July 26, 2008

Mom Expecting Quads Trying to Avoid Bed Rest Breakdown

By Aisha Sultan, St. Louis Post-Dispatch

Jul. 26--Jill and Chris Schwartz wanted a girl. They had two healthy little boys, 4-year-old Jason and 2-year-old Kyle. Three sounded like a fine number of children for their typical, middle-class family. So, just as she did when she was trying to conceive the boys, Jill, a 35-year-old nurse, took the advice of her doctor and began taking a low dose of the fertility drug Clomid.

It had worked perfectly before. It wasn't long before she was at her obstetrician's office getting an ultrasound. Good news: Jill was pregnant.

A week went by, and Jill felt nauseous, much more so than she had with her previous pregnancies. Close to three months pregnant, Jill was lying on the table for an ultrasound. She glanced at the screen and saw three heartbeats.

"Oh, who's babies are those?" she asked. The doctor paused.

"Uh, that would be you," he replied.

In that moment, Jill was elated. Sure, it was more than they had bargained for and would require planning, but they didn't know if they'd even be able to have one more baby.

Doctors say the drug Clomid increases the chance of multiples by less than 10 percent.

She took a copy of the ultrasound with three tiny heartbeats home to show her husband. She joined a support group of mothers with multiples, and they advised her to see a specialist.

At 14 weeks, she went for a consultation with a specialist at St. John's Mercy Medical Center. As she lay down for the ultrasound, she joked with the technician not to find any more babies. The technician paused in the middle of the test and went to get the doctor.

There was a fourth baby.

This time, Jill cried. She knew the risks involved in carrying so many babies. There could be serious complications. She called her husband, who was driving at the time. When he heard the news, he had to pull over. "This was much larger than what we were planning," he said.

The doctor told her she had to quit her job immediately, schedule an operation to prevent her cervix from opening prematurely and begin bed rest. She had lost 13 pounds because of the extreme nausea and vomiting and had to go on a special 3,000-calorie diet.

Their families have stepped up to offer help; different relatives watch the boys each day. The church coordinator in their Oakville parish is scheduling volunteers for shifts once the babies come home. High school friends are gathering supplies.

Jill had been doing well at home, but last month the doctor said she needed to check in to the hospital for the rest of her pregnancy. Her husband, a pharmaceutical sales rep, is juggling responsibilities at home. He brings the boys at least once a week to visit their mom.

On a recent visit, Jill spent little time actually lying in bed. She tried to amuse the boys with tubes of puffy paint, which they got all over their hands. Kyle was getting a kick out of pushing the buttons to make her automatic bed rise and fall. He got upset if she tried to lie down. He climbed over her protruding belly and pushed her back to get her to sit up.

The doctors want Jill to make it to at least 30 weeks -- about seven and a half months. Jill's goal is Aug. 8 when she'll be close to 33 weeks pregnant.

Missing her boys and being unable to carry the 2-year-old is hard, she said.

"The hardest part is when they call you on the phone," she said, her voice catching, "and when they leave."

She worries about the disruption in the boys' lives. And she worries about the health of the four babies growing inside her. Some days she has hard time getting comfortable; other days she gets migraine headaches. But like so many multi-tasking moms, it's hard for her to sit still and do nothing.

So each week, Jill sets a goal. She has set up a website and writes a daily blog. She's completed one of the boy's scrapbooks and is working on the next. They've made pictures together to decorate the isolettes of the babies. Her mentor in the multiples support group suggested she write letters to companies asking if they would send her free products, so she's writing diaper and formula companies.

Jill was healthy before the pregnancy, and her background as a nurse has made her pay close attention to the babies' nutritional needs. That, combined with a naturally sunny disposition, has helped her cope extremely well with the demands of this pregnancy, said her doctor, Dr. James Bartelsmeyer, director of Maternal Fetal Medicine at St. John's.

When the big day arrives, the Schwartzes will have not just one girl, but two -- and two more boys, for whom they've already chosen names. Once Molly, Megan, Cole and Kurt are born, they will have to spend time in the neonatal intensive care unit. When they come home, the Schwartzes will have six children younger than 5. Jill is hoping to carve out one-on-one time for each child, especially the older two, who will be adjusting to the shock of four new siblings.

Ever the optimist, Jill's signed up to coach Jason's soccer team in the fall.

It might be a nice way of getting out of the house, she said -- and a break from all those kids at home.


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