Trapped on hurricane-ravaged mountain with a breech baby due at any moment

It was Sept. 29 and Courtney Mosser, of Black Mountain, North Carolina, was 40 weeks pregnant, due for her C-section that very day. The baby was breech. She was nervous. And now she had no idea how she was going to get to the hospital in Asheville because the day before, Hurricane Helene had washed away her only path down the mountain.

Her only goal: Do Not Go Into Labor. She was resting at a house near her home when Novant Health’s Dr. CJ Atkinson strode into the yard and told her: There’s a helicopter waiting. It’s time to leave – right now.

But when Atkinson explained that Mosser’s husband, Justin, and son Dylan, 3 1/2, could not join her for the journey because there simply was no room, the calm reserve Mosser so carefully tended vaporized. No way was she leaving without them, she announced, and started marching away from Atkinson in a panic to get away from him. “I was basically running away,” she recalled.

The former Army surgeon said he understood, but there was no way she could risk her life, or the baby’s, by taking a chance and going into labor on a shattered mountainside. And due to oncoming stormy weather, there was a very tight window to get back up into the air.

Minutes later the chopper thumped its way up and across the sky with Mosser strapped securely in. She was calmer now; the tears had stopped, and she took a moment to marvel at the undulating peaks and valleys as the Blue Ridge Mountains stretched peacefully out before her. How beautiful, she thought as she gazed into the horizon. She took a moment, then looked at the landscape and gasped.

Beneath her lay total destruction, a lattice of splintered trees, obliterated roadways, flipped cars and crumpled houses — a mud-blasted nightmare that the residents of western North Carolina are still trying to come to terms with.

What awaited her in Asheville? Would her baby be OK?

‘The storm is the least of my worries.’

Before Hurricane Helene, the biggest worry Mosser, 38, had was that the baby was in a breech position, meaning the baby could not be safely delivered vaginally unless the body could be turned and pointed headfirst. Mosser, a registered dietitian with a master’s in nutrition and functional medicine, had started researching like mad at 34 weeks to see how to get that baby turned. Aside from simply wanting to not have a C-section, there was another reason.

Some of us can’t imagine giving a big speech, others are terrified of heights. Mosser was terrified of surgery. She hates IVs, dreads shots and blood-draws and she worried over a loss of control. “It’s the scariest thing for me. And I did not want to have a C-section,” she said. “I did acupuncture, I did body work, I did an ECV, I did a chiropractor twice a week. I interviewed home birth midwives. I was not going to do it.”

Nothing worked to turn the baby to a safe position. And so about two weeks before her due date, she said, “I finally got to the place where I accepted that this was what we needed to do to keep everyone safe.” She began reading up on what to expect with a C-section.

Her surgery was booked: Sept. 28 at a hospital near their home. As the day approached, the impending arrival of Helene nudged its way onto her radar. Her dad was coming from Florida to watch Dylan, so she suggested he drive up a day early to beat the rain. A cousin texted her on Sept. 27, a day ahead of Helene, to ask if she was ready. “I was so focused on preparing for the surgery that I remember saying, like, ‘The storm is the least of my worries!'" she said. “I didn’t think it was going to be anything."

Friday, Sept. 27, arrived. And in the early- morning hours, so did Hurricane Helene. Dylan was excited about the waving trees and waterfalls of water coursing down the mountain through their backyard. The power was out, and they lost touch with the outside world. Mosser had expected to get labs the day before her C-Section, so husband Justin, a data engineer who works from home, walked down the road to see how things looked. He came back a few minutes later with a look of concern. He didn’t think they’d be going anywhere anytime soon.

Mosser: “I think I said, ‘I'm going to go back and lie down for a bit.' I needed to stay calm and needed to stay lying down. I couldn’t think about that too much and I don’t want to go and put myself into labor.”

By Friday afternoon, one potential escape plan after another quickly crumbled. The couple didn’t know their neighbors well because homes in their area are spread out. But as Justin started talking to neighbors, word quickly spread that Mosser could have her baby at any time and that it had to be at a hospital.

As the day progressed and more people connected, a few had Starlink satellite internet and could reach the outside world, and they started working to clear the road for the Mossers to make their exit. (See more on this below.) But after removing fallen trees, landslide rubble and down powerlines across the roadway, they encountered an even bigger obstacle: A giant section of road above N.C. 9 had completely washed away.

They were trapped.

They knew from others that the conditions were so bad that even walking out was not an option. When the Mossers went to bed that night, Courtney calmed herself with a rosy scenario. “In my mind, I told myself, they're going to fix the roads first thing in the morning, and we're going.”

'Are you Courtney? We need to go.'

When Saturday dawned, total strangers, one after the other, were knocking on the Mossers’ door to check on Courtney. “I was going out and meeting people I’d never met before. It was cool. But it was also … a lot,” she said.

Neighbors were starting to coalesce and there was a noon meeting at a water tower down the road, so she packed her hospital bag in hopes they might catch a ride into Asheville, even though satellite calls to the hospital were not getting answered.

While Justin went to the meeting, she stayed at the house nearby. Helicopters had been buzzing overhead for more than a day. Search-and-rescue efforts were underway and there were probably news choppers, too. Then a woman explained to Courtney that if she ended up in a helicopter there’d be no room for Dylan and Justin. “I had stayed quiet that entire time,” she recalled, “but when she told me that, I just started sobbing.”

