One Little.

Sunday
Sunday night the babies were super active. I had Braxton Hicks contractions again, but the girls were so rumble tumble that I dismissed it. I even took a little video of my tummy because it was so bouncy.



The Clinic
The next morning D had off work. He made me an English muffin with cream cheese and grapes for breakfast before we headed to my Monday NST. I have so many appointments and he doesn't get to accompany me very often, so its great when he can.

We got to the clinic, climbed the stairs and checked in. When the nurse called me she was as friendly as ever. We smiled and spoke and she commented to D how great it was that I could still get around so easily. We went into the exam room and I climbed onto the table, exposed my belly, and got all jelled and monitored. She moved the wand over my tummy, starting with Baby A as usual. When she got to baby B she paused and excused herself. She came back with my doctor. Something seemed wrong. My doc, who is usually chatty and friendly was all business. The mood had changed, and I was scared. I called D up from his chair and he held my hand. The doctor ran the wand over Baby B and the scan was so still. She shook her head. She was crying. I didn't understand. The nurse was crying. The doctor looked at me and plainly said: There's no heartbeat.

Another doctor came in. Everyone in the room was crying as D and I stood there stunned. I was so confused. I asked what it meant, and the doctor looked at me and said, we lost her, sometimes that happens and we don't know why. She has no heartbeat, your baby is dead. Then she hugged me.
Mia Colores Russell, my daughter, half of my beautiful twins, my worry, my fighter, was dead.

The nurse came and hugged me. I looked at D and he looked as in shock as I was. All of this happened in 10-15 minutes. They told me to head to the hospital, I was going to be induced. They were all still crying and hugging me. Was I crying? How could she be dead? Just like that, no warning, nothing felt different, there wasn't a sign or pain. D and I walked to the car and I started to cry. What had just happened?

The drive to the hospital was a blur. D and I continued to cry. It was all so surreal, It had all happened too quickly. I called our family. There was so little to say. All I knew was that we lost Mia and we had to go to the hospital to induce labor. Tears flowed as I went over the last couple of days. I had just seen her on the monitor on Saturday. She was moving on Sunday. My belly had been tight, should I have gone in again? I was so aware that one side of my belly was so still, I kept poking it to make her wiggle. Baby A was still there, kicking and moving. I held both of them tight.

The Hospital
We got to the hospital in less than half an hour. I think it was 10:30 am. D parked and came around to help me out of the car. I remember leaning on him and crying. He reached around and undid my necklace and put it in the car (At the time I had a realty check: I'm at the hospital. One of my girls is dead. He has to take off my jewelry because I might have surgery. One of my girls is alive.). We held hands tightly to Labor and Delivery. It seemed so strange to check in, confirming things like our address and my birth date. People all around us being checked in for routine monitoring like I had two days before. There was a matter-of-factness to it all. Why wasn't I on a gurney being rushed to surgery to save her? Why was it such a simple truth? We were led to our room and the nurse was the first at the hospital to give me sympathy for my loss.

There was paper work and IV's and a whole bag of blood work. D asked if I or Baby A were in any danger (at that moment we were not). They asked if wanted a Cesarean, I asked if I could have another ultrasound. They did that first. This time I really looked. There she was, little Mia, still as can be. The space that held her heart was no longer pulsating and beating, it just looked like and empty hole, motionless.
Everyone spoke in very calm hushed voices. The doctors and nurses kept touching me, rubbing my leg or squeezing my hand. They told us there was a sign on the door to indicate loss. They kept saying things like "when there's a demise". A lot of them were also quite emotional. I could hear their voices cracking and see water in their eyes. I kept thinking, aren't they supposed to be the strong ones? They said it was unusual to lose a twin so late into the pregnancy. I think that was part of my shock too. I had spent the last six months passing milestones with my guard up and prepared for the worse. But the girls kept growing and doing well. I got passed the testing, the viability date, and the big huge 36 weeks. Even the docs reassured me that after 36 weeks there was almost a guarantee of safety. Mia had even turned so my ideal birth was in focus. I had let out my breath and felt safe and confident. I had let my guard down. We were all wrong.

I had to change my focus to Baby A and her safety. I could still feel her moving inside me. My rock star still had to be born. Was she aware that her sister was dead next to her? Was she ok, would she be? Would she know that she was a twin? Could I make her feel special and not lonely? Would she forgive me for being an over-protective mother from here on out? So many worries.

We had to make a decision, C-section or Induction? None of this was going as planned or hoped. C-section or Induction? Induction.

Induction
The first exam revealed that I was 3cm dilated and 50% effaced. They started me on a Pitocin drip. Everything I'd seen or read about Pitocin prepared me for contractions that would be false and stronger. I was determined that I could still do it without pain medication. I just had to focus and relax my body. I also had to come to grips that I was limited in movement. I wasn't allowed to walk farther than the bathroom, and even when I did that it was accompanied and they measured my urine.

