Evanston Hospital: My Review

I'm going to use this space to talk about the experience and facilities at Evanston Hospital's labor and delivery and postpartum units. I will not get into the delivery, as that's a whole different story, which you can read HERE.

To begin, let me say that Evanston Hospital is one of the best hospitals in the country. I owe them so much for the health of both myself and my beautiful sons. Anything negative I have to say is certainly outweighed by the fact that I owe the staff my life.

Let's start with labor and delivery. Because I'm paranoid and because I was pregnant with twins, I was admitted to Evanston's labor and delivery four times before I actually went in for induction. Of the five times I was admitted, three times I was admitted immediately. One time I had to wait for about half an hour in the waiting room, and the last time I was told over the phone to wait at home for three hours until more rooms opened.

While this waiting was fine for me, my mom sat in the waiting room for hours and said that there was one woman there who was legitimately in active labor but for whom a room was not yet available. While I was in recovery after my surgery, another woman was being admitted in the recovery room in a tiny cubicle with a cloth curtain for a wall. A few of the times i was there, nurses and doctors apologized for taking a while to get to me, saying "things have been crazy". Overall, I get the idea that Evanston Hospital is a little too popular for its own good. It's certainly earned its popularity, but from my multiple experiences, I found myself wondering if they might not benefit from building an addition to their popular and proficient women's hospital.

Other than the busyness, I'm a big fan of the L&D at Evanston. The nurses are excellent and some were so personal that they actually remembered me between visits. The residents are also incredibly caring, and you have plenty of hands and eyes on you, all of which feel knowledgeable and invested in your health. My only complaints are that I felt like they should've been checking my cervix more frequently during my labor and that I didn't have much faith in either anesthesiologist I saw, but otherwise the staff are excellent and make you feel informed and cared for.


Facility-wise, the rooms in L&D are almost unnecessarily roomy, and a comfy, reclining chair is available for dad. The bathrooms are accessible and close to the beds. TVs are present for prolonged labors and monitoring, but the audio isn't exactly theater quality. This is, obviously, totally unimportant. One of my favorite features of the L&D is that a television screen by the bed tracks your fetal heart rate (rates) and your contractions. This screen is easy to read and certainly helped to keep me calm during my labor.

Since I had a csection, which was a totally awful experience thanks to the anesthesiologist, I was in the operating room for delivery. The OR was fine, as you'd expect an OR to be, but I was definitely impressed by the number of hands available during the delivery. I definitely felt like there was adequate support for both my babies and myself.

After my surgery, I was taken to recovery for about an hour. I was pretty out of it, so I can't exactly review it adequately. I was a little shocked at how exposed it was--kind of like an ER with rooms separated by curtains, but you're really only there for a brief period of time.

Now on to the postpartum floor--where you'll spend the majority of your time at the hospital. The rooms here are smaller than the rooms in L&D, but ours also felt smaller because we had two babies and all their stuff rather than just one. Once your baby is rolled into the room, I wouldn't count on having more than two people besides you and your partner without feeling incredibly cramped. Some of the rooms may be larger than ours was though.

The bed in the postpartum room is comfy, and a recliner is also available for your partner. My husband slept here for four nights and seemed fairly comfortable. A television is available with a host of channels, decent audio, and a small selection of complementary movies. We personally found the music channels to be useful in soothing both the babies and ourselves.

The bathroom is fine, and I took a couple of showers while I was there. My only problem was that the soap/washcloth shelf in the shower was way too low to reach after undergoing a cesarean. It would be helpful for them to install a shelf a little higher up. There is also no shower seat, but I think you can ask for one if your surgery has you unable to stand while bathing.

While in postpartum, expect to have your room invaded at least once an hour, probably a lot more. This is obviously helpful and necessary for both your health and the health of the babies, but it also makes it difficult to establish a schedule or bond fully with your baby. Nurses and patient care technicians were the most frequent visitors to my room, and they were all so kind and friendly. Obviously some stand out more than others, but overall I'd say that the excellent nursing staff is Evanston's backbone. They made a difficult delivery and recovery way more bearable. Feel free to ask them anything and pump them for as much free advice as you can before you go home.

You'll see a host of other people while you're healing up in the postpartum room. Your pediatrician should visit once a day to check on the baby (babies), and your obstetrician should come by once a day to check on your healing. On your last day, you'll need both of these doctors to release you. On our last day, they both came pretty early for which I was very thankful.

