[TW: This article discusses the complications of MCDA and may be triggering for some readers.]
6th February 2020… a positive pregnancy test!! To some, this would be such an exciting, happy time. For myself however, it wasn’t.
Late September 2019 we suffered a ‘missed miscarriage’ at six weeks that wasn’t detected until I was (supposed) to be 10 weeks. I pushed for an early scan as I knew something wasn’t quite right. I kept telling my husband I had a feeling the baby no longer had a heartbeat or something was wrong. I was right. Unfortunately we lost our baby at six weeks, and had to go through the processes of waiting for my body to naturally pass the embryo.
Sadly, this didn’t happen, so after discussing my options with EPAU (Early Pregnancy Assessment Unit) I opted for ‘expectant management’. This was to take medication to help things along. This was an experience I will never forget. But I won’t go into those details.
We decided that when the time was right, we’d conceive again, and ‘if it’s meant to be, it will be’.
Fast forward to Thursday 6th February 2020. I had taken a few pregnancy tests prior to this day, all negative. But for some reason I woke up with the urge to take another. Not even three minutes passed and there it was, clear as day – the plus sign!
I called Adam at work to tell him the news. He was over the moon and reassured me that this time it would all be fine.
I’d worked out my dates and expected to be around four weeks. Because of what we had been through in 2019, I called the midwife to get her advice and all I could do was sit tight until I was at least 10 weeks.
The week after I had a heavy bleed that led me to have an early scan, and I expected this to be another miscarriage. All we could think about was going through the same ordeal as before. We sat anxiously in the waiting area and I was an emotional wreck. My name was called and in we went to see the sonographer. All I kept saying was “I know exactly what you’re going to tell me. We’ve lost the baby.”
How wrong we were.
The sonographer asked if we had any other children (I have a 14-year-old daughter from a previous relationship) and then she said “Well, you’re having another two.”
TWO! I burst into tears as she spun the monitor around to see two flickering little heartbeats, and Adam burst out laughing! Twins… This was the best news we could have been given! All the worry leading up to this had faded to the back of our minds. I still look at the sonographer’s printout now – foetal heartbeat – and more than one.
We had another appointment with the EPAU, to be told the twins we were expecting were high risk and only 1% of women can carry an MCMA pregnancy (Monochorionic-Monoamniotic – one placenta, one amniotic sac). But we were also told that this could change at a further scan should there be a dividing membrane.
This membrane was found at our 10-week scan, meaning we were expecting MCDA twins (Monochorionic, Diamniotic – One placenta, two amniotic sacs). This still was classed as a high-risk pregnancy. I would have to have fortnightly scans to make sure both babies were growing as they should be, and there was no risk of TTTS (Twin-to-Twin Transfusion Syndrome). Thankfully, everything was progressing as expected and Adam and I shared the early scans together.
Then Covid hit and I’d have to attend all my future appointments alone. This was daunting. Here we are expecting twins, all at the start of a global pandemic.
At 16 weeks we booked in for a private scan to see if we could find out our babies genders and Adam was able to attend. We were both on such a high that day, and left feeling over the moon. Two baby boys, both growing perfectly too.
The day came for our 20-week scan and again due to Covid, I had to go alone.
The sonographer did her measurements and checked all the babies’ limbs, but then noted that twin two’s left ventricle of the brain was measuring slightly under the guide. I would have to be seen by the foetal medicine team at Leeds General Infirmary.
Another week of waiting for our appointment. Thankfully this came, and all was absolutely fine, no issues with either baby at all.
I counted down each week after this, and prayed I’d make it to at least 30 weeks to give our babies the best chance.
Thirty-four weeks came, and I had my appointment with the consultant to discuss labour. Would it be a natural delivery or a caesarean? Given the risks of carrying twins after 36 weeks, we decided to book in for a C-section on Wednesday 16th September 2020. Things were starting to feel real now!
Our babies however had other plans… I started with tightening at home and called the labour ward. They wanted me in as I was classed as high risk. Again, due to Covid restrictions still being in place, I went alone whilst Adam waited in the car. I was gobsmacked to find out I was actually 5cm dilated and Adam could join me in the birthing suite.
Things weren’t progressing quickly, and my midwife Sue decided to break my waters to help the leading twin, twin one, along his way. The contractions stopped and started and then it was decided for me to have an intravenous drip to start my contractions properly. This is where it’s all a little bit of a blur, so my husband has had to fill in the blanks for me.
As I had been consultant-led all the way through the pregnancy, he was present during the labour and after pushing for over an hour with little joy, it was decided I would have to have an instrumental delivery (forceps) and an episiotomy. The only pain relief I had had was gas and air. The decision was made and things had to be done pretty quickly due to the risk of babies.
