‘Tis the Season (for sneezing & wheezing)

Before our babies were born, we started taking precautions to protect their fragile respiratory systems.  All newborns are susceptible to respiratory illness such as the flu, RSV, and pneumonia, but preemies are at an even greater risk, and when they become ill it is often severe.   George and I both received our flu and tDAP vaccines, and asked anyone who wanted to visit the babies during the first year to do the same.  After the babies’ birth we were diligent about things such as hand washing, not wearing shoes inside, staying away from people who had been sick, and not taking the babies into public.  Though difficult, our efforts proved successful.  We did not have a sick visit for any of the babies until after their first year, and have had only a handful in their four years of life.  After a seven week NICU stint, we had no hopes of returning.

Last month, our healthy track record was blemished.  The kids all demonstrated allergy symptoms: runny noses, drainage coughs, and itchy/ watery eyes, but all went to bed seemingly healthy.   The next morning, both George and I left for work early while the kids slept and my mom babysat.  About halfway into my commute, Mom called telling me Sydney was having a hard time breathing.  I presumed her allergies were worsening and she just needed Zyrtec, but I called the pediatrician and got an early appointment anyways.  Because my workday was booked with meetings, I sent George back home to take Sydney.  During my meeting, texts starting pinging and I started struggling with not being there.  Sydney had a nebulizer treatment for low blood oxygen something in the 70’s.  I remained hopeful the nebulizer was all she needed.  After a second treatment, things weren’t improving.  With two liters of oxygen Sydney’s oxygen saturation was only in the 80’s.  This meant an ambulance ride to the emergency room.  Feeling helpless, I rushed to the ER to meet the ambulance, but I beat it by nearly an hour.  I knew she was in good hands, but waiting to meet your child at the ER is painstaking.  As Sydney’s gurney wheeled through the waiting room, I knew she felt awful.  She barely noticed me.  Her face was pale and she appeared limp as she clutched a small tan-colored teddy.


My usually garrulous little girl sat silently in bed as nurses buzzed about her room. After having an X-ray and multiple lab panels run, we waited for answers.  Sydney dozed off trying to steal some rest as the hours passed.   Meanwhile, my mom dutifully held down the fort at home.

Before the dinner hour, Sydney’s attending physician came in with the final result: pneumonia.  Though her symptoms presented as pneumonia, it was somewhat surprising considering she hadn’t been sick prior.  No fever, no changes in appetite or sleep.  Just mild allergies.  There are two types of pneumonia: community acquired (e.g. contagious resulting from infection in public place) or aspiration (e.g. foreign matter such as food, liquid, saliva, or vomit is inhaled into the lungs).  The only way to determine and appropriately treat pneumonia is from lab work that indicates if microplasmas are present.  Though the type wasn’t yet known, Sydney was immediately put on IV antibiotics as a precaution.  She was still very sick, but within several hours, Sydney started talking again and could sit up for short periods.   Despite marked improvement, Sydney still needed oxygen to maintain healthy levels of oxygen saturation so we were in for an overnight stay.

Once settled into our room, Sydney was excited to choose her meal from room service (she hadn’t eaten in over 24 hours).  We had one slight problem when ordering: her egg allergy.  Last year, a mild egg allergy showed up on Sydney’s panel along with dogs and cats.  She doesn’t demonstrate any symptoms after eating foods containing cooked eggs, but we always disclose the allergy in case medication is derived from eggs.  If you have a food allergy of any type, you are given a rather restricted hospital menu.  An egg allergy means NO baked goods of any type and NO pasta, which are among Sydney’s favorites.  She finally settled on French fries and chicken nuggets though she filled up on Oreos snuck in by her nurses instead.   Sydney happily passed the evening hours watching movies from bed and listening to stories.  The night was difficult with hourly nurse’s checks, IV adjustments, and general hospital noises.  I managed to get a little shut-eye curled up next to Sydney while George snoozed on the oh so comfy hospital sofa.  After breakfast, Sydney finally needed to use the restroom and when we unhooked her oxygen tank, noticed her oxygen was in the 90’s!  This meant we could start the clock towards release.  She could go home after six hours without oxygen and no other concerns with her vitals.  We still didn’t know which variety of pneumonia little bit had so a mask was necessary for us to leave the room.  Sydney was not pleased with this, but she clamored to get out of her bed.  The little tan teddy who comforted Sydney during the ambulance ride helped convince her to wear a mask as well as take medication and cope with hospital life.



By late afternoon Sydney passed her six-hour test, and we learned she developed pneumonia from aspiration.  This meant she was not contagious (HOORAY) and we were headed home with a round of antibiotics.  Going to the hospital is always a humbling experience.  We are grateful Sydney’s stay was brief and that we managed to go four years without anyone going to the hospital.  Though we do not hope to repeat this ever again, we admittedly savored the individual time with Sydney.


Sydney was soooooo happy to be discharged she struck this pose with the enormous hospital toy teddy.  After coming home, Lovey, has been instrumental getting Sydney to finish her medicines.  Lovey takes a tiny bit then Sydney hesitantly finishes it.

A week after this hospital stint, Sydney returned to the pediatrician for a follow-up visit and got a clean bill of health.  In addition to being a preemie, having pneumonia puts Sydney at risk for further respiratory illness.  Therefore, all four kids, mom, and dad got flu shots.  Exactly one week following discharge, Sydney was covered in hives.  Thankfully, a friend warned us that it was possible.  Apparently following serious illness, the body can have a histamine reaction resulting in hives.  Sydney handled the itchiness well and tolerated a few rounds of Claritin and clear calamine lotion.  Within three days they disappeared as quickly as they appeared.

