Wednesday, July 31, 2013

Happy Birthday, Boys!

Baby boys were born at 9:01 and 9:03 this morning via c-section at 35 weeks, 5 days gestation.  Surgery went smoothly and everyone is doing well.  Baby A was 5lbs 1oz and B was 5lbs 8oz.  They are being taken care of in the regular newborn nursery with no indication that they will need NICU time.  Their parents are on the way from Chicago and very anxious to meet their sons!

I will update with a more detailed birth story later, but right now I am drugged up on morphine and severely sleep deprived, so it's time for a nap!

Friday, July 26, 2013

35 Weeks and Appointment Update

I am 35 weeks pregnant today!  I can't believe there are only 3 weeks or less to go!

I had my almost 35 week appointment yesterday.  First was the ultrasound.  Just did a quick check on both babies, and they are still looking good.  I was shocked to find out that Baby B has turned back to head down.  I assumed they were out of room this late in the game.  I also thought for sure that I would feel them (painfully!) in the event they flipped, but he must have done it like a ninja in the night.  Unfortunately his position doesn't really matter, and Baby A is still hanging out nice and comfy with his head in my ribcage.  So a c-section it is.  The tech said he actually looks like he has enough room to move if he wanted to, but he is just stubborn.  We were able to snap a couple cute pictures of each of them this time.  Also the tech said that she can tell Baby B is going to have a lot of hair!

Then it was on to the non-stress test.  Again, fairly uneventful.  Baby A decided he did not enjoy the contraction monitor sitting on top of him, so after   a little while he started punching it.  It was pretty funny because I could see the whole monitor moving, and the monitor readout had all these weird spikes in random places.  Other than that, everything looked great, and it was off to see the doc.

Now that I have resigned myself to the idea of a c-section, my main question for the doctor was what to do if I went into labor on my own, and what would happen once I got to the hospital (they don't really walk you through a c-section scenario on the general hospital tour).  He told me to go ahead and come in right when I was pretty sure I was in labor - no laboring at home is encouraged in this situation.  He said they would do a quick evaluation, but they wouldn't wait around to see if I started dilating more or anything like that.  He said at this point if I come in pregnant with twins and contracting regularly and strongly, they will most likely just go ahead and do the c-section rather than wait around and risk having someone get too far down in the birth canal.

I go to a very large practice with many different doctors (probably about 10-15).  He said in most cases, whoever happens to be on call when I come in will be the one to deliver me.  He said that since we are somewhat of a special case, he has put into my chart to have the medical staff call him when I get to the hospital, and if possible he will come in and deliver me.  He did mention that he is going out of town from August 3-10, so he obviously won't be available those dates.  I told him that in that case I'm pretty sure that's the time frame when the babies will decide to come, and he said yes, that's usually the way it works.

Anyway, I go back in another week for more of the same.  They told me they will probably do a growth check on the babies next time (I'm thinking they should both be over 5lbs by then), and the doctor said we will schedule a c-section date for sometime around 38 weeks.  My IF will be able to come to the next appointment (IM probably won't be able to make it), so I'm excited for him to be able to see his kiddos again and ask any last minute questions he has.

As far as how I'm feeling this week, I seem to have gotten a second wind here at the end!  I think the fact that I got over my cold really helped, because being sick just makes me miserable in general and makes it so much harder for me to deal with anything else.  Also, I broke down and bought some compression socks that I have been wearing with tennis-shoe type shoes, even to work.  They are super sexy - black and knee high, but they help a lot!  The swelling isn't totally gone, but it's much better than it was before, and it doesn't hurt to move my toes or bend my ankles now. 

I am up to probably about 10 contractions a day now, but I haven't had anything strong or regular.  Other than that I feel like my body can probably handle cooking these boys until they are forced out, unless they decide they want to meet their parents sooner than that!

Friday, July 19, 2013

34 Weeks

Well, here I am at 34 weeks pregnant with twins!  I'm happy to have made it this far.

