Personal Story of Termination For Medical Reasons

“You started as an embryo years ago. I knew you but didn't know you. All I knew is I really wanted a sibling for Eliav. I started trying when Eliav was 15 months knowing that it’s not easy and takes a long time regardless of IVF or not. Honestly, I didn't feel so ready. Having kids so close in age scared me but I knew that I wanted this. I had to stop nursing Eliav to prepare for all the meds - he was so sad. But this stuff takes time.

To my surprise I got a positive HCG test after a week and then it began to rise. What I failed to realize was that the levels were very low, to begin with - everyone was hopeful, however. At 6 weeks, there was no heartbeat, but at 7 weeks, there was! I still didn’t really believe that it would happen - it just didn't feel right. My instinct was right and I was taken off all the meds to miscarry a few days later. The meds were keeping this guy growing. So at 9 weeks, the embryo was measuring like a 7-week embryo still, and the heartbeat was gone. I was okay - I was sad about the lost time, the 2 lost embryos, all the meds used and hope lost - but this was not yet life, just an idea with a nerve connection and potential.

I miscarried it on my own. I saw the sac of cells drop. Lots and lots of blood and I had to labor it myself. I had a newborn photoshoot scheduled that day and thankfully could push it to the next day.

It didn't bother me to be surrounded by babies all day. They are so beautiful and full of hope. I never want anyone to feel bad about his or her own life. It should be celebrated!

After that, I had to take a break from everything. Maybe it was a sign it was too soon. We traveled to Israel, took a month or two off - just healed a bit from the disappointment. It hurt. It was too good to be true. I still had 3 embryos left... one had to work right? But I was hopeful really. It took 4 embryos to get Eliav why should this time be different? Little did I know how wrong I was. Eliav was a breeze. Yes, it took FOREVER to get there but I had embraced the worst part of infertility - no control over time. Time...all the time and days and hours it takes to get there. Minute by minute...

I started up again. I even timed this round of hopeful IVF to be due in a time where I would be able to book less instead of turning down jobs. When you run your own business, this is a legit concern. I have bills to pay for, and I don't get paid unless I can work.

This time, the shots hurt. It burned every shot in my tush was like waiting for the pain... but this time something crazy happened. I hit the IVF lottery...the jackpot! There were two sacs... I got two for the price of one! My HCG number with Eliav was 86. This time... it was double. Twins, maybe? I am a twin. How exciting. I can do this. I am so happy. Was I happy? I was scared. Twins? Could I handle it? This is amazing. This is frightening. Omg!

We confirmed at the 2nd visit that there were indeed 2 sacs!!!

I told only my mom and a few others but not even my husband. It was like putting it into words would make it go away...and I just wanted to get to the 12-week mark. 12 weeks and it was real, 12 weeks and they were stuck. 12 weeks it they tests would tell us if it would last.

I couldn't keep my eyes open most days. I was sleeping for 15 hours. I would pass out from a nap and I couldn't stop eating my appetite was literally insatiable. But I was so sick with morning sickness and acid reflux. I was already so large...my stomach was being pushed all the way up I felt choked. It was all going to be worth it. I have a twin; it is the best thing in the world.

12 weeks came. I went to LA and hung out with my twin and told her the news. We were both crying. 14 weeks came and I found out that not only was I having twins, I was having twin girls! I started to tell my family. It was safe now; we were in the clear. These babies were healthy and thriving. No genetic issues. TWIN GIRLS OMG!!!

This whole time I swore to myself that I would not tell ANYONE I was having twins. No matter how large I was, I would take it to the end to be a surprise. Regardless, everyone knew it was IVF and most people asked. And I lied. I was also carrying very large right away. I looked large, like I was 7 months pregnant at only 4 months. Someone asked me if I was due next week. Yes, I was that large.

16 weeks came and I went to my doctor appointment expecting the usual - everything looks good, have a nice day, see you in 4 weeks! Every time with Eliav that was the case. Nothing to see here -- see you later!⠀⠀⠀⠀⠀⠀

I chatted with the nurses about the excitement of twins. We were thrilled. The tech did my ultrasound - baby A (closest to the exit) looked great. Everything growing well, normal. Baby B too...oh wait, She couldn't find her. She was hiding. Initially it was hard to hear her heartbeat because she was further back. Didn't phase me.

