November 16, 2011
Alcohol: Is An Occasional Drink Really OK During Pregnancy?
photo from http://www.newscientist.com
A recent medical study by Dr. Ira J. Chasnoff of the Children’s Research Triangle asserts that Hispanic women who have assimilated to American culture have a greater risk of having children born with fetal alcohol syndrome. According to Chasnoff , pregnant Hispanic women in San Antonio had the second highest drinking rate of 29 cities in the states that were studied. I find that rather hard to believe based on my twenty-one year history of taking care of Hispanic pregnant women. I have seen first, second and third generation Hispanic women and never encountered alcoholism among any of them. However, Chasnoff brings up an interesting point about alcohol and pregnancy. There are two schools of thought. According to Good Morning America, there are physicians such as Dr. Jacques Moritz, who think an occasional glass of wine is okay to consume during pregnancy however the U.S. Surgeon General and the American College of Obstetrician-Gynecologists advocate strict abstinence from alcohol while pregnancy.
According to medical literature, more than one-half of women of childbearing age report drinking alcohol and 1 out of 8 women report binge drinking. Alcohol appears to have negative effects throughout the entire pregnancy, not just during the first-trimester. At present, it is not known how many drinks consumed would affect the fetus, therefore strict abstinence is recommended before conception and during the pregnancy.
What happens if a pregnant woman is alcohol dependent? She will need close monitoring because of the adverse effect on the fetus including support from a multidisciplinary team of healthcare and social work providers. Women who consume three or more drinks per day are encouraged to enter an alcohol treatment program. Women who drink less than 3 drinks per day are encouraged to receive counseling. The pediatrician should be present at the birth of a woman who is alcohol dependent in the event the baby has alcohol withdrawal. Women who continue to drink should be discouraged from breastfeeding.
Dr. Chasnoff is to be commended for studying substance abuse and pregnant women but please don’t stereotype ethnic groups in the process. Pregnant women should abstain from drinking alcohol if at all possible. Remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.
May 4, 2011
Fake a Teen Pregnancy and the Media Will Come Calling
Gaby Rodriquez will have her fifteen minutes of fame in the national media because she faked a pregnancy for 6 ½ months as a “social experiment” in her Yakima Valley high school. Only her high school principal, her mother and 20-year old boyfriend were aware that Rodriguez was not pregnant, her teachers, high school peers and even her best friend were all fooled. Rodriguez staged this charade because she wanted to make a point: “You have to take control of your life and not live your life in the shadows of stereotypes and rumors.” I’m sorry but I’m still confused. Was there a hypothesis? Did she want to know how people would treat her if she became pregnant? Was she acting out a fantasy? Is this why prime time television and media outlets from the east and west coast, as well as Canada and the BBC in London have all pursued Rodriguez with baited breath? There’s even talk about a movie and hiring an entertainment attorney.
Rodriguez lives in a town of approximately 9,000 people where 33% of the population lives below the poverty level and the median income is $26,950. Her high school is 85 percent Hispanic. These are the demographics of a community who is not surrounded by power and luxury. The irony is that the media now wants to speak to Rodriguez because she wasn’t pregnant. She didn’t perpetuate a stereotype and successfully pulled off a hoax. But is that a reason to gain notoriety? The U.S. has the highest rate of teen pregnancy of all developed countries. About 82 percent of pregnant teens are unmarried and 74-95 percent of their pregnancies are unintended. Only 33 percent of pregnant teens will graduate from high school. They are also at risk for several pregnancy complications including an increased risk of pre-eclampsia, Down syndrome, poor weight gain, premature labor and low birth weight babies. These are the facts that should be discussed in the media but I will not hold my proverbial breath and wait.
My media coaches so aptly advised me that the media’s job is to entertain and if you receive some noteworthy information in the process, consider yourself lucky. I hope the media also noted the fact that Rodriguez was taking an advanced placement course in biology. This young lady is obviously intelligent.
Wearing a prosthetic pregnant belly is now an entree to prime time television. Let’s hope it doesn’t become a trend.
September 7, 2009
National Infant Mortality Awareness Month
Did you know that nearly seven babies will die before their first birthday for every thousand who are born in the U.S. and the rate for African American, Hispanic and Native American women, are even higher? Premature births occurring before thirty-seven weeks and low-weight babies, weighing less than five pounds account for the highest number of deaths in the U.S.
