With Empathy and Advanced Care, Mount Sinai-Rainbow Clinic Supports Full-Term Births After Perinatal Loss

After previously experiencing a neonatal loss due to a preterm birth, a 34-year-old patient had a successful full-term delivery at The Mount Sinai Hospital. During her pregnancy, she was under the supervision of Joanne Stone, MD, MS, Chair of the Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science for the Icahn School of Medicine at Mount Sinai, and Director of the Mount Sinai-Rainbow Clinic.

The Rainbow Clinic was founded two years ago by the Department of Obstetrics, Gynecology and Reproductive Science in collaboration with the nonprofit foundation PUSH for Empowered Pregnancy. It offers multidisciplinary specialty care for patients who have experienced the birth of a stillborn child, multiple miscarriages, or a neonatal loss.

One such patient was Ana Schultz. In the summer of 2022, Ana became pregnant with her first child after undergoing in vitro fertilization. She and her husband lost their baby boy, Freddie (Frederick Michael), at 22 weeks and four days. After giving themselves a number of months on the road to recovery from the loss, they decided to undergo two more rounds of IVF treatment, and she became pregnant again. The couple was hoping to find additional support during their second pregnancy, and an expert they knew at Yale University referred them to Dr. Stone.

Ana met Dr. Stone in April 2023, during her first trimester, and was impressed by her knowledge and attention to detail. “She requested and reviewed tons of records and reports, asked tons of questions, and was an active listener,” Ana says. “Her questions demonstrated that she was speaking directly about our case and care.”

Dr. Stone saw Ana again two weeks later. An ultrasound and examination showed that her cervix was quite short and soft. Given her history, the decision was made to perform a cerclage, making stitches close to the cervix to help prevent a premature birth; she was also prescribed a low dose of aspirin.

Ana continued to see Dr. Stone every two weeks during her pregnancy, with regular visits to the sonography team for ultrasounds. “Our sonographers and medical assistants get to know the patients very well,” Dr. Stone says. “We try to have the same sonographers perform the ultrasounds so that they really get to know the patient and make them feel comfortable, and to ensure they don’t have to answer too many questions each time.”

All of the Rainbow Clinic team have special training to understand and respond to the special circumstances and sensitivities around parents who have previously experienced prenatal loss. Ana also met with a social worker. “Throughout the pregnancy, we got a lot of extra monitoring and specialized care at the Rainbow Clinic, and it was just so important to be with somebody we fully trusted, which is how we felt with Dr. Stone,” Ana says.

At 7 pm on November 26, 2023, Ana was admitted for an induced labor at 39 weeks. She gave birth to a baby boy, Michael “Mikey” Robert, at 11:53 am, weighing 6 pounds and 9 ounces. Ana was able to return home the next day.

“The goal of the Rainbow Clinic is to help women who have experienced the loss of a baby achieve a successful pregnancy by giving them access to a multidisciplinary team with a wide range of expertise, and to give them support that goes beyond standard prenatal care,” Dr. Stone says. The Rainbow Clinic provides specialized services and care options, including:

• A comprehensive review of patient history

• Work-up for current or future pregnancy

• Addressing any lifestyle alterations or modifications for other comorbidities

• Plan for pregnancy, including social work support, nutrition, frequency of visits, antepartum surveillance, and delivery timing and planning

• Specialist training completed by all staff

• Dedicated contact to schedule appointments

• Transition of Rainbow Clinic to labor and delivery and postpartum care, with Rainbow footprints on the door identifying patients as Rainbow Clinic patients

• Tracking outcomes

“An important part of being a patient at the Rainbow Clinic is that the staff has clearly received training to be trauma informed and to reassure this population of patients that has had a lot of anxiety,” Ana says. “They never made me feel as though I was wasting time or taking up a bed or being ridiculous by coming in.”

The Mount Sinai-Rainbow Clinic is the first of its kind in the United States and is based on a model established in the United Kingdom in 2013 by Alexander Heazell, MBChB (Hons), PhD, MRCOG, an internationally recognized leader in stillbirth research. Dr. Stone is currently working with him on the creation of criteria to help with the establishment of more rainbow clinics in the United States.