We started this blog to tell the story of our son Milo Thomas. We wanted people to learn from our mistakes and triumphs. We want others to understand the importance of becoming an educated advocate for their own health care. During our journey to parenthood, it amazed us at how the opinions of the various doctors differed, or how they just went along with what another doctor said because they just didn't know a better answer. If you are a doctor reading this, we hope you take our story to heart and try to stay on top of what is going on in your field. Science is changing the medical field everyday, which leaves doctors and parents with many more options when it comes to pregnancy complications. If you are a parent-to-be facing a complicated pregnancy, we hope you can find inspiration and education here to help you better cope with your difficult situation.
But we can’t really tell Milo’s story without first telling the story of his brothers, Joseph and Thomas. On this page, we've shared a brief version of our story, but you can click on the links to dig deeper into the various chapters in the our story, which finally has a happy ending.
Our first son, Joseph, was born on March 12th, 2010, at 17 weeks due to unexplained pPROM (preterm premature rupture of membranes). We were on vacation in Florida at the time. After a fairly uneventful and normal pregnancy, Laurie's water broke unexpectedly. Upon the advice of many doctors, we chose to induce labor and end the pregnancy, given major health risks for Laurie and a very poor prognosis for our baby if we tried to continue the pregnancy. We were never given a clear answer as to why we lost Joseph. The doctors speculated that a subclinical infection was the most likely cause, but couldn't rule out cervical insufficiency.
A few months later we were ready to try again. However, while conceiving Joseph had been a natural pregnancy (and a bit of a surprise), when we actually were trying to get pregnant, it wasn't happening. Our fertility struggles lasted almost a year and a half. Finally, with the help of fertility drugs and IUI, we conceived again in November of 2011.
Apparently the fertility meds worked a bit too well, as we conceived twins--the babies who would become Thomas and Milo. As with Joseph, the pregnancy seemed to be going really well through the first and early second trimester. And once again, this time at the 18 week mark, our world came crashing down when Laurie was diagnosed with cervical insufficiency (also known as incompetent cervix) at an ultrasound on February 28th, which simply means that her cervix is unable to naturally support the weight of a developing baby and opens up too soon. The situation was dire and our doctors didn't seem to have a plan to save the pregnancy, but we were not going to lose these babies without a fight. Dan went online and was pointed to a doctor in New Jersey who thought he could try a less common type of cerclage (surgery to stitch the cervix shut) to give us the best chance possible. We drove to see the doctor on March 1st with the plan to get the surgery on the morning of March 2nd.
Unfortunately, just 3 hours before the procedure was scheduled, Laurie went into pre-term labor. By the time she was evaluated at pre-op, an ultrasound revealed that Thomas' amniotic sac had completed prolapsed and he was already on his way out. There was nothing that could be done to save him. The doctor offered us an option to do a D&C and terminate the pregnancy, or just go back and let things progress naturally (which would have almost certainly been the same outcome of losing both babies). Dan had read about a procedure called Delayed Interval Delivery where you can try to keep a second twin in utero when one has to be born early, and asked if that was an option. The doctor said he could try, but the odds of success were very low.
As you can tell from the simple existence of this blog, the procedure was a success. Unfortunately this meant that Thomas was born too soon on March 2nd, 2012, but his brother would still have a chance. Most Delayed Interval Delivery attempts only buy a few more days to a few weeks of additional pregnancy for the remaining multiples, and we needed 4-5 weeks to even get to fetal viability and almost 10 weeks to get an age where our doctors would feel good about survival chances and long-term outcomes. We were amazingly blessed and lucky to be one of the longest ever recorded twin intervals and a Delayed Interval Delivery success story. After a tense first few weeks that included a few false alarm visits to labor and delivery, the pregnancy resumed a generally normal (though highly monitored) course and our son Milo Thomas was born at 37 weeks on July 10th, 2012, the same day her cerclage was removed. It was 130 days after his twin brother's birth. Milo and Laurie were discharged after 2 days.
Three years later, we were expecting again. With a plan of action including a preventative cerclage to be placed at 12 weeks and progesterone injections, we hoped to have a more routine pregnancy. We actually opted to drive to Tennessee to have the same doctor who saved Milo's life place the cerclage (a TVCIC, or transvaginal cervicoisthmic cerclage). The cerclage worked great, as we had a very routine pregnancy. Laurie's cerclage was removed near the end of week 37, and our daughter Nora Josephine was born 5 days later, just short of 39 weeks, and we were home the very next day as a family of 4. It goes to show that even with the kind of complicated history we experienced, a routine pregnancy is possible with the right plan and the right level of medical care.