In the middle of labor with her first child, Perrie Wilkof's pulse stopped.
What had been a healthy pregnancy for the owner of the beloved Dough Mama café in Columbus' Clintonville neighborhood became a life-or-death situation for herself and her unborn daughter.
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Surgeons, pediatricians, anesthesiologists and more at Ohio State University Wexner Medical Center had to act fast to stabilize the rapidly deteriorating mother and a baby whose own pulse was in danger of dropping from lack of oxygen. Every minute counted.
"You know, you think 'What if I'm one of those people that is unlucky?' But everybody says to you, 'no way, that's so rare that's not going to be you'," Wilkof said, holding her happy, and very vocal, daughter in a recent interview with The Dispatch.
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Yes, Wilkof and her baby girl survived that day, something she and her partner Nick Guyton, a part-owner at Gemüt Biergarten, credit to two OSU doctors in particular: Dr. Caroline Bank, the first doctor to evaluate Wilkof and focus on stabilizing her, and Dr. Sema Hajmurad, the resident who led the emergency Cesarean section.
Their gratitude to those two doctors is enshrined in their daughter's name: Sema Caroline.
With a rare complication, every minute counts
Nothing about Wilkof's pregnancy hinted that she would nearly die while giving birth.
She had a scheduled induction a few days after Sema's official due date, normal for women who are considered "older birthing mothers" like Wilkof at age 36. Despite getting the induction, labor was slow and Wilkof wasn't dilating properly 24 hours after arriving at the hospital.
The midwife attending Wilkof tried inserting a mechanism to help the process along. Contractions eventually began and Wilkof's water broke, but labor was still going too slowly. They inserted another mechanism to try to monitor contractions, when, suddenly, Wilkof wanted to vomit.
She felt like she couldn't breathe. The last thing Wilkof remembered was the nurse saying her baby's heart rate was dropping before she lost consciousness.
That's when the midwife got Bank, who sprang into action. She called for a C-section on Wilkof, and in the middle of preparing for the major surgery, her patient's pulse disappeared.
Bank began CPR and other lifesaving measures while Hajmurad stepped in to start the C-section, with both doctors working simultaneously to save both mom and baby. Within minutes, they were handing a newly-emerged Sema off to the pediatric experts to be transported to Nationwide Children's Hospital and trying to stop the bleeding in Wilkof's now hemorrhaging uterus.
"There's that split second of sort of disbelief, like, this is really happening," Bank recalled. "Then so much of it is throwing yourself into what you can do, and letting that training take over, and focusing all the anxiety and all the sort of emotion into... there's a patient who needs help in front of me."
Based on Wilkof's symptoms, the doctors believe she had an amniotic fluid embolism (AFE), though the condition is difficult to detect. It's a rare, life-threatening complication that can occur before, during or after a baby's birth when amniotic fluid enters the mother's bloodstream and triggers a sudden and severe allergic reaction. The mortality rate can be as high as 60%.
AFEs may be rare, affecting around one in 40,000 births in the United States, but traumatic or complicated births in the United States aren't.
According to the National Institutes of Health, up to 45% of new mothers experience birth trauma, and the effects can linger long after birth. Mothers in the United States also die at higher rates than mothers in other high-income countries, according to data from the CDC.
Birth can be an amazing experience, and often the happiest day of someone's life, Bank emphasized, but any birth or pregnancy can be traumatic.
"A pregnancy is not benign, and what exactly that looks like for an individual is an incredibly unique experience, but birth trauma is very real and very prevalent," Bank said. "There's no such thing as, like, a low-risk pregnancy. I'd say any pregnancy can start low risk and become high risk pretty quickly."
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On track and healing together
After a successful operation and close observation, Wilkof survived, spending five days in the hospital before she was able to finally for the first time meet her daughter, who had been under observation at Nationwide Children's.
"When they finally got to be together, it was very powerful," said Guyton, who went back and forth during those five days between his daughter, now almost 2 months old, and his partner.
Wilkof and Guyton made the decision not to name Sema until they met her, fending off questions about paperwork and next steps until they were reunited as a family. But the names they'd considered didn't seem to fit their newest member anymore.
"We were just at home, and we were just talking together about how grateful we are for those two women," he said. "Like, the whole team, but for those two women, especially."
Wilkof, who has had an intense recovery, didn't recall the names of the women who had saved her life at that moment, but when Guyton told her, they just "felt right."
Bank cried when Wilkof and Guyton told herself and Hajmurad, and Bank called it the "highest honor" as a doctor.
"It was just an incredible affirmation that they've gotten through this and are healing together," she said.
Samantha Hendrickson is The Columbus Dispatch's medical business and health care reporter. She can be reached at shendrickson@dispatch.com
This article originally appeared on The Columbus Dispatch: Ohio State doctors receive 'highest honor' after saving mom, baby from near-fatal embolism
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