I Wanted to Scream and Run Away: Postpartum Depression in a Triplets' Mother

'Food is on the table', my mother said. I felt a lump rise to my throat at such a simple sentence. I was convinced that there was a hidden impatience in her tone- a confirmation of my fears. 

I got up and with difficulty walked to the table- it still hurt where they had cut me open- sat down and started eating, when Baby-A started crying. Baby-B and C were sleeping. My mother brought the baby to me and gently but firmly placed him in my lap. The lump in   my throat grew larger and I felt tears rolling down my cheeks, and I felt very ashamed. I kept my face away so my mother wouldn’t see the tears, and I held my baby with my left arm, gently rocked him on my lap and ate with my right hand. 

On finishing, I got up and placed baby on the bed, he was fast asleep by now. I took the empty plates and slowly walked to the wash all the time hoping that my mother would say no, keep the plate there. I will wash. She didn’t. Again I felt ashamed for wishing so, and again I felt the tears. Once inside the toilet I kept the tap running and cried aloud, uncontrollably, for long minutes. When I felt somewhat better I got out and walked to the bed without letting my mother see my face.

We were in one of the private rooms attached to the NICU. It was a week after my triplets were born, and the day we got all of them in the room from NICU. My hormones were raging. I felt absolutely, thoroughly depressed. I just wanted to get out of the room, leave everything, especially the babies, and run away. I wanted my old, calm and peaceful life back. Or at least be able to just sit on the bed with my baby on my lap and gently talk to him while watching his face, make him smile, watch his expressions. I wanted to do that with each of my babies, but having all three together, I could not even look closely at one's face- I had to run around all the time. I couldn’t bear to hear the constant crying, the constant demands for milk, the constant failure to produce any breast-milk, the constant mixing of formula, cleaning the bottles, warming the water, and the diaper changing thrice every couple of hours or even less. 

First days of my babies

One month back I was still having my bed rest. I was not supposed to get up-even to eat. My parents brought the food, served it hot and I barely sat up (because I simply could not eat lying down) and ate. After washing my mouth I would lie down again. Watch some TV or read or talk to my babies in the womb. It was so much better when they were inside. All chaos started when they came out. 

After completing my 35^th week of pregnancy and still counting, I was asked to stop my bed rest, and walk for some time every day. It was very difficult, nevertheless joyful, because my husband helped me walk; we went to the open terrace of the hospital and took strolls. Back in the room my mother talked to me while I took small steps holding her hand and I was treated like a special person.

It all ended the moment my babies came out. I was brought back to my room, and my babies were taken to NICU. The pain of the C-section was killing me, the strong desire to see my babies, the grief of not being able to see them and the uncertainty about the future made me feel thoroughly depressed. 

The nurses were urging me to get up and walk when all I wanted was to just lie down and sleep forever. They asked me to try and express milk when nothing would come. I saw them take small feeding bottles to NICU, all filled with breast-milk expressed by other new mothers whose babies were also in the NICU. I felt so jealous, unhappy and ashamed. 

Then my husband went to NICU and brought some videos of our babies. I snatched the mobile and watched them with hunger and longing. My babies looked perfect, the tiny, soft fingers, and the pink color, thin lips- I felt overjoyed suddenly and wanted to see them desperately. The next day I was taken to NICU and saw them. I fell in love, I wanted to hold them and keep them with me, but at the same time I was frightened. I had no idea how to handle three tiny babies at the same time. 

In 6-7 days we got the babies in the room, one by one. They were very normal, although slightly underweight, but being new born and being one month premature, and being fed formula through a tube attached to the nose, they cried whenever they woke up. This was quite normal, and I wouldn’t have found this an inconvenience at all had it been a single baby, but three babies crying together or one after the other was getting on my nerves. It wasn’t their crying, it was my own helplessness and inability to hold them all together was what made me feel terrible. 

Then there were a lot of opinions- anyone who visited or stayed to help or just heard about the babies, had some advice- many of which contradicted with what the doctors instructed. Relatives said babies should sleep on their backs, not on their tummy like doc instructed; they said babies should be held horizontally in our hands while doc told us to hold them vertically resting their chin on our shoulder. All this confused me and I just wanted to get out of this mess. I looked at the world with hatred as if everyone conspired against me. The next moment I also felt guilty and ashamed for feeling thus. 

My parents and husband understood and supported and loved me completely, but even that I could not recognize or appreciate in my depression. But now when I look back I can see how blessed I was and am to have the three of them in my life, and how much more I could have enjoyed those first days with my babies if I had recognized the love and effort of my parents and husband in helping me out. 

As a new mother, if I had a single child, all I would have had to do would be to sit on the bed with my feet up and baby on lap, and feed him and watch his face. But as a mother of triplets I always had to move around, mixing formula, cleaning bottles and changing diapers- there was no time to enjoy my babies’ faces. Or to have the kind of traditional prasavaraksha (a postpartum care package) guaranteed to make me healthy enough to take care of the babies in the future. My mother constantly said aloud that I should undergo prasavaraksha, but it was not possible at the time. We needed all hands to help out. I could not back off and take life leisurely.

I am not elaborating. But the first year of my motherhood was a roller coaster ride of emotions- imbalances. I cried at least once every day, I wanted to scream and run away, and I always felt as if I was bound by chains, and there were these walls around me, imprisoning me, and there were these whips lashing at me urging me to constantly work while I wanted to rest. I wanted to be near my husband and cry my heart out and tell him all I felt, but I never got the chance because we were all busy all the time with the babies. Had I been able to do that I would have definitely felt better. Once we got a chance to go out for a check-up, and my parents took care of the babies for a couple of hours. That was when I chanced upon Babyhood and reading some part of it every night came as a huge relief.

On hindsight, this is what I would like to tell all new mothers of multiples, about postpartum depression-

1. If you feel that you are not treated like a special person anymore, wait for a few weeks. Once your baby starts recognizing faces, yours will be the first one she will recognize, and from then on, you will never feel you are not special- you are THE ONLY special person in the world for your baby.
2. It is perfectly normal to feel like screaming or running away. (I am not telling the other, more dangerous thoughts that I had, but believe me, I had them). If you want to talk about it, I am ready to listen, just give a call. Or there are many forums online about postpartum depression, just talk to those wonderful ladies out there. You are sure to feel better.
3. Appreciate everyone’s help, and try to love and spend time with your babies- this too shall pass soon.
4. Understand that what you are undergoing is due to hormone imbalance, and this is much more than what the mothers of single babies usually undergo. Research has proved it. So it is not your fault- don’t feel ashamed at what you are feeling. You do love your baby; it will take some time to realize it.
5. If possible read books like Babyhood, if possible show posts like this to your family- tell them you are undergoing this phase. They may not understand, but at least you tried. 

And finally, talk and share your anxieties, pray and meditate. It will help.

Five intimate questions about IVF

There are hundreds of websites on information about IVF, ways to find out whether you are ready for IVF, the medical questions you should ask your doctor about IVF etc. However, here we shall see five intimate questions about IVF which you should ask yourself and personal fears which you should resolve within yourself, before embarking upon the journey.

