Beyond the Scope of Practice

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.

Courtesy of Victoria Allen, Fresh Pine Photography

We had to wait nearly 36 hours before we got to meet Clark, and as hard as that probably would have seemed to be, it actually wasn’t. We told our big kids that their baby brother wouldn’t be coming home from the hospital with us, we met our photographer for last-minute maternity pictures, we shared with our friends and family the news, and we had a day to prepare ourselves to meet our little man on the outside and say goodbye all at the same time.

Courtesy of Victoria Allen, Fresh Pine Photography

When it was time to meet Clark, Dr. Jen was there — even a bit early to chit chat to pass the time. She was there to give me a big hug before heading back to the OR, was there to hold me as I got a spinal in my back, and was there to talk me through Clark’s birth.

Courtesy of Victoria Allen, Fresh Pine Photography

Courtesy of Victoria Allen, Fresh Pine Photography

The OR was hauntingly quiet when he was born; there was no joyous exclamation of “It’s a boy!” no Apgar score, no baby warmer even turned on. It was dead silent. I’m pretty sure you could hear the tears flowing like waterfalls down the side of my face.

Courtesy of Victoria Allen, Fresh Pine Photography

The anesthesiologist stayed right by my head with a cloth, gently wiping the tears and they continued to flow. The sweet nurse wrapped our Clark up nice and tight in a blanket so Mike could bring him over to me to see, to hold his hand. All the while Dr. Jen and our high risk OB put me back together.

Courtesy of Victoria Allen, Fresh Pine Photography

Courtesy of Victoria Allen, Fresh Pine Photography

And I shut my eyes hard, hoping it would all be a bad dream…but it was anything but. It was our reality. And it sucked. It sucked so much. But in this reality, we were surrounded by such a wonderful team of doctors and nurses who held us up in our darkest of days. And that helped, it helped so much.

Courtesy of Victoria Allen, Fresh Pine Photography

Dr. Jen showered us with hugs and she was off, and we were left under the care of some of the most compassionate, incredible nurses in the entire world. Nurses that were so quick to refill my water bottle when it was just the slightest bit emptied, who’d stay in my room and talk with me about Clark and photography and birth stories and anything I wanted to, who helped me with a major surgery recovery that is usually disguised by a newborn babe…but not this time.

My room became a revolving door — I was the patient who had just delivered her son sleeping at 22 weeks, but I wasn’t the patient they shied away from. Dr. Jen came to visit me every single day; those nurses who I’d befriended in my birth photographer role stopped by constantly just to say hi and chat, offered to bring food with them; and the high risk doctor came frequently to make sure everything was healing right and I was (physically) doing as well as I should have been.

Yes. This is their job: they care for patients that come through their doors. But the care we were given, from Dr. Jen to the high risk OB to the nurses and hospital staff far surpassed their scope of practice. They cared, cared more than I could ever have imagined someone would to us in our situation. And it didn’t stop when we left the hospital…in the days and weeks to follow, I got check-in text messages and emails from these amazing providers and it gave me a glimmer of sun on some very dark days.

Navigating the waters of loss is extremely difficult, and truly comes with a lot of unknowns. And it sucks, there’s no other way to describe it. It’s tough and awful and terrible and the worst possible thing a person could go through. But having those wonderful, amazing, impactful caregivers like Dr. Jen and the other doctors and nurses who cared for us by our side during a very dark time made such a different for us. The love and support we felt from them, beyond the scope of doing their job, will be something that is forever ingrained in our hearts. We miss our little Clark dearly and think about him every second of every day, and we are forever grateful to the incredible doctors and nurses and caregivers we were surrounded with during Clark’s short life. Because of them we can smile looking back on his birthday, his story, knowing it was told and handled by the most compassionate, wonderful people in the world.

About Alex Mooney

Alexandria Mooney is photographer, blogger, cop’s wife, and mother to three little here on earth and one in heaven.  She’s spent the past eleven years teaching middle and high school students and recently hung up her teaching hat in exchange for a full time birth and family photographer’s camera.  She’s passionate about sharing her thoughts and striving to make a difference with her words and camera lens.

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