“Lauren’s Story, Part 2: Pregnancy and Delivery of Twins Following Treatment for TTTS” – with Lauren Burstein

Dr. Fox: Welcome to today’s episode of Healthful Woman, a podcast designed to explore topics in women’s health at all stages of life. I’m your host, Dr. Nathan Fox, an OB-GYN and maternal fetal medicine specialist practicing in New York City. At Healthful Woman, I speak with leaders in the field to help you learn more about women’s health, pregnancy, and wellness.

Lauren, welcome back on the podcast. Last week, you told the first half of your amazing story of when you found out you were pregnant with twins and then you went through getting twin-twin transfusion and going to Philadelphia to CHOP and having the procedure, the laser treatment for twin-twin. And then thank God it went well and it was resolving and there were still some cardiac issues and so you’re being followed very closely in several places. You’re now an official member of our practice and you’re around 20 to 24 weeks and we’re going to pick up part two from here for the back half of your pregnancy. So what was it like for you going through that? Again, you went through this crazy situation where the babies are in real dire straits and then they do this science fiction procedure that works and things are going okay. Did your confidence that things were going to work out go up at this point or were you still really not sure how it was going to play out?

Lauren: I think it took me until about 24 to 25 weeks that I felt a little more comfortable with everything. I think that was in part, I mentioned the cardiac issues that the babies, especially baby A was experiencing was difficult. And I had this great fear of very early delivery and that was also in the back of my head, not that statistically it was probable, but just the fear of it. And it really wasn’t until I was about 24 to 25 weeks, I think it was my last appointment at CHOP and I remember I had an ultrasound there and the person doing it was this woman that I love. I can’t remember her name right now, but she was wonderful and I was so happy to get her that day. She was actually I think the head tech, the head sonographer and as soon as she did it, she said, “It looks so much better.” She said they just look so much better. And then when I met with the doctors, they were just amazed. They said, “Oh my goodness, there was no more tachycardia, all the cardiac issues were resolving, the twin-to-twin had already been pretty much taken care of and that still looked great,” and they looked essentially like two healthy fetuses at that point.

And I remember being in this little conference room with my husband and a bunch of the doctors and I just kept saying, “Okay, so something about the NICU, like when they’re in the NICU,” and one of the doctors said, “We’re going to just aim straight for the nursery.” And I said, “Really?” And it just dawned on me, they thought I could actually just continue the pregnancy without complication and that maybe I could even make it till a decent gestational age to not even warrant a NICU. It didn’t end up happening that I didn’t need a NICU, but just the point is that there was just this hope that they felt that everything looked good. And I just thought, oh, can I breathe now? Could this really actually be okay? And it was the first moment in a really long time in that pregnancy that I thought things might be okay now.

And I remember taking a walk a few days later with my husband and my daughter and we went to this beautiful park in Paramus and my husband took a picture of me. And I hadn’t really taken any pictures of that pregnancy. And I was just standing by this waterfall and I was just smiling and noticeably pregnant. And it was like, looking back, I’m like, that’s like one of the honestly few, like very relieved and happy moments of this pregnancy was that moment of just, oh, things maybe will be all right. And so I started to have more hope and that hope sort of got stronger once I hit 28 weeks because a lot of doctors had told me that at 28 weeks, just developmentally, things are much better for a baby if they’re born at 28 weeks versus earlier. It just, you’re in a better place. So once I hit 28 weeks, it was like, oh, wow, that was a milestone I was rooting for. And I remember that was in December. I’m like, okay, we got to 28 weeks. All right, let’s see what’s going to happen next. You know, I was just filled with like, okay, so now I’m just going to actually focus on having two babies soon and not on the challenges of this pregnancy piece.

And I can actually start and I remember like, like, oh, should we start thinking about like car seats and stroller and like all the regular stuff of pregnancy, right? That started to come into play. And I thought, oh my God, I’m gonna have three kids soon. Like how am I going to do that? You know, and all those like sort of normal pieces to pregnancy started to kind of come into play. But it really took until that time for it to cross my mind. You know?