We are oh so happy to be home and healthy again, and are taking as many precautions to keep things this way as we can.  I’ve since gotten a pulse oximeter to help us monitor oxygen saturation should there be another scare.



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Tiny Feet, Big Impressions

Since I was expecting quadruplets I knew my babies would have a NICU stay, and I knew it would be difficult. In the months that led up to delivery, I communicated with other moms of quadruplets and braced myself for the inevitable.  In the first week or so, I was managing NICU life relatively well, but as the days and weeks passed, it wore on my heart. Seeing my babies struggle each day hurt.  About that time, our hospital’s resident art therapist, Diana, paid us a visit and the timing was impeccable.  Diana bonded with our family immediately and quickly began working on a masterpiece.   As the years pass and NICU life fades into memories, this piece of art remains as a salient reminder of just how much our babies have grown.  Right now, the painting is housed in our study’s curio cabinet, but at every birthday celebration, it’s a centerpiece of the party decor.

we got a bath and clothes016

Sydney was so tiny that preemie sized clothes were far too large.  Her foot was about the length of my thumb.

we got a bath and clothes019

we got a bath and clothes022


Exactly three years and two days after meeting Diana, the kids and I returned to the hospital for a specialist appointment.  The appointment was at 8:30 am and I was running solo, which meant it was a huge undertaking to get everyone ready.  I decided for the amount of effort required to go to this appointment, we’d make it into a day long field trip.  Following the appointment, we stopped by the Build a Bear workshop where the quads beloved teddy bears were born.  There, each of the kids bought undies for their bear.  Next, we popped by Starbucks where I treated myself to a caramel frapuccino to sip while the kids darted about the play area.  The kids had a blast exploring the hospital where they were once long term residents.


build a bear undies


Just as it was time to head home, I spotted the smiling face of a woman clad in splatter paint from head to toe.  It was none other than Diana herself!  Though it had been three years and the quads had grown, she remembered us immediately.  I am forever grateful for the gift of art Diana gave us at a difficult time, and I can only imagine the many hearts she’s touched and will touch.   Reuniting with Diana was the perfect opportunity to thank her for the impression she made years prior. Sometimes it really is the little things that leave the biggest impression on us.



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Water Table & Sidewalk Chalk {Summer Bucket List}

Between Texas heat and potty training quadruplets, my sanity is questionable most days.  One lifesaver has been water play.   Our Little Tikes water table and iconic pink NICU bathtubs have been well used this summer.  I try to introduce novel items with water play to keep it engaging.  If I’m dressing four kids in swimsuits and setting up water, it has to last at least an hour, preferably longer.

1. Little People Bath Station

I was inspired by My Nearest and Dearest to set up a Little People water park and bath station on the front porch.  I gave each of the kids a tub filled with water, a mini bottle of baby wash, a wash cloth, and a few Little People dolls.  They spent the entire morning scrubbing dolls and squirting soap.  Lots of clean fun!


little people bath station

2. Dish Washing Station

I borrowed this idea from a neighbor because it was brilliant.  I gave each child tub of water, a stack of play dishes, a scrub brush (I found super cute ones with animal handles at the Dollar Tree), and a Softsoap bottle filled with a little bubble bath and water. They got busy washing their dishes, and then scrubbing the patio before they jumped into the tubs themselves.  It’s hard to imagine they used to take a bath in these tubs and can barely fit inside now.

As the quads splashed around, my tootsies enjoyed a Mary Kay foot soak followed by energizing mint lotion.  I was in a foul mood that day thanks to countless potty accidents paired with many tantrums.  My little Mom foot spa worked amazingly at changing my demeanor.  I felt rejuvenated and the kids behavior seemed drastically better when I felt better.


NICU bathtime

Bath time in the NICU. Rylin is on the left and Harper the right.

And now…

NICU bathtubs

water play

3.  Condiment Bottle Squirters

Another day, I set up shop on the front porch.  I situated myself on an angle so I could supervise water play on the porch and sidewalk chalk drawings on the driveway. For water play, I used the NICU tubs and Softsoap bottles with bubbles, but also gave each of the quads an assortment of empty condiment bottles filled with colored water to mix.  I enjoyed another foot soak, this time whilst sipping fresh lemonade.   From time to time, the kids would give me a little foot treatment by pouring bubbles over my calves, which was sweet.  When we were finished playing we dumped the water tubs over the sidewalk chalk art to clean the driveway.

I love knocking out two bucket list items all at once!  Stay tuned as we wrap up the bucket list.

  1. Movies
  2. Sea Life Aquarium
  3. Train ride
  4. Fire station tour
  5. Library story time
  6. Sprayground
  7. Zoo
  8. Bahama Buck’s
  9. Frozen yogurt
  10. Community pool
  11. Grill dinner outside
  12. Water Table
  13. Inflatable Pool
  14. Sprinklers
  15. Ice Cream
  16. Indoor playgrounds
  17. Lee’s Grilled Cheese
  18. Blow bubbles
  19. Chalk drawings
  20. Board games
  21. Play dates
  22. Summer Reading Club
  23. Dance classes
  24. Fireworks
  25. Sleep over with grandparents
  26. Nature Walks
  27. Bounce house
  28. Popsicles
  29. S’mores
  30. Sparklers
  31. Water pistol duels



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March for Babies

March of Dimes

This year as we prepared for our third March for Babies, I felt compelled to do a little more research about the background.  I always knew it was an organization we supported due to our personal experience with premature birth and stint in the Neonatal Intensive Care Unit, but didn’t know (or perhaps had forgotten) the full history.

