When Megan Auguste, 35, learned she was pregnant with twins last July there was no question in her mind that she would be delivering at Holy Name Medical Center.
Her first son, Lucien III, 3, was born there, but her connection to the Teaneck hospital extends even farther back.
As a child she remembers, her mom giving birth to her four younger siblings at Holy Name. "We visited each one when they we're born. At the time all the babies were in the nursery, and we'd go to the window and try to pick out which one was ours," said Auguste, of Norwood. "My mom had a good experience," she added.
Carrying twins, Megan's pregnancy was automatically considered high risk, with a higher likelihood of developing high-blood pressure, diabetes and pre-term labor, which required her to be monitored closely by her team of ob-gyns, Drs. Christopher Englert and Lucy Tovmasian.
Soon, Auguste settled into a routine of biweekly appointments alternating between the maternal fetal medicine specialists at Holy Name and her regular ob-gyns.
Tovmasian's office was helpful in giving Auguste early morning appointments, so she could get to her job in time in midtown Manhattan as a construction site manger.
Compared to a singleton pregnancy, a twin pregnancy requires frequent growth ultrasounds and other tests to ensure the fetuses are developing at a proper rate. "We have to document two heartbeats by ultrasound, and measure her abdomen to see her growth is appropriate," said Tovmasian.
At eight weeks the high-risk specialist at Holy Name performed a chorionicity scan to determine whether the twins were sharing the same placenta or had separate ones. If they shared the same placenta, the fetuses would be need to be monitored more closely; but Auguste learned her twins were growing in separate amniotic sacks with two distinct placentas.
While the babies were growing well, Auguste said her pregnancy symptoms-nausea and headaches-- were much worse this time around with the extra hormones from twins. "The doctors were good at keeping my stress level down and reminding me everything was OK," she said.
By January, 36 weeks in, Auguste was put on semi-bed rest, and had to stop working. Her belly had already swollen to the size she was at nine months with her first son.
Lucien III, 2 at the time, was getting particularly excited about the idea having two baby siblings on the way. "My son is crazy about Derek Jeter whose number is two, and he was two, so everything was two. It worked out for us and he went with it," said Auguste.
In the last two months, Auguste's monitoring increased to weekly appointments with Tovmasian. She crossed her fingers that she could make it to 38 weeks when she had a C-section scheduled.
Her first pregnancy required an emergency Caesarian delivery; therefore, her doctor recommended she opt for a C-section with the twins, as well.
She had an option of picking a Thursday or Friday for the surgery, and she had peace of mind knowing that both doctors would be present. "I knew everyone was being cared for. With two births there's so much more going on," she said.
She arrived at noon on her Friday C-section date, and when the nurses set her up to be monitored she already started having contractions. "It was comforting knowing the babies were ready to come," Auguste said.
During the surgery, she was comforted to have her husband, Lucien II, by her side, as the doctors performed the surgery on the other side of a curtain.
Since the couple opted not to learn the gender of their twins, they were excited when the first baby came out a boy. The second twin, also a boy, was breathing rapidly and required supplemental oxygen in the special care unit. "They showed me his face and then he got ushered away quickly. It was a little nerve wracking that he was having trouble," she said.
During this stressful period, Auguste remembers it making a difference that the anesthesiologist sat by her side. " He said ‘this is what's going on. He's going to be OK.'"
The second baby had fluid in his lungs, she said, and was required to stay in an incubator in the special care unit for the first 48 hours.
While she was bonding with the first twin, Thomas, in her private room, she was unable to stand and walk yet to visit the second, Renzo, in special care. "My husband could go back and forth. I didn't get to actually go see him." Her husband slept on the nearby chair that reclined into a bed.
The nurses were very attentive making sure she had enough pain medicine and helping her with breast-feeding. The doctors and nurses were also very good about keeping her updated on Renzo's condition. "They took great care of him and updated me all the time. They'd call over and explain how he was doing and how much he was eating."
Within a day she was on her feet, and a nurse helped her set up a comfortable spot so she could nurse Renzo in the special care unit.
"It's important we deliver quality patient care that's evidenced based and we deliver that in a family type atmosphere," said Sheryl Syby, a registered nurse and unit director of women's and children's services at Holy Name Medical Center.
Renzo's temperature and breathing soon stabilized and he was ready to go home with his parents as scheduled.
But on the day of discharge, Thomas' temperature started to drop and he was jaundiced, requiring him to be monitored a few extra days. "That one was hard. That was very stressful for my husband and I. There were a lot of tears. But again, the nurses in the care unit were great. I called at 2 in the morning and they were fine talking to me how he was, how much he was eating, how is temperature was," she said.
For the medical team caring for the Auguste family and other high-risk pregnancies, a fluid working relationship is what makes the difference. "The neonatologist, the high-risk ob-gyn, and us, her general obstetricians, we work well together to take care of all of these patients," said Tovmasian. "There's hardly a delivery that is ever textbook, and we're all prepared and have a good sense of team approach to a lot of these deliveries."
Thomas was able to go home three days later. Today life can be chaotic with infant twins and a three-year-old. Thomas and Renzo, fraternal twins, are doing well and have already shown their distinct personalities. "Thomas is pretty laid back. He'll sleep as much as you let him. Renzo is cuddly and needy. He definitely wants you all the time."
When sleeping in the crib together, "one tries to grab the other's hands," said Auguste.
Auguste looks back at her experience with Holy Name Medical Center and says she would recommend any friend or loved one to have her delivery there. What made the difference? "It's just all the support I got from all the nurses and doctors."