Grief over pregnant mother's death overwhelms family, friends

Ten days after his wife's death, Mike King sits on the front stoop of his home, hugging his arms around his knees. The 39-year-old man curls into a ball, as if he were a child, as if he were trying to protect his heart from the world outside.

The collision of life and death plays out in this nondescript home at the end of the cul-de-sac in a quiet northeast Colorado Springs neighborhood. King stares blankly. Behind him, three little boys run up to the front door, press their palms and noses against the glass, then run away.

"Now, they don't have a mother," he said in slow, halting words that day. "Why do they deserve that? How could this happen?"

Michelle King, his wife of seven years, died while giving birth to their fourth child on June 13. She suffered an anaphylactoid syndrome of pregnancy, also known as amniotic fluid embolism. She was 32.

Most doctors will never encounter the rare obstetric emergency in their professional career, seen in one out of 80,000 live births. It is unpredictable and unpreventable. It can be fatal, but some studies show that more than 30 percent of women survive.

Michelle didn't. But 9-pound, 14-ounce Drew did.

The crushing weight of death descended upon her family, her friends, the entire second floor of Memorial Hospital North.

Two lives in peril

Michelle was a low-risk patient. No complications. No warning that this might happen. She carried Drew to full term and was, in fact, seven days overdue when her doctor recommended induced labor.

But beneath the thin hospital gown bunched around her belly, something went wrong. She cried for her unborn baby. She cried for herself. As a nurse in the Neonatal Intensive Care Unit at Memorial Hospital Central, she knew what the pain in her right side could mean.

An oxygen mask was pressed to her face, a bucket pushed under her chin. But her condition was more serious than anyone could have anticipated.

Michelle, propped up on her side to stop the aching, buckled over, eyes rolling, mouth foaming. Her womb ripped, and her blood vessels ruptured. Amniotic fluid oozed into her blood stream. Her blood pressure plunged. Then, her heart and lungs collapsed.

Two lives were slipping away.

The doctor made a quick, vertical cut, working down from just below the navel, through one layer at a time: skin, fat, muscle, the peritoneal membrane. He reached the uterus, sliced it open and wrestled out a limp baby boy. He was breathing normally.

Nurses expended almost 90 minutes attempting vigorous resuscitation on Michelle. They were her co-workers, her friends. They knew how healthy she was, how strong she was.

"I thought Michelle would pull through anything," Mike said. "I thought nothing could hold her down."

She died without ever seeing her son.

‘It's random'

Nearly 5,000 babies were delivered by Memorial Health System last year, according to Chris Valentine, a spokesman for Memorial. In the past six years, doctors at Memorial can recall only four women who died of complications relating to childbirth.

As recently as 90 years ago, one in every 100 live births in the United States resulted in the mother's death. In 2005, the last year for which figures are available, the U.S. maternal mortality rate was 11 deaths per 100,000 live births, according to a report released by the World Health Organization. Experts estimate that less than 5 percent of deaths are due to anaphylactoid syndrome of pregnancy.

Scant research exists on the rare obstetric emergency as the number of cases is not large enough to provide meaningful data.

"It's random," Dr. Stephanie Martin, director of Maternal Fetal Medicine at Memorial Health System, said. "We don't know what causes it. And until we know what causes it, we cannot prevent it."

What confuses doctors most is why the body reacts like it is fighting a foreign substance, Martin said. Women are exposed to fetal tissue and amniotic fluid inside the womb regularly. In fact, it has been found to flow through their blood stream while pregnant. But, in a small percentage of women, exposure during childbirth leads to a complex chain of events that result in collapse and death.

About 60 percent of women and 40 percent of newborns die, according to findings from a study of less than 100 cases conducted by the Department of Obstetrics and Gynecology at the University of Utah School of Medicine. An analysis of the National Amniotic Fluid Embolus Registry showed those who don't die are, instead, left ravaged by brain damage.

"It's like being shot," said Martin, who has worked with high-risk pregnancies for nearly a decade. "We can't undo the fact that you've been shot. We can only manage it."

A father, sons struggle

Mike King stands up, carrying the weight of a man tossed into a cascade of disbelief, despair and depression.

He walks inside, where he is tackled by three boys, the fourth sleeping on his grandfather's chest. Mike reaches down to embrace his 5-year-old son. It took Dylan a week before he was startled from his sleep, crying for the comfort of Michelle. For the oldest, 7-year-old David, the tears started streaming right away. But it still doesn't make sense to 2-year-old Daniel, who tells strangers his mommy died but he doesn't know why.

Mike doesn't have a job. He was a stay-at-home dad while Michelle worked as a nurse. The couple closed on their first house together a week before her death.

"I can't think about a month from now," Mike said, lowering his eyes. "I can't think about two months from now. I've got to get through today, first."

MEMORIAL FUND

A memorial fund has been set up in Michelle King's name at ENT Federal Credit Union, to help with the family's expenses. Contributions can be made at all branches.