And then Atkinson, the Novant Health doctor and physician leader for the region, drove up to the house. Through word-of-mouth Courtney’s story had evolved from “a woman is due to have her baby” to “a woman on the side of mountain is having contractions” and Atkinson was on a chopper that had been looking for her. This was the second landing they’d made in the search.

“He said, ‘Are you Courtney? We need to go.’ And I kind of backed away and said, ‘I’m not going, I can’t leave Dylan,’” Courtney said. That’s when she started rounding the house, backing up to the edge of the property to get away from him.

“I just kept telling him, I can't leave Dylan, he has to come,” Courtney said. Atkinson explained there simply wasn’t room.

“He was really great,” she said, “because I remember him saying something like, ‘With all my heart, I know how hard this is. And with all my heart, you need to get on this helicopter. We need to get you off this mountain.

‘Because if we don't go now, I don't know when we can come back, and you can go into labor at any point. And delivering a breech baby without experienced care, or even sometimes with experienced care without access to a hospital, is way too risky.”’

At that point, Mosser said, “I lost it.”

She was crying hard but stayed focused on Atkinson and his calming energy. Plus, “I was trying to pull it together for Dylan.”

She got in a car with Atkinson and headed toward the chopper and that’s when Atkinson – who enrolled in the Army a day after 9/11 – went to work. Atkinson’s ability to stay calm in a crisis was won during warfare, when he operated on profoundly wounded soldiers who had been hit by gunfire and roadside explosives.

“He did put me at ease so much, which made a lot easier,” Mosser said. “He was saying, ‘I know what it's like to leave like your children behind (for deployments) when you don't want to.’ So it was nice, because he validated that it was hard and acknowledged that and said, I understand it. And then my rational brain could kind of kick back on, and I got out of that panic.” She waved goodbye to Justin and Dylan as the chopper lifted away.

A familiar face

Minutes later they landed in a parking lot at the Asheville High School football field, and Mosser was whisked into an operating room at Mission Hospital. “It seemed like there were 30 or 40 people there waiting because they didn’t know what was going to be needed,” she said. “The OR was overflowing with people, and I was full-on panicking.

“And then: I hear this voice say, ‘Look at me. Look at me. Look at me. I'm right here.’” And Mosser stopped and focused on the face in front of her. Her midwife was at her side, as if by magic. For the second time that day, she brought her panic to a total halt.

Michelle Tenaglia, the midwife, had heard there was a patient on the way from Black Mountain and was breech. Then Tenaglia realized: “That’s my patient!”

Once the OR team quickly determined Mosser was not about to give birth, everyone took a breath, and she started apologizing for the giant emergency reception even though it wasn’t her fault they’d gotten bad information in the swirling chaos.

'I felt very much cared for'

Mosser spent two nights at her doula’s home in Asheville. By Monday morning, a road crew eager to help carved a temporary path wide enough for a car to get around the giant washout, so Justin – who couldn’t even find out if his wife had delivered – and Dylan were able to come to Courtney.

The family drove to Charlotte, where she was cared for by the team at Novant Health Providence OB/GYN. And then on Wednesday, Oct. 2, Mosser walked into her delivery room at Novant Health Presbyterian Medical center for the C-section, performed by Dr. Deepa Etikala, an OB-GYN at Providence, whose team has continued to care for Courtney until the family can return home.

Courtney, who hates needles and had done everything she could to avoid a C-section, had this to say about her team: “I very much felt cared for.” She wanted to call out a few people by name.

• On nurse Josephine Ogbonna, who administered the dreaded IV: “She was phenomenal. I know that's a small thing, but it was so impressive to me, because I've never had an IV experience where it wasn’t upsetting.”
• On the nurse anesthetist (called a CRNA) Rebecca Lundsten: “She was amazing. She stood by my head and explained everything.”
• And when it comes to the delivery itself, she said Etikala honored all the requests she could. “I really appreciated that from her. She gave me my baby, so she was perfect.”

And the baby? She entered the world at 7 lbs. 14 oz. 20 inches. She has an elegant longer name, but they’re going to call her Maya.

She's doing just fine. One day, she'll learn her impending arrival caused a bit of a stir.

Postscript

So many things could have gone wrong for Justin and Courtney Mosser. And yet, so many things didn’t. And they’re the first to point out that it’s all due to their neighborhood, their care providers in Asheville, good Samaritans in Charlotte who welcomed them off the mountain and into the city, and the teams at Novant Health that brought little Maya into the world.

• The care team at Novant Health Providence OB/GYN and the OR team that delivered their baby and everyone who worked to build medical safety at Novant Health.
• Novant Health pediatric nurse practitioner Dana Nisley who visited her in the hospital every day. "She was just outstanding."
• And finally, Dr. CJ Atkinson, whose care shows there’s a lot more to medicine than clinics and treatment. “I think what stand stands out is that (when they met) that was the point where I was the most panicked,” Courtney said. “It was the scariest point for me. And so it's his words, and his energy that are very, very clear to me. I'm very grateful for him for being that way, for (his) demeanor, that made a big difference.”