Abby's Expecting: Part 1

I found out I was pregnant in May, while we were spending the month in Los Angeles doing the book tour for YOUR BEST BIRTH. It's funny how the second time around I didn't even need to take a pregnancy test. I was just 100% positive by feeling all the hormonal changes in my body. We were spending the weekend in Ojai so my son Matteo (now 3 yrs old) and I stopped by a local psychic who told me that she felt I was pregnant and that the baby was going to be a girl. (I kind of did too, but perhaps every mother of a boy is secretly wishing for a girl next time around...) The night after we returned from Ojai, I confirmed the pregnancy with an e.p.t. test and told Paulo, who was very excited but I think not surprised. Being Brazilian, Paulo credits our speedy conceptions to his "third-world swimmers" who are programmed to populate. When we returned home to NYC in June, I was about 4 weeks pregnant but we didn't tell people right away. A few of my friends had just experienced miscarriages so I decided to keep the pregnancy on the down-low for a while. I was feeling great and had no nausea or morning sickness. Everything felt exactly the same as last time around. But at 7 weeks, I started having some light cramps and bleeding. I quickly recognized that this bleeding was much heavier than the occasional spotting I'd had with Matteo. Certain that I was miscarrying, I called Dr. Moritz (my OB/GYN from The Business of Being Born) and he suggested I come in for a scan. When Paulo and I headed into Dr. Mortiz’s office the following morning I was feeling pretty doomy. “Well at least we conceived quickly,” I consoled myself, and I figured we could try again in a few months. Dr. Moritz was his usual jocular self and his humor put me at ease. But as soon as my uterus appeared on the ultrasound screen, it was clear to everyone that we were looking at TWO circular sacs. Dr. Moritz paused and then asked "Do you have two uteruses?" Was he joking? What in the world was he talking about? At first look, he thought we might have a pregnancy that had developed outside the uterus, called a heterotopic pregnancy, which is rare in naturally occurring pregnancies (1 in 30,000.) The issue was that the upper sac (which had a heartbeat!) was measuring about 6 weeks gestation but there was a very large sac beneath it measuring 9.5 weeks with no heartbeat. (For those who are curious, I attached the ultrasound image to this post.) Then he wondered whether this could be a superfetation, which is extremely rare, where there is actually a double pregnancy – the mother conceives 2 babies at 2 different times. (Apparently there is a couple this just happened to in Arkansas who have been making the rounds on all the news shows.) The superfetation time line actually made sense to us as we thought we had conceived a month earlier than we actually did. So off we went to the hospital where a perinatologist could look more closely with a sonogram. I was so relieved to have one heartbeat in there that I didn’t find any of the speculation alarming. The perinatologist took a look and also said he’d never seen anything quite like this before. At this point there was a gaggle of residents and interns around him, vying for a peek. The lower sac had no discernible fetal structures so he didn't think it had been a normally developing embryo but the size of it was confounding. There is a common condition called Vanishing Twin Syndrome, where a twin pregnancy becomes a singleton pregnancy after one twin literally “disappears” and is re-absorbed by the body. When this happens in the first trimester it is a very low-risk, often undetected situation since the mother may experience some spotting or cramping and never realize she had two embryos. (If vanishing twin syndrome occurs in the second trimester, it carries more complications for the surviving twin.) Now the reason that nobody could diagnose my condition as vanishing twin syndrome was because this second sac was so large. The main risk was that my body might expel the larger sac dragging the healthy fetus out with it. The other scenario would be that the healthy embryo would continue to grow and push the larger sac to the side, where it would either reabsorb or flatten against the side of the uterine wall. So basically we left the hospital with a "wait-and-see" since there was no way to intervene anyway. The perinatologist asked me to come back next week for a follow-up scan but Dr. Moritz and I agreed that I'd wait 2 weeks. For the next two weeks, I continued to bleed on and off and felt a little on edge – as if I could miscarry any minute. We were off to an interesting start here with baby #2....