By Melissa Cunningham
Jacquline Boyle and Maisie.Credit:Eddie Jim
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Maisie Cargill was simply meant to be born. The journey her mother, Jaqueline Boyle, went through to get her here is proof of that.
On Sunday, Maisie, who was born on April 20, will be spending her first Mother’s Day surrounded by her mum, grandmother, great-grandmother and aunt Rochelle, without whom she would not be here.
How this came to be is a complicated story of modern medicine and defiance of all the odds.
Boyle was diagnosed with autoimmune chronic active hepatitis, an inflammation in the liver that occurs when the immune system attacks the organ as a child, and then acute myeloid leukaemia, a type of cancer that affects the blood and bone marrow, when she was 24.
Within a week of her diagnosis, she was undergoing aggressive cancer treatment, including chemotherapy. There was no time to freeze her eggs or think about how the treatment could diminish her fertility. She just wanted to survive.
But the chemotherapy wreaked havoc on her liver. In the end, the cure came later, in the form of a bone-marrow transplant from her sister, Rochelle van Koll.
The Hoddles Creek woman did not realise it then, but the bone marrow transplant from her sister – which gave her a new immune system that no longer attacked her liver and flipped her blood group – would also be the reason she would one day be able to carry a baby.
“I don’t think I could ever repay her for everything that she’s done for us,” Boyle, now 36, said. “My daughter wouldn’t be here without her and that successful transplant, so it’s pretty special.”
Boyle and her sister Rochelle van Koll with baby Maisie.Credit:Eddie Jim
Associate Professor Ryan Hodges, director of maternity services at Monash Health, deals with some of the most high-risk pregnancies in the state.
He had never seen a case like Boyle’s in his 20 years in the job.
“It’s been an extraordinary road with many twists and turns,” Hodges said. “Jacqui’s case was right up there. It was a very severe case.
“What her sister did is really remarkable because without that new immune system she would have had such severe liver disease that pregnancy would have just been a complete impossibility.”
When Boyle was declared in remission, she and partner, Joel Cargill, immediately started trying to conceive.
They were warned by specialists about the low chance of success due to her cancer treatment, which can affect the number of healthy eggs in the ovaries, and the complication of her underlying health conditions. The couple went through five gruelling years of in vitro fertilisation.
When Boyle fell pregnant last year, they were elated.
But the legacy of chronic liver disease means Boyle’s body is unable to form blood clots.
Hodges said her pregnancy was among the highest risk because she carried the baby with a significantly elevated risk of a catastrophic bleed or haemorrhage.
“The complexity of it all was just enormous,” he said.
Such was the risk involved in getting Maisie into the world and caring for her mother, that the head of almost every medical department at Monash Health was on hand to treat Boyle in the lead-up to the birth and following the caesarean she had after her liver suddenly began to fail.
“She had an entire team of specialists including all our most senior doctors looking after her,” Hodges said.
“We had pretty much every head of service treating her from gynaecology to haematology to obstetrics to gastroenterology and paediatrics and our senior liver team.”
Boyle was given specialist blood products to give her body the ability to form clots during the caesarean.
“Maisie baby was born in perfect condition, she was just excellent,” Hodges said. “And then her mum has had a wonderful recovery since, so I was very relieved, I must say.”
‘She had an entire team of specialists including all our most senior doctors looking after her.’
After Maisie was safely delivered, doctors found a litre and a half of water in Boyle’s abdomen, prompting life-saving treatment to get her liver functioning again.
“The liver doctors really took over the next steps to try and tweak all the different hormones and proteins and chemicals in the blood to make sure that was optimum, and they got a liver back,” Hodges said.
Boyle remembered waking up in recovery and Maisie being placed on her chest.
“We just cuddled for hours,” she said. “It was amazing. I couldn’t believe we had done it.”
The next morning, Hodges arrived to check on Boyle in the hospital birth suite and found her holding her baby in her arms.
“She was just beaming and so besotted by this little bab. It was a lovely moment,” he said. “That’s when I really realised, she would have done anything, absolutely anything just for that moment.”
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