Adopting the Twins, Part 3: The 34-week Threshold, Family Language, Misunderstandings with the Ultrasound Technician, and Birth

Though waiting for the twins’ birth allowed us space to worry the birthfamily might change their minds about the adoption, in reality, the longer we waited, the better. Remember, the birthmother had a bout of preterm labor at 31 weeks. Every day she remained pregnant increased the twins’ health and reduced the chances we would have a lengthy stay in the neonatal intensive care unit (NICU). Most twins stay in the NICU for at least a few days. The birthmother’s obstetrician gave her a due date of August 24, though twins are usually delivered at least two weeks early. August 10 would have been 38 weeks. We hoped she would reach at least the magic number of 34 weeks.

34 weeks was such an important milestone because babies born before that date require a great amount of specialized intensive care. These babies have more health risks and require more medications and longer stays in the NICU. Babies born after 34 weeks fare much better and go home sooner. Further, the Kaiser Permanente hospital in Santa Rosa where the birthmother would deliver did not have a NICU that could care for babies younger than 34 weeks. If the birthmother went into labor before 34 weeks, the medical staff would transport her to Kaiser San Francisco, the closest hospital with a sufficient NICU. If we were looking at a long NICU stay, it would be a logistical challenge for our family to cross the Bay to San Francisco daily to visit the twins.

So we prayed and watched the calendar, finding greater relief with each passing week. Having twins also increased the birthmother’s prenatal appointments. She did an amazing job going to lengthy doctor’s visits multiple times a week. After each appointment she would update us on her health and the twins’ measurements.

We crossed the 34-week threshold, which eased our anxiety. At the end of 35 weeks, the birthmother went to the hospital again with preterm labor. This was her third such trip—twins increase the pressure on the uterus, making preterm labor more common with multiples. She was convinced she would give birth. But again, the doctors sent her home, this time with an induction date of August 12. Now we had a line in the sand.

During this period we quietly and slowly nested. Carey informed her work she would soon take family leave. We purchased another car seat, finally resolving that saga. We did not, however, have baby showers because of the provisional nature of the adoption. Nothing would be set in stone until the babies were home from the hospital and the birthparents relinquished their rights. We privately told a tight circle of friends and family we matched and asked them to keep the news mum.

Our adoption coordinator encouraged us to avoid familial language with Elijah concerning the twins. We told him we would take care of the girls growing in the birthmother’s belly while she decided if we would be the twins’ forever family. We did not say he would be their big brother or they would be his sisters. If the birthparents changed their minds before relinquishing their rights, the girls would leave our home. Such an event would confuse Elijah, especially as an adoptee himself. He might think, If my sisters went back to their birthmother, would my parents eventually send me back to my birthmother? We had a hard time not using familial language with him. We wanted him to form bonds with the twins as much as possible. We also wanted to bond with them, but our restraint only increased our own uncertainty and my instinct was to keep myself emotionally detached.

I have mentioned our concerns of the birthfamily changing their minds. I do not intend to communicate they gave us the impression they were fickle or unsure about making the adoption happen. The opposite was actually true. The birthfamily, particularly the birthmother, engaged in healthy behaviors that exhibited their sincerity. Nor do I want to imply Carey and I were paranoid. Rather, we tried to deal with the reality of the situation. Few choices of greater weight exist than deciding to forgo parenting and placing a child with another family. Some birthfamilies show strong commitment to an adoption, only to change their minds well into the process. Sometimes they back out and choose to parent in the delivery room after they meet the child. While rare, these situations have happened to families we know. We had no hesitation moving forward in the process with the birthfamily, but we also wanted to prepare ourselves emotionally if it did not work out as we hoped.

The twins’ birthmother invited Carey to an ultrasound appointment on July 30. Carey drove to Santa Rosa and she felt honored by this wonderful gesture of trust on the birthmother’s part. The ultrasound technician estimated the twins’ weight to be close to six pounds each. This news encouraged all of us, but Carey had her doubts. As she watched the ultrasound, she thought the technician made overly generous measurements. Carey and the birthmother also had a humorous encounter with the technician who thought they were a lesbian couple. The birthmother informed her Carey was going to adopt the twins. This news didn’t compute. The technician then thought the birthmother was our surrogate. Again, the birthmother corrected her and the technician sat in silent confusion. Adoption simply was not on her radar.

Carey and the birthmother drove to their respective homes to take a nap. As Carey slept, I received a phone call from the birthmother. Her obstetrician had reviewed the ultrasound and came to a different conclusion than the technician. The babies were in fact much smaller than six pounds each. Worse, it appeared they had stopped growing, particularly the smallest baby. The doctor wanted the birthmother to come in that day for delivery. I woke Carey and we spoke with the birthmother together. She would return to the hospital and would call us when she knew the physician’s plan. At this point the twins had a gestational age of 36 weeks 3 days.

