“That’s it. We have to get her out!”
I was pregnant with triplets, it was the afternoon of January 25th, 2012, and at 28 weeks and five days into the pregnancy, a routine solo pregnancy checkup had turned into an emergency.
But let’s back up a bit. Earlier that day I had come in for a normal (normal, at least, for a high-risk triplet pregnancy) maternity appointment at the office of our MFM (maternal-fetal medicine specialist), Dr. Michael Draper. His office was at University Hospital on the east side of the Salt Lake Valley, sandwiched between the Huntsman Cancer Center, up against the Wasatch foothills, and Primary Children’s Hospital just above the University of Utah in Salt Lake City.
Each of my check-ups started with an ultrasound exam. The ultrasound tech had put jelly on my tummy, scooted the transducer around a bit to get things going, and had just barely started taking a look at Ryan’s and my unborn babies when she quickly stood up, wiped off the transducer, excused herself, and went out to get an MD.
She returned with one of the doctors in the practice who took her own look. I don’t recall her name. After just a couple of seconds of looking, she told me that our Baby A—the tiniest and most vulnerable of our unborn triplets—was in trouble. Her amniotic fluid was all gone, and she was getting smashed by babies B and C who sat above her in my uterus. She was having heart decelerations (her heart was threatening to stop beating).
Dr. Draper
That doctor left, and just a few minutes later our own MFM, Dr. Michael Draper, came into the examination room. He said to me,
“We have a name for people like you.”
“What’s that?,” I asked.
“In-patient,” Dr. Draper said and smiled at me.
Then he asked me where Ryan was. At work downtown, I told him.
“You should get him up here,” he said. “You might be delivering these babies this afternoon.”
Yikes!
I sent Ryan a quick text message, and he left his office and hopped onto a bus to head up to the hospital.
By not long after that, after I had been moved across the hall to a room in the labor and delivery department, I was checked into the hospital (mobile check-in…modern technology, right?), had changed into standard hospital attire (big gown, opens in the back, you know the drill), and was lying on a big hospital bed (“on” because I was definitely not IN the bed) with a bunch of wires and monitors attached all over me, some for me and some for the babies.
Ryan arrived and found the labor room where I was. There was some hurried paperwork and we took care of some signatures, but things still seemed fairly calm. Ryan and I had taken a childbirth prep class and had previously toured the labor and delivery department, as well as the neonatal intensive care unit (NICU), so we had at least some idea of what was going on.
While Ryan and I were talking with the nurse, and as other people came and went from the room, Dr. Draper had been monitoring Baby A. He had been listening to her heartbeat with a Doppler monitor and watching her heart on ultrasound at the same time. The head of my bed was somewhat elevated. Dr. Draper had told me that he wasn’t sure whether what looked like Baby A’s decelerations were actually THAT, or whether it might be that the monitor was picking up my own, slower heartbeat.
Someone explained the process Ryan would have to go through to get gowned up so that he could be in the delivery/operating room, should monitoring turn into a C-section. We were chatting in a completely relaxed way with one of the nurses, discussing whether or not I should have my tubes tied as long as I was already opened up, should a C-section end up happening that day.
Everything Changes
But then suddenly everything changed from calm to terrifying.
“That’s it. We have to get her out!”
Dr. Draper quickly reached behind my head, hit the red alarm button on the wall behind me, and slammed the head of the bed down flat (seriously, SLAMMED). He instantly ripped off all of the wires that had been attached to me, shoved away the wheeled monitoring and ultrasound equipment, sending the machines sailing out of the way across the room, and released the brakes on the bed. Then he RACED the bed out of the room and down the hallway into the next-door operating room, the medical people running behind, leaving Ryan standing alone in the labor room.
My heart was pounding and everything was getting fuzzy.
A flurry of activity was already going on in the OR. There were beeps and people attaching things to me and oxygen and people moving around the bed. Almost the instant the bed came to a stop, an anesthesiologist asked me to sit up. I did, and found myself looking straight through a big glass window into the NICU where a sea of masked and gowned people were all looking back at me, three teams of seven people each, each team waiting to receive one of our babies through the window.
I found out later that as soon as Baby A’s scary situation had been found, the NICU had been notified and they had frantically called staffers all over the Salt Lake Valley in order to get enough of them, in all of the right specialties, up to the hospital in time for our triplets’ delivery. Twenty one sets of eyes were looking at me from the spaces between surgical hats and masks. Even today, almost seven years later, I get choked up when I think about that moment. All of those people, waiting to save our tiny babies’ lives. It’s hard to talk about it without crying. Such an overwhelming feeling.
