Maternal health has been a trending topic in the news due to increased maternal mortality rates due to challenges in accessing care during the COVID-19 pandemic. The Supreme Court’s Dobbs v. Jackson ruling overturning Roe v. Wade is deepening concerns surrounding this issue. The U.S. has the highest maternal mortality rate of undeveloped countries, with an alarming 23.8 deaths per 100,000 live births. My wife, Parissa, could have been part of those statistics, but because of our obstetric team’s cohesive care plan, we were able to mitigate the complications of her pregnancy.
Having spent most of my career as a nurse, I’ve been prepared for many distressing situations. But there is no medical training that would have helped Parissa and me navigate the intensely turbulent experience of the birth of our sons.
In the summer of 2021, we received the wonderful news of Parissa’s pregnancy. During a routine visit to the OB/GYN, we asked the ultrasound technician to conceal the sex of the baby. However, the technician revealed something else, “You’re having twins.” To our surprise, our family would be bigger than expected. We were later told we would have two boys, and we were ecstatic to start our family.
Parissa was doing well until she experienced vaginal bleeding. We learned through testing that she had experienced a subchorionic hematoma. Our doctors told us this was not unusual during the first two trimesters, lessening our fears.
Only a week later, Parissa believed her water broke, but no other symptoms were present. Since our next appointment with our OB/GYN was approaching in a few days, we decided not to contact our doctors and attempted to maintain our optimism.
Our OB/GYN did another ultrasound at the next visit, which affirmed our worries. Her water broke at just 14 weeks — we were shattered. We were then referred to a perinatologist, a specialist for high-risk pregnancies. Parissa was diagnosed with previable premature rupture of membranes (PROM), a rare rupture of amniotic sac membranes. We were forced to face the fact that the pregnancy may not be viable, and there was a possibility one of our sons may not survive.
We had two options: terminate the whole pregnancy or undergo a procedure called selective reduction. This surgical procedure involves the removal of the baby whose water broke, and the mother would continue the pregnancy with the other child. This was an unfathomable decision.
After careful consideration, we opted to proceed with selective reduction. After a visit to the OB/GYN, they informed us this option was not recommended. The specialist tracked their development while Parissa was on bed rest. Despite our family’s future uncertainty, we caught a glimmer of hope.
Parissa maintained bedrest for the next five months, but the PROM triggered the constant production of amniotic fluid, causing her water to break on a daily basis. Any movements caused the fluid to rush out. We were perpetually anxious that our son, affected by PROM, would not have enough amniotic fluid to facilitate his lung development.
Our doctors said there was a 10 percent to 15 percent chance our son impacted by PROM might not survive, which would be unconfirmed until 10 minutes after delivery. He would likely have other health issues even if the baby made it. We were unable to control anything. All we wanted to do was save our children.
Parissa continued her bedrest until she was 22 weeks along when she was admitted to Sharp Mary Birch Hospital for Women & Newborns. We were highly grateful for the emotional support from our friends. Nonetheless, our inspiring medical team made this unthinkable experience easier through their pragmatic optimism.
We documented the length of the pregnancy, commemorating every single day. Our nurses celebrated with us by producing weekly graduation certificates with encouraging notes. Their impressive level of knowledge, meticulousness, and professionalism made a profound impact on our experience. They were always reassuring and helping our confidence grow, and when we passed the 30-week milestone, we finally felt a sense of relief.
A month later, Parissa had a cesarean delivery at 34 weeks. With a multiple Cesarean birth, the delivery team names each baby based on their position in the womb, so the twin who ruptured was Twin A, and the other was Twin B. Twin A came out first with a loud cry, an indication of strong lungs, then Twin B followed suit. Eventually, I asked the nurses, “Is he going to make it?” With smiles on their faces, they said, “He’s going to be great.”
We named our sons Leo and Rocky. Leo was Twin B, a gorgeous, healthy boy, and Rocky was Twin A, our fighter. We chose Rocky’s name because of his unyielding grit. After delivery, Rocky only needed one day with a nasal cannula and a continuous positive airway pressure (CPAP) machine, a commonly used treatment for sleep apnea. The next day, Rocky was breathing by himself — the story was over, and at long last, we were able to celebrate our beautiful new family.
My expertise as a nurse supplied me with clinical knowledge, primarily in the hospital, which meant I was not as apprehensive and understood what to ask for. This awareness helped prevent us from panicking. But many patients do not have prior knowledge of health care to offer such a level of comfort. These families rely on their care teams to educate patients, manage expectations, and offer stability.
Hospitals and health systems should bolster the skills of care teams through education to improve patient outcomes by minimizing variations in obstetric care and being equipped to prevent, identify, and address any possible maternal emergency. Our obstetrics team provided invaluable care through communication, physical and emotional assistance, and reliable services. My family would look vastly different today if we had not received such excellent care.
Vince Baiera is a nurse and health care executive.
Image credit: Shutterstock.com