Cathryn Scheipers did not want to get on that train to New York. It was a Sunday night in December 2014, and the commercial real estate professional had an important conference the next morning. But she felt zonked. She felt swollen.
When she and her husband, Greg, decided they were ready for a child, she was in tiptop physical shape; she had run three marathons in 2013. She waited for the magic to begin. Instead, Scheipers says, it was like a permanent hangover. She kept running, but her energy levels plummeted. She never developed a cute popped belly. “I just looked like I ate too much pizza the night before,” she says, despite maintaining a healthy diet. At one appointment, a doctor took note of her puffiness and recommended that she “cut back on the cupcakes.”
There was a scare at about 16 weeks, when a blood test showed she had elevated levels of alpha-fetoprotein (AFP), a possible sign of spina bifida. At a follow-up, the fetus was cleared but her blood pressure was surprisingly high, so a doctor asked how she was feeling. “I’m here getting my baby tested for spina bifida,” she responded. “How do you think I am?”
No one at her OB/GYN practice — which rotates patients through all of its doctors — raised any other red flags.
So Scheipers, who was 25 weeks pregnant, squeezed her swollen calves into boots and boarded that train to New York. After an uncomfortable, sleepless night, she met up with her team at breakfast. Her co-workers greeted her with funny looks and urged her to contact her doctor’s office.
When she started seeing stars, Scheipers decided they might be right. Her doc’s advice? Check your blood pressure and call back.
It all seemed like no big deal to Scheipers, who went to a nearby CVS. “I’m going to do this and go back to my meetings,” she remembers thinking. But when she reported her numbers, the message was clear: Go to a hospital.
Next thing she knew, Scheipers was in the ER at New York-Presbyterian/Columbia University Irving Medical Center. She was immediately brought to a room where a doctor delivered shocking news. “She sat me down and said, ‘I think we need to take this baby today. Call your husband and call your parents,’ ” Scheipers says. Her due date was still more than three months away. She had a Caribbean vacation to go on and a nursery to put together.
The magnesium drip she was on made her loopy. “But at that point, it was a welcome feeling,” Scheipers says. Another doctor came to the room and Scheipers noticed that she was acting strange — “kinda dancing around” — until the blood pressure medication kicked in. The physician’s relief was palpable.
“I finally understood the severity at that point,” Scheipers says. “She was afraid that I was going to die.”
It’s a real concern in America, where about 700 women die in childbirth each year — more than in any other developed country. Add in the women who come close, and it’s a disturbingly high figure: 50,000, according to the Centers for Disease Control and Prevention.
In Scheipers’s case, the signs pointed to preeclampsia, a disorder that strikes about 8 percent of pregnancies and is a leading cause of maternal mortality globally. It causes a woman’s blood pressure to rise significantly and then can wreak havoc on her organs. Researchers haven’t figured out the cause, and although there are several known risk factors (such as family history), it often appears in women with none of them.
The most effective treatment for preeclampsia is to deliver the baby, which is why the medical team wanted Scheipers to know that if her blood pressure couldn’t be controlled, it probably would not be safe to continue the pregnancy.
Although Scheipers certainly had high blood pressure — her readings topped out in the 190s over 110, which put her at imminent risk of stroke — she didn’t have some typical preeclampsia symptoms, such as high liver enzymes or protein in her urine. Because of that, she says, “They were hesitant to diagnose me. Also, it was why they were hesitant to take the baby. Because if it was something else, that wouldn’t have helped me.”
So as the days stretched to weeks, tests searched for rare cancers or other diseases. One nurse urged Scheipers not to Google every morbid possibility.
In the meantime, Scheipers waited. She developed a morning ritual of “going to the spa” — that meant showering, putting on lotion and a facial mask and getting back into bed for the day. And she tried to remain calm during her never-ending blood pressure checks. “It was like the Grim Reaper coming to get me,” Scheipers says. There was almost always a high reading, which would inevitably set off a flurry of activity that she learned to endure. Eventually, the doctors agreed that it really was preeclampsia.
Fortunately for Scheipers, her friend’s mother, Mary D’Alton, is the chair of obstetrics and gynecology at that hospital. And both D’Alton and her husband Richard Berkowitz, another prominent OB/GYN, frequently checked on her. They explained the benefits of extending the pregnancy even just a little.
“Your baby is going to be in the NICU. We all know that,” she says they told her. But if she could manage to get to 28 weeks, the risk of several problems would decrease. (Longer would be even better.)
So her family regularly trekked from the District to buoy her spirits. Her mom and sisters took weekdays, and Greg spent the weekends — returning on the 3:25 a.m. Monday morning train. At Christmas, her parents and siblings drove up with a turkey dinner. She and Greg rang in 2015 wearing goofy glasses in her room.
After about five weeks, Scheipers knew every nurse, resident and fellow. She also knew to be on guard for changes, and that’s about when she developed an occasional headache. She was also almost pleased to have heartburn. “It’s nice to feel an actual normal pregnancy symptom,” Scheipers says.
D’Alton was not as happy about these developments. And there were other indications that Scheipers had reached the limit of what she could handle, physically and emotionally. “One day, I looked at my mom and said, ‘I’m not ready to die yet,’ ” Scheipers says.
It was a relief when her daughter Caroline was delivered via C-section on Jan. 17, 2015, at 30 weeks, five days. She was tiny — 2 1/2 pounds — but mighty, which was comforting after such an ordeal.
Scheipers’s blood pressure remained high enough to set off alarms, and it took another week until she was discharged. But she still practically lived at the hospital. Only now she had a new routine of skin-to-skin with Caroline and pumping milk every two hours. It took her four days to get a single drop, she says, because her body thought she’d lost the baby.
With Caroline thriving a couple weeks later, a social worker helped arrange a transfer via ambulance to George Washington University Hospital. Caroline needed another few weeks of care before joining her parents at their house in the Palisades neighborhood. Scheipers discovered she wasn’t quite healed, either.
She sought help to deal with her constant catastrophic feelings, particularly around Caroline, and was diagnosed with PTSD. Addressing the issue was invaluable, says Scheipers, who wanted another child but was petrified of repeating the experience.
She switched OB/GYN offices to one where she saw the same physician each time. That system of rotating doctors at her previous practice, Scheipers says, “was perfect for perfect pregnancies,” but it may have made her problems tougher to spot.
After one miscarriage, she got pregnant again in 2016. Everything was fine until 37 1/2 weeks, when that familiar swelling returned and her blood pressure spiked. This time, however, she knew to get help right away, and her son, Spence, was born healthy.
Scheipers considers herself lucky. When life-threatening complications arose, she landed in the hands of a capable medical team. And trusted specialists helped her safely navigate another potentially dangerous pregnancy.
That’s something D’Alton wants to make available to more women through the new Mothers Center at New York-Presbyterian/Columbia University Irving Medical Center. It’s a place for high-risk patients to receive comprehensive care, following the model of the hospital’s already-successful fetal health center. Although there are several fetal centers across the country, D’Alton notes, there’s never been something similar for mothers.
The idea is to have “everyone on the same page,” explains D’Alton, so that a woman knows that her doctors are communicating not just with her, but also one another, to create specialized treatment plans. Mental health is included in the equation because these are stressful situations for the mom-to-be.
Having this focus will help the center educate doctors and promote research that D’Alton hopes will make a lasting impact on the field of maternal health — and future patients.
Vicky Hallett, a former Washington Post columnist, is now a freelance writer based in Florence.
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