Photos of the Garcia quintuplets show five tiny, red, wrinkled siblings tucked in incubators, hooked up to a tangle of oxygen tubes, IVs and heart monitors.
Two of the girls have pink bows attached to their downy black hair. Christobal, the lone boy, lies on an apple-green blanket.
Born three months premature last Thursday at Methodist Women's Hospital in Omaha, these tiny infants have a long road ahead of them.
Combined, babies Marah, Christobal, Arleth, Jimena and Rosalyn weigh a little more than 10 pounds. The biggest, Arleth, weighs 2 pounds, 6 ounces. They're fed primarily through IVs. They're so small, so delicate, that mom Bianca Garcia has been able to hold only two.
But doctors say the prognosis is good for the babies, the third set of quintuplets ever born in Nebraska and the first to be delivered at the new Women's Hospital.
“Obviously our priority right now is keeping them healthy and getting them to grow,” neonatologist Dr. Brady Kerr said.
Parents Bianca, 30, and Jose Garcia, 32, were happy, tired and still a little dazed at a press conference held at the hospital Monday.
“We're just glad they're all here and they're all doing good, which was the primary worry,” Bianca Garcia said.
How do you prepare for quintuplets? someone asked.
“You don't,” Jose Garcia said, prompting laughter.
“We're still not ready,” his wife said.
The Sioux City, Iowa, couple already have two sons, Jose, 9, and Abrahan, 7. When Bianca first learned she was pregnant again, her obstetrician told her it looked like triplets. Soon the Garcias learned their family was about to get even bigger.
“It was shocking at first,” Bianca Garcia said. “First we were told three, then we were told it was five. We said, 'Oh, my goodness, what are we going to do?' ”
The couple did not say whether they used fertility drugs or treatments such as in-vitro fertilization that could have caused the multiple births.
Before the delivery at 28 weeks — a typical pregnancy lasts 40 weeks — Bianca Garcia spent more than 13 weeks on bed rest, 10 of those at the hospital.
The wait seemed interminable. She quit her job as a collections agent. Ten tiny feet kicked her day and night. She fought off preterm labor and other complications that could have led to an even-earlier delivery — and the risk of serious birth defects and developmental disorders. She used a walker the last few weeks because her stomach was so big, walking was difficult.
“She handled it with amazing grace,” said Dr. Todd Lovgren, the Garcias' perinatologist. “Being on bed rest that long is very, very difficult.”
The Garcias praised the staff at Methodist Women's, saying they received top-notch care.
“From the nurses to the cleaning staff to the desk help, everyone was so helpful, so nice to you,” Jose Garcia said. “Everybody cared for you. They earned our trust right away.”
The babies were born within two minutes of each other during the delivery via cesarean section, starting with Marah at 1:48 p.m.
A team of 30-plus obstetricians, neonatologists and nurses were on hand for the high-risk births, for which doctors spent weeks preparing. Each baby was immediately turned over to a team of four doctors and nurses who resuscitated the tiny preemies before whisking them away to the hospital's Level 3 neonatal intensive care unit, reserved for the tiniest and sickest babies.
They'll likely stay there for the next 2 to 2½ months, doctors said, even as Bianca Garcia prepared to be discharged Monday afternoon.
“I was ready to go, but now that the babies are here, I don't know if I want to leave,” she said.
Neonatologists will continue to monitor the infants for complications common in premature and multiple births, including underdeveloped lungs and eye and intestinal problems. Longer term, doctors will watch for developmental disorders such as cerebral palsy or motor delays.
“We haven't had any real complications at this point, but we still have a long way to go,” Kerr said.
The babies can head home to Sioux City once they've reached certain development benchmarks, such as gaining weight, breathing on their own and feeding by bottle or breast.
In the meantime, the Garcias will make the nearly 200-mile round-trip commute from Sioux City to the Omaha hospital as often as possible. Bianca Garcia may try to stay in Omaha in order to breast-feed, and her husband is arranging for time off from work at the Blue Bunny ice cream plant in Le Mars, Iowa.
Friends and family members still are helping the couple gather gear such as car seats, clothes and the mountain of diapers five babies will inevitably need.
The Garcias could seek advice from a family that's been there: fellow Sioux City residents Jodi and Kevin McCormick gave birth to quintuplets at Bergan Mercy Medical Center in 2009. The Jansen quintuplets, Nebraska's first quints, were born in 1998 and now live in Omaha.
Quintuplets are very rare, with 37 sets of quints or higher-number births occurring in the country in 2010, the latest year for which birth data on multiples is available from the National Center for Health Statistics.
In 2011, 392 sets of twins and 13 sets of triplets were born in Nebraska, according to the State Department of Health and Human Services.