What does it look like to prepare for the birth of triplets?

So, what does it look like to prepare for the birth of triplets?  In the mere 19w I have been pregnant I have learned that I have to be very flexible.  Things change from week to week, and not just size of the baby, but potentially life threatening changes.  It looks like getting in the zone for a vaginal birth one day and then having to research a pregnancy reduction the next day.  It is all over the map.

The latest update on my triplet pregnancy is that each baby is in its own sac, so no Mo/Mo, and we are still within the range of normal with regard to fluids to TTTS has not been diagnosed.  So, I'm just a regular high risk triplet pregnancy without added risk.  What a relief.  But now that I am not trying to educate myself regarding Mo/Mo or TTTS I feel like I have to do something.  For whatever reason I can't just BE pregnant.  The fewer the complications the greater the likelihood for a vaginal birth.  And so in the past few days I have allowed myself to finally read the few triplet vaginal birth stories that are out there.  They are all amazing, but I am most amazed by the VBAC moms who have had a successful triplet birth, and not just VBAC, but VBA2C.

I remind myself constantly, as does my OB and my MFM, that there are so many variables in a triplet pregnancy.  It would be foolish to sign-off on a vaginal birth now at 19w because things can literally change from week to week.  This does not mean my care providers are not supportive of a vaginal birth, should that be the best option and my decision.  In all honesty, in this pregnancy I am setting very small goals.  Goals that really I have very little control over attaining, but I set them none-the-less.  Every Sunday when I make it 1 more week that is cause for celebration and thankfulness.  Every ultra sound, which is now happening weekly, that indicates babies are growing, bladders are functioning, amniotic fluid is within the range of normal, my cervix is still holding up(and apparently it's beautiful and boxy and indicating no cause for concern), and my 1 placenta for all 3 hasn't crapped out that is cause for celebration and thankfulness.  Beyond weekly goals, my next major milestone is 24w, viability week.  Ok, so those are my goals about them living one week longer.

Then other factors that I'm at increased risk for due to the multiple gestation is pre-eclampsia and gestational diabetes.  At my 24w visit we will test for GD.  This is earlier than if I were your average woman pregnant with a singleton. And in the past, I have declined the test and I have that choice again and the "ok" from my OB should that be the route I choose.  But I don't need to have additional stress on my placenta and if there are things I can do dietary wise that I'm not already doing, sign me up.

So I suppose there are other things occupying my mind even after TTTS and Mo/Mo were not associated with this pregnancy.  But thinking about all those things I listed above aren't much fun.  Reading stories of vaginal triplet births and connecting with moms who have accomplished this feat or who are hoping for one is fun, encouraging, and gives me hope.  But I am not naive.  This pregnancy and birth is not just about thinking positive thoughts, saying affirmations, picturing my cervix opening, and hiring just the right people to attend my birth.   And quite frankly that view extremely minimizes every other issue, hardship, and concern.  It is about making it one more week.  It's about reducing the number of days each baby will be in the NICU.  It's also about figuring out how to care for my 3 children I already have at home and caring for the new little babies joining our family.  It is not about how  strong or determine I am.  Thankfully, I have already had 2 successful VBACs so I don't doubt my body.  I know that it will do what it needs to if and when it needs to.  I also believe the outcome has been determined by God, I just need the wisdom and discernment to follow the plan He has set and be at peace with it.

I can't just show up and expect to have a vaginal birth with triplets.  So I need to put some time and effort into finding what little data and information there is.  Uterine rupture, even with two successful VBACs, is still a possibility simply because of the extra babies.  But there isn't a lot of statistical data on rupture, vbac, and triplets...go figure. Each triplet pregnancy is so different, it's hard to find consistent protocols among OBs because of the great variability, so you can imagine there isn't a lot of information on the hows/whys/etc for a vaginal triplet birth.  So I am doing my homework and making friends with like-minded moms who have as much similarity to my pregnancy as is possible given my birth history and current pregnancy "profile."  As much as I am doing my homework on vaginal, I am also watching videos and reading about cesareans, specifically family centered ones.  Like I already said, I am not naive.  I know things can change on a dime.  I've said it before, I am so thankful that I am under the care of two health care providers who respect and practice evidence based birth, respect the almost delicate nature of the pregnancy, want what is best for me even if it may not be what they would choose, and ultimately leave the decisions up to me.  God has blessed me in so many ways in this pregnancy.