You'll also be visited by the lactation consultant. We were very thankful for their help, as we had trouble getting started after our boys came up from the NICU. One if the lactation consultants was more helpful and friendly than the other (I think Helen was my favorite) but they were both a blessing. A woman also came by to help us with the breast pump and to arrange the pump rental. She was very nice and personable.

Lastly, room service and house keeping stopped by multiple times per day. I always ordered my meals over the phone, but they were so good about checking on you that you could have just ordered every meal in person. Another friend who delivered at Evanston in 2011 said a photographer came by, but we never saw one.

Back to the room service. The food is pretty good, and even with dietary restrictions (I'm a vegetarian), I was able to eat with a reasonable amount of variety. My only complaint is that one of the nights they outright lost my dinner order. When my friend called on my behalf to inquire what was taking so long, she had to completely reorder and it still took an hour to get up to me. Even when it did, my drink was missing. That must have just been an off night, however, because I had no other problems, and the service staff were all pleasant and personable.

Visiting hours in postpartum ended at 8:30, but on at least two of the nights we had people in our room past nine and no one said anything. Even when staff came in to the room and saw extra people, they were reasonable and didn't try to rush us.

At night, the staff try to leave you alone, but you should still expect someone to be in your room every couple of hours, even if it's only to check your vitals.

While at the hospital, you have the option to send your baby to the nursery at night so that you can get some sleep, and the nurses will bring your baby back for feedings. Initially I thought I'd never do this, but I quickly changed my tune. You'll have plenty of time to earn your sleepless parent badge once you head home; use the nurses while you can. The last night we sent the boys to the nursery and I sent pumped breast milk with them. This enabled us to get packed up and to head home with some quality sleep under our belts.

Checkout from the hospital was, by far, the most frustrating part of our stay. We were ready to leave over an hour before we were allowed to because we had to keep waiting for a member of the nursing staff to check us out, walk us out, etc. I'm not sure what we could've done to speed up this process, but I imagine stronger self advocacy on my part might've gone a long way.

When you leave, the nursing staff will tell you to take all of the disposable items from the baby cart on which the baby has been staying. Take them up on this even if you don't think that you'll use it. You can always donate unused diapers and formula. Having the extra diapers, wipes, and circumcision bandages made our lives substantially easier once we got home.

Lastly, parking at Evanston is pretty far from the women's hospital; you certainly don't want to walk it during your labor. Instead, have your partner drop you off in the back if the hospital. A valet is even available there during daytime hours. When it's time to check out, you can leave your car in this area to load it up.

While it wasn't flawless, we were incredibly blessed to deliver and recover at such a well staffed and proficient hospital.

"Natural" vs. "Unnatural"

By far one of the most frustrating and offensive things I dealt with throughout my twin pregnancy was the persistent questions that were basically all not-so-clever euphemisms for "are these twins the product of IVF"? Some of these are..."do twins run in your family"? And "were these twins natural"?

The second question, which I actually got from medical professionals, especially irritated me. First of all, the accepted vernacular is "spontaneous" not "natural". The term "natural" implies that there is something "unnatural" about a baby conceived through IVF, and I hope that it isn't difficult to see how that could be offensive. My second problem is that these questions all ignore one basic principle--that it's none of your business. Look, I understand why a human being would be curious. I'm curious about lots of things, but just because you'd like to know doesn't mean that it's polite to ask.

So, I guess the PSA here is that you shouldn't start running interrogations on moms of multiples to derive their entire pregnancy backstory. Trust me, you'll be like the millionth person to ask, and it'll only serve to irritate. Instead, why not just try a simple "congrats" or an "twins are so much fun"?

And, while we're on the topic, my twins are spontaneous...but that doesn't make them any more "natural" or "real" than my friends' children who were lovingly and emotionally conceived through IVF.

NICU: My Emotional Reaction

When I found out I was pregnant with twins, I felt sure that the NICU (neonatal intensive care unit) would be a part of my journey. Twins are often premature, and many people I've known with premature babies have had to cope with the little ones being in the NICU for weeks and sometimes months. While I knew having babies in the NICU would be tough, I was prepared for that.

At least, I was prepared for that until my pregnancy lasted past 37 weeks. By the time I was induced, the babies were big enough and developed enough that I thought we'd avoid the NICU altogether. Although we were tremendously lucky to have our boys with us shortly after delivery (33 hours and 55 hours later), any amount of NICU time can carry with it an emotional price.

