Wednesday, December 6, 2023

When Should My Child Have a First Gynecologist Visit?

For many young people with a uterus, the thought of seeing a gynecologist for the first time can feel scary or even embarrassing, but this should be a time when they feel comfortable and able to ask questions about development and body changes. We talked with Dr. Valary Gass of Women’s Care of Wisconsin to provide you with the information you need to help your child feel more positive and less stressed out about the first gynecologist visit.

At What Age Should I Schedule the First Gynecologist Visit?

“The American College of Obstetrics and Gynecology recommends that people with uteruses between the ages of 13-15 visit with a gynecologist,” Dr. Gass explains. For many parents, a reasonable time to talk about scheduling this first appointment is after the first menstrual period. The real purpose of this appointment is to establish a relationship between your child and the gynecologist so they can feel comfortable asking questions and learn about what changes to expect as time goes on.

Preparing for Your Child’s First Gynecologist Visit

The most important thing you can do to help ease your child’s nerves is talk about the visit. Explain why this visit is important and what can be expected. Having an open dialogue with your child will encourage questions and increase comfort about the experience.

It is also a good idea to have your child create a list of questions for the gynecologist before the visit. Sometimes being nervous can cause us to be forgetful, so writing these questions down on a piece of paper will help make sure everything is answered.

Common topics for questions include periods, hormones, birth control, sex, and sexually transmitted infections. These are all normal topics for your child to have questions about. Remind your child that anything discussed with the gynecologist is protected by privacy laws. The gynecologist should be a safe and judgement-free space, so your child shouldn’t feel embarrassed about asking questions.

What Your Child Can Expect During the Visit

“Most of the time, a child’s first gynecologist appointment does not involve a pelvic exam,” Dr. Gass says, “but it should include taking a careful medical history, addressing any concerns like bad periods, and considering things like HPV vaccinations.” During your child’s first gynecologist visit, expect to have a general physical exam where the nurse will record height, weight, and blood pressure. The gynecologist may then check for common health problems and talk about any medical history. Listening to heart, lungs, and feeling the abdomen should be expected. Sexually active persons under age 25 should have annual gonorrhea and chlamydia screening. This can be done at the visit with a simple urine test. The gynecologist will ask about sexual activity and address any need for contraception.

The most important thing to keep in mind is that this visit is an opportunity for your child to speak openly with the gynecologist and ask questions.

When Is a Pelvic Exam Necessary?

“The American College of Obstetrics and Gynecology suggests that most people with a cervix begin regular Pap smear screening at age 21,” Dr. Gass says. At that point, regular screening should continue every three years until age 30 when they can switch to having a Pap smear with HPV co-testing every five years. Your child most likely will not need a pelvic exam during the first gynecologist visit, unless there are complaints of lumps, bumps, pelvic pain, or abnormal discharge. In these instances, the gynecologist may decide a pelvic exam is necessary. Our office offers nitrous oxide to help patients relax during exams or procedures if needed.

When Should My Child Stop Seeing the Pediatrician?

Once your child is seeing a gynecologist regularly, you may wonder if they need to continue seeing the pediatrician. This is largely up to you and depends on the specific needs your child has as well as the gynecologist’s preference for their practice. It is perfectly normal for your child to continue seeing a pediatrician into college and it can be helpful with a complicated medical history. Just make sure your child continues the annual gynecologist visit as well.

For More Information:

https://www.acog.org/womens-health/faqs/your-first-gynecologic-visit

https://www.acog.org/womens-health/experts-and-stories/the-latest/should-my-teen-see-an-ob-gyn-heres-what-i-tell-parents

https://www.naspag.org/for-patients

Schedule An Appointment

If you would like to schedule an appointment with one of our providers at Women’s Care of Wisconsin, please call or text us at 920.729.7105

Tuesday, November 28, 2023

Meet Jenny Taubel, Certified Nurse Midwife

We are proud to welcome Jenny Taubel, CNM to Women’s Care of Wisconsin. Jenny brings an extensive background and limitless positivity to our Appleton clinic, providing support and care to her patients during pregnancy, labor, and birth, as well as health services to women through all ages and stages of life. This quick Q & A will help you get to know Jenny. We’re certain you’ll think the world of her, just as we do.

Can you describe the journey that led you to becoming a certified nurse midwife?

