{"id":74590,"date":"2024-03-13T14:03:22","date_gmt":"2024-03-13T20:03:22","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=74590"},"modified":"2024-03-14T17:29:35","modified_gmt":"2024-03-14T23:29:35","slug":"how-an-extraordinary-team-helped-her-through-a-rollercoaster-pregnancy-with-triplets","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/how-an-extraordinary-team-helped-her-through-a-rollercoaster-pregnancy-with-triplets\/","title":{"rendered":"How an extraordinary team helped her through a rollercoaster pregnancy with triplets"},"content":{"rendered":"
<\/div>
\"Sutton
Sutton Grant weighed just 1 pound 3 ounces when he was born on Jan. 3, 2023. He’s a remarkable survivor and is doing well now. He continues to need oxygen, so his mom, Lexie Grant, carries a 20-pound oxygen tank when they go to their neighborhood park. He especially loves the swing. Photo by Sonya Doctorian, UCHealth.<\/figcaption><\/figure>\n

The first shock of the pregnancy came when Lexie Grant learned she was expecting triplets.<\/p>\n

She and her husband, Collin Grant, were eager to have another baby. But they hadn\u2019t been doing IVF. So they had zero expectations of having multiples, much less very rare naturally-conceived triplets.<\/p>\n

Lexie was suddenly considered a \u201chigh risk\u201d patient, so she started seeing doctors at the UCHealth Women\u2019s Care Clinic<\/a> on the Anschutz Medical Campus<\/a> in Aurora.<\/p>\n

At an early appointment, Lexie\u2019s doctors offered her access to an extra service. Would she be interested in receiving behavioral health support during her pregnancy from a therapist?<\/p>\n

The PROMISE Clinic<\/a> at UCHealth University of Colorado Hospital<\/a> is unique among obstetrical programs nationally, even those at prestigious academic medical centers.<\/p>\n

\u201cThere are very few truly integrated OB (obstetrics) programs around the country,\u201d said Dr. Bethany Ashby, director of the PROMISE Clinic.<\/p>\n

\"Baby
Sutton Grant, 3-months-old, with teddy bears representing his triplet brothers who didn’t survive a difficult pregnancy. Photo by Missy Long, Mx4 Lifestyle Photography, courtesy of Lexie Grant.<\/figcaption><\/figure>\n

Often patients who are struggling during pregnancy or after the birth of a baby will be referred to therapists or psychiatrists elsewhere in a hospital or community. But at University of Colorado Hospital, obstetrics experts work side-by-side with psychologists, psychiatrists and other behavioral health providers so they can give patients essential access to therapy and medications.<\/p>\n

\u201cThere are very few obstetrics clinics where you have clinicians on site every day who can see you right then and there,\u201d said Ashby, who has a doctorate in psychology and is also an associate professor of psychiatry<\/a> and OB-GYN at the University of Colorado School of Medicine<\/a>.<\/p>\n

Along with Ashby, Dr. Stephen Scott<\/a>, associate professor of OB-GYN and pediatrics<\/a>, and Dr. Debbie Carter, associate professor of psychiatry<\/a>, serve as co-directors of the PROMISE Clinic, ensuring that medical experts can address all aspects of perinatal mental health.<\/p>\n

At least one of every five pregnant patients will experience mental health challenges during pregnancy or the postpartum period. Rates of perinatal depression and anxiety are highest among people who don\u2019t speak English and those who identify as LGBTQ+. For non-English speaking patients, PROMISE has bilingual clinicians and works closely with interpreters to provide mental health support. PROMISE Clinic providers also have developed tailored treatment options for LQBTQ+ patients.<\/p>\n

\u201cDepression and anxiety are the most common complications of pregnancy,\u201d Ashby said.<\/p>\n

Thus, access to behavioral health care is essential, but as many patients know, it can be extremely difficult to find help.<\/p>\n