We put our own birth plan into action. We packed our go bags and the two car seats into our car. We called Carey’s dad so he could drive from Burbank and stay with Elijah. We contacted friends, neighbors, and our babysitter to create a chain of care for Elijah until Carey’s dad arrived. Then we waited. It took a surprisingly long time for the hospital staff to admit the birthmother. In the meantime Carey painted with Elijah. Around 4:30pm the birthmother called and said the doctor wanted to do a C-section as soon as possible and they would wait for our arrival. We told her we could get to Santa Rosa within a couple of hours. Our neighbors arrived to watch Elijah, we said our goodbyes, and drove north.

A billboard on the road to the hospital. It gave us fodder for many jokes.

A billboard on the road to the hospital. It gave us fodder for many jokes.

On the road, the birthmother’s mom texted us that the C-section was scheduled for 7:00pm. We thought we could make it, but would cut it close. As part of the birthmother’s birth plan, she wanted her sister and Carey in the delivery. Again, the birthmother’s generosity in including us in all these important events humbled us.

We pulled into the parking lot, walked into the hospital, and headed for the birthing ward. The birthmother’s mom met us in the hallway and brought us back to the room. The birthmother lay in bed in her hospital gown, ready for the C-section. Her sister wore scrubs. I pulled out my camera and started taking pictures. Both Carey and I wished we were present for Elijah’s birth. Even though we met him when he was only four days old, we still feel sad we didn’t greet him right away. That we would be with the twins from their first breaths was a wonderful grace. Carey knew from experience though the doctors wanted to start the C-section at 7:00pm, the likelihood of delay was great. This gave us an opportunity to talk.

Our friends who also adopted their kids gave their children two middle names—one they chose and one the birthmothers chose. We liked this idea and asked the birthmother to give the girls a middle name each. About a week earlier we told the birthmother the names we chose for the girls. As we waited for surgery, she told us the names she picked. This act of naming the girls together honors both their birth and forever families. We believe the act shows our commitment to an open adoption in which the girls will always know their birthfamily loves them. In an open adoption, we do not only adopt the child, we also bring together whole families. We welcome new grandparents and aunts and uncles and cousins. By naming the girls together, we honored this joining of our families.

The nurses came in with a set of scrubs for Carey. After she dressed I prayed for the birthmother. Hospital staff then wheeled the birthmother to surgery at around 8:30pm. Carey and the birthmother’s sister followed the bed. I and the birthmother’s mom went to the waiting room where we ate crackers and read old magazines.

When Carey attended the birth, she stood on the side of the C-section where she could see the incision and delivery of the babies. Well meaning nurses asked if she would be more comfortable standing where she wouldn’t be able to witness the cutting and blood. Carey gently informed the nurse that she was an obstetrician who has performed many C-sections. Later another nurse offered her the opportunity to cut the umbilical cords. Carey’s quick and certain movements shocked the nurse who also did not know Carey’s profession.

Around 8:55pm a nurse came into the waiting room where I sat and asked, “Do you want to meet your daughters?” I hurriedly gathered our belongings and followed her through security doors into the Intermediate Nursery. The nurse had me wash my hands and led me into a room with several infant warmers. I heard the tiny cries of infants, nurses moving quickly from place to place. What looked like chaos was in fact the economic and ordered movements of people proficient at their work. In the midst of the bustle I saw Carey in her scrubs, standing over a warmer. She motioned me over and said, “Say hello to Bethany.”



Then she pointed at the warmer behind her and said, “Say hello to your daughter, Joy.”



The twins were covered in white vernix. Their small size and bright red skin shocked me. Bethany weighed 4lbs 10oz and Joy weighed 3lbs 15oz. Joy breathed quick, shallow gasps. Bethany cried loudly. We held the girls’ hands as nurses cleaned them. They attached several probes to the twins, monitoring their pulse, breathing rate, and oxygen saturation. This being a nursery, the probes had pictures of animals on the pads. I do not know how a cartoon whale will make a probe more acceptable to an infant who has just seen light for the first time, but they were kind of cute. We took photographs, texted family and friends, and enjoyed bonding with our daughters in the flesh.

Once the girls were clean and their vital signs checked, the staff invited us to hold them. They were so slight and fragile. Joy especially looked like someone had draped skin over her. Their combined weight was less than Elijah’s at birth. But to witness such tiny people fully formed and alive was miraculous. The crush of action swarmed around us. Alarms went off. Nurses spoke to one another in shorthand. Doors opened and closed. Yet around those two infant warmers, our world remained still. As I try to remember those early moments, the details drift in a fog. I can better recall the emotions, the sense of it all. Relief. Gratitude. Exhaustion. Pride. Awe.

2 thoughts on “Adopting the Twins, Part 3: The 34-week Threshold, Family Language, Misunderstandings with the Ultrasound Technician, and Birth

  1. I feel so honored to be a part of this process. Thank-you, Tyler. My favorite sentence? “I do not know how a cartoon whale will make a probe more acceptable to an infant who has just seen light for the first time, but they were kind of cute.”

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