1. Are you sure you want a baby? What if it is twins or triplets?  As ridiculous as this may sound to a couple waiting to get pregnant and trying for many years, this is the first question you should ask yourself. Parenting a baby is a blessing, it is fun, and it is a huge responsibility. If you are doing IVF there is a very good chance that you might conceive multiples- twins, triplets or more, babies, especially if the cause of your infertility is primarily low sperm count or motility. So, ask yourself-  
   • Are you financially well placed to handle both expected and unexpected expenses of IVF? 
   • If you conceive multiples do you have enough support from friends and family? Because parenting multiples is a huge task, at least for the first first three years.
   • When you take help from friends and family, it is a commitment. The bridge goes both ways. Also understand that they are helping you because they love you, and your yet to be born baby. Be grateful not for their help, but for their love.
   • Are you ready to take a lot of time-off from work, may be give up on some advancements in your career for a few years? Possibly either you or your spouse will need to stay home. Decide who will take temporary leave from job and stay at home to look after the babies. Are you both comfortable with that decision? Because in future there is a good chance that you might feel you are sacrificing your life/career while your spouse is not. No matter how much I say this, you may not give this aspect enough importance now, but you should.
   • There is statistical proof that many marriages bite the dust after a multiple pregnancy and delivery. The possible reasons and solutions we shall discuss in a future post. The question that you ask yourself now is, is your marriage strong enough to withstand the possible stresses that may result from IVF? 
   I am not trying here to scare you. On the other hand I am trying o encourage you. Some marriages bond in much stronger ways after a multiple pregnancy and delivery. So do the bonds with family and friends. And after 3-4 years you can get back to your work, uplift your career. Parenting is fun, it also helps your creativity, and thus the prospects of your success in life! So, go for it! This post on my decision to have a baby might interest you.
2. What if IVF fails? Which brings us to our second question- what if IVF fails? Are you ready to handle the grief, the disappointment? Also the lost money? There are many institutions and groups which offer emotional support. But the first support should come from within you, and from your spouse. Prayer and meditation can help a lot. Remember three things- (1). Whatever happens, happens for a reason, happens for good. Count your blessings. (2). Being childless is not the end of life, you have your life, your hobbies, career, travel, books, love and romance. Even having a pet can help quite a lot. Do not be disheartened. (3).  Adoption is an option you have. If you are really ready and willing to be a parent, biology is no barrier- you can always love a baby- any baby- with all your heart, the fulfillment is not an iota less. 
3. Do you have a pet? A pet dog, cat, bird or fish can relieve your stress quite a lot. I would highly recommend having and loving one, before starting the IVF journey.
4. Are you scared of needles? Scared that IVF will hurt? Well, I was. I was dead-scared. And this is what I learned from my experience- (1) Share your fear. Tell anyone who would listen about your fear. They might make fun of you, but there is a good chance that many of them might be having the same fear. If you tell the doctor or the nurse about the fear, they will be gentle in handling the situation, distracting you from the pain. So, don't be shy to share the fear. (I have been made fun of and laughed at, for fearing the needle at this age, being a professional, a teacher and all- and now, a mother of three! Well, I am scared, and that is that). You can distract yourself by thinking about the happiest and most exciting experiences of your life, about your romantic adventures etc. Apart from the regular shots, there are a few tests that might hurt during IVF. For embryo transfer, most possibly you will be put under anesthesia. For me, I was put under general anesthesia, so I did not even know about what happened. On the whole, in my experience, I expected a LOT of pain, but thankfully it was very minimal. So take heart. (The story in detail is given in my older posts. See http://tripletshouse.blogspot.in/2011/06/ivf.html). This webpage has some great tips- http://www.wikihow.com/Overcome-a-Fear-of-Needles
   
5. What about future side-effects? I am not a medical expert, but from my personal experience, I have had no side effects at all from IVF. My triplet pregnancy and OHSS caused problems, but nothing was carried over to future. However, understand that this is your body and your life, so discuss all your medical conditions and possible side effects with your doctor first.

On the whole, my personal recommendation is that, if your answer to the first question is a yes, then, go for it! IVF is not half as scary as you might expect, and it is worth the try. 
Do you have any other personal or intimate question about IVF you would like to share? We will discuss if you just post it in the comments column. If you want you can post anonymously too.

Hindsight thoughts on IVF

I got a few emails from friends saying they could not access my earlier posts on IVF, OHSS and triplet pregnancy. The comments column was not working either it seems, and I have corrected all that. So I thought of this post with links to all previous posts and a few random Hindsight thoughts on IVF. Here is the link to the story of my decision to have a baby. If you like the page, please leave a comment.

There is a reason why you are reading this page now. You are waiting to get pregnant, contemplating IVF, and most probably you are a Keralite- Malayali. You are confused whether you should do IVF, whether IVF is painful, where you should do it, whether it will be a success, whether IVF has any future side effects,and many more related doubts. I think I might have a few tips for you. There are hundreds of websites on information about IVF, ways to find out whether you are ready for IVF, the medical questions you should ask your doctor about IVF etc. However, there are some very personal and intimate questions you should ask yourself before IVF too, and some intimate fears about IVF, for which you should find solutions before embarking upon the journey like my five intimate questions about ivf. My IVF was a horror story, not because of any reason that you might think of. I used to have a terrible fear of needles (still have some)! I was dead scared of the so-called pain during embryo transfer. I was not sure of the side effects of the hormone treatment for IVF. I was not sure if it was the right decision- whether I should wait more to conceive naturally. And worst of all, I wasn't even sure if I was ready for a baby! And no, none of these was the reason why my IVF was a horror story! It was because of the severe spontaneous Ovarian Hyper stimulation Syndrome (OHSS) due to my triplet pregnancy. It is not common at all, so you really do not need to worry about it. Here is the story of my IVF and the horrors of my spontaneous Ovarian Hyper stimulation Syndrome.

Five hindsight thoughts on IVF

If your answer to the first question in my five intimate questions about ivf is a yes, then you can look at the next four questions. Once you come to terms with your doubts and fears, you can start your IVF cycle. However here are a few things I learned after doing my IVF and going through my triplets pregnancy.

1. When you have faith, you will bring the umbrella. May be you have heard this story of faith-The community began to worry deeply about the prolonged drought. The religious leaders of the town met and agreed to call for a combined day of prayer about rain. They asked their congregations to gather together in the one large meeting house the following day. As the anxious town people settled in their seats, the ministers took turns pleading the cause for rain on behalf of all present. they suddenly heard a deep rumble of thunder, an appearance of dark clouds in the distance , and then the sound of rain on the roof. They were all overjoyed. But they were just as surprised to see that as they walked out through the rain to their cars only one person out of the entire group had brought an umbrella—a young girl whose faith had been so sure she had taken appropriate action.

When you do IVF, believe that you will get pregnant. It is also possible that you might need a bed rest, at least for a few weeks- possible, not definite. So do all the necessary arrangements for taking leave from work, and try to line up the help you will need from family and friends.

2. You are not the expert- your doctor is. So leave the tough decisions to him. There is nothing you can do to make IVF and ICSI successful. But you can and should definitely talk to the doctor about yourself, and also discuss how many embryos are going to be transferred, how many will be frozen, what will happen to the frozen ones if they do not need to be used etc. 

