Newsworthy

Pregnancy runs the gamut of emotions. It can be an overwhelming, joyous, scary experience for many women. In every case, it’s life-changing. For 20-year-old Rayana Johnson, it was all of the above.

On November 13, 2023, 60 minutes after clocking in for her shift at a Topeka home improvement store, Rayana was fighting for her son Elijah’s life after delivering him in the bathroom. 71 minutes later, she gave birth to his twin brother, Jeremiah, at Stormont Vail Health Hospital in Topeka. What happened to Rayana is nothing short of unbelievable, but it’s just one piece in her incredible journey of motherhood.

The Journey

As a devout Christian, Rayana initially tried to hide her pregnancy from her family. One week after her initial pregnancy test, Rayana took a third one, which also showed positive. As she cried in her car in front of their family’s home, Rayana’s younger sister walked outside and found her.

“She saw me in the car crying my eyes out after another pregnancy test. She just started laughing when I showed her the three tests I took.”

Rayana’s mother soon learned the news, too – but not from Rayana’s sister. Like many, the beginning of pregnancy comes with sickness and fatigue.

“I didn’t want to do anything but lie in bed because I couldn’t keep anything down. My mother kept trying to give me medicine, but I couldn’t take any of it. She kept asking why, so I had to tell her. When I did, she told me she dreamt the Lord showed her I was pregnant – she was just waiting for me to come out and say it for myself.”

Twin pregnancies classify women as high-risk due to higher risks of premature birth, gestational diabetes, and other conditions. But besides daily morning sickness, severe lethargy, and smell sensitivity during her first trimester, Rayana believed she was having an otherwise normal pregnancy.

Rayana’s high-risk pregnancy doctor at Stormont Vail opened her eyes to the importance of strong relationships between patients and their providers.

“It’s important to have a bond with your medical team and those who are helping you. I had the biggest connection with my high-risk doctor. She opened up and made a safe space that made her easy to talk to. She would go in-depth about stuff that’s going on and didn’t seem judgmental about anything I brought up to her.”

Rayana’s doctor diagnosed her with a short cervix, a condition that increases the risk of preterm birth. Her doctor closely monitored her condition, and it remained a persistent concern throughout her pregnancy. Two weeks before November 13, her sons’ birthday, Rayana’s physician prescribed progesterone tablets to reduce further shortening and her twins’ risk of premature delivery. But, as Rayana realized two weeks later, it was too little too late.

The Birthday

Rayana’s contractions began on November 12 – just 24 weeks into her pregnancy. At the time, she didn’t realize what they were. She started feeling intense stomach pains but brushed them off as she was barely halfway to term. She went to bed that night, hoping that rest would help. But when she awoke in the morning, the cramps were still happening – and, even more worryingly, in greater frequency.

“I looked online and it was like, ‘It’s Braxton Hicks.’ I guess contractions at 24 weeks are common in twin pregnancies. Most of what I read said I shouldn’t be concerned unless they’re super painful – which mine weren’t, and they would happen and then quickly stop. So I went to work.”

Rayana, who works for a home improvement store, clocked in for about an hour before the contractions started occurring at a higher frequency. On her way to find a manager and ask to go home, Rayana felt a sudden urge to use the restroom.

A sharp pain in her back struck her when she reached the bathroom. Sitting on the toilet, she reached down and recoiled in panic as her fingers brushed her first son’s head.

“As I stood up, the toilet was flushing as he came out, so I had to hurry and catch him. I just looked at him in amazement because he was so small and purple, and his arm was just waving around. I was confused – was he alive? He was so purple – the kind you only see on TV. I had so much adrenaline ¬- I knew I had to just focus on calling 911.”

As she waited for help, a customer alerted her managers, who administered CPR to Elijah until the ambulance arrived. In the ambulance, a distraught Rayana broke down sobbing, spinning from the shock of delivering her first son in a public bathroom at her job.

The Fight

At Stormont Vail’s Topeka Hospital, the care team admitted Rayana to the Emergency Room and immediately took Elijah to a corner of the trauma bay for treatment.

“That’s when it got really scary because I couldn’t see what was happening with all the nurses and doctors gathered around him. I knew they were working on him, but I didn’t know if they were resuscitating him.”

As the team worked, Rayana did the only thing she could do – focus on delivering her other son. One hour and 11 minutes after she saved Elijah’s life in a Home Depot bathroom, Jeremiah entered the world.

The care team quickly took Jeremiah to the ER. They moved Rayana to the Neonatal Intensive Care Unit (NICU), Birthplace where, for four excruciating hours, she agonized about her sons ¬- especially Elijah, who was clinically dead for 26 minutes.

