Fort Worth Zoo
Fort Worth Zoo officials spent a portion of Wednesday morning sharing details of their most recent tale of the miracle of life, this one occurring with the most unique set of circumstances and new challenges.
It’s quite a fascinating story that we were told. For the first time in the zoo’s history a primate was delivered by cesarean by a volunteer team of human reproductive and neonatal specialists.
On Jan. 5, Dr. Jamie Erwin, a board-certified physician in obstetrics and gynecology who practices at VIVI Women’s Health, assisted in the premature delivery of a baby girl carried by 33-year-old Sekani, a western lowland gorilla who was suffering from preeclampsia, a serious condition involving high blood pressure during pregnancy that can occur in both humans and primates.
The baby was born at just 3 pounds, zoo officials say. Her father is Elmo, a silverback.
She has been given the name Jameela, the Swahili word for “beautiful.” That the name is also very close to “Jamie” was intentional, a special recognition for the role Erwin played in the event, zoo officials say.
“This means a tremendous amount to all of us,” says John Griffioen, a veterinarian and Fort Worth Zoo assistant director of animal programs and conservation. “Any gorilla birth is tremendous. It's really important for the species."
Fort Worth Zoo
Premature infants haven't had all of the normal processes that help get their lungs ready to be out in the world with air. So, Jameela needed assistance with getting the oxygen she needed, which included providing oxygen and providing ventilation.
For our team, it's even more meaningful to see all of this come together so quickly, to know that we have this community support that's ready to jump in and help us. And then to know that our own teams came together for this really complicated, really intensive [event]. We're only five weeks in now, and it's been around the clock care. We've really all come together. This is a once-in-a-lifetime experience, and we will never forget this experience, and we are so pleased at how well she is doing. I think that is a testament to the care here.”
Western lowland gorillas are listed as critically endangered by the International Union for Conservation of Nature due to hunting and disease. Gorillas also have an alarmingly low reproductive rate — at an observed rate of 3% population increase. So, even if there were a drastic decline in hunting and disease, it could take at least 75 years for population recovery to occur in optimistic scenarios, zoo officials say.
Dr. Robert Ursprung, board certified in neonatal-perinatal medicine, was also brought in to consult with the zoo staff, including Sarah Cannizzo, board certified in zoological medicine. Erwin has been a “long-standing” consultant to the zoo.
In the past, the zoo’s veterinary staff has consulted with specialists in human medicine on specific cases involving apes, our closest living relatives in the wild who share many biological similarities to humans.
The surgery was “amazingly, exactly the same” as a human cesarean, Erwin says.
“It was absolutely incredible,” Erwin says. “This is definitely a highlight of my career to assist with the zoo team and the veterinarians. Truly, after that first incision, it was business as usual. The anatomy is exactly the same. Sekani’s pelvis is slightly more narrow than a human female, but the procedure was to the T exactly, like what we do in the human population. Just fascinating and wonderful.”
Zookeepers became concerned when they noticed a pregnant Sekani holding her head.
“You don't know if it's a headache; you don't know if it's allergies, but then we saw some lip shaking,” says Linda Roberts, supervisor of primates.
Fort Worth Zoo
Dr. Jamie Erwin takes a look at her unique patient.
A video taken by Angie Holmes, the lead gorilla keeper, was shown around for opinions.
“Everyone was able to draw the conclusion between the headaches and this lip shaking that she probably had high blood pressure,” Roberts says. Testing confirmed that.
Left untreated preeclampsia can progress to eclampsia, which includes seizure activity, stroke, and stillbirth.
“So, Sekani’s life and the baby girl's life were both in danger,” Erwin says.
Jameela has required around-the-clock care — literally 24 hours a day, seven days a week. Part of that is because of the circumstances of her birth.
But there is a more complicated reason: Sekani, mother to three others, has shown no maternal nurturing instinct toward the baby. Zoo officials believe her reaction is a result of her not experiencing the normal hormonal fluctuations that occur during a natural and full-term birth.
As a result, zookeepers are hand raising Jameela for now. She is bottle fed every two to three hours. Staff also must ensure appropriate temperature regulation and monitor her weight, all while ensuring that she is near other gorillas to learn their smells, sights, and sounds.
She is held by a human — wearing a furry-type vest to simulate the feel of a gorilla — just about 24 hours a day because that’s what would happen in a normal setting.
Jameela has a nest that faces the apes’ bedrooms, so, they can come by and take a look and interact without human zookeepers nearby. All have done so, says Holmes, the lead gorilla zookeeper.
“Thankfully, so far, everything has been very positive; everyone has shown interest,” Holmes says.
