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My First Time... Birthing Sextuplets

Ian Holzman, Chief of Newborn Medicine, Mount Sinai Medical Center

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I didn’t know we could do six. We have triplets a couple times a year. Quadruplets, maybe one a year. But before last October, I had never cared for sextuplets. And I finished my fellowship in 1977.

I met the couple, Digna and Victor, through their obstetrician. They already had a 7-year-old son and had used reproductive medicine to get pregnant again. Generally, most families with that many fetuses have reduction. But they were religious. I didn’t have much discussion with them about that, because when I got into the picture, it was really irrelevant. I was getting six babies no matter what.

The family had hoped, I think, that there would be publicity, because there’s a financial implication to having six babies. So they’d made a connection with the Learning Channel to film the births. But I said no. Having film crews around has an impact on the care people get.

We held our breath waiting to see how long she would carry the babies. Babies born at less than 23 weeks are unlikely to survive. At 23 or 24 weeks, we could hope to get 50-50 survival. Maybe 25 weeks, we could get 60 or 70 or more. She went into the hospital at around 23 or 24 weeks, and on a Monday at around 8:30 a.m., she started contracting. It had been 25 weeks. She was nice enough to do it then as opposed to Sunday at 2 a.m. But I had a concern that there were just too many chances for things to go wrong.

I was the official ringleader, but there were lots of doctors and nurses. I just picked up the clipboard and barked out orders. I don’t deliver the babies. I take care of them afterward. But the Cesarean section was pretty exciting to watch. All of a sudden, here comes the first baby, and then, fifteen seconds later, another. It took four minutes to get six babies out. I gave each one a military name. If you name them Baby A, B, C, D, E, and F, I could easily see someone saying, “Baby E is doing this,” and I’d think they’d said “D.” So I used Alpha, Beta, Charlie, Delta, Echo, Foxtrot. I’d always wanted to do that. And we had prepared posters. For Alpha, we had the symbol; Foxtrot, we found on Google an image of a couple dancing; Charlie was Charlie Brown. Even the parents started calling them that. And to my knowledge, we never mixed up a blood sample.

They were surprisingly similar: from around a pound six ounces to a pound nine ounces. Four boys and two girls. They all had immature lungs and needed respirators, IV feeding, and antibiotics. It was scary when one needed extra breathing help or got an infection, but none threatened to die. Three or four had a common developmental problem in small babies; the vessels in the back of the eye haven’t grown properly. But none of them lost vision. A couple will probably need glasses.

I had warned the parents, “This is great; but remember, survival at 25 weeks is not 100 percent. One or two might not make it.” They said, “Do the best you can.” Within a few days, I started thinking, “We might just be able to have six make it.”

The coolest thing was seeing how excited the parents were, how optimistic. The mom supplied milk for all of them. I’d be concerned about any parents taking care of six sick babies. But as I got to know them, I came to believe they were going to be fine.

I haven’t watched Jon & Kate Plus 8, but I chair the ethics committee at Mount Sinai and I grew very interested in how people were so angry with the octuplet mother and the doctor for not reducing. That’s a little more complicated: She’s a single mom on welfare, already has a bunch of other kids. But I’m not a reality- show person. I live the reality. I don’t need to watch it on television.


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