Yesterday I went in for an ultrasound and my first non stress test.  We did the ultrasound first.  It was quick and easy, all she did was look at the fluid levels in the amniotic sacs, the blood flow in the umbilical cords, and the strength of the hearts.  Both babies are still breech position, pretty much exactly where they were a week ago.  We also got to see both boys "practice breathing," and one of the babies had hiccups during the ultrasound, which was kind of fun to see.  She did not do a growth scan, so I didn't get any estimation on the size of the babies, but I'm guessing that Baby A is close to 4.5 pounds and Baby B is over 4.5 now.

Then we did the non stress test (NST).  Basically it's where I sit on a couch for 20-30 minutes with three monitors strapped to my belly.  One monitor was for each baby's heartbeat, and the third was to measure for contractions.  Both babies had fine heart rates for the whole time.  I had one contraction that I could feel, plus a few more that I couldn't feel, during the time I sat there.  The tech said there was nothing strong or regular about them, and that the reading was pretty typical for this stage of the pregnancy.  The whole thing seemed like a bit of a waste of time to me, but what do I know, I'm just the patient.

Anyway, next Thursday I go back for another round of the same - ultrasound, NST, and adding in an appointment with the OB.  That will be what I will do every Thursday until I deliver.  I'm hoping I make it to next Thursday without going into labor, because now that I know I'm having a c-section, I want to ask my doctor what to expect from when I go into labor through the procedure and recovery.  I have never researched a c-section before.

As far as how I'm feeling generally, this has been a pretty miserable week for me.  The swelling and associated pain have extended all the way up to my mid calves.  I had some swelling my last pregnancy too, but definitely nothing this bad.  I'm also having a lot of round ligament and back pain.  I am woken up with contractions at least once or twice a night, and the last few days I've been having them in the daytime as well.  Each boy has his head pressing into one side of my ribcage, so when they move their heads or arms, I feel like I'm about to crack a rib.  On top of everything else, I caught a cold this week, which just makes everything else so much more difficult to deal with.  I'm hoping that once I get over the sickness the rest of it won't seem so bad.  But I would say that I'm definitely ready for this pregnancy to be over.

I'm hoping to make it 2 more weeks, because 36 weeks would give the boys a good chance at no NICU time.  With all these contractions though, I don't know if I can make it that long.  But my body has surprised me before, and it very well might in this situation too!

34 Week pic:

Everyone keeps telling me I'm small for carrying twins.  I tell them I'm making up for it with the size of my ankles:

Wednesday, July 17, 2013

Coordinating with the Hospital

Another one of the many moving parts of surrogacy is the need to coordinate with the delivery hospital.  It turns out you can't just show up, pop out a baby, and then expect the hospital to allow a totally different couple to take it home.

In our situation, it was important to all of us that my IPs be treated like the parents right from the start, and for me to be left alone without being bugged about medical or legal decisions that I had no right to make.  We also wanted to ensure that the medical staff we dealt with understand our unique situation and treat us with respect during our stay.

Our first step was to find out from our lawyer what sort of legal documents we would need to present to the hospital so that they would recognize my IPs as parents.  As I mentioned in my previous post, she said we would need to get a VAP form from the hospital and sign it (to establish IF as the biological and legal parent).  That way, he would be given the full rights to access and make medical decisions for the babies without me or my husband having to act as the middleman.  The form also allows the babies to be discharged with their parents instead of me.  Since there is no PBO in Missouri, this document is the best we can do as far as getting legal backup for our situation.

My IPs decided that if possible, they would like their own recovery room, separate from mine, where they can spend time bonding with their babies before they are discharged.  I am very happy they made this choice, because while I'm sure I will love spending time with my IPs and getting some baby snuggles in, I don't really want to have to "host" them in my room all day long while I'm recovering from delivery.  Since parents aren't allowed in the nursery and babies are generally expected to "room in" with their parents, getting their own room is really my IPs' only option to be able to spend time alone with their babies for long periods of time.

While on the hospital tour a couple weeks ago, we made sure to ask the tour guide who we would need to get in touch with to figure out how to make sure they can get their own room, and can generally be recognized as the parents by the hospital staff.  She pointed us in the direction of the nurse manager for Labor & Delivery. 