That\u2019s where the PROMISE Clinic is remarkable and life-changing.<\/p>\n

Psychiatrists, psychologists and licensed clinical social workers work side-by-side with doctors, midwives, nurses and other medical experts to care for those who are pregnant or have recently given birth.<\/p>\n

The program has grown dramatically in recent years and now serves more than 1,200 individual patients each year, Ashby said.<\/p>\n

The clinic receives funding through Medicaid and the University of Colorado School of Medicine. UCHealth contributes support staff, space at the hospital and access to electronic health records. At least 35% of patients whom the clinic serves are low-income Medicaid recipients.<\/p>\n

First, news of triplets, then a roller coaster of hopes and losses<\/strong><\/h2>\n

At first, Lexie thought she\u2019d be fine and wouldn\u2019t need any counseling during her pregnancy.<\/p>\n

Then, reality hit.<\/p>\n

\u201cI was so stressed,\u201d she said.<\/p>\n

Lexie and her husband learned they were expecting three boys \u2014 each growing in his own amniotic sac with his own placenta \u2014 or what\u2019s known as a highly unusual \u201ctri\/tri pregnancy.\u201d<\/p>\n

When she learned that she was carrying triplets, Lexie went into practical mode. The couple already had an older son, Campbell, then age 3. Lexie tried to envision how their family of three would instantly double.<\/p>\n

\u201cI wanted a second child, but I was a little pessimistic about having four children overnight. I thought, \u2018How are we going to do this? Our daycare costs alone are going to be $6,000 a month. We\u2019re going to have to buy a new car and move to a new house.\u2019\u201d<\/p>\n

\"Lexie
Lexie and her husband, Collin, with Sutton and his older brother, Campbell. The family recently celebrated Sutton’s first birthday and also remembered his brothers, Noah and James, whom they were devastated to lose during pregnancy. Photo by Sonya Doctorian, UCHealth.<\/figcaption><\/figure>\n

Just when Lexie and her husband were getting used to the idea of welcoming triplets, another shock hit.<\/p>\n

The water of \u201cBaby C\u2019s\u201d sac had broken. The couple had named him Noah. Without fluid to sustain this baby, Lexie and Collin presumed they had lost one of their triplets. At a subsequent prenatal appointment, however, they learned that the fluid in Noah\u2019s sac had somehow filled again.<\/p>\n

\u201cWe ended up trying to continue carrying all three of them. It was this roller coaster of emotions, week after week,\u201d Lexie said.<\/p>\n

\"Sutton
Sutton Grant at 4 weeks old seems to gesture to a sign that recognizes his brothers, Noah and James, who didn’t survive a very challenging pregnancy. Photo courtesy of Lexie Grant.<\/figcaption><\/figure>\n

Thankfully, Cindy Covell, a licensed clinical social worker with the PROMISE Clinic, had become a key part of Lexie\u2019s team. Whenever Lexie needed mental health support, she could see Cindy either in person or via online appointments, which had greatly expanded during the COVID-19 pandemic.<\/p>\n

\u201cCindy became an invaluable part of our team. I can\u2019t imagine what it would have been like without her. We leaned on her every single week,\u201d Lexie said.<\/p>\n

As Lexie\u2019s challenging pregnancy became more and more complex, she opted to start taking antidepressants and anti-anxiety medications. With guidance and expertise from Dr. Carter, a psychiatrist and the PROMISE Clinic\u2019s co-director, Lexie tried various options, from sertraline (also known as Zoloft) to escitalopram, lorazepam and trazodone.<\/p>\n

\u201cI had never been on medications like this,\u201d Lexie said. \u201cBut I definitely needed them. We\u2019ve had some very scary moments. I call them my crisis medications.\u201d<\/p>\n

Carter is an expert at prescribing and managing medications for anxiety, depression and other mental health issues that can arise during the perinatal period. She also helped Lexie with education materials and parenting strategies to support the Grants\u2019 son, Campbell, as his mom coped with a complex, difficult pregnancy.<\/p>\n

