Pregnant after miscarriages, woman nearly dies from rare heart failure

Casey Gould’s pregnancy had gone so smoothly that swelling in the final stretch did not raise alarms. Then, after 36 hours of labor on November 1, 2024, the mother who had waited through three miscarriages said the words that signaled a medical emergency: “I think I’m about to die.”

Doctors rushed Gould into an emergency C-section and delivered her son, Archer, within minutes. Only then did the full crisis become clear. Her heart was failing, and specialists suspected peripartum cardiomyopathy, a rare form of pregnancy-related heart failure that can strike in the last month of pregnancy or within five months after delivery. The condition is difficult to catch because symptoms such as swelling, fatigue, shortness of breath, chest pain and palpitations can look like ordinary late-pregnancy discomfort.

Gould and her husband, Ben Rosenberger, had decided in January 2024 to stop trying for a baby after infertility treatments failed and they endured three miscarriages. She became pregnant the next month. By her own account, the pregnancy felt easy. Her baby moved constantly, and even the swelling she noticed late in pregnancy did not prompt concern from her doctors. She was due on Halloween, but labor did not begin until November 1.

The danger escalated fast. Later reports said Gould’s ejection fraction fell to 13%, far below the 45% threshold used to define peripartum cardiomyopathy. The National Heart, Lung, and Blood Institute says pregnancy-related cardiomyopathy affects about 1 in 1,000 to 1 in 4,000 pregnant women in the United States, while the Peripartum Cardiomyopathy Network estimates about 1 in every 2,000 live births. The American Heart Association says the condition can be hard to detect because it can mimic pregnancy itself.

Dr. Amer Sayed and Gould’s team inserted an Impella heart pump to let her heart rest. She was placed in a medically induced coma for two days. When her heart was checked again on November 4, 2024, it showed signs that it was trying to work on its own. Gould met Archer that evening.

A year later, in November 2025, Gould returned to Atrium Medical Center with her son, then about 1 year old, to reunite with the team that saved her life. Rosenberger said they were in the right place at the right time and did the best work to make this possible. Gould now returns for annual follow-up visits, a small price to pay, she says, for being a mother.