The doctor came in and glanced at the ultrasound and said right away, "Okay you have to go to the MFM. Baby B looks as though she may have hydrocephaly in her brain. That means she may have a larger head - sometimes they can fix it with a shunt at birth."

Okay...Thanks? Sounds good. What do you say to that? My first instinct was that wow. I did a big event yesterday and i picked something up that was heavy and I made the baby's head swollen. I asked him, he said no. He said everyone’s first response is that it's something they did. But it just happens.

I didn't believe him...

It was all that tuna. It was all those times I forgot my vitamins. It was the acid reflux. Here I was having twin girls...and one is going to have a large head. Google what do you say? Will I be okay? Will she be ok? The internet said that they could do surgery often if its one baby but for twins, it's very rare to be able to do this in the womb. Okay let’s just wait and see what the MFM says.

There was a huge snowstorm. I couldn't reach anyone that day. I got up first thing in the AM and they fit me in, graciously, to see what was going on.

I drove slowly through the storm to arrive at my appointment. I was hopeful - this was all a mistake. I WAS going to have twins, 2 girls; they would be best friends forever.

-

Make it a mistake

Make it okay

Make them remain twins

Both healthy and okay

I’ve been trying to go with this pregnancy like all is normal all is the same as usual

But twins...

We take it for granted. All the healthy babies.

-

What made it harder for me is that ironically I had Eliav. He was perfect and healthy and normal. I couldn't fathom at this moment how I could do that again. HOW can ANYONE HAVE A HEALTHY BABY? It is all a miracle. How did I do it the first time? Just fluke? By chance? Luck? Yes- pure luck. I just held my son and cried. How would I do this again? How could I have been so lucky!!!

The tech did lots and lots of checking of everything. She right away put me at ease and said that this was worse then we thought. I know that sounds funny, but it made the choice easier. She left me alone for a while and I just cried and cried and cried.

The doctor came in after reviewing the ultrasounds. She explained that this was very severe. It was something I had never heard of and couldn't even remember right after she told me, all I could think about was my twins I was having and all the dreams I had for them.

It was something called a neural tube defect. That meant that the spine was not fully formed and in this case, this child would never walk or go to the bathroom on its own it was so severe. She found 3 holes where the spine was missing. Then, on top of that the baby had a lemon shaped head. Due to the spine not forming all of the skin around the head was being pulled down. And then the amygdala was shaped like a banana. I will never look at fruit the same way again... There was lots of black in the brain, which meant it was full of liquid. It had spina bifida and hydrocephaly. There was no telling what would happen if I continued this pregnancy with baby B - the baby might die naturally. The baby may be born and live for years to come. The baby may die right after birth. The baby may cause the pregnancy to end. There was no answer.

But the choice was mine - I could reduce the pregnancy from 2 to 1.

Or Keep it.

It was not an easy choice. This was a very wanted pregnancy, a wanted life. I WANTED TWINS. How did I know that it was really doomed? Maybe...maybe...

No, I would reduce the pregnancy. Baby B would not have a good life. If I let her carry on not only would I be affected but baby A may suffer as well. When I was in my mother's womb, I was baby B. I raced to find others who had gone through the same thing...

I found a few. Many in secret - some had to reduce healthy babies and fetuses because they could not carry multiples. Some went from triplets to a singleton. All were choices made...but all were okay in the end. Some had to reduce much later than me. Some reduced the pregnancy right away due to ivf treatments they were pregnancy with 6-8 embryos.

Baby A felt doomed. Could I start over?

There was only one place in NJ that would do a fetal reduction for me, and it was at Hackensack. I made an appointment and the situation was so severe that they saw me the next day. I went in and the ultrasound tech did everything again, just to check that this really was the case, that there was an issue, that they were not wrong; That this potential life actually had no real potential.

The doctor informed me that this did not come without consequences to the pregnancy and I may miscarry. But I was lucky. The baby affected was the one on top, which meant the other was blocking the exit. As far along as I was, I still was in a good place to have this procedure too. The baby would stay inside and decompose overtime. The rest would be unknown. Also, the babies were not identical or sharing the same sac.

They made me see a genetic counselor to review all possible options. But neural tube defect was not genetic. You get this by not taking enough folic acid and within the first 3-5 weeks. However, when the embryo is implanted due to ivf you are already 3-4 weeks. Did this happen while I was harvesting the eggs? Did this happen after the embryo was inside of me?

