KMC Stories - Case 2

Our story is far from the typical. It all started with infertility. I was told I wouldn't be able to conceive naturally. How ironic..... Myself being a doctor assisting in deliveries day in and day out, not being able to get pregnant. So we had to resort to IVF. And after just 1 try, I got pregnant, with multiples. We started out with 4, but the 4th one lost its heartbeat at 12 weeks. We were ecstatic that I got pregnant, but at the same time feared all the possible complications of a multiple gestation. I had gestational diabetes (requiring glucose monitoring 4x a day & insulin shots 4x/day). I also had immunologic problems requiring IVIG infusions, and APAS, requiring heparin shots 2x a day. I got 10 needles a day... Everyday of my pregnancy. I also had to be on bed rest throughout my pregnancy. But little did we know that preterm labor wasn't going to be our biggest problem. At 23 weeks, my OB noticed that triplet C, wasn't gaining as much weight as the other 2. I was sent for Doppler studies, and found out that triplet C had absent end-diastolic flow through her umbilical cord. The prognosis was grim. If left to progress, Julianna would be stillborn. My OB tried very hard to prolong my pregnancy. But at 29 weeks, there was already reversal of blood flow in triplet C’s cord. Any moment, she would die. We were asked to make a difficult decision. Whether to let her die and let the 2 others reach term, or try to save her by delivering them all at 29 weeks. We decided to deliver.

I shed some tears when I heard their small cries as they were delivered out of my womb. But they were tears of happiness, that finally I was now a mother, and with hope that their cries signaled that their lungs are ok, and they could survive. Being a doctor, I prepared my husband before we visited our premature daughters in the NICU. I told him to expect numerous gadgets and tubes attached to their little bodies, various monitors beeping and checking their stats. But all my years in medical education and training couldn't have prepared me for one of the most difficult times in my life, if not the most, seeing them for the first time in their incubators. Oh how my heart broke when I saw their frail, tiny, wrinkled little bodies and limbs with tubes and needles all over. It was different this time. I wasn't a doctor anymore. I was a mother. I almost broke down, but held back all the tears because I knew I had to be strong for my little ones. They were helpless and they needed their mother to be strong. Because now started the daunting task of taking care of them. But how? I couldn't rock them to sleep. I couldn't even bring them home with me like the other mothers in the hospital who were discharged riding their wheelchairs holding their newborn in their arms. Mine was empty. Triplet A weighed 1.2kg, B weighed 1.3 kg and C weighed only 700gms. I couldn't even directly breastfeed them because they weren't strong enough. But I knew I had to breastfeed, even indirectly. Breast milk was the most precious thing I could give them to help them survive. The first few days were really difficult. Triplet A & B had to be intubated and hooked to a ventilator. I had no breastmilk for the 1st 4 days, maybe because of the stressful situation. I did everything, drank all the soups I could, to the point of nausea. Supplements, warm compresses, massages to the point of soreness. And then my milk came. I bought a hospital grade pump which I used every 2 hours, without fail, even at night. My milk supply exponentially rose to as much as 2 liters a day. Our freezer couldn't even hold all my milk stores anymore, that my mother in law had to store some in her house. Yes, that much. Because I pumped religiously, constantly fearing that my supply wouldn't be enough for my babies. I had to feed 3 after all, not just 1.

Aside from breast feeding, another vital part of caring for them was kangaroo care. I visited them everyday at the NICU. It was especially difficult because I had to divide my time among my 3 babies, and still keep my pumping schedule. But those times were precious, being able to feel them on my skin, close to my heart, giving them the comfort of the sound of my heartbeat, not just the beeps and clicks of all the machines surrounding them. We were able to bring them home just 5 weeks after birth. And we continued to do kangaroo care at home. It was hard. My husband, my mother-in-law, the nannies all took turns in holding them and maintaining skin-to-skin contact. I needed all the help I can get because I couldn't do it all for 3 of them. While I still had to pump every 2 hours. In a tropical country like the Philippines, we were all sweating profusely. We couldn't move while we were sleeping since there were tiny babies sleeping on our chests. We were constantly checking if the babies' bodies weren't too squished in their slings. It was an arduous time, to say the least. Oh but it all paid back. They survived. They grew to be the darling little girls they are today, no oxygen, no cerebral palsy, no bronchopulmonary dysplasia, no cerebral hemorrhage, no retinopathy of prematurity, no eyeglasses , no speech delays, no developmental problems. Just three little girls who argue over their toys. Three precious miracles from God.