I started off as a labor and delivery nurse right out of nursing school and I was working full time pm shifts back in the day when they were still eight-hour nursing shifts. After several years on a very busy large labor and delivery unit, I decided I really wanted something more and to try something new, so I started investigating master's degree nursing programs. I found a nurse midwife program at Marquette University. I applied and was accepted and graduated in their third class of nurse midwives.

What are your areas of expertise?

As a certified nurse midwife, I provide prenatal care and labor and delivery care for low risk, healthy, normal women. I also assist on C sections. I provide annual GYN exams including pap tests, STI screening and treatment, contraceptive counseling; I do insertions and removals of things like Nexplanon and IUDs as well.

What do you love most about your job as midwife?

What I love most about being a nurse midwife is not only delivering babies, of course, but also the long-lasting relationships that I've established with women over the years and who I talk to, to this day. And I love hearing that they've had a good experience with me, and they come back for their second, third or even fourth baby.

What can a patient expect from you when they come to see you?

What a patient can expect when they come see me is that I'm a very good listener. I want the patient to have the kind of quality care that I want for myself. I've been working in the healthcare field for a very long time and I know what good care is all about. That's the type of care that I want my patients to experience. So that means that they'll be listened to, understood, they'll be given all the information they're seeking and their options for care. And they’ll never feel rushed. Ever.

Do you have any words of wisdom for patients from somebody who has done this for as long as you have done this?

I just want patients to know that they are not alone in whatever they're going through, whether it be a pregnancy concern or GYN concern. And I, myself have been a patient many, many times, and I've gone through some very scary, crazy medical conditions that I've overcome (survived actually). And that's made me stronger and more empathetic to patients that might be going through a tough time. I feel that I can really support them because of what I've gone through and share with them some of the things and I think that really helps them.

How about a little personal information?

I'm married and I have two adult daughters. And I have two dogs and a grand puppy. I love traveling whenever I can, especially going up north to Wisconsin lakes during the summer and renting kayaks or a boat and just having a lake vacation.

Anything we missed?

Just that I feel that being a nurse midwife is my calling. And I'm very lucky that I found that because I know not everybody does. But it’s just that certain feeling you get when you just know you're doing the right thing in your life.

To schedule an appointment with Jenny, please call or text 920.729.7105.

Monday, November 13, 2023

Patient-Controlled Nitrous Oxide: What’s It All About?

At Women's Care, we believe in providing our patients with options so we can develop a health plan that meets both their physical and emotional needs. That means having the most advanced techniques, which is why we're happy to offer patient-controlled nitrous oxide to assist with pain relief and anxiety during gynecological procedures.

"We have a lot of women who are now choosing to use nitrous just because of the ease and the availability," Deidre Polar, RN, explains. "Before when we didn't have it, just the simple procedure of an IUD placement or a biopsy for a patient who couldn't tolerate it meant we would have to use sedation of some sort."

Nitrous oxide has been a common practice to help cope with pain for many years. Commonly called "laughing gas,” nitrous oxide is mainly used in dental offices to help with pain during dental procedures. When used for gynecologic pain/procedures, it is a mixture of 50% nitrous gas and 50% oxygen. The gas is self-administered by the patient and inhaled through a mask for about 30 seconds before the procedure begins.

Unlike a sedative, the effects of nitrous oxide start to fade quickly as the gas is cleared from the body through the lungs. Within a few minutes after the nitrous oxide mask is pulled away, the gas leaves the patient's system, making it a great option for women who need to drive after their procedure.

"Nitrous oxide completely relaxes the patient enough without the complications that could arise when having to go to sleep," Deidre says. "It's much better than using a sedation option where the patient would be down and out for the rest of the day."

A common question Deidre hears from interested patients: “Are there any reasons I could not use nitrous oxide?”

You cannot use nitrous oxide, says Deidre, if you:

  • Cannot hold your own facemask
  • Have a known vitamin B12 deficiency
  • Have received a narcotic medication within the past 2 hours
  • Have other medical conditions identified by your provider that place you at risk

If you would like more information about how to request nitrous oxide for your next procedure, please call our office at 920.729.7105 to speak with your provider or nurse.

 

 

Monday, November 6, 2023

Achieving Your Ideal Birth (X3): One Mother’s Story

Author’s Note 1: Natalie had reservations about sharing her journey as first submitted. While our views of the finished product differed, we are in complete agreement about whose editorial vision is most important.