Welcoming a 1-pound baby and grieving for two brothers <\/strong><\/h2>\n

As more stress and more shocking news hit, access to both medications and regular counseling proved critical.<\/p>\n

When Lexie was about halfway through a traditional 40-week pregnancy, the couple suddenly learned they had lost both Noah and another of the triplets, James. Even more frightening, the lone surviving triplet, Sutton, was not growing well due to what\u2019s known as IUGR or intrauterine growth restriction.<\/p>\n

\"Lexie
Lexie cradles the crocheted carriers that held the bodies of her two sons, Noah and James. Bears represent the two triplets who didn’t survive but were delivered by C-section when Sutton was born at 28 weeks. He weighed 1 pound, 3 ounces. Photo by Sonya Doctorian, UCHealth.<\/figcaption><\/figure>\n

Still, there was little doctors could do. Sutton was too small and undeveloped at that point to deliver. Lexie had to do her best to nourish tiny Sutton, while mourning the two other babies in her belly who had died. She did her best to make it long enough so doctors could safely bring Sutton into the world.<\/p>\n

\u201cIt\u2019s been a lot,\u201d Lexie said of the unrelenting challenges. \u201cWe made it to 28 weeks.\u201d<\/p>\n

Sutton was born on Jan. 3, 2023 and weighed just 1 pound, 3 ounces and measured about 10 \u00bd inches long.<\/p>\n

\u201cHe was the tiniest baby, a micro-micro preemie,\u201d Lexie said.<\/p>\n

As she and Collin welcomed Sutton, doctors also delivered Noah and James, who, as expected, had not survived. While celebrating the arrival of one baby, Lexie and Collin had to grieve for two lost sons.<\/p>\n

They also entered a new world of stress, navigating daily hopes and fears as Sutton fought for his life in neonatal intensive care units (NICUs) at University of Colorado Hospital and later, at Children\u2019s Hospital Colorado. In all, Sutton spent about seven months in NICUs in both Aurora and Broomfield, where the Grants live.<\/p>\n

Sutton is now 14 months old. He still needs oxygen but is a smiley happy toddler and has been growing beautifully.<\/p>\n

\u201cWhen we last weighed him, he was 17 pounds. He\u2019s gotten huge. We\u2019re so proud,\u201d said Lexie. \u201cHe\u2019s the sweetest little boy. He\u2019s really starting to develop his personality. He\u2019s calm, observant, easy-going and very, very happy.\u201d<\/p>\n

Lexie and Collin have plenty of nicknames for their son, calling him \u201cSuttie,\u201d and \u201cBubba,\u201d while now 4-year-old proud big brother, Campbell, calls his younger bro, \u201cSutton Button.\u201d<\/p>\n

\"Lexie
Sutton is a surviving triplet from a very difficult pregnancy that his mom endured. His mom, Lexie, received critical counseling through the PROMISE Clinic, a unique program where psychiatrists and therapists team up with OB-GYNs. Photo by Sonya Doctorian, UCHealth.<\/figcaption><\/figure>\n

Program started as a one-day-a-week clinic<\/strong><\/h2>\n

The PROMISE Clinic began nearly 15 years ago as a one-day-a-week clinic, with Dr. Scott leading the integrated behavioral health efforts.<\/p>\n

Services grew dramatically during the COVID-19 pandemic, as PROMISE started offering regular video visits in addition to in-person appointments.<\/p>\n

While some patients like to see a behavioral health provider in person, those who have just had a baby can find it very challenging to get out of the house for doctors\u2019 appointments.<\/p>\n

Ashby said the online visits have proven to be extremely popular.<\/p>\n

Patients can seek help throughout the perinatal period, which includes both prenatal care before a baby arrives and the postpartum period after the birth of a baby.<\/p>\n