For me, the emotional price mostly came with my second son, Brendan, who spent almost an extra 24 hours in the NICU. I felt a lot of guilt that I held his brother first and posted pictures on Facebook of just his brother and me while Brendan was still down in the NICU...alone. It took over 40 hours for me to get to see him for the first time. Logically, I know that the difficult recovery from my csection made going downstairs to see him any earlier nearly impossible, but that doesn't stop me from feeling guilty. Other people--other women--fed and held both of my babies before I did. The boys spent their first night on this earth away from their family and out of my arms. I try to give myself some slack by remembering how physically damaged I was, but it still hurts my heart to envision my boys all alone.

Before it happened to me, I thought the NICU would be no big deal, and I'm sure that with time it will fade into memory, but don't underestimate how being away from your babies can make you feel, and feel free to talk to the hospital and NICU staff about your emotions. You should be able to call the NICU 24 hours a day to check on your baby; I never took advantage of this, but in hindsight I wish that I had. Waking up during that first night to the sounds of other people's screaming babies in the adjoining rooms made my room feel so empty and lonely. I should've swallowed my pride and called.

PGAL: Pregnancy after Miscarriage

After a miscarriage, women have different reactions to trying to conceive again. While some women need time to heal and mourn the loss, others feel that the only way they can heal is to get back to trying. I definitely fell into the second camp, but I know women who have felt quite the opposite.
Regardless of when you start trying and when you get pregnant again, you will probably find that this pregnancy is wholly different than the last one. The blissful ignorance will likely be gone, and, if you're anything like me, it'll be replaced by fear and paranoia. The veil has been lifted, and you now no longer believe that pregnancy equals a baby. In addition to now being more aware of miscarriage statistics (1 in 4), you may also have doubt in the ability of your body. Almost always, this skepticism is unwarranted (the vast majority of women who have a miscarriage will have a healthy pregnancy the next time around), but I personally felt little comfort in those facts. My body had failed me, or at least that's how I felt, and so when I got pregnant again, there was less celebration and a lot more fear.

After you accept that this pregnancy is just not going to be the same effusive, effervescent journey that the last one was, there are things that you can do to help ease what is referred to in the loss community as "pgal-brain" (pregnant after a loss brain).

Here are some things that helped to ease my paranoia and stress as I went through my second pregnancy:

1. Let your obstetrician know your background--if you "only" had one pregnancy loss, it's unlikely that your doctor will implement any additional monitoring during your second pregnancy. That being said, it's still important that the doctors caring for you know where you are coming from. Letting your doctor know that you're pgal will make them more understanding about those paranoid phone calls and premature trips to labor and delivery that will undoubtedly crop up along your journey. Also, talking about loss, at least for me, has made me feel so much less alone.

2. Go for Vanity Ultrasounds--since I was pregnant with mono-di twins during my second pregnancy, and therefore, I was high risk, I had no shortage of ultrasounds to soothe my paranoia. Most women, however, will not have this to keep them calm. If you're pregnancy is "normal", you'll likely have 1-3 ultrasounds, and that leaves long stretches of time without hearing the soothing sound of your little one's heartbeat. Luckily, you don't have to jump through insurance hoops to get an ultrasound. While not everyone can afford it, non-medical ultrasound facilities exist in most areas and offer scans for $50-$250. Now, as stated, these ultrasounds aren't for medical purposes. They aren't going to look for deformities, but they are able to show you a beating heart and a kicking baby. When your pgal brain is working overtime in the paranoia department, sometimes that's all you need to see. If you can afford to be scanned at one of these facilities, I highly recommend scheduling an appointment for a time when you have a substantial gap in your regular monitoring.

3. Buy a Doppler...in the second trimester--Dopplers, like the ones used by your obstetrician, are available online for about $60. These devices are a simple way to verify that your little one's heart is still beating when that pgal brain strikes you. In the later part of my pregnancy, my doppler was my best buddy, but I will caution pgal moms about a couple of Doppler faux pas that I frequently see women make and that I've made myself. First, wait to purchase your doppler until at least week 12. I know some women find a heartbeat with Doppler as early as nine weeks, but this is rare, and not finding the heartbeat will only make your pgal brain worse. I didn't start using my Doppler with my second pregnancy until I was in my fifteenth week, and I recommend waiting this long as you should be able to find the heartbeat with greater consistency at this point. Another Doppler problem is that the device usually comes with a small amount of gel. Once you run out of this, several sites say you can use any old lotion in the Doppler gel's place. I would recommend not doing this. It never worked as well for me and just served to make me paranoid. Doppler gel can be bought on amazon for less than $10, and it's worth it for a clearer audio quality. Last cautionary note: limit the frequency and length of your Doppler usage. Check with your doctor for safe usage, as I've read a few things that suggest you shouldn't be doing daily home scans for hours at a time.

