2019 was a rough friendship year for me. I’ll sum it up by saying:

just because it’s an old friendship, doesn’t mean it’s a good friendship.

In all relationships, it takes two people to create the behavior pattern between you. So if someone’s hurt you, it’s easy to play the victim. It’s easy to go around talking about how betrayed you were. It’s a lot harder to take responsibility for the ways that the relationship failed. To forgive. To be humble. To start over.

With new friends, it’s easier to make boundaries because you can let people know what’s important to you from the very beginning of the friendship. You can let people know about your habits, behaviors, and needs, and they don’t have to take it personally.

For example, I’m really particular when I travel - I generally prioritize doing cultural things, I need a lot of alone time, and I don’t like really full itineraries for days on end. It’s a lot easier to explain this to new friends I’ve never traveled with, than to old friends in the middle of a trip where it’s like “uhh, actually, I’m exhausted from climbing that gajillion-step staircase…can I back out of that Michelin-star dinner reservation you made months ago?”

It’s can be super tricky to make boundaries in old friendships, which abound in the Middle East (I have friends I’ve known literally my entire life!), to say,

“Hey, you know how you brought uninvited guests to my party?….”I’d rather you ask me first.”

I’ve also had to take it upon myself this year to re-condition friends that take me for granted, by only being available when I’m truly available, instead of being overly accommodating. It can feel confrontational to make changes in relationships that already are so entrenched in their patterns. Sometimes, especially with old friendships, taking a break is key. If someone has hurt you, you can let them know you need a break before you can speak to them calmly. Other times, you’ve hurt someone and it’s up to you to respect their need for space. In either case, taking some time and space can really help you see the relationship from a bird’s eye view.

It can help to try and address issues before there’s a big breakdown or confrontation. Approach your friend, ask and make sure it’s a good, quiet time for you both, so she understands that it’s important and not just a passing comment.

If the idea of speaking to someone about your pain/discomfort makes you nervous, write a list of points you’d like to cover.

I know it sounds weird, but if the conversation gets intense you might forget what you have to say. Another trick I learned at a yoga training is taking the 3-2-1 approach when communication breaks down.

The 3 - 2 - 1 method of conflict mediation consists of two rounds of conversation:

• 3 minutes of Person 1 speaking from their perspective: i.e. “I am upset because I don’t feel my time is respected when you repeatedly show up late to our lunch dates…”

• 2 minutes of Person 2 repeating EXACTLY what they heard you say: i.e. “I am upset because I don’t feel my time is respected when you repeatedly show up late to our lunch dates…”

• 1 minute of Person 1 making any clarifications in case they feel they were misunderstood by Person 2.

And then you switch roles…and hopefully you can resolve stuff in under 15 minutes!

Overall, I think your friendships are a major reflection of you - your sense of self-worth, your values, your communication style…the list goes on.

I wish you lots of incredible platonic love going into 2020, full of understanding and laughter!

IN HONOR OF WORLD PREMATURITY DAY, I’VE INTERVIEWED ONE OF THE MOST INSPIRING MAMAS AROUND, NAUF AL MOAWAD. IN PART 1 WE LEARNED ABOUT HOW NAUF CONCEIVED TRIPLETS THROUGH IVF AND WAS PUT INTO HOSPITAL FOR THE FIRST TRIMESTER. IN PART 2, WE TALKED ABOUT HER TRAUMATIC NICU EXPERIENCE. And now, we see how the whole family is getting on!

Liane: It’s incredibly to see how your Instagram account, Triplets of Kuwait, has blown up in mere months. How does your online community support you in this multiply wild adventure?

Nauf: I was desperate to connect with other NICU parents at the time. I needed a safe place and people who could relate. It was non-existent. People here are very hush-hush about their NICU experiences, even though 1 in 10 babies are born prematurely!

I started my Instagram account to raise awareness and share our story in the hopes of helping other going through the same thing. And the response was incredible. It was so needed. Through Instagram, I got to know people who I now consider family. I’ve learned so much from their past experiences. I’ve been giving and receiving support, strength, hope, courage. Truly amazing.

 Liane: Can you tell us about the work you’re doing about postpartum depression and for premie awareness month? What are resources that people in similar positions can turn to?

