CLIMB

The Story of Peanut


1st June 2005

It was Thursday 12th May when we found out that we were expecting twins but that there was a complication.

On 9th January, we had been delighted to discover I was pregnant. We’d been “trying” for no more than three weeks and felt ever so proud that we’d been so very efficient! I knew that 2005 was the year that I wanted to have a baby. I’d been suggesting it to Jeremy for a while and on Winter Solstice, he turned to me and said, “Let’s make a baby!” Little did we know that the magic of that day actually created two.

Twenty-two weeks later I was lying on a couch in a darkened room at East Surrey Hospital with gooey jelly smeared on my rotund belly.

We had decided not to have a scan at 10 weeks: We were confident of our “dates” (I have always kept a record of when I menstruate) and felt that the outcome of a nuchal translucency scan (the test for ascertaining the probability of Down Syndrome) would not affect our choices for the pregnancy. There was, of course, the temptation to see our baby “for real” for the first time but in the end decided that this was a selfish motivation and not one that benefited the babe in any way.

That was a great decision. Had we had the scan, we would have found out that there were twins, but not that there was a problem. Three months of preparing for twins would have followed before the developmental scan at around 20 weeks.

Very early on in the pregnancy, Jeremy had noticed in one of my numerous pregnancy books that in the early weeks, an embryo looks rather like a peanut! So the name stuck. “Peanut” became a part of our lives. I was sure that Peanut was a boy; a steely, determined, probably stubborn and yet wise little boy. Jeremy thought that Peanut was a girl. Either way, we didn’t mind. And we didn’t want to know until the moment of birth.

My sisters and I had all been born at home. At three years old, I had the privilege of attending my sister’s very first birthday! As she crowned, I stroked her head and said, “Hello, little one! Are you a boy or a girl?” I remember it well. I don’t remember any screaming or pain or blood. I only recall the magic of my little baby sister being born into our world.

Unfortunately I missed my other sister’s birth by a matter of minutes. I was a big girl of five by then and remember peaking through the gap at the side of the door trying to see what was going on. Of course, my mother saw me straightaway and invited me into the room. I remember lots of grown-ups around my parents’ bed and my beautiful mummy lying on the bed with my new baby sister in her arms. She had a full head of hair and looked so calm and peaceful. I was a proud big sister once again.

I’d always known that I’d wanted a home birth with as little intervention as possible. I’d seen homeopathic remedies in action when I attended the labour and delivery of one of my patients in February 2004. She’d had an emergency C-section with her last baby, who was an undiagnosed breech and so was thrilled to be able to have a vaginal delivery with no intervention or pain killers, except for a little gas and air (she said it made her feel funny) and the homeopathic remedies that I prescribed. Once again, my experience – as an observer – of labour and delivery was one of joy, love and the nature of woman working at its best.

At my booking-in appointment, I was thrilled to find out that Julie, my midwife, had been born at home herself and was very supportive of home births in low-risk pregnancies such as mine. The appointment lasted an hour and a half whilst a lovely student midwife, Jackie, took copious details from Jeremy and me – about our health, our families, our domestic situation, our work and of course our hopes for the pregnancy and delivery.

One of the questions we were asked was whether or not there were twins in our family. I recounted that my paternal grandmother Blanche was an identical twin to Mary and that my second cousins, John and Edward were identical twins. I stated how lovely I thought it would be to have twins and Jackie joked as she wrote, “Hoping for twins!”

From very early on I had a feeling that I was pregnant with twins. When I read the pregnancy books, it seemed that my pregnancy symptoms were all coming a week or two earlier than the “norm”. By the time I was nine weeks pregnant, I could no longer wear my size 12 trousers and my breasts had swelled to the size of Jordan’s! When the midwife examined the height of the fundus, I was always two or three weeks bigger than the norm for my gestation time. These things backed up the feeling that perhaps we had two Peanuts, after all. But when I imagined our future, when I envisaged how our family would be, I only ever saw Jeremy and I with one baby. So I put any thought of twins to the back of mind. I joked about it with Jeremy every now and again, but I never really took it seriously.

Within a minute of lying on the ultrasonographer’s couch, we were told that we had twins. I turned to Jeremy and shrieked! A million thoughts went through my head in that moment. Would it be double trouble or double the joy? We’d have to buy another cot, a different buggy. Could we afford the nursery costs for two babies? Can you breastfeed two babies? How would we cope? But the flow of thoughts was stopped very quickly when the ultrasonographer told us that she thought she could see a potential problem. At first sight, it looked like Twin 2 was very much smaller than Twin 1.

