Karen's story for Preeclampsia Foundation My wife Karen Sclafani, an incredibly vibrant, healthy woman, died
Post On Tuesday, February 08, 2005 By
Karen's story for Preeclampsia Foundation
My wife Karen Sclafani, an incredibly vibrant, healthy
woman, died from hemorrhaging shortly after the Feb.
5, 2004 birth of our first baby, a healthy 5 pound, 15
ounce, at Bozeman Deaconess Hospital in Montana. Karen
was diagnosed with pre-eclampsia Feb. 4, four days
before our due date. This condition, along with
placenta acreta, was the main factor that triggered a
cascade of post-delivery complications that culminated
in sudden and catastrophic bleeding from her uterus
immediately after surgery to remove the placenta. She
was 37. Karen's grandmother, an Italian immigrant
living in the Bronx, died in 1932 in the same way
after giving birth to Karen's mom. We set up a website
in Karen's memory, www.karensclafani.com, Here's our
Twice in 2003, fluky events with Karen's reproductive
system necessitated surgery. We conceived that
February and learned of the pregnancy when Karen
started having abdominal pains on March 24. The
pregnancy was ectopic and Karen underwent laproscopic
surgery that night to have the right falopian tube
removed. We conceived again several weeks later. The
pregnancy went very well, with Karen working as a
hiking guide all summer. But in late October, after
her final trip of the season, Karen again experienced
severe abdominal pain on the right side. This time the
ovary "torsed," and Karen had to have fairly invasive
surgery to have it removed. As with the prior surgery,
Karen bounced back quickly and was on Nordic skis by
the time the snows hit in December.
Near the end of Karen's pregnancy we went every
Tuesday to see our midwife, who carefully checked
Karen's urine and blood pressure as part of routine
prenatal check-ups. Four days before our due date, the
midwife found protein in Karen's pee and recorded an
elevated blood pressure. I'll never forget that day.
Karen picked me up after work on Bozeman's
snow-clogged Main Street in the Volvo wagon I had
recently bought her for the drive to our midwife's
office outside Livingston. On the way, Karen stopped
in the historic rail town to pick up this red ceramic
utensil holder for the kitchen. It was a day like so
many others with work and errands. The midwife
insisted Karen go on bed rest. That night two friends
made a cast of Karen's belly. It was the last night
Karen and I would sleep together at home.
The next day, a friend came over to check Karen's
blood pressure and this time it was really elevated.
The midwife rushed over and drew blood to have a
platelet count performed. By the time I got home, the
midwife had already called off the idea of a home
delivery. When we got word that Karen's platelets were
depressed, the midwife instructed me to get packed. We
were at the hospital a few minutes later to have our
baby delivered, although Karen was not the least bit
The obstetrician on duty decided a vaginal delivery
was the safest option given Karen's elevated blood
pressure, which had become erratic and put Karen in
danger of seizures. An ulcer medication was applied to
Karen's cervix to loosen it up and we spent several
hours waiting for her to dilate. We snuggled on the
bed in the delivery room, talking about how much we
loved each other and excited for the future. When the
cervix opened enough to manually break the bag of
waters, her labor started. Karen wanted no pain
medications, but she had to take meds to control her
blood pressure and prevent seizures. These drugs made
her a little goofy and impaired her ability to push
the baby out. The four-hour labor and delivery went
fairly smoothly considering the challenges involved.
There were a few frightening moments and we had to use
this vacuum suction tool on the baby's head to pull
her out. Aryana emerged looking like a cone head and a
shade bluer than the color of grape juice.
"I love you, Babula," Karen kept saying as the
delivery nurses worked over the 6-pound little human
who was lethargic from the influence of the meds.
Meanwhile, the placenta failed to make an appearance.
Over the next few hours, the finest day of my life
turned into the worst. It was during the post-natal
surgery to remove the wayward placenta that Karen
suffered a major and ultimately fatal loss of blood.
Karen's hemorrhaging practically bankrupted the
state's supply of AB blood. High Patrol troopers were
delivering blood products from all over on Feb. 5 as
surgeons struggled to save Karen's life. More than 20
units of other people's blood were poured into Karen.
Doctors performed three more surgeries, but by the
next morning a CAT scan revealed that the shocks to
her brain rendered survival impossible. Forty-five
hours after our daughter was born, a few members of
our families gathered around Karen's bed in the ICU as
the technicians removed the connections to the
life-support machines. After a few minutes we watched
her breathe her final breaths. Her death was a
shocking loss to Bozeman, a small Montana city Karen
moved in the early 1990s a few years after college.
The night before she died dozens of her friends
crowded the ICU to say goodbye. Her girlfriends
painted her toenails red, sang us songs, and decorated
her room with her things hastily pilfered from our
house. It was clear to hospital staff they had a very
beloved person in their care.
In hindsight, I wish we exercised greater diligence
considering Karen's surgical history. But would it
have mattered? Pre-eclampsia just snuck up on us, even
though she was under the watchful care of a midwife,
as well an OBGYN part of her pregnancy. Karen's fine
health may have been masking the signs all along.
Maternal deaths are so rare for us that when they do
occur they seem like tragedies of archetypal
While our community and families grieve, our daughter
has thrived. Aryana's sweet nature, contentedness and
energetic playfulness have helped ease me into my new
life as a single parent. She just turned a year, took
her first step on the anniversary of her mom's death.
When I see how many babies are claimed by
pre-eclampsia, I realize I have a lot to be thankful