A group of highly skilled maternal-child nurses at Anne Arundel Medical Center in Annapolis, Md., teamed up with physicians to successfully deliver five healthy, premature babies, Maryland’s first quintuplets since 2005.
“It was like a beautiful symphony, with all of the disciplines coming together for the good of the patient,” says Ann Tabor, RN, BSN, one of several antepartum and labor and delivery nurses who volunteered to follow the patient, Adwai Malual, from admission in early October until delivery at 30 weeks gestation Dec. 2, 2008.
On that date, a 37-member clinical team brought four girls and one boy weighing between 2 pounds, 2 ounces, and 2 pounds, 15 ounces into the world by Caesarean section.
Malual, 28, a citizen of Sudan, came to America for medical care and stayed with family members in Maryland.
Throughout Malual’s stay at Anne Arundel Medical Center, she did not seem intimidated by all of the activity, monitoring, and planning that led up to her delivery, says Ann Nauman, RN, BSN, an antepartum and labor and delivery nurse caring for Malual. The clinical team met twice weekly and performed drills to prepare. Malual speaks English, making communication easy, and did not request any cultural or dietary accommodations.
“We gave her as much control and normalcy as we could possibly do,” Tabor says. “She wanted to be as independent as possible.”Malual, called “an amazing woman” by one RN, embraces two of her babies.
Nurses brought in movies for Malual to watch, which helped pass the time, and set her up with a laptop computer so she could stay in touch with her husband, Erjok Geu, who works in Tanzania. The nurses also encouraged her to walk around the unit, and they also took her downstairs for a change of scenery.
“There was a lot we did outside the realm of nursing, but it goes to the emotional well-being of the patient,” Nauman says.
As Malual began to experience changes, such as greater discomfort and contractions, the team decided to deliver the babies girls Nyantweny, Nyandeng, Abyei, and Athei, along with son Deng at 30 weeks, two weeks past the initial goal.
The morning of surgery, Malual invited a pastor to pray with her and staff members who wanted to participate. As with most women delivering by C-section at AAMC, Malual walked into the delivery room. Her mother, Anne Abyei, served as a support person and called Malual’s husband during the delivery.
“They came out crying like big kids,” Tabor says. “They were spontaneously viable and active.”The four girls Nyantweny, Nyandeng, Abyei, and Athei and one boy, Deng, weighed between 2 pounds, 2 ounces, and 2 pounds, 15 ounces at birth.
All five babies were admitted to AAMC’s neonatal intensive care unit. Three were discharged by the end of December. Malual planned to breast feed and pumped breast milk for the babies while they received NICU care. She will stay in the U.S. while the infants require medical care, but Tabor says Malual plans to return to Sudan with the children once given clearance. One of the babies remained longer in the NICU, where nurses formed a strong bond with Adwai and the children.
“For me, getting to know Adwai, her family, and her babies has been a real honor and privilege,” says NICU nurse Cheryl Briggs, RN-C. “[Adwai] was never intimidated by their size or their needs. She has proven herself to be an amazing woman.”
The AAMC team feels proud to have safely brought the infants into the world and given them a good start in life.
“This is what you think nursing is,” Nauman says. “This is what it can be when it works really well.”
Debra Anscombe Wood, RN, is a freelance writer.
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