The March of Dimes was originally founded by Franklin D. Roosevelt in 1938 as National Foundation for Infantile Paralysis (NFIP) due to his personal experience with paralysis from polio.  Through research grants, the polio vaccine was developed by Jonas Salk, MD and Albert Sabin, MD.  Once the original mission as accomplished, the organization later changed its mission to the prevention of birth defects and infant mortality.   Since that time, March of Dimes has supported research into the cellular and molecular basis of genetic diseases, developmental processes and abnormalities, and the epidemiology of premature birth to improve medical diagnosis and develop treatments for a wide range of birth defects and developmental disorders.

The March of Dimes is credited with leading the way to discover genetic causes of birth defects, to promote newborn screening, and to educate medical professionals and the public about best practices for healthy pregnancy. They were instrumental in the research for surfactant therapy to treat respiratory distress and helped initiate the system of regional neonatal intensive care for premature and sick babies.  These two initiatives  were critical to our family since all four babies were born in respiratory distress and immediately admitted to the NICU. Finally, the March of Dimes Folic Acid Campaign achieved a dramatic reduction in the incidence of neural tube defects, birth defects of the brain and spine.  Due to my diagnosis of MTHFR, early folic acid supplements helped me carry the quadruplets as long as I did.

Today, the March of Dimes official mission is,

“To improve the health of babies by preventing birth defects, infant mortality, and premature birth.” 

In case you wonder exactly where donations are used, The March of Dimes spends 76¢ of every dollar raised in March for Babies to support research and programs that help babies begin healthy lives.

MoD support

This year marked our third year to walk as a family team.  Our first walk was a bit impromptu, but we found the walk to be an empowering experience.   Last year was the first year we rallied a team to join us and purchased team t-shirts, which gave us a sense of cohesion.  This year, I was hesitant to walk knowing George couldn’t join us due to work, but our family and friends promised to help me and rally around our family team.  With that spirit, I ordered custom-made t-shirts from Custom Ink that would help identify our team members during the walk.  Seeing our small sea of sapphire blue in the crowd warmed my heart and reminded me why we walk each year.



Friends from all aspects of our lives joined us for the walk, and we appreciated their support immensely.

Twins, triplets & quads, oh my!

Twins, triplets & quads, oh my!


Unfortunately, Custom Ink didn’t have infant t-shirts available. My artistic friend, Jen, hand painted a custom tank dress for this beauty.


Nisey and Poppa were a huge help to me. Without George by my side, they helped me get everyone ready and off to the walk.


Along with my parents, my sister, sister’s fiance, aunt, and two younger cousins joined us for the walk.


The front of our shirts read, “March for Babies. Saving lives one step at a time.” The back read, “Shawver Quads Family & Friends. March of Dimes 2015.”

I would like to extend a special thanks to our friends and family who supported our March for Babies this year by making a donation to our team, purchasing a team t-shirt, and/ or walking with us.  In no particular order: Steve, Denise, Courtney, Matt, Tiffany, Landry, Luke, Haylie, Ryleigh, Jason, Matt, Natalie, Molly, Sadie, Brandi, Garrett, Seth, Terri, A’ Lysia, Emmerson, Mina, Laayla, Jen, Priscilla, Marco, Sydney, Kristen, Alan, Devon, Marianne, George Jr., Carol, Lindsay, Sara, Billie, Guadalupe, and Karen. 



Psst…..If you would like to make a donation to our team, it’s not too late!  Please visit our team page to make a donation here. 


History of the March of Dimes

The Origin of the March of Dimes

March of Dimes FAQ’s

March of Dimes Research Breakthroughs

Annual Sit with Santa

When the quads were infants, we were on lock down due to their premature immune systems.  Although I wanted them to have keepsake pictures with Santa, it wasn’t worth the risk of taking them out in public.  Even lock down couldn’t keep Santa away from the babies.  He surprised us with a visit and we captured some adorable keepsake pictures.

Santa watching over sleeping babies

Last year, we were still hesitant to take them to wait in long lines and still had lingering fears of germs.  Santa was kind enough to drop by our house for a second visit.


I think we’ll always worry a little about germs (the mere thought of FOUR sick kids is horrible), but we are letting go of them to experience the world.  This evening they had an opportunity to visit with Santa at our mothers of multiples Christmas party.  I’ve seen the classic kids wailing on Santa’s lap pictures, and wondered what the quads would do this year.  They didn’t grin for the camera, but not one tear was shed.  They treated Santa just like everyone else we meet.


Santa wasn’t satisfied with just visiting the children, and insisted Mom and Dad have a chat too.

family picture with Santa






Last year, we were rookies in the March for Babies.   We registered to walk only a few weeks before the big day and made very few preparations. Our skeleton team consisted only of George, Aunt CiCi, Brandi (George’s cousin), the babies, and me.  At that time, we walked in honor of our babies.  They endured seven week stint in the NICU, and at the time of the walk were making their first public appearances.   George and I felt a sense of gratitude for the March of Dimes, which funds major research to help preemies like ours grow and thrive.