She is adamant this piece should reflect that she’s a person speaking honestly and candidly about her own individual experience, insisting that in no way, shape or form should it seem “preachy.” I didn’t (and still don’t) think she was portrayed as someone advocating a certain path. As a matter of fact, she went to great lengths to tell me just the opposite.

So, consider this version similar to the original, with some minor but essential tweaks and, of course, the addition of the three paragraphs you have just read.

There’s a full spectrum of thought about dealing with the pain and intensity of labor. Some women prefer interventions that can include epidural, nitrous oxide or IV medications to calm and ease the body; others elect to avoid medication-based pain management.

Natalie Demler has strong convictions about unmedicated births. She’s had three of them.

Demler acknowledges that friends are sometimes incredulous and need to ask a question or two just to make sure she’s thought everything through.

“You know we have modern medicine, right?” they say. Or, “Do you really want to put yourself through all that?”

She got it from family too.

“My own mom was like that,” Demler said. “She didn’t want me to be in pain.”

With her first child, Demler made it a goal to have an unmedicated birth. With the support of her husband Jake, she completed a five-week course on hypnobirthing, which combines breathing, relaxation, visualization and other techniques to help naturally manage pain during labor and birth. She did a lot of reading, educating herself on birth choices and how to advocate for those choices.

“I just wanted to experience the birth of my child in its entirety,” said Demler. “I learned how incredible a woman’s body is, and how getting through those intense moments was, for me, really a question of mind over matter. It was so worth it, so empowering to be able to say that I did it. Even to myself.”

She describes what she feels are additional benefits of an unmedicated birth (“the baby is more alert, you can stand up right after because your legs aren’t numb, recovery is typically easier”), but Demler is no proselytizer.

“My friend who went into labor three days before me knew she wanted an epidural, and I totally get that,” said Demler. “It’s a completely unique experience for every woman.”

Any thought of yielding to the pain during her first labor was met with resolve.

“I just had to get through the tough moments when I started to doubt myself and my body’s ability to birth,” Demler said.

That meant complete focus on her breathing and a hyper awareness of her own mental state.

“You try to make every thought positive,” said Demler. “You try not to tense up or panic, which is easier said than done, and use your adrenaline to give you strength.”

She has a vivid recollection of what she felt after powering through intense moments.

“All of the pain disappears when the baby is placed on your chest,” Demler said.

Following the birth of her daughter Emory and her son Everett (Demler pauses here and adds “unmedicated births don’t get easier, by the way”), both delivered by an OB/GYN she called phenomenal, Demler was greeted with the news that her longtime provider was leaving the area.

She found out three weeks before her due date.

“I’d been with him since I turned 21,” Demler said. “We had a really close bond; he was with us during our miscarriage. I was pretty devastated that he was leaving and worried about how things were going to go. That’s when I found Kay.”

In her search for a new provider, Demler contacted Women’s Care of Wisconsin, and the receptionist felt that midwife Kay Weina would be a great fit for her. Demler asked around and heard nothing but good things (“Kay’s amazing!” “You’ll love her!”)

At 35 weeks, Demler met Weina for the first time and transferred her care to the midwife.

“She hugged me, and immediately asked if I wanted a tour around the facility and to look at the room,” Demler said. “She was so personable and right away I had a feeling that everything was going to be fine, that she was going to take good care of me and the baby.”

Weina made clear that whatever vision Demler had for the birth was the way they were going to make it happen.

“Birth is sacred and spiritual for every woman, and it’s every woman’s own unique experience to bring a child in the world,” Demler said. “My husband and I prayed every day that we’d find the perfect provider, one who believes in you and helps you through intense moments. I knew Kay was going to be there for me. She made me feel safe.”

For someone making transitions in the late stages of a pregnancy, Demler was pretty good about rolling with the changes. A certain amount of angst set in, however, when she found out Weina was about to do something she rarely does, and right around go time.

“I found out Kay was going on vacation for a couple of days,” said Demler. “I was not ready for someone else to deliver this baby!”

Demler had an appointment with Weina on a Wednesday; the midwife was leaving later in the week and would be gone for the weekend. Demler wanted to know what was going to happen if she didn’t go into labor before Weina left.

“No, you will,” said Weina.

Demler asked about a Plan B just in case.

“Nope, let’s not even go there,” said Weina. “You’re at four centimeters. You’re going into labor. And you’re having this baby.”