I did a lot of research. I found that sometimes IVF can "cause" this. Or something... It was not my fault, however next time I have to take x 10 the amount of Folic acid as usual. But- not my fault (still felt like my fault).

The doctor told me it would not hurt. That was a lie. It hurt a lot. I wanted to watch and say goodbye. They placed the needle with potassium chloride guided by the ultrasound into my stomach and jabbed the baby. She was moving - but I knew that this was just nerves at this point. A 16-week-old fetus to me was not viable and not yet alive. The heartbeat was purely nature... but until 23 weeks...this was just nerves. But it was still so so sad. Tears poured down my face and I said goodbye. However she did not pass yet - she was still beating and moving and I would have to come back the next day to check that she was no longer growing.

I had a bris in the morning where I clearly looked pregnant. The doctor had told me too take it easy - this was not an option but a bris was not hard for me! After the bris I made my way over to check if baby B was still there. She was. Her heart was beating - he must have missed her heart with the needle. But he didn’t want to risk stirring up any more damage while he was in there - any penetrating outside source was a risk to baby A now. They asked me if I wanted an amniocentesis too - to check if it really was what we thought and to check baby A. We decided to check at 20 weeks because of my CMV scare, it could still have CMV and the only way to check if I had CMV was to wait until 20 weeks or we would get more false positives.

He inserted the needle again, and I felt like I was given the gift of 24 hours to say goodbye again to the little potential life and heart I thought I had. She slowly stopped moving. This was ironically Valentine’s Day - we lost a heart.

The pain and emotion I felt inside can barely be put into words, looking back now it’s a blur. I just remember the sadness. Screaming in my car at the top of my lungs, how could this happen? Why? I tried to document my feelings. But it’s hard to look at something so hard. I just remember the shock, the pain, then and the ambivalence. I had to protect myself.

It hurt more the second time but I had to keep as still as possible. My husband came with me this time. It was hard for him to watch, but I wanted to watch to make sure she was really gone, safe and sound. And then before I left they checked baby A and she was doing great.

But I still felt she was doomed. Now I would wait for 4 more weeks to get tested and then 2 more weeks for results to make sure she was healthy. By this time everyone knew I was pregnant but when people wished me bshaa tova I could not help but to just nod and feel so ambivalent. I had to wait until all the tests to really make sure she was ok.

My friends brought me flowers that shabbat and a small heart cake. It helped me feel better that someone knew what I lost. I didn’t know I needed it but I did - it felt like someone knew, someone commemorated what was. Someone acknowledged my secret pain. It helped. The next week I went to the high risk OB to check that baby A was there - I had shrunk a lot, and the pressure I was feeling scared me.

I started telling people what happened. It was sort of weird, but I needed an outlet. It was a big deal, but the more I talked about it the more it helped. “Oh by the way I was supposed to have twins. I had to terminate one.” it’s a weird thing to say, but otherwise people wouldn’t know. And it was too big of a burden to carry alone. The more I talked about it and shared the more regular I felt and better.

It was a fact of life - it happened. I explain it by how you feel when you watch a really sad movie that movies you to sobbing breakdown tears. Then its over...it happened and it hurt but you have to use it to move on and build on top of it.

Of course when I say I was supposed to have twins, I was never really supposed to. I just didn’t know that yet – I was never informed of the greater plan.

The tests all came back fine for baby A at 23 weeks, and I started to embrace this pregnancy, finally. Let the countdown begin..

I was working nonstop. Events were hard on my back, and everyday someone asked if I was due next week. I had to remember I was carrying one growing baby and a fetus, and 2 placentas. My back ached. I could barely eat due to the acid reflux. But it was all going to be worth it!

Then, another roadblock.

31 weeks. I had a full day of shoots back to back. I was feeling great… on my way back from the city I felt myself pee my pants. Or was it my water breaking? Nah, just pee - I am sure it was fine. Only a few more weeks until baby!

I got home and started editing - totally ignoring my pants situation. Happens all the time…

I went to the bathroom and ohmygod...there was bright red blood everywhere. I called my doctor who said to see how it was in the morning (I don’t think he actually got the blood situation because I am not sure I explained it 100%). In the am I was still bleeding and he said to come into the office. But then I went to the ER because 2 hours is a long time to wait to see if everything is ok…to see if your baby is getting oxygen or surviving.

