Around 24 weeks pregnant I started to feel funny and suspect something wasn’t quite right.

I met my husband Rob in 2012, in Washington, DC where I had been living after college. He came to the US for a work assignment and moved into a shared house I was living in so we technically were roommates before we started dating! I definitely got a few warnings from friends to not get involved with a roommate but I would say it all worked out in the end.

We lived in DC until 2014 when we moved to Haarlem, The Netherlands for the next phase of his project. We loved living in Haarlem and got married in 2015 in the UK on his parent’s farm. In 2016 we moved to Antwerp, Belgium and decided it was time to try to start a family since we were living in a house right across from the local hospital it seemed silly not to take advantage! We were surprised when I got pregnant after 3 months of trying. I was assuming it would take about 6-12 months since a lot of people told me to not expect anything quickly.

We decided to tell our parents at Christmas - I was only 6 weeks pregnant so very early but Rob’s father was sick so we wanted to make sure he got to hear the news. I also was adamant about telling my family in person so Rob booked me a flight from Belgium to Philadelphia over New Years to tell them. I also started having morning sickness quite early on and flying was not the most pleasant experience, but it was worth telling my family in person since I didn’t want them to miss out on that experience.

The real surprise came a few weeks later when it was time for my first scan when we found out there was not one but there were actually two heart beats! I was in total shock and cried hysterically when I heard the news. The real fun was calling our parent’s after the appointment and letting them know they would be getting not one first grandchild, but two! I think I was in shock myself the next two weeks, it just had not been on my radar at all that we could have twins and in my head, I was already planning for one so skipping right to two babies was quite the curveball for us!

I hate to say it but since its my story, I will... I hated being pregnant! I was sick, everything ached, I was so tired and then couldn’t sleep at night. I was too uncomfortable and tired to exercise which was difficult since I was previously such an active person. I also had to pee all the time! I couldn’t even go on a walk without having to pee every 20 minutes!

I know I sound like I’m just complaining a lot but really the reason my pregnancy wasn’t all sunshine and rainbows was because around 24 weeks I started to feel funny and suspect something wasn’t quite right. I had had some heavy spotting the week before when we had been the UK for my father in law’s funeral but upon a check up when I was home, the doctor said everything was fine. But a week later I still didn’t like the way I was feeling and I felt as if I was “leaking”. I decided to go into the doctor again and she checked the fluid I was leaking and during the appointment she was still upbeat and reassuring me nothing would be wrong while we waited for the results. Her faced turned sombre as she read the indicator and told me that it was indeed amniotic fluid I was leaking and I would have to be rushed to the Antwerp academic hospital since our local hospital wasn’t equipped for babies arriving that early.

I must say I was terrified – and I had come for this check by myself since it was just a five minute walk across the street. They took me to the maternity ward and started to give me injections to try and delay labour and also the standard steroid injections to help mature the twins lungs in case they were indeed born at 24 weeks. The room I was in didn’t have windows and subsequently no cellphone service so I had to get the hospital to call my husband at work – which took a few tries and eventually we got through and they told him to meet me at a hospital he had never heard of. At that point they loaded me into an ambulance and rushed me to UZA - in about 15 minutes flat, with all the lights flashing and sirens blaring for good measure. I was pretty scared now – the doctors and nurses were also only speaking Flemish around me and occasionally translating to English what was happening next which made the entire experience even more nerve wracking.

Upon arrival at the academic hospital, I was given a room quickly and nurses and doctors came to check in. Rob arrived about 30 minutes later. The doctors once again explained how in Belgium, they do not intervene in deliveries if they come before 24 weeks so we had just met the cut off by a day. (Other countries, like the US and UK, will intervene and attempt more medically with earlier births but Belgian doctors believe the chances of a positive outcome are not likely enough before the 24 week mark and do not intervene with earlier births). We also had a very depressing meeting with the Neonatologist about survival rates, outcomes, possible issues the children could have when they arrive this early.

It was very difficult to to be on our own, living in a foreign country during this experience, as both of our families were was very far away (my family lives in the US and Rob’s in the UK). We had already had a very hard month losing Rob’s father and now the 50/50 chance of losing our children too was looming. I am surprised we held it together as much as we did.

