Twin girls: 1pound 13 ounces, 1pound 14 ounces

A close friend of mine recently gave birth to very premature twin girls.  At only 25 weeks gestation, they had IV’s, respirators, feeding tubes, and they needed to be in an isolette, like an incubator, until they were big enough to maintain their own body temperature.

She had many complications early on in her pregnancy, but she kept her spirits high and did her best to remain optimistic.  Since she had what was considered a high-risk pregnancy, she needed to have ultrasounds taken every two weeks to make sure the babies were growing at a normal and equal rate.  With these regular doctor visits, she became quite accustomed to the routine ultrasounds and the varying doctors or technicians she saw.  It was no secret that her pregnancy was unusual; the babies shared a placenta and one of the umbilical cords was in an awkward position which meant that there was the threat of twin-to-twin transfusion and the possibility of one baby getting less nutrition than the other, also the placenta was situated unnaturally low in the uterus which could cause complications during labor.

Our December was unusually snowy this past year, but at five and a half months pregnant, my friend and I decided to take the ten minute walk to Surrey Memorial Hospital to one of her ultrasound appointments.  It was a standard visit; the babies seemed to be growing at the same rate as usual.  She told her doctor about the week before when she had a tightening in her stomach and thought she may have had Braxton Hicks contractions, he told her that that’s probably what they were and she did not need to be concerned. We told to him about how much fun it was to walk in the snow and we talked about how crazy the weather had been lately.  She also mentioned that she had just painted the nursery a pretty blue with fluffy clouds, and soon we were sent on our way quite happy.  Two weeks later at her 8:00am ultrasound visit, her world came to a sudden halt. At only six months pregnant, she was nearly 0.5cm dilated.  She was urgently brought down to the maternity ward, and then quickly whisked off to Royal Columbian Hospital who was more equipped to handle premature labor. 

Confused and scared, she tried to get some answers from the many nurses she saw in the coming hours, but they told her she would have to wait for the doctor.  At around 6:00pm she was able to speak to a doctor who questioned her about her previous month’s activities.  My friend told her honestly about all the running around she had done before Christmas, and about painting the nursery in preparation for the babies’ arrival.  She did not expect to hear that what she should have been doing was lying in bed for 3+ hours twice a day not including regular sleep.  Apparently the only way to have full-term twins is to be on strict bed rest from the fifth month onward.  Then she was informed that she would have to spend the rest of her pregnancy at Royal Columbian Hospital lying on a hospital bed with her feet lying higher than her head level.

She was justifiably angry at her previous doctors for not telling her any of this information but was mostly scared about the two babies living inside her, if they born at this time they would have a 50% chance of survival.  On the tenth day of being on hospital supervised bed rest, something started to feel strange for her.  She told six nurses, and two doctors, and they brushed her off saying that it was only Braxton Hicks, or false labor.  She spent three days in the hospital very uncomfortable, and very upset that nobody would listen to her.  On the third night of the contractions the sixth nurse that my friend had spoke to sent her downstairs to the delivery.  The nurse informed her that she was taking these precautions because the maternity ward upstairs was too busy and was afraid she might be overlooked. Thankfully, a doctor downstairs checked her that night since she was already 3cm dilated.  By the next morning she was 5cm dilated and the contractions were a steady 5 minutes apart.  They did an emergency c-section on January 6th at 8:30am.  The girls were born at just under 2lbs each and have spent the last 70 days in the Royal Columbian Hospital Neonatal Intensive Care Unit and will probably have to be there for at least another month.

I have some questions though:

Why didn’t her first doctor tell her she should have been on bed rest?  He knew that she had walked to the hospital in the snow, he knew she would have to walk home, and he knew that she had painted the babies nursery.

Why didn’t the doctor or nurses at Royal Columbian Hospital take her concerns seriously?  There is no reason why they should assume it is false labor when she was sent to that hospital because premature labor was quite possible.