4. Communicate with your partner--Sometimes it's easy to forget that your partner is pgal too. Even though they're not growing a baby inside of them, they're probably having the some doubts and phobias that you are. No one is better equipped to relate to what you're going through than this person. Sometimes I didn't want to express my doubt and lack of investment in my second pregnancy to my friends, coworkers, and parents, because I didn't want them to doubt it as well. In moments like this, it was wonderful to have my husband--someone around whom I didn't have to put on a happy and hopeful face.

5. Join a PGAL support group--for me, the pgal board on thebump.com and the Facebook group "chasing rainbows" were my lifeline. Being able to talk to people who were experiencing the same emotions I was made me feel normal and cared for. Sometimes pregnancy boards online can be a little catty (women+Internet+pregnancy hormones=drama), but I found that the pgal community tends to be largely free of these distractions and negative vibes. Maybe this is because women on the pgal board are just grateful to be pregnant and appreciate the miracle a little more than women on other boards. Anyway, I highly recommend joining a group, either online or in your community, that is equipped to relate to and support your pgal specific needs. Even lurking on these boards without posting will remind you that there is life, and hope, after loss. It's also nice to watch other pgal women successfully have their babies; it will reinforce the fact that you're probably going to be just fine the second time around.

6. Distract Yourself--Early on in your second pregnancy, distraction is really the best way to soothe the pgal brain. You'll be tempted to second guess every symptom you have and countdown the days until your next appointment. There's no way to stop this, but I really recommend engaging in some activities that are not pregnancy related to keep your mind busy. To do this, you can take on extra jobs at work, go on weekend trips, plan non-baby related home improvements, or even just pick a new (and long) television series to watch on DVD. You'll have plenty of time to be pregnant and be a mom later on...take that tumultuous first trimester to enjoy your pre-baby life. Doing so will take your mind off of all the pgal worries.

Being PGAL was one of the most difficult things I've ever had to do. After safely delivering my boys, I had more than a few good cries to release all the tension and fear I kept bottled up for nine months. I'd start shaking in sobs and tell my husband "I was just so worried for so long!". There are things you can do to make it easier, but it likely will never be easy. I was worried literally up until I looked over in the warmer in the OR and saw my boys safe and sound. My husband cried in the labor and delivery room because he was still afraid for both me and the babies. More than anything, I hope you remember that it's okay to be scared. It's also okay to be sad about your loss even as you celebrate the new life inside of you. Just be honest about your emotions, remember that statistically you're probably going to be just fine, and reach out to others when your emotions seem to be waging war against you.

You will be a mother one day; try to enjoy the journey as much as you can!

My Journey: The Birth Story for our Twins

Short version:

Malcolm Finley was born via csection at 5:40am on Friday, november 16th and was swiftly followed by Brendan Bailey born at 5:42am. Malcolm weighed 6lbs, 7ozs, and Brendan weighed 6lbs, 6ozs.

Long version:

At 8pm on Wednesday the 14th we were scheduled to check in at labor and delivery to begin induction. At 7pm, the hospital called to say they were swamped and they'd call us when they were ready for us. After hours of not receiving a call, I called back at 10pm and they told us we could head over.

Once in L&D, they went over preliminary details and then started me on the balloon catheter to get me dilated. I was 1cm when I arrived, so we had a ways to go. The catheter didn't hurt, it was just kind of awkward and made getting up to pee kind of awkward. The docs also started me on a small dose of pitocin, and we waited.

Apparently the saline catheter method of dilation takes between 6-12 hours to get you 4cm dilated, but I was lucky and the cervical catheter had done its job by 6am on Thursday the 15th. So far, this was going well. They upped my pitocin and left me to dilate further.

At 11, the external monitor on Malcolm starts going totally bonkers, and my pgal brain starts freaking the heck out. They try to reposition the monitor, but can't find  him. The resident comes in with the ultrasound and dumbly fumbles around. She keeps saying "he's there" and I'm like "no crap, but is there a heartbeat?"

