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After moving from Washington state to Phoenix to become a patient of a doctor who specializes in high-risk multiple-birth pregnancies, a woman delivered five healthy babies this summer at Dignity Health St. Joseph's Hospital and Medical Center.

On June 4, Stephanie Freels delivered quintuplets by emergency cesarean section at 27 weeks' gestation, the hospital announced in a release. The births put Stephanie and her husband, Graham, in an exclusive set. In 2020, only 29 of the more than 3.6 million births in the U.S. were quintuplets or higher-order multiples, according to the Centers for Disease Control and Prevention.

The couple are among many who have sought out the care of Dr. John Elliott, a perinatologist who practices at St. Joseph's.

The Freelses' four girls and one boy weighed hardly more than 2 pounds each at birth. Pregnancy, birth and perinatal care of high-order multiples are all considered to be a greater risk than for individual and twin births.

For weeks, the infants — Adelyn, Eliana, Linnea, Fisher and Harper — lived in the nursery intensive care unit, which St. Joseph's calls the NyICU, receiving around-the-clock care until they were healthy enough to leave the hospital. The last Freels baby was discharged after 76 days.

"We are so grateful to have all of our children home with us," Stephanie said in comments shared by the hospital. "So many people have prayed for us and our family throughout our journey and NyICU experience. We are so grateful that so many prayers have been answered and we are looking forward to creating new memories as a family of seven."

Andrea Hassler said families "travel from all over the country to deliver their babies at St. Joseph's and receive world-class care for their newborns," including at the NyICU. Hassler is St. Joseph's nursing director of women and infant services.

More multiple births
While quintuplets are indeed a rarity, according to a June 2021 bulletin from the American College of Obstetricians and Gynecologists, the incidence of multiple-birth pregnancies in the U.S. "has increased dramatically over the past several decades." The bulletin said the increase has been attributed to the fact that women are having babies at older ages and more women are using assisted reproductive technology, such as in vitro fertilization. Both factors can increase the likelihood of having multiple babies at once.

That bulletin said "a number of perinatal complications are increased with multiple gestations, including fetal anomalies, preeclampsia, and gestational diabetes. One of the most consequential complications encountered with multifetal gestations is preterm birth and the resultant infant morbidity and mortality."

Phoenix-based Elliott specializes in addressing the risks that can come with higher-order multiple pregnancies. He has delivered more than 2,000 sets of twins, 700 sets of triplets, 109 sets of quadruplets and 23 sets of quintuplets over the course of his four decades in practice, according to a biography at Valley Perinatal Services, the high-risk pregnancy specialty group that employs him.

Many of Elliott's patients deliver at St. Joseph's, where the NyICU cares for nearly 800 premature babies annually. The unit specializes in complicated pregnancies and infants with serious conditions, including cardiac concerns, congenital abnormalities, prematurity, respiratory issues and concerns necessitating surgery.

Terrifying moment
Graham and Stephanie Freels had wanted to be parents from the start of their 2017 marriage, but Stephanie experienced multiple medical issues that prevented it. They learned late last year that Stephanie was pregnant. A January ultrasound revealed they were expecting quintuplets. Viewing five heartbeats on an ultrasound monitor the following week, was "one of the craziest moments of our lives," said Stephanie.

Knowing the risks of carrying multiples, Graham researched online to locate the right doctor to treat Stephanie and the babies. He learned about Elliott. Following a consultation with the physician and his team, the couple made their temporary move.

Near the end of her second trimester, Stephanie reported to St. Joseph's in considerable pain, and Elliott's team determined she was dilated to the point that an immediate delivery was necessary.

During their early-morning birth, each baby had a team of neonatologists, nurses and respiratory therapists in the operating room to provide them with the immediate care they needed after birth.

Graham recalled that he was "absolutely terrified" that morning, but, he said, "God was with our family through it all as St. Joseph's amazing medical team cared for Stephanie and helped us welcome our five beautiful children."

During the babies' two-plus months in the NyICU, their parents visited them and watched in excitement as they grew and gained strength. Stephanie and Graham celebrated milestones, such as when the babies were strong enough to take a bottle.

Stephanie said, "One of the best moments of our NyICU journey was being able to hold all five of my babies for the first time. I was so emotional leading up to the moment I could finally hold all of them in my arms after carrying them in my belly. It was a moment I will forever cherish.

"I am so thankful to the NyICU nursing team for giving me this experience," she said.