Laura shares her High Risk Birth Story of delivering triplets and a complicated pregnancy that Dr. Fox says required “the kitchen sink” in terms of treatments. Laura recounts becoming pregnant through IVF, debating reduction after initially becoming pregnant with quadruplets, and complications with a short cervix.
“Throwing the Kitchen Sink at my Triplet Pregnancy” – with Laura Casey
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Dr. Fox: Welcome to “High-Risk Birth Stories,” brought to you by the creators of the “Healthful Woman Podcast.” I’m your host, Dr. Nathan Fox. “High-Risk Birth Stories,” is a podcast designed to give you the listener a window into the life-changing experiences of pregnancy, fertility, and childbirth. Laura Casey, thank you so much for coming on the podcast. It’s great to talk to you. How are you doing?
Laura: I’m doing really well, and great to hear from you. I was so excited when I saw your email. So thank you very much for reaching out.
Dr. Fox: Absolutely. I remember your pregnancy very vividly, even though your triplets just turned 12. And so it’s going back into my memory bank. It just struck me as an amazing story and, you know, get into the details that I never forgot about it. And when, you know, doing this podcast, I said, “You know what? I got to reach out to Laura.” You know, thank God your email hasn’t changed and I could still track you down and thanks for agreeing. So tell me how, first of all, how are you and the family doing, you know, in the hopefully weening moments of the pandemic?
Laura: Yeah. The pandemic was a little crazy with three boys. My oldest boy is 13 and a half, and then the triplets are two boys and a girl. So two are 12 and then a girl is12. But yeah, boys don’t like virtual school and think it’s optional because that was really kind of hard. Other than that everyone’s doing really well. And I think every person out there is unique. And so, you know, for kids, even though it’s for your triplets, they’re unique, and so parenting is different. Personalities is fun. It’s fun, challenging and I love it.
Dr. Fox: Yeah. And I think that a lot of our listeners don’t know a lot of people who have triplets and have raised them and they’re 12 years old. Obviously a few people do, but, you know, that itself is pretty cool, but it’s not just the fact that you had triplets. You had a pretty, I don’t know, wild ride in the pregnancy, so to speak.
Laura: It’s funny. I’ve never lost sight of the fact that I consider them miracles, but it was interesting when you reached out because it’s my only triplet pregnancy. I’ve only had two successful pregnancies. So I was surprised you remembered me because I kind of thought you just had people like me all the time or pregnancies like mine all the time.
Dr. Fox: We take care of triplets. Certainly, you know, 10, 12 years ago we had more women pregnant with triplets than we do now just because, you know, the fertility treatment protocols have changed a little bit. I probably remember every single triplet we’ve taken care of to one degree or another. Some people I would need to be reminded more than others, just, you know, based on how many times I saw them but I think for your pregnancy, it was one of the first triplet pregnancies after I joined the practice.
You know, there was a handful of people in that first year and also the way, the chips fell, I happened to see you a lot in that pregnancy so we spoke a lot. I thought about you a lot. We were working a lot. And so definitely that’s another reason. And also, I just remember, you know, your overall like positive attitude, and also after they delivered, we remained in touch for a while about them and how they were doing. And, you know, I’d get cards and pictures and so you’ve definitely stayed on my mind for all these years.
Laura: So it’s not because I cried a lot.
Dr. Fox: You know, everyone cries a lot in our office, you know, patients and doctors. Everyone’s breaking down left and right.
Laura: The very first appointment where everything started going badly, I could have been in a movie crying through a box of tissue. Actually, it was Dr. Rebarber who handed me a box of tissues and it was like, “Oh goodness.”
Dr. Fox: We keep a steady supply of tissues in our office. As I’ve said, many times before, when people come into our office, they always walk out feeling better or worse, never the same. So hopefully we get a lot more betters than worse, but you know, it’s a high-stakes situation. You know, a lot of stuff’s going on for people. In terms of setting up your story, take us back to where you were in life with your family, and maybe career, geographically before you got pregnant with your triplets. So this would be, I guess, you know, 13 years ago. I’d say a year before they were born.
Laura: I delayed getting married because I had a career on Wall Street. I was a Drew’s trader for Goldman Sachs, and then I was an equity analyst and I loved working, but I always knew I wanted to be a mom. So when I finally agreed to marry my husband, we found out a month before we were getting married that his sperm, 85% were dead and 15% were damaged. So we were told we were going to…you know, he would have surgery. Hopefully, we could do IVF to get pregnant. I happened to get pregnant with our son, Gavin, on December 30th, 2006, the first time we were allowed to do anything after he had major surgery. So Gavin was a delightful surprise. And then I got pregnant when Gavin was three months old and I miscarried that. And I had a couple other pregnancies between Gavin and doing IVF where I would miscarry like right around the sixth, seven week.