For the next 15 minutes or so, we saw pictures of Twin 1 on the monitor. What an extraordinary experience. It is a wonderful thing to be able to see a picture of your unborn child. The measurements were taken, the heart examined, the skin and organs all found to be intact and developing properly. All seemed to be order.

Our attentions were then turned to Twin 2. It was immediately apparent how much smaller this little baby was. The ultrasonographer spent no more than five minutes looking for internal structures but very quickly decided that it would be better for us to be referred to a specialist centre for a second opinion. We did, however, see that the heart was beating strong. I will never forget that image.

The ultrasonagrapher told us very little about the problem – only that it looked like the baby’s brain hadn’t developed properly and that she thought it unlikely that it would survive. She then left the room to book an appointment with St George’s Hospital in Tooting.

I said “Sorry” to Jeremy and burst into tears. Of course, he told me never to apologise again and that it wasn’t my fault, before wrapping his strong arms around me and holding me firm whilst our tears flooded each others’ faces. For a few glorious moments we had rejoiced in the knowledge that we had twins only to be faced with any parent’s worst nightmare only moments later; one of our babies was going to die.

A second-opinion scan was scheduled for the following Monday. That weekend was the longest in my life. We had been left with no idea about the prognosis, possible outcome, the choices we may be faced with… nothing. The scan report stated that Twin 2 most likely had a condition called holoprosencephaly. I couldn’t even say it, let alone understand its implications.

The emotions that swamped us over the next few days were completely overwhelming. How does one integrate the feeling of grief for one baby with the feeling of joy for the other? After all, we’d only wanted one healthy baby and we still had that. So why did it feel so terrible? I don’t know the answer to that question. As an expectant mother, every cell in your body and every thought in your psyche are programmed to creating, and protecting the life that is growing inside you. When you discover that there are two lives instead of one, those feelings are doubled, not halved.

Had I done something wrong? Thankfully I had a clean conscience. I hadn’t drunk alcohol, smoked, taken medication and I’d eaten more healthily than I ever thought I could! We had one healthy, developing baby so I knew that it wasn’t something I had done. But still I felt inadequate. My job in pregnancy was to provide an environment for our baby to flourish and something somewhere had gone wrong. We would never discover why.

Just a few hours after the appointment, we named the little baby Coran. It’s Welsh for “heart”. Jeremy is half Welsh and we were married in Wales. We had seen that little baby’s heart beating so strong, against all the odds. Despite the fact that we would never get to know who this person was, never know what his or her favourite colour was, never see him or her grow, we knew that we would love that baby for the rest of our lives. So Coran was the right name.

I woke up in tears every day, re-living the shock and the sadness anew each morning. If I woke in the night (as all pregnant women are inclined to do), the thoughts would rush into my mind making sleep practically impossible. Tiredness and pregnancy hormones do not help one deal with such difficult, emotional issues.

As Monday approached, my fears of the unknown grew. Would they keep me in hospital from that point on? Would they suggest an early delivery by caesarean? What would happen when Coran died? Would we have to have invasive tests or maybe even be given the option of a selective termination? These thoughts terrorised me. The not-knowing plagued me. I was preparing myself for the worse.

St George’s Hospital in Tooting is an enormous place. We arrived half an hour early and used the time walking the half-mile distance from where we’d finally found a place to park our car to the antenatal department. We booked in at the reception and were asked if we’d attended before. Nobody seemed to know or care that we’d been referred from another hospital. We were told to wait in a large, square, bare room with 6 or 7 other women – some with partners and young children – perched uncomfortably on plastic chairs, like those we used to have at school.

Our name was called three minutes before our allotted appointment time. We were led into a darkened room with a large ultrasound machine by a doctor with a soft, friendly voice. He asked, “So what can I do for you today?” I couldn’t believe that he had to ask. Surely everybody in the world knew that ours had come crashing down around us? Why did he have to ask such a ridiculous question? My logical mind cut in and I answered his question explaining that a scan four days previously had revealed a twin pregnancy with an anomaly in the second foetus.

We had decided over the weekend that we did, after all, want to find out the sex of the bigger baby. There were too many uncertainties now. That moment of birth was not going to be the joyous one we had envisaged; a moment where we delight in the news that we have a baby boy or baby girl. We needed to answer as many of our questions as possible. So we asked the doctor to tell us if he could see if it was a boy or a girl. It was a girl! “Ella”. My eyes watered from the joy of the news. It was Jeremy’s instincts that had been right on that one! I secretly knew that he’d hoped it was a girl all along.