So two weeks ago, I called and got in touch with the nurse manager.  She was very nice, and assured us that as long as there were enough rooms, my IPs would be able to get their own room.  However, she was totally unfamiliar with surrogacy and had no idea about the legal forms or anything else we would need.  She seemed to think that treating the situation like an adoption would be fine, and kept on referring to me as the birth mother (um, no).  After a few promises to gather more information and call me back, and me following up after receiving no call, she finally passed me off to the hospital social worker.

The social worker was also very nice.  Unfortunately, after talking to the birth certificate department, she determined that the hospital had no idea what a VAP form was.  (As a side note - even if they've never had a surrogacy before, I find it hard to believe that they've never had a situation where the legal husband isn't the bio father of the baby.)  She said for adoptions you would normally sign a medical power of attorney form to give the adoptive parents the right to make medical decisions for the child.  I explained that that wouldn't work in our situation, because it would require me to sign away rights to a baby that I never had any rights to in the first place.  So she took down a bunch of info, said she would contact the hospital legal department and my attorney if necessary, and promised to call me back.

Amazingly, she did!  And she had good news!  The hospital legal department had contacted the powers that be, found the VAP form, and have secured it for us to sign when we arrive at the hospital to deliver.  She confirmed that IPs will get their own room (space permitting) and will both get their own bracelets to be able to access the babies whenever they want, regardless of whether I'm present.  She also told me that since she understands what's going on with us, she will serve as point person for our delivery, whenever it happens to be.  She gave me her personal pager number and told me to call it when I'm heading for the hospital.  She will then contact the medical team and make sure everyone knows what's going on.

The other thing she encouraged us to do (which my doctor also recommended) was to get a birth plan put into my file that not only states my wishes as far as labor and delivery, but has everyone's contact number and includes my IPs' wishes for what they are hoping for both during and after delivery.  That way the hospital staff can look through it and do their best to accommodate our wishes without having to ask us lots of stupid questions.

Tuesday, July 16, 2013

The Legal Mumbo Jumbo of Surrogacy

Browsing back through my blog, I realized that for the last couple months I've pretty much just been focusing on the pregnancy part of this journey.  In surrogacy, there are so many other moving parts in addition to just gestating and having a baby, so I want to try to do my best to explain everything else that has been going on in the meantime.

One of the most important things to both the surrogates and the IPs is how to go about establishing the legal parentage for the babies.  Once they come out, we both want to make sure that all rights and responsibilities for the children go to the IPs.  This process varies by state.  In many states, you can get a Pre Birth Order (PBO) signed by the judge prior to the babies being born.  You can then present this order at the hospital to make sure that the IPs are treated as the parents right from the start, and their names go straight onto the birth certificate.  Missouri is not one of the states where you get a pre birth order.  Instead, you have to do a parentage action, which takes place post birth.

The ease and process of obtaining the proper parentage work varies from county to county and judge to judge in Missouri.  Since I will be delivering in a different county from the county I live in, we have a choice between the two of where to file our parentage case.  Our attorney decided that since the judge that deals with surrogacy in the county in which I live makes it much easier to get the parentage paperwork done, that is the county we will file in.  This particular judge is very surrogacy friendly, but he asks that the paperwork is not signed and filed until after the babies are born (some will take the paperwork before and then revisit it once the babies are born).  So basically, there is nothing for us to do until the babies decide to come.

Here is how it will go down, as it has been explained to me.  At the hospital once the babies are born, we need to ask for a Voluntary Acknowledgement of Paternity form to sign.  This will have to be signed by me, my husband, and my IF (the biological father).  The form basically states that contrary to what is normally assumed, my legal husband is NOT the bio father of the babies, and my IF is the one who needs to be given parental rights to them in the hospital.  That way he and my IM will be able to get the bracelets to access the babies, and the hospital staff will know to go to him rather than my husband with questions for the care of the babies.