\u201cPatients can be seen at any point during their pregnancy and up to six months postpartum, and there\u2019s not a limit to the number of visits. We match the frequency of visits to the patient\u2019s needs,\u201d Ashby said.<\/p>\n

\"Lexie
Lexie and her husband, Collin, play with Sutton and his older brother, Campbell. Campbell likes calling his little brother “Sutton Button.” Photo by Sonya Doctorian, UCHealth.<\/figcaption><\/figure>\n

Why are the prenatal and postpartum periods so difficult for some women?<\/strong><\/h2>\n

Ashby said many people don\u2019t understand how precarious both the prenatal and postpartum periods can be. The reasons that anxiety, depression and other challenges surface or grow more severe during pregnancy are complex.<\/p>\n

\u201cOne significant component is the rapid hormone changes that occur in pregnancy,\u201d Ashby said.<\/p>\n

\u201cIn addition, some patients are more biologically susceptible to these hormone changes than others. Some patients already have a history of depression, anxiety or bipolar disorder. So, they\u2019re more likely to have an exacerbation of symptoms,\u201d she said.<\/p>\n

For some low-income patients, finances can be lacking, along with paid maternity leave.<\/p>\n

\u201cPeople who lack financial resources are likely to have a lot more stressors,\u201d Ashby said.<\/p>\n

\"Sutton
Sutton continues to do very well after a challenging start. When he was trying to eat via a bottle, he sometimes aspirated fluid into his lungs, which caused repeated infections. These days, Lexie and her husband, Collin, use a feeding tube. Sutton eats every three hours from 6 a.m. to 9 p.m. daily. Each feeding takes an hour. Sutton is a relaxed toddler and enjoys play with his toys during feedings, but someone needs to be with him throughout the process. Photo by Sonya Doctorian, UCHealth.<\/figcaption><\/figure>\n

In addition to dealing with economic challenges, some new parents may not have strong support symptoms.<\/p>\n

\u201cIn pregnancy and during the postpartum period, we need to rely on partners, family members and friends to help us. If we don\u2019t have a strong network of support, we can really struggle,\u201d Ashby said.<\/p>\n

Physical challenges also can make mental health challenges much worse.<\/p>\n

\u201cThe lack of sleep that happens right after you\u2019ve had a baby can exacerbate mental health symptoms,\u201d Ashby said.<\/p>\n

Furthermore, having a baby can bring back memories of childhood trauma or struggles earlier in life.<\/p>\n

\u201cIf your childhood experiences were difficult, trauma, anxiety and depressive symptoms can surface again,\u201d Ashby said.<\/p>\n

Are antidepressants and anti-anxiety medications safe during pregnancy?<\/strong><\/h2>\n

For many pregnant women and new mom, antidepressants and anti-anxiety medications can be very helpful.<\/p>\n

Obstetricians, psychiatrists, psychologists and other behavioral health experts have learned in recent years that many medications are safe and beneficial for pregnant women and postpartum patients.<\/p>\n

And, in fact, not treating mental health issues during pregnancy can be bad for both mothers and babies.<\/p>\n

\u201cThere are poor pregnancy outcomes associated with untreated depression,\u201d Ashby said. \u201cPatients with untreated depression are more likely to have pre-term deliveries and low birth weight babies.\u201d<\/p>\n

Can family members receive help with behavioral health, too?<\/strong><\/h2>\n

Yes, Ashby said spouses or partners can accompany the pregnant person as they receive counseling. All of the clinicians also have training in infant mental health, meaning they can assess whether newborns and older babies are thriving or need extra support.<\/p>\n

\u201cWe are always thinking about the baby and the parents\u2019 relationship with their baby,\u201d Ashby said.<\/p>\n

If parents aren\u2019t responding appropriately to their baby or won\u2019t put the baby down, they might not be bonding with their child or might be dealing with excessive anxiety.<\/p>\n