The doctor proceeded to carry out a thorough examination of Ella and confirmed the previous opinion that all seemed perfectly well with her. There were no signs of abnormality and she was a good size for her gestational age, with an estimated weight of 482 grams.

The attention was then moved to Coran. The head, femur and abdomen were all measured. The weight was estimated at just 194 grams. For what seemed like an age, the image was left hovering over the little heart beating. Nothing was said. But something seemed wrong. We later read on the scan report that there was asymmetry and an abnormal axis in the heart.

I loved watching that little heart beating. It confirmed that Coran is very much alive. And we saw kicking too! That was a lovely moment. However long or short his or her life is going to be, even if it’s just these few weeks, we saw life there. We saw purpose. We saw so much more than a bundle of cells that had failed to develop properly.

Perhaps some souls only need a very short time in order to complete unfinished business. Perhaps the lessons that Coran sought this time round can be learnt in the womb. Perhaps this was just a trial run. Perhaps Coran is too highly evolved spiritually to need a physical life on this planet. Perhaps Coran is Ella’s guardian angel and they made a pact before incarnating to stay together in this beginning. We’ll never know, of course. But it helps us to believe that there is a bigger plan; one that we’ll probably never understand. I find it hard to believe that these things are random. Fate has dealt us this hand and somehow we will deal with it.

It was just three weeks ago that we found out that we had twins. There is still a long way to go. Every day brings uncertainty. Every twinge makes me wonder, “Is this it?” But for now we will leave Mother Nature to have her way. We have no difficult choices to make. There are no tests to be done. It is a waiting game. Every day is so important. Every day increases Ella’s chances of survival should labour start early. And every day is one more day in which we are a family of four.

6th June 2005

I feel that Coran is a girl. I think she made a pact with Ella to accompany her to the moment of birth. I am no longer afraid that Coran will pass away before the end of the pregnancy; I think she will hang on to the last minute and we will have one precious moment where we will look into her eyes before she moves on. We will honour her life, even though that life only existed inside my own body. For that I feel so privileged. She is so much wiser than me. It is not for me to teach her, as is the normal expectation of a mother. Rather, it is her who is teaching me. She is teaching me to accept what life offers you and to find beauty and peace in the hardest moments. She is teaching me to live in the moment rather than allow one’s anxieties to cloud the reality of the present. She is teaching me to open my heart, to unblock my emotions and to feel like I have never felt anything before. She is teaching me to love, respect and cherish those who I have around me, especially her twin sister, Ella, who has had such a special beginning.

I even wonder if perhaps Coran has been around me before. Perhaps she has already tried to teach me all these things but I was unable, or unwilling, to hear her. Only by incarnating in a little body that will never be able to survive outside my womb, was I forced to face the lessons that she is able to teach me. It is hard. It is so very hard. And yet I know now that Coran is my angel. Coran is Ella’s angel. Coran is Jeremy’s angel. She is already an angel although she continues to live inside me. She will always be remembered. And she will always be in my heart.

9th June 2005

I read an article about the different stages of grief after the loss of a multiple. I realise that I have only just come out of the first stage; “Shock and numbness”. I had felt detached, that the situation was surreal. There were even days when I was able to carry on as if nothing had happened and perhaps even fool myself with romantic ideologies and philosophies to help me get through. The diagnosis was a concept rather than a reality.

I have now moved into the second stage; “Searching and yearning” in which I am apparently likely to seek out as many facts as I can as well as experience a longing to hold my lost baby into my arms. It is confusing. We haven’t lost anybody yet. And yet we know that this will be the outcome. I have tried searching and have found so little. There are a couple of online groups that have been a great source of support – The Centre for Loss in Multiple Births (www.climb-support.org) and Loss in Multiple Birth Outreach (eLimbo – an e-mail group on Yahoo). It has been good to finally make contact with other women who know what it feels like, even if they are on the other side of the world.

I have also become particularly aware of a very strong anxiety that I have. I think I’ve been trying to deny it and I feel guilty for feeling it: I’m terrified about how Coran – might look when (s)he is born. When I first heard the diagnosis, I had a brief look on the internet for information about this condition and discovered that it often causes facial deformities including “cyclopia” when only one eye develops. I thought it would help me to do more research. It didn’t at all. On the contrary. It has really scared me. I saw some awful images of babies with various degrees of severity of this condition. Now I’m scared that I’m going to be horrified at the sight of Coran. I feel guilty even admitting it. But it’s true and I have to admit and face this fear if I’m going to even attempt to get over it.