Dr. Fox: Yeah, I mean, I remember when, you know, when we have patients who have twin-twin transfusion and they’re going to get the treatment and, you know, we tell them that the treatment usually works, right? Which is great because without the treatment almost always it ends horribly. But usually is not really the word we like to use in pregnancy. You know, like usually is like, you know, we’re talking about the stakes are very high here. So you want better than usually. So we’re always very, you know, guarded and we’re like cautious about it even though we’re, you know, we have, you know, hope and confidence that things should work out. And so you undergo the treatment and like the first step is like no complication from the treatment like your water breaking or, you know, something like that, getting a fever, you know, because these things can happen when you do procedures inside the uterus. So that didn’t happen, thank God.

And then I remember that like 20, you know, there was there was issue with the, you know, the heart rates and the medication, which like you said, is a little bit unusual. But by 24, 26 weeks when that’s sort of all evened out, I remember thinking, great, she’s like almost like normal twins again. You know, we’re back to like, you know, again, not really, but we’re sort of like, we can almost start thinking of you that way because, you know, they’re both growing well. Your cervix looks good. The fluid looks good. Their heartbeats look good. You know, you’re doing well. And we’re like, all right, now we’re sort of like back on track. You know, we were off the road for a while and now we’re back on the road. It is a really comforting feeling because we sort of, like you said, we sort of know when twins get past 28 weeks, you know, you don’t want to deliver at 28 weeks, but you sort of get a sense like, all right, like there’s a really good chance things are going to work out here no matter what happens from here on in because we do this all the time. And so it is very comforting, not just for you, but for us, like we’re, you know, we’re also terrified of what’s going to happen. You know, we’re in it maybe not to the same degree or the type of terror, but like we’re like, oh my God, like I hope this works out here.

Lauren: Yeah, it’s very clear to me that you guys care about your patients tremendously. I mean, I mean, I knew that before this, but I really know it now. You guys really care. So I get that for sure. You know, but yeah, I mean, it felt like a number of years, honestly, until I got to 28 weeks. But when I got there, things definitely were looking better and I felt much better. And, you know, there’s always that little voice. And if you mention the statistics piece of it, you know, that probably things will be okay. But I learned to kind of not trust statistics because I had identical twins, which is apparently only like 0.3% of pregnancies and and they’re boys. So that’s also apparently more rare than girls. I don’t know. And and then the twin to twin is even, you know, more. And so I was like, we still had to keep in mind the other possibilities.

Dr. Fox: Plus, you know, you’re a liberal arts teacher. Statistics don’t speak to you. I get it. You know, you’re using words like juxtaposition and you’re talking about poetic photos that are being taken. You’re not thinking about stats. I get it. That’s okay. I’m a math guy. You know, I’m illiterate but I’m a math guy.

Lauren: I’m not a math person, but I have to tell you, and I’ve been to so many doctors’ appointments at this point, you know, and I’ve been asked by a few doctors if I myself am a physician just because I read every single report and I’m using the language that you guys use. You know, so I’m not I’m not at all a physician in any way, but I do read a lot.

Dr. Fox: I feel like, no, but I can read.

Lauren: Exactly. And that is my answer. That’s true. Reading does.

Dr. Fox: There’s a lot out there. If you can, you know, i if you have a comprehension of the language and you have access, you know, you can you can learn a lot. And you’re bright enough to be a physician. You just didn’t go to medical school. You saw you read a lot. Okay, that’s great. You know, wow. So did you I did you go back to work ultimately?

Lauren: Yeah, I did. I did. I went back to work.

Dr. Fox: Look at your devotion to Frisch, you know.

Lauren: But you know what, it was good for them, but it was good for me, too. I miss my… I really did. Like you said, like you care about your patients. Like I also I care about my students so much and I miss them. And I was happy to be back.

Dr. Fox: Plus, nothing happens there at the end of December, beginning of January anyways. You know, it’s a total free-for-all.

Lauren: Exactly. The timing ended up being pretty good. Exactly. But it was good for me, too. It was really good for me to work and to learn and when you’re learning with your students, kind of your mind is taken off of the other stuff, too. So it was good for me on a selfish level, too, you know.

