“Doctors said if they did survive the delivery, we should be prepared for them to have significant disabilities,” said Rajendram, of Ajax, Canada, near Toronto. “We were told they might never walk or talk or breathe independently.”
“Kevin and I held on to hope and trusted that our babies were resilient and would make it through,” she said.
One year later, Rajendram, 36, said two happy babies are proof that their instincts were right.
Adiah and Adrial Nadarajah are healthy and curious and are breathing on their own, gaining weight, babbling and feeding themselves finger foods, she said. And on March 4, they celebrated a big milestone: their first birthday.
Rajendram’s twins, born at exactly 22 weeks, beat the record by one day.
“Their birthday was the joyful day we’d always dreamed about,” said Rajendram, an assistant professor of education at the University of Toronto.
The couple celebrated with the twins and about 60 friends and family members at a party at a golf clubhouse near their home.
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“It was a long time coming, but we never lost faith that this day would arrive,” said Nadarajah, 37, who works for a finance company as a liquidity risk manager.
“We saw a lot of miracles along the way,” he said.
Married for nine years, Rajendram said they always wanted to start a family, but she had trouble getting pregnant.
“It was a difficult time, and then my first pregnancy [in 2021] resulted in a miscarriage,” she said. “It was a pleasant surprise a few months later to find out that I was expecting twins.”
Rajendram said everything progressed normally until March 2, 2022 — her fifth month of pregnancy.
“I woke up that night experiencing some pain, which kept intensifying,” she said. “Kevin rushed me to our local hospital, and we were told that I was in labor and the twins were coming early.”
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One in 10 infants are born preterm in the United States, according to the Centers for Disease Control and Prevention. But a 2019 study by the CDC found that births before 28 weeks are more rare, with a mortality rate 184 times higher than that of full-term infants.
Rajendram said she was told that night there was almost no chance her twins would survive at 21 weeks and five days old.
“We were devastated, but we were also determined,” she said. “I felt in my heart that they would overcome their challenges.”
The next day, still in labor, she said she asked to be transferred to Mount Sinai Hospital in Toronto, where premature infants could be delivered and cared for at 22 weeks.
“They were born by natural delivery just one hour after the 22-week mark,” Rajendram said, noting that her daughter, Adiah, weighed 11.6 ounces, while her son, Adrial, weighed 14.8 ounces.
As the babies were whisked away to the newborn intensive care unit, “I had feelings of joy that they were here, but I also worried about the pain they might be in,” Nadarajah added. “Their skin was so fragile and thin that you could literally see through to their organs.”
The couple said their tiny twins faced many challenges, including difficulty breathing because of undeveloped lungs, digestive problems and bone fractures.
Even the simple act of peeling away surgical tape would take their skin off, Nadarajah said.
“We both knew there were going to be some difficult moments,” he said. “But we also knew we would be there for them every step of the way.”
He and Rajendram took leave from their jobs and spent the next five months commuting 60 miles roundtrip to the hospital so they could be with the twins every day, he added.
“There were many scary moments, especially early on,” said Rajendram, noting that the infants’ medical challenges included respiratory distress syndrome, brain bleeds, sepsis and pulmonary hypertension.
“The babies almost lost their lives several times during those first few weeks,” she said. “We didn’t want to sleep because we didn’t know if they would still be alive when we woke up.”
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“It was extremely draining — mentally, emotionally and physically,” Nadarajah added. “We became each other’s biggest support, and the doctors, nurses and social workers at the hospital helped us to get through it.”
In time, as the twins gained weight and overcame the most serious challenges, the couple said, they were able to relax and look forward to taking them home.
On Aug. 11, Adiah was the first to leave the hospital, with Adrial following one week later.
Both babies are growing and developing and will now receive checkups every four months to access their health and progress, said Prakesh Shah, pediatrician in chief at Mount Sinai.
“There is still a long way to go with brain growth, heart growth and lung growth because they came so early, but they’re doing remarkably well,” Shah said, noting that the twins will probably face challenges as they grow and learn to walk.
“We’re rooting for them every time they visit,” he said. “It’s extremely rewarding to see them succeed.”
Holding the twins at their first birthday party was a sweet affirmation of everything they’d been through, Rajendram said. She and Nadarajah each gave an emotional speech to express their gratitude to doctors, family, and others who helped make the moment possible.
“We don’t know what the future holds, but we have no doubt that Adiah and Adrial will continue to thrive and do well,” she said. “Someday, when they’re older, I can’t wait to tell them all about the day they were born.”