Nauf: I contacted my amazing psychiatrist and talked to her about starting a campaign to raise awareness about postpartum depression. It’s very real and so overlooked. We came up with the hashtag #speak_up / #لا_نسكت

Encouraging people to tell their stories. Share their experiences. Shed light on how common PPD is and that’s it’s ok to ask for help.

I was shocked at how many people reached out privately and told me their friend/sister/cousin actually ended up committing suicide because they didn’t get the help they needed. Because it’s so taboo.

With regards to depression, people can turn to their healthcare providers in their regular government clinics. They can help. They can treat mild cases and give referrals to more severe cases. So many people didn’t know that. It’s an amazing resource. It’s free. It’s confidential.

October is preemie awareness month - and World Prematurity Day is November 17! KOC hospital, Farwaniya Hospital, and so many others organise events.

The biggest misconception people have about preemies is that it’s just a size issue. That they need time to grow. It’s not just growth. It’s development. They missed out on so much development in the womb. Our role is to nurture that and take advantage of their incredible neuroplasticity. These babies are SO resilient.

I also want people to know that I’m here. They are welcome to contact me. I am here to support NICU mamas.

I’m working on starting a NICU support group in Kuwait, but for now, I’m here. I’ve already started a group for two new NICU mamas and they’ve been so supportive of each other. Let’s all help each other out.

Liane: That's so kind! Does postpartum depression lift? Do most mothers get off the medication?

Nauf: Most of the time, medication isn’t needed. Therapy is enough. Sometimes though, when its severe, medication changes lives. Postpartum depression usually peaks at 3 months postpartum and lifts at around the one year mark. Almost all mothers get taken off the meds (some are safe for breastfeeding mamas too - just ask). From my understanding, if there are no other mental health issues/history of depression, most people are weaned off after 6-9 months. That’s how long it takes to regulate serotonin levels in the brain. And antidepressants are not like tranquillisers - they don’t cause a dependency.

Liane: Wow, cool. I didn't know this, thank you! Finally, can you tell us the most rewarding part of motherhood so far?

Nauf: Those first smiles. Watching Dina apply all the things I’ve taught her. Her manners. Her wit and sass. Her willingness to share.

The amazing feeling of seeing those babies kick those milestones then said they’d never achieve in the butt! They rolled - YES! They’re giggling. Woohoo! They’re breathing on their own - they’re eating - they’re cooing! It’s so incredible!

IN HONOR OF WORLD PREMATURITY DAY, I’VE INTERVIEWED ONE OF THE MOST INSPIRING MAMAS AROUND, NAUF AL MOAWAD. In PART 1 We learned about how nauf conceived triplets through ivF and was put into hospital for the first trimester.

Liane: You’re so brave to keep moving forward! How did the pregnancy and delivery go?

Nauf: After I recovered from the OHSS and first trimester disaster, it was relatively smooth. I was told to take it easy and was already full-term size at 20 weeks! Nothing major though, until I suddenly woke up on the 26th of February (at exactly 26 weeks pregnant) in full blown labour. On our way to the hospital I went into full-blown hysteria. I could feel Omar’s head between my legs. I was holding back and going against every natural instinct telling me to push. 26 weeks only!!!! …it was straight into the operating room. It was an emergency c-section and I was awake for it all. They cut into me. I had a wonderful doctor by my side just holding my hand and calming me down. Baby A was too far down, so Baby B came first. Abdulwahab.

The silence was deafening. With Dina, I remember the deafening cries. This time, not a sound. Doctors working furiously. I remember asking if he was alive and the neonatologist said, “We’re doing our best I promise” as he ran out with Wahab in his incubator, racing to the newborn intensive care unit (NICU). I didn’t even get to see him.

Baby A came next. Omar.

I saw the looks the doctors gave each other. They were “uh-oh” looks. They were whispering. He was barely alive. No one commented, they just ran out with him too.

Baby C next. Feisty Faye. They told me to look to my left and I saw her neonatologist working on her. I saw them intubate her. Deafening silence. They wrapped her in plastic and foil to keep her warm. All I saw is my baby girl’s scarily tiny leg. And off she went.

