Danika Jazmine Violet Smith and Kamara Saskia Smith.

I was 21 years old with a 9 month old son, Zakary when my partner and I decided to give Zak a sibling. I fell pregnant straight away (as I did with Zak) and I had a strange taste in my mouth before I had even missed my period. I knew I was pregnant and did a test in the pharmacy. The pharmacist said “it is a very faint positive so you will need to wait a week to do another”. I didn’t need to. I was exhausted! I asked my GP to test me for anaemia early on as I became anaemic when pregnant with Zak. The blood test came back fine! At my first ultrasound, I was already 16 weeks pregnant with a nicely rounded tummy, just like I had with Zak. The ultra sonographer did her thing and said “baby is good...” With that, my partner said “is that another one” and pointed at the screen. Confirmation from the ultra sonographer revealed we were indeed having twins. Given that my partner had identical twin daughters with his first wife... he clearly knew what to look for! I asked if they were identical or not but was told I was too advanced to see although on my notes I noticed a comment that said “very thin dividing septum”. I was sent with a prescription for folic acid and iron tablets. No wonder I was feeling exhausted! I couldn’t stop smiling.

I had regular scans and a healthy pregnancy. When I reached 36.2 weeks gestation, I had what was to be, my last ante-natal appointment. An ultrasound showed both the babies were head down and it was a waiting game for labour to begin. My Obstetric consultant actually said I bet you’re knackered, aren’t you?” to which I said I was... I had piled on 56lbs taking me from 8 stone up to 12 stone and with a rather hyperactive 18 month old Zak  to run around after too... He then went on to say that he wouldn’t take me in to have the babies yet because I would end up with them both in the special care baby unit (SCBU) with immature lungs. Naively – I took his ‘expertise’ on board and went home.

3 days later, I was rather uncomfortable and was certain these babies would be making an appearance rather soon. I remember struggling to walk around the supermarket that evening but thought it was a ‘twin thing’. The following day, a Saturday, I went into our
town with my mum to start looking at baby stuff as I hadn’t bought anything incase I jinxed the pregnancy. I got pointed at a lot as my tummy was large but only seen from the front or side. My mum made a comment saying she was going to stick a note on my back to say ‘yes, I am carrying twins’ because of the stares.. I found it amusing... I’m only 5ft 4ins so I looked like I had a bass drum from a marching band stuffed up my dress!

That evening at home, it was a quiet evening as my twin stepdaughters’ were staying with us. They were 7 years old at the time and alongside Zak, we chilled out. At 2 am on Sunday 5th May 1996, I woke up knowing labour had started. I rang the hospital an hour later and was told to go into labour and delivery. I rang my mum to look after Zak, Kim and Natasha and then we headed to hospital. I was in absolute agony but excited to be meeting my babies. Zak had been 9lbs 1.5oz at birth two days early and a face to pubes position making the labour very painful in my lower back.. The twins however were something else! They made me really struggle to walk. I was asked if I wanted to get in to a wheelchair but stubborn me point blank refused and walked. Once I got into the delivery room, I vomited all over the floor (lovely!) It was just past 4am. Once cleaned up, I got into a hospital gown and up onto the bed for the heart monitors to be attached. One midwife said it was unusual for twins to have the same heart rate. High on gas and air, I was vaguely aware of a portable ultrasound machine being brought to the bedside. I remember an urgent voice saying “we need to get you to theatre NOW”.. I was shaved and catheterised and cannulised in minutes  before being wheeled to theatre for an emergency caesarean section. The last thing I remember was being asked if I knew what sex the babies were. My answer was “boys”... (I was certain.), then, it all went black. I woke up not knowing where I was. I then looked at my stomach which was drastically smaller and I quickly remembered. Beside me was my partner. I looked at him and said "one of the babies have died, haven’t they?” and he confirmed one had. I asked him if they were boys or girls and I was shocked when he said both girls. I asked where the other baby was and he said “she’s in SCBU, she’s very pale but was alert and I have held her”. I asked if there were any photos and I saw that there was a brown envelope on top of a TV that was in the room I woke up in. In that envelope were 2 photos. Taken not long after birth.. One showed my angel baby, who was dark purple and one showed my surviving baby. A consultant came in to the room and apologised that what had happened had done so. He explained they had tried to revive the baby for 28 minutes but it was unsuccessful. He also explained that nobody knew what had happened - whether I had bled into the babies or them into me... I was told I had lost a lot of blood too. A midwife came in and asked if I wanted to see the baby that had died. I said yes but was scared to hold her. It was only after my partner held her that I knew it was ok to do so. I inspected her and other than some patches of skin that had come away and blood trickling from her nose, she was absolutely perfect.

I insisted on ringing my mum and when I rang she excitedly asked what sex they were etc. I just said 
“2 girls but one has died and the other is in SCBU”... she then said she would drop Kim and Natasha off home and would be up the hospital”. I don’t quite remember the sequence of events in terms of whether my parents and in laws came to see us before I was wheeled down in my bed to see my survivor or after. I also don’t remember my angel baby being in a cot next to me when my parents arrived but my mum says she was. I don’t know how long they stayed for either.

We gave the girls their names...My angel baby is called Kamara Saskia. She weighed in at 6lbs 8 oz. My survivor is called Danika Jazmine Violet. She weighed in at 6lbs 10oz.

I was a human pin cushion with phlebotomists drawing blood quicker than a vampire. The day following the birth, we had them both blessed by the hospital chaplain. It didn’t occur to me that Danika wasn’t expected to survive but apparently, she was in such a poorly condition that experts predicted she wouldn’t survive beyond the first 72 hours. Danika had to have a total blood 
transfusion and platelet top ups. She was sedated and on CPAP as she had seizures at birth and was fighting everything. She had renal failure also. After a week in intensive care in SCBU.. Danika defied the odd and was awake, breathing on her own and graduated into the nursery of SCBU. I remember saying to my mum one
day that I thought Danika had suffered brain damage. She poo-pooed it. Same with my partner. Every couple of days Danika had cranial ultrasounds but she had too much cerebrospinal fluid around her brain to see. Exactly 3 weeks after the girls’ birth, I was pulled into the staffroom in the SCBU. I was then told that Danika’s brain was full of cystic areas where her brain had died off. I cried for 20 seconds... more in relief that I knew. I then went straight back to Danika. Meanwhile, we held
Kamara’s funeral and got her post mortem results. The post mortem revealed Kamara & Danika were victims of acute Twin To Twin Transfusion Syndrome (TTTS). Danika was my recipient and over 50% of her blood supply had been transfused into Kamara via the placenta. Kamara, the recipient had died from a fatal heart attack as her body couldn’t cope with the extra blood supply. She had died approximately 12 hours before they were 
born. Because Danika then had a drastic reduction in her blood supply, she suffered severe Hypoxic Ischemic Encephalopathy (lack of blood & oxygen to the brain)
Thrombocytopenia (lack of platelets) and the renal failure as previously mentioned. Had they have been born 24
hours before; they would both be here, alive and healthy.
Fast forward 17 years and Danika is still with us. She has profound multi-complex disabilities and is life limited. She has the cognitive and physical ability of a 0-3 month old baby and needs 24/7 care She has been in and out of hospitals for the whole of her life. BUT.. .she is THE
most gorgeous and happiest girl I know. She suffers with numerous respiratory infections due to her inability to move and it will ultimately be one of those that takes her. But she has a quality of life that she enjoys... She must 
enjoy life to beat so many adversaries. She is an absolute privilege to have. However, if I was aware my girls were identical and knew about TTTS then I would have 2 very healthy 17 year old daughters with me. Thank you for reading x

Donna Palfrey
UK