Amy's Update: Dispatch from CPMC

Editor's Note: Producer Amy Miller, who was reporting the story on camera in tonight's 7/24 episode on premature births titled "Born Too Soon: Preterm Births on the Rise", was placed on bed rest for preterm labor 2 weeks after filming. She is at day 27 of mandatory bed rest at the hospital. In this post is an account of the prior week as well, day 21.

7/24/07 Day 27:

Well, the good news is that I'm still pregnant.

Now 34 weeks and 1 day. However, it's been sort of a difficult week. Finding the umbilical cord near my cervix last week triggered some intensified monitoring of one of the babies. They had that baby on a heart monitor around the clock, in addition to my contraction monitor. The contraction monitor is not such a big deal as it's just a strap and sensor that goes around my belly and measures hardening of the uterus, which is what my contractions entail at this point. They aren't painful and in fact, these contractions are pretty normal for a third trimester twin pregnancy. However, my contractions are pretty frequent and may be contributing to the thinning cervix, especially when the weight of two babies is pressing down on it.

So, the issue for me last week was having to keep a heart monitor on baby A. Because of the position of the baby, very low in my belly, near my hip, it's quite difficult to monitor him. I have to be laying flat on my back and relatively still. I accepted the fact that I wasn't going home for a while but when it became obvious that my already very limited movement was going to be even more restricted, I became quite upset. Thankfully, one of my perinatologists saw that I was not coping well with this development and ordered another ultrasound to confirm the location of that umbilical cord. My little boy must have known I was upset because results showed that he'd kicked that cord away from the opening of the cervix. Now we were in a much less dangerous situation. He didn't have to be monitored all the time, I got some freedom and mobility restored and they moved me to yet another room.

So now, although I'm still being carefully watched, everyone seems to feel that they understand my patterns of contraction, my cervix's rate of effacement (or thinning), my babies' patterns of moving and shifting and the things that set me off emotionally. So I have a bit more freedom. I can sit up, work on the computer, take a daily shower and someone can take me out on the deck in a wheelchair for 15 minutes a day. However, they aren't ready to send me home. Today's ultrasound showed that baby A's feet are now the presenting part- the part nearest my cervix, and his cord is right next to his feet. So, because there's still space in there for him to kick that cord back to the scary place, they're going to keep me here. At least until I get to 36 weeks and their sizes don't allow for more shifting and the cord is not at risk of prolapsing.

The babies are still healthy and doing well. I did get a little surprise during today's ultrasound, though. The sonographer pointed out that there is a bit of fluid in baby B's kidneys. They will continue to monitor it over the next weeks. My neonatologist said that the amount of fluid is still considered "normal." They had noticed this a month ago but because the fluid level was not an amount to be concerned about, they didn't mention it to me. That revelation today made me a little worried but it also made me realize that throughout this pregnancy, there has never been anything for me to be concerned about with regard to the babies health. We've all been very lucky.

This is certainly an intense experience. I'm trying my best to count all my blessings every day and take advantage of the opportunities that this experience has to offer to me. But bed rest is definitely not a cake walk. It's a lot of work; emotionally, physically and intellectually. Nearly every day, someone tells me to enjoy the rest and quiet while I can. This sentiment is has a similar effect on me as when someone tells me to "relax" when I'm upset. In other words, the opposite effect. I want to be home, with my man, preparing for the arrival of our twins and enjoying the last few weeks of life before babies. I'm getting weaker by the day as my muscles disappear before my eyes. I worry that a likely c-section in combination with the loss of strength and endurance that 6 weeks in bed causes will make it really difficult to care for newborn twins. I have these thoughts then remember that I'm strong and will get through this with the help of my partner, family, QUEST colleagues and friends. And of course, the joy of bringing two healthy babies home will instantly make all of this seem like a minor inconvenience.
7/17/07 Day 21

My mood has been pretty up and down. Yesterday, it was down. An ultrasound revealed that baby A's cord is beneath his butt, near the opening of my cervix. He's breech, with feet and butt nestled down in the cervical opening. The fact that his cord is where it is means that if my water breaks and cervix dilates, I'm very likely to have a prolapsed cord, which is an obstetrical emergency. In other words, the cord would be the first thing to go through the cervix, which would cut off the oxygen supply to the baby. SO. It's a bit of a setback for me in terms of my overwhelming desire to get the hell out of here. They had moved me to a less critical care room day before yesterday then promptly moved me back up to the labor and delivery floor today. This is my 4th room. The most disappointing thing is that they are much less likely to send me home for bedrest now. Unless baby A turns head down or the cord moves, I'm likely here until I deliver. Which could be 3 more weeks or more. I'm finding it difficult to bear the thought of 3 more weeks.

My OB is talking about having an amnio done next week to assess the babies' lung maturity. She's sort of urging me to consider delivering the babies (c-section) early if their lungs are mature enough. So that would be somewhere between 34 & 35 weeks. I feel weird about delivering them for my own convenience. But she's saying that considering baby A's cord situation, there would be more of a medical reason to deliver early. Still, as trying as it is for me to be stuck here, my inclination is to gestate as long as possible. There are a number of opinions flying around so my challenge is to take one day at a time and talk to all the docs and sort of put the opinions in the pot and stir it around before I decide to serve it up.

On the positive side, the babies continue to grow and are doing well. My cervix is holding steady at "very thin". They measured it today at 9mm. It's been about that length for roughly a week now.