3. Once you are done with the first cycle, go about your daily life as usual. Have faith, but do not count the chickens before they hatch. No need to plan your nursery or buy toys before you hear the great news. If the cycle does not work out, it will cause grief and disappointment if you have done too much planning.

4. If you have bloating belly, vomiting and nausea, you might be suffering from OHSS. If it is mild, it is OK. But if it is unbearable, seek immediate medical help.

5. Document your experience. Each IVF and each pregnancy is unique. Write down your experiences- physical, emotional, everything. Even if the results turn out negative. Someday it might help someone else. Even if it does not, you can always go back to it and after a few years, trust me, you will be very thankful that you documented it.

My posts on the story of my IVF and spontaneous Ovarian Hyper stimulation Syndrome show how the documenting part helped me!

Why don't you share your experience of infertility journey, IVF, pregnancy etc in the comments section?

Triplets Birth and NICU

They have arrived!

I was too occupied these days.. so all the entries in this post are written by Ramesh on my behalf.

09-02-2012

The preparations are on. 50 cm x 50 cm white cloths washed and dried with edges stitched kept ready , two white double dhoti washed and dried in sun is also ready. B+ blood might be required, so identified four people. (Blood is available at IMA, but we can replace it).

10-02-2012

Puja and prayers at temples done. Had a bed side scan. Nothing significant.

11-02-2012

Raining mightily. Rare for February.

Just getting ready for the big day.

14-02-2012

At the conclusion of a journey of waiting, hoping and praying we became parents at 9.30 am today. 36 weeks and 6 days.

Operation theater at 8.00 am. I drifted off with anesthesia. When I woke up I thought the effect wore off in the middle of the surgery, because I felt that my belly was still cut open, searing sharp pain cutting through the skin. In a few seconds I gathered that the surgery was over, the skin is indeed stitched, it is only the pain of the past. Then I heard the magical words- one of the doctors was telling someone else (on the phone, I think)..'..two boys and one girl..' I savored the moment. As I was quiet, and since they knew I was conscious, the nurses became concerned. They told me that it is over and prompted me to ask something. When I asked how much the babies weigh, they were relieved. They said, 'eldest is son, he is 2.07 kg,(I smiled), second is girl, 1.74 kg (a little low?) and third is boy, 1.545 kg (oh, is he OK?)'. They said all three are OK, and are taken to NICU. 

Then they pushed the stretcher out and took me to the room. A mix of happiness and sorrow filled me. I think it is very important that the moment mother wakes up the baby/ies should be there for her to see, touch, hug and kiss..That moment will never come back. At least just for five minutes..it is the need of her body and soul, and may be the same for the babies too. I now think that I should have requested it before the surgery started, they would not have denied it, unless there was an emergency (which, thankfully, wasn't there). But at the time I did not know what was about to happen. I still miss not seeing them the moment I opened my eyes. Nevertheless I was so, so deeply thankful everything went well, babies were healthy and I felt blessed.

Version of my parents and husband- 

Many relatives were present outside the OT, Ramesh's brothers and sisters, my mother's sister, and my dear friend MD teacher (she was the first to come, and stay throughout). Akka was inside the OT all throughout. At 9.40 am a nurse came out and informed everyone about the births. Soon three nurses came out one by one, each holding a tiny white bundle with only a sweet, tiny face outside, and they rushed off to the elevator to the NICU. My mother also crammed into the elevator and got a glimpse of the faces. Only Baby-A was making a kitten like sound. B and C were sleeping.

Baby-A, 3 hours old, at NICU

Baby- B, 3 hours old, at NICU

Baby-C, 3 hours old, at NICU

Much later I woke up in the room. Many of our relatives and well wishers came and left. Ramesh had a chance to go to NICU and see the babies. He brought back the video which I watched hungrily many times. The most beautiful babies in the world. Couldn't take my eyes off the tiny pink fingers. When my little girl opened her mouth as if to ask for milk, my heart melted. She had a lot of hair on her body-my naughty chimp! Baby-C was crying a lot, the nurses said. They had some little problems like yellowish tint of the skin (they call it jaundice, though it is not very serious) which was being treated at NICU. Also they were being given vitamins, iron and other supplements. They were covered in tubes. Formula was being fed through nose. I could not yet produce milk. (This whole issue is described in another section). In the evening nurses came and forced me to get up and walk, so my cut would heal soon. It seemed like torture, though they were extremely gentle and patient with me. I simply could not walk to the bath room, and I simply wanted to lie down, curl up and sleep.

Thus I went to bed with a lot of physical pain, lot of craving to see them, and anxiousness and hopes for tomorrow.

15-02-2012

Saw my babies today. All three cried. Then they got their pacifiers and slept. I just watched them for a long time, touched them and then left.

Neonatologist is DrAG. He is very good. All babies in NICU are made to lie on their stomach. Reduces gas it seems. My family and elders are apprehensive about it, but we are following doc's orders anyway.

16-02-2012

Last night was too painful Could not sleep. Morning doctor came and insisted that I walk, only then the gas will go and pain will subside. Bought formula for babies.

17-02-2012

We shifted to one of the private rooms attached to NICU. Small room, two small cots. Then they gave my eldest- Baby-A- all to myself.

Usually DrAG allows only parents in NICU. But in my case as we require help with the trio, my parents are also allowed to come. In the afternoon after Baby-A came, Ramesh went to buy cloths, formula and diapers for him. They placed him on a pillow, on his stomach. Me and mother were too scared to move him or pick him up. Later the nurses showed us how to change diapers, how to give olive oil massage to him etc. Every one hour they come and feed him 6 ml formula through the nose. Some of the nurses are very good and sweet, some are a bit rude. 

Late evening mother left and Ramesh went out to have dinner. He had just had his formula, and the nurse left. I was alone with him, I closed to door and tried to hold him and feed him. He tried to latch on, too. Blessed moments. Have described it in another section.

Started the process of obtaining birth certificates.

19-02-2012 

Got our little girl- Baby-B- at 2 pm today. I am becoming slightly possessive of them.  

Nurses taught us how to hold the babies supporting their heads- holding behind their necks. Very easy to pick them up and hold once we master it. Mother still prefers to hold them horizontally, but holding them vertically is more scientific- lets out the gas, easy to burp and less colic. Both babies sleep a lot but at the end of an hour, if formula feeding is a bit late- even 5 minutes- they stir up and start crying. Even though DrAG has instructed 6 ml and 5 ml, sometimes nurses give them more formula saying they are still hungry. I criticized them once for this, and they were surprised saying that we should see to it that they are well-fed. I felt sheepish. May be I should not adhere to rule book- I should understand the babies' needs more.

Both babies sleep next to each other, on the same pillow. Cute to watch.

NEXT...NICU days

35 Weeks

25-01-2012

Completed 34 weeks today.

01-02-2012

Scanning results : Baby-A 2.1 kg, Baby-B 1.8 kg and Baby-C 1.6 kg. Cervix 4.8 cm. Blood flow values PI-RI 0.1 to 1, Heart beat 187, 159, 152, Presentation, A and C cephalic (vertex), B breech. Everything looks excellent.

