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Their days are filled with the highs that come from holding the babies who weigh less than 3 pounds, and the lows of helplessly watching a baby whose foot is the size of his mother’s pinkie finger getting a blood transfusion.

“You want to protect your kids and it’s out of your hands,” Nicole said. “You have no control.”

The Kivistos, who have a 2-year-old daughter who was carried to term, gave birth less than two weeks ago to three boys almost 10 weeks premature, Lucas, Jayden and Cade. Now their days are spent in the NICU at St. Alexius Medical Center waiting for their boys to gain weight and ward off infection so they can go home, maybe by Christmas.

“That would be the best Christmas present we could ever have,” Nicole said.

Matt and Nicole found out in June that she was pregnant with quadruplets during an exam that was supposed to be for Nicole’s peace of mind.

“We were having indications that something wasn’t right,” Nicole said. “The nurse basically told me it was nothing major. So I told Matt not to come. Then I found out we were having multiples.”

Nicole was taking Clomid, a drug that helps women ovulate, but her gynecologist-obstetrician, Mid Dakota Clinic’s Dr. Jan Bury, said the chance of having multiples while on the drug is 5 percent — the same percentage as people who aren’t taking fertility drugs who have multiples.

About a month after her first appointment, Nicole and Matt found out one of the babies had been absorbed. Bury said absorption is not common for a pregnancy of multiples.

In the Kivistos’ case, their fourth baby didn’t have a heartbeat when Nicole went in for her second exam, and the fetus was absorbed back into her body.

“The biggest thing for me was when we lost one,” Matt said. “On the same token, there are much better odds for the mom and babies as a whole with triplets. It was very devastating, but at the same time we knew it would be better.”

From the moment in June when Matt and Nicole found out they were going to have premature babies, they tried to brace themselves for the emotional journey that was ahead.

A coworker of Nicole’s put her in touch with a family that had premature triplets a year ago to help prepare her and Matt for what was in store. The Kivistos visited the family and their three boys to see what life was like a year later.

“Talk about reassurance,” Nicole said. “It made us realize that we could do this. It made me realize that it really is a miracle.”

Matt said the biggest way the family helped him was in preparing to see their babies in the NICU for the first time. To brace themselves for that, the couple took a tour of the NICU before their babies were born. But they later found out nothing could ease the shock of seeing their own children in isolation chambers.

“When it’s your own baby it’s different than seeing someone else’s,” Nicole said. “I bawled. There were tubes everywhere and their faces were covered with masks.”

As time passed and the babies became more stable, being taken off oxygen and eating through tubes, the initial shock has faded.

“When they were first in there and breathing, almost their whole ribcage would touch their backbone,” Matt said. “I just wanted to go in there and breathe for them.”

Nicole was able to carry the three boys past 30 weeks, which was past the initial goal of 28 weeks Bury had set in the beginning.

There was a point where it looked like Nicole wouldn’t make it to 28 weeks. At 27 weeks she started having contractions a minute apart and was dilated to 3 centimeters. Nicole was admitted to the hospital and given magnesium sulfate to relax the uterus and stop the contractions.

“The doctor said it was my choice whether we delivered then or not,” Nicole said. “I wasn’t ready. I was too freaked out because I was only at 27 weeks. We were later told that they were getting beds ready in the NICU. I never realized we were that close.”

Doctors were able to stop the contractions and Nicole was put on full bed rest in the hospital. The Kivistos and their doctor set a goal of waiting until the Monday of Nicole’s 30th week. When Monday rolled around Matt and Nicole decided to wait until that Friday to deliver.

The Kivistos told Bury that Wednesday they wanted to try and wait until the 31st week.

“The doctor said we had to check to make sure it would be OK to do that and that’s when they found out I was dilated between 4 and 5 centimeters,” Nicole said. “She could feel a foot. They were afraid of the water breaking and that a baby would be caught in the birthing canal.”

The next morning Nicole was having contractions and Bury decided it was time to do a Caesarean section. A little after noon the first baby was born.

“It was hard,” Nicole said. “The first thing they told us was the babies might not cry because of their lungs. But they did cry.”

Bury said the lungs of babies born before 34 weeks aren’t fully developed and often lead to complications. With the Kivisto babies they were able to avoid that by giving Nicole a steroid while she was still carrying the boys that stimulated a substance in the babies’ lungs that kept the air sacs open, which would have otherwise collapsed.

“I think it helped them tremendously,” Bury said. “They didn’t have any long term respiratory distress at all. They didn’t require long-term ventilation, where some babies have to be on the ventilators for weeks after birth.”

The first 24 hours after premature babies are born are often referred to as the honeymoon period.

“They said with the labor from breathing during the first 24 hours might make them tired and they would have to be intubated,” Matt said.

The babies made it past their first week without major problems. There was one scare with Lucas, who has been lagging behind his brothers in advancement because of a heart murmur.

“Within four hours of when we last saw him Lucas’ heart rate was too high because they said his iron levels were too low,” Matt said. “A couple of hours later he was getting a blood transfusion. It reminds you how quickly things can change.”

The same day Lucas had a blood transfusion, the Kivistos got to hold Jayden and Cade for the first time. They are still waiting to hold Lucas, but know it is worth waiting for.

“You carry these babies and you get attached to them in the womb but when you hold them it’s a different step,” Nicole said. “It starts to establish the bond between the mother, child and father.”

Although the couple are limited in the amount of time they can hold Jayden and Cade, they have been able to touch them and cradle them with their hands through holes in the isolation chambers since they were born.

“That was scary for me at first,” Nicole said. “I touched Lucas and his stats did weird things. I found out that you can over-stimulate them.”

Now the Kivistos are stuck playing the waiting game. They are spending a majority of their time at St. Alexius, but are trying to keep some normalcy for their daughter’s sake because they said they realize there is only so much they can do right now.

“Every day is a blessing that you are here,” Nicole said. “We are so consumed with the babies but something could happen to our daughter tomorrow. Life is so uncertain that you can’t worry about everything or you will drive yourself crazy.”

By SHEENA DOOLEY, Bismarck Tribune

(This is the first in a series of periodic articles about the parents of triplets in neonatal intensive care. The Tribune will follow the family until the babies go home.)

Reach reporter Sheena Dooley at 701-250-8225 or [email protected].)