And I was pretty much told that, you know, because the sperm was damaged, the babies or the fetuses, embryos, wherever you want to call them, didn’t develop heartbeats. Their hearts didn’t form properly. So we did IVF and the mortgage crises happened right after Gavin was born in 2007. So I got a nice payout from my employer not to return from maternity leave. So we did IVF to have baby number two, and it was through that process out of 17 eggs I’ve produced 4 fertilized. And we were told two were Grade A and two were duds and like, couldn’t be frozen. So they agreed to implant all four. And I was actually pregnant with 4 for the first 11 weeks. Believe it or not, I begged, I begged, I was willing to sign a waiver that I would never sue my OB-GYN to keep me as a patient because I really loved her. And I thought, “Hey, I read the books. I’m 5’9. I’ve had a full-term pregnancy, all these books that say I should be perfectly fine carrying triplets.” So the fact that I ended up at your practice was because my OB-GYN went to, I guess, a seminar or something that your practice gave. And so she was really impressed with you guys. And she said, “Laura. you really need to go there and it’s closer to your apartment because I lived on the Upper East Side.
Dr. Fox: Got it. When you were going through the IVF process and they decided to put in all four embryos, what was your thought at the time of the likelihood that you would end up pregnant with twins, let alone triplets or quadruplets? Did you think that was a high chance, or you thought like, “We’re lucky if we get one?”
Laura: So this is going to say a bit about my personality. I was positive I was going to end up with triplets because I wanted four kids. I’m the youngest of four and my husband only wanted two. So I thought, “Okay, this is my only chance to end up with triplets.” So when they implanted the embryos during the IVF practice, and they made me stay in bed for two days, which is really a nightmare for me because I’m a high energy kind of go-do-things type of person, I literally meditated about being pregnant with three. And I felt four embryos. Like, I felt the pinch in my uterus, I believe when the embryos were planted. So when I went to the follow-up appointment, I said to the nurse, I said, “I’m pregnant with four.” And she goes, “Oh no, no, no, no. You don’t know that. You don’t know that.”
And I said, “No, no, no, no. I was, I was praying for three, but I felt four pinch.” And I told her exactly where they were. And she was like, “No, no, no.” And the doctor comes in and I said, “I’m pregnant with four.” And he goes, “No, Laura, you just be happy with one. You should just be happy with one.” And I said, “No, no, I’ll be happy with three, but I’m pregnant with four.” So anyway, it was interesting. I feel like I’ve always known my body pretty well when things go wrong and all that kind of stuff. But yeah, I was right. I was pregnant with four and then we had to do the high-risk thing. I think it was like Columbia Presbyterian where they make you watch these videos to do reduction, which were terrifying and all the statistics and all that kind of stuff. And I looked at my husband, I was like, “Oh my God. What have I been praying for? Like, we’re going to lose them. Like there’s too many. I’m not that big.” and et cetera. Anyway. So they went in to do the ultrasound during that high-risk thing. I guess that my insurance maybe go and I had miscarried one. So then I ended up with three. And I think I must have met you slightly thereafter. I’m not sure when I joined your practice.
Dr. Fox: Around 13 weeks or so with triplets. I’m curious, did either, you know, I guess you were at Columbia or by us or anywhere, or the fertility doctors once it was clear that it was triplets, that it was three and not quadruplets, not four, were you still getting a lot of messaging about reduction or did… You know, obviously, you know, just from hearing your story, it wasn’t something you were looking to do, but did people sort of push you to really think hard about that and you should really consider it and it’s a such a high-risk pregnancy?
Laura: Well, what was interesting is the statistics between twins and triplets first survival rate weren’t that bad. It was when you got to quads where statistics became crazy. So I think when we were watching these videos and we thought we were pregnant with four, I think my husband and I probably turned white just because we didn’t want to lose them. It’s interesting. My husband and I are not particularly religious. I believe there’s a higher power and a God out there, but, you know, what you want to call them, I don’t really care. But all of a sudden, when it comes down to like, actually there’s like a heartbeat in my belly and, you know, should we reduce it or not, I think we both were just steadfast, no. Like that’s a life, and I don’t think religion has to necessarily come into play or politics. Like to us, it was a life and we weren’t going to end it.
Dr. Fox: People that get pregnant with triplets are told a lot of different things and, you know, some doctors, and this is, you know, whether it’s an OB-GYN or fertility doctor, maternal-fetal medicine specialist, some doctors are very much forward about saying like, “You should reduce,” and others are more hands-off and, you know, but the numbers are, they’re not as straightforward as you said. You know, the difference between twins and triplets, there is a difference in terms of outcomes. You know, twins are less likely to deliver preterm and whatnot, but the majority of the time, it’s not as big a difference as people would think. And you’re talking about doing a reduction, you know, to sort of reduce the chance of that smaller chance outcome happening. And so it is more complicated, and as you said, a lot of people are legitimately very opposed to it. They don’t want to do it unless absolutely positively it’s the right thing to do. Like, if you’re carrying four or five, the numbers are different.
