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In a recent episode of the Healthful Woman podcast, “Julia’s Story: Making peace with difficult decisions,” podcast host Dr. Nathan Fox and Julia discuss her difficult pregnancy. At 37 years old, she had a history of c-sections and preeclampsia and wanted to have another child. She followed Dr. Fox’s advice before trying to have another child and unexpectedly became pregnant with twins.

Julia’s Story

Julia is a 37-year-old pharmacist from Brooklyn. She and her husband, who she met in pharmacy school, own Madison Apothecary on the Upper East Side and have three children. After three prior C-sections and a history of preeclampsia, Julia knew another pregnancy could carry risks. She found Dr. Nathan Fox, a maternal-fetal medicine specialist, and scheduled an appointment before trying to conceive again. With his support, she and her husband decided to move forward.

Julia’s Pregnancy

A few months later, Julia became pregnant. Early scans suggested a single pregnancy, but by week five, doctors noticed twins. Soon after, a complication was suspected, where one sac appeared to be implanted within her Cesarean scar. Julia shared, “I’ve had three prior C-sections. I wasn’t even aware that every single time you have a C-section, that when you get pregnant again, that there’s a risk for a Cesarean scar ectopic.” Cesarean scar pregnancies are rare and can be dangerous.

Further monitoring showed the pregnancy within the scar was not viable, meaning she was no longer carrying twins. Julia shared, “I was so grateful that I had an act of pregnancy because this was something that I was hoping for and dreaming about. And I just wanted the baby to be healthy and me to be able to sustain the pregnancy because I do have three other children that we take care of. And we live our life as a family.”

Julia shifted from the excitement of having twins to the reality of carrying one baby. Some doctors recommended termination due to potential risks, while Dr. Fox and a specialist in ectopic scar pregnancies, Dr. Timor, believed the nonviable sac would resolve on its own. Julia chose to continue under close supervision, with weekly visits and ultrasounds. By around 20 weeks, the second sac was no longer visible, and her pregnancy continued normally.

Julia’s Birth

Julia’s pregnancy was closely monitored throughout. She was admitted once for contractions and later required a blood transfusion due to low hemoglobin. At 34 weeks, she felt sick and was admitted again to Mount Sinai West. Though her C-section had been scheduled for 36 weeks, her condition led to an earlier delivery.

On September 30, Julia underwent a C-section, and her son, Liam, was born weighing 5 lbs 10 oz.

Liam’s NICU Experience

Liam required 16 days in the NICU to develop his sucking reflex before he could feed effectively. Julia and her family remained by his side throughout his stay. Julia shared, “I believe in the happily ever after fairytale in my mind, and this is how I choose to live. that there’s always a happy ending, that there should be goodness at the end of all of this.”

Julia’s Recovery

Recovery following her fourth C-section was slower than with her prior births. Her creatinine levels were elevated, raising concerns about kidney function. Doctors monitored her closely but determined her kidneys were stable and that hydration and rest would allow recovery. Julia was eventually discharged with follow-up care.

Learn More

If you are interested in learning more, listen to the full episode of the Healthful Woman podcast. To receive pregnancy care, contact Maternal Fetal Medicine Associates in New York through the online contact form.

Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!