27 weeks

Have you ever wondered what it would be like to hear you are pregnant with twins? You lie in the doctor's room while he is moving a probe over your bare stomach and suddenly he looks intently at the screen. You hear a noisy sound - like the beating of running horses thundering through a field... and then he smiles and shows you the pulsating heart of your unborn baby. You are over joyed and excited... and then he shows you another heart beat. You suddenly feel a little light headed. You heart is racing and your mind is numb and ecstatic all at the same time. You were prepared for one... not 2!

Cassandra and Ruan had all the excitement and joys of pregnancy and then the amazing news that she was expecting twins. Unfortunately pregnancy with mulitples can be very tricky and they soon ran into some obstacles. At 23 weeks Cassandra experienced intense pain in her abdomen and was rushed to hospital. She gave birth to a little baby girl. Miraculously, her sibling remained in the safety of their mother's womb. The baby lived for 8 hours. There was no birth photographer present and sadly her short life was not documented in pictures except for a few cell phone pictures taken by dr. Joubert... 5 weeks later my phone rang on a Tuesday afternoon.

"Can you come in for an emergency c-section in an hour?" dr. Richard Joubert asked. His normally pleasant voice sounded strained. "I don't know if the baby will live... "

He gave me a quick rundown of the situation and I grabbed my camera and drove to the hospital, praying as I went. Cassandra had gotten an infection and she was sick enough to make the emergency c-section their only option. The whole theatre complex was running around in a nervous frenzy, organised and structured, following protocol to the letter, double checking every piece of equipment and talking in hushed tones. The paediatrician came into theatre with sweat glistening on his forehead. I had worked with him countless times and I have seen him in stressful situations before, but worry was etched on his experienced face. He scurried around and gave a few orders before turning to me.

"Please Lizelle..." he started

"You tell me what I can document and I will do that, I know this will be hard", I replied

"Take as much pictures as you can during the surgery, but you can't photograph when I intubate him." he said apologetically.

"No problem, I will clear the photographs with you before I release it. You have the final say. If I get something I shouldn't give to the parents, we can delete it. As it is, the photos might be all they may have if something goes wrong today."

The heaviness in the room was palpable.

Another gynaecologist came by while we waited for the patient to arrive. "Tiny baby..." he said with a sad face, "good luck." He shook his head as he left.

The doors opened and Casandra was wheeled in. Ruan had changed into scrubs to join her in theatre and there were deep shadows in his eyes. His wife had been in hospital for over a month already and he was tired. And worried. She had a light, friendly personality and smiled bravely at me as I explained to her what will happen next and that I will be her husband's theatre tour guide in the next hour, showing him where he can stand and sit while the medical staff go about their duties as undisturbed as possible. I have grown into the role over the past year and a half while working with dr Joubert and we have formed a comfortable rhythm that is paced by a glance from him or the assisting doctor.

We discussed what will be photographed and who the medical team is. I assured her that she had the best doctors waiting for her in theatre and then we wheeled her to a large theatre for the c-section. Everyone smiled and attempted to keep the atmosphere as light as possible, but there was no denying the densely packed dread in the air.

C-sections tend to be less bloody than most people expect. One would think that having your abdomen cut open wil result in blood spewing all over the place, but these doctors have performed thousands of operations and has it down to an art. While there is blood loss, it is not nearly as dramatic as is expected... accept in this case. Blood gushed out of the incision and pooled around the surgeon's feet, a sight rarely seen. Something was very wrong.

Cassandra looked at me with worried eyes as her complexion paled. She couldn't feel anything due to the spinal anaesthetic but she was feeling the effects of the blood loss and infection.

The baby's head was the size of a tennis ball and his tiny body disappeared in the doctor's hand. My camera shutter opened and closed in rapid succession as I attempted to capture the miracle of life in the seconds available to me. Delayed clamping. The cutting of the umbilical cord. Close ups. Wide shots. And then it was over. My window had closed. The baby boy was rushed to a corner where the baby warmer and oxygen waited. A faint cry came from him while the paediatric team worked.

"Is he ok?" his mom asked me, the least qualified person to answer.

"Can you hear him cry?" I asked. "If he is crying, it means he is breathing."

"I don't feel so good. Did I lose a lot of blood?"

"You are having a c-section, blood loss is expected." I replied, glancing at the assisting doctor.

"Will I need blood?" Cassandra asked. Still looking at me.

"Not now, but later", the assisting doctor answered with a smile that did not quite reach her eyes. She glanced in my direction, her eyes having a conversation of their own. Keep talking. Keep her calm and distracted. We need to work to get this situation under control.

I forced a smile and talked while keeping an eye on the paediatrician's bent figure. From where I stood I could see the baby's foot, smaller than one digit of my finger. How would he ever get through this? I prayed and took a wide shot of the room. In one corner the paediatrician was fighting to keep the baby boy alive, on the other side the surgeons kept their heads down and worked to save the mother's life, and in the middle stood the lone figure of the new dad. Ruan touched his wife's hand and looked over at the huddle of people in the baby corner. He stood up, then sat down... And finally he just put his head down into his hands, no doubt praying desperate prayers. His whole world was hanging in the balance. There was a very real possibility that he could lose them both. My heart broke as I watched him.

Minutes ticked by. The baby was rushed to NICU. He weighed in at 990 grams. Cassandra was transferred to high care following the surgery. Another emergency had come in and I was needed in theatre. An hour had passed when I found Ruan waiting outside the NICU. He was still waiting for news. Just then the paediatrician came out and talked to him before taking him to see his wife. Their baby was alive and would be under the watchful care of the NICU staff - a specialist group of nurses and doctors who would monitor him day and night until he was big enough and healthy enough to be discharged.

I caught up with Cassandra a few weeks later outside of the NICU on prematurity day. She was radiant. Her baby boy was growing and well over 1.2 kilograms. He was getting stronger and growing fast. Looking at the pictures from the event it is hard to imagine how dire their situation was. I pop in every few weeks to take a few picture of him to document his growth. This afternoon was one of those days. Cassandra sat in NICU holding her boy. She is one of the most beautiful sights to behold, happy and content, wearing a black dress with no sadness surrounding her. The worry and tiredness had left her eyes and she is head over heels in love with the tiny human in her hands. They had decided to name him Zaiden. He is 1.7kg now and had his first bottle recently. He has beautiful eyes and looks like his daddy. If he keeps feeding well and gaining weight he might be discharged when he reaches around 2kgs. He is a miracle boy.

This family has been through much but the best days of their lives are ahead of them. I don't know what the future holds but Isaiah 60:20 comes to mind when I think of them. "Your sun shall no more go down, nor shall your moon withdraw itself, for the Lord shall be your everlasting light, and the days of your mourning shall be ended."

I look forward to seeing what this little boy does to the world. He is brave and strong and the mere fact that he is alive is proof enough that he destined for great things. His tiny life has made ripples and those ripples become waves that will change the tides of people's lives. I am so hopeful and excited for the beautiful days that are coming.

Until our next adventure!


Lizelle and Charlotte