Dr. Fox: Did your colleagues know specifically what was going on? Did your students know, like who…? I mean, they knew you were pregnant. But did anyone have any idea like exactly how crazy your pregnancy was? Or do you keep it kind of vague?

Lauren: I think so for my close friends at work, my colleagues, I was really close with, they definitely knew everything that was going on. And then my students, I actually told them, I actually told them not maybe everything, but I told them a lot, you know, and I think I felt pretty close to them and especially my seniors, because I had had them some of them… This is my third year having some of them. And I think that they were actually really like interested in it. I mean, they cared about me. So there was like an emotional response. They care. They wanted me to be okay. I remember when I came back after my surgery, after being on bed rest, my seniors made me this big card like, welcome back. It was very sweet. But they cared about me. They’re also kind of interested. Like, what is this thing that you’re talking about? I never heard of this. What is a placenta? You know, so it was actually for them, they’re actually kind of interested in it. Like, oh, like, tell me more. And what happens and like, what are the chances that both babies are going to be all right? And, you know, they’re asking actually some good questions there. So I think they actually learned a little bit. You know, I definitely didn’t know about any of this when I was in high school. So, you know. But so that was kind of interesting to sort of share.

Dr. Fox: Did you have any identical twins in your class?

Lauren: I did not have identical twins. I actually had a student that I thought was an identical twin, but it turns out she’s fraternal. But so I had her and I had a few other sets of twins, but not identical.

Dr. Fox: Got it. So they must have thought that was pretty cool.

Lauren: Actually, that’s not true. What am I saying? I actually I did have one student who is an identical twin. I didn’t have her sister, though. I had her. Yeah.

Dr. Fox: Okay. And she’s like, she’s like, “Sorry, ours was easy.”

Lauren: Yeah. There’s definitely a difference, though. You know, I’m part of like an identical twin parent Facebook group. And well, first of all, like, you know, so 15% of like identical twin pregnancies, like something like that, right, experience twin to twin of some sort or some other complication. Right? And so they talk about twin to twin and and this other thing called TAPS and other things like as if, yeah, like a bunch of us had this, you know, in this group. And just I think it’s a more challenge, usually a more challenging pregnancy. I think it’s like 70% of identical twin pregnancies have one placenta. Is that true? I’m not sure if the numbers are correct, but most or 75%, something like that.

Dr. Fox: If you’re an identical twin, that’s probably closer to 90% that have one placenta. But the opposite, whether that’s the converse or the inverse, I don’t remember, but if you have one placenta, you definitely have identical twins.

Lauren: Right. Right. For sure. For sure. So most people in this group had one placenta, a very minority had two placentas. You know, but the one placenta, I mean, there’s just a lot of extra. Some go very smoothly and most go very smoothly, I would imagine. But you still just like there is, I think a lot of the people in the group seem to have had some anxiety over their pregnancy. You know, there is it’s not so straightforward. You know, it’s not like a regular pregnancy and it’s not even like a regular twin pregnancy.

Dr. Fox: Right. The ones, the people with identical twins who don’t have any stress in their pregnancy are people who either just went through it swimmingly with no bumps in the road, which is great, or there are people who were not informed of like, you know, what what could possibly happen. They’re blissfully unaware and nothing happened, which is, I don’t know, maybe that’s better. I’m not sure. But, you know, that’s not how we typically do things, because people need to know like what they’re getting themselves into, like because they’re always asking, like, “Why do I have all these visits?” Well, here’s all the things we can find. And it’s sort of like, do I scare people? Do I not scare? Like, it’s an art, as they say. So, all right. So you’re going along. It’s wintertime. You’re back in school. You passed 28 weeks. What’s next?

Lauren: What’s next is just regular pregnancy sort of stuff. You know, I remember it was like, remember, you said to me, “Okay, so now you can come every other week.” And I said, “Really? That’s crazy.” I was going like twice a week every other week. Wow. Like, what am I going to do with my time and myself? You know, so I was going every other week. Things were looking good. And I remember even the pediatric cardiologist said, “Yeah, we don’t need to see you till the kids are born.” And I said, “Really? Okay.”

