Navigating a first pregnancy and managing prenatal complications is stressful for moms (and dads) any time. Navigating a first pregnancy, carrying twins, and managing prenatal complications amidst a pandemic is a whole different ballgame. Nyah and Dan of Northfield experienced this firsthand.

“I was very sick with hyperemesis gravidarum (extreme, persistent nausea and vomiting),” Nyah said. “I had to receive fluids twice a week because I was vomiting so much. I was admitted to Concord Hospital in January 2021, because I lost 30 pounds. I was not eating, I was dehydrated, and I had low potassium. When I was released from the hospital, I received total parenteral nutrition (TPN), which is fluid given intravenously, through a PICC (peripherally inserted central catheter) line.”

Following discharge from the hospital, Liz, a registered nurse with Granite VNA’s Pediatrics and Maternal Child Health team, visited Nyah weekly to check her lab work and her PICC line, and to provide routine prenatal assessments and additional prenatal education.

“Luckily, I was able to work from home,” Nyah said. “I never left the house unless I had medical appointments. I didn’t drive during my pregnancy because I was so sick – either Dan or my mom drove me. And Liz visited me in our home.”

During Nyah’s pregnancy, physicians informed her and Dan that there may be complications. The babies were diagnosed with intrauterine growth restriction, and the maternal fetal medicine specialist was concerned that the twins may have genetic disorders.

“The day we were told their genders is the same day we were told that they were really small,” Dan said. “Physicians said there could be complications, issues, or they may have Down syndrome.”

“Right before giving birth, I was having special ultrasounds every week to check the babies’ growth and their growth had slowed down,” Nyah said. “They weren’t moving as much as they were supposed to, and my amniotic fluid was low, which could have been dangerous for the twins.”

Giving birth
On July 1, 2021, Nyah gave birth by emergency cesarean section to twin babies, Evelyn and Samuel, at 35 weeks – five days before her scheduled C-section. Samuel weighed three pounds, nine ounces, and Evelyn weighed three pounds, three ounces. Both babies spent the next 26 days in the special care nursery at Concord Hospital. On July 27, 2021, Nyah and Dan finally brought Evelyn and Samuel home.

Nyah’s and the twins’ medical appointments seemed to be constant, especially over the first few months. The family traveled all over New Hampshire to multiple Dartmouth-Hitchcock Health facilities, a specialty clinic in Somersworth, and as far away as to Boston Children’s Hospital.

Evelyn has a heart murmur that, according to her cardiologist, may go away and correct itself or may eventually require surgery. Samuel had cranial surgery on November 1, 2021 and must wear a special helmet for six months to help correct his condition. He also has a benign hemangioma tumor which is being monitored, and he is on medication for the tumor that must be given twice per day. Evelyn and Samuel also see a swallowing specialist/speech pathologist, and a nutritionist. Evelyn and Sam have gotten so much better, but there were times they wouldn’t take their bottles,” Nyah said. “Liz would come and she
would assure me that they were fine; their weight was fine.”

Liz also set up community resources to support the twins’ nutrition, feeding, and swallowing, and has provided the family with much-needed support and reassurance along the way.

“Having Liz’s support and guidance has been so helpful,” said Nyah “She’s been our connection for everything.” In addition to Liz, the family is supported by other members of Granite VNA’s Pediatrics and Maternal Child Health team.

“Evelyn was refusing to turn her head from right to left, so Brittany, a physical therapist, showed me different ways to lay her down to help work on that,” Nyah said. “Sam had colic and Brittany taught me how to help relieve it.” Granite VNA’s Pediatrics and Maternal Child Health team has played a key role in Nyah’s prenatal and postnatal care, and in helping Evelyn and Sam to get a strong start. Liz’s, Brittany’s, and the rest of the team’s ongoing support of the entire family further cements

Granite VNA’s critical role in providing services and programs for people of all ages, from birth to end-of-life, throughout the 82 communities we serve.

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