After days of anxious anticipation, a watching world focused its eyes Wednesday on seven tiny newborns in a hospital in the heartland of America.
With members of her church praying in the hospital lobby, 29-year-old Bobbi McCaughey was helped into the intensive care unit where her premature septuplets lay in individual incubators, breathing with the assistance of ventilators.
For weeks, McCaughey had known the children only through grainy pictures, ultrasound images showing a tangle of legs, arms and bodies. But on Wednesday, shortly after delivering the babies within six minutes of one another beginning at 12:48 p.m., she got to see and touch them for the first time.
The four boys and three girls, some of whom entered the world squalling and with their eyes open, are believed to be the world’s first set of surviving septuplets– seven children born at once. McCaughey had used the fertility drug Pergonal.
The children, named before birth, are: Kenneth Robert, 3 pounds, 4 ounces; Alexis May, 2 pounds, 11 ounces; Natalie Sue, 2 pounds, 10 ounces; Kelsey Ann, 2 pounds, 5 ounces; Brandon James, 3 pounds, 3 ounces; Nathanial Roy, 2 pounds, 14 ounces; and Joel Steven, 2 pounds, 15 ounces.
Kenneth Robert, the first and heaviest, was nicknamed “Hercules” because he had “held all the others up” in a pyramid formation in the womb, said Dr. Paula Mahone, who helped perform the Caesarean section at Iowa Methodist Medical Center.
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McCaughey and her husband, Kenny, 27, both staunch Baptists, had rejected suggestions that they abort one or more of the fetuses, calling the multiple pregnancy a gift from God.
The births caught the world’s attention. News of the arrivals was broadcast to scores of countries via television. Inside the hospital, scores of journalists trained notebooks and cameras on doctors as family and friends came to share in the event.
Oblivious to it all were the babies, in a neonatal intensive care unit.
“They will tell us over the next two weeks what issues will be coming up for each of them,” said Dr. David Alexander, medical director of Blank Children’s Hospital, where the children were moved from the adjacent Iowa Methodist hospital.
At the end of that period, physicians will have a better idea whether all the children will survive and what problems they may face.
The birth of a child once was celebrated by a small circle of family and friends, but modern reproductive technology has led to births in multiples never intended by nature and created a worldwide fascination with what otherwise would be the most intimate of moments.
In September, a Saudi Arabian gave birth to septuplets, but six died. In January, a woman in Mexico City had seven, but one was stillborn and the others died. Until Wednesday, the last set of U.S. septuplets was born in California in 1985 to Samuel and Patricia Frustaci. One was stillborn, three died and three survived.
As of Wednesday night, all seven McCaughey children were listed in serious condition.
Neither of the McCaugheys was available for interviews. But their pastor, the Rev. Robert Brown, of the Missionary Baptist Church in the small town of Carlisle, where they live, said: “We rejoice and give praise to God for his marvelous gift of lives to Kenny and Bobbi. As the Psalmist (King) David says, this is the Lord’s doing, and it is marvelous in our eyes.”
Doctors said the delivery room seemed calm because the 40 medical specialists assembled for the birth had spent hours developing a plan. They decided to deliver the septuplets on Wednesday because McCaughey had developed contractions, and the homemaker “had had it,” said Dr. Mahone.
Asked what went through their minds during the procedure, Mahone and Dr. Karen Drake exchanged glances and burst out laughing.
“By that point, we had been through the, `Oh my goodness, this is the day,’ ” Mahone said.
Added Drake, “I just felt things were going to be okay.”
The births were greeted with an outpouring of concern and support. Iowa Gov. Terry Branstad visited McCaughey at the hospital Wednesday and asked what he could do for the family. After the meeting, he announced that, before next year’s Thanksgiving, a corporate coalition would be assembled to fund construction of a new house big enough to support the McCaugheys, who also have a daughter, Mikayla, almost 2.
“The Des Moines business community will build this home no matter what it takes,” said David Fisher, former campaign manager for Branstad. “We will raise the money and build a house as big as they need it.”
Neonatologists treating the babies initially will be most concerned about three things: lung development, cranial hemorrhaging and bowel problems.
During her pregnancy, McCaughey was treated with steroids to accelerate fetal lung maturity. Still, doctors say, the children may have respiratory problems. On Wednesday, doctors were discussing whether to treat the babies with surfactant. That substance is produced naturally by the lungs, but premature babies may need a boost of artificial surfactant to prevent lung collapse.
Doctors also will be checking to see whether the babies develop cranial hemorrhaging. Such bleeding is rated on a scale of one to three, with three being the most severe and the only level that would cause a “grave prognosis,” said Dr. Norman Duerbeck, associate professor of obstetrics and gynecology at Southern Illinois University.
Bowel problems are the third potentially serious complications for babies born after 30 weeks.
“The bowels may be so premature, the babies can’t feed well,” he said. That problem may successfully be treated with antibiotics.
Other problems, such as developmental delays, may not become evident for months or years.
Doctors, ethicists and average citizens wondered what the live delivery of septuplets would mean to the field of assisted reproductive technology. Questions are being raised about whether more women will now attempt to try to carry five, six and seven fetuses and more doctors will give fertility drugs.
“If they do they’re foolish, because the literature about higher order multiples is littered with train wrecks, with all sorts of reports of premature delivery, loss of the children and all sorts of complications,” said Dr. Louis Keith, president of the Center for the Study of Multiple Births at Northwestern University and also a professor of obstetrics and gynecology at Northwestern University Medical School.
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But, he added, “I think a lot of people are going to use this case to reassess the use of fertility agents in the United States and in the rest of the world.”