People kept coming in and out. New nurses. Doctors asking if I wanted an autopsy. People asking my pain level (which was still a 0). The social worker informing us of our options. (Did you know that if you choose cremation through the hospital they keep the remains? I didn't ever wanna know that). My brother in law came by with our hospital bags. Friends started to drop by to lend support (the thought of company seemed overwhelming to me at first, but they helped keep me focused on labor instead of loss). The shifts changed and I met new nurses and doctors. The second nurse wrote the girls' names on a dry erase board and under the first baby she drew a smiley face, under Mia's she drew a sad face. In between the people I watched the heart monitor on Ripley and how she reacted to each surge. We all watched. When I turned my head I could see pine branches outside the window swaying in the wind, the world was still spinning.

My mom and auntie arrived from Arizona around 10pm. I was only 4cm and 80% effaced. The Pit was up to a 16. There were two doctors on the night shift. One was pushing the epidural and the other wanted to manually break my bag of waters. My body felt like it was all wrong. Everything felt forced, it wasn't time to labor yet. I tried to help by standing and moving my hips, and by bouncing on a labor ball. The contractions were getting very strong. D lightly tickled my neck to help me through them. The doctors kept coming in and were insistent. They said if I let them break the water my hormones could help the Pit speed my dilation. Finally, around 2am I caved. The doctor placed her hand inside me (which was already painful because of the contractions), and then inserted what looked like a crochet hook and started scraping around. Not pleasant. After a minute or so there was a gush of liquid. My insides were achy. The doctor was pleased.

After that things got harder. I felt delirious. My body was so exhausted from grieving all day and now there was only pain and the moments in between to catch my breath. There was also a violent shaking. Before that I could breath and relax my muscles, but each shake seemed to tense me even more. Everyone in the room tried to help me. Massaging my back and hips, holding my hand. D lent me his body so I could lean and rest. I hit my first wall. I asked for non-spinal pain control options and the doctors took that as a cue to start their campaign. They explained that since I was still at 4cm they were going keep the Pit around 20, they also said that when it was time to birth Mia there "might" be a possibility for way more pain if they had to manipulate her into the birthing canal at all. They said the Epidural would help me relax and allow me to rest. I was so tired. I looked up at D, and he said he'd support any decision. I could see his worry and his exhaustion. The doctors looked so eager and determined. I gave them the ok.

Saying yes to the Epidural absolutely defeated me. I knew that the labor was now completely out of my control. Everything went into motion after that. The anesthetist came in so fast I swear he was waiting outside the door. The room cleared so D and I could face it together. I was so disappointed in myself. I sat over the edge of the bed and leaned against him crying. The contractions were still terrible and the shaking was making it scarier. I have met three people who spoke about Epidural side affects. From spine pain to headaches and pelvic ache. How could a giant needle go in accurately if I was so shaky? The needle went in and I tried to breathe. There was instant pain in specific areas. I was also having a really strong contraction. I asked the guy to stop, I begged the guy to stop, I looked at D and he told the guy to stop. I could hear the irritation in the anesthetist's voice. He said the faster he could go the sooner I wouldn't have pain. I took the moment to breathe through it and gather myself before him continued. By the time he taped me up and finished I felt like I didn't have any fight left in me. D laid me down and the nurse informed me that I was now officially bedridden and she would have to insert a catheter. I gave into it, and in some time I fell asleep. It was about 4am.

Labor
When I woke up the room was dark and quiet. There were four people sleeping around me, D, my mom, auntie, and our best man. They had all stayed up with me, so once I fell asleep also took a break. It felt so nice to have things quiet. I could only hear the soft heartbeat in the background. It was still dark outside. The doctors came in to check me again and I was 10cm dilated, 100% effaced and at a station 2. It was time to push.

My final nurse came on shift. Theresa. She was great. I was tired and sore, I had spent the day before crying and I had only had ice chips in almost 24 hours. She was the perfect combination of sympathy and encouragement. The new doctor came in and Theresa was so excited that she was on shift that it eased me. The sun came up and I could see the Pine branches again.

I started pushing around 9am. I was no longer in pain, but the whole positioning was awkward. D was on one side and my mom on the other. Their arms created my stir-ups as they lifted my feet and bent my knees in towards my head. With each contraction I had to grab onto the back of my thighs and put my chin to chest as I tried to push the baby out. Even though it felt like I was pushing with every muscle Theresa said I needed much more. Eventually I asked if I could try different positions. I tried pushing lying down, but it felt like I needed gravity. The nurse put up a bar and I tried to lift myself into a squat, but with the Epidural my legs weren't any help and my arms could only support me for a couple of tries. All I wanted was a stool or something to sit on so I could push downwards.