This year, we started much earlier and rallied our friends and family to join us.  We even ordered royal purple team t-shirts to show group cohesiveness.  Our team doubled in size when our neighbors with quads also joined the cause.  Together our team was over thirty-eight members strong and raised $1650!  This year, the cause was bigger than just our own family.  It was in honor of our healthy, thriving babies, but also in memory of the many babies who passed away this year.  Our community of multiples is a small one, and when tragedy strikes, we all feel the sorrow.  Far too many families experienced infant loss, and the March of Dimes is helping to make sure that more families do not endure similar situations.  I can only hope that our team grows even larger and stronger next year!

The sea of royal purple warmed my heart.

The sea of royal purple warmed my heart.

This sign proudly hung in the "Garden of Hope" for other families facing premature births.

This sign proudly hung in the “Garden of Hope” for other families facing premature births.

Our sign was surrounded by signs honoring other babies.  Take a close look at each one though.  Some signs honor babies while others are memorials for babies.  We walk to help prevent future families from hanging memorial signs.  No family should have to endure the loss of an infant.

Our sign was surrounded by signs honoring other babies. Take a close look at each one though. Some signs honor babies while others are memorials for babies. We walk to help prevent future families from hanging memorial signs. No family should have to endure the loss of an infant.


This year, my parents and sister's boyfriend (Matt) were right at our side.

This year, my parents and sister’s boyfriend, Matt, were at our side.

Along for the walk were the Murphy Clan (top) and Bonnie Brae Crew (bottom).  Two of these walkers were expectant mothers with babies due this summer.  They know the March of Dimes is working to make sure their babies are delivered full term.

Along for the walk were the Murphy Clan (top) and Bonnie Brae Crew (bottom). Two of these walkers were expectant mothers with babies due this summer. They know the March of Dimes is working to make sure their babies are delivered full term.

Along for the walk were the Murphy Clan (top) and Bonnie Brae Crew (bottom).  Two of these walkers were expectant mothers with babies due this summer.  They know the March of Dimes is working to make sure their babies are delivered full term.

Along for the walk were the Murphy Clan (top) and Bonnie Brae Crew (bottom). Two of these walkers were expectant mothers with babies due this summer. They know the March of Dimes is working to make sure their babies are delivered full term.

Wait a minute...one of these is not like the others.  Which one doesn't belong? When Harper was unhappy in the Runabout, Spencer happily took his place.

Wait a minute…one of these is not like the others. Which one doesn’t belong?
When Mason was unhappy in the Runabout, Spencer happily took his place.


Aside from group cohesiveness, a nice perk of having a large team was that we didn’t face a barrage of questions or a sea of paparazzi like we did last year.  It allowed us to just walk and enjoy the spring weather.  Also, it was far easier managing four babies with so many helping hands.  Everyone gladly took turns pushing our 120 pound stroller and entertaining fussy babies.

We crossed the finish line as a group for one cause.

We crossed the finish line as a group for one cause.  Everyone, including he babies, received a sticker that read, “I did it!”


Quads doubled!

Quads doubled!

After the walk, the babies enjoyed quick picnic lunch of their favorite staple: peanut butter and honey sandwiches with apple slices and goldfish.

After the walk, the babies enjoyed quick picnic lunch of their favorite staple: peanut butter and honey sandwiches with apple slices and goldfish.

Nisey and Papa beam with pride when they are with their grandbabies.

Nisey and Papa beam with pride when they are with their grand babies.  Our family team shirts didn’t come in toddler sizes so I ordered March of Dimes onsies for the babies that read, “Proof Miracles Happen.”  I thought it was quite fitting for them.


Have you ever participated in a charity walk or fun run?  If not, I hope you’ll consider joining the March for Babies next spring.







We would like to extend a special thanks to those donated to our team: George Shawver, Jr., Carol Vincell, Kristi Bowman, Melissa Shaw, Megan Haley, Karen & Brad Cox,  Ashley Lopez, Patty Winkle, Leslie Murihead, Melissa Dumas, Marianne Southwick, Lindsay Howard, Treva Muirhead, Cathy Wildman and Terri McGuire.

And for those who walked with us: Jaime Balderas, LeeAnn Brager, Esmeralda Colmenero, Gracie Colmenero, Alfonso Cordova, Joey Cordova, Juana Cordova, Jen Crawford, Candelairo Hernandez, Griselda Hernandez, Kimberly Hernandez, Rojelio Hernandez, Matt Johnson, Kristen Klatt, Kelsey McGuire, Daniel Murphy, Debbie Murphy, Dennis Murpy, Sara Murphy, Ann Odom, Brenda Quintan, Alan Reid, Deven Reid, Jessica Rivera, Alondra Rodriguez, Mina Rodriguez, Viviana Rodriguez, Daria Schwalbe, Paul Schwalbe, Priscilla Serrano, Kaylie Slaughter, Tyler Slaughter, Brandi Steele, Evelyn Villanueva, Courtney Zehnder, Denise Zehnder, and Steve Zehnder.

Banding Together, Raising Awareness

Despite having a few scares, George and I were lucky during my pregnancy and subsequent NICU stay. From the moment we learned we were expecting quadruplets we were painfully aware of the inherent risks for all involved and we chose to accept them.   Even knowing these risks, it never occurred to me that we may not take one or more of them home.  The past year has been a difficult one in our community of quadruplet families.  In the past eight months we’ve wept as many families lost one or two babies.  And, three different families lost all four babies due to extremely premature deliveries.   The Peterson family was the latest to suffer this grave loss.  They bravely share their story and photographs on their Facebook page, Prayers for the Fantastic Four.