Her reaction? "I can't tell but I think his chest is behind your hip bone. Let's put in the internal fetal monitor". That's the one that goes in through your cervix and attaches to the baby's scalp. I'm panicking, but thankfully they get the monitor in and there's my boy's heartbeat looking nice and normal. Sigh of relief.

By noon, I was at 6cm, and the doctors were pushing to break my water and get me on the epidural. I was having contractions, but none that really felt "epidural-worthy", but I figured I'd want it before my water was broken.

Enter the anesthesiologist. He is cold and quiet, and the insertion of the epidural takes a couple tries. I feel...a little dullness, but certainly not the total numbness I'd been told to expect. However, I'm not in pain so I ignore it.

We break my water. It feels very warm and there sure is a lot of it. The doctors leave me to dilate further and up my pitocin again.

From noon until 6pm, I make no progress, except that I hit extremely painful contractions and the epidural isn't doing diddly crap. I'm crying and grabbing on to the edges of the bed. The anesthesiologist comes in again, but this time it's a new guy who is like the biggest jerk in history. He gets snappy with the nurse, and asks me if I'm "uncomfortable" as I cry and wince through contractions. No crap, buddy. But instead of investigating the viability of my epidural or upping the levels, he gives me narcotics that knock me out for hours.

Early in the evening, I make it to 8cms. I'm getting hopeful! By around midnight, my doc comes in and says I'm almost there--like over 9cm. She ups my pitocin and says she's going to take a one hour nap and then we'll start pushing.

After an hour, the extremely painful contractions thing happens again and the super jerk anesthesiologist comes back and once again gives mr narcotics rather than investigating my epidural. Cue another 2 hour drugged out nap. My doctor, mind you, is nowhere to be seen.

I wake up after 3am on Friday, and a resident checks my cervix and tells me there's still a little lip of cervix blocking Malcolm's head. Great. My doctor comes back in and is noticeably salty that it's taking so long. She says we're going to try to push and see if she can help Malcolm's head get through the cervix. We try pushing for about twenty minutes, but it's useless. He's not going anywhere.
My doc looks at me and says it's time for csection. My water has been broken for too long and my temperature is elevated--they're concerned about infection.

My reaction? Fine. What the heck took them so long? My doctor says she wishes that I'd stalled out earlier, to which I want to say "being stuck at 6cms for over 6 hours wasn't enough of a stall?!", but I keep it in. I'm tired and frustrated and ready to see my boys.

We head in to the OR, and I keep insisting that I'm still in pain and can still feel a fair amount--too much, I'm concerned, to be cut open. Once again, cue the narcotics. They make me a foggy mess and cause me to shake uncontrollably, but I'm not numb below the waist.

While they're setting me up, they hold my husband in a different room and don't bring him in until the very last minute, but I guess that's pretty common.

Now to the surgery--holy Jesus. I'm sure I wasn't feeling EVERYTHING, but I was feeling enough to be crying and screaming as they pulled the boys out of me. I was so drugged and in so much pain that I couldn't even enjoy looking over at my boys as they were placed in the bed to my left. I looked enough to see that they were adorable and alive, but that was about it.

As they sewed me up, the pain intensified and I started shouting obscenities. At one point my husband says that I passed out, but honestly the whole thing is pretty cloudy in my head. I just remember being in way more pain than I expected with an epidural, and after talking to others, I'm skeptical about the level and/or placement of my epidural.

All that aside, my delivery resulted in two healthy, nice sized baby boys and a sore but alive mama. That's all that matters to me.

Malcolm spent about 33 hours in the NICU and Brendan spent closer to 55 hours there because of their blood sugar levels and they had to be given antibiotics due to my infection from my broken water. I know we're lucky that it wasn't longer, but it was still hard to be away from them. I couldn't really get out of bed for like 24 hours, so I didn't get to see or hold them until Saturday afternoon/evening. Because they were fed formula in the NICU, getting them on breastfeeding was tough, but by the time they came home they were formula free, so my worry was all for nothing!

My Journey: Our Miscarriage

In May of 2011, after almost a year of hard work to lose weight, quit smoking, quit drinking and get my life back into orbit, my husband and I began our journey in, well, the usual way. I had been counting my cycle for almost a year at that point, and I even stopped in to my obgyn for a little preconception check up. He gave me the all-clear, some advice and his blessing and away we went.