And then it was 28 weeks. We got to 30 weeks, then 32 weeks. I had an appointment. I remember at that point, my mom said, “Oh, you’re delivering at Mount Sinai. Maybe you should like…which one is it because there’s east and there’s west?” And I said, “I don’t know, actually.”

Dr. Fox: You didn’t know.

Lauren: I didn’t know. I just didn’t know. I think there was just so many other things to talk about.

Dr. Fox: Yeah. We have signs all over.

Lauren: I know. I just wasn’t paying attention.

Dr. Fox: There’s flyers and signs, it’s on the website. We told you.

Lauren: I know. It’s not your fault. It’s totally my fault.

Dr. Fox: You’re busy with other things.

Lauren: I was head-deep in like twin-to-twin and cardiac stuff. So I would just wasn’t… And then I remember 30. So I had my mom actually came with me to my 32-week appointment. And she never came with me to any other appointment before that. And I was with Dr. Jessica Spiegelman, who was wonderful. And she said, “Well, you have a scheduled C-section and that’s at Sinai West. That’s where we deliver.” And I said, “Oh, okay, it’s good to know.” And then she just kind of went over in a little. And I had spoken with you about this, but she kind of went over again, just sort of like we have a C-section scheduled because one baby was breech. One was head down. The baby that was actually breech was labeled baby A. But then at that point, baby B, who was head down, was actually presenting, which means that was the baby closer to the cervix who would essentially come out first. And so they’re like, okay, so baby B is head first and is presenting. So if it remains that way, you could actually have this vaginal delivery where you deliver head first and then we do like something called the second baby. Baby, you know, they call it baby B, but like second baby breech extraction. And she just kind of went over, you know, again, that usually most of the time it goes very well, but there are some risks to that. And there are some people who even just choose to do a C-section, you know, just because of the, you know, the small amount of risk that it comes with.

Dr. Fox: And the fact that you had twin-twin and laser. So, I mean, we’re you know, it’s not we’re on the edge. You know, not everyone is comfortable laboring twins in general, but certainly twins who have had what you had. But, you know, our opinion is we watch them during labor. So if they look fine, they look fine. And if they don’t, we can switch. Like, we’re near an operating room.

Lauren: Exactly. So this was January 9th and I was exactly 32 weeks. And I remember she went over this with me and my mom and I were talking about it in the car on the way home. And I remember thinking, I don’t know what I want to do because I’m a very risk-averse person in general. And I thought, well, maybe the safest choice is to just go for the C-section, you know, and my mom thought, yeah, you know, me too. And I thought, well, I don’t really want to have a C-section, but maybe that’s the best thing. And then I was talking about it with Avi when I got home. And we saw, you know, there are no signs of labor at that point. So we thought, we’ll have a few more weeks. The C-section was scheduled for my I think I was like 36 and a half weeks. We had a few weeks. I said, “Well, think about it.” I’m like, let me just put this out of my mind because we have a few more weeks. And went to bed that night. Still a little not sure what I was going to choose, but thought, okay, all right. I’ll think about it in a few weeks from now.

And then the next morning I woke up and felt a little odd, just feeling like a sense of fullness. And I thought, oh, like, maybe this is digestive. I have to go to the bathroom or something. But I otherwise felt fine. And, you know, my daughter was, you know, needed to get up. And this is like, I don’t know, between 7:30, 8:00. So I get up, I get dressed for work. I get my daughter, I get her dressed. I remember we come downstairs and I’m giving her breakfast. And I had to take her to daycare. Usually I leave around 8:45 to drop her off and then go to work from there. And about 8:45, remember, I was on the floor playing with her. And then I got up to sit down for a minute and drink a sip of tea before taking her. And then as soon as I got up, I just remember thinking like, oh, like, I’m having a little bit of pain. Let me sit back down. So I sat on the couch. I thought, let me just give myself a few minutes. She was still playing. And this is like 8:50 now. I’m like sitting on the couch.

