A rare set of identical quadruplets will be reunited Friday at a Calgary hospital after spending their first night apart Thursday - two in Canada and two in the United States.
Karen Jepp, 35, of Calgary delivered four healthy little girls Sunday at a hospital in Montana, after being sent there because of a shortage of neonatal beds in Canada.
Babies Calissa and Dahlia, the strongest of the newborns, were flown to Alberta by air ambulance Thursday afternoon with their father, J.P. Jepp - only two babies can be accommodated at once in the air ambulance.
They are to be joined by sisters Autumn and Brooke Friday.
"It's all going to be OK," said Dr. Thomas Key, a high-risk pregnancy specialist who helped bring the four crying babies into the world Sunday at the Benefis HealthCare centre in Great Falls, Mont.
"The prognosis and outlook for each of these little girls is perfectly normal," said Key, who has previously delivered two sets of quadruplets and a set of quintuplets.
"They're small, but very healthy, very alive. They've just got some growing to do."
The babies, who doctors had dubbed babies A, B, C and D, - names the parents extended into Autumn, Brooke, Calissa and Dahlia - were delivered via caesarean section in about 15 minutes.
The babies were delivered at 31 1/2 weeks because of concerns doctors had for the condition of Dahlia, the U.S. physician said.
"One of the fetuses was in somewhat of a dangerous position," Key said.
But all four emerged without complication and in order of A through D.
"It was just a tremendous sense of relief," the doctor said.
The four newborns ranged in size from two pounds six ounces to two pounds 15 ounces, according to the family's Internet blog.
"All are breathing fine," said a family blog. "Autumn actually cried like a full-term baby when born . . . Both parents are over the moon with guarded happiness."
None of Jepp's babies required artificial respiration after they were delivered Sunday, although two required some air pressure to assist their lungs.
After sharing a womb for almost eight months, the babies were kept in close proximity after they were born.
Each was presented individually to the mother and father, who doted over their new babies, making sure they received lots of physical contact in their first few days, the U.S. doctor said.
"Phenomenal parents, very capable parents," he said of the Jepps.
"They certainly will grow up in a very blessed environment."
Each child was also tagged with a band on her wrist and ankle shortly after her birth, to keep their identities straight.
Calgary Health Region officials say the chance of giving birth to naturally conceived quadruplets is one in 13 million, adding that Canada's last identical quads were born in 1982.
Calgary doctors had been closely monitoring Jepp's pregnancy and were anticipating her newborns would require care at Foothills Hospital's neonatal intensive care unit in Calgary.
However, when Jepp began experiencing labour symptoms on Friday, the unit at Foothills was over capacity with several unexpected pre-term births.
Lynda Phelan, a spokeswoman with the Calgary Health Region, said no other Canadian NICU had space for Jepp's four babies.
"There wasn't space anywhere in Canada, so we had to turn to our friends in Montana," she said.
Jepp was transferred by air to Montana on Friday - the fifth Alberta woman to be transferred to Great Falls this year because of neonatal shortages in Calgary.
The babies face about six more weeks in hospital.
The Calgary Health Region is picking up the tab for the babies' U.S. health care - from $1,500 to $2,000 a day for the mother, Karen, and from $6,000 to $7,000 a day for each of the four girl's stay in intensive care. Had Karen delivered in Calgary, her care would have cost $800 a day, and it would have been $2,500 a day for the quads.
The cost of each air ambulance trip will be $10,000 to $15,000.
It's been a remarkable year for multiple births. In January, a woman gave birth to sextuplets in Vancouver.
Two of the premature babies later died and four were then apprehended temporarily by authorities to make sure they received blood transfusions, which their parents, Jehovah's Witnesses, opposed on religious grounds. The parents have applied for a judicial review of the removal orders.
In April, an Algerian woman gave birth to six girls.
The 27-year-old had been expecting seven children, but one, a boy, died in utero.
Last month, a 32-year-old Mexican woman gave to quintuplets - three boys and two girls - in an extremely rare occurrence of a multiple birth without fertility treatment.
The costs associated with higher-order multiple births can be staggering, including medical costs of specialized obstetrical care during pregnancy, intensive prenatal care for babies and increased incidence of prematurity and handicaps.
Between 1975 and 1990, with the growth of fertility treatments and an increase in older mothers, the number of triplets and quadruplets in Canada increased about fourfold.
As of last summer, there were about 66 quadruplet families in Canada and seven sets of quintuplets। There had been at that time no cases of sextuplets in Canada in which all the children survived.
Michelle Lang and Keith Bonnell, CanWest News Service
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