Liane: :((((((( that leg…How was the time at NICU? How long did it last and what happened to the babies?

Nauf: I went into shutdown mode. I pushed everyone away. I couldn’t deal with normal life. Life stopped for me and people were complaining about things like colds, sore throats and missed flights. It enraged me! My coping mechanism was to retreat completely. I clung onto my husband for dear life. I even followed him into the bathroom. I couldn’t bear to be left alone for a second. I cried uncontrollably. Non stop. My babies. Seeing them for the first time in the NICU paralysed me. 850, 860 and 980 grams in weight. That’s a tin and a half in baked beans. Both boys had Grade IV Intraventricular Haemorrhages (Grade 4 brain bleeds). That’s the most severe kind. I was told that IF they survive, they will be vegetables. That anywhere else in the world, I’d be advised to withdraw care. There was so much blood in their brains, you couldn’t see any brain matter.

Omar got sepsis. Faye got sepsis. Wahab got MRSA (a horrible, stubborn hospital bacteria). They all had Retinopathy of Prematurity (their eyes). They all have Chronic Lung Disease diagnoses. It was a living, breathing nightmare.

 Nauf: Faye was in for 61 days, Wahab for 72 and Omar for 84

 Liane: Ouf, that's long! What was it like when they got home?

 Nauf: If I’m honest, it got worse for me when they came home. I didn’t feel like their mother. I felt like their doctor, their nurse, their pharmacy, their lawyer, their secretary, their caretaker. I was too scared to pick them up and cover them in kisses because I didn’t want to get them sick. I was scared they would break. The hospital flashbacks started when everyone came home. The machines beeping, making my heart race in the middle of the night. The sound of running - shoes hitting the floor. Following me in my dreams. I could feel them cut into my stomach again, and again, and again.

I was too scared to sleep. What if they stopped breathing?!

Liane: How did you deal with the PTSD, and were you able to get into a "normal" state with your family? And how was Dina throughout!

Nauf: I had to get help. I went to see a psychiatrist and she immediately diagnosed me with PTSD. She put me on antidepressants and recommended therapy.

Dina was really struggling at the time. She went from being a  fully potty-trained, fiercely independent, sassy, confident little girl to a quiet, clingy, terrified child who was having accidents everywhere. It was heart-wrenching.

When the meds kicked in and I started opening up and talking, my life changed. Completely. I fell in love with those babies - as their mother. I left the medical stuff to the professionals and finally became their mother. I made time for Dina and I. I got all my children back. It wasn’t magic, it didn’t happen overnight. But it happened for us.

After our NICU experience, I don’t think I’ll ever go back to our old “normal”. We have a new normal now. And it works. I will go to bed and wake up every single day with worries. But that’s what a mother doesn’t, right? Developmentally, amazingly, the boys seem to be unaffected by the bleeds and are on track with their milestones. Wahab has some weakness in his legs, but nothing physio can’t fix hopefully. And I accept them fully. They’re perfect in my eyes.

Liane: Yay! I’m so happy. How does it measure up to the childhood fantasy you had growing up about Prince Charming and your son and daughter?

Nauf: It’s actually a million times better. My husband is so much more than a Prince Charming. He’s my rock, and he showed me strength and resilience I never even knew existed. I couldn’t dream of a better father for my children and a more perfect life partner. It’s not all roses and butterflies and you know what? That’s so boring anyway!

I now have two sons and two daughters instead - how amazing is that?!

NAUF STARTED THE ACCOUNT TRIPLETS OF KUWAIT TO DOCUMENT HER UNIQUE JOURNEY.

In honor of World Prematurity Day, I’ve interviewed one of the most inspiring mamas around, Nauf Al Moawad. Nauf is mama to an incredibly smart four-year-old, and not one but THREE premature babies. Since the news that her IVF treatment was not only successful but triply fruitful, Nauf started the account Triplets of Kuwait to document her unique journey. Here are some questions I was dying to ask, and the answers that Nauf generously shared:

Liane: What was your childhood like?

