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In this episode of the Healthful Woman podcast, Dr. Nathan Fox speaks with Dr. Esther “Esty” Rollhaus, a reproductive psychiatrist, about the first half of her own high-risk pregnancy and premature twin birth — a story she is sharing publicly for the first time. Part 1 covers her path through infertility, an unrecognized preterm labor, and a complicated delivery that sent her twins to the NICU.

Esty’s Story

Before she was treating patients through pregnancy and postpartum as a reproductive psychiatrist, Dr. Rollhaus was navigating her own two-to-three-year struggle with infertility during medical school and residency. She and her husband went through multiple failed IUI attempts and, after her husband underwent a testicular extraction procedure for male-factor infertility, four rounds of IVF before a transfer of two embryos finally succeeded, in her second year of psychiatry residency.

The twin pregnancy itself came with its own turning point. What Dr. Rollhaus described feeling as contractions was initially dismissed by her OB as “probably” gas pain. Labor ultimately stretched across roughly six days, Friday through Thursday, and her twins arrived at 32 to 33 weeks, delivered vaginally in the OR at about 5 pounds each. During pushing, her oxygen saturation dropped to 70 percent, and in the days after delivery she developed a fever from chorioamnionitis, an infection of the fluid and membranes around the baby, along with atelectasis, a partial lung collapse tied to the prolonged labor and shallow, pain-limited breathing. Her son, Nadav, was born with sepsis and needed three weeks of IV antibiotics and a lumbar puncture to rule out meningitis; her daughter, Kira, was born cyanotic with facial trauma from delivery and had recurring bradycardia and apnea episodes. Both twins spent seven weeks in the NICU. Looking back on how she got through it, Dr. Rollhaus put it simply: “I’m going into action mode. I’m going to be the best NICU mom ever.”

Understanding Preterm Labor and NICU Care

Recognizing preterm labor. One of the hardest parts of Dr. Rollhaus’s story is how easily her real contractions were mistaken for something ordinary. Preterm labor doesn’t always announce itself clearly — it can feel like cramping, pressure, or gas pain rather than the textbook picture most people expect. Any regular tightening or pain before 37 weeks is worth calling your provider about right away rather than waiting to see if it resolves on its own, since early recognition changes how much time there is to intervene.

What NICU care involves for premature twins. Babies born at 32 to 33 weeks are considered moderately preterm, and it’s common for them to need specialized support while their lungs, temperature regulation, and feeding reflexes finish maturing. Bradycardia (a slowed heart rate) and apnea (brief pauses in breathing) are among the most frequent reasons premature infants stay in the NICU for observation, and an infection workup — like the one Nadav needed — is standard practice any time sepsis is suspected in a newborn, since infants can decompensate quickly and antibiotics are started before all the test results are back.

Learn More

Listen to the complete episode, “Esty’s Story, Part 1,” on the Healthful Woman podcast to hear more of Dr. Rollhaus’s journey in her own words — and check back for Part 2, where she discusses what happened once the twins came home. If you’re navigating infertility, a high-risk pregnancy, or a premature birth and have questions about your own care, contact Maternal Fetal Medicine Associates today by completing the online contact form.

Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!