The best day of Yvonne Rothermel’s life was also the worst.
Finally, after struggling to get pregnant for so long, going through in vitro fertilization and hoping she and her husband, Gordon Renwick, could start a family, she was about to give birth to twins.
Yvonne wanted to name one of her daughters Sophie after her old Norwegian college roommate, Anne Sophie.
She wanted to name her other daughter, Maya. When Yvonne was working as a social worker at Sharp Grossmont Hospital's Women's Center & Prenatal Clinic a few years prior, one of the moms told her she named her daughter Maya because it meant “creative force in the universe,” and that always stuck with her.
Yvonne was due for an induction on a Sunday evening, and on Friday, her OB-GYN told her that everything was normal. However, that Saturday night, Yvonne felt frantic kicking. She felt around her stomach to find the babies and recognized what she thought was a limp arm.
“I just knew something wasn’t right,” Yvonne says.
Shari Abdalla remembers the shift. In her 33 years as a nurse and advanced clinician with Sharp HealthCare, most of which at Sharp Mary Birch Hospital for Women & Newborns, she flashes back to June 29, 2003.
“It was the most profound day of my nursing career,” Abdalla says.
When Abdalla was a nursing student at San Diego State University, she gasped in awe when she saw a nurse wheeling out a mother with her newborn baby. That’s what she wanted to do. Never mind the fact that she had never even held a baby in her life.
Working in maternity is normally joyous. How many times does someone say the best day of their life is when their child is born?
But this was a shift unlike any other. The charge nurse assigned her a room toward the front of the sixth floor. Seeing the report made her pause.
The mother just birthed twins, but only one twin survived.
Usually, Abdalla can tell what kind of support her patients need, whether it’s teaching them something about newborns, a way to decrease their anxiety or even a little snack.
She always wanted to offer her patients a good experience, but how could she on this day?
Abdalla paused, collected her thoughts, took a deep breath and walked in.
About 21,000 stillbirths happen each year in the United States, according to the Centers for Disease Control and Prevention. Each loss represents an unfathomable tragedy.
When President Ronald Reagan declared October as National Pregnancy and Infant Loss Awareness Month in 1988, he shined a light on what thousands of expecting parents experience each year.
“When a child loses his parent, they are called an orphan. When a spouse loses her or his partner, they are called a widow or widower," President Reagan said. “When parents lose their child, there isn’t a word to describe them.”
Sharp Mary Birch offers numerous resources for women and newborns, from classes on pregnancy and childbirth to navigating the “fourth trimester.” Nearly 8,000 babies are welcomed each year, and there are 1,000 specialized caregivers every step of the way.
Like nurse Abdalla.
Gordon drove Yvonne to Sharp Mary Birch, where she went into triage. Nurses put a monitor on her and told her they found Sophie’s heartbeat right away but couldn't find Maya's.
Immediately, Yvonne hurried doctors to perform a C-section to get Sophie out. Yvonne was in a state of shock, terrified and crying as she was wheeled into an elevator.
“I didn’t know if whatever took Maya was going to take Sophie,” Yvonne says.
At around 12:30 in the afternoon, Sophie Elise Renwick was born, weighing 5 pounds, 3 ounces.
Shortly after, Yvonne delivered Maya, who had died in the womb. She was 3 pounds, 14 ounces.
“I wanted to keep Maya in me forever,” Yvonne says, knowing she would be going home as a family of three instead of four.
Abdalla could empathize with Yvonne’s grief because two years before, she lost both her mother and her brother in a span of just a few months. Even though she had returned to work after a couple of days each time, she still carried them with her. Their deaths made Abdalla more sensitive to grief, and being able to focus on other people helped her cope.
This wasn’t a time to walk in cheery and say, “Oh my gosh, congratulations!” She wasn’t going to walk in somber with a “Sorry for your loss,” either. Words, at that point, could not help.
Abdalla thought about what anyone would need in that moment — the two principles that have always guided her: compassion and love. She opened the door to the parents laying in the hospital bed together, holding Sophie, and saw Maya in the crib next to them.
