop culture doesn’t have much of a track record addressing prematurity. Which makes sense: prematurity is not telegenic. Preemies can be ugly or scary or just a bit too….fetal…to be comfortable to look at. They are tiny and fragile and hooked up to all sorts of crap.

Black-ish did a pretty great job with the maternity stuff; everything they said about pre-eclampsia was correct, and the parents’ fear and panic was pretty on point too. But then the show was stuck with a premature baby that they had to deal with, and that’s where I thought the show went off the rails a bit.

First of all, that baby was gorgeous. Small, but chubby. Not hooked up to any breathing apparatus. No long lines, or lines of any description. No incubator. Just a few monitoring devices so we knew this was Not a Normal Baby.

I mean, I understand. I thought Daphne was gorgeous straight out of the womb. In the first picture ever taken of her, she has one eye just cracked with Not Impressed expression that remains her trademark seven months later. Watching from the operating table, I saw the nurse hold up my tiny 2 lb baby and I knew that things couldn’t be that dire or they wouldn’t be hoisting her up like Simba for photo ops. But really, to the untrained eye, she looked pretty raw. I had that picture printed but my mother suggested I not send it to my grandmother. I look at it and think, ‘damn, my baby is a fighter’ but in retrospect I can see how other people would just react with alarm.

Preemies are alarming. But the show could easily have circumvented the need for a close-up by showing an incubator (also called an isolette), or by simply reporting on his condition. Instead, they made it look like the scary part was over. Anyone watching would see that baby and think ‘oh, that’s not so bad, he looks fine.’

I realise I am complaining about a sitcom, and I shouldn’t hold them to documentary standards, but the experience of having a premature baby doesn’t end a couple days postpartum. The fact that the girls were early is still very much with us seven months later (five months adjusted), and will likely stay with us forever, in the form of soft teeth of poor vision or attention or behavioural disorders. We are very lucky that the biggest thing they faced in the NICU was ‘smallness’ – they were just really, really tiny. Daphne was so small that, for a long time, she kept cutting off her own airway when she moved her head. She just didn’t have the strength/maturity not to.

September is NICU Awareness Month. The show originally aired this spring, but it seems fitting to me to talk about it now, after it ran in the UK. Most NICU babies are, in the grand scheme of things, Just Fine. But they are fine because they have the benefit of an incredible amount of care and support and science: they NEED incubators and long lines and various unpleasant, humming machines, and for a television show to skip that part of it – while demonstrating the very accurate fear and anxiety of the parents – is to do NICU babies, and neonatology in general, a disservice.

Festivals: not what they used to be.

Last year, when I was the parent of one child, I got tickets to the Cambridge Folk Festival. The plan had been to go en famille, but my husband was out of town. I considered throwing in the towel on the whole damn weekend. I booked a babysitter, then cancelled the babysitter, then considered ringing the babysitter and begging her to come after all, then finally took a deep breath, packed my picnic blanket, hauled my kid to the festival and hoped for the best.

I was so amped up when I got home that I sent the following email to a friend:

HE WAS SUCH A CHAMP I AM SO PROUD OF HIM IT WAS AMAZING.
I saw KT Tunstall and Glen Hansard, who I wanted to see the most in the whole festival, and in between sets he said ‘more music! Music, mummy!’
You know how when you first fall in love, and it just seems like an utter miracle? That this person exists, and they’ve consented to hang out with you? Having kids is, at its best, 1000x better than that. Theo was sitting on my lap, clapping at the end of every song and saying ‘another song?’ and I felt like my heart was going to burst.
We didn’t get home until after 10, which we’ve never even attempted before. He negotiated a couple extra stories, which seemed ridiculous because it was 10:20 by that point (inhaler, tooth brushing, offering him the potty, etc.) but then he jumped off my lap and marched to bed as agreed and I haven’t heard a peep. I am just so proud of him. He held it together the entire time we were there, the entire way out (it was a little walk) and the journey home, and then he was almost exclusively perfectly behaved once we got home.

We went to the festival Friday-Sunday last year, and while nothing was quite as magical as that first day, I booked our family tickets as soon as they became available this year, ready for Round 2.

So naturally Theo didn’t give a shit about the festival this year. He loved the ice cream van, and he loved the trampoline in the children’s area, but the actual music he could take or leave.

This year, though, the festival was very good for me. Ian took Friday off work, and so I was able to cycle over to see the She Shanties on Friday – an all-female sea shanty group. I love sea shanties (really. I love them.) so I made a special trip and stood surrounded by old people and teenagers, yet all by myself. The music was lovely. Later that night, I went back and met up with friends for the Indigo Girls. I sang Galileo and Closer to Fine and the Wood Song. I felt like a person with a life.

We hauled our kids to the festival all four days, too; it wasn’t just me sneaking out for an hour at a time. Theo was indifferent to the music but I loved being there. More than that, it was significant that there was an ambitious thing we wanted to do – go to a music festival – and we had done it, with minimal drama. The girls were great, the weather was marginal, Theo was disinterested, but I had a great time, and I felt like I’d taken a significant step forward as a parent of three children.