Laura: I just got more of a message from a doctor in your practice pregnancy earlier on in the pregnancy about selective reduction at that time, which seemed scarier. Like, it was scarier to me…
Dr. Fox: As you said, again, you know, even within one practice, it’s hard to get everybody exactly on the same page because, you know, the numbers are the numbers, but how you look at them is very different. I mean, you could say, you know, “You have a 10% risk of something.” Okay. So one person looks at 10% and says, “Well, 90%, it’s not going to happen, and I’m okay with that. And I don’t want to do the thing to avoid the 10%,” because, you know, let’s say it’s a reduction. It’s like too big of a deal whereas others look at 10% and it’s like, their world is ending. They’re like, “Oh my God, that’s crazy high.” And neither is right or wrong. It’s just how people view numbers and risk and odds, and that’s true in so many of the things we do with pregnancy and with medicine. And it’s really incumbent on us to help people work through the numbers where they’re at and how they see the statistics more so than how we see the statistics.
Laura: No, it is true. On a side, but related note, I was hung out with a friend yesterday I haven’t seen in 20 years. And she was talking to me about how hard motherhood is. It’s the hardest thing she’s ever done and do that. I was talking to my husband before I talked to you and I said, “God, I don’t view it that way.” I said, “Yeah, we’ve had some really crappy things going on with the kids or health and stuff like that,” I said, “But what a joy. How lucky am I that I get to raise these four kids and I get to see them develop?” And so I think it is just understanding how people view life and statistics open. I definitely carry a lot of hope with me with different facets of my life. So I think that’s played into a part of the triplet pregnancy as well.
Dr. Fox: Right. And so I think the pregnancy started to get a little bit more complicated when you were around 20 weeks or so, correct? Your cervix was short and that’s, I think what you were talking about before with the other doctor. So what happened?
Laura: Well, I had been in Florida with my parents and my son. Had the best time. I felt the best I had in the pregnancy. I was no more morning sickness. I walked the five blocks to your office singing a song on my iPad. And I get there, and all of a sudden the technician’s like, “Oh no.”
Dr. Fox: Oh, that’s always good. That’s always encouraging, the oh no.
Laura: I still didn’t think much of it because like “Jon & Kate Plus 8,” was on TV back then and some other shows and, you know, doctors have all these tools and they save babies all the time. So I thought, “Well, whatever, if there’s a little hiccup, you know, doctors will save me. No big deal.” And then I went in and saw the one doctor and he’s like, “Yeah, we need to abort your pregnancy.” And I just was like, “Why?” And he goes, Well, either the whole thing or two of the kids.” And it was just funny because I really was like, “Well, no, no, no. You have all this medicine. You don’t need to do that.” And he was like, “No, you don’t understand. Your cervix is eight millimeters. Like you’re going into labor. You have contractions. Like, this isn’t good.” And I still was like, not believing him and then I think, yeah, I finally believed him and I cried. I cried as if they had already died because he was killing my hopes. He was killing my hope for my triplets.
I think with a lot of women when you become pregnant, especially when you really want the pregnancy, you start dreaming about what is going to be like to have triplets at home and how is Gavin going to be as an older brother. And you play out years of their lives in your head and dreams and just wishes and all that. So when someone squashes that, whether it’s a miscarriage or an actual doctor saying, “You should abort,” it’s heartbreaking.
Dr. Fox: Yeah. The fact that you have triplets now sort of is a spoiler alert of where this story is heading. Obviously, you didn’t have any abortion of sorts. So what happened after that point? So this gets dropped on you and you’re balling. And then what happened?
Laura: Well, quite literally, I got into a cab and the cab driver couldn’t move because I couldn’t talk to him where I lived. But no, I think what happens is like the hypothetical conversations you have about whether you believe in abortion or not, you know, Roe vs Wade and women’s rights, I think those hypothetical conversations become real. And when it becomes real to you and your husband and your parents and the son that’s alive, you know, what am I doing to his life if I have three children that have massive special needs and I deliver them at 24 weeks, it becomes real. And you realize like, God, I usually view life as black and white and there’s a ton of gray out there I never really considered. And for a lot of people I could see with my situation abortion might’ve been the right choice for other people, you know?