Nauf: Despite my parents getting divorced when I was five, it was filled with love. I was raised by my mother and maternal grandfather, who was my biggest hero. He was the most interesting, most intellectual, most loving person I’ve ever known. My childhood consisted of Liane and I spending endless weekends in The Kuwait Bookshop - my grandfather’s bookshop - devouring shelf after shelf, drowning in books, in knowledge... there are no words to describe the feel of the place, and the smell of fresh magazines being stacked!

 Liane: Mmm, divine! Did you want to be a mother when you were a little girl?

Nauf : Always. I always wanted the fairytale ending. The Prince Charming on a white horse. Two children: a boy and a girl. I always knew I wanted a family.

Liane: How did you decide to have your first child?

Nauf: We felt we were in a solid place in our marriage. We spent the first year travelling, ticking things off our bucket list... until we realised there was nothing more we wanted than to be parents. When nothing was happening, we had to see an RE. I was told I had PCOS, which meant my cycles were inovulatory. I was absolutely devastated and felt like I had let us both down. Thankfully, we were able to conceive Dina with the help of Clomid (to help me ovulate).

Liane: What do you think she came here to teach you?

Nauf: Patience. Unconditional love. Selflessness. I will openly and honestly admit that before becoming a mother, I was a selfish person. I put myself, my wants and needs and my own happiness above everyone else’s. I came first.

Then, I peed on that stick and my world changed.

I was suddenly responsible for another life. Another person’s needs and wants - and guess what?! They actually become more important than my own! She showed me a love I didn’t believe existed. It wasn’t all rainbows and butterflies though. It didn’t happen immediately. I cried when she was born and felt like I wanted to protect her from everything and everyone - myself included. But that bond? That selfless, indescribable love? That took time and work.

 Liane: What were the most valuable resources to you as a first-time mother?

Nauf: Mother and baby classes. YouTube videos on how to relieve colic. My baby carrier. No, I didn’t spoil my baby by wearing her round the clock - I gave her love, confidence and security (and gave us both sleep!!!!!). I guess I just picked up on her cues and we both learned as we went along.

 Liane: How did you decide to become a mother for the second time?

Nauf: Again, Dina. She had so much love to give. The way she’d “mother” her dolls. I was never into dolls as a child, so this was new territory for me. But she had SO much love to share. I reflected on my own relationship with my brother and how integral he was/is to my childhood and my life. I wanted to give her that.

Liane: Aw! Tell us about the IVF experience.

Nauf: I’m a very impatient person (I know, I know. I’m working on it!) I got told by a new fertility specialist that time was ticking (gasp the big 30!) He didn’t recommend I wait/try with Clomid again and that I should just go straight into IVF. I agreed, because he’s the professional right?! He then said we “might as well” transfer 3 embryos since we’re doing it anyway. He said hopefully one will take.

Nauf and Dina during Nauf’s first trimester. Images generously shared by Nauf.

Everything was relatively smooth until a week post embryo transfer. I suddenly started blowing up - literally. I gained 22 kilos in fluid over 72 hours. I couldn’t breathe. I was in so much pain I was actually begging to be sedated. At first, I was told it was “normal”. That it was just my ovaries overreacting to the IVF drugs. Just regular Ovarian Hyperstimulation Syndrome (OHSS). Then my kidneys started shutting down and my left lung collapsed due to the fluid. I got transferred to Sabah Maternity Hospital. They were absolutely AMAZING and saved my life. I was in the ICU for about a week. I had pigtail catheters surgically put into my abdomen to drain all that fluid and spent the entire first trimester of my pregnancy in hospital.

Liane: How did you feel when you learned that you were pregnant with triplets?

Nauf: I was absolutely gobsmacked! I was worried my husband would faint! 3 babies? How? What are we going to do? What about my job? Will we manage? How am I going to do this?! We were then told that if we choose to have a reduction, the doctor would be completely supportive of that decision. (However, reductions i.e. partial abortions are not legal in Kuwait). He explained all the risks associated with a triplet pregnancy: gestational diabetes, preeclampsia, preterm labour, etc etc.

Three heartbeats! Images generously shared by Nauf.

Once I actually saw and heard all 3 heartbeats and was told they’re all equally healthy and equal in size, it was a no-brainer. As their mother, how could I ever consider losing one of them willingly? Which one? I was SO scared. My husband was too.