The 'miracle twins' separated by birth
It has been described by doctors as nothing short of a miracle in progress.
A Bermudian couple have experienced the joy of seeing the first of their twin sons born three months ahead of time, while his twin is still in his mother's womb.
The rare interval delivery made history for the health centre where Emyr Gabriel Joshua Ryan Bean was born. All being well Emyr's twin brother will also be born there during the coming weeks and months.
Proud parents Edonna and Ryan Bean expect to have quite a time eventually explaining how their twins ended up with two different birth dates — and possibly in different years.
The two bundles of joy were initially expected to arrive next March, by way of a planned c-section delivery at 38 weeks. But that plan changed drastically on October 2.
“I was 18 weeks and three days when the amniotic sac ruptured for Twin A [Emyr]. Fraternal twins have separate sacs,” said Ms Bean.
She was admitted to the King Edward VII Memorial Hospital Maternity Ward for nine days. Her lead physician, Dr Dale Wilmot anticipated the delivery of the first twin within 48 hours.
“At that point he was considered too premature for survival,” said Ms Bean.
She was told Emyr was not considered viable but both she and her husband never lost faith.
“His heart beat was maintained during the whole duration of our nine-day stay. They realised that he was surviving without an amniotic sac,” she said.
She was discharged and remained at home on bed rest until November 4 when she was readmitted to be air ambulanced overseas.
The couple left for Halifax, Nova Scotia, the next day bound for IWK Health Centre, which specialises in high risk pregnancies.
Ms Bean was 23 weeks pregnant.
“We met with the neonatologist and the team at IWK. They told us if he was born at 23 weeks ordinarily there would be no resuscitation because they consider viability at 24 weeks in Canada. But if we requested it they would honour that and we signed documents for automatic resuscitation,” said Ms Bean.
She was placed in isolation on arrival. It took 24 hours before she was cleared for MRSA, which is protocol for all patients transferred from one hospital to another.
Seventeen days after arriving, on November 22, Ms Bean went into labour.
Emyr was eventually born on November 25, at 26 weeks and one day, weighing 1lb 14oz and just over 12 inches long. It was a medical first for the Canadian facility.
“He gave a cry when he was born, opened his eyes and started breathing on his own. They ventilated him, he was working very hard to breathe and now they're calling him the miracle preemie because of his size and the fact that he's breathing so well,” said Ms Bean.
Both parents were confident Dr Wilmot made the best decision to send them abroad. And they both commended the team at IWK for their “open honesty about the chances of survival”.
After hearing about the birth, Dr Wilmot said: “Edonna and Ryan Bean are wonderful people and their story is truly extraordinary and miraculous. This experience is a first for me as well and I continue to keep them in my thoughts and prayers.”
Emyr is surpassing the expectations of doctors and staff at IWK.
“Delayed interval births of this length usually take place when one multiple is delivered prematurely. Delayed interval births are rare and only a very small number of births occur days, weeks and even months apart,” said Dr Krista Jangaard, Head, Division of Neonatal-Perinatal Medicine, IWK Health Centre.
“The baby born is doing extremely well and the unborn twin will benefit immensely from the extra time in the womb.”
Mr Bean who has been at his wife's side through it all. The couple discovered they were having twin boys when they arrived in Halifax, which was a surprise because he was convinced they were having girls.
Now that Twin B is inside her womb on his own Ms Bean said: “He's been giving the nurses a hard time trying to locate him when placed on the fetal monitor. They're convinced it's because he has more room to play and when they do find him he's gone again. A few times he's kicked the monitor,” she said.
Although the baby is currently breached she's hopeful he will move to the birthing position when the time comes. And after a first successful vaginal delivery she's sure she can do it again.
“His brother delivered after the first contraction, just three pushes and he was out, and I'm very proud of that.”
Medication was administered after Emyr's birth to stop any further contractions and defer labour for Twin B.
Emyr is still on a ventilator using oxygen at a rate of 27 percent leaving doctors shaking their heads, with such premature lungs he “should be on a much higher percentage of oxygen”.
Confined to bed rest and only allowed out of bed long enough to take a shower, Ms Bean must use a wheelchair until her next delivery, hopefully next year.
Her husband is looking forward to it.
“I am just overwhelmed with the feeling of love that a parent feels for a child,” he said. “I've heard about it but I'm experiencing it now for the first time and it's amazing. I've left it all in God's hands and I have peace that surpasses all understanding. I was there for the first delivery and I'm ready to do it again.”
Both parents are yearning to pick up Emyr from the incubator, but know they can't for now. For both, it's has been very humbling “knowing the limitations for his best interest”.
“Being a father is one awesome experience and I'm grateful. But to see your own son being born is a concentrated blessing and the fact that I get to do it again in a few weeks or months is just God showing me how much he loves us to bless us in this manner.”
Emyr is set to make hospital history again when he becomes the first premature baby to receive donor breast milk that will be expressed all the way from Calgary.
He is due to begin between 0.5ml to 1.0ml for the first six days and will go up in intervals if he accepts the milk later this week.
“If he's anything like his parents he will love food,” said Ms Bean, who is aware that if she breastfed him herself she would “would stimulate contractions and bring on the delivery of Twin B”.
Emyr's weight has dropped down to 1lb 7oz as newborns are known to lose weight before they gain it, but that's expected to change. And so will the reddish colour of his skin once pigmentation sets in.
At last check he was listed in a stable condition and his blood work is “great”.
“The common word that seems to come out of the doctors' mouths is that this whole interval live birth is a miracle,” said Ms Bean.
Delayed interval births are rare. The American Journal of Obstetrics and Gynaecology, in 1998, reported 93 days as being the believed record gap between the birth of surviving twins.
If all goes well, in a few years' time the Beans plan to tell their twin boys how Twin B saved Emyr's life.
Both parents now know that because Twin B was at the top of Ms Bean's uterus with Emyr at the bottom, Twin B was literally holding her uterus up to sustain Emyr's life.
The emphasis now is to keep Emyr thriving while his brother gets ready to make his grand entry into the world.