And I like to learn and I like to think a lot in my head. And I think that was just really learning for me. You know, one of the things we were told was after that appointment, I could deliver these babies any day because my cervix was so thin. So, you know, we went home. And you also had the practical matter of, “Okay, do I want to miscarry a triplet pregnancy with my 15-month-old at home watching his mom fall apart?” [inaudible 00:16:00] and so we made the plans to… Sorry, I still can remember all of the feelings, all of the heartbreaks from back then, but we made the plans to have my 15-month-old spend two weeks with my sister. And then he was in our apartment for two weeks with the nanny that didn’t work. And then he spent 12 weeks with my parents in New Jersey when we lived on the Upper East Side.
So my husband would drive Gavin to my parent’s house. They’d spend the week there. He would drive down Sunday night in the shore traffic, bring them back to New York City so I could spend the weekend with him. But by spending the weekend with him, it literally was me laying in bed or the couch watching him play getting to the side hug him for fear of, you know, losing the triplet pregnancy. So it was a crazy emotional time. I consider myself fiercely independent. I realized that, you know, it’s okay to ask for help. It’s okay to say you can’t do something. So that was kind of a learning experience for me. But really it was, I think, to give people the benefit of the doubt when they make choices that you wouldn’t otherwise because I think I was pretty much a black and white person prior to that experience.
Dr. Fox: Yeah. Yeah. Listen, I think that makes a lot of sense. And I think it’s, I mean, for lack of a better word, it’s so cool that you still have the same emotions over this. I mean, it’s 12 years and, you know, that’s how impactful it is at the time that 12 years later just thinking about it brings up so much emotion, how you just, as for people and like you said, it’s not black and white. People look at this so differently and so emotionally for good reason.
Laura: I mean, I don’t know how much detail you have in front of you about that pregnancy and how many times, like, you thought it was going well and then it kind of crashed. Like, I was remembering the other day that I don’t remember the acronym, but the tests that they take, a chemical is released when the placenta starts separating from the uterus.
Dr. Fox: The fetal fibronectin test.
Laura: So that chemical was in my urine, meaning that I potentially would deliver the babies in the next, was it a week or something? It was like some period of time. I don’t remember what it is.
Dr. Fox: You were around 23 weeks and your cervix is very short and this test, this fetal fibronectin test, came back positive, which in twins would mean about a 50% chance of delivering before 28 weeks. So in triplets it’d be even higher, and you know, I, listen, I remember we threw the kitchen sink at you. I mean, we were just, you know, seven kinds of smoke doing we’re for you. Whatever we had or we’re throwing it at you.
Laura: If I can tell you about that day because I remember it so clearly because so many things went on. So I ended up in the waiting room of the hospital after you wanted me to be admitted and I’m literally bawling my eyes out. And then the doctor that told me to abort comes in and stands next to me, which made me feel worse because I didn’t like him. I get admitted and I have, you know, the heart rate monitor and all that because I was monitoring my contractions. At some point during that day, I met with the NICU specialists that went over, you know, the do not resuscitate because I was just so concerned about having these babies then that were, you know, not breathing on their own or needed all this help and basically ruining my older son’s life by not spending so much time with triplets that he never really got full-time parents.
So we went over all of that and all the statistics. And then my husband shows up to bring my 15-month-old to see me and my son’s wearing a hat over his head, his winter jacket. So my husband says, “They have really bad news for you.” And I’m looking at him. And we were still troubling with not wanting to have Gavin be with my parents in New Jersey, just so I could see him more often. So I said, “Oh my God, your mom’s coming up to take care of Gavin.” And he justlooks at me and he kind of chuckled. We had a one-bedroom apartment. So my mother-in-law is somewhat lovely, but we had 600 square feet. And to have me there all day with her there all day and Gavin would have been hard. And then he’s like, “No, no, that’s not it.”
And I’m like, “You got fired,” because all I’m thinking about is health insurance, How are we going to pay for all of these if he got fired?” And he was like, “No, no,” and he takes Gavin’s hat off and my poor little blonde-haired boy has just blood coming out of the back of his head. And he goes, “Well, yesterday when we took the cab from our apartment, you know, to visit you, you said that I wasn’t supposed to seat belt Gavin.” I was like, “Yeah, you don’t seat belt a 15-month-old boy in a taxi cab.” And he goes, “Yes. So I didn’t seatbelt him. So he was standing looking out the window and the taxi cab got an accident. Gavin went flying and hit the rim of the chair, you know, the seat.” You know how they pull the first seat all way up? “And the rim came out and sliced Gavin at the back of his head.” And I go, “What are you doing here?” And he says, “Well, I didn’t know what to do.” I was like, “You take him to the emergency room for goodness sakes.”
