Washington - In the predawn hours of one Saturday last September, Shelly Cawley's husband and their newborn daughter were being escorted through hallways of a North Carolina hospital.
Cawley had slipped into a coma during childbirth just hours earlier and some thought it might be time for her family to say goodbye.
Her blood pressure was dangerously low (60/40, doctors later told the family) and her heart rate was soaring (more than 180 beats per minute). Cawley was hooked up to what doctors called "the last-chance ventilator," a machine pumping air into her lungs with such force that it rattled her hospital bed with each artificial breath, her husband, Jeremy Cawley, said.
But the hospital staff had one more idea to try.
"The nurses instructed us to strip the baby down and put her skin-to-skin with Shelly," her husband said. "Their hope was that if Shelly could smell the baby, feel the baby, hear the baby - even in the coma - it would give her a reason to fight.
"They needed her to start to fight."
And they thought Rylan Grace Cawley - just hours old - might be the only one who could help.
They put the newborn on her mother's chest, Jeremy Cawley recalled, and the child went right to sleep.
"We pinched Rylan and tickled her a little bit so that Shelly would hear her cry," he said with a chuckle.
When the baby did, her mother's vitals jumped, doctors told Jeremy Cawley. He said he was told it may have given her the strength she needed to push through. A week later, Shelly Cawley woke up and met her baby daughter.
"It was a weird feeling- like I was between a dream and reality," she said. "But I do remember as clear as day looking at her face, how beautiful she was. I don't think I knew at the time I had been asleep for a week. But it was my first time meeting my daughter. I was so overwhelmed."
Jeremy Cawley, now 35, is a YMCA director in Concord, North Carolina. Shelly Cawley, now 24, is a nursing student. The couple wasn't trying to get pregnant, Jeremy Cawley said, but they weren't trying not to. When they did, they were excited.
It would be her first and last pregnancy.
Shelly Cawley planned to deliver naturally, bringing her husband to weekly classes on natural birthing.
"Having a child with the person you love is such a big deal, and I was looking forward to getting to experience that with him," she said. "We knew what we were going to do, and then all of the sudden that plan was taken away from me."
A month before Cawley's due date, she said she developed a blood clot in her leg. Doctors began treating it with blood thinners.
On Sept. 5, 2014, her water broke.
She and her husband went to the Carolinas Medical Center-NorthEast in Concord and waited for her labour to progress. It never did.
Doctors diagnosed Cawley with pre-eclampsia - characterised by extremely high blood pressure - and a life-threatening condition called HELLP syndrome. Doctors, she said, told her that the only option was to deliver by C-section.
She was wheeled into the operating room at around 11.30 that night.
"I was telling the doctors that I was scared I wasn't going to wake up," she said. "To this day, I don't know why I had that feeling. I guess it was some sort of sense I had that something was going to go wrong - a premonition - because they had treated everything throughout my pregnancy just fine."
At 11.44pm on September 5, Rylan was born. She weighed 7 pounds, 11 ounces and was 21 inches long.
Within minutes, she was in her dad's arms.
"They just told me that Shelly was going to be in recovery and it would be a little bit before she reunited with us," Jeremy Cawley said.
Then, he was told his wife had taken a turn.
Doctors told him that Cawley's lungs were filling with fluid and she was having trouble breathing on her own. He said doctors later discovered that Rylan's weight was holding the blood clot in place and, when she was delivered, the clot migrated to Cawley's lung — quickly causing a pulmonary embolism.
Ashley Manus, Rylan's nurse, said the medical team decided it was time to bring the family together.
"We didn't know how she was going to make it and she had had no interaction with her child," she told The Post. "If that was going to be it for her, we wanted to be able to tell the baby: 'Your mom held you.' "
Manus and others on Cawley's medical team came up with the idea to lay Rylan on Cawley's chest.
Medical professionals use the skin-to-skin method to reinforce the mother-baby bond — a technique that, doctors say, has noticeable medical benefits for both a mother and her child. Immediately after childbirth, the baby is placed on the mother's chest. This physical touch has been shown to stimulate the newborn's brain development, stabilise heart rate and help maintain body temperature.
Research has shown that it also helps prepare both mother and baby for the first breastfeeding.
"We put infants on their moms' chests every day and it seems to be beneficial for the babies," Manus said.
In Crawley's case, the nurse said: "Shelly was the one in crisis so we thought we should try to have the baby with her as much as possible and, maybe somewhere in Shelly's subconscious, she would hear her baby was calling out to her."
Once they finally got the baby to cry, Manus said, the medical staff saw "a little spike" in Cawley's vitals.
As the week wore on, Jeremy Cawley tried to forge a bond between his unconscious wife and newborn daughter, he said. He swaddled Rylan in one of Shelly's T-shirts so the baby could smell her mom. He learned how to pump his wife's breast milk (the lactation consultant told him he was the first husband she had ever taught), so she could breastfeed if she ever woke up.
"It was such an emotional and spiritual journey for our family while she was gone," Jeremy Cawley said. "God's hand was all over everything."
Doctors kept Shelly Cawley in a coma so they could give her the care she needed to survive. She was pumped with 21 units of blood to replace what she lost due to blood thinners, Jeremy Cawley said. She was hooked up IVs, ventilators and a heart-and-lung bypass machine to keep her body functioning.
"But all the doctors said there's no way they would have gotten to that point if Shelly hadn't made it through the night," Jeremy said.
Rylan made all the difference, the couple said.
"In my heart I like to think that," said Manus, the nurse.
On September 12, 2014, seven days after giving birth, eight days after falling into a coma, Shelly Cawley opened her eyes.
"One of my clearest memories was asking her if she knew who I was, asking her if she knew my name - and with the most breathy voice she said my name," Jeremy Cawley said. "It was just such a huge thing."
Then, he brought Rylan in.
"She still couldn't move," he said of his wife, "but you could see her eyes - and as soon as I brought in Rylan, her eyes locked on Rylan. She just stared at her. And I laid Rylan on her chest."
Cawley's mother stood nearby with a camera, showing Cawley - eyes half-closed, mouth wide open - looking at her baby for the first time.
Jeremy Cawley brushed the hair from her forehead and asked her a question: "Are you happy?"
Cawley nodded.
"I've got stories to tell you," he said.
Washington Post