\u201cSome parents are so afraid that something is going to happen to the baby that they won\u2019t put them down or let others help care for the baby,\u201d Ashby said.<\/p>\n

Conversely, other new parents who are struggling with mental health issues might not respond enough to their baby\u2019s cries.<\/p>\n

\u201cReally depressed patients often feel completely overwhelmed with the tasks of caring for a newborn. More depressed parents often respond more slowly to their baby\u2019s cues or when their baby cries\u201d Ashby said.<\/p>\n

‘Nothing can prepare you for the NICU journey’<\/strong><\/h2>\n

When Lexie was suffering through extreme stress, her PROMISE Clinic team wrapped her in a cocoon of support.<\/p>\n

\u201cWe gave her a lot of reassurance,\u201d said Lexie\u2019s primary therapist, Cindy Covell, a licensed clinical social worker who has worked with PROMISE for five years.<\/p>\n

\u201cFirst she was dealing with the stress over having triplets. Then, there was the acute grief over the death of two of their three triplets and the uncertainty about Sutton\u2019s health. It\u2019s was a pretty tough situation,\u201d Covell said.<\/p>\n

\"Sutton
Sutton Grant was born weighing just 1 pound 3 ounces. Here, in the earliest days of his life, he holds his dad’s pinky. Photo courtesy of Lexie Grant.<\/figcaption><\/figure>\n

She helped Lexie process her grief in the moment.<\/p>\n

\u201cI let her know that what you\u2019re feeling is normal. You\u2019ve had major life changes. You were just getting used to the idea of having triplets, then you lost two of them,\u201d Covell said.<\/p>\n

\u201cIt was beautiful that she named her boys. We concentrated on assisting her with Sutton so she could have a positive outcome with one of the triplets,\u201d she said.<\/p>\n

Along with their PROMISE team, Lexie and Collin Grant had a wonderful support system outside of the hospital including loving family, friends and great employers. Even so, Sutton\u2019s survival at birth marked the beginning of a new period of ups and downs.<\/p>\n

\u201cNothing can prepare you for the NICU journey. You hear it\u2019s going to be a roller coaster, and you nod your head and think you\u2019re going to understand,\u201d Lexie said.<\/p>\n

But the period after Sutton\u2019s birth marked a new time of challenges and heartaches.<\/p>\n

\u201cSutton was just so small and so underdeveloped. He was intubated and extubated. He had BRADY events (when an infant stops breathing and their heart rate slows), and that\u2019s terrifying. One time, we thought he had a collapsed lung,\u201d Lexie said.<\/p>\n

\u201cThere\u2019d be times when you\u2019d leave at 3 p.m., then get a call a short time later and hear that he wasn\u2019t acting right and had developed an infection. You\u2019d kick yourself. And of course, we have a 4-year-old who goes to daycare, so we were extra terrified about seeing Sutton.\u201d<\/p>\n

Thanks to the seamlessness of the PROMISE Clinic program, Covell was able to continue supporting Lexie during the months after Sutton\u2019s birth.<\/p>\n

\u201cThere were a lot of ups and downs and emergencies. It was a rough time because progress (with preemies) can be very slow at first. You\u2019re afraid all the time that your new babies is going to die. It\u2019s pretty awful,\u201d Covell said.<\/p>\n

\u201cI was able to talk with her throughout all of it. I would hear the alarms in the background,” Covell said. “I encouraged her to take breaks from the NICU even just to go for a short walk outside the hospital.\u201d<\/p>\n

Covell loves the integrated behavioral health model at the PROMISE Clinic.<\/p>\n

\u201cWe\u2019ve developed close relationships with all of the medical providers. They trust us and call on us to see any patients who might have mental health challenges,\u201d Covell said.<\/p>\n

\"Lexie
Lexie Grant with Sutton and Campbell. She received counseling and medications for anxiety and depression that helped her endure a challenging pregnancy with triplets. Photo by Missy Long, Mx4 Lifestyle Photography, courtesy of Lexie Grant.<\/figcaption><\/figure>\n