The anesthesiologist put a needle into my spine, injected the anesthetic, and then had me lie back down. The surgical team quickly put up a curtain across me so I couldn’t see my lower body. I also couldn’t see or hear Ryan.
“Where’s Ryan??!” I yelled. Nobody answered. “WHERE’S RYAN???” No response. Everything was happening really fast. There hadn’t been anyone available or enough time to help him gown up.
Dr. Draper ran something across my lower tummy. Three times, in quick succession as the anesthetic took hold, he asked, “Can you feel that?” “Yes.” “Can you feel that?!” “Yes.” “Can you feel that?!” “No,” and instantly Dr. Draper cut me wide open with a big scalpel swipe across my lower abdomen.
Babies Out
In seconds, Baby A was out and had been passed through the window into the NICU. No crying. Then Baby B was pulled out, and I could hear a weak cry as he too was passed through the window into the hands of the team that was waiting for him. Then there was some HARD tugging, and Baby C was out and into the NICU as well, one more tiny cry as he went.
All three babies were delivered within two minutes. It had been less than seven minutes from when Dr. Draper hit the alarm button until all three babies were in the NICU. It had all happened so fast, Ryan hadn’t been able to get gowned up fast enough to get into the operating room before all of the babies were gone.
Ryan did get into the OR in time to see my uterus being sewed up and put back into me. Dr. Draper stitched up the layers of my body where the babies had been pulled out, and then I was wheeled back into the labor room where we had started.
Apgar = 0
A bit later, as I was being monitored to make sure I was doing okay, one of the nurses told us that when Baby A was pulled out her head was smashed flat, she had no heartbeat, she wasn’t breathing, and she was completely blue. Her first Apgar score—a way of describing a newborn’s overall health on a scale from zero to ten—was zero. The NICU team had had to resuscitate her, but thankfully her heart had started beating again and she had started breathing. Her head popped out into a more normal shape (babies’ heads are amazing things), and she pinked up. The nurse told us that Baby A wouldn’t have made it to the next day if we hadn’t found out how bad off she was and delivered her that afternoon.
I later learned that Baby A had suffered from what’s called “intrauterine growth restriction,” or IUGR. Ryan noticed that Baby A’s umbilical cord looked like a thin, curly old-fashioned telephone cord. The boys’ umbilical cords, in contrast, were as thick as Ryan’s thumb. At some point in gestation, babies begin to produce their own amniotic fluid. A’s body apparently hadn’t been getting everything it needed through the defective life support system she was attached to inside of my uterus. She had stopped growing and had stopped producing amniotic fluid. Without enough of fluid to adequately cushion her, she was smashed between her twin brothers and my pelvic bones, putting her into fetal distress.
After they had been stabilized and placed on ventilators, all three babies were moved into the highest-care room in the NICU. I was transferred into the regular maternity ward. The triplets had been born just before staff change, a period of time during which parents are not allowed in the NICU. After staff change, someone came to my room and asked whether I wanted to see my babies. Of course, I wanted to see them! But I couldn’t get out of bed; I couldn’t move my legs right yet, and I was still in a post-surgery haze. So they took the whole bed with me.
NICU Babies
They wheeled my bed out of my room, down the hall, past the labor and delivery ward, and into the NICU. They threaded the bed through a narrow hallway and into the small, dark rooms where the triplets were. Tiny, tiny babies, with tubes and wires all over them, lying in gently-lighted plastic incubators. At birth, Baby C was 3 lbs. 4 oz.; Baby B was 3 lbs. 1 oz.; and tiny Baby A was 1 lb. 5 oz. So small!
I didn’t think about it at the time, but after our babies had been in the NICU for a while I realized that rolling an entire bed into there was not typical. I suspect that they had done that for me so that if one or more of the babies didn’t survive, I would have at least had a chance to see them when they were alive. As it turned out, I was able to see them, hold them, and—eventually—take each of them home from the hospital with me. Not all NICU or preemie parents have that happy outcome, and my heart goes out to them. I can’t imagine anything more heartbreaking. We were very fortunate to have all three make it.
The morning after the triplets were born, Dr. Draper came by my room in the maternity ward to visit for a few minutes with Ryan and me. As we talked, he told us that the nurse in the labor room had been wrong about Baby A. He said he wanted us to know that her survival had been a true miracle. If we hadn’t found out that she was in distress right when we did, and if she hadn’t been delivered right when she was, she would have died.
He said, “She wouldn’t have made it for five more minutes.”
And that’s how our triplets’ lives began.