Drifting in and out of consciousness, reassuring glimpses of her care providers gave a surrogate mother the strength to push through the pain. After giving birth to twins at Horizon's Dr. Everett Chalmers Hospital (DECRH) in Fredericton, she was rushed to the ICU. Her uterine artery had ruptured, putting her life in danger. That February day three years ago, a bevy of medical professionals worked feverishly to stop the bleeding.

For as long as she could remember, Ann Marie Babineau had wanted to become a surrogate mother. Growing up in Minto, New Brunswick with five siblings helped nurture her love of children and family.

After marrying Tom Meadus and having two daughters of their own, her family was complete but her heart tugged for more. At age 38, the time seemed right for Ann Marie to get this show on the road.

Fondly describing her own children as the centre of her universe, she couldn't imagine the distress of fertility issues. Offering that hope to another seemed like "a very logical thing to do."

PLANS IN MOTION

She and Tom did their research, weighing the pros and cons. As a civilian RCMP member with a physically facile desk job, another pregnancy seemed doable. In April 2015, she contacted an agency that pairs intended parents with surrogates.

After long discussions with the intended parents, her fertility lawyer and theirs, the paperwork was drawn up and signed. In July, to improve the likelihood of success, doctors at a Toronto hospital transplanted two embryos instead of one into Ann Marie's uterus. Shortly after returning home she learned that both transplanted embryos were developing. The procedure was a success. Both she and Tom were thrilled; Tom liked to joke that, "my wife went to Toronto and came back pregnant," leaving Ann Marie to explain.

A CAREFUL PREGNANCY

Ever mindful she was carrying someone else's babies, Ann Marie was careful about her diet and activities.

"It's much like babysitting your brother or sister's child," she said. "When it's somebody else's, I had to think everything through all the time."

By December, Ann Marie's medical team was concerned about premature deliveries.

Her physicians put her off work. With no improvement in January, she was prescribed in-hospital bedrest, resulting in Ann Marie spending several weeks before being discharged shortly before the births.

IMMINENT BIRTHS

Ann Marie was alone at home when her water broke.  February 18, 2016 was a dry and bitterly cold afternoon with clear roads and little snow as everyone involved in the impending birth headed for the hospital.

The birthing process began without incident and at 4:00 a.m. on the 19th, they welcomed a little baby girl.

Tom was home with their children and would join Ann Marie later in the day, while the intended parents acted as coaches. They symbolically cut the umbilical cord.

"They were both crying so hard that I was scared they weren't going to be able to cut the cord," Ann Marie recalled.

TROUBLE WITH BABY BOY

If only it were that simple for the second birth. Emerging arm-first, the second baby's little clenched fist was tangled in the umbilical cord. Doctors tried for several minutes to deliver him safely before ordering a C-section. Ann Marie was wheeled to the operating room. The little boy arrived 40 minutes later. Both babies had healthy weights and appeared robust but nurses whisked them off to the NICU to be sure.  

Elation filled the room as the intended parents had become the actual parents of twins, holding them for the first time.

"They were just on a cloud about the babies and were so thankful and so happy," said Ann- Marie. "My husband arrived with Starbucks for everybody."

She desperately wanted to share in the jubilation.

"I remember thinking I'm not feeling progressively better, I'm feeling progressively worse," she recalled, not realizing the seriousness of her situation.

"WE NEED BLOOD NOW!"

Ann Marie was losing blood fast. Like fast forward on a VCR, time accelerated in the recovery room as blankets were brought in and Dr. Richard Chisholm, anaesthesiologist arrived. In and out of reality, she remembered the new parents and another patient being escorted from the recovery room. As fluid bags hung from IV poles like a chandelier, Ann Marie recalled Dr. Chisholm's commanding voice, "When I say blood now, it means now!"

She now understood the circumstances were critical but sensed she was in good hands.

"I will never forget Dr. Chisholm's voice and just a feeling that he's got this under control," she recollected.  "I remember him shouting out orders, being very assertive and people were moving."

