Aug. 13, 2026

It was supposed to be one of the most exciting times of Ashlee Ruvalcaba’s life. The year was 2014, and Ashlee was 25 years old and enjoying life. She was healthy, just having completed a half-marathon weeks earlier, and she was 10 weeks pregnant. Ashlee and her husband, David, were expecting their first child.

When symptoms of fatigue and nausea popped up and Ashlee started having issues keeping down food or water, it was easy for her OB-GYN doctor to chalk up her state to the normal effects of early pregnancy. Debilitating headaches made Ashlee think otherwise, and when she started getting nosebleeds and rashes all over her body, Ashlee went to her local urgent care for bloodwork.

“I could not get out of bed,” Ashlee said. “It was that bad. I had chunks of blood coming out of my nose and a rash all over my body that nobody could determine what it was. I was starting to get dehydrated because I couldn’t keep any water down, and because I was pregnant, I was thinking more about, like, I want my baby to be safe.”

When tests at the local urgent care center indicated something was off, Ashlee was transferred three and a half hours away to Stanford. Her hemoglobin, the protein in red blood cells that carries oxygen from your lungs to the rest of your body, was at seven (an adult woman’s is usually between 12 and 16 grams per deciliter), and her platelets, the cell fragments in blood that help form blood clots to stop bleeding, were at 13,000 (an adult woman’s is typically between 150,000 and 450,000 per microliter of blood). Ashlee’s body was starved of oxygen, and she was at risk of bleeding out.

“It was very scary,” Ashlee said. “I didn’t know how severe and how sick I really was.”

While teams of doctors tried to diagnose Ashlee’s condition, she received transfusions of packed red blood cells and platelets to stabilize her numbers. Improvements were temporary, and Ashlee’s health continued to deteriorate.

At last, Ashlee was diagnosed with Thrombotic Thrombocytopenic Purpura, a three-in-a-million blood clotting disorder. With TTP, the deficiency of the ADAMTS13 enzyme leads to blood clots in small vessels throughout the body. Healthy red blood cells run into the clots and are destroyed, and your body uses platelets it doesn’t need for unnecessary clots. TTP can be genetic or caused by a viral infection or pregnancy. In Ashlee’s case, it was her unborn child. As a result of the TTP, her organs were starting to fail.

“When they finally got my blood out, it was like red Jell-O,” Ashlee said.

Ashlee did get better from the treatment, but it didn’t come without great loss. At 16 weeks, an ultrasound revealed that Ashlee’s baby no longer had a heartbeat. It was unclear whether Ashlee would ever have kids.

“It was scary to think about getting pregnant because not only I was affected, my husband was affected, my parents were scared, my grandparents were scared,” Ashlee said. “Nobody knew if I should even try again because they didn't want to lose me, but I also was like, ‘I want to have a family.’ ”

After two years of recovery and close monitoring, Ashlee and David decided to try again. Zephaniah was born in 2018. Five years later, they welcomed Savannah. Ashlee describes Zephaniah, now 8 years old, as a sweet, gentle spirit who loves baseball. Savannah, 3, is their ball of energy.

There’s always a chance that TTP could come back, but if there’s one thing that the health scare taught her, it’s that we don’t always get to choose our plan.

“This almost didn’t happen,” Ashlee said. “It’s so fun to see. It’s beautiful.”

What allowed Ashlee’s dreams to come true is the choice blood donors made to help people like her. One in four people will require a blood transfusion in their lifetime for a wide range of treatments, and donors give every day to help those they will never meet.

“I almost want to cry thinking about it, that some random person just decided to go, ‘Hey, I'm going to donate because someone is going to use this blood one day and someone will need it, and it could save their life,’ ” Ashlee said.

Those donors saved more than just her life; they provided new life.

“Think about your mom, think about your dad, your grandparents, your siblings,” Ashlee said. “One day they might need that, and you could be that match for them.”