Heather McNamara: A delicate situation
Heather and Ryan McNamara already had two beautiful girls — Ellie who was four and Abby who was two. Both children were born at St. Clair Hospital, and both times, labor and delivery were normal. When Heather became pregnant with a third child, the couple was excited. The new baby was going to be a little boy. They decided to name him Patrick.
On March 31, 2017, at 18 weeks, Heather and her husband went to the Hospital for a routine ultrasound. “I remember the date like it was yesterday,” says Heather. “I was already showing. I was feeling kicks from the baby. Everything felt normal. But immediately after the ultrasound, the tech sent us to our doctors.”
The Peters Township couple walked to the office of St. Clair Hospital OB/GYN Deborah A. Lenart, M.D., who delivered a heart-wrenching diagnosis. The baby had anencephaly, a condition in which the baby’s skull and brain don’t develop normally. Their baby would not live long after birth. “It’s really hard to explain to a couple that their baby has a defect which is incompatible with life,” says Dr. Lenart. “It’s a very rare condition. I suggested they take some time to think and read about it before deciding what to do.”
“The doctor was so kind. She was as informative as possible,” says Heather. “But hearing that there was no possibility for Patrick to live was an absolute shock. It was easily the worst day of our lives.” Heather and Ryan went home and researched anencephaly. They elected to go through with the pregnancy. “We decided to make every day count and celebrate every little thing.”
They also decided they wanted to do everything they could to make Patrick’s life as meaningful as possible. Contacting the Center for Organ Recovery & Education (CORE), the couple began to explore organ donation. “A CORE representative called and walked us through our options. We were hoping to do a live transplant, but there were certain criteria Patrick would have to meet.”
Thanks to a family member, Heather also got in touch with the Still Remembered Project, a local miscarriage and infant loss group. The group made a number of very helpful recommendations, including setting up a meeting at the Hospital to review a birth plan. “I spoke with the Director of Women and Children Services at St. Clair, Shawndel Laughner, MHA, BSN, CNML, RNC-OB, C-EFM, and she was phenomenal,” recalls Heather. “She set up the meeting with my doctor, a nurse, a grief counselor and a pediatrician. It was nice to meet with people who were on our team, on our side, who were letting us know that they would honor our wishes and accommodate us as much as possible.” The Still Remembered Project gave Heather and Ryan a special care package, with an angel gown, sibling gifts for her children and items to make memories with Patrick. They also gave her a book called “I Was Going To Have A Baby, But I Had An Angel Instead.” In the weeks leading up to delivery, the family read it together every night. “Our kids had a lot of questions. They were trying to make sense of it all. The book helped us process the whole situation,” says Heather.
Throughout her pregnancy, Heather received monitoring from the Hospital’s maternal fetal medicine specialist. Everything was going well until she reached 30 weeks, when an ultrasound indicated she had polyhydramnios, an excessive amount of amniotic fluid. “It can lead to higher risk conditions,” explains Dr. Lenart. “In this case, the baby wasn’t growing.” With this new development, the doctor and couple chose to induce labor at 35 weeks. “We always said that as long as Patrick was happy and healthy inside of me, we weren’t going to do anything,” says Heather. “As soon as it became a risk, it was an easy decision to induce.”
On July 26, when the couple arrived at the Family Birth Center, a nurse was waiting to greet them. Heather also gratefully recalls another nurse who spent time in their room, making them feel welcome. “It was such a good experience, considering what was going to happen,” says Heather. “It felt nice to have that connection and feel like we were in good hands.”
The following morning, another OB/GYN from St. Clair helped Heather deliver Patrick. Complications arose when the baby was slow to move down. The doctor needed to break Heather’s water, but she had to be careful due to the excess amniotic fluid. The Family Birth Center was well prepared. “You don’t want the fluid to come gushing out because the umbilical cord could prolapse,” explains Dr. Lenart. “The OB/GYN used a tiny trumpet that makes the fluid come out slowly, so you can guide the baby’s head toward the cervix. This way, the head is the first thing coming not the umbilical cord.”
Once they broke her water, Patrick came quickly. He weighed 3 1⁄2 pounds, and he lived for approximately 5 minutes. “It was the most serene five minutes of my whole life,” says Heather. “Everyone in the room stood there silently. They backed away and gave us our time. I liked how delicate they were in handling the whole situation. It allowed us to enjoy those five minutes as fully as possible.”
Heather and Ryan had prepared their daughters for what was to happen, and had chosen to have them come in after the delivery. “My daughter Ellie ran up to me. She hugged me while I was holding Patrick. I was afraid she would be terrified, but she looked at him and said, ‘I just love him. He’s so beautiful.’ I knew then my family was going to be okay.”
Because Patrick was born early, he did not meet the requirements for a live organ donation. However, he was able to donate for research. That meant there was no rush to take the baby. Patrick was placed in a special ‘cuddle cot,’ a bassinet that has a cooling feature. The couple stayed in the room with him until the following morning. They had time to make memories, such as clay hand prints and foot prints. They cut a tiny lock of hair from around his ears. A nurse stayed and helped them make ink hand prints and foot prints for everyone in the family. “It’s a testament to how wonderful the nurses are in the Family Birth Center. They really do strive to make sure you have the best possible experience. And it should be. It should be the happiest experience of your life when you give birth. I wouldn’t go anywhere else.”
Dr. Lenart believes allowing parents to have a greater say in their delivery experience is one of the reasons the Family Birth Center is so special. “In the face of a horrific situation, these parents had the power to play a key role in their delivery experience. It wasn’t the outcome they wanted, but it was the experience they wanted,” she says. “It was an unusual case. We deliver hundreds and hundreds of babies every year that are normal and perfect. There are unexpected complications and expected complications like this, where we can plan and make everything as perfect as possible. We’re capable of those extremes, as well as anything normal in between.”
After Patrick, Heather and Ryan knew they wanted another baby. When she became pregnant with Colin, it opened a whole floodgate of emotions. “I needed the support of my OB/GYN. I needed them to hold my hand again,” says Heather. This time, her doctor was St. Clair Hospital OB/GYN Douglas H. MacKay, M.D.
“The first ultrasound was reassuring,” Dr. MacKay remembers. After a healthy pregnancy, Colin was born in February of 2019. “My experience with Patrick was unique,” says Heather. “But I didn’t feel like I got any different care with my three other babies. I always felt like they were the most welcoming, warm people.”
Dr. MacKay agrees. “We offer the kind of compassionate care that you don’t get everywhere. It’s more of a family atmosphere with a personal touch. We have all the specialists you need, but we also provide more of the physical, social and psychological services that women need.”
DOUGLAS H. MACKAY, M.D.
Dr. MacKay specializes in obstetrics/gynecology. He earned his medical degree at The Ohio State University School of Medicine and completed his residency in obstetrics and gynecology at West Penn Hospital, Pittsburgh. Dr. MacKay is board-certified by the American Board of Obstetrics and Gynecology. He practices with Advanced Women’s Care of Pittsburgh, P.C.
To contact Dr. MacKay, please call 724.941.1866.
DEBORAH A. LENART, M.D.
Dr. Lenart specializes in obstetrics/gynecology. She earned her medical degree at Wright State University, Ohio, and completed a residency at the University of Texas. Dr. Lenart is board-certified by the American Board of Obstetrics and Gynecology. She practices with Advanced Women’s Care of Pittsburgh, P.C.
To contact Dr. Lenart, please call 724.941.1866.