Hopeless is defined as a feeling or causing despair about something. After multiple complications and miscarriages, Marchelle Simms and her husband, Greg, knew the feeling all too well. It wasn’t until a chance visit from a high-risk specialist that Marchelle realized there was hope for moms like her.
“My husband was in the Marine Corps at the time so we were moving house; I was 5 months pregnant; and, I wasn’t getting the care I needed at our local Veteran’s Hospital,” said Marchelle. “I ended up in the hospital with complications and happened to be there when a high-risk doctor was doing rounds… that’s when I realized I needed a different level of care.”
Marchelle switched her care to Akron Children’s Maternal Fetal Medicine (MFM) group in the hopes of delivering a full-term baby. After years of setbacks it seemed 2014 was going to be the year but, tragically, she lost her baby shortly after delivery due to a serious birth defect.
After much discussion with her MFM team and husband, Marchelle decided to try again. But, this time, she’d also receive progesterone treatments, which are known to help reduce the risk of prematurity by as much as 45 percent.
“She had very frequent visits with her past pregnancy but, this time, we saw her for cervical length screening every 2 weeks beginning at 16 weeks to monitor her health and the baby’s progress,” said Melissa Mancuso, MD, FACOG, FACMGG, director of Akron Children’s Fetal Treatment Center and Interim Chair of Maternal Fetal Medicine. “We also started Marchelle on progesterone therapy and, because of her age and past history, we utilized our Genetic Counseling services, as well as advanced ultrasound and genetic testing options to support her pregnancy.”
Progesterone aims to supplement the body’s hormone production that’s involved in stimulating the uterus to grow to accommodate a developing baby and keep the uterus from contracting. Progesterone is administered via nightly vaginal suppositories or weekly injections from the 16th through 36th week of pregnancy.
“Our MFM group provides all-encompassing care – from preconception counseling to care for any medical condition – before, during and postpartum all at one place, during one office visit,” said Dr. Mancuso. “Our Home Care Group is an integral part of our preterm prevention services because it allows us to provide ongoing care in the convenience and comfort of a patient’s home, which is ideal for progesterone injections.”
At 16 weeks, Marchelle received her first progesterone injection at home via Akron Children’s Home Care Group skilled nurse, Lauren Smolinski, RN, with her husband by her side.
“During the first visit we go over a lot of educational materials, answer questions and really get to know the patient beyond the paperwork,” said Lauren Smolinski. “Each week we not only administer the injection, but also talk about symptoms or concerns and check heart rate, temperature, weight and blood pressure…We share all of this information with the MFM team to make sure everyone is on the same page.”
A highlight of the weekly visit for Marchelle was getting to hear her baby’s heartbeat.
“It’s kind of reassuring to hear it (the heartbeat) since the whole time you’re hoping everything is okay in there,” added Marchelle.
Marchelle did have some complications – gestational diabetes and gallbladder pain. Smolinski talked with Marchelle about balanced nutrition to manage her diabetes and MFM’s Diabetes and Pregnancy Program provided prenatal massages to help relieve the pain.
“I was worried about how much everything was going to cost, especially the Home Care visits,” said Marchelle. “I kept asking, ‘why can’t I just give myself the injections?’ After a few visits, though, I realized I was receiving more than injections; I was getting extra support which was very comforting… Lauren was so awesome; we definitely formed a bond by the end of her visits.”
For women who are high-risk like Marchelle, worries about expenses aren’t uncommon and something the MFM team is also able to help with.
“Our MFM team includes a social worker who can help moms navigate and deal with financial concerns,” said Dr. Mancuso. “Our goal is to make the pregnancy go as smoothly and worry-free as possible, understanding that many of our patients are already experiencing complications so added stress isn’t productive for her or her baby.”
Happy Charles Day!
At 38 weeks, just shy of her due date, Marchelle went into labor while attending an Akron Children’s fundraiser, THE RACE, with her entire family including grandmother, Neatzie Samples, a member of the Friends of Akron Children’s Hospital.
The day was not only a big event for the hospital, but also for Marchelle who, after a long labor, delivered a healthy, 6 lbs., 2 oz. baby boy, Charles, the next day, July 30.
“After delivery I was waiting for the other shoe to drop…I thought for sure there would be some kind of issue or health concern, but there wasn’t,” said Marchelle. “We were thrilled to take Charles home!”
The Akron Children’s Home Care Group and MFM team were equally excited about Marchelle’s delivery and have Charles’ baby photo proudly displayed in their office.
“I’m convinced my pregnancy wouldn’t have made it full-term if it weren’t for the progesterone and the care I received,” said Marchelle. “Everyone – from the woman at the parking attendant booth and Jade the receptionist to all of my doctors and Lauren – was so kind to me and supportive. I felt I was really taken care of every step of the way.”