Still, only having gas and air and going through all this, I remember feeling an excruciating pain, a pain I will never ever forget. My husband still remembers my face to this day.
But with all I had left in me I pushed, and with help of the forceps, twin one was born at 3:13am on Monday 14th September, weighing a healthy 5lb 8.5oz.
My consultant at this point was highly concerned for twin two as he had a cord prolapse (the cord of baby delivered before baby), which can be fatal if not dealt with promptly. I was under strict instructions that I HAD to deliver this baby within minutes or I could end up in theatre.
Here I was again, pushing to deliver our second baby. Seven minutes after twin one was born, along came twin two. Born 3:20am weighing 5lb 12.5oz.
Both our boys had to be taken up to the neonatal unit due to their breathing. Little did we know at this point, this is where all of our journeys really began.
After a couple of hours on the labour ward, trying to get my thoughts and feelings together, I was wheeled up on to the ward. My husband had gone to be with the boys who at this point, I had only had a quick glance at after I gave birth and seen the photos Adam had taken. I still didn’t feel too great and little did I know I later would have to have a blood transfusion due to losing over two litres of blood during labour.
Adam wasn’t allowed onto the maternity ward due to the restrictions, so I was left with my own thoughts. I felt groggy, upset and alone at this point. I had no idea how the boys were or what the next plan of action was.
The staff on the ward were faultless. They called the neonatal ward for me to see how things were, and the nurses said they were waiting for me to come and finally meet our precious babies. With that, I was straight into a wheelchair and on my way to the neonatal ward.
To be 100% truthful, I didn’t know what to expect. I was nervous, excited and emotional. All I had read during my pregnancy were stories of babies that ended up on neonatal units and the pain and upset they faced.
This was supposed to be the happiest days of our lives, where we could hold our babies straight after birth and get them dressed into the freshly washed baby clothes we had lovingly packed and prepare for home. But for the next 16 days the neonatal unit become our second home.
Both Elliott (twin one) and Chester (twin two) were suffering from an infection, for which antibiotics were being administered. Unfortunately, after 24 hours Elliott’s infection markers were still on the rise and they were struggling to identify what was going on. There were consultants monitoring him throughout the day, deciding the next plan of action.
At two days old it was decided Elliott would need a lumbar puncture to rule out meningitis or sepsis. This was all too much for us and a build-up of emotions came pouring out. Luckily, we knew he was in the right place. The results came back clear thankfully, but the infection markers were still on the up, even after trying different antibiotics. Then they thought it may be his gut as he wasn’t tolerating any feeds so he was transported to Leeds General Infirmary, where they could do more tests on his gut to rule out a blockage or anything more sinister.
Transport for Elliott was arranged and he was loaded into a specialist incubator and off he went to Leeds. Adam followed whilst I stayed with Chester who was doing amazingly well.
This was utterly heartbreaking for us. Already the boys had been separated and I didn’t have the support from my husband or vice versa. To cut a long story short, he spent two days in LGI and further tests were performed on Elliott. They found out he was suffering from E. coli. At last, we had a definitive answer and could administer the vital medication he needed, and he could return to be with his brother.
Within 24 hours he was like a different baby, he was tolerating his feeds and was much more alert.
After around 14 days, the nurses were happy that both boys were making huge progress (Chester a little further on than Elliott given the circumstances) but the talks of ‘home’ were mentioned. The day we had been waiting for! Both boys were now in cots, and the feeding tubes had been removed.
30th September. It was finally our turn to walk the neonatal corridor for the last time and take our baby boys home! Both Adam and I were like Cheshire cats. Twin life was about to truly begin.
The boys are now 17 months old and are absolutely thriving. For anybody reading this either expecting twins, a singleton or who are yet to start their pregnancy journey, don’t let the thoughts of ‘special care’ or ‘neonatal’ scare you, as now for me, it was all part of our journey. I have a lot of fond memories being there and I am still in contact with Sarah the ward manager at Airedale General Hospital. They cared for our babies 24 hours a day and instilled some sort of routine. We are absolutely blessed, and I am so thankful to my wonderful body that it grew not one, but two beautiful babies at once.
Thank you for taking the time to read my story. Steph Lacey x
Steph Lacey is a wife and mother to three children – Olivia, age 14, and twins Elliot and Chester, age 17 months. As well as being a busy mum, she works part time as an insurance broker. After her experience of an MCDA twin pregnancy, she shares her pregnancy experience to bring reassurance to other couples on their own journeys.