We were told that I would have another injection of steroids to help the twins lungs along and hopefully I could keep them in 24-48 hours more to get them to work to their full capacity. So I sat in that bed. Waiting. Wondering if every little twinge was something happening and blaming myself for failing my children and not keeping them safe. We got to 24 hours. Then 48 hours. Rob left briefly once to go home and get us overnight bags - funnily enough I had been thinking I should pack my “Go Bag" in the next week. It is a bit comical when you go through the bag your husband packs you in a rush - I wouldn't say that lace thong underwear was something I was going to wear while on bedrest... but we still laugh about that part today.

We made it past the 48 hour mark and the situation remained 'stable' with minimal leaking of the amniotic fluid of baby A’s sac. The doctors were getting a bit more relaxed and so we did too. I was still to remain on bed rest and just hope I didn’t go into labour. I would ask the midwives often, what will labour feel like and they would always just say… “Oh you will know".

Rob eventually had to go into work after a few days off and would come back in the afternoons to spend the evening and every other night in the hospital with me. I really hated the nights he was at home and I was there by myself. I was very lonely but I knew he needed to sleep in a proper bed at least occasionally since who knew how long I would be in there!

I made it two and half weeks – two and half weeks of daily seated showers, compression stocks, DVT injections, swabs, stress tests, glucose tests… and of course hospital food, which was 4 slices of bread and cheese in the mornings, maybe some fruit, a hot meal at midday and once again 4 slices of bread and cheese or meat for dinner (you have to love the Flemish/Dutch diet!). We were very lucky to have some other expat friends who were kind enough to come visit on occasion and bring us real food!

I think the one thing that got me through those weeks sitting in a bed looking at the same walls was a journal I kept. I tried to write something each day and I also had a chart which I made to track my time there. A friend who did a long bike race across the UK told me this method helped her. Each day I would have two boxes - midnight to noon and noon to midnight. I would check the box once I got through those 12 hours. So I checked my boxes each day knowing that extra time the twins were inside me was helping them to keep growing and helping their odds whenever they would arrive.

Eventually towards the end of the second week the doctors started to discuss the option of me going home for bedrest. Which I thought would be wonderful since I was starting to really hate that hospital room. They let us go for a short trip out to Ikea (the closest thing which had wheelchairs to borrow) for a test run on being out of the hospital. Rob wheeled me around Ikea and we ate Swedish meatballs for lunch. It was heaven.

The doctors let me go home a couple days shy of me being 27 weeks. I slept in my bed and would then come down and lay on the couch during the day until Rob came home from work. I had one scan just after 27 weeks and everything looked ok still but I was to keep taking it easy. That Saturday, I was starting to feel very achy in my back and was complaining a lot that night to Rob about it. I couldn’t really sleep since my bad hurt so much - the only thing that helped was laying on pillows on the ground. The morning after I had spoken to my Mom she mentioned I may be having back labour and once looking it up I decided we should probably go to the hospital – but wasn’t sure if it was serious so I went to my old hospital across the street again. They did a quick check and confirmed I was 5 cm dilated! Apparently “you will know when you are in labour” is not true for everyone!

Once again, I put into an ambulance and rushed to the teaching hospital since I was at 27 weeks and 6 days, so still couldn’t deliver our local hospital. They gave me the steroids injections again and this time another injection that made me feel like I was burning up. I remember being so hot and wondering if I was going to die from overheating on that stretcher in the ambulance. Eventually the heat went away as we arrived at the hospital and I was checked back into my old room. It wasn’t long though in that room and they moved me then to the delivery rooms and told me we would wait it out in there and to expect to have the babies that night. I honestly didn’t really feel like I was in labour like you see in the movies. I would have a few waves of cramps (like a period) but then it would go away and then I went to the toilet to pee and my water full on broke, like soaked the floor!!

We alerted the midwives and they alerted the OB and Neonatologist to be ready once I got to 9cm. They checked me when my water broke and I was at 7cm then so only had a few more to go and at that point I actually felt proper contractions, but it wasn’t long until the doctors came in and said they would have me push soon. I didn’t have an epidural since I had gotten to 7cm I didn’t think I needed one at this point. They then told us I could try to push since my daughter was head down and engaged. I gave 3 pushes and they told me she was stuck. Then the doctor tried to manually turn her – which was way more painful than all the contractions I had had put together. The doctor said I had one more chance to push and if she didn’t come out I would have an emergency C section. I gave one push and no luck.

