Tiny twins’ dramatic arrival 1000km from home
TINY twins Francesca and Henry Morris could not have had a more dramatic entry into the world, born 16 weeks early after a 50-minute lights and sirens ambulance ride from the Sunshine Coast.
Their first-time parents Sam Morris and Caroline Chalmers were 1000km from their Sydney home when she went into premature labour in Noosa at just 24 weeks gestation - on the cusp of what is considered survivable.
The Kawana hospital is only accredited to care for babies born from 29 weeks gestation.
But there was also the risk the twins would be born in the ambulance en route.
At the Sunshine Coast University Hospital they were told the best chance for the twins was for them to be born in Brisbane where they would have the most specialised treatment available for such extremely premature babies.
"If they hadn't been able to get to Brisbane before the twins were born, things may have turned out quite differently," neonatologist Pieter Koorts said.
"Everyone talks about the Golden Hour in medicine and it's no different with extremely preterm infants. Everything's got to be perfect in that first hour after birth. If they'd been born in the ambulance, that's a disaster."
Luck was on Francesca and Henry's side. It was a Saturday night and traffic on the Bruce Highway was light.
When the ambulance arrived at the Royal Brisbane and Women's Hospital, obstetrician Johanna Laporte was at the emergency department's entrance waiting for them.
"We got a very strong sense that we were where we needed to be when we got here," Caroline said. "Dr Laporte was standing at the front door. I remember that very clearly.
"I knew I wasn't going to give birth in the ambulance. I really never felt that I wasn't going to take them both home. That just wasn't going to be our story. I don't know why."
Also waiting at the RBWH were two of Brisbane's top neonatologists - Dr Koorts and Dr Tim Donovan - one to work on each twin after their delivery.
Just after midnight on May 26, Francesca and Henry were born by emergency caesarean.
Francesca was delivered first weighing just 628g. Her brother was 685g.
It would be 15 days before their parents, who were in Noosa for 60th birthday celebrations for Sam's father Tim, would be able to hold them for the first time.
"The first few days they can grab your hand and you can touch them but they look like a baby bird almost, they're just so small and delicate and that's quite confronting," Sam said.
"One of the first things we were told was that it's going to be a rollercoaster ride. You naturally think: 'Oh, of course.' But it's not until you've lived it that you understand what they meant.
"It's not like the babies are sick at 24 weeks and they gradually get better. It's not a linear progression, it's a rollercoaster. One day when you think things are going really well, one of the babies falls into a hole and has problems with their breathing or something else.
"We've stared down the barrel on a number of occasions, particularly with Henry. It's been very, very challenging."
Henry recently had to be transferred to the Queensland Children's Hospital for an operation to repair three hernias, but is recovering well back at the RBWH.
Dr Koorts said that last year, the hospital's neonatal intensive care unit looked after eight babies born at 23 weeks gestation and 18 delivered at 24-25 weeks.
He said about 60 per cent of the 23 weekers and 70 per cent of those born at 24 weeks survived.
"It drops if you've got twins," said Dr Koorts, the RBWH's director of neonatology.
"Survival doesn't just depend on gestation. Males do worse than females. It there's been an infection or the baby hasn't grown well in the womb, they tend to do worse."
Extremely premature infants are at a higher risk of issues such a cerebral palsy and learning difficulties.
After more than 100 days away from home, Sam and Caroline are finally preparing to return to Sydney with their babies tomorrow, grateful for the care they have received at the RBWH, particularly the expertise of the twins' neonatologist, Dr Donovan.
"Tim Donovan has been critical in us being able to go back to Sydney with two beautiful children," Sam said.
"Whether it was coming in on weekends to offer assistance or spending hours talking Caroline and I through the spread of outcomes of certain decisions that had to be made for their welfare. He gave his expertise and compassion willingly."
To donate to neonatal research: rbwhfoundation.com.au