Twins Nathan and Natalie Barbosa made the record books with their recent arrival at Morton Plant Hospital. They came healthy and howling, with chipmunk cheeks and tufts of dark hair. But their birth was anything but routine.
Their mother has an exceptionally rare medical condition called uterus didelphys. Instead of one typical uterus, she has two, which can lead to infertility.
Yet defying great odds, Andreea Barbosa conceived at the same time a boy and a girl — in separate uteruses.
She and her husband conceived the twins without reproductive medicine or any extraordinary effort. Quite frankly, her doctor hadn't thought it possible.
"It was definitely a shocker," said the 24-year-old Clearwater mother, who learned about her unusual double pregnancy during an ultrasound at seven weeks. "I was frightened and scared — a little bit of everything in one."
Make that two, and then some. Her obstetrician, Dr. Patricia St. John, placed the odds of such a pregnancy at 1 in 5 million, explaining that a woman would have to release two eggs at once and both would have to be fertilized and implanted successfully in separate uteruses. Then both had to develop into viable pregnancies.
The biology is routine: Egg plus sperm equals baby. Like other women who conceive nonidentical twins, Barbosa could have released multiple eggs from both of her ovaries, or from just one, her physician explained.
But in Barbosa's case, the fallopian tubes connect to separate uteruses, each with its own cervix.
Only about 1 in 2,000 women worldwide experience this rare condition, St. John said. Researchers don't know the cause, but it develops before birth when two tubes that normally fuse to form the uterus develop into separate cavities.
The condition can be associated with kidney abnormalities, suggesting a developmental issue with these related structures. Barbosa has just one kidney, instead of the normal two.
In some women, the condition causes infertility and miscarriage. Many experience painful and abnormal menstrual cycles. But Barbosa had no signs.
"From the outside, there was nothing wrong with me," said Barbosa, diagnosed four years ago following a routine exam.
Believing she needed a cyst removed, her doctor sent her for a detailed scan. That's when Barbosa learned about her unusual anatomy.
Later, Barbosa conceived easily in her right uterus. With St. John as her doctor, she gave birth by Cesarean section to Izabella, now 2 years old.
At the time, St. John saw that Barbosa's left uterus was much smaller than the right. She considered a double pregnancy such a remote possibility that she never even brought it up.
Two years later, Barbosa was carrying a baby in each uterus.
Already at high risk with twins, Barbosa experienced another pregnancy complication called placenta previa, which can lead to bleeding and prematurity.
She received ultrasound monitoring to make sure both babies were developing properly. The pregnancy progressed uneventfully. Barbosa continued working as a Walmart sales associate until the week before she delivered the twins by C-section at 36 weeks.
"She had a perfect pregnancy. She was so lucky," said St. John, calling the experience once-in-a-lifetime. "She was delivered a little early, just to preclude any problems with the placenta bleeding and causing an emergency situation."
Last Thursday, Nathan Barbosa arrived at 5 pounds, 8 ounces. Two minutes later, he was joined by sister, Natalie at 5 pounds, 10 ounces.
Both babies are now home in Clearwater with their mother and father, 23-year-old Miguel Barbosa, a supervisor at Best Buy. The twins sleep during the day. At night, they take turns crying, so their parents hardly rest. Izabella helps by bringing diapers and pacifiers.
Content with her family, Mrs. Barbosa has zero interest in once again playing her fertility odds.
"The first pregnancy I had one, the second I had two," she said.
"I can't risk having three the next time."
Letitia Stein can be reached at firstname.lastname@example.org or (727) 893-8330.