The doctors worked fast then and told us quickly there would be two teams - one for each baby delivered. And I was quickly wheeled into the surgery suite. Rob had to watch from behind the glass in the room next door, but he would get to see the babies in that room once they arrived. I remember watching the nurses swab my stomach with iodine and I asked them if they would put me under before cutting into me. They laughed at my question but it was all happening so fast I honestly wasn’t sure! Next thing I knew I was out and I woke up what seemed like 5 minutes later. But back in my old maternity ward room- which I had spent those previous weeks in. I was very loopy and they told me it was from the morphine. I asked if the babies were alive. They said "yes" and that my husband was down in the Neonatal ward with them.

The room was dark since it was 4 am and I let myself drift in and out of sleep until Rob came in around 5am. He said the babies were stable but the doctors were still working on them. My boy was getting assistance breathing with CPAP and my little girl was intubated and on a ventilator since she suffered more during the delivery. She basically was trying to come out ear first and they even thought she had a broken leg from delivery and a black and blue face from the doctor attempting to turn her during the delivery. They both weighed 1050g which was hard to comprehend before I saw them.

A few hours later, after a bit more sleep, the midwives came in and asked if I would try to breastfeed and would be willing to express in the mean time. Yes, was the answer and they promptly set me up with a hospital pump and started showing me how I could harvest some colostrum. Unfortunately, nothing was really happening for the first day. Since I was in theory only 28 weeks along and my body had just had major abdominal surgery to remove the twins.

Next thing was asking to see the twins and naming them. The doctors had asked when they were delivered if Rob knew their names yet and he didn’t want to choose without me so waited. Their names at the moment were “Jongen Eato” and “Meijse Eato”. We had a few names ideas going into it all but hadn’t decided for sure. We chose Olivia Jo and Oscar George (after Rob’s father). The midwife and Rob wheeled me down to the neonatal unit - in my bed - since I wouldn’t be able to try standing up for another 20 hours still! Once downstairs they showed us to a large room with two incubators and two of the tiniest little babies I had ever seen inside. Up until that point in the day I didn’t feel like I had given birth yet and having not seen them I didn’t feel a connection yet. But then I finally saw them and I cried. Oscar was doing better of the two of them and only breathing with CPAP so they let me skin to skin with him. Which was such a wonderful experience but I was also terrified due to all the wires and tubes coming off of him. I wasn’t able to hold Olivia that day since she was intubated and on a ventilator still but stable enough that I could reach through and touch her hand.

That night the nurses told me to rest and not worry about attempting to express but I was to start in the morning. Every 3 hours. I woke that morning feeling like I was hit by a bus. A C-section is really no joke. I was not prepared at all for the recovery portion and even sitting up in bed was a huge effort. They eventually removed my catheter that morning – I admit it was kind of nice not worrying about using the toilet since after that point getting up out of bed was so very painful, but it was my goal to get moving a little bit each day so I could eventually walk myself down to the Neonatal floor.

I would have to wait for someone to take me down to the Neonatal unit in a wheelchair for the time being and that feeling of wanting to be downstairs near your babies was so overwhelming. I was so upset even being upstairs that far away from them. I would call down to the unit every hour or so in between my visits just to hear the nurses say they were doing ok. Luckily, that second day Olivia came off the ventilator and onto CPAP, but Oscar took a turn that day breathing-wise and they decided he needed to be on the ventilator.

This would be the beginning of a very long “one step forward and two steps back” with their breathing. Obviously, they had been born so early that their lungs were still not even close to being fully developed so they would need assistance with their breathing for many weeks after that. Oscar came off the ventilator a day or two later and Olivia remained on CPAP for a few more weeks. Oscar was on CPAP and varying levels of O2 for 7 weeks and the doctors wouldn’t let us leave and transfer to our local hospital until Oscar came off O2.

I was allowed to stay in the hospital for 5 nights after my C-section (thanks to Belgian health insurance) so I obviously stayed the full time knowing once I went home it would be without Oscar and Olivia. The day I left, a Saturday, was probably the hardest day of my life. I cried in the hospital, the whole wheelchair ride to the car, the entire way home and probably most of that night. I think I only stopped the next morning when I was finally back at the hospital again to spend the day there with my babies.

