The Couple Whose Twins Survived Birth at 22 Weeks

Photo-Illustration: The Cut; Photo Getty Images

Shakina, 36, and Kevin, 37, had been trying to conceive for seven years when they discovered that Shakina was pregnant. For eight weeks, the pregnancy seemed to be progressing smoothly, and Shakina walked into her first ultrasound feeling both nervous and excited. She couldn’t wait to tell Kevin about hearing their baby’s heartbeat; he wasn’t allowed to go in with her due to COVID-era visitor restrictions. It was spring 2021.

But that unmistakable, rapid thumping sound never materialized. As she lay on the crinkly paper in a silent exam room, Shakina learned that her pregnancy was ectopic, which means that the embryo had developed outside of the womb. Ectopic pregnancies can be life-threatening, and Shakina knew the pregnancy couldn’t continue. She and Kevin were shattered. 

Yet three months later, the couple discovered Shakina was pregnant again. “I remember the ultrasound technician being very quiet, which made me even more nervous. I looked at her and kept asking, ‘Is there a heartbeat?’ recalls Shakina. “And then she looked at me. She didn’t say anything; she just put two fingers up.” Shakina was pregnant with twins. She broke the happy news to Kevin in the car. “It was just this delirious moment of excitement,” he says. “At the back of my mind, there was some concern. But mostly I just chose to hope and believe and be optimistic.” 

Weeks and then months passed without cause for alarm. Shakina had all-day morning sickness, but apart from that, it was a textbook pregnancy. “All of the ultrasounds showed that the babies were progressing in size and development and so on,” she says. The couple selected a photographer for a maternity photo shoot and started to plan a babymoon in Hawaii. They were about to click “book” on their itinerary, but were tired from a long day and decided to wait until the morning to make their reservations. Hours later, at 21 weeks and five days gestation, Shakina awoke in pain. She didn’t know it at the time, but she was in preterm labor. 

The American College of Obstetricians and Gynecologists (ACOG) defines weeks 20 to 25 weeks and six days gestation as the periviability period — when there is a marginal chance of survival for a baby. Infants born before 23 weeks face a 5 to 6 percent survival rate. 

The couple shares what happened next

On labor beginning more than four months early

Shakina: When I woke up in the middle of the night in pain, I tried to force myself to go back to sleep, and I managed to get a couple more hours. But then I woke up again, at about 7 a.m., and this time the pain was even more severe. I could also feel that I was bleeding. I went to the washroom and looked down, and I was soaked. There was so much blood. I’d heard about Braxton Hicks, false labor pains, so I thought maybe that’s what was happening. But in the back of my mind, I had a sinking feeling. At that point I called out to Kevin, who was downstairs having coffee.

Kevin: I was with our dog, Eden, just having a normal morning. Then I heard Shakina’s voice and immediately knew something was wrong. She was at the top of the stairwell with this look on her face. I packed whatever I could in a bag and we left to go to the hospital, which was about 30 minutes away.

On pleading to sustain the pregnancy

Shakina: When we got there, while Kevin was parking, I was put into a room and told to lie down. Kevin came in, and then the OB who was on call arrived. He put a speculum in and looked at me for like 30 seconds —

Kevin: And then he looks at the nurse —

Shakina: And then he looks at us and says, “I’m really sorry. You’re going to be losing your pregnancy today.”

Kevin: It felt like we were hit by a bus.

Shakina: I was frozen. Kevin says my face turned white, like I looked like I’d seen a ghost. Then the doctor says he’s going to give us some time to be by ourselves and he’ll be back soon. After he leaves, we turn to each other and I say, “Kevin, call whoever you can and try to get help. Get people to pray for us.” I called one of my friends who is a doula, and Kevin called his sister, who’s a doctor. We were trying to get whatever advice we could, to find out what to ask for — medications to delay labor, whatever we could do to buy more time. When the doctor came back, I started asking questions, to see if they could stitch up my cervix or give me medication. And I was just kind of dismissed. He said, “There’s no point. Your babies are not going to survive.” He kept saying that: “There’s no point.”

Not long after that, a nurse came in holding this silver bedpan, and she said, “I’m going to put this in the toilet, because when you go to pee, your babies might fall out, and we want to make sure that you don’t accidentally flush them down the toilet.” I couldn’t process it. I was shocked.

Kevin: She said it in the most nonchalant way. It was insane.

On finding a hospital willing to deliver the babies

Kevin: Shakina kept asking for an ultrasound.

Shakina: I wanted to see the babies. Because I could feel them; I could feel them moving inside me.

Kevin: But they said they couldn’t because they needed to triage ultrasounds based on priority.

Shakina: I’m in extreme pain at that point. I’m having contractions like every three or four minutes. The nurses tried to help. They said, “Walk around the room, keep moving.” So I did all of that — things I know now that I shouldn’t have done, that could have triggered the birth right away.