I got up again. I’m like, oh, I’m feeling pain again in my like abdominal area. I thought, okay, like I probably just have to go to the bathroom. I remember I called my husband. He was like in the middle of a meeting. He works from home. He was in the middle of a meeting. I called him to kind of said, “I think you have to take Leanna to work. I’m not feeling 100%. I’m sorry, you have to take Leanna to daycare.” I’m like, “I need a few more minutes before I go to work.” So he’s like, “Okay, I’m going to get ready.” And he’s getting ready to come down. And then at 9 a.m., I’m like, wait a second. I’m feeling pain now. And I just felt pain a minute ago. What’s happening? And like I’m starting to process that I’m now having pain like every minute. And it’s coming and it’s going. And this is familiar to me.

And I called my mother. My parents live down the block, thankfully. I call my mom and I just said, “Mom, I think I’m in labor. I think you have to come here now.” And she’s like, “What?” And she just like dropped the phone and I think she just ran over. And at that point, it was very clear to me that I was having contractions. And I remember and then my husband comes down. He’s like, “Okay, I’m taking Leanna to daycare.” I’m like, “Avi, I think I’m in labor. I’m having contractions.” And he’s like, “Okay.” And I said, “Okay.” And I said, “Okay, let me just let me call.” Like I called your office and I called them and I said, “I think I’m in labor, but I’m in Teaneck, New Jersey, I’m having like contractions about a minute apart. Should I go to a more local hospital or should I try to get to Sinai West?” And she said, “Well, what does Google Maps say?” Google Maps says 26 minutes. She said, just get in the car and go. And I was like, okay.

So I didn’t pack a bag. I probably should have. I didn’t pack like my hospital bag. I remember, like, my mom was already there. So she was taking care of my daughter. I like kissed her on the cheek. I was like, “Avi, we got to fly into the car.” We like get in the car. I remember I had my work, my fresh like ID card. I remember the last thing I did was I took it off. I threw it onto the couch and I just like got in the car. And at that point, it was just very clear. Like, of course, I’m in labor. Like, how could I have thought otherwise? You know, and it’s like this is like a movie scene. Like we’re driving and I don’t know, miraculously, there was like very little traffic to get there. And and we pull up, we were getting there. And I said to my husband, I’m like, “Are we going to make it?” He’s like, “I don’t know.” I’m like, “You tell me we’re going to make it.” Like all I need is support right now. So he’s like, “Okay, yes, yes, we’re going to make it. Everything’s going to be good.”

We pull up. It’s a scene from a movie. He runs, you know, we get to the hospital. He runs in. He grabs the wheelchair. I’m like, I sit in and they’re like, “Okay, go up to the 10th floor.” We get into the elevator and there’s another person in the elevator. And she’s just like staring at us and mouth agape, just like, and I’m like, I’m like trying to hold in all of my, like, all of my screams because there’s another person there. But she gets off, I think, at the eighth floor. We finally we get to the 10th floor. And I think I had texted you in the car like, “I’m an active laborer. I’m on my way to Sinai West. I think you should get there.”

Dr. Fox: There were several texts and several phone calls, you know, as if a grenade had gone off in your house. And so I think we sort of knew what was happening.

Lauren: Yeah, yeah. I think my sisters probably called someone that knew you or I don’t even know, maybe Myhal or whatever. And you were like on your way. But I just remember so I’m now at the 10th floor.

Dr. Fox: Twelfth.

Lauren: But yeah, sorry.

Dr. Fox: It’s okay. Just in case anyone’s listening and going into labor, go to 12.

Lauren: Sorry. Is 10th a NICU? Is that what it is?

Dr. Fox: Eleventh is the NICU.

Lauren: Eleventh. So what is the 10th? I don’t even know what the 10th is. Okay.

Dr. Fox: I don’t know if I’ve ever been on the 10th floor. I’ll find out.

Lauren: See, I’m not good with numbers, right? So the 12th floor, we get there and I just… Like, we’re there. And they’re like, my husband’s like, “Okay, my wife’s in labor.” I’m like, “Okay.” We got to go to triage. And I just start shouting like, “I’m 32 weeks. I had twin-to-twin transfusion syndrome. I had the laser ablation at 20 weeks. Naty Fox is my doctor. Baby B is breech, or whichever one. One of them is breech.” And then and I’m like just shouting information at them. And then I remember I was just in so much pain. And then Dr. Jessica Spielman was there and I had just met her the night before. And she’s like, “Hi, Lauren. So I’m really glad we spoke last night.” And she’s like, “We need to check you.” And so she was great.

