Once upon a time. . .

My two older children were born in San Francisco. As a third generation City girl this appealed to me but the real reason behind it was that I was seen by a high-risk obstetrician who worked at California Pacific Medical Center. I have a complicated medical history and that, plus a twin, IVF pregnancy put me square in the category of high-risk for premature labor. Even though we were living in Martinez at the time it didn't seem too crazy to drive into San Francisco for all of my appointments. . .and there were a lot of them. My liver doctor is there. My gastroenterologist is there. Now my OB was there so I was getting all my ultrasounds there. When I was diagnosed with low iron I got two iron infusions there, alongside roomfuls of cancer patients getting chemo. Talk about a strange dynamic. My perinatologist was there--the woman who greeted me at our first appointment with "Oh, I've been waiting to meet you! Laurie called me at the grocery store to tell me about you and once I looked at your chart I couldn't wait to meet you."

Um. Thanks? For doctors who like a challenge I was looking like one sexy patient.

I never really worried about having the babies early, despite all the anxieties of the doctors. My OB always erred on the side of caution and she had me do every test, every extra ultra-sound. She always whirled into my room like a hurricane, thoughts flying, words speeding out of her mouth. We didn't talk much about my labor because she always seemed to be shushing me like, yeah yeah we'll get to that. She was a woman who got what she wanted and more than once I was shoe-horned into last minute, i.e. non-existent, holes in peoples' schedules where I was greeted with poorly hidden rolling of the eyes as if to say "Here we go again". I was always fine. This doctor was like a highly strung master musician. She checked my cervix at every appointment and would stare off into the distance and they tell me something felt off. Off to ultrasound I would go where the tech and then the doctor would assure me that everything was fine.

At the end of May I saw her and she examined me, attuned to her fingers like an artist. "Something is not right," she said. "These babies are coming soon." The next doctor agreed that my cervix was shortening, a sign of labor coming soon. Not right away, though. Come back next week. I went back next week, June 6th, and had three doctors appointments before lunch time. An appointment where they strapped me up to a monitor to check for contractions (they call it a non-stress test). No contractions. An appointment for an ultrasound to check the length of my cervix. That doctor told me things still seemed slightly strange but that I could come back the following week to check in. He debated giving me a shot of steroids to strengthen the babies' lungs but worried that the timing wasn't right and he didn't want to give it too soon. And finally a visit to my hepatologist, my liver doctor. Can't even remember why I went to see her. A regular check-up perhaps. All fine, see you later.

My cousin and I had lunch together and then she went to the opera with a friend while I drove myself home. I sat down to watch TV and my water broke shortly after.

I texted my husband that I thought my water had broken. What?!? he said. I think I'm ok I said. Maybe I should go get checked out but I think it's fine. We discussed driving down the hill to the local county hospital but I called my OB's office where the nurse told me to come to our hospital in the city. My husband was home by that point, around six in the evening I think. He packed up in a hurry, trying to decide whether or not to put the car seats in the car, trying to decide what baby stuff we needed. We brought the car seats, just in case. Just in case what? I was two days shy of 32 weeks pregnant. Full term is 38-40 weeks. If we had these babies we would not be taking them home any time soon.

My contractions started on the drive to San Francisco. My cell phone rang--it was the Berkeley Rep Theater calling to ask if I wanted to renew my season ticket subscription. I tried to get off the phone quickly but the guy wasn't paying attention. I finally said something like "I'm in labor" but I think he must have ignored me, thinking that wasn't possibly what I could have meant. The sky was so beautiful over the Bay. So, so glowingly gorgeous. Tranquil.

By the time we were pulling off Octavia the contractions were coming hard and fast. We timed them and there were about two minutes apart. I was having a hard time concentrating on giving directions--we'd never even been to the hospital together so he didn't know where it was. Even as we glanced at one another, thinking the contractions were pretty close together and thinking that might mean. . . no, I still didn't think those babies were coming that day. No way.

We pulled up in front of the hospital, on California Street. I waddled quickly up the brick stairs only to discover the front door was locked because it was after hours. I huffed in frustration and came back down, following signs taking me around the corner to the ER entrance on Cherry Street. I almost barreled into a couple rounding the corner but they quickly drew apart to let me pass. It was like being in a movie. I think my husband was parking? I can't remember. He must have been. He came to meet me in the chairs outside triage. As we waited I urgently needed to find a bathroom. I ran down the hallway and locked myself in, convulsively throwing up and well let's say emptying everything in every way. Eww, gross. As I sat on the bathroom floor, head on the toilet, heaving, I let the knowledge that these babies were most likely coming that night sink in.

