Medical Examiner

Before I Got Pregnant a Second Time, I Had to Build a Cocoon for Myself

After losing a twin, I wanted another child. But I was also terrified.

A silhouette of a visibly pregnant woman with mountains within the silhouette.
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When the OB-GYN first told me that there were two babies inside my body, I laughed.

I’d been incredibly sick for most of the pregnancy so far, unable to get off the couch and throwing up everything I ate. It was my first pregnancy, and at eight weeks in, I thought maybe it would be my only. We wanted two kids. Twins meant that I’d never have to be pregnant again.

Twins also felt exciting and different, like something worth admiring. I downloaded books from the library and scheduled appointments with a nutritionist. We told family and close friends right away. At 11 weeks, we decided to tell the world on social media, too. The slideshow on Instagram included a photo of my husband and I with a letter board that said “Gritters Twins Coming January 2020.” We posed with the ultrasounds, our faces as excited and shocked as we felt. We dressed the dog in a T-shirt on which we’d written “big brother x 2” in block letters. It was my most-liked post ever on the social media platform.

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The attention confirmed what I’d suspected and craved: Twins could point me toward a unique and impressive version of motherhood. I am embarrassed to admit that I imagined myself as one of those influencer twin moms, and I followed many of them on social media to learn how to breastfeed two babies and schedule life around caring for two babies at once.

But the next ultrasound, five weeks after the first, showed one larger baby and a smaller one. The smaller one did not have a heartbeat.

Vanishing twin, they call it in medical terms: a baby who’s heartbeat slows down, then stops. Then the fetus begins to shrink, eventually disappearing altogether. By the 20-week scan, there was no evidence left of “Baby B” at all. It had been absorbed into my body and the body of its twin, no miscarriage or blood in sight. In the next months, this detail at turns gave me comfort and felt horrifying, depending on my mood.

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If you’d asked my doctors, they would have said that “everything was back to normal.” To the hundreds of followers I’d shared my news with on Instagram, where I chronicle my life and share updates about my coaching and writing business, I was “devastated but processing.” But realistically, any joy I felt about the pregnancy vanished with the twin. In hindsight, I was dealing with the beginnings of what would unfurl into severe trauma.

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In some ways, the doctors were right: After the twin vanished, my pregnancy progressed fairly “normally,” which in pregnancy terms means I dealt with routine sufferings like insomnia, stabbing pains in my groin, and the persistent taste of metal in my mouth. When my nausea didn’t abate after the first trimester, I was diagnosed with hyperemesis gravidarum, the official term for very, wildly, nauseous. I vomited regularly up until 34 weeks. That’s when I caught a case of severe norovirus and puked so hard that my water broke. My son was born in an accidentally unmedicated, whirlwind, three-hour birth. He would need to spend two weeks in the NICU for breathing issues. And because I was potentially still infectious with norovirus, I was prevented from seeing him for the first 36 hours of his life.

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When I was eight months out from my son’s birth, the panic attacks began. Then came the flashbacks of scenes from my pregnancy and my son’s NICU stay. I would drop him off at day care and sit in the car shaking, struggling to breath, reliving the moments in which I was told I couldn’t see my son at first when he was in the NICU. As I was doing the dishes in the evenings, my brain would suddenly flash to the ultrasound when we learned Baby B had no  heartbeat—even though it had been over a year since that day—and my body would break out into a cold sweat, sending me into a sobbing fit. Once, when my mother-in-law asked to hold the baby, my arms went rigid and my brain flashed to scenes of him hooked up to machines, just days old, barely breathing on his own. What was wrong with me?

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What was wrong is that I had postpartum PTSD, which is estimated to affect between 4 percent and 10 percent  of postpartum parents, and nearly 15 percent of those who’ve had a child in the NICU. (These numbers are on the rise, with rates as high as 40 percent reported during COVID.) When I told my therapist, and later my midwife, about my flashbacks and panic attacks, they diagnosed me quickly. I was a textbook case. But despite knowing what was wrong, I was still depressed, frustrated, and grieving a more naïve version of myself I knew I could never get back. I spent the better part of the following year in an intensive therapy called EMDR, combined with anxiety medication and huge life changes, to try to get back to a normal life. This was extra difficult because shortly after my son was born, the coronavirus started circulating, and we all altered our lives to survive a pandemic.