So they’re like, “Okay, you’re 10 centimeters dilated. And baby B, who is presenting, is face down. And baby A is still breech. So you have to decide now what you want to do. Do you want to do the C-section or do you want to try for the vaginal delivery?” So I thought I had a few weeks to decide this.” Right? And my husband was filling out paperwork. So I couldn’t even like talk about it with him. And like, “You have to decide now.” And I said, I just looked at her and I said, “Well, what should I do?” And she said, “You have a really good shot with the vaginal. But really, this is your choice, your decision.” And I went back to this moment of like, this is my journey. This is my choice. Like, this is me in this moment. I have to decide. And I just said, “Let’s just go. Let’s just go for the vaginal delivery. Let’s just do it.” I don’t know. I just looked at her. I just had this trust in her. I said, “We’re going to go. We’re going to go for it.”

She said, “Okay.” And they got everything ready. And they said, “You’re delivering in an operating room just in case we have to switch to the C-section. And there were so many people in that room. There were just like the teams for the babies, the pediatric teams. There are medical residents in there. There were the anesthesiology team and they were amazing. I was so nervous about the epidural because the one hiccup I had with my daughter was that when I did have an epidural with her, when I had it, like it didn’t work properly. And I had like half my body numbed for three hours while still in seething pain on the other half of my body. So I was really nervous for the epidural. And I wasn’t even sure I like I was going to have one because I was like, I felt like I could just push them out, you know, like it was they were coming. But they said no, that they had to actually give me I think it was like a low-dose epidural because in case they had to switch to the C-section, you know, I had to have some anesthesia, right?

Dr. Fox: They do it because you can deliver twins without it, because if you needed to switch to C-section, they can put you to sleep. But the main reason is we knew that for baby B, we would have to deliver him feet first. And so we have to sort of reach in to do that. And without an epidural, it would sting. So, yeah. So by the way, just so you know, I know this is your birth story, but during all this, I’m hauling ass in a cab from the east side to the west side because there are many, many, many people calling me saying, “Why are you not there delivering Lauren’s twins?” I’m like, “I’m coming. I’m on my way.” She’s going into labor 10 minutes ago. No one told me. She’s texting me like, “She’s 10 centimeters, moving to OR, putting it’s final,” you know, and I’m responding back like, “In cab, in lobby, putting on scrubs. Four seconds away,” you know.

Lauren: The play-by-play of your journey too. I mean, yeah, it was they said, “Okay, like we’re basically ready. We’re just, you know, we’re just waiting for Dr. Fox to get there.”

Dr. Fox: Well, I had to get breakfast on the way, get a coffee.

Lauren: And then you were there and I was like, “Oh, thank God you’re here.”

Dr. Fox: I think it’s the first time I met Avi, actually, was in the operating room. I was like, “Hey, nice to meet you.”

Lauren: Yeah, because he had to watch my daughter for all those Mount Sinai visits.

Dr. Fox: Yeah. I’m the guy who’s seen your wife twice a week for the past 10 weeks. You know?

Lauren: I know you guys like so casually, “Hello. Nice to meet you.”

Dr. Fox: Yeah. How’d the birth go? I mean, it was awesome. It was one of the greatest births ever. It was awesome.

Lauren: It was really straightforward. And I would always tell people like my pregnancy was really hard, but the actual delivery part was really nice. Because once they put the epidural in, like I didn’t feel anything. It was great. The pushing was so easy. And so baby, well, was called baby B in the womb, but baby B now comes out as baby A. Right? He comes out head first and he just, he’s crying. And I was like, so relieved. I’m like, oh, my gosh, he’s crying. Like that means he’s probably breathing, you know. And I remember like you guys put him on me and he was just there. And I’m like, I start crying. I was like, oh, my gosh. And I remember I was like a little afraid to touch him. And you’re like, “It’s okay. You can touch him.” And I’m like, “Oh, my gosh.” And he looked like to me, he just looked perfect. He just looked like this healthy baby. And I was like, just so relieved. And then it must have just been a minute later because I saw the birth certificate later on, but like you guys just pulled out baby B like super quickly. And then I heard him cry, too. And I was like, oh, my gosh. And I heard you say something like the windshield wiper.

