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Sarah & Andrew Navigate the NICU After Birth of Twin Boys


Sarah and Andrew Sapperstein were looking forward to being parents and were overjoyed and shocked to discover that they were having twins.

As the months passed, Sarah's pregnancy was going smoothly, and they planned to welcome their babies by cesarean section (C-section) at 38 weeks.

However, during her 32-week checkup with Ann Marie Rockamann, MD, obstetrician gynecologist on staff at Missouri Baptist Medical Center, Sarah learned that her blood pressure was higher than usual. "Dr. Rockamann ordered bloodwork, and when the labs came back, I found out that I had preeclampsia."

Emily Fishman, MD, a Washington University neonatologist on staff at Missouri Baptist who specializes in the care of preterm babies, explained, "If left untreated, preeclampsia is a pregnancy complication that can lead to serious problems for both the mother and the baby. Often, early delivery of the baby is recommended."

An Early Delivery

Because Sarah had preeclampsia, Dr. Rockamann admitted her to MoBap's Childbirth Center. On her way to the hospital, Sarah was anxious, thinking about what may happen. "But when I arrived, the labor and delivery nurses were calm and made me feel comfortable. I knew we were in the right place."

Over the next 48 hours, doctors monitored her lab results and used a fetal monitor to keep an eye on their babies. Sarah also received two doses of a specialized medication to help speed up the development of the twins' lungs in case they had to deliver early.

"Because my lab work wasn't improving, the decision was made to deliver, which meant our babies would be born six weeks early and be in the NICU."

MoBap's Neonatal Intensive Care Unit (NICU) cares for premature babies, high-risk newborns and multiple births with a staff of Washington University neonatologists from St. Louis Children’s Hospital. Neonatologists are available 24 hours a day to provide the highest level of care.

Before delivery, Sarah and Andrew met the neonatologists and a high-risk obstetrician. "They answered our questions and talked to us about what to expect," Sarah said. "Everyone worked seamlessly together. There was always a clear plan, and we were part of the planning process."

On September 18, just two days after being admitted to the hospital, Sarah had a C-section. Theodore (Teddy) entered the world first, weighing 3 pounds and 15 ounces. A few seconds later, Oliver (Ollie) followed and weighed 4 pounds and 2½ ounces.

"Teddy and Ollie each had a team of neonatal intensive care specialists who immediately took care of them in the operating room," Andrew said.

Dr. Fishman explained that the NICU team goes to high-risk or complicated deliveries like Sarah's. "As a team of neonatologists, nurses, pediatricians and respiratory therapists, we provide support to babies immediately after delivery."

MoBap NICU Cares for Twins

Teddy and Ollie were moved to the NICU, where they were in isolettes to help maintain their body temperature and received breathing support. "They also had IVs and feeding tubes and were hooked to machines to monitor their vital signs," Andrew described. "Seeing Teddy and Ollie in the NICU was overwhelming. But the nurses and doctors explained the equipment and what to expect, which helped us feel comfortable."

Over the next four days, Sarah recovered in her room on the Mother-Baby Unit down the hall from the NICU. "Andrew and I visited Teddy and Ollie throughout each day to bond with them. Once they were settled, we got to do kangaroo care."

Dr. Fishman described kangaroo care, or skin-to-skin contact, as a way to closely hold newborns, which can help reduce stress and make newborns feel calm and safe.

Andrew added that they saw a neonatologist every day. "Everyone went the extra mile to make our NICU stay easier. They even helped us celebrate each of their growth and milestone moments."

Dr. Fishman said that the NICU team focuses on providing family-centered care. "It can be stressful to have a baby in the NICU, but parents should know that they aren't alone. As a team, we work hard to treat the babies and families like our own. We keep parents informed and involved in their baby's care from admission to preparing to take their baby – or babies – home."

Early in her pregnancy, Sarah decided that she wanted to breastfeed and knew she'd likely need to adapt since her babies would be premies. "The nurses helped me start pumping after delivery, and everything I pumped went to the NICU to supplement the feedings the boys were getting."

When Sarah was discharged home, she said it was harder than they imagined leaving Teddy and Ollie behind, but they knew the twins were receiving the best care at MoBap. "The thoughtfulness and wonderful care we experienced made the challenges of having NICU babies easier."

Bringing Teddy & Ollie Home

After four weeks in the NICU, Teddy and Ollie were ready to go home. To help the twins with breastfeeding, Sarah had weekly appointments at MoBap's Infant Feeding Clinic, where she and the boys worked with Elisa Doherty, an occupational therapist and international board certified lactation consultant (IBCLC). "The Feeding Clinic was an amazing resource. Elisa taught us countless tips and tricks, and it was encouraging to see the boys' progress."

Looking back on their experience, Sarah and Andrew are grateful for the support they received from everyone at MoBap during every step of their journey. "It's stressful when your babies are in the hospital, and it's easy to feel overwhelmed," Sarah said. "The kindness we experienced from the entire MoBap team made all the difference in the world."

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