Making Parenthood Possible For More Families

When Porshea Gaddy became pregnant in 2022, her joy and excitement were tinged with fear. The 34-year-old New York City bus driver knew that as a Black woman with obesity and high blood pressure, she faced greater odds of having complications like preeclampsia — dangerously high blood pressure in pregnancy.

“I did my research and I knew the numbers, the greater mortality among African Americans,” says Porshea who had learned that Black women are about three times more likely to die from pregnancy-related causes than white women, and in New York City, nine times more likely. “And I knew someone personally who died from childbirth because of preeclampsia. It was devastating. I was more nervous and fearful than anything.”

In her sixth month of pregnancy, with her blood pressure rising, her obstetrician at NewYork-Presbyterian/Columbia University Irving Medical Center referred Porshea to its Mothers Center. The team at the center cares for the most complex pregnancies, providing high-risk obstetric and specialist care all in the same location.

Porshea recalls her first meeting with her new obstetrician, Dr. Whitney Booker. “She instantly reassured me and told me, ‘You’re going to be fine,’” Porshea says.

Dr. Booker, who also happened to be pregnant at the same time, told Porshea that she had high blood pressure too, and was also a patient of the Mothers Center.

“Dr. Booker said, ‘Listen, I’m pregnant, and I have things going on with me, so you’re not alone. And I’m going to make sure you’re OK.’”

Porshea remembers, “She understood where I was coming from. She was like my big sister. And I said, ‘OK, Dr. Booker, we’re in this together now.’”

Opened in 2018, the Mothers Center at NewYork-Presbyterian/Columbia University Irving Medical Center is a place where high-risk pregnant patients can access all the comprehensive care they need. This includes maternal-fetal medicine experts like Dr. Booker for high-risk obstetric care, as well as specialists like cardiologists, surgeons, endocrinologists, and neurologists. Patients are also offered on-site mental health services to manage the emotional stress of having a high-risk pregnancy.

To make the appointments more convenient for patients, specialists come to the center, allowing women to receive their tests and care in a single visit rather than traveling to separate doctors’ offices. Working together as a team, the specialists meet regularly to discuss and collaborate on each patient’s unique case.

“We are a one-stop shop for everything,” says Dr. Mirella Mourad, director of the Mothers Center and an assistant professor of Obstetrics & Gynecology at Columbia University Vagelos College of Physicians and Surgeons. “You come in, meet with your doctor, get your ultrasound, and meet with the different consultants that are necessary for your care. We make sure the baby’s doing well and that we have a good plan for the pregnancy, for labor and delivery, and postpartum.”

The Mothers Center is equipped to care for patients with challenging conditions, such as placenta accreta — a complication that increases the risk for premature birth and hemorrhage at the time of delivery — diabetes, heart issues, liver, kidney and heart transplants, and recurrent pregnancy losses and preterm births.

“We have everything to help support you during your pregnancy, no matter what it looks like,” says Dr. Mourad.

Adds Dr. Booker, “Women come to us knowing they’re at high risk. They’re willing to do whatever it takes to grow their family. We support and guide them through their journey.”

Porshea took her blood pressure at home every day, and at her check-ups every two weeks, she received tests including ultrasounds to check the growth and health of the fetus. Dr. Booker kept a close watch for signs of preeclampsia and adjusted Porshea’s blood pressure medication several times. Soon, Porshea’s visits with Dr. Booker increased to every Friday. “I always found Dr. Booker to be so soothing,” she says.

At Porshea’s routine check-up in her 37th week, however, her blood pressure reading hit a new peak: she had developed preeclampsia.

“With preeclampsia, women have high blood pressure that can damage the kidneys and liver,” says Dr. Booker, an assistant professor of Obstetrics and Gynecology at Columbia University Vagelos College of Physicians and Surgeons. “Sometimes they can have neurological complications like seizures and strokes. Porshea’s blood pressure was at that level.”

Dr. Booker asked Porshea to sit down in her office and explained the need to deliver the baby immediately.

Porshea was not ready. Her mind ran through the things she needed to accomplish and the baby shower planned for the next day. But most of all, she felt afraid.

Dr. Booker knew that she needed to appeal to Porshea, not with test results but by showing she cared. “I sat not across from her but next to her with a belly just as pregnant as hers and told her I was concerned,” Dr. Booker says.

“She had a tear in her eye,” Porshea recalls, “And she said, ‘Please, please, I’m begging you. If you don’t [deliver the baby soon], there’s a possibility that things will go wrong. Please, let me deliver the baby today.’”

Porshea recognized the seriousness of her condition and agreed to have labor induced. As her labor progressed over the hours, with husband John holding her hand, the baby’s heart rate became concerning, and the team performed a cesarean section to deliver the baby quickly. Venus Harmony, now 19 months, was born a healthy 7 pounds, 11 ounces with a full head of hair.

When she held her baby in her arms, Porshea remembers thinking, “You’re here!” she says. “I couldn’t stop staring at her. She was so beautiful.”

Today, Porshea is juggling life with her toddler, graduate school, and her job driving the M5 bus, which has a bus stop right in front of the Mothers Center. Whenever she stops there, “It always reminds me of my pregnancy journey, Venus’ birth, and of Dr. Booker. I feel like I’m her family.”

It’s patients like Porshea who inspire Dr. Booker’s work. “Seeing good outcomes and healthy babies is what drives me to come back and do this every day,” Dr. Booker says.

The Mothers Center also connected Porshea, who had weighed more than 300 pounds, to a nutritionist. She decided to undergo gastric bypass surgery and has been delighted to see the number on the scale steadily dropping.

“Now I have a baby to live for,” she says, “so I definitely want to be my best.”