Teresa Lance, lovingly known as Teri, is the Clinical Nurse Specialist (CNS) for the Labor and Delivery Unit at Winnie Palmer Hospital. For two years, I have had the pleasure of working with Terri during placenta accreta deliveries. A placenta accreta pregnancy occurs when the placenta grows abnormally into the uterine tissue and can even invade other organs. In a normal delivery, the placenta detaches from the uterine wall soon after delivery. If a placenta accreta does not detach as usual, it can cause huge blood loss that threatens the mother’s life.

Teri coordinates the deliveries of these high-risk mothers by ensuring all is in place to safely deliver the baby in an environment in which the mom is cared for by a multidisciplinary team ready to save her life if an emergency presents itself. Teri ensures that all specialties involved are ready to go on the scheduled day and time at the same place. She ensures all services, and all members of the multidisciplinary team are aware of the condition of this mom and what the plan is.

This is the journey of an accreta mother:
The mother’s care starts with follow-up appointments and ultrasounds at Winnie Palmer Hospital. When it is time, at about 34 weeks, she gets admitted to the Antepartum Unit for needed lab work and observation in preparation for the delivery of her baby via cesarean section the next day. On the day of surgery, the mom is transferred to Orlando Health Orlando Regional Medical Center (OH ORMC) PACU where she is prepared for surgery which will take place in a specially equipped operating room. Mom’s team in the operating room is huge and it includes but is not limited to Anesthesiologists, Obstetrics, Interventional Radiologists, Surgeons, Angiogram Techs, Scrub Techs, Circulating Nurses, Labor and Delivery Nurses, Anesthesia Nurses, and the Neonatal Transport Team who will care for and transfer the baby to Winnie Palmer Hospital for further care. After delivery, the mom will be recovered in PACU at OH ORMC and sometimes she will need ICU care too. When mom is stable, she will be transferred back to Winnie Palmer for the remainder of her stay.

All along, Teri ensures all consents are gathered properly, and the patient’s cultural and language preferences are considered. She takes pictures of the baby at delivery and prints them for the family to see and share with loved ones.

Did you catch all the departments involved in this one single patient’s care? Maternal-Fetal Medicine, Labor and Delivery, Antepartum, PACU, Surgery, Anesthesia, Interventional Radiology, Blood Bank, ICU, NICU Transport, Post-Partum, and of course Ambulance Transport for mom. All this coordination takes months to prepare, and there can be no mistakes.

Teri is amazing at doing all this work and getting us all together for this life-changing event for this mother and her family. While meeting with this family during the pregnancy, she builds loving relationships with this mother and father. This relationship adds a huge level of support in such a concerning time for this family. Many mothers have expressed “I couldn’t have done it without Teri” while visiting their baby in the NICU after delivery.