Rough beginnings made better

For most parents-to-be, an ultrasound is an exciting occasion, ending with baby’s first picture and measurements. For some, however, life isn’t so simple. If the physician sees any cause for concern, the parents proceed to a specialist, who will either comfort them or confirm their worst fears.

Enter Dr. Colleen Hendershott, chief of paranatology at Kaiser Permanente Hospital and one of only a handful of high-risk-pregnancy specialists in Sacramento. In the generally impersonal realm of health care, Hendershott provides a more nurturing approach to the potentially tragic—or miraculous—experience of high-risk pregnancy. Having survived two complicated pregnancies of her own, she offers both empathy and expertise.

Why high-risk obstetrics?

I decided to do ob-gyn when I was in med school in Cincinnati because it’s bringing life into the world—what could be better than that? But by choosing to do the residency I did, which was in L.A. County, I got to experience a whole different side of things. Most of the women I saw were Spanish-speaking immigrants. I found myself drawn not to the women who had the smooth, happy experience, but to the women who had really horrible things happen, frequently through no fault of their own. Often the complications were unexpected because, whether they were illegal or not, they didn’t have the social support or health-care literacy to get necessary care.

After doing my residency and fellowship in L.A., I had my own kids, and had all the complications known to man. The eldest was six weeks early and the younger eight weeks. I’ve been lucky: My kids are doing wonderfully and don’t have any of the long-term side effects of being born premature. But it was a really great learning experience to have to be on the humility-required patient end of it, because all of the control is taken out of your hands. Trying to direct my own care didn’t go over well with my nurses and doctors! At the time, I wasn’t aware of how beautiful it was in the big picture, but it has helped me immensely in connecting with my patients.

What other personal experience do you bring to your work that helps you in such emotionally intense situations?

I grew up in a very unemotional household, and that’s not who I am. So it has taken a fair amount of time and energy and experimentation to realize that it’s OK to cry with a patient, to really feel for the situation, without having to take it home. Doing my own personal-growth work … has been huge in allowing me to be comfortable with feeling and then to see how amazingly people open up as soon as you’re willing to initiate it.

Especially working with other physicians, who are taught to keep everything inside and appear very tough, giving them permission to talk about how these experiences are affecting them is like watching a flower open. Having that happen once or twice made me realize that that’s the only way I want to be, with families, as well. I want to provide a safe and supportive environment for people to really deal with the issues they’re facing.

How does the experience of one of your patients differ from typical pre-natal care?

The people who come to me, for the most part, already know that something could be wrong. Even if I say, “Everything’s good,” emotions and questions come out that they might not have anticipated. And for the people who do have a problem, their care doesn’t stop with a diagnosis. I work with fabulous counselors and geneticists that I feel incredibly lucky to have as part of the team, because we each provide something different for the patient. It extends past, “Here’s what you do if you don’t want to have the baby. Here’s what you do if you do—ba-bye.” It extends to, “What are you feeling? Part of our job is to tell you the worst thing it could be, so you can prepare for anything. What can we do to help?”

In many cases, they may have to make a choice about a baby who is very much wanted, but who might suffer greatly. There are some who, after presented with all the possible outcomes, choose not to continue the pregnancy. We help set that up, and we help them afterward, knowing that no one enters into that lightly.

Some people think, “How awful that must be,” dealing with these kinds of situations. And yet, having gone through some of it myself, I see how ultimately, no matter how the big picture ends up, it’s an incredible learning and growing experience for moms and dads and families, especially when you approach it in a more comprehensive manner.

And, yeah, it is heart-wrenching to watch people have to go through this. But knowing that because of what we do, we are helping them through something that, no matter what, is going to be one of the hardest things in their lives. … For me, that’s what makes my job absolutely worth going to every single day.