First Dialysis Patient in Community to Deliver a Baby

Vanessa Grisdale has been an active volunteer at Sault Area Hospital (SAH) for many years. She chairs the Patient and Family Advisory Council for the Renal Program. She also co- chaired the SAH Corporate Patient and Family Advisory Council, supported the labour and delivery/NICU units and is a Board member for a local daycare facility.

Vanessa has also been a long-time renal patient at SAH. She started peritoneal dialysis 22 years ago at the age of 16. By the age of 19 she had a double kidney transplant but unfortunately, it failed less than a year later. She was 20 years old when she met Dr. David Berry, Nephrologist and began hemodialysis three times a week at the hospital.

Dr. Berry has been a Nephrologist at SAH for more than 20 years and is the Chief of Renal Medicine. He has participated in many local and regional board and committees over the years. Most recently, he was asked by the Ontario Renal Network and Trillium Gift of Life Network to join their newly created Integrated Kidney Transplant Forum. This strategic advisory group brings together professionals to address challenges and identify opportunities to create a person-centred, equitable, and integrated kidney transplant system.

According to Vanessa, many healthcare professionals told her that having children as a dialysis patient was too risky and would not be likely in the future. “The probability of a successful pregnancy for a dialysis patient is very low,” says Dr. Berry. Vanessa resigned herself to this fact at a young age.

In 2020 at the age of 35, Vanessa began exploring the possibility of fostering a child and this led to discussions with Dr. Berry. “He asked me if I was interested in having a child and I told him that I didn’t think this would be possible,” she explained. Vanessa expressed her interest in having a child.

“I have known Vanessa for over 18 years. She is a strong health advocate and a champion for renal care. I knew that she would be a strong part of the care team,” states Dr. Berry. He introduced her to Dr. Michelle Hladunewich, Nephrologist at Sunnybrook Health Sciences Centre who specializes in kidney disease in pregnancy. “When I put Vanessa in touch with Dr. Hladunewich, we knew that she had a higher chance of complications and we counseled her on the risks so she was aware,” he added.

Dr. Hladunewich’s research interest includes pregnancy outcomes in women with chronic kidney disease. She directs the Pregnancy and Kidney Disease (PreKid) clinic which helps women with chronic kidney disease plan their pregnancies and she has developed protocols for safe follow-up most notably for women on dialysis.

“I put my foster application on hold,” says Vanessa. Dr. Hladunewich had a meeting with Vanessa and she learned that in order to conceive and carry to term, she would require intensive hemodialysis 7 days a week, 5 hours a day in the midst of the COVID-19 Pandemic. “I was on dialysis for 35 hours a week while still working from home. “I work at the Ministry of Labour, Immigration, Training and Skills Development and I was so fortunate to have the support of my employer,” says Vanessa.

Vanessa began her pregnancy journey. “We ramped up dialysis up to 7 times a week, she had frequent blood pressure monitoring, and ongoing visits with Dr. Hladunewich via Telehealth,” explains Dr. Berry. “Telemedicine allowed Vanessa to remain close to home while receiving her dialysis close to home at SAH. It made a world of difference.”

She did this for the duration of her 32-week pregnancy. In addition, she was followed closely by the renal program, the obstetrics team and Dr. Hladunewich in Toronto. She had regular, ongoing medical check-ups, lab work, and diagnostic testing. “We had obstetrical support here and in Toronto and we had birth plans and back up plans in place that included discussions with Vanessa every step of the way,” says Dr. Berry.

Managing Vanessa’s kidney disease and pregnancy required a close eye. “We made adjustments along the way. Her care needs changed often and we had to be very flexible and adaptable in our approach. Her care included extensive involvement of many care providers including dietitians, social workers, and nurses,” says Dr. Berry. “We truly had a team-based approach to her care and the care of her baby.” 

In November 2021, a blood test revealed that Vanessa was pregnant. Her pregnancy was considered high risk but it progressed normally. Her blood pressure was a bit elevated and she was on bed rest. At 32 weeks, baby Seth was born in April 2022. “We were thrilled to have a beautiful healthy baby boy,” she says.

Shortly after Seth was born, Vanessa and her husband had a surprise – she was pregnant with their second child. “This was a shock,” says Vanessa. “I began intensive renal dialysis once again – this time I was working, doing dialysis 35 hours a week and I had a baby to care for.” Vanessa credits her husband, Ryan, and family for the incredible support.

Vanessa’s pregnancy and delivery of her second son was also smooth. She had gestational diabetes and low blood pressure. Baby Trip was born in May 2023 at exactly 32 weeks like his brother. He was born premature at 3 pounds and flown to London where he stayed for about a week for medical tests and observations.

After her children were born, Vanessa went back to doing dialysis 4 days a week for 3.5 hours. “I feel good,” she says. Today, she has dialysis 4 times per week at SAH, she is a busy mother of 2 toddlers, and she is working full time and volunteering in the community.

“In the 20 years that I have practiced in Sault Ste. Marie, Vanessa’s is the first pregnancy we have seen with a hemodialysis patient,” says Dr. Berry. “Even more remarkable is that she has had two healthy pregnancies. This is truly inspirational!”

Vanessa’s story is indeed one of hope and determination. “At times, we thought it would never be possible and now we have 2 beautiful sons. Words cannot express how truly grateful I am to everyone who helped me along this journey, especially Dr. Berry and Dr. Hladunewich. I would also like to thank staff from Sault Area Hospital and Sunnybrook Hospital including, Dr. Mir Shafiee, the Obstetrics teams, diagnostic imaging staff, dieticians, NICU staff and the renal team (who have become my second family). I thank them for taking such good care of me and helping make an impossible dream a reality,” says Vanessa.

Vanessa acknowledges the tremendous support from her husband and family. “My husband Ryan’s unwavering support and dedication to me and our boys is truly remarkable. Seeing him become the Dad he always wanted to be has been truly moving and inspirational,” she says. “My mom and dad, my in-laws Carole and Donny, my late grandmother Gabriel, and all my family and friends have been my support system and I thank them for helping us in every step of this journey and showing our boys the true meaning of it takes a village.”

Despite her challenges, Vanessa is thankful for her gifts. “Renal failure and dialysis brings many challenges which means uncertainty in life but one thing I am certain is that my boys and I are cared and loved for, and for that I am forever grateful. My boys are miracles and they are my everything. I could not be prouder to be their mom.”