Dr. Fox: Yes. One of the maneuvers when delivering a breech baby is you have to rotate them side to side like windshield wipers.

Lauren: So I remember you say to Dr. Spiegelman, you’re like, “windshield wiper.” And I was like, okay. In my head I’m thinking, I’ve got to look this up after. I actually found a paper that you co-authored about the windshield wiper maneuver about baby B breech extraction. So I was like, wow, I’m like with the really like the right doctors here. But yeah, so baby B was extracted breech. And he came out so quickly that I was like and that was what I was really nervous about, right. That was why like maybe I should do the C-section. But he came out and he was crying and I was like, oh, my gosh.

Dr. Fox: Yeah, it’s safe because they’re not, you know, they’re not that big, right. They’re going to fit. So like the geometry is in your favor. I know you’re not a math person, but geometry is a form of math where the shapes and so the geometry is in your favor. You just delivered one. You’re in labor and you have anesthesia. So, I mean, you know, things obviously in end delivery, things could go wrong. But the chance of something going wrong and harming one of the babies is just as low as if you had a C-section. So it’s really, that’s why it’s again, unless there’s some sort of like wrinkle with the twin-twin transfusion part. But we didn’t think there would be. So we were pretty confident it was going to work. You’ve done it before. Right? And you had a baby that was probably about as big as both of these guys put together. And so, yeah, it wasn’t a surprise that the birth went smooth on our end, but it was a delight because it was a really straightforward birth on our end. And obviously, we’re all so super excited that they’re coming out healthy. And after what you’ve been through, because, you know, you sort of like, okay, like these are these are two good kids.

Lauren: Yeah. Yeah. It was such a relief. It was it was the greatest relief of my life delivering these guys. I mean, it was. Oh, my goodness, I was so grateful. I was so just filled with like gratitude that almost I couldn’t be contained within my body. Like, that’s how I felt. And it was just it was amazing. And I remember being in the recovery room after. And the sad part was I couldn’t really hold them so much right away because they obviously have to be taken to the NICU. They were preterm babies. But then a nurse brought down some kind of record of their birth with their, I guess it was their footprints and it said the time of birth. And it was 10:40 and 10:41 or maybe 10:41 and 10:42, whatever. And I just remember thinking, wait a second, I was just in my house at 9 a.m. And I didn’t leave my house until like 9:30. Yeah. And I got there at 10 and they were born and we were stalling a little bit and they were born. And in my head, like I didn’t process how quickly everything went. To me, it felt a lot longer just because every second was like very intense for me. But it was really fast. It was really, really fast.

Dr. Fox: How long did they stay in the NICU?

Lauren: So they were in the NICU. Jonah was in the NICU for 25 days and Ethan was there for 27 days. He did have to go back. He had some complications, had to go back for 10 days to a different NICU, to Englewood Hospital, but overall they did very well in the NICU. You know, they were babies. They did not need any breathing support. They just really had to grow and learn how to feed. Like that was essentially what we were doing in the NICU with them. It was hard. I’m not going to lie. The NICU experience is not easy. It’s a very, very strange sensation to like to have children that are not at home with you. And I remember just every day leaving them and then being home. And everything felt surreal. I’m home. I’m with my daughter at home. And then I have these two other children, but I’m not with them all the time. And it was just very strange. It was a very strange feeling. I remember thinking like, I don’t really want to see friends right now because everything just feels weird, like it felt very strange. But at the same time, just like I was still filled with this gratitude. And I was so grateful that they were generally okay and that everything seemed to have worked out, but it was hard. It was definitely hard to… I would wake up. I’d take my daughter to daycare. I would drive to Sinai West. And by the way, it hardly ever took me 26 minutes to get to Sinai West.

