Counselor to Sonographer.

I have been a volunteer at a pregnancy medical center since the beginning of 2014.  As a nurse practitioner I was thrilled to sit down and listen to these women in need without a clock looming over my head reminding me that there were a hundred other tasks I could be doing.  I relished being in the moment with a woman in distress.  I was able to be truly mindful of what was really happening to the woman seeking information, to the baby floating in the balance, and to the changes taking place inside me.

Each day at BirthChoice (BC) I felt a deeper pull into the center, as though the Holy Spirit was baiting me with awesome testimonies of babies saved and I was biting hard on the hook and getting closer to my captor and redeemer.

One day our nurse manager left me a copy of the “RU-486 reversal protocol’ that was being practiced by a small handful of physicians in our area.  I know my heart fluttered when I thought of the possibilities of this protocol.  But I was comfortable in my role as counsellor. I envisioned myself in other roles outside the pregnancy center, holding abortion pill reversal signs at the abortion clinics and counting on the ambivalence of human nature and our potential to step in and help those last minute converters.  I am a dreamer, a romantic, in love with the promise of grace that abounds in all people- in all walks of life.  While I know this about myself, I also know the value in getting accurate information from the ultrasound. It is critical to the safety and well-being of the woman, the baby and the pregnancy center.

In April 2015 I registered my name with the folks in San Diego who spearheaded the Mifepristone reversal protocol.  I wanted more information on the reversal ‘kit’ for my own intellectual satisfaction, knowing full well I could not offer this reversal at my full time job. I did not think of the logistics of how it would play out in the pregnancy center.  I did not have to wait long to be reeled in further.

On a Saturday in July of 2015 I received my first invitation from the reversal folks.  There was a woman in my geographic area who called the hotline and wanted to reverse her medical abortion.   I was miraculously at the pregnancy center when I got the call on my personal cell phone.  The other miracles were yet to be rolled out.   The two medical clinic administrators happened to be coming by the office that day and I was able to share my haphazard collusion with these folks in San Diego.  In all my excitement and disorganization I was able to convey that there was a person, actually 2 persons out there who needed us.  The directors went straight to work, figuring out the details and getting me in touch with a local OB who was willing to prescribe the drug as long as I did the assessment and promised to get the patient to her office the following Monday.

The final part of the miracle was that the nurse manager was scheduled to do the ultrasounds that day.  She is certified in women’s health as a nurse practitioner and is highly skilled as a nurse sonographer.  Her abilities are without question.  The woman did come and her pregnancy test was positive having taken the pill 12 hours earlier at a local abortion center.  Our nurse sonographer tracked the anatomy of the vagina to the cervix to the fundus leading to an empty gestational sac.  No fetal pole, no baby, no heart.  It was devastating.  But it was accurate information.

I then thought out the algorithm in my head: “Baby present in uterus, give progesterone”. I had not counted on the “baby not in uterus or not viable”.    My mind started to imagine other scenarios with less trained nurse sonographers and I broke out into a sweat.  What if there really was a baby and it was “not seen” and I withheld the progesterone therapy?  Or what if I gave the progesterone to her based on her positive pregnancy test and gestational sac and she had an untoward reaction.  This particular client had a history of uncontrolled hypertension and did not need the added progesterone based on an uncertainty.  I realized I would not have been able to do make this clinical decision had it not been for my confidence in the nurse sonographer.  I was certain I had better be prepared to know how to scan with the same proficiency as our nurse sonographer.   This weight of “doing no harm” and was far heavier on my heart than my mystical calling and my eternal good will.

From that point on I was relentless in asking for the necessary training to become proficient as a nurse sonographer.  I was privileged to attend the National Institute of Family & Life Advocates (NIFLA) training in December.

The NIFLA course confirmed this mantra of “doing no harm” and how to keep our clients and medical centers safe.  Making a mistake that causes any client hardship is the main grievous offense.   But this mistake would be compounded by those forces that want to abolish this ministry.

The information was dense with important facts on anatomy, ultrasonography pearls and how to keep our patients and our centers safe.  Upon completion of the didactic and mini hands on session

I was convinced that I made the right decision to be trained as a nurse sonographer.

            Barbara Hegermiller-Smith, N.P., Nurse Trainee in Limited Obstetrical Ultrasounds  Birthchoice (Raleigh, NC)