Confession: When I think about my reproductive history, that whiny little question, “Why me?” sometimes slips into my thoughts. I know that I have a lot to be thankful for: I have twice been able to get pregnant on the first try. (Admittedly, our honeymoon baby was more a “surprise” than a “try”.) Weeks 13 through 26 of my last pregnancy were low-stress and enjoyable. And most importantly, I have a beautiful, happy, healthy little 18-month old.
But why was I born with a septate uterus, a womb that tends to kill babies during the first trimester? Why do I have one child and not three? Peter and his twin would have been best friends, I’m sure. Why were they not allowed to grow up together?
I reached the conclusion after Peter was born that it was probably a good thing that we lost his twin before the end of the first trimester. The pair would almost certainly have been expelled from my uterus before 27 weeks… 24 or 25 weeks seems probable. But then I can’t help wondering, why couldn’t my uterus carry even a singleton to 28 weeks gestation? The majority of women with Mullerian anomalies who make it safely past the first trimester are able to carry their babies to term. What’s wrong with my anatomy? Why did my baby have to spend his first 73 days of life in a newborn intensive care unit?
I suppose it was this lingering question that inspired me to participate in a research study to determine the genetic causes of Mullerian anomalies. My parents and I agreed to ship a sample of our blood off to a research group affiliated with Harvard and MGH for analysis. The researchers will look for gene mutations in our DNA and compare the results to those of other women with renal and reproductive tract malformations.
Will a better understanding of the causes of Mullerian anomalies make me feel better? Probably. At least for a few days. Understanding the causes of a disease somehow makes me feel more in control despite the fact that this understanding often does not lead to a cure.
Over the past year, I’ve connected with many women with uterine anomalies via the Internet. Sometimes I’m jealous that they had more successful pregnancies than me. And sometimes their stories make me feel lucky. Many women with a septate uterus suffer 3, 4, 5, or more losses before ever giving birth to a living child. Some women endure years of unexplained infertility before their uterine anomaly is discovered. And some women deliver their babies even earlier than I delivered Peter.
That could have been me. This thought has been reverberating in my ears since yesterday, when I learned the outcome of another woman’s twin pregnancy. She has a large but not-quite-complete uterine septum, much like my septum pre-resection. She managed to carry twins – one in each horn of her uterus – past the first trimester. I have to admit that I was jealous of her luck when she reported at 11 weeks, 14 weeks, 17 weeks, and 19 weeks that the babies were looking great, that everything was going perfectly.
I’m not jealous anymore, though.
The end of her pregnancy was not unlike the end of mine. First there was bleeding and relatively minor contractions. She was given tocolytic medications, but the contractions eventually became more painful. Her cervix dilated to 3 cm, she was transferred to a hospital with a NICU, and then, after about 4 hours of labor, her son was born via breech vaginal delivery.
Of course, there were two big differences between her birth story and mine: she was only 23 weeks pregnant, and she was carrying twins. Her daughter was born via c-section an hour after her son. Oliver weighed 1 lb, 4 oz and was 11.5 in long. Emma weighed 1 lb, 3 oz and was 11 in long.
Twenty-nine hours after he was born, Oliver died of a massive brain hemorrhage. Emma is still fighting in the NICU. She seems to be doing well, all things considered, but the odds are not in her favor. The survival rate for babies with her birth statistics is only 37%. The rate of survival without profound neurodevelopmental impairment is only 24%. She needs all the prayers, luck, help, and support she can get.
I get chills thinking how easily this could have been my own story… if Peter’s twin had not passed away at 9 weeks…
I have been planning a charity drive for the families of micr0-preemies at the UMass Memorial NICU. The week before Valentine’s Day, I’ll be accepting monetary and in-kind donations from members of the MCPHS community to assemble care packages containing preemie-size outfits, small blankets, hand sanitizer, lotion, single-use cameras, journals, and informational pamphlets. I hope that faculty members and my fellow students will be generous… because families of babies like Emma need all the support they can get.