Friends and relatives keep coming. My cousin's son was born last week here in the same hospital, normal delivery but slight problems with weight, feeding etc. Now everything is fine and they are getting discharged today. My colleague Manju came today, she is doing all the work to help me with my taxes and other salary related things in the treasury. How can I ever thank you enough?

DH got a new project. He might soon quit the office and start work independently. A little sadness there because we both love the office, but anyway, life has to move on. He will require more free time, more money too, so quitting now will be better to avoid future complications. 

DrSri said if needed we can get discharged for two weeks and come back afterwards, but we decided against it. It won't do any particular good. Cesarean scheduled for 14th February, Valentines Day, Visaakham star. Just the day I had in mind from the first day I heard I was pregnant.

Ramesh's mother is not very well, health problems. He has triple responsibilities now, with mother, hospital and setting up new office.
Next.. Birth!

33 Weeks

18-01-2012

My weight has finally reached a respectable 79 kg now. On 20th January there is going to be a bedside scanning. Yesterday movements were very few, probably due to my Citrazene intake. I am still taking it to fight my dust allergy. As expected, doctor asked me to walk for a few minutes every day. Otherwise it will be very difficult to move or feed after cesarean it seems. The foot elevation of cot is still there, though they may remove it tomorrow. Me and DH went to the breezy terrace of the hospital. Walking is very difficult for me now.

01-02-2012

Scanning done. Baby A 2.1 kg, Baby B 1.8 kg and Baby C 1.6 kg.

NEXT...35 weeks

32 weeks

11-01-2012

32 weeks completed! Almost 78 kg now. Maximum I can expect is 82-83 kg. That is each baby should be somewhere to the tune of 2 kg. Once all babies are 2.5 kg only they will discharge us from NICU it seems. DrR said today that mother can enter NICU and sit for sometime. Relief! 

DrR (Akka) said now the strict bed rest routine will not continue. I will be asked to move around a bit. So that means, another time like this- when I am completely in rest, completely taken care of by others- is not going to happen for a very, very long time..

I am not sure if total bed rest was really required for me. Doctors instructed me to do so, and I followed the instructions mostly. Sometimes I could not, though. According to the hospital records, I leave the bed only once a day, when I get up to go to the bathroom in the morning. Finish toilet, and bath at the time, and then everything else is to be done in bed. Food tray connected to bed, and someone should feed while I lie down. Similarly use bed pan to relieve myself. I am told that ladies with multiple pregnancy who used to take rest like this go full term, or at least 36 weeks. I guess they will cite my example to the future inmates here, saying I took absolute bed rest, so went full term (if that happens)! But the truth is that everyday I eat sitting up. I don't want to disobey them, but I simply can't take food as my stomach always feels full, and it is essential that I eat. And I simply cannot eat while lying down. That too, my cot is slightly raised at the bottom (For all cases where a preterm delivery is suspected, the cot is slightly raised at the foot part. To defy gravity I think. While I was taking rest at home also my cot had this extra wooden piece attached at two legs to keep it up). 

So eating becomes very difficult, and I sit up and eat. Similarly I hate using bedpans, and always walk to the bath room. I get up from bed at least 15 times a day. All my instincts insist that I really did not need bed rest until the last trimester. So my advice to the future expectant moms is, not to say no to bed rest, but to listen to your body, understand its capabilities, strengths and limitations. Then consider your own intuitions, and take a decision.

NEXT...33 weeks

When do I get to see you!

1-1-2012

Looks like they are celebrating New Year inside me! Got a few very strong kicks today, I think from Baby-B. These are the first REAL kicks I am experiencing! Till now it was only movements.

5-1-2012 (31 weeks)

I shouldn't have told the nurses about the vaginal itching, I think. Candid-B was good enough, but they insisted on a Betadine wash, and got one today. Very dilute solution since it is said to have some minor side effects. Wash was slightly painful, no side effects though. Next time, Candid-B is enough!

Afternoon, a UV scan was scheduled. A nice change from the confinements of the room. We went right after my lunch. There was a queue, so it took about 90 minutes for my turn. Cervix 4 cm long (great, considering it is 31 weeks) (OK, may be an explanation is needed here- the baby comes through this small tube path called cervix. At the time of delivery cervix dilutes and becomes zero length, and baby comes out. Cerclage is done so cervix does not dilute fast and the required length is there. As delivery approaches cervix starts to shorten to 2.5 cm, 2, 1.5 and so on). I was lucky my cervix was still holding tight. Baby-A was in the lowest position and in vertex presentation, Baby-B breech and Baby-C is in transverse. Vertex is the best position it seems, vertical with head down. Breech means vertical, but feet down and transverse is horizontal, the most difficult position for natural delivery. But as my case is going to be a C-section, no worries about positions. They showed the monitor to me, but except for three outline of sacs, nothing was clear. Their weights were estimated at 1.596 kg, 1.628 kg and 1.631 kg- fairly good weights. In 32 weeks, the ideal weight is 1.7 kg. Now it should be seen if the same growth and weight increase will be maintained. I am praying that they will be inside me till 36-37 weeks at least, and their birth weights be at around 2.2 kg each. I wanted to go for a normal delivery. But in that case, Baby-A should remain in vertex presentation. Also I read that there is a chance when A comes out, the breech position baby's chord might get entangled causing blood supply to brain to get cut off causing autism. I do not know about all these, just sharing what I heard or read. If all three babies become vertical, head down.. great!  But rare chance.

A nurse said my next room lady had twins, both transverse; so they decided on C-section, got it scheduled, but the day before the surgery both babies turned around and it was a normal delivery! So anything can happen. I am asked to lie on my side, which I am doing now. Whole body is aching and feeling tired.

06-01-2012

Hospital bills are mounting. Working hours for DH is half of what it used to be. For me, whether the salary would be there or not is still undecided. All in all, financially not a very good situation. Slight depression is setting in and I am trying to fight it off.

Day dreamed while staring at the balcony..An afternoon 6-7 years later. I am promising my naughty kids a trip to 'Hill Palace' (Tripunithura, Kerala) to see the deer. They are happily collecting mango leaves in three separate sacks to give to the deer. Evening, all five of us riding to Hill Palace park. Deer happy and content with all the food..

10-01-2012

Tomorrow I will complete 32 weeks.Average gestational period for triplets. Still I need to carry at least four more weeks- I am hoping to carry at least until February 14th. Even then NICU admission will be required to check if everything is stable, it seems. In other countries I read that parents are allowed to sit inside NICU. Here that is not possible- only one visiti per day is allowed. Why do the doctors and nurses here so adamant about theses things? Don't we have a right to see our babies? to decide whether we need normal delivery or C-section? to decide whether to go for breastfeeding or formula? to see the uv scans? to see the other test reports? But here everything is kept inside and unless we insist very, very strongly, they do not allow us to take decisions for ourselves. We, being no experts on these things, are reluctant to insist as we fear something might go wrong. That system is wrong. The doctors and nurses should tell us the possibilities, our options, the pros and cons, and leave the decision to us, to take peacefully. They always refer to me, and all would-be mothers as 'patient'! It is so unfair! I am sure if I ask them whether I can sit in the NICU, they will laugh at me. If I can't pick up my babies and hold them close to me, how am I am I going to know if they are all right? Isn't a mother's instinct sharper than all those machines and tubes in the NICU? I really hope they act mature and let me inside the NICU for as long as I want, let me hold the babies, so that I can encourage them and give moral support so they can fight their weaknesses and become strong.

