Newswise — Netanel is the middle name the Kleins gave to their firstborn twin, Yosef. It means "God has given" in Hebrew and applies equally to brother Yaakov, says their father, Shmuel. The twins' births on July 7th were indeed a gift to Shmuel, a quadriplegic, and his wife Rivkah, who is paralyzed from her hips down as a result of having polio as a child.
Yosef Netanel and Yaakov Aryeh were born healthy, by caesarean section, at a little more than 35 weeks gestation at Cedars-Sinai Medical Center. Their birth, say their parents, was the culmination of dreams, prayers and medical science.
"One of our goals was to have children," explains Shmuel, who met Rivkah on a blind date in 2001. "When you are a quadriplegic there can be difficulties, but we have a lot of faith in God."
That faith plus the best in medical care made the couple's dream possible—twice over.
The couple began researching options for conception about a year after their marriage in June 2002. "Due to my condition we knew there might be challenges," says Shmuel. "We knew that for quadriplegics, the chances of having a child is lowered due to the condition but it is not impossible. Many quadriplegics have children naturally while others need to use other methods to reach that dream. We, of course, wanted to have children as close to naturally as possible so we decided to educate ourselves in all areas. We wanted to be prepared to climb the ladder from natural conception to in-vitro and everything in between," he adds.
"We covered all the bases—from homeopathic to in vitro—and became pretty informed. There are many options for people with paralysis. The key is to find out what might work for you, and not to get discouraged," adds Rivkah. The Kleins explored information available through the Miami Project, an organization dedicated to those with spinal cord injuries.
"They persevered," adds Harold Peart, M.D., the Klein's obstetrician at Cedars-Sinai, "and didn't take no for an answer."
Shmuel and Rivkah each have a long history of perseverance. Born in Israel, Rivkah contracted polio at 14 months of age. Her family moved to the U.S., where they felt Rivkah could receive the best care, settling first in New York and later Los Angeles. Though "quite independent," says her husband, Rivkah lacks motor movement in her legs, though she does have sensation.
"She drives a van and does most stuff on her own," says Shmuel of his wife, who has also worked as a bookkeeper for her CPA father.
Born and raised in New York, Shmuel describes himself as "able-bodied" until age 22, when an unfortunate accident left him partially paralyzed from the mid-chest down. Shmuel, who also has sensation, can move his arms and wrists but has no motor movement in his legs.
He spent years in and out of therapy programs, one of which led him to L.A., where he decided to settle. A graduate of Queen's College in New York, he holds a degree in economics and now works as a tutor and graphic designer.
The couple met through friends who thought the two would make "a good match," Shmuel recalls. "We had something in common, something that both of us could relate to. We had a basic understanding of each other and a level of patience. Someone not in a wheelchair could learn this over a course of time maybe, but with us it was already there."
Dr. Peart remembers the Klein's excitement when they appeared at his office, announcing, "We're pregnant! And guess what? There are two of them!"
Rivkah's pregnancy proceeded normally, though her increasing girth restricted routine activity, says her husband, "She was all baby, and it got hard for her to cook and lift a pan, get into the van and climb into bed."
At about 33 weeks, Rivkah thought her water broke and headed to the Emergency Room. A subsequent ultrasound determined she was experiencing contractions, and Dr. Neil Silverman, a high-risk obstetrician and Medical Director of Inpatient Obstetric Services at Cedars-Sinai, advised that Rivkah remain hospitalized until delivery to avoid a premature birth.
Dr. Silverman had monitored Rivkah's pregnancy via ultrasound for several months, and the couple was reassured by his soothing bedside manner, "He was excited to show us everything—like where a bone in the foot was or where the heartbeat was. He took the time to familiarize us with the babies so they weren't strangers when they were born," says Rivkah.
During her hospital stay, Rivkah was given steroids to speed maturing of the babies' lungs. At 35 weeks, and after an amniocentesis showed that the babies' lungs were mature, the decision was made to deliver the babies. Yosef was born first, weighing 5 pounds, and Yaakov followed 2 minutes later at 5 pounds, 3 ounces. The babies' lungs had developed fully, and neither required special medical intervention.
"Dr. Peart delivered the babies and he was so fantastic," remembers Shmuel. "He was reassuring from the get-go. He explained the pros and cons, and made all the information available. He told us it would probably be a C-section. He wanted to be cautious, not take any chances. He wanted all four of us to go home together."
Shmuel was in the delivery room as his sons entered the world, "It was amazing, a fascinating experience."
Rivkah recuperated for four days and then—as Dr. Peart had hoped—headed home with her babies. "Home" for now is her father and mother's house, where family can lend some extra hands and support to the new family.
"It's definitely an adjustment, way more for Rivkah," Shmuel admits. "She's breast feeding and has that whole schedule to work with." Between family, friends and some hired helped down the line, they expect parenthood to settle into a routine with time.
"Twins are big job for anyone," says Dr. Peart, "There are certainly people who've told the Kleins, 'You can't do this!' But they manage to do it."
What does the future hold? For the Kleins, the years ahead are filled with the hopes and dreams of any parents for their children.
"We want them to stay healthy and get stronger," says Rivkah. "As parents we want to give them our love and devotion, and instill in them the same value of life that we were taught. We want them both to grow with the Jewish values and traditions that gave us the ability to remain positive all the time and strive to reach our goals in life. We want them to be happy in life."
A Magnet Nursing accredited facility, Cedars-Sinai Medical Center is one of the largest nonprofit academic medical centers in the Western United States. For the fifth straight two-year period, it has been named Southern California's gold standard in health care in an independent survey. Cedars-Sinai is internationally renowned for its diagnostic and treatment capabilities and its broad spectrum of programs and services, as well as breakthroughs in biomedical research and superlative medical education. It ranks among the top 10 non-university hospitals in the nation for its research activities and was recently fully accredited by the Association for the Accreditation of Human Research Protection Programs, Inc. (AAHRPP).
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