Including Sekani, who apparently still, though, doesn’t recognize the baby as hers.
Zoo officials have made a decision to go forward in training a surrogate mother for Jameela. She is 24-year-old Gracie, mother of two, including 1-year-old Bruno. The zoo has another option if Gracie doesn’t take.
“We're very hopeful that Gracie will be an ideal surrogate mother and exhibit the maternal behaviors necessary for the baby to thrive,” says Griffioen.
Those behaviors include holding and carrying the infant, presenting the infant to keepers for supplemental bottle feedings, and protection.
“And most importantly, teaching the little one the social skills she needs to be a gorilla.”
Says Roberts: “Because she's going to live 40, 50 years and we don't want her to be a person in a monkey suit.”
Fort Worth Zoo staff and experts
Sarah Cannizzo, MA, VMD, Dipl. ACZM
Fort Worth Zoo
Board Certified Specialist in Zoological Medicine Associate Veterinarian
As lead veterinarian for the emergency procedure, Dr. Cannizzo, a board-certified specialist in zoological medicine, facilitated the inclusion of experts in human medicine and was the veterinarian focused with Dr. Erwin on the mother gorilla, Sekani during the surgical procedure and post-operative care. Dr. Cannizzo has continued to provide veterinary care and close monitoring of the infant since birth.
John Griffioen, DVM
Fort Worth Zoo
Assistant Director of Animal Programs & Conservation
Dr. Griffioen served as the primary veterinarian with the infant gorilla immediately following delivery, working closely with Dr. Ursprung. Since delivery, Dr. Griffioen has been assisting with ongoing veterinary care as well as facilitation between animal departments at the Fort Worth Zoo to optimize her care.
Jamie Walker Erwin, M.D.
VIVI Women’s Health
Board Certified in Obstetrics and Gynecology
OB-GYN consultant for the Fort Worth Zoo since 2016
Dr. Erwin assembled a delivery team consisting of an anesthesia provider, surgical assistant and neonatologists. Dr. Erwin assisted the Zoo team during the emergency cesarean delivery on Sekani due to preeclampsia with severe features.
Robert Ursprung, M.D., MMSc
Pediatrix Medical Group
Neonatologist and National Director of Quality and Safety for Neonatology Board Certified in Neonatal-Perinatal Medicine
Dr. Ursprung assisted with the immediate resuscitation and stabilization of the premature gorilla post-delivery. This included respiratory support, temperature regulation, serial examinations and radiographs. In the subsequent four weeks, he helped the team optimize temperature regulation and nutritional strategy including safety of oral feeding.
Linda Roberts
Fort Worth Zoo
Supervisor of Primates
Linda Roberts is the point person for the management of the gorilla troop including care of both mother and infant after the procedure. She worked with the Zoo’s mammal curators to coordinate the 24/7 care of the infant as well as planning for troop reintroductions.
Dennis Occkiogrosso, CRNA
Certified registered nurse anesthetist
Mr. Occkiogrosso has more than 19 years of experience specializing in obstetric anesthesia with an emphasis on high-risk OB patients. Mr. Occkiogrosso, assisted Dr. Sarah Cannizzo and the Zoo veterinary team in safely administering anesthesia during Sekani's cesarean section.
Ann M. Ward, MS
Fort Worth Zoo
Zoo Nutritionist, Director of Nutritional Services
As lead nutritionist for the case, Mrs. Ward worked with neonatal specialist Dr. Robert Ursprung to facilitate the nutritional plan for the infant. She also consulted with the Zoo’s national partners who have experience with premature gorilla infants as well as a gorilla milk composition specialist at Smithsonian’s Conservation and Biology Institute. Mrs. Ward has continued to provide nutritional input and close monitoring of the infant since birth.
Stephanie Crowson
Fort Worth Zoo
Associate Mammal Curator
With more than 25 years of Zoo experience, Ms. Crowson is the primary curator for World of Primates. Ms. Crowson helped to develop the gorilla birth plan, was the husbandry curator present during Sekani’s procedure and following the infant’s birth, participated in her direct care and coordinated scheduling of the more than 35 staff involved in the husbandry, veterinary and nutritional care of the infant.
Angie Holmes
Fort Worth Zoo
World of Primates Keeper
Mrs. Holmes has 15 years of zookeeping experience and is the primary keeper for the Zoo’s gorilla troop. Mrs. Holmes helped to develop the birth plan and has been the primary for surrogacy training for Gracie including training her to hopefully nurse, hold, carry and present the new infant as well as cooperate with the zookeepers during feeding time.