Kevin: I remember at about 2 a.m., I was just sitting in a chair in the room, crying, pleading with God, thinking, You’ve brought us so far. I’m not willing to accept that we’re going to lose this pregnancy. I just really need a sign that you’re in this. Show us a way out. About a half hour later, one of our friends messaged us on Instagram with screenshots of a mother who had twin girls at 22 weeks and three days. The second screenshot showed them at 3 years old, thriving. It gave me hope. I wrote a message to the account where she’d gotten the screenshots, a micro-preemies advocacy group called TwentyTwo Matters. One of the co-founders responded right away with all of this information — including which hospitals nearby resuscitate babies at 22 weeks. There was one not far from us. She told me we should push for a transfer. So Shakina and I talked about it and decided to ask for it in the morning, when the doctors changed shifts.

Shakina: The new doctor was open to it. After we spoke to her, she left for a while, and when she came back, she told us, “Okay, that hospital has accepted and they’re sending an ambulance.”

On the agonizing wait for the twins’ birth

Shakina: Once we got there, it was like, phew. Everything’s gonna be okay. But we kept having these conversations. The first OB who came in to talk to me said, “If your babies are born today, it’s going to be a death sentence for them.”

Kevin: And he was the doctor who accepted the transfer! And it just got worse. Every time someone came in, they’d ask the same questions: Do you realize that the babies have a very minimal chance of survival? And if they do survive, they’re going to have significant disabilities?

Shakina: And: “Are you prepared to make significant changes in your life? One of you may have to quit your job to be their full-time caretaker — are you prepared to take that on?” It was scary. I’m thinking, I don’t know how to care for a baby who’s blind. I don’t know how to care for a baby who’s in a wheelchair. I don’t think it was their intention to scare us — but it did feel like they didn’t want us to keep the pregnancy. We found out later on, after building good relationships with these people, that they’ve worked with parents who wanted their babies to be resuscitated and then, later, told them that they hadn’t warned them about what it was going to be like and said, “This is not what we signed up for.”

On the delivery

Shakina: It was about 1 p.m. on the day of our transfer. I had about 11 hours to go until I hit 22 weeks. I started having contractions every two minutes, and I’d been fully dilated 10 centimeters for more than 24 hours.

Kevin was still talking to the co-founder of Twentytwo Matters.

Kevin: She informed me, “As soon as you get transferred, ask for magnesium sulfate for the babies’ brains (which may reduce the risk of cerebral palsy) and steroid shots for their lungs.” These treatments are fairly standard, and yet it’s us asking for this stuff. We’re not hearing the doctors say any of it. Keep in mind too — we hadn’t had an opportunity to even go to a pregnancy class. We didn’t know anything. We’re having to pick up information from wherever we can get it, because it’s not coming from the hospital.

Shakina: Around 11:40 p.m., I was 20 minutes from when I hit the 22-week mark. I thought my water had broken and one of the babies’ heads was down. I was terrified, because I thought I’d lost the babies. But I got checked, and my water was still intact. I begged the nurse to give me something to help me sleep. When I woke up again, it was 12:15 a.m. I’d just passed the threshold. They checked me again and told me the babies were coming. Our daughter, Adiah, was born at 1:22 a.m. They showed her to me quickly and rushed her into the resuscitation room. Adrial, our son, had a harder time coming out; I’d push, and then he’d go back in. At one point the doctors looked at each other and they’re shaking their heads, and I’m thinking, we’ve probably lost this baby. I was about to give up. But then our nurse took over, held my hand, and said to everyone, “Hold on. Don’t tell her to push. Let her take a breather, and she’ll push with the next contraction.” She looks at me and says, “I’ll tell you exactly when to push.” So we waited. And then the contraction came, and she said, “Push!” And with that one big push, he came out. And then there was this big panic and they took him away. Adiah was 11 ounces and Adrial was 14.8 ounces. The doctors said our daughter was the smallest baby the hospital had ever seen. They had a hard time intubating her because they didn’t have a tube small enough. As a last resort, a respiratory therapist came up with the idea of using a second type of tube. It just barely fit, and it’s the only reason she survived.

On the babies’ critical first weeks in the NICU

Shakina: Kevin talks about the six months we were in the NICU in three phases. What do you call the first phase?

Kevin: The dark days.

Shakina: They were really, really dark. We didn’t know this at the time — we learned a lot after the fact, from reading the NICU charts — but after our son was born, Adrial didn’t move or breathe for about seven minutes. He was really critical.

Kevin: The morning after the birth, we were on our way up to the NICU when two doctors stopped us and said, “We need to talk to you.”

Shakina: They were from neonatology. They said, “We have to tell you that your babies have really advanced brain bleeds, and if they get worse, they’re not going to survive.” I just broke down. That’s what it was like, in the dark days. In the twins’ first few weeks of life, every day there was some new problem. Everything that could go wrong went wrong. Both babies had chronic lung disease, sepsis, and brain bleeds. Adrial had a perforation in his bowel, and later, an inflammatory gastrointestinal disease called necrotizing enterocolitis, which can be fatal. They also had holes in their hearts that hadn’t closed before they were born. Adiah at one point had so little blood left in her body from all the blood draws, she needed more than a dozen blood transfusions. They both had translucent skin that was so delicate it would peel with the slightest touch, as well as something called retinopathy of prematurity, which can sometimes lead to blindness.