“They had to give him two shots in the lungs – the first one didn’t work, so they gave him another six minutes later, and it worked. It started his heartbeat. When I finally saw the boys, they struggled to breathe and were tiny.”

Both boys were born with a hole in their heart, a condition known as patent ductus arteriosus (PDA). In addition, they both had Grade 4 intraventricular hemorrhage (IVH) of the newborn, or brain bleeds, a condition that occurs most often in premature infants. After physicians downgraded Jeremiah’s condition to Grade 3, Rayana’s care team told her he might have a fighting chance. However, Elijah was unlikely to survive more than 72 hours.

Rayana and her sons’ first night in the NICU was nothing short of exhausting. From 10 p.m. to 7 a.m. the next day, Rayana, reeling from the day’s events, lay awake listening to the heartbreaking sound of Elijah’s ventilator.

“I just started praying to God. I was just so mad at myself because I should’ve gone to the hospital when I was having those contractions. I shouldn’t have listened to the Internet. I don’t think I’ll ever forgive myself. You always have that mom guilt, but it feels so much worse because all those things leading up to the day of the birth were from my contractions. I should’ve gone to the hospital as soon as I finished babysitting. There’s just so many times when I should’ve gone.”

The Decision

The beginning of Rayana and her sons’ NICU journey was one of the most challenging times of her life. But it was also a transformative experience that opened her eyes to the true depth of her strength and resilience.

Rayana knew that even if her boys lived, they would face numerous lifelong challenges. Weighing her sons’ chance of survival against their future quality of life and facing an increasingly overwhelming and unclear future, Rayana spent the rest of the day praying and reflecting alone.

The next day, she returned to her son’s room resolute in her commitment to her sons and their survival. Rayana told her care team she wasn’t giving up on them. With her decision final, the family and their practitioners spent the next few days preparing for the next stage of their journey.

The Promise

Given Elijah and Jeremiah’s conditions, the care team transferred the boys from Stormont Vail to its affiliate, Children’s Mercy Kansas City, to receive specialized care and extensive surgical needs for the PDA and IVH. Unwilling to endure another separation, Rayana made her temporary home in Kansas City, Missouri, at the neighboring Ronald McDonald House, where she stays five days a week.

At the time of writing, the boys remain at Children’s Mercy Hospital, where, against all odds, they’ve made remarkable progress under the care of the Children’s Mercy team. Rayana, who held her sons for the first time on January 1, 2024, sees new developments and improvements every visit.

“Since they’ve reached full term, it’s so much fun! We get to do so many activities. They both love sitting up, bath time, playing on the ground, tummy time, and doing different baby stuff. Seeing them grow, play with their toys, and get dressed is so fun. I love their outfits!”

Of course, Rayana recognizes the long road ahead. Despite the challenges, she remains hopeful and eager for the day she brings her sons home.

“As a mother, I want to give them everything they want. I want to be someone who’ll always be there for them.”

Rayana’s words echo those her grandmother shared when she came home from the hospital.

“She said, ‘I’ll always be there for you. I want you to talk to me about whatever you’re going through and how you feel you’ve changed since you went through so many different things in one year.'”

From the moment her first pregnancy test showed positive, Rayana has relentlessly worked to become the best mother possible. Since the beginning, her focus on giving her sons a great life once the three return home for good remains unwavering.

Her top priority for her sons is ensuring plenty of opportunities for them to be happy, learn and experience new things, and reach their goals while supporting them through it all.

The Lesson

Looking back, Rayana wishes many things had gone differently, starting when she learned about her pregnancy. Although she initially hid it out of fear of judgment, her family’s support subverted her expectations in the best possible way. Their reaction and subsequent support taught her the importance of surrounding herself with others to advocate for her when she couldn’t for herself.

“I shouldn’t have waited to tell my family. My parents are so understanding, especially my dad. Right after I told my parents, my dad thought it was the funniest thing ever. My mom was just crying. She was just so happy.”

She also wishes she had more conversations to learn about urgent maternal warning signs so she could discuss her concerns with her provider and make informed decisions.

“I wish I knew that my contractions weren’t just regular cramps when I was already eight centimeters dilated. I’ve heard my cervix could have been sewed or I could’ve delivered one before the other since they had separate sacs.”

Rayana believes her story can help other young parents in her situation.

“You must keep faith and believe in your kid and yourself.”

Find Education & Resources to Support Black Maternal Health

As we strive to improve access to comprehensive perinatal and reproductive healthcare, we created a resource directory to empower expectant mothers with education and support. We encourage anyone to support this initiative (and our neighbors) by learning about these resources and sharing them with your community.