So he took him to the emergency room and he said there were so many gunshot victims in the emergency room at Mount Sinai that they took Gavin to Lennox Hill, which is closer to our apartment and where Gavin was born. Well, wouldn’t you believe it, unfortunately, and very sadly it was the night that Natasha Richardson had passed away. And so there was all this pressure and everything in the waiting room of Lenox Hill. So I’ve actually written Liam Neeson a couple of letters thinking like there was a bond there that maybe she helped me save my triplets because she went up to heaven because that was such a scary day for me with failing the fetal fibronectin test. Anyway, Gavin ended up fine. He got a couple of staples in his head and [inaudible 00:21:48] but I called my brother who lived in California since he was like three hours earlier, and I was like, “I’m divorcing Brian. He’s the biggest idiot.”
Seriously, how do you not know to hold a 15-month-old in your lab in a taxicab, especially a New York City taxi cab. I just really couldn’t believe it. But my brother is really sweet. He’s like, “You know, Laura, have you tried to see this from his perspective? Like, it’s kind of stressful for him too. He’s working full-time. He’s taking care of you and he’s juggling the boy and driving around,” and I’m like, “Oh, okay. So I shouldn’t have [inaudible 00:22:23].
Dr. Fox: You’re like, “I hate you brother. I hate you for saying that.”
Laura: Also, I think sometimes when things go wrong, you want someone to blame and there’s really no one. I mean, I was winning myself a lot because I knew that triplets, genetically, they had the CVS testing done. So we knew genetically that they were fine. So to me in my mind, if they weren’t born healthy, that was a 100% my fault. But there wasn’t really anything I specifically could do to save them, you know what I mean, other than ask you to do everything that you could, which you did. And I prayed. I prayed to whoever, Budha, Abraham, God, Jesus. Like, I really didn’t care. I did yoga breathing. I imagined my cervix growing. I would do that. I did deep breathing. I would breathe in 10 times every night. And I would imagine the oxygen getting inside the babies. I literally was like, “If it’s on the internet,” and there’s a lot on the internet, “and it suggested that this could help,” I did it. I had all day. I had all day to sit and do nothing. That was a crazy day. That was a really crazy day.
Dr. Fox: Right. How long were you in the hospital continuously let’s say? What was the longest stretch where you were an inpatient?
Laura: I think the longest stretch was that one and it was three days. And it was interesting because I kept reading on the internet like if your cervix is short, they should do inversion and this and that. But what I kept being told was there’s a chemical process as to whether you go into active labor or not. You know, for all intents and purposes, I was in labor. I just wasn’t in active labor. I mean, I had remembered contracting at 13 weeks. I felt it like getting super hard, like a basketball. So I don’t know if it was you or Dr. Rebarber that basically said, “Look, at this point, it depends when you go into active labor and inversion’s not going to do anything. The placentas were in a proper place. I wasn’t bleeding or anything like that. So yeah. Now, I wasn’t in that much, which was nice because, you know, hospitals aren’t necessarily that much fun.
Dr. Fox: Yeah. Yeah. By inversion you mean, just to let our listeners know what you mean, that’s like when people are in a bed and you put like feet up and head down. The thought is like, let’s have gravity keep these babies in, which is not helpful. That’s not how birth works or it doesn’t work.
Laura: I think the other thing that I had discussed with you, which is interesting, because I heard that they did do it with some triplet pregnancies was the cerclage.
Dr. Fox: Yeah. Yeah. We don’t do it routinely. It doesn’t seem to help and…
Laura: You are the one that explained the statistics to me and I love numbers, and I’m fine with not having that part of my body sewn up, so…
Dr. Fox: Yeah, I mean, it’s possible that your cervix would have remained longer for a little bit longer and maybe reduced some of that scariness, but the contractions would have come either way. You would’ve delivered at the same time. Even earlier sometimes the cerclage can cause problems, but, you know, normally sort of the textbook says that the medications we use to stop contractions don’t work, period. And if they are going to work, it’s going to work for two days, which just gives you enough time to give steroids, which helps the baby’s lungs mature. And that’s what most of the data shows, but, you know, the data’s collected in groups of people who are totally different from you. Everyone’s unique. It’s not tested in triplets and triplets who’ve had a full-term birth and with the sort of… There’s so much, you know, individuality with this that you have to be humble and say, “Listen, we don’t really know what’s gonna work, what’s not gonna work.”
And our goal is to do whatever we can that’s not dangerous. Like, we don’t want to do anything harmful to you or the babies. So we tried this. We tried something that we normally wouldn’t use for a long time and then we did use it for a long time. And so we had to check the babies closely for, you know, possible side effects. We had all these things and, and again, it either worked or it was unnecessary. Right? We don’t know. I mean, obviously, we don’t know what would’ve happened if we didn’t give you anything. We think it helped but who knows?
Laura: I believe that the Indomethacin definitely works. So the Indomathicin, if it’s… So I guess you could say what it is, but it’s an arthritis medicine that ended up turning off the baby’s kidneys. So they drank amniotic fluid and then it would go through the umbilical cord and out through me. Is that…?
