Monday, March 17, 2014

Pregnancy Bed Rest

Twin pregnancy was the most exciting yet fearful 37 weeks (and one day!) of my life.  The first month I scoured the internet searching for anything and everything about twins (and babies) in general.  Finding out I was pregnant put me into panic mode and every pain in my belly, or cramp, or cough (seriously) made for a second guess and a quick Google search.  Soon after reaching that 14 week mark and graduating to the second trimester, I gained confidence in myself and my pregnancy.  FREEDOM.  Finally.  

At my very first appointment with my OB I was given a large packet and a laundry list covering everything from what to expect, safe pregnancy, and finally, expectations as a patient. These expectations didn't come as a complete shock to me when reading through them with Dr. Walsh looming over my shoulder.  I had already been a patient of hers for a couple years, so I knew her conservative nature.

"I've had a tremendous amount of successful twin pregnancies, but you have to trust me and follow my lead.  At 24 weeks you can expect to stop working because I am placing you homebound to the end of your pregnancy.  If you don't agree with this recommendation you should go ahead and find another OB to care for you through the remainder of your pregnancy."

Well.  Ok then.  At 10 weeks I obliged to this request and began to make plans to stay home starting at 24 weeks.  To be honest, around 20 weeks I was counting down the days.  At that point my lung capacity was significantly reduced and when you basically talk for a living (I provided nutrition counseling as well as spoke at public events) it was getting a little tough.  I was so exhausted by the end of the day.  

Finally!  24 weeks had arrived!  I was given instruction that I was able to be up and move around a bit, but for the most part I was supposed to stay off my feet. At my 24 week appointment I "passed" with flying colors.  "You have a cervix of steel."  My cervix was measuring 4+, which is awesome, especially since at that point the girls (together) had added another pound of weight to that belly I was toting around (I was at a 5+ at my 20 week appointment).   

Fast forward two weeks. 26 weeks.

I walked into the office like it was any normal appointment.  My belly was measuring 37 weeks- that's 4 cm larger than the 2 weeks prior.  Clearly I was growing at super high speed.  First stop was always getting a sonogram to check my cervix and then getting a peek at my beautiful growing girls.    I'll never forget the look on the sonographer's face.  She quietly stepped out of the dark room and left me to get dressed and meet Dr .Walsh for my exam.  After reviewing the results of my sonogram, Dr. Walsh observed some significant funneling due to the weight of carrying two babies.  My body was clearly preparing for delivery and it was way too early for that. I had been having mild contractions causing the funneling to occur (I didn't notice or feel them).   She prescribed Procardia (a blood pressure medication that is also used to prevent preterm contracting) and I was placed on strict bed rest. Walking into the appointment that morning I was nervous, but the anxiety was due to me taking my initial glucose test, not because something was going to be wrong with me.  My cervix was still measuring 3+ (which is a positive!) but in just two weeks it dropped from a 4+.  My OB was confident in my cervical length--it was the funneling that had her concerned.  

I was just so sure all was going to pan out perfectly.   I was going to reach 37 or 38 weeks without a problem due to the simple fact that we had left every appointment leading up to this being praised for how well everything looked and how well I'd been carrying these babies.  How naive and ignorant I felt in that moment. So many emotions. How could this have happened when just two weeks ago I had "a cervix of steel'"? 

Bummed.  Defeated.  Sad.  Wrecked.  Disappointed.  Helpless.  Fearful.  Tearful.  Angry.  Confused 

I cried nonstop for three days.  Even though, according to my OB, there was nothing I could have done to prevent this.  I know this was the case because I asked, more than once. The weight of what would be a full-term singleton and having at least 11 more weeks to go was too much for my body to handle.  Simple gravity had taken its course.  After three solid days of laying in bed I went for my follow-up appointment. The funneling had significantly reduced--it had even had started to close--and my cervical length increased from 3.0 to 3.2. I could have hugged the sonographer's neck when she explained the image we were viewing on the screen.  While all of this was well and good, I was still not in clear waters.  The following week I started bi-weekly Non-Stress Tests (NST) which determined if and when I was having contractions because I couldn't feel them.  I remained on Procardia once a day and was sent home with continued orders for strict bed rest for the next 11 weeks.  I had 20 minutes a day allotted to be "on" my feet.  Usually that 20 minutes was used up for a shower, which was the highlight of my day at that point.

I was praised and pitied for being on bed rest for so long, but to be completely honest I would go back and do it all over again.  I wasn't sure which I preferred... not physically working, cat-napping all day, or watching Law and Order marathons on USA.  I had terrible insomnia starting at 24 weeks so I wasn't sleeping at night at all (my children loved a good dance party at 3:30 am). Catching up on sleep during the day was welcomed with open arms.  Ultimately I decided who cares if I couldn't drive, make my own food, take a shower and blow dry my hair, or even sit at the computer for longer than 20 minutes.  I relied heavily on friends, family, and, most importantly, my husband.  He did everything for me and when he couldn't we asked a close friend or his mom to help.  Without him (and them) I wouldn't have been as successful on bed rest as it all panned out to be.  

Surviving bed rest is simple.  Television and movies (I preferred childhood favorites and classics like Clueless and Pretty Woman.  Yes, Clueless is a classic!), music, and social media.  I lived on Pinterest which eventually led to my husband's demise because I had all the time in the world to make honey-do lists due to fun things I had "pinned."  Books, games, and good friends.  Having my girlfriends come over for a visit always lifted my spirits.  
At the end of the day this is not at all about you. You are simply an incubator and those babies become the most important.  I was doing the time now so my babies didn't have to do it later (with a NICU stay).  Every single day I kept them safe in my belly was three days less they would have to stay in the NICU if they happened to arrive early.  I was doing this all for them.  
Having things put in that perspective for me after being placed on bed rest at 26 weeks carried me through.  Successfully carrying them to 37 weeks and bringing them home from the hospital safe and healthy (and without a NICU stay!) melted away the time lost laying in a bed.

Listen, listen, listen, and take the advice and recommendations of your clinical team.  They know what they are doing.  Bed rest is serious business.  Don't take it lightly and you can definitely have the success I had with my little birds.  

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  1. This was so good to read! I'm still only 18 weeks pregnant with my twin girls, but I've been thinking a lot about bed rest and what it will be like if it is a part of this pregnancy. Thanks for sharing!

  2. I have a question for Amber!! You were put on bed rest at 24 weeks, how did that work with your employer? I just started a new job at a hospital in the DFW area and we are planning on our first round of IVF around June! We will be implanting 2 embryos so there is a possibility of twins! Obviously there is no way of knowing if both, if any, will take but I am trying to be prepared in case they do! I have the option of signing up for short term disability and since I am a new hire, they waive the Evidence of Insurability and I am just trying to figure out how someone with a full time job can take a leave if needed for bed rest and maternity. From what I've read an employer only has to hold your job for 12 weeks, is this true? Any help would be appreciated!!

  3. I'm 24 weeks pregnant with twins and I was just put on best rest last week as a precaution, my little girl was born at 34 weeks. Your blog gives me hope that I can make it through this, what did you do to keep your self busy while on bed rest?

  4. Hey ladies i just found out im 12weeks pregnant with twins and my husband just started his job corp program so he cant be there during our pregnancy and i already have two young children any advice for a mom of multiples and soon to be twins?