When Samantha Terraciano learned she was pregnant at 35, she and her husband were overjoyed. After trying for another child for over a year, Sam and her husband were more than ready to welcome their daughter into the world, but they couldn’t foresee the challenges they would encounter in the process. A myriad of health risks made the journey difficult, but with a compassionate and knowledgeable maternal fetal medicine (MFM) team at her side, Sam embraced the unknown and came out the other side with her precious child, this time as a more empowered and confident mother.
With a history of preterm labor and cesarean section, Sam had a feeling that she could be at a heightened risk during this next journey. Sam had a 15-year gap between her last pregnancy and this one, so she was not surprised when her age was mentioned. “Advanced maternal age, I think, was the initial reason that they referred me to maternal fetal medicine. Then, my glucose screening numbers were high enough that I was developing gestational diabetes. Those were the two big things,” Sam said.
These factors required monitoring early on, so Sam and her husband were sent to Logan Health Maternal Fetal Medicine, a specialist clinic for patients with high-risk pregnancies. As they met their care team, including Mallory Novack, DO, and medical assistant Molly Lavin, Sam and her husband knew that they were in good hands. “We were just immediately comfortable with the team. You could tell that they were knowledgeable,” Sam said. They took their time, discussing her health history and current concerns, and offering any resource her family might need in addition to the clinic’s services. “We both really enjoyed that nothing was fast,” Sam noted. “At that first appointment, we were there for two hours. We had an ultrasound and met with the care coordinator, and we just loved the empathy and compassion we felt from the moment we walked in.”
This feeling only grew as her pregnancy progressed. Dr. Novack and the MFM team faith-fully monitored her blood glucose and ultra-sounds, and paid close attention when risks rose. “Her treatment plan became more com-plicated after her diagnosis of diabetes,” Dr. Novack said. “We saw her every two to four weeks for blood glucose monitoring, every four weeks for serial growth ultrasounds to ensure proper fetal growth, and at 32 weeks, we started weekly antenatal testing to ensure that the placenta and baby were doing well in utero. Sam also monitored her blood pressure at home and communicated any abnormal readings.” While this laundry list of tests could be daunting, Sam showed resilience through it all. “Sam was an excellent patient, working very hard to control her blood glucose values with diet and exercise in addition to insulin,” Dr. Novack observed.
As if a high-risk pregnancy journey is not stressful enough, Sam found herself navigating gestational diabetes with a severe needle phobia. “I only did the finger sticks for about three days, and I panicked every time,” Sam admitted. “It doesn’t matter what the needle is for, I don’t like it. I was in tears stressing myself out, and it got to a point where my sweet husband said, ‘You have to stop. You have to call them and figure out what else we can do.’” So, Sam called MFM. “Luckily through our diabetes education program at Logan Health, and with the help of Molly Lavin, who is well-educated in diabetes management during pregnancy, we were able to get her a continuous glucose monitor,” Dr. Novack said. “Molly applied it in the office for her when needed, and this way her blood glucose was monitored without having to do four finger sticks daily.” This greatly helped Sam and her family, and although she did end up needing insulin shots later in the pregnancy, the stresses of injections and finger pokes were greatly reduced by this thoughtful solution from Molly and her team.
In addition to navigating gestational diabetes, the pregnancy itself was challenging. “With a 15-year gap between these pregnancies, there were lots of years to forget what’s normal and what’s not.” Sam said. “I loved the fact that I could call the office and talk to Molly. There was a two week stretch where I think I talked to Molly almost every day. The staff knew exactly who I was and always made sure that I was comfortable and felt at ease enough to move on with my day.”
Further testing was needed to address some of the care team’s concerns, as well. “Our little girl did not want to let anybody look at her and would not cooperate, so we had to do quite a few anatomy scans,” Sam recalled. “There was one where her stomach appeared to be too small, which could indicate a condition like trisomy or down syn-drome.” After genetic testing, they found that their daughter was at low-risk for those conditions.
In one last nerve-racking episode, the MFM team detected that Sam had low amniotic fluid and placental insufficiency, a condition when the placenta cannot supply enough oxygen and nutrients to the fetus. Sam had to deliver her child a month early. She remembers that conversation vividly. “You never want to go to an ultrasound and hear them say, ‘Alright, you’re having a baby—today or tomorrow!’”
Nevertheless, her daughter was born safe and healthy and all of Sam’s worries were in the past. “I couldn’t ask for anything better. It’s literally the best part of my day when I get to come home from work and see my husband, son and daughter together.” Having seen her entire journey, Dr. Novack and her team are inspired by Sam’s resilience and were honored to take part in it. “We were proud to provide her with the empowerment to participate in her health care and the wellbeing of her fetus,” Dr. Novack said. “Oftentimes, women feel that once they require the attention of a specialist, they lose control over their pregnancy and birth plan, which is not the case. Women always have a voice in decisions that affect their health care and their babies.”
Now, Sam visits the MFM clinic with her daughter, worry-free and confident. “Every once in a while, we’ll stop and say hello. Usually, it’s just a quick, ‘Hey, look how cute she is!’ But we’ve told them time and time again that if we decide to have another baby, it will be because of the amazing care we had with them.” For other moms who are facing the challenges of complex pregnancy, Sam hopes that they will find them-selves empowered and confident enough to ask questions. “My big-gest piece of advice is to advocate for yourself, even when your babies are in utero. Stand your ground if you don’t get the answers you need, and don’t be afraid to ask for help. Find a village of people that will stand by what’s best for your family and what’s best for you.”
Article as seen at 406Women.com