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Kelly Coupland: My birth story

One twin mum-to-be’s battle with placenta previa and pre-eclampsia

Author Kelly Coupland
Categories   Birth Stories

The Edit

[TW: This article discusses pre-eclampsia and placenta previa and may be triggering for some readers.]

No two pregnancies are the same.

After a great first pregnancy, I was looking forward to being pregnant again. I naively thought I’d go through the same motions as before, but second time around things couldn’t be any more different.

From very early on, the symptoms began. I felt nauseous when pregnant with my first child, Harry, but this was a whole other level! I constantly felt sick, was throwing up countless times a day, my skin broke out, I had severe heartburn and I was showing much quicker. My gut was saying ‘it’s twins’ (they run in the family) but I didn’t want to get my hopes up. We booked an early scan and I was right!

After 14 weeks, I began to feel a lot better. However, this was quickly replaced with ligament pain - I felt like I was carrying a giant bowling ball around and just walking short distances felt impossible. I was really afraid thinking about how I would cope full term if I was like this already.

At my 20-week scan I was told I had two low lying placentas, one of which I later discovered was complete placenta previa – something that only occurs in 0.5% of pregnancies. As a result, I was told I could experience some bleeding and might need a C-section if the placentas didn’t move up. I didn’t think much of it as I rushed back home to get ready for my gender reveal party.

The complications began

At 23 weeks, I experienced my first bleed and I remember feeling shocked that I had to be admitted to hospital for four days. I left knowing I needed to take it easy and was looking forward to getting back to my family, even though I knew it would be difficult not being able to pick up my toddler.

Three weeks later it happened again. This time the bleed was a lot bigger. It wasn’t until I arrived at hospital that I realised the seriousness of the situation. A team of midwives and doctors were waiting for me at the door and rushed me straight in. I remember seeing two cot beds next to me and the tiniest woolly hats thinking “Is this really it?!” Luckily the bleeding slowed down quickly, but they still wanted to keep me in until I had stopped bleeding for 48 hours.

A week later I was still in hospital and, as I was under 28 weeks pregnant, the decision was made to transfer me to John Radcliffe Hospital (JR); a specialist hospital for extremely premature babies. Just before my ambulance ride to hospital, they noticed my blood pressure was recording high.

After more tests at JR, they diagnosed me with pre-eclampsia. Just as I felt like I had got my head around a twin pregnancy and placenta previa, I had a new complication to add to the mix! As my pregnancy was now seen as ‘very high risk’ I was told the next time I’d leave hospital would be with my twins. This was something I was so unprepared for. I remember thinking I haven’t even done a handover at work and there was so much to sort out at home.

The news we never imagined hearing…

Ever since 23 weeks when I had my first bleed, the consultants spoke about the big ’28-week milestone’ where the survival rate sky rockets as babies move from extremely premature to very premature.

The day before we reached our 28-week milestone, I had an ultrasound which detected one of the twins was feeling the impact of pre-eclampsia. There was poor blood supply through the placenta to the baby causing them to stop putting weight on at just 1lbs 13oz.

As the only cure for pre-eclampsia is to deliver, I was under constant monitoring to make the daily decision on when to deliver based on my deterioration, the babies’ and pushing me as far along as possible for the best chance of the babies’ survival.

The consultant estimated on the day of delivery, saying it would be any time between now and three weeks, with 10 days from now being most realistic.

Although the bleeds had been alarming, having the twins this early never truly crossed my mind and it was weird that we now had a concrete piece of information – we’d soon be parents to very premature girls.

At this gestation, every day counted. One day was equivalent to 3-4 days. I remember after each scan the consultant said “better in than out” and off I went back to my hospital bed feeling so relieved.

After a week at JR, I was transferred back to my local hospital and that evening I went to sleep and experienced a bleed at around 3am. At 6am, I then experienced my biggest bleed to date at 350ml. The emergency button got pressed and what felt like a team of millions flooded into the room, pumping me with a blood transfusion – magnesium sulphate for the babies and fluids for me. I remained calm until the consultant shouted, “Get ready to deliver.” I burst out crying.

Since my diagnosis of pre-eclampsia, I really thought the little twin would drive the decision for delivery, not me, when the babies were still fine inside me.

I pulled my oxygen mask down and asked “Why now? What’s the reason?!” I knew this seemed like a bigger bleed, but I could feel it was stopping and the babies were happy. Luckily the bleeding stabilised and despite other doctors wanting to deliver, my amazing consultant had my best interests at heart and with backing, they reverted the decision.

He explained there was no right or wrong decision in that moment – it’s an extremely risky scenario and if it happened again, they would need to deliver.

Every single day was a milestone, yet every single day I lived in fear of this happening again.

The next day, the exact same events occurred. At 3am I had a bleed and at 6am a bigger bleed… well, so I thought. It was in fact my waters breaking! The midwife said I was having quite regular contractions (I had noticed tightenings for a couple of weeks) so the emergency button got pressed again, and soon a big team was in the room.

The consultant said they needed to deliver, but wanted to wait a few hours for the day shift team to come in so they had a bigger team. This time I didn’t fight it. My body was going into early labour and I knew natural labour wasn’t possible with placenta previa as it would cause an abruption. However, 10 minutes later, I experienced my biggest bleed yet of 500ml and it wasn’t stopping. Luckily the theatre was all set up for me from night before when they nearly delivered.

Emergency caesarean

The C-section was worse than I thought it would be, but then again I did little research – my whole mentality before that was ‘must keep the twins in’ so I never really thought about getting them out. They gave me magnesium sulphate to help the twins’ brains on a fast drip of five minutes. My whole body instantly felt hot and I began to vomit so they quickly pumped anti-sickness drugs into me.

I’d then be chatting away to my husband and all of a sudden be fast asleep. As I was losing blood, my blood pressure was dropping, but after a blood transfusion I’d be wide awake again. We purposefully distracted ourselves from the babies being born as we didn’t know what the circumstances would be so just kept talking. We were so relieved when they said the girls came out pink and breathing on their own.

I had no idea it would take so long after the babies arrived to stitch me up, although maybe I wouldn’t have felt like this if my babies came to me. I was just lying there witnessing the tugging and thinking “Any time now?!” It took one hour from after the babies were born to finishing. Weirdly I felt the spinal block wore off really quickly. I felt them putting the bandage on and taking off my compression socks so I’m glad it ended when it did.

I got a glimpse of the girls as they were wheeled straight to NICU and I remember thinking they weren’t as small as I had imagined and how perfectly formed they were. As I went down to recovery, my husband visited the twins and came back feeling so overwhelmed with the sheer amount of information. I was overdue with Harry and he weighed 8lb 14oz – how could things be so different?

Overall, everything went a lot better than expected. Despite the very risky pregnancy, being in hospital under the incredible care of the consultants and midwives and everyone knowing my case meant all the precautionary steps were followed.

My baby girls, Sienna Grace (3lb 1oz) and Bella Rose (1lb 15oz) are doing really well in NICU and after what felt like a lifetime in hospital, I was finally discharged, armed with six weeks’ worth of iron tablets (having lost over two litres of blood and needing three blood transfusions), blood thinning injections and blood pressure tablets.

We can’t wait for them to come home so we can start life together as a family of five.

Author Kelly Coupland

Kelly is a mum to rainbow baby, Harry and twin girls, Sienna and Bella born in March 2022 at just 29 weeks. After a complicated twin pregnancy, Kelly shares her unexpected NICU journey whilst juggling spending time with Harry. She likes to shines a light on the positive aspects of parenthood; to encourage people to share their victories and lift each other up.

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