After the last scan there was a rumor that I might be discharged for a few days as there is no more major risk of preterm delivery. But later Dr said no, and this became a big disappointment for me. The room got stuffier and smaller, and I got a cold and cough. They shifted my room last week, and now it is better. Why don't they understand that the bedrest in the hospital itself is causing problems for me? I didn't have to get admitted in the first place. I could have spent the time at home, and avoided wasting the money, inconvenience to lots of people, and so on. Also all these medicines they give for minor problems! Like the betadine wash and suppositories for a slight itch, all the medicines for this slight cough now.. So I didn't tell them about the pelvic pain I have. I read that pressure and pain in pelvic area is common- it is due to a hormone being released, called Relaxin, which functions as separator for the two bones in pelvic area, to ease the passage of the baby. All these are preparations of the body to let the baby out. Surely, this means me and my body are normal. So I shouldn't kill that normalcy by giving it medicines, right? (Don't get me wrong here- the doctors, nurses and other staff in this hospital are very nice, knowledgeable and helpful. The systems I mentioned are going on forever, and they are just following it. It is not their personal choice to force me to stay in hospital, or give me medicines or anything, it is what they think is right, and good for me. The intention and the action- everything is good. Only an analysis of the system is required, that's all).

The babies are moving inside. I can see small wave like movement on the belly- fun to watch. At times on naughty kick, and the skin will rise at the place. Absolutely delightful!

Sometimes friends and relatives drop by. It is too good to see them- a relief from the monotony of the hospital stay, and a chance to update myself on what is going on around. Thank you dears.. :)

NEXT...32 weeks

Hospital Bed Rest

16-11-2011 (24 weeks)

Nov 4th, the day I got admitted (22 weeks)

November 30th- 26 weeks

This wonderful feeling fills me.. Today there was a bedside scan. From morning I was waiting for it, and I had planned to ask doc to show me the monitor during scanning. DrSri came did the scan and I mustered the courage to ask her. She said 'sure', and turned the monitor towards me. First I saw the usual B&W moving unruly waves, then suddenly the tiny body came into focus. My baby was lying on his/her back, very calmly as if sleeping, but moving the tiny hands. the little knees were up, supported on the back and feet. I fell in love instantly. Then the scanner moved ever so lightly inside me and the scene shifted. Now I saw a constantly moving baby, it was difficult to make out the head, body, hands etc. But I saw the baby moving and sort of saw the head. I could almost hear the giggles of a little baby! Then doctor shifted scanner again and I saw what looked like total chaos. Baby C was jumping up and down! A very blurred, constant motion, like a flash, that's it. I was not feeling many kicks, but the baby was certainly kicking. Then the screen was blank as she removed the scanner.

Babies are OK, she said. 'Baby C is very active, that's why you couldn't make out the image. Now you should start counting the number of kicks and mark it on a paper'. So I started kick counting from today. Baby C was jumping and moving like a spear. Me and Ramesh nicknamed him/her 'Chattu'. Baby A was much less active. And surprisingly once I got a real kick from Baby B! Actually that was the only kick, every other movement was just movement, sort of wriggling. I am worried about it. So even if I am doing the kick counting, it is not really making much sense.

01-12-2011 (26 weeks)

Today there was a test to see if I had tendency for gestational diabetics. I was asked to drink two full cups of sweet water. They took my blood samples before and after the test. I got the results soon enough, they said I was low-risk. (It seems my blood sugar level is much less than the standard 140 mg/dL. Besides I do not have a family history of diabetics).

17-12-2011 (28 weeks)

Crossed another milestone. My babies have developed their lungs it seems. I was given an injection for lung maturity of the babies, called Betnesol. I have this habit of going online about every tiny thing- may be because I am jobless, taking bed rest and not allowed to even sit up to write. So all I have is my mobile phone to keep checking internet. I know, it is bad, the radiation is bad. I am praying as much as possible, reading books, but not much, watching TV at times. It is quite boring. Anyway..so while checking net and reading stories of other multiples, I came across this story about a baby born in 27 weeks and survived after a lot of effort from the doctors. Also there are sad stories about babies who could not make it. I feel for the mothers, and the stories are making me get prepared for anything that may come.

Betnesol injection is required only if pre-term labor is suspected to happen within a week. I don't think it will happen, however I did not object when the medicine was prescribed. Its effect will last only for another week. Baby movements considerably reduced after the injection and I was concerned. Nurses said it was only a temporary side effect. They took the fetal heartbeat, and I listened to the beautiful rhythm of fast beating little hearts. My heart leaps with the memory of that music.

20-12-2011

Tomorrow I will complete 29 weeks! Previous night my BP was quite low- 100/60, body became weak and movements became difficult. Now it feels better. Today morning when DrSri came, she was accompanied by a battalion of nurses, and I forgot all the doubts I wanted to ask her. She said that the right due date is March 8th, I have to try and carry at least till February 1st. She asked if I am doing kick counts, if the movements are OK etc. How am I supposed to know if the counts are real baby kicking, or if it is only gas? I wish she spends some time here in peace and talk to me. Then I could ask whatever I wanted to know. At least with DrTC, there was enough time. Then when I was thinking this, DrTC came. When he saw me with the kick count charts he made fun of it saying that 'Goodness! you will need an essay book to mark all kicks from the triplets!' I found that funny, and relieving. He said not to worry about counts being less or more or anything of the sort.

Woke up yesterday morning with a lot of anxiety about upcoming cesarean. There will come a day- emergency or planned- when DrSri will come and say, 'OK, time for C-section! What will it be like! The preparations, the pain afterwards, babies' condition, health, feeding them afterwards, possible infections- a thousand worries hover over me. I do not know what I will have to face after getticg discharged from here.

21-12-2011 (29 weeks)

Successfully completed 29 weeks! Ramesh wrote on his diary:"Today my babies completed 29 weeks on this Earth(his exact words, in Malayalam- ente kunjungal bhoomiyil vannitt inn 29 weeks akunnu). A life in fact forms when it starts pulsating inside the parents, then today is the 29th week completion after I became a dad and she became a mom.."

