Orphaned when she was 11 years old after her father died from cancer and her distraught mother committed suicide, Kristen Holland was separated from her four siblings and grew up in foster homes.
So when the newly married Holland discovered she was pregnant in the fall of 2016, she was ecstatic. At age 35, she finally was getting the family she had yearned for all her life. A few weeks later when a cardiologist advised her to terminate her pregnancy to save her own life, Holland fought to preserve her child with every ounce of grit and determination she possessed.
“I’ve been through a lot, but I tell everybody not to feel sorry for me,” she said in the backyard of her Aberdeen home.
“My life has taught me to overcome the odds and fight through the challenges. When my doctor warned that I would probably die and that my baby could die too, I started to cry, but I never wavered. I had already heard the baby’s heartbeat. I was not going to terminate my pregnancy. For me, that was never an option.”
Suffering from heart failure, Holland and her husband, Roger, knew she was taking a huge risk. But, thanks to a combination of their own resolve, luck and the skill of their doctors at the University of Maryland Medical Center, their gamble paid off.
On Saturday, Holland, Roger, his teenage son Travis and about 40 family members and friends threw a joyous party to celebrate Ayden’s first birthday. There was a backyard barbecue with hamburgers, hot dogs and chips, with Ayden’s beloved dump trucks doing double duty as serving dishes. There was a giant water slide for the children and a game of pinata. There was a running video of images taken during Ayden’s first year of life that played on an outdoor monitor and a string of photographs arranged by week and year.
Best of all, there was Ayden himself, a smiling, blond, blue-eyed little guy in robust good health who tips the scale at 28 pounds.
According to Dr. Stacy Fisher, Holland's cardiologist with the University of Maryland Medical System, Holland was born with a congenital heart defect that resulted in her having just two leaflets of the aortic valve instead of three. Successful surgery at age 2 widened the valve, and for the next three decades, Holland was symptom-free. A trim 100 pounds, she worked up to 60 hours a week as a waitress at the International House of Pancakes, a job that kept her in great physical shape.
In a way, it was Holland’s lack of symptoms that magnified the risk. In the past, children with congenital heart defects rarely lived long enough to become pregnant, Fisher said. That changed due to major medical advances made in the 1970s and 1980s, and there’s now a group of young women with histories of heart disease who don’t realize that getting pregnant could endanger their lives.
It wasn’t until Holland went for a routine check-up at the end of her first trimester that she was diagnosed with severe heart failure. Fisher told her that if she didn’t terminate the pregnancy, her chance of surviving for the next six months was no greater than 50 percent.
“In the past, my heart just had to pump enough blood for me,” Holland said. “Now, it was pumping for two of us. My doctors were afraid that when I got to the 26th to 30th weeks of my pregnancy, my heart would give out and I would die.”
Roger Holland told his wife that he would support whatever decision she made. But secretly, he was terrified.
“I don’t have really good luck,” he said. “I knew I could lose them both. I went out and bought a baby tree for Ayden, a little red maple that I planted it in the front yard. I know it sounds silly, but I told myself that as long as the tree kept growing, it would mean that Ayden would live and would come home to me, and so would my wife. That’s how I kept myself thinking positively.”
On April 26, when she was 28 weeks pregnant, Holland was admitted into the hospital to undergo a procedure that used a balloon to open the aortic valve. The operation succeeded but the valve tore, allowing blood to seep out. Holland remained in the hospital for the next six weeks while doctors monitored her heart around the clock. On June 8, 2017, when Holland was 36 weeks pregnant, she gave birth to Ayden by Cesarian section. Three days later, she had surgery to replace the defective valve in her heart.
“After the surgery, I took a deep breath,” Fisher said. “I looked at this beautiful baby and his beautiful mother. I was so humbled and grateful that they would be able to move forward and have healthy lives.”
The doctor has a message for prospective mothers who, like Kristen Holland, have histories of pediatric heart disease:
“Get checked out before you get pregnant,” said Fisher, also an associate professor of medicine and pediatrics with the University of Maryland’s School of Medicine. “That’s the take-away from this story. If Kristen had known before she got pregnant how tight her aortic valve was, we could have done something about it then and she would have gone on to have a normal pregnancy. If you know what’s going on ahead of time, you can avert a lot of the risk.”