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Worried Mom-to-Be Finds Care that Goes Above and Beyond

 

Obstetricians Dr. James McCarrick and Dr. Deirdre Lyell 
Dr. James McCarrick and Dr. Deirdre Lyell
Bethany's first pregnancy had been uneventful, so she wasn't particularly worried when, on a winter Sunday in 2008, at 27 weeks, she didn't feel quite normal. Her obstetrician, James McCarrick, MD, PhD, saw her immediately, and everything seemed fine. And then, in an instant, it wasn't. 
 
"She was just about to go back home when suddenly she had terrible abdominal pain," McCarrick recalls. "She'd had a sudden placental abruption -- the placenta had pulled away from the walls of the uterus. The baby's heart rate dropped and he was in complete distress."
 
Bethany's baby boy was delivered immediately by emergency C-section, three months premature. After 20 minutes without a heart rate, he was resuscitated. Then, six harrowing days later, it became clear that her son Willem had suffered extensive and irreparable brain damage. Holding the hands of Nilima Ragavan, MD, and nurse Lindsay McNabb at the Neonatal Intensive Care Unit of Lucile Packard Children's Hospital, Bethany and husband Michael made the decision to take Willem off life support.
 
In the weeks and months that followed, Bethany was overwhelmed with grief -- and fear that the tragedy would repeat itself if she got pregnant again. It was this concern that brought her to obstetrician Deirdre Lyell, MD, maternal-fetal specialist at Packard Children’s.
 
"I first got to know Bethany when she was thinking about having another child," Lyell says. "I explained to her that the risks of a recurrent abruption, happily, are very low. But whenever a woman has experienced such a difficult pregnancy, the subsequent ones never feel easy. They don't really rest easy until they're holding their baby."
 
And so, when Bethany did become pregnant again that year, her care team made it their mission to escort and guide her to that moment with as much support as possible. Lyell, an expert in high-risk obstetrics, kept in frequent contact and was always available to address questions or concerns. McCarrick saw her weekly for the entire pregnancy, making a point of showing Bethany her new child's healthy fetal heartbeat. Indeed, it's a strong collaborative relationship between the two doctors -- one a Stanford/Packard Children's faculty and the other a Community physician -- that's key to caring for high-risk patients such as Bethany.
 
"A lot of what we did was just listen to her," Lyell says. "A small worry can grow to the point where it's distracting, so I think it was helpful for Bethany to constantly hear from us that she was right on track."
 
In the midst of a profoundly difficult and lonely time, Bethany says, "Dr. McCarrick and Dr. Lyell extended hope, structure, a path and a strategy for moving forward. They are among the very best clinicians practicing in the Bay Area today -- but they also truly partnered with me and Michael."
 
In February of 2009, the couple welcomed their healthy baby girl, Shaler, into the world -- as did an affectionate circle of greeters. McCarrick delivered her, Lindsay McNabb rearranged her schedule so she could care for her, nurse Monica Bullard from McCarrick's office took the day off work to be there, Ragavan sent a congratulatory email from her vacation, and Lyell made a special effort to celebrate with the family during their stay at Packard. It was a welcome that Bethany says still astonishes her.
 
"Our precious daughter created a family out of a couple who desperately wanted to become one. Shaler is our greatest joy. She's got these huge fat cheeks, she's curious and precocious -- she'll look at me in the eye and drop Cheerios on the floor, one by one, just to see what happens," Bethany laughs. "And she connects us to Willem. That's our son's legacy. We draw meaning from his life by being very present, very grateful parents. "
 
Nearly a year and a half after Shaler's birth, Bethany still thinks often of the care team that stayed with her every step of the way.
 
"I have boundless gratitude and total faith in them," she says. "They are the reason why Michael and I get to cherish our baby girl every day, why we get to cuddle her and play with her and watch her grow."