As far as filling out the birth certificate info in the hospital, we are to do exactly what the staff tells us to do.  So most likely, I will be listed as the mother, and because of the VAP form, my IF should be able to be listed as the father.  Then the hospital staff will forward that information to the Department of Vital Records.  Usually what happens from there is the info takes several weeks to make it through the system at the Department of Vital Records, and once your baby is a few month old, you finally receive the official original birth certificate.  In our case, we will obtain the court order within a few days of the babies being born, and then our attorney will take the order to the Department of Vital records to have the hospital's information thrown out and replaced with the correct information as dictated in the order.  That way, by the time the official original birth certificate comes out, my name should not be on it.

The attorney started the process when I was around 23 weeks pregnant.  I am now 33 weeks pregnant, and we have not seen a single piece of paper related to this.  We have all been told for the last several weeks that it's done and ready to be signed and filed as soon as the babies are born.  I pointed out that it might be a good idea to have us all review it, even if we can't sign yet, just to make sure there are no mistakes.  Since time will be of the essence once the babies are born to get this doc to Vital Records, it seems like a good idea, no?  I have asked the attorney, as have my IPs, as has the rep from our agency.  Yet, no one has received a copy to review yet.  It really makes me wonder what's going on here.  I've never heard of an attorney being so opposed to letting her own clients review a document that they are going to have to sign.

We went with this law firm because the attorney was supposed to be the best of the best when it came to parentage paperwork.  Unfortunately, she recently seems to have passed the torch to her daughter, who is not getting such rave reviews.  My IPs have said it takes days for her to return phone calls and emails, and even when they are contacted they don't get much info.  Basically the only time the lawyer initiates contact is to ask for more money.  As someone who works in the legal profession myself, I find this to be totally unacceptable.  If my firm did business this way we would be out of jobs in a month.  Once the babies are finally born, how long is it going to take her to give us the paperwork?  If one of our names is spelled wrong (since it's apparently too much to ask to review it in advance), how long will it take her to fix the mistake?  Then, how long is it doing to take her to actually get the document filed with the Court, approved, and then taken to Vital Records?

If I have to adopt out my IPs' own babies to them because this lawyer can't get her act together, I am NOT going to be a happy camper.

Friday, July 12, 2013

33 Weeks and Appointment Update

I'm sure you all have been waiting at the edge of your seats to see how my appointment went. Head down or head up? Vaginal delivery or c-section? Well at the ultrasound yesterday, we learned that I no longer have one, but TWO breech babies. So it's nice to know that all of the chiropractor appointments and spinning babies exercises have made it possible for the other baby to move the WRONG way. Baby B's position really doesn't matter as we could try for vaginal delivery as long as Baby A was head down, but it's just adding a bit of insult to injury. So while the doctor said that there is still a slim chance that A can flip, I am mentally preparing myself for a c-section at this point.

The rest of the ultrasound was good. Both babies still look great, they are growing well and have good fluid levels. Baby A is measuring 4lbs even, and B is measuring 4lbs, 6oz. They were relaxing during the ultrasound, with Baby A smooshing his face into his placenta and Baby B turned face down, so we didn't really get any cute pictures. But at least my IPs were able to make it to this ultrasound and get a look at their little guys.

Then we had our appointment with the doctor and we went over the plan for the rest of the pregnancy. Starting next week I will have an ultrasound (to check growth, fluid levels, and positions) and a non-stress test (where they hook the babies up to monitors for about 20 minutes to make sure they aren't in any sort of distress) once a week. I will meet with the doctor in two weeks, and then every week after that. So starting two weeks from now, I'm going to be spending pretty much a whole afternoon at the doctor's office once a week - non-stress test, ultrasound, and OB appointment all in one. We will not be doing any internal exams to check for dilation unless I request them because I have concerns about lots of contractions or something. The doctor said that they don't really give a good indication of when babies will come, and they can introduce infection and irritate the cervix or even start labor before it should be starting.  Probably in 3 weeks or so if I haven't already had the babies, we will pick a c-section date, which will most likely be sometime the week of the 12th.

