Triplets are not something you see every day.

But that all changed on February 7 when the Cuevas family welcomed baby girls, Amelia, Florence, and Olivia, to the world. The trio are the first triplets born at Kaiser Permanente Fresno’s birthing center in nearly two decades.

“It’s a gift from God, you can say, or miracle,” said father, Diego Cuevas. “It was a real surprise that doesn’t happen too often. Very rare. We’re very excited.”

Born at 34 weeks and weighing in at approximately 4.5 pounds each, the triplets faced potential challenges that are fairly common with premature births. However, thanks to the thorough and thoughtful planning of the KP Fresno maternity team, these three new arrivals are off to a thriving start.

Planning and Coordination

David Aguilar, MD, pediatric hospitalist at Kaiser Permanente Fresno, helped lead the planning and coordination efforts that resulted in the healthy delivery of all 3 babies.

“When it comes to teamwork, it’s not just about doing your part, it’s also about knowing what everyone else’s part is so we can all do what is needed,” Dr. Aguilar said. “This highlighted the extraordinary abilities of our doctors and nurses, and how simple things like communicating what the needs are helped to take care of a unique and challenging event.”

There are potential challenges with just one premature birth, let alone 3 at one time. Recognizing the potential for greater challenges, the team began detailed planning well before delivery day.

Three teams of providers were assembled — each of which included a neonatal intensive care unit nurse, a labor and delivery nurse, a respiratory therapist, and a pediatric hospitalist. Each baby had a dedicated team ready to meet her immediate needs and respond to concerns.

Two clinical pharmacists were also brought in to ensure any necessary fluids and resuscitation needs would be immediately available. Finally, a nursery team was established to receive the babies.

With staffing set, rehearsals began. Teams plotted out the diligent choreography of delivery day to maximize efficiency and determine the quickest access to care and resources.

Dr. Aguilar said they accounted for every little detail, such as knowing where people would stand and counting steps between the operating room to post-op to determine which room would be closest in case of an emergency.

A healthy arrival

On February 7, the Kaiser Permanente Fresno team put the planning into practice.

With nearly 20 staff in the operating room, the dance began. As the babies were born, their times of birth were announced, and they were handed to their dedicated team for care. The three newborn sisters quickly received oxygen, had their lungs checked, and intravenous fluids placed.

Within 20 minutes of their births, all 3 babies were stable and in the nursery. Within 40 minutes, all were doing well.

“Everything that could go right went right, thanks to the planning involved,” Dr. Aguilar said. “It really makes you proud as a provider that we are able to take a group of people that have never encountered this type of situation before, and through communication, coaching, and planning were not able to just do it, but do it well.”