CONCORD, N.H. – After giving birth, most new moms can't wait to see their child.
For Macenzee Keller, it would take more than two months, as she fought for her life against COVID-19 while under sedation and breathing with the help of machines.
Mother and child were reunited on Feb. 3 when Keller's mom brought the healthy, 11-pound, 13-ounce baby boy named Zachery to her hospital bedside.
“It was very emotional because I was like, ‘Oh, I got to finally see my baby that I was waiting for so long to see,’” said Keller, who has since returned home to Manchester, New Hampshire.
Two weeks before her Dec. 7 due date, Keller was diagnosed with COVID-19. She remembers leaving her apartment for the hospital on Nov. 27, suffering from shortness of breath — and that's it.
Her son, Zachery, was born the next day via emergency cesarean section at Catholic Medical Center in Manchester. She was sedated and intubated at the time.
She was later transferred to Dartmouth-Hitchcock Medical Center in the city of Lebanon.
Keller — still sedated, still very sick — was put on a specialized blood oxygenation treatment. Blood was pumped out of her body into an extracorporeal membrane oxygenation machine, ECMO for short, which removes carbon dioxide, then pumps the blood back into the body.
“People like Macenzee who are younger and have a really good chance of getting better — she's kind of the perfect candidate for us to offer it,” said Ciaran Moloney, a nurse who was part of her care team at Dartmouth-Hitchcock.
There have been other cases of expectant mothers who were so sick with COVID-19 that they had to deliver quickly. In Wisconsin, a mother was in a medically-induced coma with the virus when she gave birth to her daughter via cesarean section in November 2020. She ended up spending 75 days on life and lung support. She met her daughter over two months later, when she was discharged from the hospital.
Keller was on the ECMO circuit for 47 days. Patients usually get the treatment for closer to a month or less, Moloney said. One of the physicians handling her treatment had read research saying recent post-partum patients benefit from extended time on ECMO, he said.
It was touch and go at times. Keller was still hooked up to a ventilator.
“I would come in some days and she would be taking larger breaths, and then she would have setbacks,” Moloney said. “She had a number of setbacks while she was on the ECMO circuit. ... There were times where we were very scared of how she was doing.”
Keller’s mother, Brandi Milliner, got phone updates from Moloney. She and family members participated in Zoom calls with her daughter during the holidays “just so she could hopefully still hear us and know that she was loved, and we were still there.”
She finally got to visit Keller on Jan. 7.
“They were starting to wean off some of the sedation. So I could go in and I could say her name and she’d open her eyes a little bit, small commands that she was following,” Milliner said. “By the end of my visit, she had actually kind of squeezed my hand a couple of times. So that was an amazing feeling.”
Keller continued to improve over the next few weeks, eventually being taken off of the equipment. It took her a little while to realize where she was when she came to.
“Do you know like when you fall asleep somewhere and then you wake up somewhere new? And you’re like, ‘Whoa!’ That’s kind of what I felt,” Keller said.
It wasn’t too long after that she was able to move around with a walker, continuing to improve.
Keller was not vaccinated against COVID-19, and says she planned to wait until after she delivered to get the shot. She'd heard that some people feel sick for a day after getting the vaccine, “and I was just nervous that if I did get it, it would cause complications to Zachery.”
The Centers for Disease Control and Prevention says COVID-19 vaccination is recommended for people who are pregnant, and that the benefits of receiving the vaccine outweigh any known or potential risks of vaccination during pregnancy.
Doctors told Keller she has to wait a couple more weeks before she can be vaccinated now.
In hindsight, when asked if she would have made the same choice, she said, “I don't know. Part of me says I would have got the vaccine, but then another part of me still says that I didn't want to risk anything.”
Keller, who is engaged to be married, still uses a pulse oximeter to measure her blood oxygen levels and has additional therapy appointments to help with her walking. But her recovery is considered amazing, Moloney said.
“She went from being completely reliant on the ECMO pump to being fully interactive within just a span of a couple of weeks,” he said.
He added, “My wife, we found out she was pregnant roughly around the same time, and that just made it very emotional for me to see everything that Macenzee was going through.”