Jen and Chris shared this photograph of their angels.

Here, Jen embraces three of her angels.  Her first daughter, Serenity, is represented by the teddy bear.  Serenity was delivered  two days prior in hopes of saving her mother and siblings.  Unfortunately, the delivery of the remaining three could not be prevented.  The Peterson family has a Go Fund page established to help offset funeral and hospital expenses.  If you are able, any donation is appreciated.

What broke my heart even more was knowing that these lives may have been spared.  I believe this because of my friend, Kathryn.  Before I met her, she lost her twin boys at just 16 weeks due to incompetent cervix.  Since her losses, Kathryn has become the most articulate advocate of TACs I know.  Because she is the expert on this topic, I asked her to share her knowledge in hopes of raising awareness and helping mothers realize their options.  Here are Kathryn’s words:

Ever watch Dexter?  It’s a Showtime program chronicling the ongoings of a serial killer while following a moral code.  Dexter successfully detaches himself from his killing tendencies by referring to that part of himself as his ‘Dark Passenger.’  I have a Dark Passenger, too: an incompetent cervix.  And it killed my sons.

The cervix sits between the uterus and the vagina and acts as a safe keeper of baby.  A good cervix stays closed during pregnancy and holds baby in tightly.  A column of mucous forms in the center of the cervix to plug any possibility of good (or bad) vaginal bacteria ascending.  At the end of the gestation, contractions essentially slam baby into the cervix repeatedly to send the message, “Hey, open up, it’s time!”  After that timely prodding, the cervix will dilate and allow baby to be pushed out vaginally.  There are some other things that tell the cervix to get ready – but those also all occur at the END of gestation.

In contrast, an incompetent cervix fails.  It opens willy nilly – even at 16 weeks!  It could open ever so slightly to lose bits of the mucous plug and allow bacteria to ascend.  It could open just at the top forming a funnel that baby slips into causing all sorts of problems.  It could even open all the way causing the baby to fall out.  And just as fast as it opens, it can close back up never having its misbehavior detected.  This earns an incompetent cervix the nickname ‘Silent Killer.’

Diagnosis of IC can be difficult.  The cervix can change so frequently, that often it’s not detected as problematic until an emergency arises.  Most often, women must lose several 2nd trimester pregnancies before most doctors will even consider IC as a diagnosis.  Doctors treat it as a diagnosis by process of elimination rather than a diagnosis based on IC symptoms.

Treatment options are severely limited by gestation and severity of the situation.   In a nutshell, current treatments include:

  1.  Wait and Watch Approach – Doctors may suspect (or even KNOW) a patient has IC and elect to simply monitor the cervix via ultrasound every two weeks from about 16 weeks to 24 weeks gestation.
  2. Preventive Transvaginal Cerclage (TVC) – entering through the vaginal canal, a cerclage is stitched in/out of the bottom of the cervix, pulled taught like a purse string, and tied off.  This placement occurs between 10 and 14 weeks gestation as an attempt to prevent any cervical changes occurring and becoming problematic.  The TVC is removed at the end of pregnancy to allow for vaginal delivery.
  3. Rescue/Emergency Transvaginal Cerclage (TVC) – This occurs during the pregnancy when doctors notice that a dangerous change has occurred in the cervical length or dilation.  There are many limits to even utilizing this option as there has to be enough length remaining to place the stitch and most doctors will not place a rescue cerclage at gestations close to or beyond viability (24 weeks).  Again, the TVC is removed at the end of pregnancy to allow for vaginal delivery.
  4. Transvaginal Cervicoisthmic Cerclage (TVCIC) – A TVCIC may be placed prior to or during pregnancy.  Though this is still a vaginal cerclage, it is placed ABOVE the cardinal ligaments.  It may be removed to allow for vaginal births or left in place for future pregnancies (and a c-section performed).  Fewer doctors currently know about and perform TVCIC than TAC.
  5. Transabdominal Cerclage (TAC) – A TAC may be placed prior to or during pregnancy at 10-14 weeks. Through an incision in the abdomen, a mersiline band is placed AROUND the very top of the cervix to disallow dilation.  Vaginal delivery is impossible with a TAC and a c-section is required.

Once a person is diagnosed with definitive IC, there should be no question that placing a preventive permanent transabdominal cerclage (TAC) is the correct path.  (side note: tvcic is a viable option, but I reserve recommending tvcic in only extreme situations such as a rescue or when multiple abdominal incisions would occur in such a tight time frame that increased risk is assigned to the patient)

While statistics depend on each doctor, here are a few rough numbers to consider:

Success rates of TVC = *80% for a live birth (about 40% of these births are preterm)

Success rates of TAC = 97%+ for a live TERM birth (certain TAC doctors have even higher success rates)

*these may be exaggerated because some women receive TVC placements who do not actually have IC and are counted towards being a TVC success even though they would’ve been successful without one.

Clearly, TAC gives the best possible outcome for baby’s life.

Another consideration ought to be the quality of pregnancy.  With IC, uncertainty rules pregnancy.  Every twinge, every pain, every flutter, every kick, every toilet visit – it’s all filled with dread and fear.  As odd as it sounds, IC support sites are filled with pics of women asking if discharge looks normal.  On top of that, TVCs often require (and I ALWAYS recommend) bed rest to keep as much pressure off the cervix as possible.  Forget baths, exercise, intimacy, lifting toddlers, etc.  Your baby’s life is relying on that thread of support at the bottom of the cervix.

