Episode Transcript
Alli Harrison (guest):
I remember just crying in my office for like a good 10 minutes and then fanning my eyes, being like, “OK, we’ve got to go back to work.”
Courtney Collen (host):
Alli Harrison, a nurse practitioner, had just checked her hormone levels.
Alli Harrison:
I saw the level. I knew that this was going to be a miscarriage. Like I’m working at a fertility clinic every day seeing all these pregnant people. And so that was hard in itself. And then when I got pregnant the first time and had that early loss, it’s shocking. I prepared myself for it. But when you’re actually the patient and the person going through it, it’s just a whole different scenario.
Cassie Alvine (announcer):
This is “Family Portraits,” a new podcast series by Sanford Health.
Courtney Collen:
In this series, we focus a lot on family, but the word family can bring varying emotions. Families come in all colors, shapes and sizes. Family units are dynamic, never perfect, but always evolving.
Growing a family is easier for some than it is for others. Couples who dream of bringing new life into the world spend years of their life struggling to do so.
That brings us to infertility, which can be really hard to talk about. One in six people around the world have a hard time getting pregnant after trying to conceive and grow their family. Unfortunately, so many of them experience miscarriage. It’s a heartbreaking reality. And for some, that painful feeling of loss never goes away.
Alli Harrison:
Well, we know that infertility is definitely increasing.
Courtney Collen:
That’s Alli. Like I mentioned before, she’s a nurse practitioner in Fargo, North Dakota, specializing in reproductive medicine at Sanford Women’s.
I sat down with her in early 2021 as she spoke broadly to that awareness around infertility and the emotional toll it can take on expecting parents.
Alli Harrison:
I think what happens is people usually keep this information to their self. It’s kind of personal. They have people around them that want to support them, but maybe don’t know what they’re going through. And it can be mentally taxing for people. If you think about every month that someone tries to get pregnant and they don’t, that’s just like a monthly reminder that it’s another month that it didn’t work. And so we do see a lot of anxiety and depression with our patients.
Courtney Collen:
When I talked to her as part of that podcast a few years ago, I asked her this: What do you enjoy most about the work that you do?
Alli Harrison:
This area is challenging. It’s challenging for patients. It’s challenging for providers because we’re working really hard to help someone make a family. And so the most challenging part is that obviously heartbreak when you’re not able to achieve a pregnancy. But the best part about it is really supporting them along the way and then hopefully being with them as they navigate that first part of a healthy pregnancy.
Courtney Collen:
Beyond the clinic, family is everything.
Alli Harrison:
My husband Shaun and I have been married for 10 years now, and we have two little boys. Our son Rhett is three and he’s going on 13. And our son Tripp is going to be four months old. In our spare time, we love to go to the lakes. We love to do outdoor activities. Our sons both love the water, so we spend a lot of time swimming and doing all types of sports. We like to spend a lot of time just with family.
Courtney Collen:
But as Alli explains growing her family wasn’t an easy journey.
Alli Harrison:
Prior to the birth of our son, Rhett, we did have one miscarriage. And after Rhett, while trying to get pregnant again, we did have two additional miscarriages. The most recent one, we found out we were pregnant in December of 2021, and because we had had two prior losses, we decided that we should monitor the pregnancy closer in the early parts. And so we had frequent blood work and we had early ultrasounds. And that first ultrasound that we had, they saw that the baby was there and was growing, had a heartbeat, but the heartbeat was low. And so there was a little bit of concern with that.
So we repeated the ultrasound a week later and we saw that the baby had stopped growing, but that there was still a heartbeat. And so that was a little bit different than what we had experienced in the past where that miscarriage happened spontaneously. With this experience, we were basically told, you’re going to miscarry. We just don’t know when it’s going to happen, and therefore you have to keep doing these ultrasounds until the heartbeat stopped.
And so that was a lot to kind of mentally grasp. You know, it’s your baby, so you want it to keep growing, you want it to be healthy. But at the same time, we knew it wasn’t going to be a healthy pregnancy.
Courtney Collen:
She remembers the day she experienced her first miscarriage that same day she was in the clinic caring for patients.
Alli Harrison:
I do specifically remember that day because I was working in the women’s department, so working with a lot of people that were already pregnant, I was like, “I think I’m starting to miscarry.” And so I had asked one of my doctors that I work with, I was like, “Can you put in a blood pregnancy test? I just want to see where that level is.” And so I did, and I actually got that result back while I was at my desk getting ready to go in with my next patient. And I saw that it had dropped.
I will never forget that moment because I was just like, oh my gosh, how am I going to do this? Right? and so I saw the level. I knew that this was going to be a miscarriage. I remember just crying in my office for like a good 10 minutes and then fanning my eyes, being like, “OK, we’ve got to go back to work.”
