Shiniqua Aschenback woke up the morning after her 43rd birthday and immediately knew something was wrong. Both of her legs had inexplicably swollen to twice their normal size overnight.

Aschenback was pregnant with her fourth child and halfway through her second trimester with no complaints besides swollen ankles, a common symptom she had experienced in earlier pregnancies. But her primary care physician had warned her this fourth pregnancy would be challenging, given her family history of heart problems. Aschenback called her best friend for a ride to the nearest hospital to be examined. Two weeks later, she woke up in the UF Health Heart & Vascular Hospital nearly 100 miles away with no memory of what happened.

At 19 weeks pregnant, Aschenback had coded and been revived twice in St. Augustine before being transferred by helicopter to UF Health in Gainesville, where she experienced a third cardiac event and resuscitation.

She received a temporary balloon pump and gradually came out of sedation under the supervision of a multidisciplinary care team including physicians, nurses, social workers and other caregivers from cardiology, obstetrics and gynecology, neonatology and more.

Aschenback awoke to a frightening reality: Her heart was failing and couldn’t support her and her child. She was diagnosed with multifactorial peripartum cardiomyopathy, a weakening of the heart that left mother and baby with just a third of the normal blood volume pumped during pregnancy.

While Aschenback’s scenario was extreme, cardiovascular disease is one of the leading causes of maternal mortality nationwide, according to the U.S. Centers for Disease Control and Prevention, following mental health conditions and hemorrhage.

“The heart has to work more during pregnancy because the blood volume increases by 50%,” said Tony S. Wen, MD, one of Aschenback’s physicians, the W.C. Thomas Chair of Obstetrics and Gynecology and chief of the UF College of Medicine division of maternal-fetal medicine. “At that point, Shiniqua’s cardiac output was very low.”

Surrounded by the support of her mother, her sister, her aunts, her eldest sons and her faith, Aschenback chose to continue with her pregnancy at UF Health Shands Hospital, a Level IV maternal care facility recognized by the Joint Commission’s Maternal Levels of Care Verification program in collaboration with the American College of Obstetricians and Gynecologists and one of the top 10% of all U.S. hospitals for cardiology and heart and vascular surgery, per 2024-25 rankings from U.S. News & World Report.

“They told my mom to prepare for my funeral,” Aschenback said. “I told them that my God told me otherwise, so they needed to go back to the drawing board, please get back in there and talk some more. That’s when they came back out and told me about the Impella.”

Twenty-nine weeks. That was the point in pregnancy at which Aschenback’s UF Health care team determined she would be far enough along that her son, Shawn Brinson, could survive in the Neonatal Intensive Care Unit, but not so far along that fluid buildup common in the third trimester would fatally overwhelm her heart. To make it there, she needed more than just a balloon pump.

She needed the Impella 5.5, a top-of-the-line, minimally invasive heart pump designed for long-duration support, or as her cardiovascular surgeon Eric I. Jeng, MD, MBA, called it, “the diamond ring of heart pumps.”

At UF Health, Impella 5.5 had never been used to support a mother through pregnancy, delivery and postpartum recovery. In fact, Aschenback’s case was the first of its kind in Florida and only the second in the U.S.

“Being able to offer patients that option is an amazing thing; It does come with risk, but we now know it’s possible,” said Jeng, an associate professor in the College of Medicine and associate director of the UF Health Aortic Disease Center, as well as the surgical director of the Mechanical Circulatory Support Program and the Bicuspid Aortic Valve Program at UF Health.

Derek Frazier, the associate area manager for the Impella pump’s medical technology company, Abiomed, and an adviser on Aschenback’s care, said the technology that saved her and her son’s lives has only developed in the past decade.

“To see what the Impella was able to do — I don’t think she or Shawn would have survived without it,” he said. “It was a balancing act and collaborative effort from the hospital as a whole. I’ll never forget it.”

For Aschenback, her Impella pump — which she named Wilson — gave her the physical strength she needed to keep going.

“He was my best friend,” she said. “With God’s help, we went through the ups and downs together.”

Aschenback vividly remembers the first time she saw her son in the NICU after he was delivered via cesarean section in April 2023. Weighing just over 2 pounds at birth, Shawn was supported with specialized equipment like an incubator to care for him until he could thrive at home with family.

“It was like heaven,” Aschenback said. “They wheeled me into the NICU, with the whole bed and everything. He was so tiny. I picked him up, and it was exactly where he was supposed to be. He just fit right in perfectly.”

Soon after, to thank Frazier for his support of her journey and the lifesaving Impella pump, she asked him to remain connected with the family as Shawn’s godfather.

“I’m so grateful everything turned out the way it did,” Frazier said. “I don’t have kids; it’s just me and my wife. It was a special moment in my life, too.”

After her time in the hospital, Aschenback, her second-youngest son Guy, 7, her mother, Sonia Robinson, and her aunt, Laura Gee, moved to Gainesville to be with Shawn during his treatment in the NICU. They’ve stayed ever since, grateful to the lifesaving caregivers at UF Health.

“The UF Health staff were great,” Aschenback said. “They helped keep me positive. No matter what, they kept trying to make me smile and keep my spirits up. Everybody treated me so well. It was just a very blessed experience. I’m thankful I came here. If I were anywhere else, I wouldn’t have made it.”

Now, as the family celebrates Shawn’s second birthday, mother and son are recovering well in their new Gainesville home just blocks from their care team at UF Health. They often go for walks and love to spend time outdoors at a local park. Aschenback has a pacemaker, and her heart function is slowly improving with time. Shawn, affectionately called Shuggie, receives regular infusions at UF Health Shands Children’s Hospital to manage a cytomegalovirus infection.

“I’m so proud of Shiniqua,” Gee said. “And I’m very grateful to see Shuggie from first being born to the baby he is now; I just want to see him grow up and be healthy.”

Robinson added, “It was an experience, a close call to death for them. God has his reasons why things happen. I’m still scared. But they’re alive, and I thank God for that. We’re blessed. It was a miracle.”