With a TAC, IC considerations are gone.  The cervix will not budge.  Even if the length shortens, the cervix cannot dilate.  It cannot open and allow baby to slip out.  Baby is baking until doctor says otherwise! Unless it’s for other non-IC reasons, bed rest is not required.  I personally worked up until the day of my c-section and that is the norm for TAC sisters.  Pregnant in the summer, I spent hours each day in the pool.  In the winter, I practically lived in the bathtub.  Intimacy was allowed.  I was able to lift what I wanted, shop til I dropped, and live my normal life.  TAC allows normal pregnancy!

As women, we rely on our doctors to prescribe the best treatment.  We assume they have the same goal – and same urgency – at protecting our babies that we do.  To be clear, I do not think doctors prescribing a preventive TVC have the ill will of wanting to risk or kill our babies.  Unfortunately, every doctor placing a preventive TVC or advising a wait and watch situation when IC is known is doing just that: risking your baby.  Sometimes it’s due to a lack of education, but sometimes when you press the doctor, you’ll hear them utter, “If this doesn’t work, then next time…”

So what can a mama do?

Educate yourself on the realities of cervical insufficiency.  Understand how the cervix should work and how it fails.  Fully understand what each treatment option entails.  Find women to talk to on support boards about their experiences.  Evaluate your lifestyle and mental health and figure out what you could realistically handle during a pregnancy.  Speak to the top IC doctors in the country (Drs. Haney, Davis, and Sumners).  Talk to your OBs and MFMs.  Pointedly ask them what happens if you funnel to the stitch and shorten at 22 weeks.  Ask them what will happen if your membranes bulge or baby’s leg dangles into the vagina.  What then?  Ask them who makes the final call on treatment for baby.  Remember, this is your body, your baby, and your choice.  Nobody is going to look after preserving and protecting your baby better than you are.

As a specific point, I want to offer an asterisk to all the successful tvc stories you may hear: firstly, a woman with known IC could absolutely have a completely normal, intervention-free pregnancy.  That’s the crapshoot of IC: sometimes the cervix works and sometimes it doesn’t.  It may behave well during one pregnancy and terribly during another.

Additionally, you need to understand this equation:

TVC Success = surgical skill + cervical behavior

TAC success = surgical skill

With an IC diagnosis, you already know your cervix does not work.  Understand that choosing a TVC continues to rely, in part, on the behavior of that broken cervix.

For me, TAC was the muddy answer at the time, but oh how clear the waters have become.  I was able to slaughter that serial killing Dark Passenger who stole away my sons and conquer IC altogether.  I now have beautiful twin rainbow daughters thanks to my TAC.  And I will never regret choosing life at any cost for them.

Kathryn Nguyen is a proud mother to two sets of twins and a prayerful TAC-only advocate.  Visit her blog Beyond This Desert for more information on cervical insufficiency and TAC.  

Three other quad mom bloggers joined me in the effort to raise awareness on this sensitive topic, please visit:

Capri + 3

Chillin’ with Chad

Quads from Heaven

In honor of Pregnancy and Infant Loss Remembrance Day, I addressed my own losses, Casting a Light in the Darkness & Reflecting.

World Prematurity Day

Today is World Prematurity Day-

Each year approximately 15 million babies are born prematurely worldwide, with about 500,000 in the United States alone.  With each passing day, we are grateful for the health of our four babies who were born nine weeks too soon.   I am grateful for the medical care they received prior to birth, our delivery team, our NICU care team, and for the therapists who have helped them thrive since coming home.   Each night, I kiss our children and hug them in gratitude for them moments we are given, and try my best not to take them for granted even on the most trying days.  I will never forget the days we spent in the NICU, and each night I pray for families currently facing a NICU stay that they find solace and strength.

These images tell just a bit of our NICU stay.

Wires and tubes became part of our normal while in the NICU.

Wires and tubes became part of our normal while in the NICU.

Unlike typical mothers, I did not get to hold my babies for well over a week.  This was the moment I held Mason for the first time.

Unlike typical mothers, I did not get to hold my babies for well over a week. This was the moment I held Mason for the first time.

After birth, our babies were each fitted with a CPAP and bonnet to help them breathe.  I did not know what my babies looked like for well over a week.

After birth, our babies were each fitted with a CPAP and bonnet to help them breathe. I did not know what my babies looked like for well over a week.

Our eyes adjusted to days of blue lights in our NICU room, helping to remove the billi from our babies' systems.

Our eyes adjusted to days of blue lights in our NICU room, helping to remove the billi from our babies’ systems.

The first time we could hold Sydney, I feared breaking her because she was so tiny and fragile.

The first time we could hold Sydney, I feared breaking her because she was so tiny and fragile.

In the days I yearned to hold my babies, all I could do to comfort them was hold their tiny bodies through portholes in their incubators.

In the days I yearned to hold my babies, all I could do to comfort them was hold their tiny bodies through portholes in their incubators.

It still makes me shudder recalling the pain Sydney endured as multiples nurses attempted to set a hair thin IV.  At one point, her IV could only be placed through her forehead.

It still makes me shudder recalling the pain Sydney endured as multiples nurses attempted to set a hair thin IV. At one point, her IV could only be placed through her forehead.





Navigating the NICU


Over the past few weeks, we’ve returned to Cook Children’s where the babies resided the first seven weeks of their life. Thankfully, we’ve not returned as patients, but as visitors.  We returned to deliver a presentation, and also to visit a friend and her twins who are currently in the NICU.