This was now June 3rd and Oscar finally came off O2 on July 17th and the twins were transferred to our local hospital on July 20th. They always told us “white boys” struggle the most in neonatal units and this was definitely the case for us. Olivia did well with her breathing after only a couple weeks and was only on the occasional flow of air through a nasal cannula for a long time before Oscar caught up. However, as hard as I found our time in this unit there were definitely more devastating stories than ours. I became friends with a few families there and not all of them were able to bring their babies home in the end. Those days were so hard to witness.

On July 20th, 7 weeks after O&O were born they were transferred by ambulance to our local hospital, which I was so very ready for. I knew they were one step closer to coming home. The goal at this hospital was to teach them to breastfeed and make sure they grew a bit more. They told me to expect them to come home around their actual due date. So in my head it was difficult to think it could be another month of hospital visits but at least it was only a 5 minute walk from our house to the door of the neonatal unit. Infinitely better than a 30-40 minute drive, which is how long it took us to get to the hospital where they were born to visit every day.

I had decided early on that I was going to try my very hardest to breastfeed both of them exclusively for as long as possible, but I didn’t really get a chance to make any decisions about breastfeeding or do any reading about it. I always assumed I would attempt to breastfeed but also I knew I was having twins and wasn’t going to beat myself up to exclusively breastfeed them if it didn’t work out. I had a friend who had a baby 5 months prior to me having my twins and she was very pro breastfeeding and I did learn a lot from her in those months and knew I would give it a good try. 

Unfortunately, my birth experience was not as I planned or expected. Since my twins arrived almost 3 months early, my breastfeeding journey began with expressing for them while they spent those 11 weeks in hospital. 

I actually received a ton of support at the hospital where my twins were born. We were living in Antwerp, Belgium and had given birth in the teaching hospital which could accommodate their young gestation. Even just hours after waking up from my emergency csection the midwives on the recovery floor introduced me to hand expressing and using the breastpump to stimulate my milk to start coming in being the babies were too small to be put on me. They also had a neonatal midwife who was also a lactation consultant and she spent a lot of time with me those first few weeks coaching me how to up my milk supply for the twins.

She had a bit of a tough love approach but I also made it quite clear I didn’t want to give formula so she pushed me hard to keep expressing, staying hydrated and doing as much skin to skin possible once the twins were stable enough to hold. The step down unit we went to after the teaching hospital was not as pro breastfeeding since their goal was to discharge babies as soon as they could feed on their own and bottle feeding was easier in their opinion. They also often told me I wouldn’t be able to breastfeed twins exclusively. The other hospital had warned me of this before we left so I at least went in to their unit quite strong willed and determined to breastfeed both my twins and come home with them.

We did have to use some bottles at that hospital in the end, as they simply wouldn’t let me not use them and my son had a tongue tie which hindered things a bit. I was exclusively breastfeeding my daughter when we were discharged and breastfeeding my son about 50/50 of time and bottle feeding expressed milk. Once we got home the home visitor assigned to me immediately the first day set me up on the sofa to try tandem feeding. She kept working with me, showing me different holds and strategies for helping my son catch up to my daughter. Looking back I think I was very lucky to be given so much support without even seeking it out. The Belgian health system was top notch in my opinion and I am grateful for all the support I received. 

I expressed for my twins from their birth until about 2 months after they came home from hospital so about 5 months. (I really grew to despise expressing so was happy when I came to the decision to stop) I was also breastfeeding them from about 2 weeks prior to their discharge from hospital until they were 11 months old. After 6 months we began weaning and I also ran out of my frozen expressed milk so I started to supplement with formula. I would breastfeed first thing in the morning, at lunch time, and before bed and supplement with formula for any extra feedings they were asking for. I know I could have continued to exclusively breastfeed but for my own sanity I needed the breaks in the later morning and afternoon.

