Cora’s Law

by, Elizabeth McIntire

In northern Indiana in November of 2009, Cora McCormick was born–a full term apparently normal newborn. Her parents were thrilled at the birth of their first child. Her mother had experienced a perfectly normal pregnancy, labor and delivery. Cora took well to nursing and the new family went home from the hospital 48 hours after Cora’s birth.  Cora, her dad and mom Kristine spent three wonderful days together– until tragedy struck.

Kristine was nursing Cora when suddenly her baby girl turned blue/gray in her arms and stopped breathing. They rushed their newborn daughter to the hospital but nothing could be done. Cora died at five days of life. Cora’s cause of death was congenital heart disease.

Shortly after Cora died, her mother took up a crusade to make congenital heart defect screening in Indiana required as an addition to current newborn screening.

Due to Kristine’s efforts, in January 2012 “Cora’s Law” was passed by the Indiana legislature and required hospitals to screen newborns for critical congenital heart defects.

This is where I got involved. Prior to the law going into effect, perinatal providers throughout the state needed to become aware of the law and how it impacted newborn screening. I was responsible for developing an education program for these providers. As we were gearing up for implementing this law, I had the good fortune to meet Kristine McCormick, witness her advocacy for this screening and witness a mom who’s own heart was broken turn her grief into something truly amazing. I knew that if we could use Cora’s newborn picture—that of a completely healthy looking cubby cheeked baby girl, it would make an impact as we talked to physicians and nurses about the importance of the screening and new law.

Baby Cora

Kristine gave me permission to use Cora’s picture in our educational presentations and in a postcard I helped develop with the screening algorithm on it. Fast forward to February 1st, 2012, one month to the day after Cora’s law went into effect. On that day a baby boy, Gabriel, was born in southern Indiana. He too looked perfectly normal—like Cora. However, before he went home he underwent the screening that Cora’s mom advocated for. The screen was abnormal. The staff at the hospital repeated the screening and again, he failed. With the screening algorithm at hand, they knew what to do and he was transferred to a quaternary center for management. He was diagnose with a critical heart defect and underwent emergency surgery to correct the issue. He did well postoperatively and was able to return home with his family.

Several months after surgery, Gabriel came back to Indianapolis for a routine postop checkup. It occurred to me that Kristine needed to meet Gabriel’s mom and Gabriel’s mom needed to meet Kristine. I wanted these two women to come together—both bound by motherhood, tragedy and victory. They needed to meet, to heal, hug each other, and share Cora’s baby picture, laugh and cry.

Mother to mother—each of them understanding that Cora Mae McCormick was the reason they were there, the reason Gabriel was wiggling in a blanket in Kristine’s arms. I watched as the local news channel filmed the event and next to me was one of the neonatologists who helped with the statewide teaching efforts. I leaned over and told him—“this is what it’s all about. This is why we do what we do”. It was and still is one of the most profound moments in my nursing career.

Click here for additional information on Cora’s Law. You can also find information on the Cora’s Story Facebook page.

To find out more about pulse oximetry screening, visit: http://www.childrensnational.org/PulseOx/ 

 

Elizabeth McIntire, WHNP,WHNP-C, EFM-C
Elizabeth is the Director Maternity & Newborn Health at 
IU Health Riley. Elizabeth started her career in obstetrical nursing and has never looked back. Besides her family, her passions are high risk obstetrics, perinatal safety, and high reliability, challenging the process and modeling the way.

A Nurse Making History

By, Lori Boggan

Organ transplantation, according to the U.S. Department of Health and Human Services, dates back as early as 1869 with the first skin transplant. The first kidney transplant occurred nearly one hundred years later in 1954. Organ transplantation has saved countless lives. In 2014, transplantation history was made. It was the year the first transplantation bore life.

Tips to Ease Parental Concerns about Vaccinations

Parents consider health care professionals one of the most trusted sources in answering questions and addressing concerns about their child’s health. A recent survey on parents’ attitudes, knowledge, and behaviors regarding vaccines for young children ¾ including vaccine safety and trust ¾ found that 82% of parents cited their child’s health care professional as one of their top 3 trusted sources of vaccine information.  With so many parents relying on the advice of health care professionals about vaccines, a nurse’s recommendation plays a key role in guiding parents’ vaccination decisions.