Turning the corner to the NICU corridor back brought back a flood of emotions and memories.  I recalled fond memories of milestones being reached, but there were others I repressed.  Our experience in the NICU was a good one and we were pleased with our care.  Yet, it still was a NICU journey and there were many frightening, difficult moments. The twins are on the same floor where our babies stayed and it brought me back to a difficult place.  After reporting to the NICU for 49 days, there were quite a few things I learned along the way.  If I could rewind the clocks, here are the things I’d tell myself (and why).


1. Become an active participant in your baby’s care ASAP

In the early days of NICU life, I remember feeling detached from the babies as we peered at them in their little boxes. I was terrified I’d contaminate them or break something, but honestly they needed our gentle touch. George reminded me several times that the wires were not life sustaining, but merely monitored the babies, and that gave me confidence to touch them.

I recall the nurses teaching me how to gently touch their fragile skin (stroking causes preemies pain). I gradually began spending increasing amounts of time just cradling them in my hands through isolette windows as I spoke to them, encouraging them to grow stronger. It wasn’t long before their IV’s were removed and we could finally hold our babies, which meant I could even do more. One of our nurses taught me how to do the “cares”, which involved swabbing their mouths out, changing diapers, checking body temperature, and moving their pulse ox (oxygen monitor) from one foot to the other every three hours. Being able to do those small things helped me bond with the babies, learn their unique qualities, and finally feel as if they were mine.

2. Don’t be afraid to ask questions

Being in a hospital in general, let alone the Neonatal Intensive Care Unit, can be intimidating.  With the quads, we found ourselves surrounded by numerous professionals who tossed technical jargon around as if we were medical school graduates.  Several weeks passed that I called the babies’ Pulse Ox (Oximeter) “Pole Socks”.  At first, I felt foolish forcing them to stop and explain things, but I learned how important it was.   As parents, it is important to know what is happening in your baby’s care and be a stakeholder, advocating for someone without a  voice.

3. Bond with staff

We spent a few weeks in the NICU before I learned about “Primary Nurses”. These are nurses who agree to tend to particular patients every time they are on shift. Our primary nurses became imperative team members in the care of our babies. They knew each baby’s nuances, cheered for them, and fought for them (and me). When George went back to work, I spent many days in the NICU alone. I felt helpless, isolated and lonely some of the time. When our primary nurses were there, they not only helped our babies, but kept my spirits up and taught me a wealth of knowledge regarding how to care for a preemie. One nurse even helped make sure I got the Medela pump that worked best for me, even though it meant she had to retrieve and clean it every three hours.

It was vital that when we left our babies, we felt confident in their care takers and that those care takers respected us as parents. By spending my days at the NICU, the nurses and other hospital staff came to know me and in turn wanted our babies to thrive even more. When we were away, they took time to dress the babies to match their linens, make name plates for their cribs, and snapped pictures of things we missed. They did all that not only because they cared, but they knew we did too.

To show our appreciation, I occasionally brought our nurses warm cookies from the cafeteria or a Starbucks drink.

4. Take time for yourself, and your partner

At first, NICU life was somewhat novel and we were absorbing all sorts of knew information. A few weeks in, it got to be nearly too much for me to bear. I felt defeated and that we may never leave the NICU. I needed a break from my new routine of spending the entire day at the NICU only going home to shower and sleep. At that point, George and I enjoyed a few date nights, time with friends, and I did some shopping. I admittedly felt a tinge of guilt for leaving the babies alone when I could physically be there, but I needed breaks for mental health. One night, we even enjoyed a few cocktails and I did the whole “pump and dump” thing with my milk. While breast milk was like liquid gold I didn’t want to toss it, but I needed just an evening for me, even if that meant sacrificing a few ounces of milk.

5. Meet your social worker

I did not meet our social worker until weeks into our NICU stay and I wished I befriended her immediately.  She had knowledge about how to access resources and services we needed, such as how to apply for multiple birth programs.   Because I met her late in the game, Sydney did not receive benefits she was entitled to based on birth weight.

5. Bring items from home

We were fortunate that our NICU had all private rooms with many amenities including a fold out sofa, television, and laundry facilities. In addition to those things, they provided things such as baby clothing, baby wash, and dish soap (for pump parts and bottles). However, over the course of our stay, I brought other creature comforts to help us feel as at home with the babies as possible. If our NICU nurses had not made name plates, I would have done that as well because it would personalize the space for us. I have a page devoted to items we kept at the NICU in case others would like to know.

6. Welcome visitors

As I mentioned, I spent the majority of my time in the NICU alone. The NICU is a place where emotions are high and being there alone can be intimidating. Fortunately, our NICU allowed four visitors per day (one per baby) and as best we could, we welcomed friends and family to come. Even if someone dropped by for just 30 minutes, that brightened my day. Because of our private rooms, I believe that visiting rules may have been more lax than at other places. If our NICU was more strict, I think I would have welcomed visitors to meet me at the hospital for lunch or coffee at the very least.

Despite welcoming visitors, we were strict regarding who could come visit. Before the babies were even born, we sent a memo to friends and family explaining the precautions we were taking to protect the babies’ health. These precautions were in place during our NICU stay and for the first 7 months the babies were at home. I believe that our efforts, while taxing, were worthwhile. After all, we did not have a sick visit to the doctor until after the babies’ first birthday. That is incredible considering the average baby battles eight colds in the first year!