“What’s her name?” Abdalla asked.
“Maya,” Yvonne replied.
“Do you mind if I hold her?” Abdalla asked.
Abdalla picked Maya up and then sat down in a rocking chair, cradling her ever so gently. “She’s beautiful,” she told them.
If it was two minutes, it felt like hours. Time stopped.
“I don’t remember anything else,” Abdalla says.
On a typical 12-hour shift, Abdalla might come into the room 20 times. Maybe 50 times, depending on the needs of the parents. The first interaction sticks out the most.
"I think a lot of people tend to not know what to say or do, so they avoid the situation," Yvonne says. "Having someone come toward you with that kind of compassion was really special."
Abdalla remembers driving home from work and crying the whole ride home.
“We take our work with us,” she says. “As a nurse, you have to do that.”
When she got home, she went through her drawers and found a small pewter angel holding a baby with a white organza ribbon. Engraved on the angel is a Willa Cather quote: “Where there is great love, there are always miracles.”
Immediately she thought of Yvonne.
Abdalla gave it to the family the next day. Twenty years later, it’s still on their mantle.
When Yvonne and Gordon took photos with the twins in the hospital room, she wasn’t sure what to do.
“I didn’t know whether to smile or to look sad,” Yvonne says. “I was so excited that Sophie was here but so devastated that Maya wasn’t. I didn’t want to betray one or the other.”
For over four days in Sharp Mary Birch, she held Maya for as long as she possibly could, because when it was time to leave and start life as a family of three, she knew it would be the final time Yvonne would see Maya.
“Motherly instincts,” Yvonne says. “I couldn’t leave my daughter behind.”
Yvonne wasn’t ready to hand Maya off to the social worker, so Abdalla sat in bed and held Yvonne until she was ready.
As Gordon pulled the car around Sharp Mary Birch, Abdalla wheeled them out. Seeing two car seats inside crushed Yvonne, but Abdalla reassured her that their new life was going to be OK.
“I’m not sure I could have done that without her,” Yvonne says.
Learn more about coping with infant loss.
Yvonne remembers picking up Maya’s urn at the funeral home and the attendant saying, “Don’t worry, you could have another baby,” as if babies are replaceable.
As if Maya won’t always be part of the family.
There wasn’t a specific instance when Yvonne and Gordon sat down with Sophie to explain that she had a sister that passed away. But they have always kept Maya’s presence alive.
Maya’s urn is blue and features two swans making a heart, representing the twins. It rests on the mantle, alongside the pewter angel from Abdalla.
The family finds symbols of her all over. An egg that has two yolks. Planting one seed and having two flowers bloom. Any time they see a white butterfly, there’s Maya.
Every June 28, the family goes to Sunset Cliffs to eat Thai food and release flowers into the ocean.
“We celebrate her and make it a fun thing,” Sophie says.
As a toddler, Sophie would play with a miniature stroller and push it around the house. Inside the carriage would always be two dolls.
“Without us telling her,” Yvonne says, “it felt like she missed something.”
Sophie loves researching about “Lone Twin Syndrome” and understanding some of her feelings that could trace back to when she was in the womb.
“When I was younger, I would always long for a ‘best friend,’ and no one would ever fit that model,” Sophie says. “I think that’s subconsciously because I knew I had a twin.”
Sophie became a big sister two and a half years after she was born, when Yvonne welcomed Delaney Kate Renwick to the world. Delaney because Yvonne’s sister loved that name, Kate because that would have been Maya’s middle name.
In fact, Delaney was born with the same strawberry blonde hair as Maya.
“Delaney was the exact replica of Maya when she came out,” Yvonne says.
Since she was a child, Sophie had been interested in working in science and medicine. Any time she was sick, she would diagnose herself to physicians, and she’d let out a little fist pump when doctors confirmed her thoughts.
