My partner and I had been together for 13 years when we decided to try for a baby, and we were surprised with how, and how quickly, we succeeded. On August 29th, the test turned positive, and on September 4th I found out I was pregnant with twins. I had had some mild bleeding and so had a scan at the hospital, where the sonographer found two heartbeats and two healthy babies.

I was aware that there were additional health risks with twins, and the hospital laid out a care plan which should keep a good eye on us all, and I wasn’t too worried. The babies were DCDA – two placentas, two amniotic sacs – which is the most straightforward type of twin, and all seemed well. At my booking appointment with the midwife a few weeks later, I was told I should take aspirin as having twins meant I was at a high risk of preeclampsia, but she forgot to actually issue the prescription, and I didn’t bother reminding her, because I thought aspirin was for reducing blood pressure and mine was already low. I was given the prescription at 16 weeks and started taking it then.

The pregnancy was proceeding normally until the 20-week scan, when out of the blue, the sonographer identified problems. We were referred to the Fetal Medicine Unit and told that both babies were very small (in the first centile), and one was even smaller and appeared to have swallowed blood. The doctors were unsure why they were so small and did a large number of tests, and booked us in for another scan a fortnight later. One possibility was that there was an issue with one or either placenta, and this seemed particularly plausible as I remembered during the appointment that I had been born small and the midwife had told my mother that there was a problem with the placenta. Unfortunately, though, we weren’t tested for preeclampsia at this stage: I should have had an appointment with a midwife along with the 20-week scan but a mistake was made with our appointment booking and this was never arranged. I realised this and phoned the Twins Clinic to ask about the tests but the person I spoke to didn’t understand the question and just told me about my scheduled diabetes test, and I didn’t push it.

About ten days later, I woke in the night with what I thought was back pain, below my right shoulder. We had recently moved house, and although I hadn’t lifted any boxes, I had probably dragged some and could have pulled a muscle. I got up and the pain shifted to the front of my chest, in the centre beneath my ribs. I tried to eat some toast, which had normally solved my earlier pregnancy nausea, and immediately vomited. After a bit of anxious googling, I took my blood pressure and realised it was very high. I phoned the Maternity Assessment Unit who said I would be welcome to come in but given my gestation (at that stage I was 22 weeks) and where the pain was presenting (centrally), and as the blood pressure monitor was two years old and so might be unreliable, it was unlikely to be preeclampsia and was probably just acid reflux. Relieved, tired with the move and a bit fed up with repeated trips to the hospital, I didn’t go in. I had similar symptoms a few days later, but assumed it was acid reflux again.

About five days after this phone call, we had the next growth scan. Nothing had changed – the babies had grown but were still both in the first centile – and I requested a preeclampsia test. The healthcare worker took my blood pressure and assumed I must be nervous, because it was very high but I seemed fine in myself. She went into the next room to test my urine and came back and said it showed high levels of protein. She took my blood pressure again, and it was still high. I was sent to the Maternity Assessment Unit, where repeated blood pressure, urine and blood tests confirmed that I had preeclampsia. People kept asking if I have a history of blood pressure problems (I didn’t) or pre-eclampsia in the family (I don’t unless that my mother’s placental issue was undiagnosed preeclampsia). That evening, I was sent away with nifedipine and told to come back in two days. Early in the next morning, though, I was phoned and told they had found elevated levels of something in my blood (I didn’t understand what they said, but I now suspect it was liver enzymes), and told to come back in. After several hours waiting, I was admitted.

Over the next 24 hours, it became clear the situation was bad. I still felt fine – no headaches, visual disturbances, swollen wrists or ankles, or symptoms at all – but my blood pressure was consistently very high and could not be controlled by the medication. I was trying my best to stay as calm as I could so that my distress wouldn’t artificially raise it, but that was very difficult. My bloods also showed high and worsening liver enzymes and increasingly low levels of platelets – in other words, HELLP syndrome, although the doctors only used this word later. On my second day in hospital, the pain returned, and I vomited again. The doctor then said that my bloods were bad and they would almost certainly have to induce labour soon or my life would be at risk. I was 23 weeks and one day pregnant, and although babies sometimes survive at that gestation, mine would not as they were so small. A few hours later, a second doctor said that they needed to induce me then. I was put on magnesium to protect me from eclampsia, and the induction process started.

36 hours later, both babies were born sleeping. They were tiny and perfect baby boys, named Robert and Matthew. Robert was born first, even tinier than his brother, with a gorgeous but grumpy expression on his face. Matthew – bigger, more peaceful – was born second. They had only ever been happy, peaceful, and together. I stayed in hospital for two more nights for observation, and we were able to spend a lot of time with our babies. In the meantime, my bloods and blood pressure showed a consistent improvement, and over the next few weeks returned to normal.

We will have a meeting at the hospital in the next few weeks to discuss what happened and whether it has implications for a future pregnancy, but – as one of the doctors said – we know the answer already: a problem with at least one placenta meant that the boys weren’t growing enough, and also gave me preeclampsia. In any future pregnancies, I will be at a higher risk of preeclampsia, told to take aspirin and closely monitored. I will never know if taking the aspirin earlier would have made a difference in this pregnancy, or if it would have made a difference if I had been tested for preeclampsia between 16 and 23 weeks, when it perhaps could have been controlled. All I know is that while I am still here, we lost our tiny perfect babies.