I've lived a pretty blessed life, so it makes sense that I naively thought this would be an easy trip. No flat tires, no detours, no traffic jams. I thoroughly expected to be already refusing champagne at my friend's wedding in June 2011.

But the first cycle came and went and no baby. I sighed. I cried. I was impatient and frustrated with my body for being less than perfect. But I kept at it. July? No dice. August? Sigh. No. September? Still empty. October? Drank and smoked at the Halloween party. No reason not to, right? Sigh.

In my brain, I knew that five months was the average and that there was no cause for concern. Many of my friends and family have had to wait a lot longer than that for their blessed miracle. After the fifth month I started to relax a little. This wasn't going to be a short trip, so I might as well enjoy the scenery. I still counted my cycle and timed our trying, but I was a little less frustrated by negative pregnancy tests. The thoughts of my emptiness did not consume my every waking moment by October and November.

And then...in November...that blessed positive pregnancy test! I was sitting in the bathtub, casually glancing at the plastic stick on the sink. I figured it'd be a negative like usual, so I was truly a little disengaged. But then I turned the stick to meet my gaze and...that word. That beautiful word. And no, this time there was no annoying "not" stamped in front of it. I told my husband and we both squealed with glee. We were going to be parents!

At Christmas we told family and friends. Sure, we were only 6-7 weeks pregnant then, but so what? We saw our baby's heartbeat on ultrasound at 6 weeks, and the chances of miscarrying were 5% at that point, or so the internet told us. The husband and I are both poker players and we kept saying "I'd play 95% odds"...and so we did.

But at 8 weeks and 4 days I began to spot. Just a little at first, so I freaked out and called my obgyn. They had me in and did an ultrasound, which ended on a high note. Baby was there, fine and showing a heartbeat of around 150 bpm. Big sigh of relief. Even though the spotting continued, it wasn't too bad. And when it got a little pinker at 9 weeks, I called the doctor's office and was once again told not to worry. I'm a paranoid person, so I told that little voice in the back of my brain to shove it. I went on vacation and tried to enjoy myself.

My first pregnancy should have ended in the maternity ward at the local hospital on August 17th, 2012. Instead, it ended in a Las Vegas ER at 4am on January 16th, 2012. The insensitive staff made jokes about never having seen a positive pregnancy test before. They asked which hotel we were staying at and if we were having a good time. I shot my husband a "not worth it" look as he was about to throttle the staff. Our nurse in the ER congratulated me on my pregnancy. Are you kidding me? At this point I had cramps and heavier bleeding. I knew this was the end and I just wanted to be home, not 28 hours away in the desert of sin city.

They wouldn't allow my husband in the ultrasound room, which has to be illegal. And while the woman was conducting the ultrasound she wouldn't speak to me or make eye contact. I know it's not her job to tell me, but laying there and watching her face in the hopes of catching some sort of sign was even worse than just knowing. She pulled out the transvaginal wand and it was saturated with blood. I wanted to die.

The ER doctor gave us the news. Thankfully, he was an actual human being unlike his colleagues. The prognosis? The baby was still there but there was no heartbeat and my pregnancy hormone was about 10% of what it should have been at almost 10 weeks. That meant miscarriage...and it was only a matter of time before I passed the "tissue".

Thankfully, my body held out until we were back in the windy city. A trip to the obgyn the next day was only supposed to be to confirm the ER's findings. Instead, it ended up being my baby's final resting place.  When the doctor told me to undress for the examination I began to and instantly miscarried right into my hand. Blood splattered on the white tile of the examination room at the end of the hallway. I held the sac with my dead baby in my right hand and, shaking, I set it on the counter. This was the end. This was truly the end.

It took a while to make myself want to do anything except sit on the couch and stare off into space. I was angry at my body, the universe, luck. I went back to smoking for a couple of weeks because why not, right? Everything felt so unimportant compared to the loss of life and the changed outlook for my coming year.

Despite my sadness, I couldn't think of anything that would help me to heal more than continuing to try. Even though we had lost our first little one, we still wanted to be parents. In fact, I think we both wanted to be parents more than ever before. We had to wait six weeks until our follow up doctor's appointment, but thinking about the future and planning for our eventual parenthood helped the loss of our first little one seem like part of the journey rather than a horrific and depressing waste of time.

What's The Goal?

During the four days we spent in the postpartum unit, we had a parade of nurses. One of them, a young Polynesian woman whose name I stupidly ignored, saw us a number of times. She was a bubbly, vibrant woman who kept things light during an obviously stressful time, and I appreciated her care more than I can say.