Kevin: One time, Adiah’s breathing tube came out.

Shakina: They were trying to reposition her, and the tube came out.

Kevin: We saw her heart rate drop into single digits. Suddenly the whole staff flows in —

Shakina: And they’re trying to put this tube back in. And they almost couldn’t.

Kevin: The tube had been taped to her cheek, but it had to be replaced. We hear the doctor say, “Rip it if you have to.” So they did. And it actually peeled off a chunk of her skin.

Shakina: I was shaken up for days and days after that. I couldn’t go into her room without crying.  Another time, a couple of months in, I asked if I could hold Adrial, skin-to-skin. It was always involved; the respiratory therapist and the nurses all had to help. They tried putting him on me, and he turned blue. Thankfully, I couldn’t see it, but Kevin watched it happen. They had to take him away from me and ask us to leave the room. The whole staff had to come in and help bring him back to life. That really broke me, because I felt like it was my fault — like I shouldn’t have asked to hold him. Adrial also almost died many times; he was so critical at one point that the doctors suggested we withdraw life support.

On turning a corner, slowly

Kevin: Adrial was on 100 percent oxygen for pretty much the first month. Then, I remember walking in one day, and his oxygen support was at 30 or 40 percent — significantly lower. For me, that was sort of like, “Hey, he’s a fighter. There’s progress being made.”

Shakina: We decided early on we would focus on small wins.

Kevin: Like even weight gain.

Shakina: In Adiah’s first week, she dropped from 330 grams (about 11 ounces, her birth weight) to 290 (about 10 ounces). But then she started putting on, like, one ounce every few days. So it was all these small moments we celebrated. We spent eight to ten hours a day in the NICU, you know, every single day, so we saw all the small improvements. I saw Adrial’s fighting spirit. I knew my son. I just knew.

Kevin: Our social worker played an incredible part in celebrating the small wins with us.

Shakina: She’d give us these milestone cards for small things, like, your child finally weighs one kilogram, and you’d get a card and put it in your NICU room, like a badge of honor. I remember the first time we got to help with a diaper change; we got a card for that. Being able to hold the babies for the first time, that was another one. One of my happiest moments was when a nurse decided to put clothes on Adiah. Seeing her for the first time in clothes … I cried so much. We’d never seen our babies in clothes. That, for me, was progress.

On bringing the babies home

Kevin: Adrial had always been tracking almost a month behind Adiah because of all the complications he had — but toward that home stretch, he made huge strides.

Shakina: They ended up coming home a week apart, which was good. It gave us time to prep our house.

Kevin: Driving them home was terrifying. And once we were home, we worried about their breathing. They both had a long list of meds. At one point, I created a poster that said “Adrial’s Cocktail Menu.”

Shakina: Adrial ended up having to go back into the hospital due to an infection that caused a lot of fluid and pressure around his heart and lungs. We almost lost him again. They couldn’t get his IV in, so they had to drill a hole in his leg to place it. We’re hearing the drill, seeing like 15 people trying to revive him, and we’re thinking, Not again. How are we here again? When he came home, he was on oxygen. That was another adjustment. On top of everything else, now we had oxygen tanks everywhere. 

On the twins’ health and development

Shakina: Adrial has been off oxygen for a few months now. Because the twins were born more than four months early, their corrected age is 14 months. They’re standing up on their own now, cruising along furniture, but not walking yet. They’re also babbling; Adiah can say “Mama” and “Dada,” and Adrial seems to recognize those sounds. But they’re not speaking. They’re about three months behind on where they should be with their gross motor skills and speech. We’ve been told that a lot of that has to do with their spending six months in the NICU. When most babies come home, they get a lot of tummy time; they develop their muscles. But the twins spent a lot of time flat on their backs. Doctors have told us that we may continue to see the effects of prematurity until age 2 or 3. Until they hit that mark, I think I’ll continue to think about what challenges the future may hold. But we’re really proud and excited about the progress they’re making.

On processing their trauma

Shakina: I still get bad dreams sometimes — nightmares that something happened to one of them and I wasn’t there to save them. You know that feeling — and maybe all moms feel like this — but when the babies are sleeping in their nursery, and you’re in a separate room and you’re worried if they’re still breathing? But as time goes by, I’m not having as many anxious thoughts and nightmares. Sometimes we talk about having another baby. We are afraid of the possibility of having another premature baby. If we went through it again, I think it would be less scary this time around, because we’d know what to expect. We came out on the other side and survived it.

On life with the babies today

Kevin: The twins are amazing.

Shakina: They have their own little personalities. Adiah is obsessed with books and is very methodical, with close attention to detail. And she’s feisty. She makes herself known. Adrial, he’s a daredevil — he climbs everything and doesn’t know fear at all. He’s just extremely brave. And he’s a foodie. He loves eating. They crack each other up. They’re always looking at each other, laughing.

Kevin:  I wake up early, and every morning, when I go back into their room to get them to bring them into our bed with us, they’re just in their cribs, waiting for me, smiling.  Like today, Adrial was just sitting there, smiling this big smile — like he was so happy to see me.

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The Couple Whose Twins Survived Birth at 22 Weeks