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But I still wanted a second child. Because of the twin pregnancy, I’d imagined my son as part of a pair from the start. I wanted him to have a sibling to bond and play with. When I thought about being one and done, I worried that I would regret not seeing my son do sweet things with a sibling, like snuggle and hold hands. When I approached my midwife around my son’s first birthday and told her this, though, her response made me realize how serious things had gotten: “If you want to have another child, you’ll need two feet on the ground,” she said. ”Right now you have one toe.”

There are ways to have a child without becoming pregnant, of course. We considered adopting, or fostering. I started researching these options and prepared myself for the long timelines and waits that could be part of either process. And we considered waiting longer to get pregnant ourselves, too, giving me more time to recover. I didn’t want it to take so long. I’d become attached to the idea of having two children close in age. I have hundreds of journal pages full of processing and asking myself, “Are you ready?” For many months, the answer was no.

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My therapist said to me a while ago: “You cannot control how your body does pregnancy. You cannot control if this pregnancy ends up adding a child to your life or not. But you can control the cocoon you build around yourself during this time, to support you in whatever comes.”

So before I focused on getting pregnant again, I focused on building a cocoon. I knew that if I had another kid, I needed to be able to walk into an ultrasound room or a hospital without feeling like I was walking into a fire. I also needed a therapist in place and a psychiatry referral at the ready. And I needed to drain the panic from some of those past events. I poured myself into the EMDR therapy, or eye movement desensitization and reprocessing, which is similar to exposure therapy. I’ve gone through the story of the second ultrasound with the twin with the stopped heart, the story of leaving the hospital without my son for the first time, and the time I was told I couldn’t see my son so many times that they mostly just feel like a set of facts now— hard facts from events I wouldn’t want to relive, but also facts that don’t cause a negative bodily response or a panic attack anymore.

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Beyond therapy, one of the best recovery tactics for trauma survivors is to have a measure of control in a situation where you previously had none. So I knew I needed a say in everything if I were to undergo Round Two: the timing of ultrasounds, the blood tests, the medications I used for nausea, the labor setup, the breastfeeding or lack thereof, and the golden hour of skin-to-skin contact with a brand new child that I didn’t get with my son. I specifically searched for a nurse midwifery practice that would allow me agency in the pregnancy and labor processes. Nurse midwives are nurse practitioners who are trained to care for the whole patient, including their mental and emotional health, with appointments that last for nearly an hour and more priority placed on providing birthing parents with options. After interviewing several doctors and nurse practitioners in town—which you can do, by the way, for free!—I picked the one that seemed to listen most closely to my needs.

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Other parts of my cocoon will look ordinary to anyone who has tried to practice more self-care: a good massage therapist, a chiropractor, space to practice slow yoga, a support system for my husband, trusted child care for my son, and flexible hours at work (luckily, I work for myself). Last year, we moved away from Seattle to a town in the mountains of central Oregon, where we could afford a home with more space and spend plenty of time outdoors.

Perhaps most importantly, I needed to be able to talk about pregnancy (and parenthood) honestly this second time around. So much of my last pregnancy was colored by a grief I couldn’t explain. People tended to focus on the healthy baby growing inside me, but I was still processing the loss of the twin. I wasn’t sure how to put words to the fact that I couldn’t trust my body anymore, because it hadn’t warned me that something was amiss. I felt like I should shut up about my hyperemesis symptoms, even when they dragged on for months. If I were to get pregnant again, I wanted to be able to say, loudly: It’s OK to hate pregnancy!

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Being honest about how much pregnancy sucked for me is ultimately what allowed me to do it again. About four months ago, I answered that big question—are you ready?—with yes.

Thus far, the ultrasounds look good. We found out today that our second baby is a girl. I cried when I saw her heartbeat on the screen for the first time, then marveled that there could be joy in pregnancy, something that had previously felt like constant, low-lying devastation. I feel safe for now—even in a process that I know from experience is out of my hands.

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