So I did end up just going in with that next patient just a little bit late feeling like a little fragile. I could feel like my pulse was racing the rest of the day. And, you know, I just felt like, well, this is what I have to do. I have a full schedule of patients and I’ll navigate these feelings when I get home. It was kind of like a quick message to my husband saying like, you know, I think I’m miscarrying and I’ll talk to you as soon as I can. But I, yeah, I did continue the day. But I just, I will never forget that feeling of like, just my heart was dropping when I saw that.
Courtney Collen:
When we recorded that podcast talking about infertility, I had no idea that she was struggling with her own infertility. So I sat down with Alli again to talk about her journey. I wanted to know what it was like to work as a fertility nurse while she was experiencing infertility and loss. How did she do her job? How did she navigate her emotions, yet maintain that professionalism of care?
Alli Harrison:
The doctor that put that level in for me and had me go get my blood drawn was messaging me is like, I’m really sorry. Like, what do you need? And in that moment I was like, “It’s OK. It’s OK.” You know, like I kind of just built up that wall immediately and was like, OK, we can do this. We’ll get through the day.
I do remember thinking like, “Wow, this is what it feels like for those patients that have that loss in the clinic.” And, and thinking right away, like, “Wow, this is way different than I expected it to feel.” You know, until you experience that loss on your own, it’s hard to really put yourself in those shoes completely. And so I kept thinking to myself like, well, the work has to keep going. We have to keep going, and there’s people here that are here because they need to be here. And so I just, yeah, I just put it aside. And then navigated that when we got home.
Courtney Collen:
Alli said her approach to how she cares for patients changed that day.
Alli Harrison:
I felt I had a good approach to people that, you know, I’m sitting in front of and telling them like, you know, your baby’s heartbeat has stopped. Or this will not be a good pregnancy. It has not progressed. But I think having that experience myself definitely changed a few things on how I talked about that with patients. I think the biggest thing that I did change is just kind of like sitting in that moment with them. So, you know, telling them like, your baby’s heartbeat has stopped. I’m so sorry. And then just sitting. And that’s a really uncomfortable space, whether it’s, you know, that quiet with your friend as they’re telling you something or a patient. But it’s important to not move forward immediately and start talking about other things, right? So it’s more of a, you know, that this pregnancy is not going to continue and I’m really, really sorry, and I know this is really, really painful. And then just sitting there, and usually if you give them that time, it’s like, OK, there’s tears, there’s shock involved.
And then it’s a discussion of what do you feel like you want to talk about? Do you want to talk about next steps or do you want to go home? Right? Like sometimes that shock of getting that news, you can’t comprehend anything at that point. Your brain instantly is saying like, there’s no more due date. Like, our family’s not growing. Like, what am I going to tell my husband if he’s not there? Or how am I going to tell my kids? Right? Like, what if you had already told them and you’d showed them ultrasound pictures?
And so there’s so many things that they’re going through in their head about what they’re going to do in their personal lives that it’s hard to jump into things and say, OK, how do you want to manage this now? Right? Like, we know that this miscarriage is going to happen. And so I think just giving them that extra time, like clinic runs behind sometimes, and when you go in with that next patient and you’re late and you say, I had a patient that needed more time today. And that’s the truth. I mean, they just need that time and it’s not a quick in and out visit.
And so I think that’s a big change that I did is just really taking it slower and asking them what they want to hear in that moment. Because if they’re not processing, you know, do I want surgery? Am I going to have this happen at home on my own? They’re not going to be able to receive that information and understand it in a way that needs to be there.
Courtney Collen:
Another component to her care is checking in with the partner.
Alli Harrison:
We always have our eyes on the mom, talking to them about how this is going to go. And a lot of times their partner is really feeling it too, right? And so, just because they’re not carrying the pregnancy doesn’t mean that they don’t feel those same feelings of pain. They’re running through, how am I going to support her? How am I going to get her through this? They maybe were having relationship troubles from the start because they’re going through tons of fertility treatments. And so there’s just so many things that are going on in that initial five minutes of hearing this information that I try to just take a step back and just sit there and just be there for them in that moment.
Courtney Collen:
In Alli’s three miscarriages, her first two were naturally progressing miscarriages. In other words, the bleeding and loss happened naturally. Her third was further along, but there were concerns with baby’s heartbeat and baby’s growth.
