To the women pregnant with my children: Here is what to expect [Totally TMI – Proceed on your own risk]

Last year I got a strange email, from a person entirely unknown to me, letting me know that one of their acquaintances seemed to pretend an ultrasound image from my twin pregnancy was their own. They sent along the following screen capture that shows a collection of ultrasound images. It springs to the eye that these images were not taken with the same device as they differ in contrast and color scheme. It seems exceedingly unlikely you would get this selection of ultrasound image from one screening.

In comparison, here is my ultrasound image at 14 weeks pregnancy, taken in July 2010:

You can immediately see that the top right image from the stranger is my ultrasound image, easily recognizable by the structure in the middle that looks like an upside-down V. The header containing my name is cropped. I don’t know where the other images came from, but I’d put my bets on Google.

I didn’t really know what to make of this. Why would some strange woman pretend my ultrasound images are theirs? Did she fake being pregnant? Was she indeed pregnant but didn’t have ultrasound images? Did she just not like their own images?

My ultrasound images were tiny, glossy printouts, and to get them online I first had to take a high resolution photo of the image, straighten it, remove reflections, turn up contrast and twiddle some other software knobs. I’m not exactly an award-winning photoshopper, but from the images that Google brings up, mine is one with the highest resolution.

So maybe somebody just wanted to save time, thinking ultrasound images all look alike anyway. Well, they don’t. Truth be said, to me reading an ultrasound is somewhat like reading tea leaves, and I’m a coffee drinker. But the days in which ultrasound images all looked alike are long gone. If you do an inverse image search, it identifies my ultrasound flawlessly. And then there’s the upside-down V that my doctor said was the cord, which might or might not be correct.

The babies are not a boy and a girl, as is claimed in the caption of the screenshot; they are two girls with separate placentas. In the case with two placentas the twins might be fraternal – stemming from two different eggs – or identical – stemming from the same egg that divided early on. We didn’t know they were two girls though until 20 weeks, at which age you should be able to see the dangling part of the genitals, if there is one.

If I upload an image to my blog, I do not mind it being used by other people. What irked me wasn’t somebody used my image, but that they implicitly claimed my experience was theirs.

In any case, I forgot all about this bizarre story until last week I got another note from a person I don’t know, alerting me that somebody else is going about pretending to carry my children. Excuse me if I might not have made too much effort in blurring out the picture of the supposedly pregnant woman

This case is even more bizarre as I’ve been told the woman apparently had her uterus removed and is claiming the embryos have attached to other organs. Now, it is indeed possible that a fertilized egg implants outside the uterus and the embryo continues to grow, sometimes for several months. The abdomen for example has a good blood circulation that can support a pregnancy for quite some while. Sooner or later though the supply of nutrients and oxygen will become insufficient, and the embryo dies, triggering a miscarriage. That’s a major problem because if the pregnancy isn’t in the uterus the embryo has no exit through which to leave. Such out-of-place pregnancies are medical emergencies and, if not discovered early on, normally end fatally for the mother: Even if the dead embryo can be surgically removed, the placenta has grown into the abdomen and cannot detach the way it can cleanly separate from the rather special lining of the uterus, resulting in heavy inner bleeding and, often, death.

Be that as it may, if you’ve had your uterus removed you can’t get pregnant because the semen has no way to fertilize an egg.

I do not have the faintest clue why somebody would want to fake a twin pregnancy. But then the internet seems to proliferate what I want to call, in absence of a better word, “experience theft”. Some people pretend to suffer from an illness they don’t have, travel to places they’ve never been, or having grown up as members of a minority when they didn’t. Maybe pretending to be pregnant with twins is just the newest trend.

Well, ladies, so let me tell you what to expect, so you will get it right. At 20 weeks you’ll start getting preterm contractions, several hours a day, repeating stoically every 10 minutes. They’ll turn out to be what is called “not labor active”, pushing inwards but not downwards, still damned painful. Doctors warn that you’ll have a preterm delivery and issue a red flag: No sex, no travel, no exercise for the rest of the pregnancy.

At 6 months your bump will have reached the size of a full-term single pregnancy, but you still have 3 months to go. People start making cheerful remarks that you must be almost due! Your cervix length has started to shorten and it is highly recommended you stay in bed with your hips elevated and so you’ll go on sick leave following the doctor’s advice. The allegedly so awesome Swedish health insurance will later refuse to cover for this and you’ll lose two months worth of salary.

By 7 month your cervix length has shortened to 1 cm and the doctors get increasingly nervous. By 8 months it’s dilated 1 cm. You’re now supposed to visit your doctor every day. Every day they record your contractions, which still come, “not labor active”, in 10 minute intervals. They still do when you’ve reached full term, at which point you’ll start developing a nasty kidney problem accompanied by substantial water retention. And so, after warning you of a preterm delivery for 4 months, the doctors now insist that you have labor induced.

Once in the hospital they put you on Cytotec, which after 36 hours hasn’t had any effect other than making you even more miserable. But since the doctors expect that you will need a Cesarean section eventually, they don’t want you to eat. After 48 hours mostly lying in bed, not being allowed to eat more than cookies – while being 9 month pregnant with twins! –  your blood pressure will give in and one of the babies’ heartbeats will drop from a steady 140 to 90. And then it’s entirely gone. An electronic device starts beeping widely, a nurse pushes a red button, and suddenly you will find yourself with an oxygen mask on your face and an Epinephrine shot in your vein. You use the situation to yell at a doctor to stop the Cytotec nonsense and put you on Pitocin, which they promise to do the next morning.

The next morning you finally get your PDA and the Pitocin does its work. Within an hour you’ll go from 1 cm to 8 cm dilation. Your waters will never break – a midwife will break them for you. Both. The doctor insists on shaving off your hair “down there”, because he still expects you’ll need a Cesarean. These days, you don’t deliver twins naturally any more, is the message you get. Eventually, after eternity has come and gone, somebody will ask you to push. And push you will, 5 times for two babies.

I have no scars and I have no stretch marks. The doctor never got to use his knife. I’m living proof you don’t need a Cesarean to give birth to twins. The children whose ultrasound image you’ve used are called Lara Lily and Gloria Sophie. At birth, they had a low weight, but full Apgar score. They are now 4 years old, beat me at memory, and their favorite food is meatballs.

The twins are now 4 years old.

If there are two cases that have been brought to my attention that involve my images, how many of these cases are there in total?

Update: Read comments for some more information about the first case.