March is Endometriosis Awareness Month. John Petrozza, MD, chief of the Division of Reproductive Medicine and In Vitro Fertilization at Massachusetts General Hospital and director of the Mass General Fertility Center, explains what endometriosis is and how it can impact fertility.
When Colleen and her husband Bryan became pregnant in 2019, they were overjoyed. After meeting as volunteers in AmeriCorps after college, the pair eventually settled down on the North Shore of Massachusetts, not far from Boston, and were excited to start a family together.
The parents-to-be immediately began preparing and organizing for the birth of their baby, only to be devastated by something they couldn’t plan for: a miscarriage. This is heartbreaking news for a family, but they did not give up hope of one day having a baby.
When Colleen became pregnant again in 2020, every twinge of pain filled her with anxiety. She had been cared for by a local midwife during her first pregnancy, but wanted extra reassurance given what she had been through.
“It was very important to me to have a midwife for both my prenatal care and during labor and delivery,” she says. “While I technically wasn’t classified as a high-risk pregnancy and wasn’t expecting a complicated pregnancy or birth, I also knew I wanted to be cared for by the very best just in case of the unthinkable.”
Choosing Mass General
As a marketing manager at Massachusetts General Hospital, Colleen knew of the Midwifery Service. She liked that it was a larger practice with more than 20 certified nurse-midwives (CNM) on staff, ensuring a CNM would be available when she delivered. She also knew the CNMs collaborated closely with their OB/GYN colleagues for any complications that might arise during pregnancy, labor and delivery and postpartum.
At her first appointment, she felt reassured about making the switch to Mass General.
“I appreciated the approach of the midwife I saw. The program is so well-rounded, it felt like I was ticking all the boxes of the things I wanted,” Colleen says.
Prenatal Care and Reducing Anxiety
As part of her prenatal care, Colleen sought therapeutic support for her anxiety. At each prenatal visit with her midwife, she came prepared with a list of questions.
“I never felt rushed, even though I probably asked a lot more questions due to my prior miscarriage,” she says. “My midwife was always more than willing to talk through things with me, and I felt very supported.”
When a routine ultrasound showed a potential placental abnormality, Colleen’s midwife worked with a maternal-fetal medicine specialist for extra follow-up care, which was coordinated to take place all on the same day.
“Everything was very integrated and coordinated, and I appreciated that,” she says.
Further testing revealed there was nothing to worry about, but throughout it all, Colleen was reassured by her midwife. “She kept me calm and had a more holistic conversation with me about what might be happening. I really liked her how she framed the situation.”
Colleen and Bryan also took some of the childbirth and parenting education classes offered by Mass General.
“Knowledge always brings me comfort,” Colleen says, “and I left the class feeling so much more prepared, especially for this huge life-changing experience.” She and Bryan still use materials – especially the CPR manual – from the classes in their day-to-day parenting, finding them especially helpful once her daughter started eating solids.
Delivering a Healthy Baby
As her due date came and went, Colleen had multiple ultrasounds to monitor her baby and was relieved her midwife didn’t push for an induction right away. Eventually, she was scheduled for an induction at 11 days past her due date.
“Our midwife encouraged us to be flexible, because if you have a very rigid birth plan, you could be disappointed. In the end, our birth plan was more about preferences. It felt so empowering, and that we were part of my own care,” the couple says.
After Colleen was admitted into their labor and delivery room, she was given cervical ripening medication to help prepare for the induction. They expected a long wait and had settled in to watch the Red Sox game when Collen’s water broke.
“My midwife told me, 'The induction is off. You’re in labor now.'” She laughs. “Things just started to happen naturally.”
It was at this point that her birth plan came into action. “Part of my preferences was to have as few interventions as possible, as long as it was safe. They hooked me up to mobile monitors and gave me an extra-long IV cord. They brought a yoga ball for me to bounce on and I had a room with a shower, which was so nice.”
As her labor progressed, Colleen felt cheered on and supported by her care team. The atmosphere felt cozy and intimate.
“It actually felt like I could have been at home with a supportive team of women around me, delivering a healthy baby,” she says. Their daughter Diana was born just under 12 hours after Colleen was admitted.
Bryan appreciated that “the nurses and midwife were so inclusive and empowering for Colleen. I was so impressed how they helped us feel like this was truly a family moment.”
“As a nurse-midwife I have two main goals in providing care to our patients, says Susan Hernandez, chief of the Midwifery Service at Mass General. “I hope that whatever their journey, they feel cared for and that their choices are respected. Birth is a unique event in the lives of birthing people, and I aim to be responsive and attentive to the wishes of each person.”
Postpartum Recovery and Adjusting to Parenthood
After she and her family were moved to the postpartum floor, Colleen was grateful to get breastfeeding support from the nurses.
“There were a lot more variables than I realized,” she says, “and the nurses showed me so many different techniques to make sure that both of us were comfortable.”
She was also impressed by the specialist care that’s standard for all newborns at Mass General. Diana was examined by a pediatrician from Mass General Hospital for Children, and the hearing test was administered by a specialist from Mass Eye and Ear.
Once she and her family were released from the hospital, she continued to see her midwife for her postpartum care, including her six-week check-up.
Colleen and her husband continue to adjust to parenthood and life as a family of three. The couple enjoy going to local farmer’s markets with their daughter and cooking meals together while she observes from her highchair.
Looking back at Diana’s birth, Colleen is grateful for the care she received from Mass General midwives.
“I almost can’t believe it, but everything went so well and just the way I was hoping it would go. I’m so thankful to have had such a wonderful birth experience.”
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