Dr. Fox: Yeah, I was like, that’s more miraculous than this laser surgery, that you got there in 26 minutes at 9 in the morning. I was like, well, it’s crazy.

Lauren: And with everything like I knew this couldn’t be like side of the road, police officer delivers my twins. Like I had to be at Sinai West. And so like that just made me even feel more. There were days that took me an hour and a half to get there, you know, so it was like I couldn’t believe that. But yeah, I would take her to daycare. I would go to Sinai West. I’d spend the day with them, leave, go back, pick Leanna up from daycare, come home with her and then just repeat every day. And I remember there was just, you know, there was also just you’d get blood work, especially for my son, Ethan. He has some kidney issues. So they were monitoring these kidney issues, which we didn’t know about until he was born. And every day it was like they took blood and I was just like this anxiety of like, okay, what’s his creatinine level? You know, what’s the level going to be today? And there was a lot of anxiety associated with the NICU, you know, but overall I would say they did very nicely in the NICU, you know, and it was it was amazing. It was really amazing to see that.

Dr. Fox: Looking back now, you know, eight months later, what do you take away from all this sort of crazy rollercoaster of a pregnancy?

Lauren: I take away a lot. I mean, I think that, first of all, just like that feeling of awe that I have about modern medicine is still with me, I am still in awe of it. I think for me, you know, like I said earlier, you know, having that knowledge that I had early in the pregnancy about twin-to-twin, just because I heard someone else’s story, that was really powerful. That was really helpful to me. It prepared me for just at least understanding what could happen and what could be and that helped my emotional reaction to this whole thing. And I just I think about how important it is to talk about our experiences if we’re comfortable, obviously, but to share when we’re comfortable and when people want to listen, because I think that even though twin-to-twin is really rare and no one should be afraid of twin-to-twin transfusions. This isn’t like a fear people should just have that they’re going to have twin-to-twin. I think if you have obviously a shared placenta pregnancy, you have to know about it, but even then the odds are probably in your favor that you’re not going to have it. Right? So it’s not a fear that people should have.

But I do think that most people go through life and they do have some experience with something that’s a little bit rare or something that’s a little bit unusual at some point, whether it’s them or a family member or a friend that they know. And to just have like an understanding of different people’s experiences helps because even my son, who Ethan, who thankfully he’s doing really well and he’s doing beautifully, but he does have, you know, he was born with kidney anomalies and so it’s something we have to monitor. I think that my whole experience with my pregnancy helps me with him because I’m able to understand sort of what to look for. I understand now, like with twin-to-twin, I understand that going to CHOP was really important because while twin-to-twin is really rare and this laser ablation therapy is really unusual, you go to the place for whom this is not unusual. These doctors do the surgery once a week on average. So for me now, like with Ethan and his kidney stuff, you know, like we’re going to go to the places where, you know, that the doctors are really experienced. That was something I took away, and and getting multiple opinions and just reading different reports and just having that breadth of knowledge and that sort of like holistic picture of what’s going on is really helpful, I think, for any medical scenario, you know. That was that’s something that I, you know, that I take away and it helps me honestly now.

Dr. Fox: Amazing. Wow. Lauren, thank you so much for taking the time, telling your story. It’s awesome. I’m so happy how it turned out, obviously. And I love your perspective on it. And I really appreciate you taking the time to let everyone else hear about it.

Lauren: No, thank you. Thank you so much for letting me and giving me the platform to share my story and also to you for everything you did for me, you know, during the pregnancy is just tremendous. It’s really just I’m very grateful to be in this position and being able to share.

Dr. Fox: Thank you for listening to the Healthful Woman podcast. To learn more about our podcast, please visit our website at www.healthfulwoman.com. If you have any questions about this podcast or any other topic you would like us to address, please feel free to email us at hw@healthfulwoman.com. Have a great day. The information discussed in Healthful Woman is intended for educational uses only. It does not replace medical care from your physician. Healthful Woman is meant to expand your knowledge of women’s health and does not replace ongoing care from your regular physician or gynecologist. We encourage you to speak with your doctor about specific diagnoses and treatment options for an effective treatment plan.