I began writing this post several months ago when the NICU director from Cook Children’s Hospital asked George and I to speak at an upcoming event about infant mortality. I abandoned it for fear of seeming lackluster or coming off as conceited. However, I’ve recently come into contact with several expectant mothers of multiples and think this post is worth finishing.
Apparently Dallas and Tarrant counties boast the worst infant mortality rates in Texas and some of the worst in the United States. I stumbled across articles from The Star Telegram and Washington Post that mention some startling statistics. According to current research, it appears that prenatal care is one of the most critical factors. The NICU director felt that George and I made sound decisions early on to help me carry the babies as far as possible for the betterment of everyone’s health. Reflecting back on the dog days of my pregnancy, here are some of the things I feel were beneficial.
1. Got into Shape Beforehand
When family building did not come as easily as anticipated, George and I decided to change our lifestyle to one of health and wellness. We figured if we were dealing with infertility we knew we were in for a journey and better prepare. I mean, you wouldn’t attempt to run a marathon without getting into shape first. Just like a marathon, pregnancy is difficult on the body. After scheduling routine physicals and catching up on vaccines, we developed an exercise regime. Together, we took kickboxing classes twice weekly and I practiced yoga three days a week. Additionally, we made an effort to eat well. We cooked fresh foods at home most of the time and rarely ate out. I can honestly say I was in the best shape of my life just before becoming pregnant with the quads, even better than I was at 18.
2. We found “the quad guy”
The day of our initial sonogram with the quads, we knew we needed the best doctor for the job. My RE referred us to a perinatologist who had experience with high order multiples, including several sets of quadruplets. All of my prenatal visits were exclusively with my perinatologist.
3. Educated Ourselves and Found Support
Together, we made an effort to educate ourselves about pregnancy, especially regarding multiple gestation. This included close communication with my perinatologist. I read several books, including The Mayo Clinic Guide to a Healthy Pregnancy, which was my favorite one. I read a few books about twins, but chucked them when they only mentioned terrifying things about high order multiples. Fear was not helpful to me. The single best advice I received from Dr. Tabor was to look up Steece’s Pieces, a blog maintained by a former patient who also had quadruplets. I read the archives of her blog many times over to help cope with bed rest and the future with four babies. I kept contact with other mothers of quadruplets, both expectant and mothers of older children. They served as a resource for “Is this normal with quads?” and served as a sounding board. In fact, this wonderful group continues to serve as a resource for raising quadruplets.
4. Made Calories Count
During my pregnancy, my doctor advised a diet of approximately 3,000 calories. This included the usual 1,800 calories for me and an additional 300 calories per baby. I could have easily met the 3,000 mark with a few Whoppers and Blizzards, but I knew that what I ate was for the babies. I wanted those calories to count. I kept a variety of healthy snacks in my office (when I was working) and at home. I noshed on things such as Greek yogurt (high in protein and calcium), nuts, fresh fruits and veggies, popcorn (high in fiber), cheese sticks, and protein shakes.
3. Kept Hydrated
I also drank water by the gallon. If a visitor ever asked what she could do for me, I would ask for a refill on both of my large Tervis Tumblers. Staying hydrated was critical to keep contractions at bay and to help keep amniotic fluid levels stable (Sydney’s fluids were low at several appointments). I veered away from most other beverages, particularly caffeinated drinks. Popsicles, however were a fun source of fluids especially in the Texas heat.
5. Popped Approved Supplements
Prior to taking any medication or supplements, I consulted with my perinatologist. I have a blood clotting disorder called MTHFR and was prescribed a mega dose of folic acid and low dose aspirin to manage it. In addition to those, I also took gummy prenatal vitamins (I could not keep the regular ones down so I opted for gummies) plus calcium and iron.
6. Listened to My Body
Just prior to being put on bed rest, I could feel my body become increasingly taxed. After years of practicing yoga, I knew it was critical to listen to my body. If I felt dizzy or fatigued, I simply rested. It did not matter if I was at work walking to a classroom or at Walmart. I literally found a suitable place to sit and I took deep cleansing breaths as I rested. When I felt normal again, I took care to rise slowly and carry on. When I felt thirsty or hungry, I took care of those needs. I never pushed myself beyond what I felt my body could manage even though that is something I tend to do. I knew that pregnancy was not the time to test my limits or try a bit harder.
7. Tossed My Pride Out the Window
I am a highly independent person and I struggle to accept help. However, with a high risk pregnancy, I knew it was necessary to swallow my pride. When I was working full time, I was not ashamed to prop my feet on a box at my desk, to sip water during meetings, or to roll my ergonomic chair to conference tables. The weeks just before bed rest, I wanted to do a lot of “nesting” but knew I needed to be wary of overdoing it. When I went shopping, I did the unthinkable and used the store’s power chairs. It was totally embarrassing zipping around in those, but it was good practice being noticed in public. Looking back, it was probably more discreet for a pregnant girl to ride in a power chair than for me to push a stroller limo loaded with four babies now! For the first time in my life I also let the bag boy at the grocery store load my car and I let people do things for me at home. When I was bed ridden it pained me to sit idle while other people cooked and cleaned, but I knew that was for the best.
8. Obeyed Orders
I am a rule follower in pretty much every aspect of my life, from turning library books in on time to coming to a complete stop at stop signs. Pregnancy was no different. I did EXACTLY as directed. When put on strict bed rest, I took it seriously. I literally stayed in my bed except to go to the bathroom and shower. After the first few weeks of strict bed rest, George impassingly mentioned to Dr. Tabor that I had not been in the kitchen. Dr. Tabor was literally stunned that I followed his orders exactly. I suspect this is one of the reasons I was not admitted to the hospital (rumor has it that Dr. Tabor prefers to admit mothers of high order multiples early so he can keep an eye on them).
Because quads are always delivered prematurely (34 weeks is usually the furthest they can be carried), we knew there would be a NICU stay. Early on in the pregnancy, George and I compared the NICU facilities in our area and took tours. We made the decision to have the babies transferred to the nearest children’s hospital (Cook Children’s). While we knew our delivery hospital could provide outstanding medical care, we felt that the children’s hospital would better meet the needs of our family and provided a family centered approach. I encourage all expectant parents, especially those in high risk situations, to be aware of the NICU facilities available to them. Even parents with one baby and no known risks can have surprise NICU stay. Being aware of options ahead of time can serve you well in the future.
10. Summoned the Power of Prayer
Pregnancy can be a stressful time, and pregnancy with high order multiples is exponentially risky and stressful. Despite knowing all of the risks involved, George and I remained calm as possible. He and I both knew that letting stress take over would be to the detriment of me and the babies. To the best of our ability, we did everything we knew to maintain everyone’s health. However, we knew it was not fully under our control. We left the rest up to God. People near and far prayed specifically for us and for specific situations such as when Sydney’s fluids were low. Via this blog, I communicated very specific needs and I know that people heard them, adding them to prayer lists. Just recently, a neighbor stopped us during an evening walk. She exclaimed, “Oh you are the family I prayed for! A neighbor told me someone was expecting quadruplets and needed prayer. I prayed for these babies.”
Ultimately I did everything in my power to sustain my pregnancy as long as possible and to give the babies the best chances I could. I never wanted to look back and wonder “what if”. However, every mother and baby is unique. Some mothers do everything perfectly and outcomes are not as good as ours. Other mothers seem to make all the wrong choices and yet everything is problem free. The best advice I can offer if you are expecting one baby or seven babies is to do your best to make sound decisions for yourself and your babies.