23-12-2011

I developed a habit of praying early in the morning while lying down. Yesterday for an hour around 5.30 am I prayed while keeping a hand on the belly lying on my left side. All three babies were playing, jumping around! Wonder if they can see/feel each other? Feel me? Afterwards nurses came for the regular check-ups and found that my Hg is low- 9.3. So Iron supplement increased to twice a day. Urine test revealed some bacterial infection, probably due to cervical stitch allergy, and they gave a suppository to use for three days- Clotrimazole, Clindamycin tablet. The infection somewhat scares me, because a friend had a cesarean and she got allergic to the stitch thread, There was too much complication and some major surgery had to be done later to replace the stitch with another thread. I was suddenly running high fever too. And during all this fear and anxiety, a Government order fro Higher Education Department came which made matters worse. Mother tried to make me relaxed- she said we have tried our best, did whatever possible. Now let us wait and see what happens. Anyway, the job is not lost. Whatever financial debts come after this, we can somehow take our time and repay to the Government. Whatever physical problems may come, we will face it and try to overcome. (I was worrying about rejoining the course in July and reapplying for QIP extension in August- the uncertainties of it all). Then gradually I relaxed. Nurses gave Dolo for the fever. And by night I was feeling much better.

My weight is still 75 kg- it was 65 kg in 16 weeks. Doctor suggested eating nuts, cashews etc. and said we will monitor every two weeks.
NEXT... 31 weeks

Pregnancy and Bed rest- from July to October, 2011

May be later I will do a complete week by week or at least month by month progress details, but now I am too tired for that. So I will just attempt a summary of what happened from August 2011 to Feb 2012. 

My morning and day sickness more or less stopped after the first trimester. In the 7th week, 20th July 2011, we had an ultrasound, to determine the babies' heartbeats. It was somewhere between 150 and 170 per minute, for all three. I had read somewhere that baby girl's heartbeat count would be more, though it was unproven. So I just assumed that I had one baby girl and two baby boys. Still I thought about finding three names each for both genders. I easily got three nice girl names. During the initial months of our marriage, me and Ramesh had decided on a baby boy's name. So that was also there, but I just could not come up with two other boy names. So I left it at that. Some time during the 11th week, we had a scan in which we SAW the fetuses. It was three tiny rounds, size of grapes. One was very small. Doc said they were 4.2 cm, 3.9 cm and 3.7 cm long, and that this was normal growth. I remember vividly those images, of beating fetuses and the fast rate at which the hearts were beating.

As days passed, my hormones started taking a toll, and I had bitter mood swings. I would become depressed suddenly, cry a lot, and this made my parents worry. May be it wasn't just my own emotions, but the emotions of the babies as well, merged with that of my own. It is a very complex situation- you have three complete, but unknown and unconscious selves within yourself, apart from your own known, conscious self. And those minds and hearts act through you, something like a multiple personality. And then suddenly one day those selves liberate themselves and come out. You no longer feel emotions that are not really your own..Complex indeed.

Our doctor had suggested hospital stay many times, but I was unwilling. I preferred home, and besides hospital stay would be expensive. Only Ramesh was working at the time, that too in a very erratic work schedule. We had some reserve money, but that was all we had in cash. I did not want to spend it all unnecessarily. But my mood swings and the cramps I sometimes felt, and just general nervousness, together worried my family, and made us think of shifting to the hospital, getting admitted. Still I thought it would be better to move sometime during November. By 15th week, DrTC handed my case over to DrSri, the Gynecology specialist, and said she would be in charge from then on. She is a very sweet person, though much more reserved than DrTC. She gave a small briefing on what to expect, and said it was now too late to think of selective reduction, if we were planning one. We were not. During these visits and later hospital stay, one thing I really disliked was being referred to as 'patient' by all doctors, nurses and hospital staff. I was not a patient, and being and remaining pregnant only emphasized the fact that I was healthy, not a patient. But that was the system in the hospital.

13-10-2011 (20 weeks)

I had a Triple Screening test on 30th September, during my 17th week. This was a blood test supposed to find out if the baby/ies has any neurological disorder like Down Syndrome. The quantity of blood taken for the test was more than the usual blood tests, but by then I was quite used to needle sticking on my body. I coolly let them take the blood, and in the process got some admiring glances from other ladies waiting their turn at the lab, They were scared, and were not used to as many needle sticking. I never got the result of the test in my hand, but later learned from the doc that the test was negative, meaning there was nothing to seriously worry about. She said there was another test called amniocentesis, an invasive procedure, which was done if there was a possibility of risks during Triple test. She said it was not necessary in my case, even a bit dangerous, since it was an invasive procedure, still if wanted to do it, they would do it. I said no, and was relieved. Those days I had this habit of going online for every single thing, every word, every symptom, every medicine, every test. Everything seemed fine, yet I found something new to worry about.

21 weeks

Finally, towards the end of October, one night I had a terrible stomach pain. We rushed to the hospital, waited endless minutes in front of the casualty before someone attended to us. I was writhing in pain eighty percent and fear twenty percent. My mother was with me while Ramesh went to fetch a doctor, and she got very worried. At long last I was taken to the ICU, given medication and finally the pain settled. Much later I was told that the pain came because one of the fetuses shifted position in an unusual way. This made us all get real panicky and finally we decided to move in to the hospital- on November 4th, 2011.

NEXT..24 weeks to 29 weeks

Cervical Stitch

31-8-2011 (13 weeks)

I am worried sick. Doctor told me to undergo a procedure called cervical stitching. It seems this will reduce the possibility of pre-term delivery. A suture will be applied to cervix, under anesthesia. It is a safe procedure, she assured me, yet I am very nervous.

07-09-2011 (14 weeks)

Cervical cerclage is done. It was not painful, nothing serious. I was admitted, taken to labor room. Another table was next to me, a lady in labor lying on it. I was put under general anesthesia. (Frankly, I like the feel of drifting off to unconsciousness when the gases are released in my system). When I came to again, I heard a new born cry somewhere. There were conversations. I am not sure if all this was imagined, or real. Anyway, I was kept under observation for a day, in the room, and then discharged. No pain, no irritation whatsoever.

NEXT..22 weeks

My triplet pregnancy - my diet during pregnancy

Sept 30, 2014
Craving for certain foods during pregnancy is a well known phenomenon. I was also hoping that when I got pregnant I could eat all the food I wanted without the slightest botheration about gaining weight because I would be expected to gain weight anyway. Then during the days of OHSS I developed an aversion for most foods and the bloating of stomach made sure that I could not eat much. Later on, I also developed a liking for raw mangoes and some raw fruits like jambu (champakka/wax apple). During the initial months I had severe morning thickness which lasted till the afternoon, vomiting bitter yellow liquid 3-4 times every morning. It was a horrible time, yet it was very comforting. It assured me that everything was fine, I was still producing beta hcG and all was well inside. On a rare morning when I felt no sickness it scared the hell out of me. But the nausea attacked with a vengeance later in the day. Those days I had the same pre-pregnancy diet.

After the first trimester, things settled a bit. I started my rest period, lying on bed or couch most of the time. I wasn't interested in TV much, but as my parents were watching a few serials which had stories of Gods and Goddesses, I watched too. But mostly I looked through the window, watching the birds outside the house or the cat which had a brand new litter of three kitties. I saw how the mother cat keeps all three kittens safely protected, how she goes out to find food, yet is always at hearing distance so she can run back if something attacks her babies. Not all mother cats have the same luxury or same skill, and many kittens die due to malnutrition, predators, sickness etc. But this mom was skilled and all three babies survived and grew strong. I watched them play outside, learn to climb trees etc. The birds were many, various species, and I even found that we had the nest of a bright yellow oriole on the tree in our yard. I listened to their calls and told the babies in my belly that there is bright and colorful world outside..come, we'll explore it together!