Tandem feeding is tough since you often are stuck on the sofa for hours at a time as they will feed then fall asleep - maybe one wakes and feeds again and you would be stuck under two babies! By the time they were 11 months I was just feeding them at bedtime which was my favorite feeding time. In the end, I combination fed them since we did every method really at one point or another.   I used the breastfeeding website quite a bit for late night googling and I joined a Facebook group specific to breastfeeding twins that is UK based which was really helpful.  It is very pro-breastfeeding but still supportive to Moms who choose to combi-feed. If anything, it’s a place where you can see firsthand that breastfeeding twins is definitely possible despite what some doctors and midwifes tend to say. It was such a lovely group as well since you could post your accomplishments for how long you breastfed for and generally was a very supportive group. I definitely wouldn’t have fed the twins as long as I did it it wasn’t for that group. I think our biggest successes came from the one-on-one support I received for learning to hand express and breastfeed. If anyone is very serious about breastfeeding and feeling like they are not getting the support they need you can reach out to groups like La Leche League or find a registered IBCLC (lactation consultant in the UK) to get more face to face support. 

I started to really hate expressing as the weeks went on. I felt it was time I would rather spend with them- holding them. But I was still determined to give them only breastmilk for as long as possible. Olivia was a little champion eater we discovered early on and actually latched fairly easily (around 35 weeks equivalent) but on any given day would maybe be sleepy and not each much from me. Oscar was a whole different baby and was very difficult to latch. The nurses and midwives luckily determined early on that he had a pretty severe tongue tie and we had to have it clipped twice since the first time wasn’t enough, poor little guy. Towards the end of our stay at the local hospital it was just Oscar that was preventing the doctors from discharging the twins. He wasn’t eating consistently enough from me or from a bottle for their liking to get his NG tube out. So I had to keep expressing. I was breastfeeding Olivia every other feeding now and would try Oscar each time and the nurses would cut me off with him after about 10 minutes if he wasn’t taking anything on. I would have to leave and go express to have enough milk for him later on.

Reflecting on our time in the hospital we didn’t have any really big scares with Oscar and Olivia’s health but it was hard work each day trekking to the hospital- bathing them both, dressing them, weighting them, changing endless amounts of tiny diapers, expressing/breastfeeding every 3 hours, and still trying to get some skin to skin time each day with both of them separately. I felt like the schedule the nurses and I had created left me with barely any time to eat or use the toilet. At times Rob and I would argue, mostly since I was so exhausted. He would tell me to skip a few hours at the hospital and that the nurses would take care just fine and I needed more breaks. He was probably right but to me I just couldn’t stay away from them. It was the most primal urge I have ever experienced.

Being a NICU parent is hard work and so emotionally draining. You gave birth to this/these little baby/babies and they are just so helpless and small you want nothing more to be there for them as much as humanly possible. To me all I wanted was both Oscar and Olivia home with us as soon as possible. I was so convinced it would all be easier at home.

On August 12, 2017 we brought Oscar and Olivia home. I practically ran the stroller out of the hospital I just wanted us all to be free of all that clinical stuff!

However, since they were born so early they did mandate we bring them home with apnea monitors. They did have many alarms the week before they were discharged so I wasn’t too concerned but I will say it was so nerve wracking those first couple weeks at home. Any time an alarm went off I would run over to check them or jolt out of bed if I was lucky enough to be asleep for a moment. Olivia stayed on her monitor for the minimum period of 6 weeks and Oscar needed to stay on his longer- until just before Christmas that year.

Oscar and Olivia also had and still have chronic lung disease due to being on oxygen for so long while in the hospital. We kept them away from people through most of our first winter since I was so afraid of them getting sick and having to go back into the hospital but we were lucky that none of their colds every progressed that far. We were lucky enough to qualify for the RSV shots over the winter months as well which probably helped them to stay out of the hospital.

Last summer, everything was a blur. So much time spent in hospitals and then once we brought the twins home. Those first couple months were a blur as well as most twin parents are familiar. You just get through one day at a time but its hard to say what you did to pass your days since you are so sleep deprived.

Both Oscar and Olivia are doing very well for how difficult the start of their life was, we have traveled with them many times, including to the US to see their grandparents and family and just after they turned one we moved from Belgium to Scotland. They have adapted to all the changes so well. Maybe even better than me!

Oscar and Olivia are now 3 and doing so very well. We are so grateful that they are here today and its possible we will eventually forget about the hardship of that first summer but I hope that in sharing our story, other families who's children are born prematurely will find some hope in hearing, while incredibly difficult, NICU journeys can have happy endings.

Ellen - Mom of Oscar & Olivia - Edinburgh, Scotland

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