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Since it has been so long since I last posted anything about Isaac and Evan, I figured I should fill in a few details about what happened.

A few weeks ago we got the pathology report back on the placenta. My OB had suspected that there was an infection in the placenta which caused me to go into labor. When I delivered Isaac and Evan he said that the fluids looked dark/greenish and then I also had a fever after delivery.All of these things went along with the infection theory, so that's what we took it as.

Of course it was hard, but the thing that was comforting about an infection was that it was asymptomatic and there was no way for me to know that I had it.

I had come to peace with that. There was no way to know and nothing that could have been done.

I got thrown through a loop when the report showed that there was no infection. My OB has no idea what went wrong.

At this point (and I haven't met with a specialist to review the ultrasounds and discuss it further yet), I largely suspect that I went into preterm labor because of a subchorionic hemorrhage/hematoma. And I was in the 1-3% that ended up losing a pregnancy because of it.

At about 14 weeks I had a large gush of blood after walking around a trade show  for 4 hours. I was seeing a midwife at this point and I had just heard a heartbeat the same day. I came in on Monday and we checked for a  heartbeat and it was there and steady. I was told to take it easy- just do normal daily activities- and that it may be a subchorionic hemorrage, but it usually isn't a problem at all. I pretty much put myself on bedrest for about a week and only had a little brown spotting, so I thought I was okay to pick up a little more activity. We went furniture shopping and I did a bit of walking and lots of sitting. I thought I would be okay because it wasn't going to be that much walking. I still ended up tired by the end .
The next day I had a little more fresh blood, so I went back to taking it easy(ier). I didn't have any bleeding except maybe occasion spotting. 2.5 weeks later I went grocery shopping for 3 hours and lifted a couple cases and then had more bleeding. It was all dark brown that time and there wasn't a lot of it. I wasn't terribly concerned since it seemed to be old blood just trickling out. I had a midwife appointment a few days later and they didn't seem concerned about it and we decided to get an ultrasound in the next week or 2 and check things out at that point.
I wish I would have set up an ultrasound days later, but I put it off and didn't have it until 2 weeks later. At that point I had been spotting for over 2weeks.
At the ultrasound they of course found that there were 2 babies and they also see the blood. Since I was having twins I transferred care to my OB, but as it was the weekend I wouldn't have an appointment until at least Monday.
2 days later (on Sunday the 24th) I passed 2 mid sized clots, so I went in to the hospital. They found the heartbeats and said that everything seemed to be fine and to take it easy until I could get in to see my OB and have them do an ultrasound to see what was going on... preferably on Monday. I called and got an appointment the same day with the CNM there who grabbed the OB to come in and do an ultrasound. He did a quick look around and saw a hematoma. It wasn't behind/touching the placenta at all and he said it was totally fine. It's essentially like a blister full of blood and it can pop, which is probably what all of the bleeding initially came from. Then there's just been blood sitting and pooling and slowly draining out which is all the dark brown spotting and then of course clots that is old blood that has been sitting and clotting. He wasn't concerned and said that everything looked good.
We set up an ultrasound appointment a month down the road and we were good to go.
On the 26th I got a larger clot than I had before. My OB had brushed off the clots and said that I may have more, so it didn't concern me TOO much.
On the 27th I called to have my OB refer me to a MFM since my boys were mono-di (shared a placenta, but were in separate sacks) and I wanted to be sure they were closely monitored for twin to twin transfusion (where there is unequal sharing of the blood supply). We got that all set up for Monday the 2nd.
The night of the 27th I started having contractions as we were packing up our sit n' stand stroller to return since we bought it before we knew we were having twins and it needed to be back by the 30th. I thought I was having some braxton hicks and so I drank some water and went to bed. I woke up at 4 am to more
intense contractions, so we called my mom and dad to come watch the kids and we went over to the hospital. At this point I was thinking oh sure they'll give me something to stop the labor and hopefully figure out the problem and everything will be fine.Looking back, I wish I would have been more proactive/persistent in telling them that I had been bleeding and I had a subchorionic hemorrhage/hematoma. I wish they would have immediately given me IV fluids to see if that would have calmed my uterus if it was just being irritated by the blood. (I didn't get an IV or any oral fluids while at the hospital until I was getting set up for an epidural).
They gave me a terbutaline shot and it stopped the contractions for a bit and then they came back. After a 2nd shot, the contractions just slowed but never really stopped. 

