Those of you with a new baby might want sympathy every now and then. It can be tough, can't it? He's up all night. You're sick to death of nappies. She pukes all down your new outfit. Well, take this stress and multiply it by seven. That's what Fahad Al Qahtani, 29, and his 28-year-old wife have in store for them since Mrs Al Qahtani - who doesn't want her first name known - delivered septuplets two weeks ago.
Obviously, whingeing about nappies is the last thing on anyone's mind at Georgetown University Hospital in Washington DC where the babies are in neonatal intensive care. Indeed, it's a small miracle that they have come this far. The septuplets are, as far as anyone knows, only the third set to survive birth (octuplets were born in Houston, Texas, in 1998 but one baby subsequently died).
The babies were born just over 28 weeks into the pregnancy (their mother went into labour), which, though 11 weeks premature, is about a month beyond the point at which doctors consider a foetus "viable".
The birth itself was a huge event. Attended by more than 50 doctors and nurses, all of whom had rehearsed for weeks beforehand, the infants were lifted out of their mother's womb in three minutes flat: boy, girl, boy, girl, and three more boys. Each baby was greeted by its very own "medical SWAT team" including a neonatologist, nurse and respiratory therapist.
They were all tiny - none weighed more than 2lb 7 oz and none was bigger than an adult's hand. That weight is typical for 28 weeks, says Dr Craig Jackson, associate professor of paediatrics at the University of Washington. The death rate for babies that weigh between 1.7lbs and 2.8lbs at birth is about 11% (normal birth weight babies have a less than 0.3% death rate). It's impressive, then, that they all made it out alive.
Six - all but the smallest, a girl - needed to go straight on to respirators. They are currently in incubators, being fed with an intravenous solution of glucose, protein and fat as well as their mother's milk through a tube in their stomachs (they are too tiny to suck).
So far, say doctors, all their internal organs seem to have formed normally. But there have been complications. One baby is being treated for a heart defect: a common problem associated with prematurity. A blood vessel - the ductus arteriosis - that connects the heart to the lungs had not closed properly (usually it closes within hours of birth but if it doesn't and is not treated then it can deliver too much blood to the lungs, making breathing difficult and putting a strain on the heart). And while three babies are on a ventilator now, all are described as "critical".
So what are their chances of growing into healthy, normal children? Jackson says that one of the most serious complications premature babies can suffer is a bleeding in the brain known as "intraventricular haemorrhage" that can lead to severe disabilities. This is just about the worst thing that can happen. Fortunately none of the babies seems to have had this, which lowers their chances of disability. But they still have, says Jackson, about a 15-20% likelihood of "some neurodevelopmental handicapping condition". This can't be diagnosed at such an early stage. The babies may gradually show signs of mental retardation, cerebral palsy, deafness or visual disability.
But right now they could be taking in more than you'd think. At this stage, babies can open their eyes and though their vision is poor they can "detect some aspects of a face," says Jackson. They may look foetal (they sleep, curled up, 20 hours a day) but they can show "signs of distress, like yawning and stretching" and will even try and push you away if you pick them up too roughly.
For the hospital, the birth was a medical coup. "It was handled with the same precision as launching a rocket ship," says Richard Goldberg, Georgetown's vice president for medical affairs. But to the parents - who have already lost two children in the past five years, a six-month-old son and a three-year-old daughter who were both waiting for organ transplants - it seems like "a gift from God".
The couple originally wanted 12 children and Mrs Al Qahtani took fertility drugs (a treatment called "induction of ovulation") which made her produce more than one egg at a time.
Seven babies in one go might seem excessive, but this would not have been a deliberate move. In the UK, says Lord Robert Winston, professor of fertility studies at the Hammersmith hospital in west London, "we do the procedure a good deal more carefully". He says: "There is no reason why you should have sextuplets if the procedure is managed properly." This result is, he believes "a completely unnecessary disaster".
Gestating seven embryos is a perilous process and Jackson, too, is wary. "There are an enormous number of things that can go wrong before the birth," he says. Umbilical cords can become entangled and babies can strangle themselves; the blood vessels of the babies may connect to one another, causing one foetus to bleed out into another (the foetus receiving the extra blood would then suffer from congenital heart failure and die); and the placentas - if there were seven separate eggs they will each have one - can merge and attach themselves over the cervix (a condition known as "placenta praevia" that leads to bleeding and can kill baby or mother). The list goes on. And the mother, too, is more likely to suffer complications such as pre-eclampsia or hyperemesis (severe vomiting).
The hospital asked Mrs Al Qahtani - who was discharged earlier this week - if she wanted surgeons to remove one or more of the foetuses, a process known as "selective reduction". This would have given the others - and her - a better chance of survival. She refused as this was against her Muslim faith.
The couple believe that God will help them. Which is good, because they're going to need all the help they can get. They have named all their children after members of the Saudi royal family - a hint perhaps - and the Saudi government has offered to cover their $1m [£700,000] medical bill.
But the real challenge has got to be coping day to day with seven children of the same age. Speaking to a convention of Christian women last year, Bobbi McCaughey, mother of Iowa septuplets born in 1997, recalled how her children (two of whom have cerebral palsy) once simultaneously broke into a chorus of Jesus Loves Me. "I think," she mused, "it's times like these that keep you from killing your kids."