What Children with FASD Want You to Know

by, Marilyn Pierce-Bulger, ANP

Jason is a 13 year old boy who knows he is different but he does not understand why.  He blames himself for the difficulty he has had in school and with social relationships over the years. He thinks he is not trying hard enough or is not smart enough.  His teachers and parents view him as willful, rather, than ‘unable’ due to his hidden disability.

Cardiovascular Disease In Pregnancy & Peripartum Cardiomyopathy

by, Julie Vasher, DNP, RNC-OB, CNS, C-EFM
Clinical Implementation Lead at the California Maternity Quality Care Collaborative at Stanford University

Janine is a 27-year-old African American woman who gave birth to her second baby without complications ten days ago. She came into the emergency room with complaints of cough and extreme tiredness. She attributes the fatigue to her new baby’s sleep schedule. She spoke in bursts because she appeared to be short of breath. Her vital signs are: blood pressure 120/60; heart rate 112 bpm; afebrile; respiratory rate 28 with an oxygen saturation of 94%; and she is considered obese (BMI 36). She has continued swelling in her feet. She is given antibiotics, steroids and breathing treatments. She feels better and is discharged home. A week later she returns to her physician with continued and worsening symptoms. The physician changes her antibiotic for an upper respiratory infection and suggests future testing for asthma.  A few days later, the patient experiences cardiac arrest at home and resuscitative attempts are not successful. Autopsy findings indicate she died from cardiomyopathy. (A composite case study representative of several PPCM cases found online)

Women are entering pregnancy with more chronic disease like hypertension, diabetes, and obesity. (CDC). Cardiovascular disease (CVD) is the leading cause of death for women during pregnancy and the postpartum period (Hameed, Lawton, McCain et al., 2015). Peripartum cardiomyopathy (PPCM) is an unusual disorder occurring in pregnancy that causes the heart to dilate and weaken, leading to symptoms of heart failure.

Perinatal Nurses Advocating for Bereavement Care for Women who Miscarry in the Emergency Department

by, Joyce Merrigan, RN

“If we don’t do it……it will never be done.”

The image will be forever ingrained in my memory: the remains of a miscarriage scooped up by a gloved hand in the emergency department,  tossed into a plastic specimen container and left on a counter. No condolences were offered to the woman who had experienced this loss. This memory haunts me to this day but also drives me to advocate for change.

Top 10 Posts of 2015

When we launched AWHONN Connections in May of this year, we could not have imagined the response that we would have received from our members, nurses, parents and members of the media.

In less than a year our blog has received over 232,000 visits, from 167 countries and had 4 blogs republished on the Huffington Post! As the year comes to a close we want to say a HUGE Thank You to our readers and our bloggers.

Here’s Our 2015 Top Ten Round Up!

Top 5 US Airport Mother’s Lounges & Nursing Stations

The holidays are in full swing and that means a lot of busy moms on the go! Traveling during the holidays can be stressful and traveling with little ones can add more stress. Finding a private and/or quiet place to nurse or feed your baby in a busy airport can be like finding a needle in a haystack, luckily we’ve done some research for you, here’s a look at the Top 5 US Airport Mother’s Lounges/Lactation Rooms.

6 Tips For Postpartum Care for Mom “The Patient”

by, Kristen Wesley “The Mom”

There is a moment after labor when you realize that not only is your sweet little baby a patient, but that you are too. At least for me, that was something that hadn’t really registered. On the day that my little baby girl Isla was born I very quickly began to understand we would both need a ton of care in the hospital and at home.

You would think from all the books I read, articles I scoured, and the numerous second hand accounts from friends I received, it would have sunk in. But it just didn’t. It literally never occurred to me that I’d be a patient too during and after labor and birth.

Why Every Baby Deserves Optimal Care In The NICU

by, Tracy Whitman, RN

Premature babies depend on us as nurses and parents to be their advocates, their protectors, and most importantly their voices.  Their development in the NICU should mimic as closely as possible the uterine environment.  As new parents of NICU babies, it is often hard to understand this concept, and that is when the NICU nurse is your best resource for education about your new baby.