7. capture memories

We took plenty of pictures documenting the babies’ milestones while in the NICU- the first time we held each of them, first baths, and bottle feedings.  What we avoided, was documenting when they were fragile because I feared preserving those memories.  Now that we have been away from the NICU over a year, I would like to reflect upon the progress the babies made, but there is little proof.  I also took very few video clips, and the ones I have are primarily from when the babies were near discharge.  Seeing the twins in the NICU made me want to remember how our babies were once so tiny, but I have no video to review.

Fortunately, our NICU had an art therapist on staff who helped us create memories through art.  The babies painted a canvas with their foot prints and molds of their feet.  I am in awe each time I pass their first masterpiece hanging in the playroom.  If it weren’t for our art therapist, I may have missed out on creating art.  However, it would be simple to do even without a therapist, and I’d recommend doing it.

8. Find someone who can relate

I was fortunate to have a network of other moms of quadruplets to support me in the NICU journey and give advice and tips for dealing with the NICU.  However, that support was solely online.  With the help of a few thoughtful nurses,  I was fortunate enough to meet a mom of triplets born five days after the quads in our same NICU.  Meeting another mom in person who was right there dealing with the same things simultaneously was immensely helpful.  In fact, we continue to maintain communication, supporting each other along the way and we’ve held play dates!

When we returned to visit the twins, George and I took turns watching our own babies in the family play area of the hospital.  I think they too enjoyed being on the other side of things at the hospital.

I only wish we had a space in our house large enough for a padded play area.

I only wish we had a space in our house large enough for a padded play area.



After the babies had a good romp in the play area, we retreated to the cafeteria for a brown bag dinner.

After the babies had a good romp in the play area, we retreated to the cafeteria for a brown bag dinner.



P.S. In reading the archives from when the babies were in the NICU, I made a great effort to stay positive.  Yet, I think I marginalized some of the things we endured, and consequently made it seem easy.  For parents currently dealing with a NICU stay, we encountered these things-

respiratory distress- CPAP, oxygen, nasal cannulas; jaundice- bilirubin lights, collapsed lung- chest tube surgically placed, reflux- milk fortifiers/ thickeners, Dani sling, pneumonia- IV antibiotics, MRI- white matter trauma, grade I brain bleed, car seat tests, bradycardias, de sats, caffeine drips, PIC line (through a vein in Sydney’s head because the tiny veins in her arms, legs and feet collapsed.  this was horrifying), transpiloric feeding tube, gravity feeds, occupational therapy, physical therapy, blood panels, platelet transfusion, low birth weight, anemia- poly vi sol

Preemie Prints

Back in November, we were given the gift of photography courtesy of Preemie Prints.  It is a charitable organization that provides complimentary photography sessions to babies in the NICU and NICU graduates for the first year.  They are willing to meet on site, which was perfect for us since getting out is a feat.  We took advantage of this wonderful gift just in time for grandparent Christmas gifts and cards.  Our photographer, Ashlee, captured fantastic family photos in an hour’s time.  The babies really could not tolerate more than an hour as they began their nightly transformation into Gremlins.  I spent the last month deciding which photos to print and then mulled over where and how to display them.  As I considered the lack of wall space in the house, it occurred to me that we could use our entry way niches to display the photos.  While my two cousins, aunt, and a family friend were kind enough to babysit, George dashed out for a little jaunt around town.  (Yes, that is correct, it took FOUR babysitters for us to snag a date.)  We enjoyed dinner at Mi Cocina and then bought paint and accessories for our weekend warrior project.

Our entryway was bathed in a deep crimson with dark, heavy accessories for at least six years and it was high time for a refresh.  We coated the once dark walls with a fresh splash of cream and accented it with bright, cheery picture frames of various sizes and textures.  At Hobby Lobby, we found some kitschy iron art that says, “Family” and a plaque that reads, “Friends are God’s way of caring for us”, which I thought were fitting.   I absolutely LOVE the results of this mini weekend project and the way it captures our family’s personality.  It makes me want to refresh other areas of the house, but who knows when we’ll scrounge up the time for that!





Below are some of my favorite photos taken during our session-

Our friend, Terri worked behind the scenes to help us dress and entertain babies.  I know she is not fond of this shot, but I think it's precious.

Our friend, Terri, worked behind the scenes to help us dress and entertain babies. I know she is not fond of this shot, but I think it’s precious.  You can see a bit of our living room with baby gear.  It’s a slice of life!

Sydney and a snoozing Rylin

Sydney & Rylin

Mason & Harper

Mason & Harper

Rylin, Harper, Sydney, & Mason

Rylin, Harper, Sydney, & Mason

This one is priceless!  George may have worn this expression when we saw four little circles on our first ultrasound.

This one is priceless! George may have worn this expression when we saw four little circles on our first ultrasound.  I bought the cutest socks for the babies to wear in the pictures and I later noticed 1. George is cupping their feet with his hands so you cannot see them 2. George is barefooted!  That is life with quads for you.


It is not exactly easy holding four babies simultaneously. Poor Mason was being squished out here.

I like this candid shot of me trying to load all of the babies in George's arms.  Notice Sydney is in my lap with her feet sticking out!

I like this candid shot of me trying to load all of the babies in George’s arms. Notice Sydney is in my lap with her feet sticking out!


George managed holding all four better than I did.



Rylin slept through the majority of the session, but I thought her below the Christmas tree picture was absolute perfection. Sydney, on the other hand, was not too keen on laying there.

For more information about Preemie Prints, check out their blog: