Visit to the High Risk Clinic

Keep Calm and Choose Life

It has taken me over a week to process our first visit to the perinatal high-risk clinic. Frank and I went into the visit excited and prepared to askour long list of questions about how we can make this pregnancy the most successful it can be. We anticipated a thorough discussion on treatments, tests and procedures as well as detailed instructions for each trimester. Much to our dismay, this is not what occurred.

The visit started off wonderfully. We had our second ultrasound and had the opportunity to see all five of our blessings at appropriate lengths and with strong heartbeats. The ultrasound tech was amazing! She walked us through everything we were looking at for each of the fetuses. It was breath taking!

Frank and I were so encouraged after the ultrasound that we decided to launch our announcement and once again we were overwhelmed by the love and support from everyone! We don’t have words to describe how thankful we are!

We then headed over to the consultation room to meet our maternal and fetal medicine specialist and his fellow. Even within the first few minutes I sensed tension that you could have cut with a knife. The doctor also did not congratulate us, but hopped right into reviewing my medical history and highlighted each condition that put this pregnancy at risk. Then, he decided to transition to the stat list and read the probabilities for each of the chronic and acute disabilities and conditions. I made it halfway through the list and burst into tears. The fellow kindly stopped and was very apologetic. He just kept saying, “Oh no, Oh no… I’m so sorry.” I sensed his compassion at this point, but unfortunately the floodgates had already opened. The specialist quickly took over and the fellow excused himself; I’m fairly certain he went out into the hallway to cry because he came back with tear-stained cheeks.

I knew where this conversation was going. Our perinatologist then walked us through additional studies on the risks of quintuplets and the benefits of multi-fetal reduction. I must admit his approach was much softer than our first doc, but it was clear he was on a mission. He told us that there was a chance that all five of our children could be born with cerebral palsy. This really hit home; would I be able to mother 5 children with several disabilities? My immediate answer was yes, if that’s what I was called to do.

He also shared several studies that highlighted the importance of gestational age and birth weight. There is no doubt that I comprehend the risks we are facing of CP, compromised lung function, IVH, blindness, deafness and the list goes on and on. But, as a mother-to-be I cannot help but be optimistic and fight for these little ones. I have catalogued the research articles that were shared by the docs below, and would love others’ opinions. But, I have also found countless studies that demonstrate that medical technology today provides strategies to prolong gestation and decrease the risk of neurological abnormalities and respiratory complications.  If any others have additional research studies that have been pivotal to their care, please do not hesitate to share.  My hope now hinges on the fact that I could make it past 32 weeks. For quints, this would resemble a birth at 28 weeks, which continues to pose a risk, but according to the articles the risks tremendously decrease for (Condition, probability):

If we can make it to 34 weeks, the probabilities of RDS decreases to 55%, IVH to 2%, Sepsis to 11% and NEC to 15%.  So, our Doom and Gloom conversation, part II, finished up on a very sad note. Frank and I drove home in a haze of what if’s, statistics, and desperately sought some good news. Our next visit back to this clinic is not until our 2nd trimester, or one month. Until then, we continue to take one day at a time doing all that we can to prepare mentally, physically, emotionally, spiritually and of course financially to parent five beautiful babies.

Research Articles:

Multiple Gestation associated with infertility therapy: an American Society for reproductive medicine practice committee opinion

Contemporary outcomes with the latest 1000 cases of multifetal pregnancy reduction (MPR)

Estimation of neonatal outcome and perinatal therapy use

Long-term Medical and Social Consequences of Preterm Birth

Long-term family outcomes for children with very low birth weights

Multi-fetal Pregnancy Reduction, Committee on Ethics

Management of High-Order Multiple Gestation

High-Order Multiple Gestations

The Case Against Multi-Fetal Reduction

Determinants of Gestational Weight Gain

Outcomes in Young Adulthood for Very-Low-Birth-Weight Infants

Written by: Cassie Vanderwall


3 thoughts on “Visit to the High Risk Clinic

  1. One day at a time my dear sweet Cassie. Statistics are statistics. We (your family and extended family) will be here every moment. HUGE gains have been made in every single one of the above listed %. Will it be rocky here and there? Probably, but that is life. You have been blessed, and you and Frank would not have been picked if God didn’t have a plan. It is fine to know all the information you can gather, but remember, we don’t have a Cassie and Frank pregnancy rule book or blue print to follow. Every pregnancy is different. I am sorry that you seemed to have the MD with the personality of a rope burn. You and Frank have compassion, hope, love and each other. Seems to me you are on the right path. Xoxox Judy

  2. Cassie and Frank,
    Thank you for sharing your challenging adventure with a multiple child pregnancy. I’m glad you and Frank are in this together and have good family and friend support. Praying for God’s hand and direction through this situation. No one can really tell you what to expect or what will happen with your pregnancy… you’ll have to walk by Faith and not by sight on this one. The Babies lives are in God’s hands. I’m trusting God to give you the strength and insight into all the decisions that lie ahead. If all doctors can offer you goes against your beliefs, then you need to base your choices on what you believe to be right and wrong and trust God with the things you can’t change.
    Take it a day at a time.
    Be of good courage.
    Praying in Reno.
    auntie lisa

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