As anxiety and depression rose among all populations throughout the pandemic, it became especially clear that pregnant and postpartum patients were especially vulnerable.<\/p>\n

There\u2019s a myth that expectant mothers and those with new babies are full of joy. The reality can be quite the opposite, Covell said.<\/p>\n

\u201cThere are so many women who have had trauma,\u201d she said. \u201cIt\u2019s great to have mental health services and medications available to them.\u201d<\/p>\n

Covell loves working with babies and their moms. Many years ago, she worked with pregnant teens.<\/p>\n

\u201cI really enjoy working with women. It\u2019s wonderful to help them with empowerment,\u201d she said.<\/p>\n

Hearts open to an expanded family<\/strong><\/h2>\n

While the Grants have endured a very challenging journey over the last three years, Sutton keeps proving how resilient he is. After 107 days at the University of Colorado NICU, he finally got to go home. There were some setbacks soon afterward, and he had to spend additional time at Children\u2019s Hospital Colorado, both in Aurora and in Broomfield.<\/p>\n

But the Grants recently got to celebrate their babies\u2019 first birthday, during which they honored all three of their triplets.<\/p>\n

\u201cJames and Noah are part of our family, too,\u201d Lexie said.<\/p>\n

Remarkably, even after all they\u2019ve been through, Lexie and Collin are open to having another child.<\/p>\n

\u201cWe always talked about having two or three kids. Then we thought we were having three overnight,\u201d Lexie said.<\/p>\n

\"Lexie
Despite a very challenging pregnancy with triplets \u2014 two of whom they lost \u2014 Lexie and Collin Grant are considering adding another child to their family. Lexie said she couldn’t have survived a very difficult pregnancy and postpartum period without support from her doctors and other providers at the PROMISE Clinic. The family’s journey has been marked by both deep losses and overwhelming love. Photo by Sonya Doctorian, UCHealth.<\/figcaption><\/figure>\n

They had already bought a stroller that would accommodate triplets. They had told Campbell that he would soon have three new little brothers. He sometimes asks when Noah and James are coming home from the hospital. To help Campbell \u2014 and eventually Sutton \u2014 understand all that has gone on, Lexie is working on a children\u2019s book about loss of siblings for a triplet.<\/p>\n

The entire saga has been torturous, and at the same time, the Grants\u2019 have found their lives, homes and hearts full of love.<\/p>\n

\u201cIt\u2019s heartbreaking and beautiful,\u201d Lexie said.<\/p>\n

So, why not add one more child to their lives?<\/p>\n

Said Lexie: \u201cThe first baby breaks you in. Our second, third and fourth almost broke us. Our next one could build us up again.\u201d<\/p>\n

If she and Collin decide to add to their family, Lexie said they won’t be doing it without their University of Colorado obstetrics and PROMISE Clinic teams.<\/p>\n

“There will only be another kid if we can walk that journey with them again,” she said. “Hopefully, we’ll leave the NICU out next time.”<\/p>\n","protected":false},"excerpt":{"rendered":"

The first shock of the pregnancy came when Lexie Grant learned she was expecting triplets. She and her husband, Collin Grant, were eager to have another baby. But they hadn\u2019t been doing IVF. So they had zero expectations of having multiples, much less very rare naturally-conceived triplets. Lexie was suddenly considered a \u201chigh risk\u201d patient, […]<\/p>\n","protected":false},"author":2123,"featured_media":74576,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[511,509,4010,4814,212],"class_list":["post-74590","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-neonatal-intensive-care-unit","tag-obstetrics","tag-pregnancy-childbirth-and-newborn-care","tag-stillbirth-miscarriage-bereavement-support","tag-womens-care"],"acf":[],"yoast_head":"\nHow an extraordinary team helped her through a rollercoaster pregnancy with triplets - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Depression and anxiety are common pregnancy complications. 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