Alli Harrison:
So it’s like, OK, what do we do now? And it is a matter of you just need to wait it out, but you are going to miscarry. So that was just such a weird scenario to go back to work and be like, OK, I know this is going to happen. I don’t really know when it’s going to happen. And you also have to keep doing ultrasounds to get to that point where the heartbeat has stopped before you can do any type of management of the miscarriage. So that was like, well, how do I do this? I’m going into this ultrasound, these ultrasound techs are thinking like, oh, this doesn’t look good. And I kept having to tell them, I’m expecting this, right? Like, I’m almost at the point where I can’t do this anymore. I can’t keep seeing this positive heartbeat and things like that. I am actually hoping for it to stop, which is such a weird thing to navigate as a mom because you’re like, I would give anything for this pregnancy to continue, but this isn’t going to be OK. And so once I finally did get that ultrasound and the pregnancy had stopped and the heartbeat had stopped, then it was that discussion of, OK, how do we want to manage this?
Courtney Collen:
After this third miscarriage, Alli wished to undergo genetic testing.
Alli Harrison:
And it was actually coming home from surgery that I get home and I’m … resting and I get a message reminding me to put in that PTO or, you know, allowed time away.
Courtney Collen:
Through this recovery, Alli had to go back to work.
Alli Harrison:
I responded, is there a bereavement code you can put in for this? And that’s when I found out that Sanford did not have bereavement leave for the loss of a pregnancy at any point in pregnancy, which is just was wild to think about. I’m like, here I am at 11 weeks. What is someone else gonna do at 24 weeks? Right? Obviously I was upset by that. And, the craziest part of it all is that my husband had two days of bereavement leave for a miscarriage for a partner.
Courtney Collen:
This was early 2022.
Alli Harrison:
That was part of the reason that I was a little bit driven to pursue this topic further. I was shocked to find out that with women having miscarriages or pregnancy losses, that no matter where they were at in the pregnancy, they wouldn’t have any days off to recover. Whether that be an early miscarriage or the loss of a pregnancy later on, I knew that miscarriage happened often. I know it happens to one in four women – in our case three different times. And I also knew that it’s physically and emotionally stressful on a patient or a woman or her partner to navigate those feelings after.
So with knowing that I had had surgery and had to physically recover, I also knew that there’s the mental side of that, which is, you know, going through that grieving process and acknowledging what happened. I also thought about the families that have to explain that loss to their children. So they maybe had told their children that they’re pregnant and maybe aren’t going to bring home that baby.
And so knowing that we have to navigate those topics that emotionally can take some time, and not having a day or two or five off to go through that is stressful for people. The other side of that is, you know, I see patients every day that go through this, and I know that when you get that positive pregnancy test that you instantly think about the future. You know, what’s our family going to look like? What’s delivery day going to look like? And it’s a time of planning. And so when that shock comes that you’ve lost that pregnancy it takes time to go through all that.
Courtney Collen:
Alli did her research, and she was determined to get answers. So she emailed Sanford President and CEO Bill Gassen.
Alli Harrison:
I knew that if I was gonna write this letter to Bill that I’m going to have to have some support behind it. I’m going to have to have some statistics, some facts, some reasoning as to why this needs to change.
Courtney Collen:
She first connected with friends outside of the organization to learn about their policies.
Alli Harrison:
I listed all those organizations. I listed what their bereavement leave was, and shockingly, we were pretty much the only one that didn’t have it. And so I think showing him that evidence and giving him that, I knew that that would help. I still didn’t think it was going to change, right? You just feel like this small little voice amongst this huge organization. And so I was still skeptical of it, but I did include in that message to him, I just said, you know, this is how this goes.
Courtney Collen:
Bill got that email.
Bill Gassen:
Allison sent me a personal, heart wrenching email telling me all about her miscarriage, and then asking me why Sanford Health didn’t have a leave policy in place for employees who were experiencing a pregnancy loss. To be honest with you, I did not have a good answer for her.
Courtney Collen:
In April of 2024, he shared Alli’s story and some of his own in his opening remarks to a room full of corporate leaders during their annual meeting.
Bill Gassen:
And I couldn’t stop thinking about her story, especially because I’m sure, as some of you can relate, I was drawn to my own personal experience and remembered when my wife Jill and I went through a very similar experience.
Before we were blessed with our five children today, Jill also experienced a miscarriage, and she experienced that actually while she was at work in surgery. And I’ll never forget the phone call that I received that day, nor the pain that we felt in the days and the weeks that followed.
And for anyone who’s gone through a miscarriage, you know how painful that loss is and how with all loss, how important it is to be able to grieve and to be able to take time to process that.
Courtney Collen:
Alli’s email and courage marked the beginning of something new.
Bill Gassen:
By having the courage to speak up, Allison led important change at Sanford Health. Allison’s story led to Sanford Health adding compassionate leave for pregnancy loss as part of our employee benefits starting this last year.
And I can only imagine the courage that it took for Allison to first just share that story with me, someone who she didn’t know personally. And then at that same time, to be able to advocate not only for herself, but importantly for the entire Sanford family. And for that, for that courage, I will always be thankful to Allison.
