Rainbow Clinic Helps Mother Have a Healthy Child, After a Loss
When Ruby was born in August 2023, her mother, Chloe Acerra, was overcome with joy. “I kept looking at my baby and saying, ‘I love you, I love you, I love you.’”
Chloe’s joy was hard-won. About a year and a half earlier, she had given birth to her firstborn, who died in utero at 34 weeks. “Losing my daughter, Birdie, was the hardest thing in my life,” Chloe said. The death was difficult to understand as Chloe was a healthy 33-year-old who exercised, ate healthily, and followed all her midwife’s guidance. Her pregnancy was uneventful, aside from gestational diabetes that was mild enough not to require treatment, so it was unclear what had gone wrong.
Chloe and her husband, Chris, wanted to try to get pregnant again. Right away. But since they didn’t know the cause of Birdie’s death, it was hard to know exactly what to do differently. Chloe was sure about one thing, though; she wanted to use expert obstetricians. They met with, Joanne L. Stone, MD, the Ellen and Howard C. Katz Chair of Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai and Mount Sinai Health System. Dr. Stone is also the Founding Director of the Mount Sinai Rainbow Clinic, which offers enhanced clinical care and psychological support to women and their families who have experienced a loss during pregnancy.
The Rainbow Clinic, the first in the United States, is based on the United Kingdom model, named for “the rainbow after the storm.” “The Rainbow Clinic gives women access to state-of-the-art services and support that goes beyond standard prenatal care,” Dr. Stone says. The physicians are all specialists in maternal-fetal medicine, and the clinic emphasizes the parents’ mental health. Rainbow Clinic patients have 24/7 access to doctors and as many appointment and sonograms as they want. A dedicated social worker provides extra support. The goal is to reduce fear and anxiety, as well as to prevent perinatal losses.
Chloe’s obstetrician was Samsiya Ona, MD, Assistant Professor in the Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai. “I'm so grateful that we were paired with her,” Chloe says. “I really felt like she cared about me, mentally and physically.” It wasn’t just Dr. Ona. “Everyone at the Rainbow Clinic was so warm, so compassionate,” Chloe says. “They never said, ‘we're too busy.’ They were always willing to help, and they understood that my fears were rooted in reality.”
Chloe saw Dr. Ona every two weeks until week 28, then weekly until week 32. After 32 weeks, she saw Dr. Ona twice a week for an exam and sonogram. But she also had extra sonograms. Chloe explains, “I could call up the scheduler, and say, ‘Hey, I'm having a really tough day. Is there anyone who can get me in?’ And she would find a way to get me in for at least a sonogram. It really helped to hear the heartbeat.”
Chloe’s worries became more intense around the “anniversary” of Birdie’s death, at 34 weeks, which is not unusual for Rainbow Clinic patients. Birdie’s heart had stopped beating overnight, so Chloe was afraid to fall asleep. During the 36th week of her new pregnancy, Chloe slept at the hospital. “She was afraid she was going to miss something,” Dr. Ona says. “So when she woke up in the middle of the night and became anxious, someone could do a fetal assessment and just let her hear the heartbeat.”
The Rainbow Clinic offers patients the choice to deliver at 37 weeks, the point at which a fetus is considered viable, rather than waiting until the full 40 weeks. “The anxiety of staying pregnant longer with the unknown is far worse than the potential risk, if any, of delivery at 37 weeks,” Dr. Ona says. Like many Rainbow Clinic patients, Chloe elected to be induced at 37 weeks. She delivered a healthy baby girl, naming her Ruby.
Chloe mentioned to the social worker at clinic that she wished she had been able to speak with someone who had successfully given birth to a rainbow baby. So the social worker, Chloe, and three other Rainbow Clinic moms developed a mentoring program for women entering the clinic. “People in our trainings tell us that they feel like this program honors their babies who aren’t here,” she said.
While the mentoring program has been important to Chloe, the best part of her experience at the clinic is—not surprisingly—Ruby. “The loss of Birdie allows me to live presently with Ruby, and to realize how precious she is,” Chloe says. “Every day, I am just soaking up that my baby is here and that we get to be together, and that I get to watch her grow up. I am so grateful to Dr. Ona and the Rainbow Clinic.”