It’s wonderful to have one central location where you’re taken care of and where you know that all of your doctors are talking to each other.
Six-month pregnant Ebony Boyd had been feeling mild stomach pain the morning of Valentine’s Day 2017, but she chalked it up to “contracting and stretching muscles.” Soon into her workday, however, the pain intensified.
“It was out of control,” Ebony recalls. “I was bowled over, holding my stomach.”
A friend rushed Ebony to nearby NewYork-Presbyterian Lower Manhattan Hospital, where tests showed there was no fetal heartbeat. While grappling with the devastating news that she had lost her baby as a result of placental abruption, a condition in which the placenta separates from the uterus, Ebony began hemorrhaging, a potentially life-threatening event. She was also experiencing preeclampsia, or dangerously high blood pressure, another serious condition that can lead to seizure or stroke.
Physicians performed an emergency cesarean section and administered blood transfusions. But several days later, when she was due to go home, her care team saw that she had developed yet another potentially life-threatening complication — a pulmonary embolism, or blood clot in her lung. Ebony remained at the hospital for five more days.
“I felt like a part of me was ripped out completely,” she says of her loss.
Later that year, Ebony was pregnant again. She decided to receive prenatal care at ColumbiaDoctors Riverdale, which referred her right away to Dr. Kirsten Lawrence Cleary, a maternal-fetal medicine (MFM) specialist at NewYork-Presbyterian/Columbia University Irving Medical Center and assistant professor in the division of maternal-fetal medicine at Columbia University Vagelos College of Physicians and Surgeons. Dr. Cleary began seeing Ebony as a patient at the Mothers Center, a facility dedicated to providing comprehensive, multidisciplinary care before, during, and after a high-risk pregnancy at NewYork-Presbyterian Morgan Stanley Children’s Hospital. A first of its kind in the nation, the Mothers Center, which opened in its new location in 2018, was created as a model of maternal care to help combat the growing public health concern of maternal deaths and “near misses.”
The U.S. maternal death rate is higher than the rates of almost all wealthy countries and many poorer countries. The rate of severe complications around childbirth has steadily increased in recent years and affects more than 50,000 women every year, according to the U.S. Centers for Disease Control and Prevention. An estimated half of maternal deaths in the U.S. are preventable.
Ebony had experienced three of the leading causes of preventable maternal deaths in the U.S. — hemorrhage, hypertension, and blood clots. So when she learned that she was pregnant again, she admits to being concerned.
“We were nervous and thinking, what if it happens again?” says Ebony, 37.
At the Mothers Center, care coordinators arranged for Ebony to be seen by Dr. Cleary, her hematologist, and other medical disciplines at the same time, in the same location. She was offered access to on-site mental health services to help her cope with the emotional stress that women with high-risk pregnancies face.
“When you have a whole lot of complications with your pregnancy, bouncing around from office to office becomes a lot,” says Ebony. “Then, the longer you’re pregnant, you’re tired, and you don’t want to travel all over New York City going to four or five different doctors. It’s wonderful if you have one central location where you’re taken care of and where you know that all of your doctors are talking to each other.”
Based on her history, Ebony had a 40 percent risk of experiencing preeclampsia again, says Dr. Cleary. So in addition to seeing Dr. Cleary frequently, Ebony took daily baby aspirin, monitored for danger signs like headaches, vision changes, and swelling, and bought a blood pressure machine, which she used daily. Because of the pulmonary embolism she experienced during her previous pregnancy, she was put on a blood thinner.
Under Dr. Cleary’s close supervision, Ebony’s pregnancy progressed. She and her boyfriend, Lonnie Darden, found an apartment in the Bronx and moved in together. They held a gender reveal party, where they learned they would be having a baby girl.
“I feel much more relaxed, much more relieved,” Ebony says. “I feel safe. I feel very secure in the care that I’m getting. We can finally start to relax and enjoy this pregnancy.”
In July 2018, Ebony gave birth to a healthy daughter, Janiyah S’Mori.