Editor’s note:
In 2009, shortly after marrying her (first and only) husband, Paolo, Elizabeth Heath was diagnosed with premature menopause and resulting infertility. Paolo and Liz are now parents to a baby girl, Naomi. In this series, Liz recounts the couple’s struggle with infertility, and how they finally achieved a successful pregnancy and parenthood.

So here we were, pregnant for real. The hCG had confirmed as much. We called the ObGyn we’d selected to work with in the event we got lucky and needed an ObGyn. He scheduled our first appointment for an ultrasound at five weeks, about the time a fetal heartbeat can first be detected with a transvaginal ultrasound. In the meantime, he told us to have one or two more hCG tests run, to make sure the pregnancy was developing.

In a normal single (or singleton) pregnancy, hCG rates should double about every two days. So we tested again to see how my hCG was building. The result was a bit of a surprise: in two days, my hCG had tripled. A third test showed that two days later, it had quadrupled.

Paolo’s cousin Diana and I were both sure what this meant—both embryos had implanted, and I was pregnant with twins. I consulted every online hCG calculator I could find, and all seemed to point to the same conclusion. Paolo was his usual skeptical self. “Wait until the ultrasound,” he said, as I was busy shopping for double strollers.

At our first appointment, the doctor did a transvaginal ultrasound, as a fetus can’t immediately be detected with an abdominal ultrasound. He poked the ultrasound wand here and there as Paolo and I both gazed at the monitor with rapt attention. “One,” he said, as we saw a black blob with the tiniest flutter of a heartbeat. “And two.” Another blob appeared onscreen, with a slightly fainter flutter.

I smiled, and Paolo nearly swooned. “Two?” he asked, incredulous. When we left the doctor, we both had to sit down in the hospital lobby and collect ourselves. Twins. Twins. We knew the possibility existed—when two 5-day embryos are transferred, there is a 20-30 percent chance of twin pregnancy. I had suspected as much with my fast-climbing hCG numbers. But still, the reality of those two flickering heartbeats on the screen was a whole other affair. Neither of us was disappointed—not by a long shot. Although we had concerns about the risks for me and the fetuses, as well as the additional expense and work of two babies versus one, we were both happy with the idea of completing our family with one pregnancy.

Read Related: Facing My Infertility Part 7: The Hail Mary Egg

Back at home, I set about researching physicians and hospitals that could handle high risk OB. Between my age and a twin pregnancy, I definitely fell into the high risk category and we didn’t want to take any chances. Since our local hospital didn’t have a high risk OB unit or a NICU (Neonatal Intensive Care Unit), I looked to Rome, which would be easily reachable by train. I found a hospital on Tiber Island—the tiny island in the middle of the Tiber River, in the heart of Ancient Rome. There’d been a hospital there since the Renaissance, and nearly two millennia prior to that, a temple to Aesculapius, the Greek god of healing, once stood on the island. The same Renaissance hospital, now thankfully more modernized, has a high risk OB ward, NICU, and—a big plus for me—at least one English-speaking ObGyn.

It was decided then: our babies would be born in Rome, on an ancient island in the middle of one of the world’s most iconic rivers, in the middle of the most ancient part of the Eternal City. The archaeologist in me was delighted by the epically historical nature of the location. I even started calling the fetuses Romulus and Remus, the abandoned twins who were nursed by a she-wolf and went on to found Rome. That Romulus eventually killed his brother (which is why the city is called Rome and not Reme) was a little detail I chose to overlook.

Our fun with names and twin strollers and wondering whether we’d have two boys, two girls, or one of each, was short-lived. About eight weeks into the pregnancy, I awoke in the middle of the night with strong cramps. I went to the bathroom and found my underwear soaked with blood. The cramps were getting worse. I called to Paolo, who rushed into the bathroom and immediately caught sight of the blood, which was impossible to miss. “We have to take you to the emergency room,” he said, stricken.

It was a good 10 minutes before I was able to move from the toilet, my cramps were so fierce. I fumbled to get dressed and he loaded me into the car and we headed to the ER. It was about 2am. Police had roadblocks set up in the town next to ours, as there had been a recent rash of home break-ins. “My wife is sick,” Paolo told the police who stopped us on each end of town. They waved us on.

When we arrived at the ER, we were immediately escorted up the OB unit and into the ultrasound room. The young ObGyn gently prodded with the ultrasound wand, and found one black blob. But there was no heartbeat. “This one is gone,” he said, as we both stared at the unmoving spot on the monitor. He moved the wand around and found the other blob. Inside it, there was what I could only describe as the tiniest of miniature babies, which seemed to be jogging in place. “This one is still okay,” said the doctor.

Paolo teared up with relief, but I was too stunned at the sight of the jogging mini-baby to even know how to react. The doctor said the second fetus was still okay, meaning we might lose that one, too. He sent us home, ordered me to stay in bed for a week and said, “Good luck.” It was one of the weakest “good lucks” I’d ever heard.

When we got home, Paolo’s mother, Franca, called immediately. We were living at the time in her garage apartment while we renovated our home, and she’d heard our car pull out in the middle of the night. Paolo told her what had happened, and she came down in the morning, after Paolo had gone to work. I was lying in bed, and she stroked my hair and offered words of comfort. I started sobbing; it was the one and only time I cried over the lost twin.

The week of bed-rest proved to be the longest week of my life. I shuffled from bed to couch, couch to bed. I didn’t cook, or take the dog out or even work at my computer. But I had no more spotting, no cramping, nothing out of the ordinary. Our little jogging mini-baby, minus a brother or sister in the womb, appeared to be hanging on for the marathon.