Dr. Fox: So Indomethacin is like a very strong Ibuprofen, like a very strong Motrin. It’s used sometimes for pain or for, you know, inflammation, but in pregnancy, it has actually two effects. The main effect is it reduces inflammation and hopefully stops contractions directly. Like, the inflammation that might cause contractions and it’s pretty effective for that. But the second thing is sort of a side effect of it is when it gets to the babies, it sort of affects their kidneys and they sort of pee less and that’s considered a negative. It’s usually a negative side effect, like something you don’t want to happen. But as I recall, I think you had actually pretty high fluid in one or two or three of the babies. And so for you, it was actually like a therapeutic effect to have them pee less so there’s less amniotic fluid, less stretch on the uterus.
And again, this is one of those that you can’t study this. Like, there’s no way to do a study, says, what do you do with triplets when high fluid doesn’t work. I mean, like, it’s use your best guess. You know, you try, you watch closely. It can have an effect on the baby’s heart. So that’s why we check the hearts very frequently to make sure they weren’t being affected by the medication, and I think we gave it to until like 28 weeks. I mean, that’s really, I think, what got you from that really scary period of 23 weeks to 28, and then we went a little more conventional at that time. And you were taking, I think, Terbutaline, which we don’t give anymore.
Laura: That was horrible because I kept not seeing the bump because my belly was so big and I ripped that thing out of my way. That hurt a bit. And then I would have to put it back in, which it wasn’t… I mean, the needle’s not that big, and [inaudible 00:27:56] but definitely when you rip it out, it’s not too much fun. And then you feel like an idiot because you’re like, “It’s been in my leg for months now, but [inaudible 00:28:05] but to go back a little bit with the Indomethacin, so I don’t know the dates, but early on, I think when I was first given it, after a week, I met with Dr. Rebarber and I was coming to your practice, what, like three times a week. So the first couple of times I came after I was given the Indomethacin, it actually worked pretty well. And then after a week, my cervix actually went down to five millimeters and Dr. Rebarber literally looked ghostlike. And I had written that book, which apparently I messed up when it was put on Amazon and I can’t find it now. But to me, our conversation was kind of like, “Okay, we’ve tried everything we can. The Indomethacin isn’t working. How about we double it? There are no studies, but we have nothing else.”
So when you say throw the kitchen sink at me, I do think, and correct me if I’m wrong, that you tried things on me that you hadn’t tried or dosages, I should say, that you hadn’t tried on anyone else because he’s like, “Yeah, we’re doubling it. It could damage the baby’s heart. They could die in utero, or you’re probably going to have them in the next week.” And that was like the very beginning of when things went bad. And like at 20 to 28 weeks, it seemed like every week or every 10 days, like something was going wrong or becoming worse.
And you’re like, okay, because there was something else you had me on too. Well, I guess it was just progesterone. Right? So it’s the Indomethacin that really is the progesterone but yeah. Then, we doubled the Indomethacin, and doubling it had ended up working. But when I had to get that fetal echocardiogram, that first one with the doctor, you know, they have you on your back. And it was really cool because they backed out of the whole baby’s hearts, all their veins and arteries and the chambers and the valves. And they could see everything. And it was only like, what, 23 weeks or something. So you kind of figured out how small were those babies that they could see that level of detail. So that was really, really cool, except it took her forever and I’m sitting there like, “I don’t feel well, I don’t feel well.” And then I ended up getting sick all over the poor doctor. She was so nice too, but I pretended like I wasn’t feeling like[inaudible 00:30:24]. This isn’t going right. I’m on my back too, and yeah, so that was bad, and then she didn’t see me. The next time I went and I saw someone else.
Dr. Fox: Yeah, She said, “I don’t want the puker.”
Laura: [inaudible 00:30:35]
Dr. Fox: During that time, let’s say during that, you know, five, six week period when you’re having all these visits and all that, were you in a constant state of like fear or was it more hope or, you know, sort of optimism? Like, what was going on in your head during that time period emotionally?
Laura: I was all over the place. I will tell you, we had a black lab at that time. And he was so stressed out. He licked his paws raw to bloody raw, which is really funny because after I delivered, then his paws all cleaned up. So we created a lot of stress for him. I would tell you that I was all over the place. My mom would call and I would say hi, and she’d start crying and I’d start crying. So I kind of stopped talking to my mom for a little bit, not clearly stop talking to my mom, but like I felt really guilty. I felt really guilty that my body wasn’t managing things well for the babies because I knew they were healthy. That would probably be like my biggest memory of how I felt was guilt. I cried. I cried a lot feeling guilty.