At that point they sent me home and drink a lot of water and told me to come back if the contractions got more intense. I also kind of knew at that point that the contractions would not stop since they came back before. Adding to this was my OBs reluctance to do anything because of research showing that tocalyictics don't do much. I hoped and hoped, but knew that if  the terbutaline didn't work I would be left without any other options because of my dr.'s hesitance that anything would even work. I was also at that magical 19 weeks and 6 days gestational age where you're not to the point where any hospitals will really try to stop labor. 20 weeks, yes. Anything less, no. The funny thing is that if I didn't know so much about my cycles, my due date would have been a day earlier. I would have been 20 weeks in their book.. I told Jon at one point that we should go to a bigger hospital if these guys couldn't get things figured out (and I could tell them that my due date was September 15th instead of the 16th) but it was just easier to go back to where they had already seen me.
At home I laid in bed and drank what I thought was a lot of water (though maybe it wasn't enough to totally calm things down). I took a little nap, but a few hours later the contractions had gotten stronger, so I went back in. They did more terbutaline but it didn't really do anything. They did a transvaginal ultrasound to check my cervix. The tech said that my cervix was still long and thick. I was maybe dilated to a 2, but closer to a 1 at that point. So even though I had been having contractions for over 6 hours at this point without them doing much to my cervix, they kind of considered me a lost cause at that point.

My OB came in and said that they didn't know why I was having contractions. He had consulted with a MFM who said absolutely no magnesium before 22 weeks and even then it only holds off labor for who knows how long. They gave me some loratab to help with the pain along with a drug that would help calm the uterus down if it was being irritated... and said I could go home since they couldn't do anything else and the contractions didn't appear to be dialating me (there had been no change even with all the contractions I was having). I was both angry and sad that nothing else could be done and that I was being sent home with killer contractions that even loratab wasn't doing anything for every 2 minutes and there was nothing I could do about them.

After that news, I tried to muster up the energy to get out of bed and dressed between my contractions and couldn't ever do it because they got much longer and more painful. They gave the loratab an hour to work and then checked me and I was dilating at that point. Delivery was inevitable. I knew I could have my boys naturally, but they advised an epidural since in preterm labor/late miscarriage cases the placenta doesn't release. I got my epidural in and working probably 5 minutes before Isaac and Evan were born.

Isaac and Evan were born 2 minutes apart at 4:58 and 5:00 pm after 13 hours of contractions (not including the initial ones I felt before going to bed). They had many of the same features that Alex and Kaitlyn have and were fully formed and perfect. Just too tiny to live. We adored them from the second we saw them.

I still remember the look of horror/pity/sadness on the nurse's faces standing at the end of the bed. I can only imagine what I looked like to them. Instead of having a baby to happily distract me from the usual stitching for me, I held my two tiny fragile sons in the palms of my hands while sobbing and getting much more than stitches to get the placenta out.
I will probably always consider that day- that moment- to be the worst day/moment of my life.Nothing can prepare you for such an experience.
I am so thankful that we got to hold our sons and spend as much time with them as we wanted, but we were still saying goodbye to something we did not want to say goodbye to. Something that no one would want to say goodbye to.Those hours that we held our sons and tried to memorize them before we didn't have them anymore will end up being mere seconds of our lifetime. Those memories will fade with nothing new to replace them. 

I don't know how anyone could hear that story and not wishing that something more/different could have been done. It seems like there were so many opportunities to do something more/different, so I can't help but wonder if one of those somethings would have been something that would have kept Isaac and Evan cooking for even just a few weeks longer. Just long enough until something more could have been done.

Sigh. Maybe I'll understand it or at least accept it one day. It's just so hard.