Sure enough, a few hours later Demler started having contractions.

“I got the kids home, my daughter had her first dance class, and I felt my first contraction,” she said. “I texted Kay right away, which I thought was really cool. I mean, who gives you their cell number?”

Demler returned her focus to breathing techniques, keeping herself in rhythm. Paradoxically, she found the opposite of focus could also be beneficial.

“Distractions, like taking a bath or cleaning the house during contractions, helped too,” she said.

Weina met them at the hospital shortly after Demler donned her gown. The midwife walked the halls with her, the movement and Weina’s peaceful demeanor bringing comfort. The hospital room exuded a feeling of calm as well, as treasured music transformed the space into something more like a birth center.

Later, when things began to ramp up and intensify, especially early in labor, Demler needed to fight. As contractions became acutely painful, she leaned into them, bolstered by a powerful thought that became a meditation:

“That was a big one; I’m getting closer to meeting my baby!”

Weina delivered Elsie Rae on July 13, 2023

“Kay was phenomenal during labor, cheering me on. Jake was encouraging me the whole time. I focused in on what I needed to do. With Kay and Jake’s support, Elsie was born into a room full of love and joy.”

Author’s Note 2: Following our interview, Natalie shared a note she jotted down one night during a late night feeding session with Elsie soon after her birth. Powerful words.

Elsie is our greatest surprise. A surprise pregnancy but little did I know that she would be all our family needed and more. I’ll never forget sitting on the bathroom floor that November morning with our two year old and six month old—they were both very sick with RSV and I had been spending a lot of time in a steamy bathroom with them to help them breathe. We were sleep-deprived parents and it had been a rough week to say the least, and that’s when I found out about our surprise baby. Staring at the positive test while holding my sick babies, I just thought “How am I going to do this?” but after the initial shock that we were going to have three under three faded, we couldn’t have been more excited. I dreamt of who this little one would be every day—a boy or a girl. Deep down I had a feeling, she would be a girl and we would name her Elsie. I can’t imagine our life without her now—she is the most perfect addition to our family. She has the bluest eyes and sweetest smile (with one dimple). She is the calm to our storm most days. The reasoning of why we chose Elsie is special to us as well. It means, “God is my oath,” or “Pledged from God” in Hebrew. Middle name is after my mom and great grandpa Ray. She was born at 12:34am, which is an angel number. Angel numbers are said to be special and I can’t help but think this sweet surprise baby is here for a very divine purpose. I continue to see 12:34 on the clock, just as I see 11:11—which is the time our son Everett was born (another surprise baby).

Although it was not what we had planned for our family, we trust that God knew what our family needed.

Wednesday, November 1, 2023

An Important Time to Raise Awareness

Pregnancy is one of the most exciting and vulnerable times of a woman's life. Most of us have thought about pregnancy and how our pregnancy would go long before we were actually pregnant. Most of the time, everything goes just right. However, almost one in ten women deliver preterm (defined as less than 37 weeks). These babies miss out on the important growth and development that happens in the final weeks. Preterm birth is a leading cause of infant mortality. Babies who survive can have health problems, both short and long-term. 

Some of the signs and symptoms of a preterm labor are:

  • Contractions (the abdomen tightens like a fist) every 10 minutes or more often
  • Pelvic pressure – the feeling that the baby is pushing down
  • Low, dull backache
  • Cramps that feel like a menstrual period
  • Abdominal cramps with or without diarrhea

It is important to notify your doctor if you think you are experiencing preterm labor.

While we don’t understand all the reasons some babies are born too soon, we do know that some factors increase the risk of preterm birth, including women with a history of preterm delivery, short cervical length noted on ultrasound, a history of cervical surgeries such as a D&C, and smoking. Other risk factors include young or advanced age of the mother, substance abuse, stress, depression, and carrying more than one baby.

The Centers for Disease Control (CDC) has identified five proven strategies to reduce preterm births:

  • Prevent unintended pregnancies and achieve an ideal length of time between pregnancies
  • Provide women ages 18–44 years access to health care before and between pregnancies to help manage chronic conditions and modify other risk behaviors
  • Identify women at risk for giving birth too early and offer effective treatments to prevent preterm birth
  • Discourage deliveries before 39 weeks without a medical need
  • When in vitro fertilization is used, elect to transfer just one embryo, as appropriate, to reduce multiple births

As November is Prematurity Awareness Month, we invite everyone – future parents, pregnant women and everyone supporting them through their pregnancy, healthcare providers, public health professionals, and others – to learn about preterm birth and take action to prevent it.

