The life-saving power of teamwork at GRH.
When Katelyn Forcier of Arlington became pregnant with her second son, Braxton, she didn’t know just how glad she’d be to have a team of familiar faces caring for her.
With Nina Appleby, DO, as her primary care provider, Katelyn decided to pursue shared care between Dr. Appleby and Kristen Budahn, MD, FAAFP, for her pregnancy and delivery. She saw both providers during her prenatal appointments, and planned to have Dr. Budahn deliver her baby.
“With shared care, we split appointments between providers in an intentional way,” said Dr. Appleby. “It offered more flexibility in scheduling and allowed Katelyn to have more people she was comfortable with on her team.”
During her labor with her first son, Brantley, Katelyn partnered with both Dr. Appleby and Dr. Budahn.
“I liked that they both had that connection to Brantley’s birth, and they partnered so well together during Braxton’s birth, too,” said Katelyn. “It was just so easy with them. They were so wonderful.”
Katelyn chose Dr. Budahn to deliver Braxton, and began seeing her for appointments at 20 weeks.
For Braxton’s delivery, everything began normally when Katelyn came in for an induction. However, during labor, Braxton began to have heartrate decelerations, showing signs of stress. With each push, Braxton’s heartrate would lower, and then recover in-between pushes.
“They were really good about recognizing something wasn’t right,” said Katelyn. “Dr. Budahn took care of the situation very quickly.”
Initially, Dr. Budahn spoke with Katelyn and her husband, Justin, about the possibility of a C-section if Braxton’s heartrate continued to lower to an emergent level.
“I always tell my patients that my goal is to get a vaginal delivery if we can, but my ultimate goal is to make sure we have a healthy mom and a healthy baby at the end of the day,” said Dr. Budahn. “If I can’t have all three things, there’s only one I’m willing to compromise on, and I’m not willing to compromise on having a healthy mom and baby.”
Throughout Katelyn’s labor, Dr. Budahn kept Dr. Appleby and OB/GYN John Mark Johnson, DO, FACOOG, in the loop about Katelyn and Braxton’s progress.
“Because we were in communication and I knew there were concerns, I was prepared to be there as quickly as possible,” said Dr. Appleby. “This was a great demonstration of what teamwork looks like at GRH.”
Dr. Johnson was also a critical member of Katelyn’s care team. Any time we perform a C-section, we have two providers present to ensure the highest level of care for both mom and baby. During Code C-sections, our most urgent cases, both Dr. Budahn and Dr. Johnson are paged. Having both providers present ensures there is additional surgical expertise available when needed.
“We have an excellent team of providers here, who know each other and work well together,” said Dr. Johnson. “Any time a provider has a concern about a patient or is seeing a complication, they can consult with me. We’re equipped to handle high-risk, complicated scenarios, and we collaborate to provide excellent care.”
Teamwork in Action
When Braxton’s heartrate stopped returning to normal between pushes, Dr. Budahn called a Code C-section, and Dr. Johnson, Dr. Appleby, and our surgical team assembled in the operating room.
“A lot of it was a blur,” said Katelyn. “There was so much happening, but I remember knowing there was a plan and they were prepared for any way the situation could go. They did such a great job.”
In the operating room, the team checked Braxton’s heartrate and position once again – fortunately he had come down enough in position for a vaginal delivery, with the support of a medical vacuum. When Katelyn had a contraction and pushed, Dr. Budahn was able to pull Braxton, which expedited delivery. Braxton was delivered within one contraction.
However, it was clear that something was still not quite right.
“There was no cry at all,” said Katelyn. “I was panicking, wondering why my baby wasn’t crying. It was so scary.”
Braxton was pale and not breathing on his own. The team clamped and cut the cord quickly, and Dr. Appleby brought him to the warmer, where he still did not begin breathing on his own. Dr. Budahn swiftly joined her, and both providers worked to resuscitate Braxton, while Dr. Johnson delivered the placenta and repaired a tear that Katelyn had.
“It was a very traumatic birth, but Dr. Johnson was very reassuring that things were going to be okay, even in those scary moments,” said Katelyn. “He took very good care of me; he’s really good at what he does. I’ve worked with him in the past for a D&C, so it was really nice to have a familiar face, especially in such a scary time.”
“Reassurance is key,” said Dr. Johnson. “Holding your patient’s hand and telling her that she’s going to be okay, your baby’s going to be okay, and we’re going to take care of you. That communication can take a lot of the stress and fear out of complicated situations.”
The team worked in tandem to ensure Katelyn and Braxton were okay, and after positive pressure ventilation and oxygen with CPAP, Braxton was breathing on his own.
“Once he turned that corner, Braxton was a normal, healthy newborn and did great during the rest of his hospital stay,” said Dr. Budahn. “We kept a close eye on him, but he was a healthy baby.”
Both Braxton and Katelyn had smooth recoveries and are doing well now.
“I’m lucky to see them both in the Clinic now,” said Dr. Appleby. “Braxton is a healthy little boy, and Katelyn is thriving as a mom of two. She’s a fabulous mother to both of her kids.”
Katelyn and Braxton continue to see Dr. Appleby for primary care.
Katelyn was able to rely on Dr. Appleby as a breastfeeding resource, as well. After the stress of birth, Braxton had difficulty latching.
“Dr. Appleby is an awesome resource for breastfeeding,” said Dr. Budahn. “I encourage my patients to see her for at least one appointment. Her lactation consultation certification is a huge strength for us at GRH, and an excellent resource for our patients.”
For Katelyn, the support she received went beyond just medical care – it was the connection and trust built over time that made all the difference.
“I’m grateful to have had so many familiar faces throughout my delivery. It was easy to talk with them and trust them, because I knew them,” said Katelyn. “It was nice to know that people who have previously taken care of me through tough situations were there for me and my baby again.”
Learn more about our pregnancy care options by clicking here.