In recognition of September as the National Infant Mortality Awareness Month, I’d like to share some SMART tips to pregnant women:
S = Seek prenatal care early. Problems in pregnancy cannot be fixed at the last minute. Tests for genetic problems can only be detected in the early first and second trimesters. A first trimester ultrasound is also the MOST accurate in terms of a due date.
M = Mention all high-risk factors such as family history of diabetes, high blood pressure or bleeding. Do not omit information such as smoking or “recreational” drugs. It will come back to haunt you.
A= Ask to have your cervix measured during your ultrasound if there is a previous history of premature contractions or delivery. A cervical length of 2.5 centimeters or less is a risk factor for preterm labor.
R= Research your hospital and prospective physician or midwife carefully. Is the physician or midwife skilled in managing high-risk conditions? Will they continue to see you even if you lose your insurance? Has the hospital had any recent outbreaks of antibiotic-resistant – infections in the newborn nursery? Is there 24-hour anesthesia?
T= Test for potential problems such as Gestational Diabetes, Sickle Cell Trait or sexually transmitted infections.
The U.S. is one of the most industrialized countries in the world, yet we rank below Cuba and Taiwan, with respect to our national infant mortality rate. The health of a nation is judged by its national infant mortality rate. We can do better. We must do better. The health of our future generation is depending on it.
August 31, 2009
Indelible Footprints
I was glued to the TV this weekend, saying farewell to an American patriot. I know the end of human life is inevitable but oh how I wished Senator Ted Kennedy could have remained just a little bit longer.
Like most Americans, I admired the Kennedy family from afar and their compassion had far-reaching effects. President John Kennedy sent troops to the Deep South and protected the civil rights of my relatives. Senator Robert Kennedy transformed my beloved Bedford Stuyvesant Brooklyn community into a successful economic empowerment zone that created jobs and stability. We always looked forward to the annual ice skating party that was organized by Mrs. Ethel Kennedy even after that horrendous assassination. Because of Kennedy’s vision, the price of a Bed Stuy brownstone in today’s market begins at one-half-million dollars.
My introduction to the magic of Senator Edward Kennedy began in medical school during the early eighties when my former Assistant Dean, Dr. Van Dunn, resigned from BU to become the senator’s Senior Policy Advisor. Senator Kennedy was full engaged and committed to healthcare reform and Dr. Dunn had the privilege of helping him. Kennedy’s name re-emerged during the early nineties when I was working in a small southwest Louisiana community. Towns were buzzing for miles around about the marriage of Kennedy and a Cajun woman named Victoria Reggie.
I love walking through the congested WIC (Women, Infant and Children) department at work and beam with pride at the sight of beautiful, healthy babies and children. They are truly Kennedy’s legacy. If you’ve ever received a Medicare benefit, a WIC check, SHIP benefits, a Family Medical Leave, the right to vote or a COBRA benefit, you can thank Senator Ted Kennedy. He served “the least among us” nobly.
I hope more legislators and physicians will do the same.
May 31, 2009
Judge Sonia Sotomayor: A Great American Story
- Image by Jay Tamboli via Flickr
2009 could possibly be called the year of miracles. First, the election of President Barack Hussein Obama, the Orlando Magic are in the NBA playoffs and now the nomination of Justice Sonia Sotomayor. Somebody quick, hand me another tissue.
The tears of joy that I cry are for all of the pregnant women who step out in faith, not knowing what the future holds for their unborn children. Out of humble wombs emerge some of our greatest gifts and it never ceases to amaze me. As a physician who once lived in a New York City housing project (the same former home of entertainment mogul, Jay-Z) I can attest to the inordinate amount of courage, tenacity and stamina it takes to excel in an Ivy League institution. Thank you Columbia University and BU School of Medicine for believing in me. Sotomayor’s ascent from the South Bronx to Princeton and Yale makes her nomination to the highest court in the land that much sweeter. She will not render justice with an inflated sense of entitlement.
As a public health servant, I have dedicated my professional career caring for the least among us who deserve the most. My patients are from every corner of the globe and while some may be “undocumented,” all are carrying jewels. We thank the mothers of President Obama and Justice Sotomayor for giving us such sacred gifts.
The Latino presence was clearly felt during the 2008 election and as the landscape and demographics of America continues to change, we celebrate its diversity. We are a blended family bound by a desire for the common good of all.
Thank you Justice Souter for holding down the fort. Please enjoy your well deserved retirement. The spirit of Thurgood Marshall can finally rest in peace. Who is Sonia Sotomayor, CNN asks? She’s a Latina from the Bronx who will definitely watch our backs.
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