Dr. Chisholm is surprised Ann Marie remembers anything about the ordeal. In his 30-year career she stands out as one of his sicker patients.

CLASS 4 SHOCK

"When I saw her, she was in what we call Class 4 shock because of blood loss," Dr. Chisholm recalled.  "I commenced resuscitation and I made a decision that… she should go to the intensive care."

Dr. Steve Arnason, an interventional/vascular radiologist was tasked with stopping the bleeding. Dr. Samantha Collins offered additional support as Ann Marie endured the pain and discomfort involved in lying perfectly still on a cold table while the surgeon sealed the leaking artery.

"Had Dr. Arnason not been there I'm very certain I would not be here today," said Ann Marie, choking back tears as she remembers the looks of concern on the faces of her husband and sister waiting in the hallway following the procedure.

IF I DIE

"I remember thinking those will be the ones that will look after my children," she said. "That's just how it's going to be and I can't do anything about it."

Dr. Chisholm, who initially pumped seven bags of blood into Ann Marie's system, had similar feelings while trying to save her life, knowing she was already a mother of two very young children.

"I thought, 'my goodness, these kids could have no mummy if she dies' and to me, that was a terrible thought," he said. "It was in the back of my mind the whole time."

As Ann Marie spent another week in the ICU under the watchful care of Dr. Zeeshan Aslam, she wondered what else could possibly go wrong.

The answer, unfortunately, was plenty. Swollen from surgery and hormonal fluctuations, and feeling like the Pillsbury Doughboy, Ann Marie could barely fit slippers onto her feet during several more weeks of recovery. The pain and discomfort made those days among the darkest of her life. To add to her afflictions, a suspected exposure to C. difficile led her to be placed into isolation. She wondered, is this as good as it gets?

HOME AGAIN

Outfitted with a walker, she was released in March. By early April, Ann Marie felt well enough to attend the provincial curling championships. While there, she became ill, experiencing intense chest pain. A friend rushed her to the hospital where an ultrasound revealed her gallbladder needed to be removed. Following surgery and a short stay at the DECRH, she returned home.

By May, she was readmitted for a dilation and curettage (d & c) procedure. During this stay, doctors discovered another complication: cardiomyopathy, a group of diseases affecting the heart. This explained her shortness of breath, fatigue and swollen legs. Her drug treatment fully cleared the condition but it wasn't until the end of 2016 before she felt well.

NO REGRETS

Friends have asked whether she regretted ever starting the surrogacy process. But regret is not a word that tumbles easily from Ann Marie's lips. It's remembering the purpose behind her decision.

"It wasn't to have children, it was to give parenthood to these people," she said, adding there was such small likelihood that any of those things would go wrong.

Ann Marie and her family retain a close relationship with the children she carried and their parents. The twins are three and a half now. Big sister, the quiet one and little brother the hyper one-just like in-utero, she recalled.

As much as she would be willing to carry more babies for parents struggling with fertility issues, those who love her and the medical professionals who saved her life have given her a resounding "no."

Life is much calmer now for Ann Marie. Her experience has taught her much.

"I realized that I have to be able to ask for help when I need something," she said. "Not everything has to be perfect in the world, so enjoy the time you have."

If Ann Marie could change anything, it would be to thank every person who played a role in saving her life for "bringing their 'A' game." She does her best. Every year, on the anniversary of the births, she writes thank-you notes to the ICU staff, the Maternity Ward, Dr. Arnason, Dr. Chisholm and the Obstetrics team.

Dr. Chisholm swallows hard when he recalls how the young mother dangled near the precipice of death but chuckles when he remembers the annual cards of appreciation.

"The first year she came back with a card and I said, 'what the heck' and this year she sent me a card with a picture of her own kids," remembered Dr. Chisholm. "I've run into her a couple of times in the hallways here and we've talked a bit."

During those times he is also thankful to have played a role in Ann Marie being able to continue to enjoy her life and family.

"I'm just happy it had a good outcome."