I’m not a very big person, and I think back then I liked the fact that I was thin and, you know, I was running and I was in shape. And then all of a sudden you’re like, “Wow, this body sucks for what I really wanted to do. I wish I was wider. I wish I was sturdier-built.” You know, so that was kind of interesting like hating your body because I don’t know, I’ve never really been like vain or that kind of thing. But I wanted it to do something and it wasn’t doing what I wanted and that was kind of frustrating. But I was very hopeful. The OB-GYN who delivered my first son, she said, “I know you, Laura. I’ve gotten to like you. You’re going to do everything you can.” And that’s why she said, “Even though they don’t really believe in bed rest, just do it because you don’t want to have any regrets.”
And I think that’s why I scoured the internet for hope. I don’t know if that exists anymore, but there was an incompetent cervix forum. And I would read the stories, which were heartbreaking of these women who would miscarry multiple babies, you know, up at eight months or so because of an incompetent cervix, but you would have the stories of hope. And I think one of the things just in general in humanity is hope. I mean, I think there’s kind of, you know, everyone wants to be loved and feel loved and everyone, you know, wants hope. If there wasn’t hope, I mean, that’s where you get a lot of the violence and destruction. But I think for the majority of society, people are hopeful and I wasn’t going to let go of that. I wasn’t going to let go of that hope until either they were born living or they miscarried.
I’m not sitting here and saying I never cried. I cried a lot. I mean, there was one night I went to sleep. To be honest with you, I thought I was going to die. And I actually said to my husband, I said, “I think I might die tonight.” And he’s like, “Why?” I said, “My heart is struggling. I can hear it beating. It is beating so loudly. I feel like it’s taking all of my energy to pump that blood to the babies.” And it wasn’t at the very, very end. It was probably when things were scary, but I’d never heard my heart beat so loudly. It was like so loud, you know? And he’s like, “Oh, you’re crazy. You’re crazy.” And I said, “I just want to make sure I tell you that I love you and to tell Gavin,” and yeah it was because I was crazy then. Anyway, it was crazy. And, unfortunately, I have a really good memory. So I do remember all the things that I can feel. I can feel how I felt that at that time. I can bring myself back to that place. But I like it and I try to make those feelings remind me when my kids are driving me crazy and I wish they would just vaporize, I’d be like no, no. I really wanted them.
Dr. Fox: I really wanted these kids. At what point in the pregnancy do you recall it sort of flipped that you were like, “Yeah, this is happening. They’re going to be okay,” or, you know, “There’s a really high chance they’re going to be okay?” Do you remember when that happened in your mind or was it not until they were born?
Laura: I think I got permission and I don’t know if you know this, but I got permission on Memorial Day because the day was early. They were born on a Saturday, May 30th, Memorial Day was the week before or the weekend before. I got permission to go to Bay Head, the Jersey Shore, the weekend before they were born. And it was really funny because we drove there and I got there and I was like, “Oh my God, what am I doing? I’m so far away from my doctors.” Like, all of a sudden I got terrified, but I think that’s when I knew they would be okay. I was talking to my friend yesterday. I said, “Oh, when you had your kids, like everyone says, they’re so full of love, like, the moment they were born. Is that how you felt?” She’s like, “Oh yeah.” And I’m like, “Really?” I said, God, when my kids were born I loved them, and I knew I wasn’t going to hurt them, but there was no like miracle you know, feeling of love or whatever.” So I think it was, you know, when they were born more so.
You know, there was the relaxed bit about it. But I think… I don’t want to say like, I’m a tactile person, but I need to see it. I need to see that they’re actually alive before I really truly believe it. I mean, I think my first pictures of my first son I looked almost disgusted. I was like, “What the heck is this thing that they just took out of me?” Like, you know, it was just so surreal. And I think the triplets, it was so surreal and I think it was even kind of surreal the first couple of months they were alive. You know, you’re so busy feeding them, and changing them, taking care of yourself, and reclaiming my 15-month-old that I didn’t get to be a mother to kind of three months. I don’t know. It’s interesting how everybody’s different.
Dr. Fox: Yeah. And you ended up delivering them vaginally. Is that something you even thought was an option?
Laura: Yes because my OB-GYN that delivered Gavin told me to ask.
Dr. Fox: Looking back, you know, it’s 12 years since they were born and you’ve had a lot of time to think about this. And I know that initially when they were young, you wrote about it a lot. You blogged about it. You wrote online. You wrote that book you were talking about and, you know, subsequent to that. What do you think when you look back on all this?
