This is the story of James and Poppy
On Saturday, 13 April 2019, my life changed forever. My much wanted and loved twins, James and Poppy, were born at the gestation of 24 weeks and 2 days and didn’t survive the birth.
The birth and days leading up to it were incredibly traumatic. I had been hospitalized in Brisbane, an hour and a half away from my home in Toowoomba, just the day before the twins were born because I had severe preeclampsia. Scans also revealed that the blood flow to the twins was intermittently absent and even reversing at times, which is incredibly dangerous. We had been counselled by specialist obstetric doctors and neonatologists who advised that the twins were measuring at approximately 400 grams each. A plan had been made that I would have scans every few days in the hope that I would make it to at least 26 weeks and that the twins could get up to at least 500g, when the doctors felt that they would have a better chance of survival. While I was worried, I felt supported by the doctors and comfortable with the plan in place.
Sadly, that plan went out the window overnight. On Saturday morning, blood tests revealed that my platelet count had drastically dropped and my liver enzymes were elevated to over ten times higher than they should be. I had HELLP Syndrome, which I can best describe as a severe form of preeclampsia, and my body was starting to shut down.
I was advised by the doctors that if I didn’t deliver the twins that day, I would die. The neonatologists counselled us on what we could expect if the twins were born that day and explained that while they believed the twins would not survive the birth, if they did and the doctors intervened the twins would most likely survive for only hours and would be in pain and distress the whole time. If the twins did by some miracle survive the birth and beyond, they would most likely have severe disabilities and not much quality of life.
After probably the most difficult discussion we have ever had, Dan and I made the heartbreaking decision that if the twins survived the birth, then we did not want the doctors to intervene. As much as this decision devastated us, and still I question whether it was the right one (my head knows it was, but my heart… my heart still wonders), we felt that if we asked the doctors to intervene then it was for our own selfish desire to have the twins here. It was out of love that we had to let them go.
Another element we had to consider was whether I should birth the twins vaginally or by way of c-section. Due to the HELLP Syndrome my blood platelets were too low for me to have an epidural or spinal block, as the risk of paralysis or bleeding out was too high and so if I had the c-section I would have to go under a general anesthetic. The c-section would also have to be a classical one, meaning that my uterus would have to be cut vertically to deliver the twins which in turn would add additional risks for any future pregnancies (as it turned out I ended up needing a classical c-section to deliver my rainbow baby Arthur, but that’s a whole different story). If I had the general anesthetic and the twins survived the birth then I would probably miss any precious moments we had with them alive, so we decided that I would deliver the twins vaginally in the hope we would be able to spend some time with the twins before they passed.
I was induced to deliver the twins on Saturday morning, and by around 8:30 pm I was in full-blown labour. I don’t think there are words to convey just how traumatic delivering the twins was for me. Because my platelets were so low, I couldn’t have an epidural and so gas and a pethidine injection were all I had to help with the pain. It was quite a fast labour too, so I didn’t really have time to lean into the pain as it built up. Ironically, we had been due to have our first antenatal class that day and therefore I had no idea what to expect during labour and no techniques for how to cope with the pain.
I distinctly remember looking at Dan and saying, “This is fucking cruel, going through this pain and knowing my babies won’t survive.”. At one point I felt a pop and a gush of warm liquid flowing from my vagina. I screamed, “Somebody help me, PLEASE, I’m bleeding!”. A nurse gently reassured me that it was my waters breaking and not blood gushing out, but that was a terrifying moment for me, wondering whether I had started bleeding to death. During the birth, my blood pressure rocketed up into the 190’s, which is the “stroke zone”. I remember my obstetrician and the nurses working frantically to get my blood pressure to drop, they even had Dan packing ice packs around the back of my neck because if it didn’t go down then I’d have to be handed over to an emergency medical team and my obstetrician wouldn’t be able to maintain control of the room. Thankfully my pressure lowered enough so that could be avoided, and Twin A was delivered at 11:36pm.
One of the most heartbreaking memories of that night for me is when I looked over at Dan and asked what gender the baby was – seeing the devastation on his face and hearing it in his voice as he answered, “a little boy.” absolutely broke my heart. The doctor then told us that the baby wasn’t breathing. I remember looking at the clock above the bed and praying that I could deliver Twin B before midnight as I just couldn’t face having two birthdays to remember them on every year. Thankfully Twin B, our little girl, was delivered not long after at 11:43 pm. Like her brother, she never drew breath earthside.
While we hadn’t found out the gender of the twins prior to the birth, something told me that we would have a boy and a girl, so we had only chosen one name per gender. We settled on James Louis (Louis for my middle name Louise) and Poppy Danielle (Danielle after Dan) as the names for our beautiful babies.
Something that I really struggle with now is saying that the twins were “stillborn”. It’s not because of the stigma attached to stillbirth, but because I know they were alive until the point they made their way through the birth canal. I felt them moving as I was in labour. James and Poppy weren’t delivered because they had died inside me, they were delivered to save my life and to give them the smallest chance of a life themselves. For this reason, I find it hard to say they were “stillborn”, even though they were, because it was only at the very last part of their exit into the world that their little bodies couldn’t keep going. And so, I straddle the line of being the mother of stillborn children and the mother of infants who died. These days, I say they were “born sleeping” or that they “didn’t survive the birth”. It may seem neither here nor there to an outsider, but the wording to describe the life and death of my babies is extremely important to me.