The providers of Women’s Care of Wisconsin believe having a healthy pregnancy starts before a woman is pregnant. Healthy babies begin with healthy mothers. We promote a well-balanced lifestyle to our patients, which means preconception care, proper nutrition, routine exercise, a healthy, safe environment, as well as a daily prenatal vitamin with folic acid. With good guidance, avoidable conditions that may have everlasting consequences may be prevented.

We would love the privilege to take care of you and answer any questions you might have about pregnancy care or preterm deliveries. Call or text us at 920.729.7105 if you have any questions or concerns.

The physicians at Women's Care of Wisconsin are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information and a compassionate, caring staff. Our providers offer a well-rounded approach to your OB/GYN care, one that meets both your physical and emotional needs throughout every phase of your life. We call it our Circle of Care.

Wednesday, October 18, 2023

Nikki's Journey

“I was so blessed to have the twins,” said Nikki Riehl.

Still, when you have a toddler and hear that you have twins on the way, it’s an attention-getter.

“I’ll admit there was some worry going through my head,” said Riehl.

Once the impact of the news was processed, Riehl’s focus shifted immediately to the health of her babies, as a twin pregnancy can mean an increased chance of health complications. Riehl’s twins were fraternal.

Developing babies get oxygen and nutrition from the mother via the placenta and umbilical cord. In the case of fraternal (aka non-identical or dizygotic) twins, each has its own placenta and umbilical cord. Fraternal twins can be same or opposite sex and can look different.

Riehl knows something about fraternal twins, as she is one.

“I had my mom to lean on when it came to questions, which was really nice,” she said.

 A twin pregnancy with separate placentas and amniotic sacs is the optimal twin pregnancy, as each baby has its own source of nutrition (and protective membrane as well).

Mothers expecting twins can expect more ultrasounds, and one of Riehl’s ultrasounds revealed that Baby B (the baby positioned lowest in the uterus is known as Baby A) had an excessive amount of amniotic fluid surrounding it. Symptoms are generally mild, but severe cases can lead to shortness of breath, swelling, discomfort and malposition of the fetus. Complications include premature birth.

Riehl was diagnosed with gestational diabetes, a known cause of an increased level of amniotic fluid (aka polyhydramnios). To combat the condition, Riehl saw a dietician, changed her diet, and was instructed to be more active.

“I went on a lot more walks,” Riehl said. “And I had to poke my finger and check my blood sugar four times a day.”

Her c-section was scheduled the Tuesday after Memorial Day. Riehl visited her OB/GYN, Dr. Therese Yarroch, on the previous Tuesday for her final checkup, and things seemed to check out.

“Dr. Yarroch said I’ll see you next Tuesday,” said Riehl, “but I got a call from her on Saturday.”

Yarroch’s review of the last ultrasound showed a potential anomaly: the umbilical cord could be wrapped around Baby B’s neck. While the image was inconclusive, the excess amniotic fluid could have led to the baby moving around more emphatically.

“She wanted me to go to the hospital right away for an NST,” Riehl said.

An NST, or Non-Stress Test, is performed in the third trimester of pregnancies to measure fetal heart rate as well as the contractions of the mother. It can indicate if the baby is not receiving adequate oxygen because of an issue with the umbilical cord.

The test showed Baby B’s movements were good. If the cord had been wrapped around Baby B’s neck, his heart rate would have been dropping and he wouldn’t be moving as frequently as usual. The NST usually takes 20-30 minutes. Riehl’s was at the two-hour mark.

“I felt Baby B moving in there and the heartbeat was fine for that entire time,” said Riehl. “I wasn’t sure why they were monitoring me for that long, but then Baby’s B’s heart rate started to drop.”

Yarroch suggested the c-section be performed right away.

It turned out Baby B’s cord was wrapped around his neck, three times, and he wasn’t breathing when he arrived. Baby A was breathing normally but five minutes later he too began to struggle. Both were whisked to the NICU and intubated.

“They just needed a little kickstart to help their lungs,” Riehl said.

She couldn’t go to the NICU until she was well enough to get out of bed and into a wheelchair, which took several hours.

