‘We Were Told to Consider Termination’: World’s Smallest Twins Survive After Premature Birth at 23 Weeks

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When mother and nurse Talia Keates, of Trowbridge, England, gave birth to twins at just 23 weeks into her pregnancy, there was every reason to expect that they might not survive.

Talia knew there was trouble at 17 weeks after a visit to the doctors, but it quickly became clear that their lives were on the line. “When we had the problems before birth, we were told to consider a termination,” she told The Sun. “Then [one of the twins’] waters broke early and they told me he may not survive and could die at birth.”

Three weeks later, Talia went into natural labor. “We were told that the babies may have died in the womb as they were without the waters for a while, so when I went into labor I didn’t know what to expect,” she told This Is Wiltshire.

Against all odds, she gave birth to the smallest surviving twins on record in England, Joe and Ashley, who each weighed less than 1 pound (approx. 454 g).

Born on April 16, 2019, in the Southmead Hospital in Bristol, Ashley weighed all of 14.2 ounces (approx. 403 g), and Joe, whose amniotic sac had broken first, weighed just 15.1 ounces (approx. 428 g). Talia Keates and her husband, Oliver, have been on an emotional roller coaster since week 20.

“It was devastating when I realized my waters had broken,” she told This Is Wiltshire. “You associate that with giving birth and I knew they weren’t ready for that.”

Turning down advice from doctors to consider terminating the pregnancy because of the 1 percent odds her twins had of surviving, Talia persisted. “When I gave birth to them and heard them cry it was such a relief, although I knew there was a long and hard journey ahead,” she said.

That journey included 129 days of intensive care in Bristol due to their underdevelopment. “They were tiny, they were probably the length of your hand and their skin was almost transparent and their eyes were still fused together, so it was quite a shock to see at first,” she told ITV.

Dad Oliver said, “You just wonder how can they survive when they’re that small and they look that vulnerable?”

The new parents didn’t get much time with their babies after birth, as the newborns were rushed straight to the NICU. Both twins suffer from chronic lung failure due to prematurity, and they had to be on constant ventilation until their lungs developed enough to keep their blood oxygen. Doctors told the couple that the first 72 hours were the most crucial.

“It was nerve wracking as we didn’t know what the outcome would be,” Oliver told the BBC. It wasn’t until week 5 that proud mom Talia was finally able to hold her twins.

“I wasn’t able to touch them at first,'' she said to The Sun. “They said that if you touch them it really distresses them because their skin is so thin.”

The twins’ doctor, Paul Mannix, knew they were in for a serious struggle, especially as Joe’s lungs completely failed at certain points, rendering him 100 percent ventilator dependent.

“But Joe and Ashley were real fighters and we were over the moon we could help them make such a miraculous journey to full health,” he said.

“We prepared for the worst but as each day went by it got a bit easier,” dad Oliver told the BBC.

The best day for the Keates was when they finally headed home with their twins—although they must remain on oxygen 24 hours a day until their lungs develop fully. The great news is that their prognosis for the future is very positive, with no brain damage or developmental difficulties expected.

“They’re happy and smiley and we just want to live as normal a family life as we can,” Talia told the BBC. She has been posting pictures and updates for others to follow along on Instagram at @miracletwinboys. “I want my story to give hope to others who find themselves in a similar situation,” she adds.