James and Poppy were absolutely perfect, aside from the fact that they were very, very tiny. James weighed in at 362g and Poppy at just 326g. For context, the average baby should weigh around 600g at 24 weeks, which shows just how growth restricted the twins were. My obstetrician, who at this point was only a few years off retiring, remarked that the twins’ placentas were the smallest he had ever seen in his career, so it’s no wonder they didn’t do their job of helping my babies grow.
Our immediate family members were all at the hospital while I gave birth. They had been waiting there so if the twins survived they could meet them before they passed away. An hour or so after the twins were born, our family were allowed into the room to see them and hold them. Our parents and siblings were all there, along with their partners, and despite the tragedy of the situation it was special being able to share James and Poppy with their extended family. The decision to allow extended family in to share in a moment like this is very personal, and while it was the right choice for us it may not be something that everyone would choose to do. I know that our family members are all grateful that they got to meet James and Poppy and we are glad for that too.
I remained in critical care for two days after James and Poppy were born. Due to how unwell I was, I remained in the birth suite instead of being moved to ICU and this allowed us precious time alone with the twins. We had a cuddle cot in the room with us which meant they could stay with us the whole time. I felt so afraid to handle the twins too much – it wasn’t because they were dead but because they were so tiny, and I was scared of handling their delicate bodies. This is something I think I will always regret – I wish I held them more, undressed them and dressed them again, bathed them. But my fear wouldn’t allow me to. To be fair I was also on a magnesium drip to prevent seizures, which doesn’t allow for a lot of clarity of thought. If I could offer one piece of advice to another mum going through the same thing it would be to do all those little things like giving the baby a bath etc. Those are lost moments with my babies that I can never get back.
Dan and I made the decision that we would say goodbye to the twins when I went back up to the ward instead of taking them up with us. I honestly felt that if I didn’t leave them then I would never be able to. Wrapping my babies in their blankets and kissing them goodbye for the final time is one of the hardest things I have ever done. Even writing about that moment now brings such a visceral response, as if I am reliving it all over again.
Leaving the hospital without James and Poppy was so distressing, I think I cried all the way from my room to the car and then half-way home to Toowoomba. Thankfully I was taken out of the hospital through areas only accessibly by staff, so I didn’t have to endure seeing other women leaving with their babies, but it was still so hard. To leave the hospital carrying a memory box instead of a baby (or in my case, babies) is something I wouldn’t wish on anyone.
Once I was home I couldn’t bear to be around anyone other than Dan, my mum and my sister. I know there were other people who wanted to see me or to be there for us, but I couldn’t handle it. To see people and discuss what had happened or talk about funeral arrangements etc. made it all “real” and it was too much to bear. Dan was my rock during this time, I’m very thankful that our grief drew us closer together rather than pushed us apart. I am also so grateful to my sister for being the intermediary for us at this time, fielding messages and calls from people despite feeling her own grief about the situation. Advice I would give to any woman dealing with the loss of a child is to not feel bad about setting boundaries about who you want to see and talk to during those difficult early days.
Planning the funeral was difficult, and we chose to have a private service at the chapel we were married in, conducted by the priest who married us. Watching Dan carry the tiny coffin that held James and Poppy out of the church was horrible, as was seeing the hearse drive away from the church and knowing that we would never have the opportunity to see the twins again.
Learning to live in a reality that didn’t include James and Poppy was very hard. I cried myself to sleep most nights and on many mornings I cried when I woke up and realized that the twins dying wasn’t a dream. I also found that for months I would cry whenever I was in the car by myself for more than 10 minutes as well as in the shower every night. The grief just weighed me down. Over time I started to live “normally” again – I socialized, went back to work and started trying to conceive another baby when I was given the all-clear by my medical team, but I was still so sad all the time.
It all came to a head during the first national lockdown we had due to COVID-19. Dan was away for work for weeks at a time, so I was alone almost always. I was undergoing fertility treatment (as I had done when trying to conceive the twins) and had had a miscarriage earlier in the year. I felt as though I would never be a mother to living children. It got to the point where getting out of bed each morning was a struggle and while I didn’t want to take my life, I didn’t care whether I lived or died.
I reached out to a psychologist which was the best thing I could have done for myself. She could hear the despair in my voice during our first phone call and made an urgent appointment for me, and I never looked back. Until that point I hadn’t felt like I needed to see someone to discuss my grief and fear around falling pregnant again and I definitely think it’s something you can only do when you feel ready.
I’m pleased to say that my story does have a happy ending. In May 2020 I was thrilled to discover I was pregnant again and I went on to have my rainbow boy, my beautiful Arthur, in November 2020 at 30 weeks and 3 days gestation, again delivering early due to preeclampsia and blood flow issues. Arthur spent 8 weeks in the NICU and special care but is now home and thriving. Being pregnant after a loss is extremely hard and something I didn’t anticipate was that having a baby at home wouldn’t necessarily lessen my grief for the twins – in fact, it often exacerbates it as having a living child at home has only served to show Dan and I what we have missed out on with James and Poppy.
Overall, I am doing well. I have a happy and full life, but there will always be two parts of my heart that will be missing, in the shape of a J and a P.
Written by Samantha, Poppy and Jame’s Mum. You can connect with Samantha and find out more about her journey, and HELLP Syndrome via her instagram account @hellpmeifyoucan