I went back to the stir-up position when I began to feel a pain in my leg. I hadn't used the "gimme more Epi" button because I didn't want to interfere with the Pit. I could feel the contractions a bit, but just enough to know when to push and go with it. The leg pain came with the contractions. Suddenly like a charlie horse. It circled my hip and shot down my thigh. I felt that if it was a muscle cramp I could stretch it. The next thing I knew I was on all fours on top of the bed trying to push and stretch all at the same time. The pain was suddenly searing. I lost all focus on everything. I couldn't push, I couldn't think, with each contraction the room would go white, I know I was moaning, I may have been yelling. The shakes came back. They thought the baby's head may have trapped a nerve. D told me that all the doctors and nurses looked perplexed and concerned. He also said it was then that he was afraid that he might lose all of us and he'd have to go home alone. They called in the anesthesiologist (who Dan now refers to as "the Bozo" because he spent a lot of time just watching me and discussing the situation with his assistant). I was writhing. . He adjusted my catheter and gave me more medicine. He also put the Epi button into my hand and told me to use it more often.

When the meds kicked in I rolled onto my back again. I had hit my second wall. I was so exhausted. Even though the babies' head was visible I didn't think I had it in me to continue. I felt like even if I could have managed to deliver the baby, the fact that I had to go through the same process again with Mia was heartbreaking. I have never before felt so hopeless. I rolled on my side and stopped pushing. I looked at D and said I was ready for surgery. He was so encouraging, he said I was so close and that I was strong and he had faith in me. Theresa was a cheerleader, telling me that she had every confidence that I could do it on my own. She called the doctor in.

For 9 months I have been hearing Cesarean for twins. C-section, C-section, C-section. My nurse's favorite doctor came in and said that I could have a surgery if I wanted to, but then she began to tell me all the reasons why I shouldn't. The conversation is a blur, but I remember thinking that everything she was saying was what I believed in. I knew why I shouldn't have surgery, but I didn't know if I had anything left. I now think of her as my shining ray of light. She removed everyone from the room, dimmed the lights and let me rest of 20 minutes before I had to make a decision.

Birth
I woke up in a daze. The nurse came in and I quietly said that I would push. I had no energy. I bent my knees and she called in for people to help me raise them, but I said no. I let the waves pass over me and pushed when I could feel them. In between I went back to sleep. D was so worried, he'd ask, "Are you still with us? Stay with me." Then I'd push again. Slowly, calmly. It was all I could muster. Eventually my strength began to regenerate. Everyone started cheering me on again. I was back into the stir-up position and my pushing got better. There was only one time that I lost my temper. Everyone kept saying "you're almost there!" and every time I moaned D would empathize and say "I know, I know". After a couple of hours of this I finally said "You're all lying to me! I'm not almost there, you've been saying that forever. And D, you don't know anything!". That one moment has given my family the only inside joke from the whole experience.

I pushed for 5 hours before the first baby came out. Ripley Mia Russell was born around 2pm on Tuesday. The poor thing had been stuck in my canal for all that time with the cord wrapped around her throat and but was fine. My rockstar. They put her on my chest and I held her. Too spent to cry I just looked at her, not wanting to let go. That is, until the pain came back.

The last doc I had on shift was very calm and quiet. She stood over me almost meditatively as Mia made her way down into position. I was so achy and tired. The movement was uncomfortable but not too painful. Then the leg cramp came again. It was just as bad as before. Nurses were handing me the Epidural button to push. The head charge nurse, Connie, called for the anesthesiologist again. When an anesthetist came instead she was not happy. I lay there listening to the commotion and grabbing my hip while D tried to massage every spot on my leg I pointed to. Finally the guy gave me a narcotic since Mia was beyond harm. No name to the drug - just narcotic. It took a few minutes, but the drug finally kicked in. The pushes seemed much easier, and since there wasn't any risk everything was more relaxed. There weren't any monitors, just the sound of the room and my blood pressure cuff (which after two days had left quite a few welts on my arm). After just an hour Mia came out.

They handed her to me right away. She was exactly like her sister. But she was so still and limp. A part of me had been holding onto a last shred of hope that she really was ok. But she was spiritless. I filled up with grief. I would never know her beyond that day. We would never know how special it would be to see the girls grow up together - little mirrors of each other. I stroked her little hands and feet, looked at her little lips and cheeks. She was perfect. How could someone that had grown so well against lots of odds just fade overnight? I didn't understand. I don't know if I will ever understand.

The charge nurse went beyond duty that evening. After I had handed Mia to her she cleaned her off and dressed her. She left her in a bassinet so the many visitors could see her and she could be real to them as well. She also took lots of pictures of her and made us a memento box for us to take home. It was the kindest act.

****************************************************

It has been a week since we were told Mia had passed. Ripley is so beautiful and amazing to me. I am worried about her safety and very much aware of fragility. I have already apologized to her since she will be completely overprotected. I already find myself spoiling her more than I would have ever allowed myself if there were two.
Its difficult to be filled with joy and sorrow all at once. All we can do is give all our love to Ripley and let the tears come when they do.

-drea

Ripley Mia Russell, born December 6th, 2011.

https://open.spotify.com/track/3iHJm7dUroZYvbqrhobLZs?si=77169e1468134e0d