Our triage nurse was awful. I don't think she really had a clue of what was happening. She couldn't get an IV in. She kept us there forever--at least an hour, maybe more. She kept asking us the same questions over and over again and both of us wanted to smack her. We finally got sent upstairs, me in a wheelchair. I kept throwing up, over and over. The contractions were strong. I felt panicky, like if I could just get a second to catch my breath I could actually do this but the puking kept happening and the contractions kept happening. Fast, hard. I hate throwing up.

More of the same questions, more people in and out of the room. I was crying at that point, though still seriously considering how to answer the question "On a scale of 1-10 how much pain are you in?" We hadn't called my parents or my sister yet--didn't want to worry anyone too early. The doctor came in, not my doctor. The on-call doctor--a tall, gentle-faced, gentle-voiced Asian man in his 50's or 60's.

"Ok, let's see how we can keep these babies in," he said calmly as he gloved up to examine me. He put his fingers inside me and took them out almost right away. "No, we can't keep them in. You're 5cm dilated. We need to take them out."

No one asked if we wanted a C-section. No one said they were worried about the babies so I'm not sure why we immediately went to the OR for a C-section. It didn't occur to me to ask or to lobby for a vaginal delivery. We did what they said. I was still throwing up every few minutes. I wanted to rip the monitors off of my belly because they felt suffocating. "Call my mom," I said to my husband. He did and went to put scrubs on to join me in the OR.

I wanted to marry the anesthesiologist. He sat me up and tried to get me to hold still and stop puking for a second so he could stick a needled into my spine for the spinal block. It worked quickly and the relief was so intense that I seriously wanted to hug him. Except I couldn't move very much. As they lowered me onto the table and set me up I mentally observed how the feeling in my legs drained away. My friend Nikole had recently described her C-section to me so I felt prepared and was interested to compare how I was feeling to what she said. I don't think I felt scared--not that I remember. I'm at home in the operating room--I've been in there many times, as a patient and for work. It's cold but it's familiar. They drew the blue sterile paper drape up so I couldn't look down and see him cut into my belly. And then, one after another, our babies arrived.

Lily, Baby A or as we called her "Steak Baby" because she always kicked after I ate steak, came first. We didn't know she was a girl until the anesthesiologist told us. It took her a few seconds to cry but then I heard her. They came and showed her to me--tiny, bright red, unrecognizable--and then took her away to clean her up and check her out.

A few minutes later Cyrus arrived. Before they got him out I felt lots of pressure, lots of pushing on my belly to get him out. The anesthesiologist exclaimed "You've got one of each! It's a boy." We smiled. But he didn't cry. I'm not sure how long it took me to get concerned--not long. I noted the different tone in the room. The quiet, anxious scrambling. And no crying. They didn't bring him up to see me but took him to the incubator to my left, a team of people huddling over him. I turned my head to the side and could see him. Limp. Tiny. Pale. Still no crying. A doctor finally came up to me, not the OB. He quickly and calmly introduced himself as one of the perinatologists. Your son is very sick. We need to take him out of her so we can take care of him. Ok, I said. And they took him away.

I got sewed up. They wheeled me out into the hallway and there were my parents, looking so relieved to see me. I kept going, into Recovery. The babies were gone. My all-over body itching was back, even though I couldn't feel my legs at all. Was I scared? I don't remember. I can't call up anything about how I was feeling right then, except for itchy and kind of stoned. Stunned. I know we named the babies in the OR but as I write this I can't remember or imagine when that would have been. After Cyrus came out, our Ice Cream baby who spent much of the pregnancy shoved up under my ribs by his sister. But he wasn't in there very long and they were working fast so who asked us for names and when? I don't know. My husband and I looked at each other, suddenly parents, and raised our eyebrows at one another like, are we really sure? Are we really ready to name these people who we weren't ready to have met yet? The enormity of speaking two names out loud for the first time, of naming people, sunk in but yes, we were ready.

Lily Helena and Cyrus Wilder. They had arrived. Eight weeks early. Our first NICU experience had begun.