A Successful High-Risk Birth: The Baiera Family’s Story

The Baiera family’s birth story unfolds like a movie we would love to see. It features a hopeful young family, a daunting obstacle to overcome, and a happy ending.

But it wasn’t a Hollywood creation — it was real life for Vince Baiera, his wife Parissa, and their twin sons, Rocky and Leo.

Their memorable story represents a case of many things going right over five long months, ultimately resulting in two healthy babies. We’ll look at what happened, how they and their care team managed such a difficult case, and whether we can learn from it to improve maternal outcomes for other high-risk cases.

How Rocky and Leo’s Story Began

New dad Vince Baiera is no stranger to healthcare. He started his career as an ICU nurse, then became a travel nurse, living everywhere from the Virgin Islands to Las Vegas and the Carolinas before settling in his current state of California. Eventually he transitioned out of nursing and into education, where he taught at the college level, then moved into the business side of healthcare.

Baiera is also a published author and entrepreneur who runs Step2Health. He currently serves in a principal role in the Solutions Group at Relias, where he provides a clinical voice for post-acute healthcare through consulting, sales and marketing support, publishing, and public speaking.

After being married one year, the Baieras were excited to find out they were expecting during the summer of 2021. Aside from severe nausea, the pregnancy began uneventfully until Parissa experienced a subchorionic hematoma (vaginal bleeding). They learned it was nothing to be alarmed about and returned home relieved.

Soon after that, however, they had another scare. Hoping it was again nothing major, they learned at their appointment a few days later that a serious complication had occurred. One twin’s water had broken. They had a preterm premature rupture of the membrane (PPROM) at just 14 weeks.

Entering the Realm of a High-Risk Pregnancy

Suddenly classified as having a high-risk pregnancy, they began seeing a specialist — a perinatologist. Baiera recalled the agony of hearing about what might happen and the choice they had to make.

“It was really hard,” he said. “The doctor told us, ‘At 14 weeks, the babies aren’t viable. You have a couple options — you can terminate the whole pregnancy, or there might be a way to do something called a selective reduction and then carry on with the other pregnancy,’” he recalled.

The Baieras faced this difficult choice for a few days and thought they might need to proceed with the selective reduction even though it meant losing one of their babies so that the other could survive.

But it turned out that their perinatologist didn’t recommend that route due to the risk of the procedure to the other baby. The doctor cautiously recommended continuing on and monitoring the twins closely. It meant that Parissa had to go on complete bedrest for the rest of the pregnancy.

A Remarkable Outcome

Incredibly, both twins continued to grow and develop, first at home, and then in the hospital after they reached 22 weeks. But because of the continuing loss of amniotic fluid due to repeated ruptures, the Baieras worried that Rocky would experience complications such as compromised lung development and other issues.

Parissa, a dentist at a large nonprofit homeless shelter, went on disability leave. It was no longer possible to work with the imminent risks of going into labor or contracting an infection. On top of all the sacrifices they made, the stress and worry were constant during their long and challenging hospital stay.

Despite the hardship, Rocky and Leo Baiera were born healthy, weighing 3 pounds, 6 ounces each on January 27, 2022.

What Went Right and What We Can Learn

Vince Baiera reflected on the course of events that led to his sons’ births and pointed to a few key moments that helped them achieve a positive outcome.

Take the Time To Consider All the Options

The first significant event in the Baieras’ case came from the fact that the membrane broke on a Friday, and they didn’t go to the ER that night. Uncertain, they waited to see their doctor the following Monday. Since Parissa hadn’t gone into labor, nor had she gotten an infection, and both twins had good heart rates, they had the option to continue as they were.

• While the Baieras will never know for sure, a visit to the ER could have resulted in a different outcome. In this case, a wait-and-see approach, while not providing a short-term resolution, was the option that led to the best outcome in the end.
• Their doctor’s cautious optimism and hesitancy to intervene also paid off, possibly saving the lives of both babies.

While it was not a typical course of action to take after a premature membrane rupture, a less common, non-invasive option eventually became the best option. The Baieras made a fully informed decision that aligned with their wishes based on good communication with their healthcare providers.

Examine the Resources Needed

The Baieras acknowledged that they didn’t have other children at home to care for that would have made their long hospital stay even more challenging. They were also able to take time away from their jobs, and they had good health insurance coverage.

On top of that, they expressed gratitude for the stellar care team at Sharp Mary Birch Hospital for Women & Newborns, which delivers more babies than any other hospital in California and was only 15 minutes from their house. They also had a solid support system of friends who helped with meals. And they had each other.

• It is a documented reality that health outcomes vary due to social determinants, factors such as community resources, family support, income, and access to health care.
• It is important to consider how to provide equitable resources for patients regardless of where they live and what resources they have so that everyone has an equal opportunity to achieve the best health outcomes.

Felicia Sadler, MJ, BSN, RN, CPHQ, LSSBB, Patient Safety and Quality Executive at Relias, explained that providing equitable care for all patients may mean different things for different patients, hospitals, and populations.

“Equitable care means not varying the level of quality or health care in the delivery process. Healthcare systems should be mindful of the unique needs of patients as individuals. There should be no variations in the level of care based on personal attributes or characteristics, ethnicity, geographic location, or socioeconomic status. It’s important for system leaders to know and understand the patient population they serve, to identify and analyze where there are disparities and opportunities, and to begin to address and close those gaps.”

A deep understanding of who you serve, the implicit biases that could come into play, and the determinants of any disparities should lead to developing strategic plans to address them.

Prepare Your Care Teams for Everyday Excellence

Consistently for five months, the Baieras’ care team provided the communication, support, and services they needed for their successful care journey. Through regular ultrasounds and monitoring of the amniotic fluid, as well as the physical and emotional support they needed to get through each day, the Baieras will be forever thankful for the care they received.

• The Baieras’ prior professional experience and knowledge of healthcare afforded them a level of comfort during their ordeal that many patients don’t have. For those who need help adjusting to the requirements of the care setting, we look to our care teams to help educate patients, manage expectations, and provide consistency that they can rely on.
• Highly educated, well-trained care teams can more reliably provide a standard of care for patients across care settings. With high levels of training, they are positioned to achieve better patient outcomes in a greater percentage of cases.

Working To Create Good Outcomes

The Baieras — and even their doctors — can’t completely explain how the twins made it so far in the pregnancy, arriving at full term and heading home after less than three weeks in the NICU. They didn’t need advanced technology or new treatments to do it. They readily acknowledged that every situation is different, and not everyone experiences the outcome they hope for.

By carefully considering their options, harnessing the right resources, and working with a well-prepared care team, the Baieras increased Rocky and Leo’s outlook for having the best possible start in the world and the enduring joy and gratitude of their parents.