An excerpt from The Preemie Primer.

There’s a well-entrenched theory that OB/GYNs have the most complicated pregnancies.

In reality most of us probably do not, but doctors remember complications most vividly when they happen to people they know and love. My pregnancy was, unfortunately, a good example of that old adage. Many of my colleagues who looked after me during that time have said, “It was the worst night of my life.” To be remembered this way is odd, although I know they mean well.

I had been practicing OB/GYN for eight years, 13 if you consider residency, when my husband Tony and I decided we wanted a family. Things did not go as planned naturally, so after a frank discussion we decided to try one cycle of infertility treatment; if it didn’t work we would adopt.

In February 2003, after a battery of blood tests, I started daily injections to try and coax my ovaries into action. My doctor tried to sound positive, but I can read ultrasounds and knew I wasn’t responding well. I gave myself one cycle, and although I tried to put it out of my mind, it was difficult as there was so much time, energy, and money tightly packed in with our hopes and dreams.

I was very surprised when my cycle failed to start. Not wanting to make my disappointment public with blood work at the hospital, I took a home pregnancy test. A few minutes later I was standing in my bathroom looking at the stick, stunned beyond belief. Years of training simply vanished while I anxiously looked for a blue line. So I did a second one, and then a third to be sure.

I was pregnant.

And then I started to worry. I was afraid the pregnancy I had dismissed as impossible would somehow vanish. All those fears and desires I had efficiently locked away came flooding out. And then I had my first ultrasound and I realized we did have something to worry about: I was pregnant with triplets.

On July 5, 2003, when I was 22½ weeks into the pregnancy, I woke up in the middle of the night in a pool of water and knew I had ruptured my membranes. I needed a few minutes to summon my courage, so I silently sat in our bathroom staring into the night. I felt as if I were in a way station between worlds. After a few minutes I would have no option but to stand up and move on. I could see my old life, one of constancy and control, slip away into the darkness and a new existence, more painful and uncertain, emerging. I took a deep breath and walked through the door.

“We need to go the hospital right away,” I said from the middle of the bedroom. My husband sat bolt upright. He could sense my harnessed panic. I knew he wanted to believe I was overreacting, that it was probably nothing, but deep down he understood.
There are no words to describe the sadness in our hearts as we drove to the hospital in the quiet of night. Just breathing seemed to be an effort, so we silently sat beside each other in the car, enveloped in a cloak of darkness and sorrow.

I wanted to believe I had somehow been mistaken, that in a few minutes we would all laugh about the OB/GYN who couldn’t tell if she had ruptured her own membranes. But after the testing was complete, the doctor on call came into the room and sat on the edge of my bed. I couldn’t look at Tony as we listened to the grim statistics. I had known all along what this meant, how bad it really was, but I couldn’t bring myself to be the one to tell my husband. I didn’t cry until I saw the look on his face.

And so I lay in a hospital bed waiting for the inevitable: to lose three boys, a whole family, at once. I imagine this is what it feels like when you’re waiting for your execution but have not committed the crime. You cannot believe it’s happening, but you still hold hope for a pardon that, in reality, almost never comes. We ordered pizza, friends visited, and as long as no one made eye contact, we could pretend the elephant was not in the room. All the while I couldn’t forget that a storm was brewing inside of me.

And then the storm broke.

I woke up to go to the bathroom and as soon as I closed the door I knew. I was terrified to reach down and feel what my body was telling me, but I did anyway. My first son was delivering. I was shaking so hard it felt as if the earth must be shaking too. And then instinct took over and I screamed and screamed. I was still screaming inside, even after I stopped making any noise.

It was one of those moments in life when everything seems to happen in slow motion. It was probably only seconds, but it seemed like hours, and the nurse was there, catching my son with one arm and guiding me back to bed with the other. The memories of those few moments, from the act of closing the bathroom door to the delivery, are burned in my memory. I can close my eyes and see it today just as it was years ago. I can feel the cool linoleum on my feet, hear the bathroom door shut, and touch his frail body. If I don’t distract myself the loop can play over and over again, like a bad movie clip.

And then the worst words that I have ever heard, “Do you want to hold your son? He is dying.” How do you answer that question? I was too scared to make it real, to understand what I had just lost. Tony was braver and gently held Aidan. Eventually he lay in my arms, swaddled in a blanket, with a tiny, perfect face that would make you cry to look at it.

It was all too much to process. So I lay there quietly waiting for my other two boys to deliver, for this tragedy to come to fruition. And then I realized nothing was happening — it was as if my uterus had simply run out of gas. Somehow, I was still pregnant with two.

Jennifer Gunter is an obstetrician-gynecologist and author of The Preemie Primer. She blogs at her self-titled site, Dr. Jen Gunter.