I’m hoping that my motherly instinct will help me see past physical appearances and that when I hold Coran in my arms, I will simply see the most beautiful little baby in the world (with the exception perhaps of Ella). But I’m still scared. No-one can comfort me. Only time will tell.

10th June 2005

I feel so sad that Coran will never know Daddy. Coran’s inside me, so can feel me, get to know me, share my emotions and be intimately entwined with my spirit. Jeremy can feel Coran kick but can (s)he feel him? I sincerely hope so. It makes me so sad that Coran will never feel the love that Jeremy has for her and will never reap the benefits that would come from being his child.

I feel so sad that I’ll never walk in the woods with Coran holding one hand and Ella the other. I feel sad that we’ll never buy them matching outfits or watch them fighting over the remote control! It’s the simple things that I’m going to miss.

Will every milestone that Ella makes remind me that Coran isn’t here to reach them too? How can we celebrate a birthday that will always remind us of our loss? Will I be able to lose myself in pride and happiness when Ella takes her first steps or will that moment only remind me that Coran is not here to ever make a single step?

Perhaps there will always be a conflict between these emotions. Can there ever be resolution when dealing with birth and death in the same instance? There are so many questions.

We saw Mavis at East Surrey Hospital today. She’s a midwife who has also trained in counselling. She was lovely and very compassionate and understanding. But it reminded me, once again, that our situation is not “fixable”. However kind and caring people may be, nobody can take away the hurt or give us back a sorrow-less pregnancy.

I wish that I’ll wake up and find that it’s all been a terrible dream. I dream that I’ll wake up from this nightmare and life will be restored to that of a ‘normal’ expectant couple. But I know that cannot be.

It is so unfair. Life can be so cruel. Holoprosencephaly has an incidence rate of 1 in 285,714. That’s less than a 0.00% chance! So why us? Why me? I have always done my best to be kind, to do the ‘right’ thing, to seize every opportunity that life presents me. I have never knowingly hurt anyone and am so sorry to anybody that I have hurt accidentally. I have never taken life for granted or forgotten to thank the universe for all that there is to be grateful for. So why has this happened to us? We don’t deserve it. Life can be so unfair.

What if there is no higher power or bigger plan? What if we are just a series of biochemical accidents that has somehow led to life and consciousness? What if there is no meaning that one day we’ll come to understand? Perhaps these ideas are all delusions after all; delusions that we humans indulge in order to ameliorate the inevitable pain and suffering that accompany life.

I try to stay optimistic and positive. But it is so very hard when every moment is accompanied by shadows. Jeremy does his best to remind me of all that we have to be thankful for. He’s a great support. I worry though that he’s not allowing his own sadness and grief to surface in order to protect me from them. And how many times can I cry on his shoulder? He’s a “fixer” but he can’t fix this. He’s learning to be a great listener but I know he’s hurting too. Seeing me in pain only adds to his own.

13th June 2005

I am feeling more positive today. Friday night was the most painful day yet. I cried and cried for five hours and couldn’t imagine that it would ever stop. But it finally did around midnight. The pain never goes away. I don’t suppose it ever will. Jeremy and I decided that it was going to be rather like managing chronic asthma: The grief will come in particularly bad attacks and will always be underlying the surface. Hopefully with time, the attacks will become less severe and less frequent but each one will be as uncomfortable as the last.

Somehow we got through the weekend. The tears were constantly close and when they fell, they did so silently.

I can tell now who’s kicking me! Ella seems to particularly like music with strong rhythms. She’s moving around (dancing?) within minutes of an upbeat song playing on the radio and she seems particularly partial to Latin jazz! Coran always wakes up just as Jeremy and I settle down to sleep. It’s wonderful because Jeremy can feel Coran kicking now when he places his hand on my belly. It often seems like I feel Coran more than I feel Ella. Perhaps because of her (his?) position or perhaps because, being smaller, (s)he has more room to move around! When they kick me, I tell them I love them. Often they kick me again after that, as if they’ve heard and understood me. I love those moments. It is only in these moments that exist now that I will be able to interact with our little Coran. I tried to sing them lullabies on Friday but the lyrics “waking” and “sleeping” made me too sad knowing that Coran will only ever sleep.

15th June 2005

I can feel myself nose-diving again. The last few days – since Friday – have been OK. Yesterday I had a strange feeling of emptiness and today I woke up and started crying. I’ve been thinking about the delivery. In so many ways I feel that a ‘natural’ delivery is by far the best option for all of us: It’s what I’ve always wanted to experience and I feel that somehow it must be an easier, more gradual passage for the baby rather than just being wrenched out of the womb on a set day at a set time. I also feel that it would give me a chance to fulfill Coran’s destiny as nature truly intended. If there is any rhyme or reason to this crazy situation then perhaps it is best to intervene as little as possible.

