On Wednesday October 17th2012, at 10:14am, a tiny baby boy weighing just 1.05Kg was lifted from my wife’s womb through an emergency Caesarian section. One minute later, following a slight widening of the incision, he was joined by his 915g twin sister.
As I sat, head-end of the partition, comforting my awake yet spinally anaesthetized spouse, I caught glimpses of red and pink flesh being whisked away into the corner of the room, where a half-dozen doctors and nurses immediately busied themselves with swift, practised efficiency. For the next minute or so, the operating theatre seemed eerily quiet, then a brief, soft, plaintive cry broke the silence. This was followed almost immediately by a repetitive, almost musical set of tones reminiscent of an arcade game, but which, under the circumstances seemed more likely to be an alarm of some kind. Here I must admit, I lost track of time. For what seemed like a further 30 minutes, but which in hindsight was probably only 5 or 10, we waited, trying to take comfort in each other’s presence, desperately hoping to hear that our babies were safe and well.
To say we were completely unprepared for the events of that morning would not be entirely accurate, since the previous 28 weeks of pregnancy had not been without complication, and by that morning my wife had already been in hospital for 4 days, following the premature rupture of one of the amniotic membranes – that of the girl. As a result, we were already well-informed of the potential risks associated with extreme pre-term delivery, and while neither of us dared voice such thoughts, both our minds were silently entertaining the various negative outcomes from disability to death. During this time, my wife was somewhat distracted by the strange sensations, despite the spinal block, created as the surgeon rooted around inside her womb, retrieving what was left of the placenta and then sewing up the gaping wound from which our twins had been so untimely ripped.
While this was going on, I was surreptitiously scanning the faces of the doctors and nurses as they hurried about, looking for signs that would either confirm or allay our fears, but alas, either they were all members of the Birmingham Women’s Hospital Poker team, or else expertly trained to give neither false hope nor unwarranted fear to their anxious patients. I rather suspect the latter.
Eventually, one of the doctors from the corner of the room where all the baby-centred activity had been taking place, came over and with a tentative smile, offered, “Congratulations!” The initial relief evoked by this word, while considerable, was soon tempered by subsequent explanations of how neither twin was able to breathe without the assistance of a ventilator, and how various lines had had to be attached to their tiny bodies to sustain and monitor the fragile lives that beat within. Of course, what we both yearned to hear – that our babies would be okay – was the one thing we both knew they wouldn’t be able tell us for many weeks to come.
And so began our twins’ slow and arduous climb to normal, healthy babyhood – a climb with many precarious ledges, ridges and ascents, all riven with loose shale. We are now on day 4 of that climb and already the ventilators and antibiotics have been left behind on the lower contours of the slope, hopefully never to be seen again. Sealed in perspex under the watchful, expert eyes of the staff at the BWH neonatal intensive care unit, our two little babies lie naked but for their cotton nightcaps and slightly oversized nappies amid a tangle of tubes, wires and monitors. Their skin is a ruddy pink and barely conceals the muscles and bones beneath, and yet, as they stretch, twitch, yawn and kick, all the while their little chests rising and falling with each rapid breath, we are struck by their vitality. Although, all things being equal, they should have been completing the remaining three months of their gestation in the warm, watery safety of their mother’s womb, they are, thanks to modern medical science, surviving in a wholly alien and artificial environment. Through a combination of steroids, surfactants, vitamins and other drugs, their lungs, which should not have had to start working for at least another 8 or 9 weeks, have been jump-started into early action. Likewise a small shot of caffeine administered each morning provides a welcome boost to their nervous systems (as indeed it does for their dad), and instead of receiving all nutrients through the umbilical cords, they are already feasting on their mother’s milk, albeit through tubes passing through the mouth and directly into their stomachs.
For most of human history, such babies would never have survived and even their mother’s life would surely have been held in the balance also. Prayers would have been said, animals might have been sacrificed, and the outcome would have been deemed to be in the hands of the gods. Yet we now live in an age where our understanding of biology is sufficient to diagnose, intervene and even cheat death in all but the most pernicious of circumstances. We can even simulate a mother’s womb with sufficient accuracy for the majority of pre-term babies to successfully complete up to 20% of their gestation outside the mother’s body.
For the parents it is a heady mix of elation, pride and anxiety. For my wife, as her body releases a cocktail of hormones and brain chemicals to aid bonding, and yet is denied the close contact she craves as a result, there is an added sense of confusion and loss. For me, I am reminded of the profound love and attachment I felt twice before in my life as each of my somewhat larger daughters, now 19 and 21, lay in my arms for the very first time. As I look down at these tiny, vulnerable little people, reach into the incubator and touch their surprisingly large feet and hands (at least in comparison to the rest of their bodies), it is hard to imagine that in 21 years time these feet could be on a 3-month trek through India and Nepal as their elder sister’s have just been, or, appending a second year medical student, these hands could be administering their first injection into another human being. Sometimes, their eyelids reveal the rapid eye movements we would usually associate with dreaming, although what kind of dreams such nascent, inexperienced brains could be creating is beyond my imagination.
Although we are still far from reaching it, the summit of our climb is now just visible through occasional gaps in the cloud above, and the prospect of admiring the view together as a united family in our own home this Xmas seems just a little bit closer.