We also found out that my doctor will be on vacation the week of August 5th. What a pleasant surprise right at the end of the pregnancy. Who wants to guess the probability that the babies will decide to come that week? 90%? 95%?

As far as how I'm feeling, some days are better than others but I'm definitely getting ready to be done. My ankles have completely disappeared due to swelling, I have round ligament and pubic bone pain that comes and goes, and my boobs sometimes feel like they are engorged with milk already. It's getting harder to sleep, especially because I'm woken up at least once or twice a night with contractions, and then have to stay up while the babies have a dance party for a while. But, we have less than 5 weeks to go, so I can handle it!

Friday, July 5, 2013

32 Weeks

Happy 4th of July to all my U.S. readers out there.  Hope everyone had a fun-filled and safe holiday.

Today I am 32 weeks pregnant with these little guys.  Once again, this feels like a big milestone for me.  The chances of babies being born healthy and strong increase with each passing week.  It's hard to believe that there are only 2-6 more weeks to go!

I don't really have too much to add from my last post.  I am definitely feeling like I'm ready to be done with the pregnancy.  I feel like I did at probably 36 weeks or so with a singleton - tired, big, grumpy, and achy.  I still wouldn't say I'm totally miserable yet, give me a couple more weeks. :)  I have gained about 30 pounds so far, which is less than I gained at this point with my own daughter.  Also, even though I'm experiencing some swelling, I'm still able to fit into my wedding ring at this point (I had already had to give it up by 32 weeks last pregnancy).  I think the relatively mild St. Louis summer is helping with that.

I had another chiropractor appointment today, which will be my last before my ultrasound next Thursday.  So one more shot for the chiro to get that baby turned.  I'm actually not sure where the babies are positioned at this point.  I'm pretty sure Baby A is no longer transverse and is now up and down along the right side of my body.  Whether he's head up or head down, I can't tell.  If I had to guess, I would guess he's still breech.  I think Baby B is now hanging out head down on the left side of my body, but I'm not sure about that either.

During the last week I have been having a lot of anxiety about the birth, mainly worrying about a c-section.  The logical part of me knows that a c-section isn't really that big of a deal - women have them every day and are perfectly fine.  It's not even so much the surgery itself that scares me.  My main worry is that if I have to have a c-section, unless I make it to a scheduled date at 37-38 weeks, my IPs (who have a 5 hour drive) will almost certainly miss the birth.  I asked at the last appointment, and the doctor confirmed, that if I go into labor on my own they will not wait around for my IPs to get there, they will take the babies out immediately to avoid the risk of a breech baby getting too far down in the birth canal.

Even before I was matched, one of the things I really wanted to experience out of this journey was to be able to see my IPs meet their child/ren for the first time.  I wanted to soak up the moment of joy and awe and watch a family be created right as it happened.  Yes, I realize that I am being compensated monetarily for this journey, and I realize that I will have plenty of time to visit with my IPs and their sons later on during the hospital stay, but for the 18 months of my life that I have been working on this surrogacy, that first moment was my ideal reward.

If I have a c-section, I will miss that completely.  Even if my IPs are there, they will not be in the OR with me, and the staff will take their babies out to meet them while they finish putting me back together.  And if they don't make it in time for the birth, I'm sure they will stop in to check on their babies before coming to visit me.

I think I'm just overly hormonal in general right now, but I have really struggled with this fear and anxiety this week.  I have been losing sleep over it, randomly breaking into tears (and those who know me in person know that I am not a crier), and obsessing over every little movement to try and figure out if it's being caused by a hand, foot, butt, or head.  I think the main problem is that I just don't know.  I'm hoping that after the ultrasound next Thursday, even if the results aren't what I want, having a sense of certainty will help me accept what's going to happen.

Until then, I'm really trying to focus on the positives of this pregnancy.  I have made it to 32 weeks without any complications or bed rest (and none in sight), and aside from general last month aches and pains, I really feel pretty good.  Although my first contraction as at 23 weeks, since then they have been few and far between, and I don't get the feeling that I will be going into labor anytime soon.  So here's to at least a few more weeks of baby-growing!