Stories of Hope: Reem Ali

Reem Ali was a student at Cuyahoga Community College when, in 2011, she met Baker Mayoof. The couple – both natives of Jordan – married in 2015.

Both were from big families – Reem has three siblings, Baker has seven. They knew they wanted to start a family and Reem became pregnant within a few months.

Early in her second trimester, Reem developed gestational diabetes. Because she already had asthma, she was considered high risk. Reem began seeing Kelly S. Gibson, MD, MetroHealth’s Division Director of Maternal Fetal Medicine.

Her daughter Layan was born 12 months after the wedding.

Reem became pregnant a second time and the gestational diabetes returned. After daughter Bayan was born in 2018, Reem’s blood sugar levels stayed elevated and developed into Type 2 diabetes.

In early 2023, Reem sent Dr. Kelly Gibson a message in MyChart with news of her third pregnancy. She had recently switched her medical care to a hospital system closer to home but wanted to return to MetroHealth, and Dr. Gibson, for her prenatal care and delivery.

At nine weeks, an ultrasound revealed that Reem was carrying twins.

Twins don’t run in either of their families. But they were excited to have a large family.

Just weeks earlier, Reem had interviewed for a nursing position in MetroHealth’s cardiac ICU and had received a job offer. Her pregnancy even higher risk now, Reem had to pause plans to return to the workforce after several years away.

At 18 weeks, an ultrasound revealed the sex – two boys. After 32 weeks, Reem started getting an ultrasound every week.

Baby “A’s” head was down. He could be delivered vaginally. Baby “B’” was breech, feet down. That meant a higher chance he’d need to be delivered by cesarean section.

Reem had told Dr. Gibson she was OK with a C-section. But since her two previous pregnancies were vaginal, Dr. Gibson said they would wait and see. Ultimately, Dr. Gibson said, the planned mode of delivery is the patient’s decision, but she is there to guide them. “We like to say that plans in OB are written in pencil.”

The final ultrasound on December 18, when Reem was almost at the 38-week mark, showed the babies remained in a “bunk bed” position, baby “A” on the bottom, baby “B” on top. Once “A” was born, Dr. Gibson would try to turn baby “B.” Dr. Gibson would induce labor the following day.

The birthing plan for Reem was for her to remain in her room after labor was induced. She would be checked on every hour, then brought to the operating room for delivery – the standard procedure for any multiple birth.

At 11:30 a.m., just three hours after labor was induced, Reem told the doctors she felt like she needed to push. She was taken to operating room.

Sultan (baby “A”) was born at 12:35 p.m., weighing 5 lbs. 13 oz. Abdullah (baby “B”) was born 10 minutes later, weighing 6 lbs., 6 oz. No C-section needed.

Reem had developed preeclampsia during labor. The babies stayed with Reem in the postpartum room for three days while her blood pressure stabilized. Everyone went home on December 22.

Today, the family is settling into their life as a family of six.

“For now, we are not planning to have any more children,” Reem said. “But if anything changes, I would go back to Dr. Gibson and MetroHealth with no doubt.”