Sanaya B Kaufman and Sadye Dina, (23 months). Sanaya also lost identical twin boys to Twin-to-Twin Transfusion Syndrome (TTTS) and prematurity in October 2013.
"My first pregnancy and loss changed me. I am a different person now - scarred and heavy, but also stronger and more empathetic".
Sanaya and her husband tried to get pregnant one time, on a whim. She assumed it would take months to get pregnant but woke up one day and realized she was almost 10 days late. "We were living in a sublet while renovating our apartment, opening a business, and generally insane. To my shock and awe, I was pregnant. I laughed uncontrollably all day".
Their first ultrasound was at a midwifery practice that delivered at a birthing center. She didn't know much about birth, but thought she wanted a natural birth. Sanaya remembers the moment her midwife paused the ultrasound on her belly and she saw two tiny blinking lights. Twins. She says she cursed and felt completely overwhelmed and terrified.
Sanaya switched to a high-risk OB practice and at 12 weeks learned that the babies were identical - mono-di meaning they had their own amniotic sacs but shared a placenta. The doctor spent a lot of time with them and explained all the possible complications and printed out a lot of information about TTTS. She was monitored closely with bi-weekly appointments to confirm that the boys were developing normally and at the same rate.
At 18 weeks, the TTTS was officially diagnosed and was already Stage 3. They went to CHOP in Philadelphia to try laser surgery to correct the flow of blood from the placenta. Sanaya was incredibly itchy all day and was diagnosed with cholestasis of pregnancy, a rare liver condition that affects pregnant women and is more common in multiples but generally shows up at the end of pregnancy.
After a long day, and many tests, the team of doctors sat them down to share the grim news that the placement of the boys and her anterior placenta made attempting to save both boys through the laser surgery very very risky, the prognosis was not good. Sanaya's cervix was already thinning quite a bit and the doctors strongly recommended that we try a fetal reduction to try and save one of the boys.
After much deliberation and tears, they decided to do what they could to save baby A even if it meant losing baby B. The grief of losing Baby B felt heavy and terrible. She went in for surgery at 7am, they extracted 2 liters from baby's A's amniotic sac which provided some relief.
Sanaya was sent home on bed rest and had to stay in Philly for a week to be close to CHOP. She cried a lot and eventually returned to Brooklyn to work remotely for a few weeks. Their goal was to keep their surviving baby in as along as possible - 28 weeks was her goal, 32 would be even better.
At 22 weeks, Sanaya went into preterm labor and she lost her baby boy on October 27th, 2013. She had been with her parents at their country house, and woke up with intermittent cramping and pressure. Her husband was working in Brooklyn but she decided not to drive back to the hospital in NYC because she was terrified to be in a car for 2.5 hours while having contractions, and not knowing what was going on. They went to a rural ER that didn't know what to make of her.
"The realization that I would have to birth these boys was terrifying. I had not thought about birth much, having been so entirely focused on staying pregnant. It was very scary. They offered me some kind of pain medication, which I gratefully accepted. They gave me Pitocin, to speed up labor, and as soon as the IV was in, my contractions were one on top of another and incredibly painful. Baby A was born a few minutes later in a burst with my water breaking. A few minutes later Baby B was born. We had a wonderful nurse that was very supportive. She encouraged us to visit the boys and spend time with them, but I could not. I was incredibly conflicted but ultimately decided that I didn't need to see them for closure. My husband wanted to, and spent time holding Baby A in a special room. I don't regret my choice, but I do wonder how my grief would have been different had I spent time with them".
Sanaya and her husband knew they wanted to try again, and all these complications were very unlikely to repeat in a subsequent pregnancy. They waited six months to try again and got pregnant again after two months of trying. Her second pregnancy was completely different in every way, but shaped in the shadow of the twins. They stayed with their high risk practice, and she was closely monitored. She developed gestational diabetes at 28 weeks, and had to start testing her blood daily.
At her 32 week appointment, the doctor started talking about induction and she was caught completely off guard. They had taken a Bradley method class to prepare for natural childbirth but with everything they had been through, she did not have it in her to take any risks, she just wanted this baby to arrive safely. Sanaya was induced at 39 weeks in the middle of the night. Pitocin started at 6 and by 8 she had progressed to 3 or 4 cm. The doctor suggested breaking her water to move things along and almost immediately her contractions were unbearable. They were lasting for a few minutes at a time, with hardly any pauses in between so she asked for an epidural. Once the epidural took, she was able to rest a little bit in-between contractions, but was having bad back labor and needed a lot of counter-pressure.
Sanaya was shocked when the doctor said she could push. Within 20 minutes Sadye was born. "The doctor placed her on my chest and I cried and laughed so hard. Holding this slimy slippery little being I asked the doctor, “what is this baby?” The doc said to Chris {her husband} “Dad, what is this baby?” Chris took a minute because the umbilical cord was in the way and then announced “It’s a girl!” I couldn't believe she was a girl. I was so happy. I had thought I was having a boy the entire time I was pregnant. Everyone thought I was having a girl. Old ladies on the subway. Aunties at baby showers".
She had never considered anything other than breastfeeding before Sadye was born and had naively assumed it would be easy if she was committed to doing it. She didn't even have a bottle or pump at home, but Sadye had a pretty significant tongue and lip tie. She was unable to latch at all for the first two weeks. After revision she did latch a few times, but only for a minute or two at a time, and it was incredibly hard and frustrating for both of them. Sanaya turned to pumping and ended up doing so exclusively for 11 months.
"Someday I'll tell her about her big brothers. I don't think about them as much as I used to, but they're here with me. Part of me. Shaped me as a mother and wife and friend. That grief is deep and doesn't go away, it just gets folded in to the person I've now become. I've lost so much. And if the twins were here, I would never have met Sadye, which feels incomprehensible. I feel guilty having that thought, but it feels honest".
"I didn't remember how I found this project, but in recent weeks I've realized that it is likely because of TTTS. Happy moms and happy babies look like everything is fine and easy. But nothing is easy, and everyone has a hard story to tell in different ways. It's just figuring out what's gonna be the hard thing for you. Women's bodies are amazing. And it doesn't matter how our children came to being, or what we do professionally, but motherhood is special and so damn hard. Most of my friends and colleagues know about my history, but none of my larger concentric circle of social media friends and acquaintances. We tend to hide loss in the shadows. when I lost the twins, so many women came to me and shared their stories of loss. I want to be honest about my past. And share my story and hope it helps another woman out there."