Alli Harrison:
I didn’t think this would change. I didn’t think that I had the ability to create a change. It’s hard to picture big-picture Sanford, which is huge, amongst many, many states. And to think that like that impacts all those people was pretty crazy. It did give me that motivation to really think about the things that are important and things that I’m passionate about and things that other people might be passionate about, and really encourage them to try to make that change.
Tripp is our rainbow baby. And he’s just the best. We feel very, very blessed to have two healthy boys now. We picked his name because, oh gosh. We picked Tripp’s name because it means the third boy and the pregnancy that we lost in January was a boy.
And so, not only do we love the name, but it also has a little bit of meaning to us that he’s our third boy, and although our other boy isn’t with us, we can think of him when we’re hanging out and using Tripp’s name.
We didn’t know how big brother Rhett was going to adjust to a baby at home, but he just loves him so much and he’s just obsessed with him and has been a really great transition becoming that family of four. And I think our family’s complete, so I don’t think that that compassionate leave will ever apply to us, but I am glad that it’s there for the people that do need it.
I fully recognize with the work that I do that we’re lucky to have two boys at home, and not everybody gets to create a family like that. And so this whole experience has really driven that home for us. We’ve lost three pregnancies, but we’re very, very thankful to have our two healthy boys at home with us.
Courtney Collen:
Allie’s perspective from this journey has given her an entirely new sense of gratitude she takes into the clinic every day.
Alli Harrison:
It’s amazing. And I don’t take it for granted, like the fact that I work in an infertility clinic where these families would give anything to have a baby. You know, you tend to feel a little bit guilty about having your own two healthy kids.
I always think there is no stronger pull that a female can feel that if they want to be a mom, they are going to do anything they can to get to that point. And that heartstring pull is really, really strong. I mean, women go through losses and years and years of treatments and medications and all that, all for that ultimate goal. And I just hope that people know that, you know, whether this journey ends the way you want it to or not, like just, I just want you to, to keep going.
Courtney Collen:
Through this change, Alli and her family honor the three little ones who aren’t here on earth.
Alli Harrison:
We don’t forget them. People often say, I wish I could talk about it more. And remember that and remember them. It is a way to say we didn’t forget about you. We’re working towards ways to make this better for people that go through this and that don’t get to see their babies earthside and don’t get to meet them until later. And so yeah, it absolutely is a way to acknowledge that this happens and acknowledge the pregnancies that didn’t make it and really be somewhat of a support for the people going through it.
Courtney Collen:
Alli ended up talking about her journey, including sending that email to Sanford, CEO, Bill Gassen in a video that Sanford produced for their internal series called “Blue Chair.” Alli never could have anticipated the impact of sharing her own losses on others.
Alli Harrison:
Obviously makes me emotional, but I mean, I’m talking like 50 to 100 people emailing me saying like, “I just saw your Blue Chair Story and this is so cool.” I ended up posting the video actually on social media. I had this one lady message me, and she’s like, I’m an old mom now, and you’re a young mom, but us old moms are cheering for you because they didn’t talk about this stuff. They didn’t take time for themselves. They didn’t have any support.
I think the part that makes me emotional is these are unforgettable, real moments for people. This is not like, oh, I had a fender bender and I moved on and I don’t really remember when that happened. These are things that are real-life scenarios that could impact your physical, mental health for the rest of your life.
These are really real, real painful things for people. And so to have the ability to speak out about that and have people share their stories, which maybe was sharing for the first time, I feel really honored to have them send me those things. And it just really comes full circle. I got an email saying, “I now know how to support my daughter better,” right? Like, I had miscarriages, I never told her, and now she’s had one. And she said to me, “I wish you would’ve told me. I wish I could have reached out to you and knew that you knew what I was going through right now, and you’ve felt this pain.”
It’s opening conversations for people. It’s opening that conversation about benefits for employees. It’s pretty, pretty awesome to see.
Courtney Collen:
The influence of Alli’s story began to move beyond Sanford Health to other companies.
Alli Harrison:
People were messaging me, saying, “I just checked with my company and we don’t have that either. How did you enact this change?” And I think there was maybe five now that have messaged me back almost a year later saying, “I changed it for my company.” So to think that it’s not just Sanford is so cool. To think that all these other places are kind of listening, and listening to their employees and really focusing in on how can we keep these employees and how can they be the best that they can be?
Courtney Collen:
A caregiver by day making a difference in the name of family and motherhood.
Alli Harrison:
Moms, ugh. They just – they carry the world. Being a mom to these boys is amazing. And if people ask me about them, I’ll share. But I always say, I am here doing this job because I want you to feel what it’s like to be a mom.
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Posted In Corporate Services & Administration, Fargo, General, Gynecology, News, Parenting, People & Culture, Physicians and APPs, Pregnancy, Specialty Care, Women's