But remember I run my own business. I am needed at all my events. I had a bris that am in 20 min! I called my friend Lia Jay and she graciously covered for me. I drove to the office and it was closed...he meant at 9 am! My friend, Bracha, came to meet me there. She remembered whatever the team said because I could not fathom the situation at all. Honestly all I was thinking about was how I was going to work and pay my bills and be at the events I had lined up. Yes, I cared deeply for the baby but it was so hard to comprehend…

They admitted me right away laughing at the fact that I said there was just a little blood. They did an ultrasound where they found a blood clot and potential placental abruption. I was on bed rest for 3 days. I could not move. I had to pee in a bedpan. I could not eat for fear that I was going to go into labor or deliver via C-section. I was having severe contractions. They set up the heart rate monitor and watched the baby as I went through it all. They gave me magnesium for 24 hours, which made me completely out of it and 2 shots of steroids 24 hours apart to help the baby's lung development if she was born early.

I was still in denial...this was fine, not as bad as they are making it seem. It was all going to be okay.

We watched my output to see if the bleeding was slowing. After 2 days finally there was only old blood, nothing new. They were going to let me go home on modified life. I could not pick up eliav. I could do photography but with lots of help…

I missed a few major events that weekend. I was devastated for my clients. My friends and family and peers came to my aid - some helping me at any cost or loss to them. I am so grateful to have a photo community I could rely on. When you run your own business, this is a big deal. A weekend we planned for months and months and finally I couldn’t be there. Yes, my health and my baby come first.

How did I get here, after all this? We thought we were in the clear! While on bed rest, they put compressors on my legs to help the blood flow. I had to ask for help at every turn. What was incredible were my friends and sister who came to visit me in the hospital. They brushed my hair and painted my nails. They talked to me and kept me company. They were there for me when I didn't realize I needed it. They brought me food when I could finally eat and just showed that they were there for me. It helped. One friend sent me food via uber eats. One brought me steaming hot soup for shabbat. These are the little things that I remember and got me through.

My husband brought me my large desktop computer so I could edit for a bit. I had thousands of photos to edit - it was a lifesaver. I will never forget the feeling of being so helpless and hospitalized. And everyone understood it wasn’t my fault...but me.

The next 8-9 weeks I went to the doctor weekly to monitor everything. I was still bleeding old blood, but old not new. It was scary. But I just had to believe...it would all be okay. It would!! I hired people for thousands of dollars to help me at events I had planned. I got through them one by one. They were instrumental in helping me survive.

I could not pick up eliav. I was so hard and sad for me. I was getting so large. It was hard to move as well. By 36 weeks I had another blessing - PUPPS rash that grew all over my expanding pregnant body in and out of the stretch marks and on my legs and arms too. Imagine you have a to itch and can’t stop it feels so good to itch but then after it hurts but you just have to itch more! Pine tar soap helped a little.

The comments that people said to me the entire pregnancy were also comical.

“Are you sure you’re not having twins?” yep.

“Triplets” yep.

“I know you’re having a boy!” Almost everyone said this to me. To their shock I replied, “Nope. It’s a girl. I’m just really sexy. And large.”

ARE YOU SURE IT’S NOT A BOY? “Yes.”

Wow, due next week? No, 10 more weeks!

Wow if you are this large now, I am worried for you!

Thanks.

On your way to the hospital? Nope.

Gee I thought you might give birth up there!

I could go on and on. I don’t mind honestly - I just laugh at them.

The night before I gave birth I spent a lot of time with Eliav. I hugged him tight and cried. We have had almost three years together and now we are changing everything. I am sure it will be amazing and worth it...I hope. I felt so heavy. I was still vomiting everything constantly. Eliav was so in love with my belly though it was amazing. I could not even wipe my butt normally because I was so large. Weirdly I didn’t get hemorrhoids this time.

Week 39 came and I walked into the into the hospital for my C-section.

We made it.

The story isn’t over as the hard part is just beginning. Eliav getting used to a sister. The pain of healing and nursing. The feeling of being torn between two kids. Balancing a newborn and a toddler. Healing.

But we made it.”