Beyond the Scope of Practice

February 4, 2019

By: Alex Mooney

Going into my fourth pregnancy, I was so happy I had such an amazing OB whose care I was under, and such a wonderful hospital with the best, most compassionate nurses and staff I was planning on delivering at in February. Being a birth photographer and capturing little ones arriving at many different hospitals all over the area, I got to encounter so many doctors and nurses in the baby havin’ field. I soon would realize I truly had the best possible ones overseeing my care.

I had three textbook pregnancies prior to my fourth. Absolutely no issues, other than needing a bit of help in getting my babes out — thank you c-sections — with any of them. I had three perfectly healthy kids, and when I found out I was pregnant for the fourth time, I expected the same: textbook pregnancy, c-section delivery, healthy 9-pound newborn coming home with me after my 4 day hospital hotel stay.

And then, my expectations were flipped on their backside. I walked into my 19 week anatomy scan by myself, chatting with the tech about how I hadn’t felt any movement yet and suspected an anterior placenta was to blame for that, and telling her how this is my fourth and since we’ve done this rodeo three times before my night shift working husband stayed home to sleep while I came by myself. Not even thirty seconds into the wand, coated in that warm, slippery gel, grazing over my belly I knew something was wrong. The tech’s face dropped, mentioned something about edema, and said she was going to get my doctor.

Dr. Jen. My doctor of nearly 10 years. The only OB/GYN I have ever went to, the one who I first told about my now husband Mike and I’s relationship, the one who had overseen all of my pregnancies, delivered my babies, the one who’d supported my photography endeavors and had my birth prints hanging in her exam rooms, the one who a few weeks earlier I sent a frantic panicked text message to feeling that something was off and who encouraged me to bump up my anatomy scan, the doctor who I fully trusted in her insight, whether it be pregnancy related or advice in regards to my job.

The tech got Dr. Jen and she came in — she always had good things to say, always something positive. This time she did not. And my world came crashing down around me. Our little boy had a host of fatal prognosis, and we would be meeting him much sooner than his anticipated February arrival, probably saying hello and see you later all at the same time.

I sobbed to her. I couldn’t believe this was happening — how was this happening?! My older three were textbook pregnancies and babies…why isn’t this one? What is wrong with our little boy? I handed off my phone so she could call my husband and fill him in. I sat in her office, numb, wracking my brain with all of the information swirling in it waiting for Mike to arrive so we could go upstairs to the high risk doctor for another ultrasound they were able to squeeze us in with. She gave me the biggest hug, sent me off upstairs, and told me she’d text me later.

The rest of the day was a blur — another ultrasound, more doctors, and more bad news. Our little boy, whom we named Clark, was fighting away in there against a whole array of issues that were taking their toll on his little body. We didn’t know how much longer we had with him — could be days, could be weeks, could be months. It was a waiting game.

But Dr. Jen was there for me, for us. She doesn’t handle high-risk cases, as my pregnancy was just shifted to. But she stayed on for me…messaging me to check in, answering the infinite amount of questions I came up with, spending her days off calling me to fill me in on the options we had, and so much more. She went above and beyond the scope of her practice.

And my nurse friends, ones who I had developed a relationship with over my time photographing births at the hospital, called. And texted. And sent the sweetest cards, and a bracelet, and infinite messages just to say hello and that they were here for us, and offered to go to lunch just to escape for a bit. We had an outpouring of support from our friends and family, but also from the wonderful medical staff too that was there by our side through all of it.

And the high risk OB, bless his heart with his compassion and willingness to take me on at the drop of a hat, fit me into his busy schedule, and commit himself to figuring out what was causing our sweet little Clark’s issues. He communicated back and forth with Dr. Jen, knowing how important it was to me to still have her part of our boy’s pregnancy, and that meant the world to us to have two highly skilled providers by our sides.

Several weeks later, after a whirlwind of a day and some crazy suspected pregnancy related itching, I sent a frenetic text to Dr. Jen early on a late October Sunday morning asking what I should do and she had me go into Labor and Delivery for bloodwork to rule out Cholestasis. Upon check-in, the sweet nurse could not find our Clark’s heartbeat. After his strong fight for weeks after that initial ultrasound, his time was up. We knew this was coming but never knew exactly what to expect, how to feel, when it did happen. And we were just crushed beyond belief. But she was the first one to message me, asking how we were doing. She said she’d be there to assist in my c-section whenever it was set with the high risk OB’s schedule. And I felt at ease knowing she’d be there — because she’d been there for my older kiddos’ arrivals and I wanted her there for Clark’s.