Though she long dreamt of going to UC Santa Barbara, a visit to Cal Poly in San Luis Obispo changed everything. It had a unique homey feel to it, and walking by the dorms, she noticed a green car with a sticker on the back.
It was a white butterfly that had a quote next to it: “I like it here, too.”
She took her commitment pictures later that day.
“It felt too coincidental,” Sophie says.
Stillborn births are classified in the U.S. as any fetal death after 20 weeks. They can be caused from placental complications, high blood pressure, infections and other fetal anomalies.
But nearly 1 in 3 stillborn births go unexplained, according to the Cleveland Clinic.
“When the death is ambiguous, it’s harder not to blame yourself,” Yvonne says.
Yvonne has worked in bereavement since the 1990s. She worked in hospice care out of college and later became a social worker at Sharp Grossmont. After losing Maya, she started volunteering at the San Diego Post-Partum Health Alliance.
“I wanted to be like a Mama Bear for other moms who had been through this,” Yvonne says. “I was very motivated to learn as much as I could about perinatal anxiety disorders and loss so I could be an advocate and help moms.”
She opened her own private practice specializing in birth loss and reproductive trauma in 2011.
“It’s very taboo to talk about,” Yvonne says. “A lot of people are uncomfortable with it and don’t know what to say. That causes grievers to feel lonelier.”
Saying Maya’s name helps.
“People feel like if they say their name, they’re going to upset the family, or they’re worried about making it awkward,” Yvonne says. “For most people who’ve lost a child, it’s nice when people remember them.”
Yvonne doesn’t normally tell her clients that she experienced firsthand what they endure.
“There can be a lot of grading of losses,” Yvonne says. “If someone had a miscarriage, they might feel bad talking to someone who’s lost a 1-year-old. They minimize themselves, and you don’t want that.”
But Yvonne empathizes with them. She grieves with them. The same values that Abdalla showed her strengthen how she communicates with her patients.
Compassion and love.
Abdalla opened her phone — her background a white butterfly — and saw a notification pop up.
“Do you remember us?”
Many times, Abdalla will receive messages from patients saying they’re pregnant with their second child and want her to take care of them again. Abdalla wasn’t Yvonne’s postpartum nurse when Delaney was born, though she did run into them in the lobby and has received their yearly Christmas cards ever since.
Of course Abdalla remembered them. She could never forget them.
With Sophie preparing for her third year at Cal Poly, Yvonne enlisted Abdalla to impart some wisdom onto her oldest daughter.
They met for the first time in 20 years over Thai food, Abdalla pinching Sophie’s cheeks in disbelief, seeing a 4-day-old turn into a bubbly, beautiful adult.
The gravity of the reunion brought them all to tears.
“You know,” Sophie told Abdalla, “you were the only other person besides my parents to hold my sister.”
Sophie told her all about how she loved working with kids, especially as a gymnastics coach. Turns out, Abdalla was a gymnast for 15 years.
Sophie wanted to be a labor and delivery nurse until Abdalla told her working in postpartum would allow her to work closely with the babies and moms to prepare them for life at home. That thought made Sophie's eyes beam.
Who knows what Sophie’s future holds? Maybe one day after she graduates, she’ll find herself working at Sharp Mary Birch.
As an advanced clinician, Abdalla leads programs and orients new nurses. Could she envision mentoring Sophie down the road?
“If she gets a job here,” Abdalla says, “absolutely.”
Before they left, Abdalla gave them a card with a Maya Angelou quote written: “People will forget what you said, people will forget what you did, but people will never forget how you made them feel.”
Inside the card contained another gift: a Guardian Angel pin.
The Guardian Angel program at Sharp offers patients and their loved ones the opportunity to recognize their caregivers while also supporting Sharp.
Over the years, Abdalla has received nine Guardian Angel pins from patients and their families, each one a treasured reminder of the impact she can have in only a matter of seconds.
She wanted to give one pin to Yvonne and Sophie, a third angel to always look over them.
When Yvonne and Sophie returned home, they carefully placed the pin on the mantle, forever keeping Maya’s spirit alive.