There were various medical tests and procedures, some of which I have mentioned in another post. After a few months I was admitted at the hospital, because everyone-me, my family and the doctors- felt that that would be safer and better. My parents also shifted to a house belonging to a friend (more like a sister) which she very generously let us use during those months. So every morning my husband would leave for work, my dad would come to the room at around 8AM with my breakfast which was idli or dosa with kadala curry (a spicy kerala dish made of Bengal gram) along with a large glass of milk. I was supposed to take full bed rest meaning I was supposed to eat lying down. But that was impossible for me. As such I had no hunger and my stomach became full with a tiny intake, probably because there was not enough space in the stomach after the uterus grew in size with my threesome. So it was difficult to eat anything at all, yet I had to gain weight. So I ate while sitting up, and if by chance the doc dropped in for a quick rounds precisely at that time, I was sure to get a scolding for sitting up instead of lying down. After breakfast there was an assortment of vitamin and calcium tablets. Iron tablets and tonic had to be taken, but if iron is taken with calcium, iron will not be absorbed it seems, so I took iron at night. After the tablets and the regular visit by nurses to check vitals, I used to lie down while dad sat on the balcony and read. At 11.30 AM I had another course consisting of two boiled eggs and two oranges. Now when I think of all that my mouth waters, but those days it was a horror to eat all these food. However I crammed it down. By noon dad would leave and mother would come with the lunch she cooked. Rice, lot of vegetables especially leafy ones, and lime juice. After lunch we would sit(she would sit while I lay on bed) and chat or read something or watch a movie. By 4PM dad would return with a block of cheddar cheese (approximately 30 gms) and a handful of sprouted green grams and sprouted urad. I hated both, but forced them down anyway, followed by another large cup of milk. then the three of would watch TV, the regular Bhakthi serials. We all knew about the damage of TV, mobile phones etc. but it was difficult not to use them. During the evening I would also eat a large spoonful of peanut butter and sometimes a banana. By 7 PM my husband would return from work and my parents would leave. Then both of us would have dinner together, mine consisting of the leftover veggies and rice or chapathis. Then the iron and other vitamin tablets along with orange juice to facilitate iron absorption. We used to sleep by around 11PM.

This was more or less my regular diet. I could not eat lots, so whatever small quantity that I ate had to ensure enough nutrition and weight gain. The idli/dosa, rice/chapathi/banana gave enough carbohydrates. Milk and cheddar cheese ensured Calcium (processed cheese does not have any nutrition. Cheddar or any other type with good Calcium content is a good food during and after pregnancy), and were supplemented with the tablets. The leafy veggies and oranges were for Iron and vitamins supplemented by tablets and tonic, while the sprouts and peanut butter contained lots of protein. This was all I could force myself to eat. Never a chip or chocolate cake or anything. I read online that fish contained Mercury and bacteria which were harmful, so although I liked fish I did not eat it. Once I had a craving for fish, so I chose anchovies (kozhuva), which is among the safer fish varieties, having very less Mercury. Besides I love Kozhuva fry. So that was the only non vegetarian food during pregnancy. Red meat is excellent it seems, to eat during pregnancy (beef etc), but I never liked it. White meat (chicken) was okay with me, but it contained no relevant nutrition. Horse radish leaves is very good. And there are certain foods which should be eaten from the last trimester to ensure good breast milk (which I have noted in another page), a fact which I did not know then. 

I am sure this is not an exhaustive list of options, but this worked well for me. I gained just enough weight (83 kg at 36 weeks, my original weight being in the range of 58-62 kg). The babies, once they started eating solids, showed a peculiar taste for foods- Baby A, who is a very fussy eater, likes peanut butter! Baby B likes fruits, veggies etc, and Baby C loves cheddar cheese! They all like kadala curry! And only Baby A has a liking for sweets. I hope the information will be useful for at least some of you.

NEXT..13 weeks- cervical stitch

My triplet pregnancy - pregnancy spotting, Susten and progesterone

We came to my parents' house a few days back. The news of my triplet pregnancy is not out yet. Relatives and just a few friends know that I am pregnant (nothing about triplets). I am out of Facebook for a while. Morning sickness is there, but not too much. One early morning I had a slight pregnancy spotting, and since then everyday every few hours I check for spotting. That morning we made a frantic phone call to  DrTC and he told me to use Susten (a suppository of natural progesterone, which I had been using before also). Ramesh sprinted out to get to a medical shop, (that was a Sunday, we were in a remote town where shops lazily open at 8.30-9.00 am), and somehow got hold of a Susten (last in the stock I think, but thankfully within expiry date) and rode back full speed and gave it to me. Nothing happened. Spotting was not there anymore. It was really nothing to worry about. But I kept checking. This happened once or twice again, and we bought a box of Susten and are keeping within reach.

Ramesh left for office in the morning, as usual, and I am just spending time reading, watching TV and watching birds through a window. I am also researching good diet during pregnancy, about risks of triplet pregnancy and similar things.

NEXT...My diet during pregnancy

IVF in Kerala - Triplet Pregnancy

We did IVF- ICSI and conceived!. Read here about the IVF

Then started the OHSS symptoms.

It's TRIPLETS!!!

Well, facts are always more complicated than fiction, no doubt. In the last two weeks, especially on one particular moment today morning, my life changed entirely. Whatever I was, whatever I was planning for myself, whatever I was expecting in the future..everything changed so drastically..I am yet unable to believe, and I am exhilarated, I am scared, although what can be the consequences and implications of it all I may not fully grasp until after many years.  

After coming home on 5^th, my parents went to their house to fetch the things for a stay that might be little longer than expected before. When Ramesh left for office, I sat alone. I felt very nervous about my P.G. course. If I do not go to complete the course, then it might become a problem (as described in the post 'Post Graduation'). Besides I did not want to waste the first two semesters of hard work, good fun and good marks. So just to make myself believe that I would be going, I booked train tickets to Chennai, on the 11^th July evening train, for myself and Ramesh. Then I called up my friend and P.G. classmate Sari and transferred the next semester’s tuition fees of around Rs.45,000/-.  

The next couple of days I spent reading something and worrying about everything. On 10^th my parents returned, and my mother took over cooking from the maid. Mily, our pet dog was allowed everywhere inside the house before, but since my parents were worried about pet allergy to pregnant women, she was now allowed only inside the sitting room.