“I was anxious to get to the NICU because I hadn’t seen my babies yet,” said Riehl. “They had four nurses working on them and they were in contact with me, so I was hopeful. The nurses were so awesome.”

She got to hold her twin boys, Rhett (Baby A, “the laid back, relaxed one”) and River (Baby B, “who just wants to be held”), on Sunday morning. They were out of the NICU the next day.

Many thanks to mom for telling her story while deftly caring for three-month old twins and their big sister Maddie—who let us know repeatedly that she did not appreciate the lack of attention, at all.

We end with the Facebook comment from Riehl that was the catalyst for us to reach out and learn more:

“Dr. Yarroch delivered our twin boys on May 27th via c-section. Baby B was having some complications and she used her professionalism and followed her gut to get both boys out safely to avoid further problems! I am so thankful for her and now we have two beautiful and healthy boys!”

 

Wednesday, September 20, 2023

Chrissy's Journey

After several years of marriage, Chrissy O’Connell and her husband Patrick decided it was time to start a family.

“We were trying and it just wasn’t happening,” she said. “I went to see Dr. Reed to get tested; the results revealed I had poor egg quality and low egg quantity.”

That begs the question of how O’Connell came to meet the provider who would be with her on her fertility journey.

“As a marketing guy, you're gonna love this: I picked Dr. Reed because of her video on the Women's Care website,” O’Connell said. “And we clicked immediately. When we talked about fertility, she understood my struggles because she had had her own.”

Long story short, after three rounds of intrauterine insemination (IUI), the O’Connells were still not pregnant.

“We decided on one last round of IUI,” O’Connell said. “It gets expensive. It's not covered by insurance, it's never guaranteed, your body's going through a lot because you're on different drugs, you’re getting injections into your belly, tons of ultrasounds, the egg checks and the bloodwork. It's just a lot to physically go through.”

But the fourth time was the charm.

“We got the news about our miracle baby,” she said.

Later, they’d receive other news.

At her 20-week ultrasound, O’Connell found out she had placenta previa and vasa previa. The first condition is when the placenta partially or fully covers the cervix; the second is when some of the blood vessels that connect the umbilical cord to the placenta lie over or near the entrance to the birth canal.

“Basically, my placenta and the baby’s umbilical cord were routed right over my cervix,” O’Connell said. “Those sure can’t come out first.”

The presence of placenta previa required that her team keep a watchful eye on the position of the placenta (a low-lying placenta can cause severe bleeding in the mother before, during or after delivery) and cervical length (a short cervical length is associated with increased risk of hemorrhage and preterm birth), as well as to closely monitor blood flow through the umbilical cord.

Vasa previa, a rare and serious pregnancy complication, can lead to severe, potentially life-threatening blood loss to the fetus. Once diagnosed, a c-section is scheduled, typically at weeks 34-37. Careful monitoring continues throughout the pregnancy to maximize the amount of time pregnant while taking care to deliver the baby before the onset of labor.

“They told me I was going to be in the hospital at a certain point in my pregnancy, that I was probably having a NICU baby at 34 weeks,” O’Connell said.

For O’Connell, this meant being admitted to the hospital at 28 weeks.

“In the six weeks of my hospital stay I think I met every one of Dr. Reed’s partners at Women’s Care,” said O’Connell. “I was there long enough that everyone had the chance to round on me.”

Dr. Reed would deliver baby Maggie via c-section at 34 weeks. And there was a NICU stay.

“We had our miracle baby, then we lost two babies that we conceived naturally,” said O’Connell. “Then we had our second baby, Bailey, two and a half years later. I had a repeat c-section so I knew what I was headed into, but I did not know what it was like to be pregnant after 34 weeks. So every day was like ‘I’ve never been this pregnant before!’ But after Bailey we did have two more miscarriages.”

O’Connell ends with a memory from her first pregnancy.

“There was one day that Dr. Reed came in and sat on my bed,” said O’Connell. “She held my hand and told me how I was handling the situation with such grace. She was my biggest cheerleader. She helped create baby Maggie, supported us through miscarriages. She’s one of my absolute favorite people.”

Maggie is now in first grade (“she’s energetic and compassionate”); Bailey, who loves being a little sister, is in 4K (“she’s playful and silly”). The two are different in many respects but share the most wonderful commonality.

“They are our miracles,” said O’Connell.