Laura: It’s actually funny that you talk about writing the book because my friend just went through something traumatizing and she’s writing. And I say, I guess that was a lot more traumatizing than I really gave it credit for at the time. You don’t have to… I think for me, at least, I don’t generally notice when I’m stressed until I look back and you’re like, “Wow, that’s crazy.” And you know, I think that’s one of the things my husband and I, when we kind of fight and stuff, when we make up, it’s like, “Wow, we were going to let that stupid fight break us up and we managed the whole triplet pregnancy and all of that. And we’re going to let you know this silly fight about the dog or whatever it is, you know, it’s always silly you know, breaks us up.” So yeah, I think I wouldn’t recommend that for anybody. I wouldn’t do it any differently.
And at the same time I had no choice, right? You’re never given the chance in life to do two things parallel at the same time and figure out what works and what doesn’t. So, you know, I said it in letters to you. I said it in my book and whatever. It is your practice that saved my babies. It is you mainly you and Dr. Rebarber that saved my babies and my husband and I wholeheartedly believe that, willing to do try things you never tried before. I’m friends with triplet moms on Facebook and sadly, you know, some either have kids with feeding tubes or other issues or they didn’t make it, or the babies didn’t make it, but they they’re still, you know, triplet moms. And so thank you from the bottom of my heart. And I hope I get my kids in the city someday to meet you. It is you. You know, I understand you because you’re kinda like me and you’re probably all humble and bashful and “Oh, I was only doing my job,” but you weren’t just doing your job because you did something extra. And I appreciate it. I’ll always appreciate it.
Dr. Fox: That’s very sweet.
Laura: [inaudible 00:38:33] Just so, you know, when he reached out to me, my reply to him was I love you. And I do. My dream was to have a family and I have my family because of you guys. So thank you. And I’m crying again. So you can take that out.
Dr. Fox: I’m not taking that out. Are you crazy? It’s the best thing anyone’s ever said about me my whole life. It’s not this like false humility thing because yeah, we really work our butts off to help everybody and try everything possible. And you know, we do that. It’s not just, “Well, I was doing my job.” Like we really take a lot of care in it, but the humility is that we just don’t know what things work and what things don’t work, meaning, yeah, I’d like to think, it’d be great to go to sleep at night saying, “Oh, you know, Laura has these three babies because of what we did.” And maybe it is the case, but maybe it’s not. And so it’s just one of these things. That’s where the humility part comes in that we just don’t know, and so I think it’s important to try and, you know, to do everything possible.
So it’s not like a full sense of humility. I think it’s true humility that we just don’t know everything we should be knowing in medicine, particularly in pregnancy. And how you face complicated situations in the reality of not knowing the right thing to do is really what defines you as a doctor. You can either say, “Well, I’m not gonna do anything, right, because I don’t know, or you can say, “I’m gonna try this and try that.” And I think that that’s important, but it’s difficult. But ultimately, at the end, we don’t know. We just know what happens and we don’t know what would have happened had we not done it.
I appreciate those kind words, and I’m, most importantly, so happy for you. I’ve always been so happy for you for how well it worked out comparatively to where, you know, it could have been at that 22-week visit when it’s, you’re going from aborting three babies to having three, you know, children who drive you crazy all the time. Like, that’s such a huge change and it just brings me so much joy. It’s why I love my job. It’s why it’s awesome. And that’s why I come to work every day. It’s just because of stories like this. It’s awesome.
Laura: Yeah. Thank you. I hope Dr. Rebarber hears about this as well. You were the one that helped me through it but he was there at the beginning and then he was there at the delivery. I think we’re busy you were busy when I gave birth.
Dr. Fox: Well, I’ll let him know. I’ll make them listen. Laura, thank you so much for coming on the podcast. I am going to see these kids whenever you migrate back to New York City and it’d be great to see you in person. But thank you for coming on. Your story is awesome, and you have such an amazing outlook on it and life in general. And I just am, you know, better for knowing you and I just think it’s fantastic.
Laura: Well, clearly, my family is better for knowing you, so thank you very much, and I hope you get outside and enjoy the sunny day.
Dr. Fox: Thank you for listening to “High-Risk Birth Stories,” brought to you by the creators of the “Healthful Woman Podcast”. If you’re interested in telling your birth story on our podcast, please go to our partner website at wwwdothealthfulwoman.com and click the link for sharing your story. You can also email us directly at firstname.lastname@example.org. If you liked today’s podcast, please be sure to check out our “Healthful Woman Podcast,” as well, where I speak with leaders in the field to help you learn more about women’s health, pregnancy, and wellness. Have a great day.
The information discussed in “High-Risk Birth Stories” is intended for information and entertainment only, and does not replace medical care from your physician. The stories and experiences discussed in our podcasts are unique to each guest and are not intended to be representative of any standard of care or expected outcomes. As always, we encourage you to speak with your own doctor about specific diagnoses and treatment options for an effective treatment plan. Guests on “High-Risk Birth Stories” have given their permission for us to share their personal health information.