I’ve even started to look forward to the pain of childbirth! It is, after all, a tangible pain and so different in that respect to the emotional pain that is engulfing me. I’ve started to look forward to screaming and shouting… something I’ve wanted to do since 12th May but have either been unable or unwilling to do. In a way, it feels like the process of natural delivery and the pain that accompanies it might be quite cathartic.

But this morning I had a different thought. Suppose that we attempt a natural delivery and Ella is born first and Coran is still alive. After a few precious moments acquainting myself with my beautiful new daughter, I will then have to deliver another baby knowing that with every contraction, with every push, I am a few moments closer to losing Coran forever. I know that my physical body will not give me any other option, but will I be strong enough emotionally to handle that? I can’t even imagine how that will feel. I’ll then have to deal with emotional pain at the same time as the physical pain and I honestly don’t know how I could survive that. I would, of course, but a part of me would surely die in the process.

In every possible way I long to have just a few moments with Coran after birth so that I can look into those eyes and see the soul that resides there. But the pain of knowing the ending is so very great. It sometimes feels that it might be easier for me if Coran was to pass away before delivery and I was then to go into labour the next day. That would save me the trauma of delivering a baby that I know will only live moments, if that. And it will save me the trauma of continuing the pregnancy knowing that I am carrying my dead child. There will be trauma and heartbreak each and every way. To look into Coran’s eyes would be a magical experience – heartbreaking, but magical – and one that would stay with me forever.

Perhaps it is even more likely that Coran would survive delivery if we were to have an elective caesarean. Perhaps the trauma of childbirth itself would mean that Coran would die during birth. But if we were to have a section, then that trauma would be saved.

The Health Visitor, Caterina, who I saw on Monday seemed to think that it was highly likely that I would be offered an elective caesarean. She said that East Surrey Hospital tend to ‘veer on the side of caution’ in such situations and had a very high rate of sections compared to the national average. (I knew this already from some research I did when I first got pregnant.) Had anyone asked me a couple of months ago, I would have insisted that I would fight against a caesarean at all costs. But now I’m not so sure. There are the obvious disadvantages in terms of longer recovery, major surgery, risk of infection, and so on but it is beginning to seem as if there are advantages to me as well as to the babies. If we attempt a natural delivery, I know that even if one of the twins is born successfully, there is a very high likelihood that the second one would need to be born by caesarean. This seems to be a very common outcome in twin pregnancies, even ones without complications such as ours. So if there is such a high probability of that, why not go for an elective caesarean anyway?

These questions are mostly academic at the moment. I’m going to see the new consultant on 13th July – I complained about the first one who was so very uncompassionate and this was the next available appointment. Yet again, I find myself waiting and without any answers to the millions of questions that I have. I suspect there’s a reason for that too; it forces me to sort out my emotions before addressing the practical issues with which we’re faced (I think my usual tendency is to do things the other way round!)

We have another dilemma to work through too. Our antenatal NCT (National Childbirth Trust) classes are due to start on 30th June. It’s a class for six couples, all first-timers, that runs weekly with the last session on 1st September. It’s for preparing for natural delivery, birth positions, coping with labour as well as how to look after a newborn and very importantly, meeting other new parents in the area. So Sod’s Law would have it that out of the six, there’s another couple expecting twins! It’s extraordinary the run of extremely unlikely things that have happened to us!

I’ve just had a flashback to statistics lessons (that also is an extremely unlikely occurrence, I might add!) – if 1 in 100 pregnancies are twins, then out of 6 couples chosen at random, there’s only a probability of… nope, actually I can’t work it out. That’s too challenging for my mushy brain right now! But the odds of there being another couple expecting twins, in a group of just 6 is very, very low. I don’t know if I could handle it. On good days, I know that I’ll be delighted for them that they have two healthy babies to bring into this world. But how will I feel on the bad days? Will I feel angry? Jealous? Resentful? I truly hope that I would only feel great joy for their good luck but it would kind of be rubbing it in my face and a constant reminder of what we might have had. I really don’t know what to do. I keep changing my mind. On Monday I was sure that we’d go to the classes; after all, we’ll need more support than we originally thought and we will still be parents of a newborn baby. Today I don’t think I could bear to do it. There’s also, of course, the issue of whether or not it’s worth spending ten weeks preparing for an “active labour” and “natural delivery” when I might end up having an elective caesarean anyway.

I wish someone could just tell me all the answers.

Vicky