One of her mantras, which I took with me as we left the hospital, was "what's the goal for today?". On day two, the answer was "walk down to the NICU to see my son". On the fourth day the answer was "breastfeeding".

It seems relatively obvious, but this nurse was keeping me focused and moving forward. Postpartum, it's easy to get bogged down in all of the minutia and completely shut down. It's also easy to look too far ahead and get overwhelmed at the impossibility of getting from point a to point z. By setting a simple, daily goal, I was given a sense of purpose, and ultimately a sense of achievement when I achieved that goal. During a time when things seem an endless trail of diapers and feedings, having a goal breaks up the days and makes progress more noticeable.

So I ask you "what's the goal today?". Set something necessary and achievable--a shower, five mins of tummy time, getting the baby into the swing--and take pride when you achieve it.

Extra Help

When we were in the hospital, every nurse asked us if we "had help" once we were home. I nodded and told them that all four grandparents lived nearby, to which they seemed relieved.

Of course, when they said "help", I assumed they meant someone to bring us meals, do a load of laundry, hold the occasional baby. I did not, expect that the "help" the nurses were referring to would need to be nearly round the clock assistance for the first few weeks.

First of all, after the birth I was not physically capable of caring for the boys by myself because of the csection. If my husband was asleep, I couldn't bounce the boys for long periods of time or carry them upstairs to the changing table. Also, emotionally speaking, I needed some company. The "baby blues" was pretty intense and led to hourly bouts of crying and a persistent sensation of helplessness for the first week or more postpartum.

Most difficult in the beginning was that neither baby would sleep in a crib or really anywhere that wasn't a warm chest or lap. Because we refused to cosleep with our babies, this meant we needed at least two people to be awake and holding a baby at any given time. That's completely impossible with two people.

Even once my husband and I figured out how to care for both babies simultaneously while the other parent slept (a combination of swing sleeping and just manning up and holding both babies), we still needed extra hands to prepare and bring us food and to help with chores. Breastfeeding twins requires 3200 calories a day, and it's pretty difficult to get that in your body unless you have someone around to basically hand-feed you.

So, in summary, get help, and I don't mean the "aww!! I wanna hold your baby and chat with you!!" kind of help. Line up friends and family who you know you can be honest and demanding with, and be sure to pay with plenty of thank yous.

If you don't live near family, you can hire help, but that's obviously not cheap. I would encourage you to strongly consider flying a parent out to stay with you for a few weeks or going to stay with them. We stubbornly thought we'd be able to do this as a couple, but the first couple of weeks have really reinforced that it takes a village...especially with multiples.

PUPPP--A Pregnancy Horror Story

As your skin stretches, everyone gets a little itchy in late pregnancy. But for a lucky 1% of pregnant ladies, this itching will surpass any discomfort they have henceforth experienced--they will develop PUPPP.


So how does PUPPP start? I'm not a doctor, but I can tell you how it happened to me. At 36 to 37 weeks with my twin boys, I started to develop a small, bumpy rash on my gigantic belly. It was itchy, and quickly became noticeably uncomfortable.

About 24-48 hours after the rash first appeared, it began to itch way more and it spread to my arms and legs.
 By the time I went in for my scheduled induction at 37 weeks, I was noticeably marred by the rash. It itched uncontrollably and had spread to my fingers, butt, feet and back. The bumps were quickly inflating with...there's no nice way to say this...puss.

During my induction and my entire hospitalization, they have me on benadryl to forestall some of the debilitating itch.
 After delivery, it almost got worse before it got better. In the few days after delivery it spread to my palms and the bridges of my feet. The itch caused me to break the pustules and make my legs and feet bleed quite a bit.


Now, 10 days postpartum, the pustules are gone and so is the rash, but it has left behind an incredibly dry, cracked, and scabby layer of skin, especially around my ankles, as well as on my feet, hands and tummy. It still itches a whole lot and I leave a pretty disgusting residue of dry skin wherever I sit and itch.


If you are pregnant with multiples, pregnant with a boy or boys, or your baby is of a larger size, you're more likely to develop PUPPP, but the "why" appears to be largely unknown, and there's of course no cure. Cortisone cream sort of helped me, but mostly I think it's just something you have to itch your way through. Hopefully you'll avoid developing this complication though, as I cannot possibly communicate how painful and distracting the itch is.