On 11^th  (Monday) morning we went to the hospital, got the blood check done and found that Beta hCG doubling rate has reduced. I was very anxious, and my face showed the anxiety while waiting outside DrTC’s room. He saw me through the half door and we were called inside. He said the Beta hCG rate will get reduced as time passes, and later it will stop entirely. There is a  chance of increased hormone production by body at the end of the gestation period, and a very remote chance of recurrence of OHSS, but it will not be nearly as severe as the one before. He said that the ultrasound scan report says that it was multiple gestation, and he confirmed it by doing a vaginal scan. I told him that I was planning to leave for Chennai that evening, and he said outright that I should not go. There would be another scan on 19^th, and once it was done we could take a decision. If it is indeed multiple gestation, then I would have to take bed rest. I got very agitated by this. We left the hospital, and I cancelled the tickets. The waiting started again. I was too anxious. Anyway, I spent day and night lying down, reading and watching TV. In between we also went to watch ‘Salt n Pepper’ and ‘Harry Potter VII’. ‘Salt n Pepper’ talks about food and the opening scene song sequence features a lot of mouth-watering delicacies. But my stomach was still tight, no trace of hunger, and I missed feeling hungry watching those scenes. HP-7 we watched on 18^th  -a late night show (somewhere deep inside I knew I would not be watching another movie in a movie theater for a very long time to come). Ramesh was tired from office, and he generally disliked HP movies ("books are so much better!”), so he started snoring loudly. People in front rows turned around and laughed. I felt so embarrassed, but there was no way to wake him up.  Gradually he stopped snoring, still slept through the movie.

Today morning I had yet another ultrasound and vaginal scan. My father came along with us as he had a body check-up (after the angioplasty a few months back) at another hospital on the way. We dropped him there and went to our hospital. This ultrasound was done in the main block of the hospital, in the main scan room. The lady doctor with the accented Malayalam did the scan and she gave her findings to the person typing the report. (Online I have read many stories of pregnant women talking about their scans etc. where the doctors show them the monitors and discuss the results. But here it is not like that. We are considered ignorant, delicate weaklings with whom the important medical information about our own body cannot be shared). She was telling something and I noticed her saying ‘triamniotic’. A mild anxiety crept through me. Really, it can’t be triplets... My mind went numb. I could not pray for anything except that all was well. Even if it was triplets..well, whatever God gives, I should happily accept..after all these years..I closed my thoughts and concentrated hard on praying all was well…

I came out, saw Ramesh waiting there and told him that there might be some unexpected news. He frowned, but kept quiet. Then we went to DrTC’s room. The senior nurse was standing outside the room. She called me aside and said ‘Hey, it’s triplets!!’ I smiled, but it was forced. ’ Really?’ I said. ’Yes, Congrats! And now you take good care of yourself’. With that she went inside. I came back and told Ramesh what I was just told. He smiled, but I could not really make out if it was real, or forced. Then we were called inside and DrTC was sitting with a huge smile. He did not know that I was told, so with all the air of breaking a life changing news (which it was), he said, ‘You know, it’s triplets!’ ’Yes, we heard’ I said. The first thing I wanted to know was if I could go back to Chennai. He said, yes, I could, but then if there was some mild problem, or if there was a spotting (bleeding during pregnancy which to some extent resembles a period, but much less in quantity. It is a common occurrence, nothing serious most of the time, yet scary enough), then I might have to visit a hospital there, and as soon as they found out about the multiples, they’d make me stay in the hospital. Unknown hospital, unknown people, unknown city. And if there was any serious problem, then every single person in the family would blame me for going. So, really it was up to me to decide, and yet I had no options. I said I had a comfortable room to stay, good helping friends around. He laughed at this and said I was saying all these because I had no idea how complicated and difficult life could become during pregnancy. Ramesh offered that he could come and stay with me, and again doctor said, the problem was that things were unpredictable. If something happened then all the effort, all the sufferings, all the money, all the prayers and hope everything would be wasted. And so, finally I had to face that tough moment of actually realizing that I was not going anywhere for the next year. I could not believe it.

Then we talked about the babies. Doctor explained that I might have to stay in bed at least in the last trimester, and he would prefer if I stayed in bed during the whole time. Since the first day of my last period was 2^nd June, my due date for delivery, that is 40 weeks completion, was 8^th March. It might not go full term, but it would be very good if I could carry on till 37 weeks or 36 weeks, or at the very least 33 weeks when babies' lungs would be mature enough to breathe. I looked at the calendar and wondered if I could carry on till 14^th February- Valentines day, that is one day before 37 weeks complete. I felt strong and willful, and somehow felt I could carry my babies full term. We discussed many things, like other couples with triplets, the possibility of my continuing the studies later etc. Then DrTC said in a serious tone- ‘It is not going to be easy, carrying three babies, and going full term. You have to rest completely. Then after the babies are born, it will feel like a kindergarten at home. You will need a lot of patience. You have a choice to do selective reduction, that is, there is a procedure in which the weakest foetus is identified and reduced, so only twins will be there. You can opt for it, but then I would advise against it. Because of all the complications, there is a good chance that if we do this procedure, the other babies also might get harmed.’  ‘Oh, We are not planning any reduction’- Ramesh said quickly.  I had read that sometimes when there is a triplet pregnancy, and there is a health issue, then in that case it is better to do selective reduction so that at least the two surviving babies are healthy. So I wasn’t very sure, and remained quiet and listened to the doctor. He said, ’I am not advising selective reduction for two reasons-one, you both hoped and tried so much, and when you got such a blessing, it is not right to do such a thing when you actually can afford to not do it. You are well settled, you can afford three babies. Then you have the support of the whole family. People do selective reduction when they can’t afford to raise multiples due to financial problems, or because they don’t have enough help. Your case is different. I agree that it will slow down your career growth for may be a few years, but well, it will also enrich you in many ways. Second reason is that the process itself needs to be done expertly. And it is not something we have a lot of experience in. Anything can go wrong, it can affect the other fetus also, I am not saying it will, but it can. Also it is not necessary that the fetus that gets reduced was the weakest. It is just an assumption after studying certain characteristics. So, now the decision is up to you. Think about it, and decide wisely. Your decision, whatever it is, is right’

We came out, and I said, ‘In a way it is good now that we know where all the three transferred embryos are, because otherwise I would have wondered where the third embryo went, whether it is in the tube or something..but then the three frozen embryos, what will they do to them?’ Well, we may never find out.

Much later, experience made me wonder about selective reduction, the technique of identifying the embryo to remove if we so decide-in case of multiple pregnancies. If the criteria for selection is weight, then what we find from experience is that the baby born with the least weight is the smartest one. If the criteria is survival instinct, well, how do they identify if an embryo has more survival instinct? Anyway, that is for experts to think and decide. 

As we started back, we discussed selective reduction. Ramesh would not hear of it. I also did not want to do it, now that the doctor assured that if I could carry at least 35 weeks, then the babies would have no major health or developmental issues. So, no selective reduction for us. We picked up my father on the way, told him the news and he got very excited. We reached home, told Amma. She got thrilled too, but also very worried about the health risks for me and for the babies. 

We are planning to go to my parents’ place and stay there for a few days, to get things settled there and my parents can come with us for a longer stay. I am doing a lot of internet research on pregnancy, especially IVF, that is how I read about ectopic pregnancy, where the baby can get stuck in the tube. Also I read about birth defects when it is a multiple pregnancy. The possibility of autism and other developmental problems due to pre-term delivery. I am having all kinds of bad thoughts these days. I am inventing all sorts of reasons to worry.

I was worried about many things at the time and I could not really appreciate the abundant blessing I was provided with. But later we realized the dedication and expertise with which DrTC and the rest of the doctors and nurses approached each case and the care they give to each one.

NEXT...First trimester