May 17, 2010
On February 10, 2010, Katy Hayes, a free lance massage therapist and mother of two, gave birth at home to her 10 pound daughter after 8 hours of labor without medication or intervention. (See AOL’s link http://alturl.com/8bh9). It is not known whether the home birth was attended to by a midwife.
Katy did not have health insurance, nor did her husband, Al. Four days later, Katy was rushed to the hospital because of increased excruciating pain and almost died shortly thereafter. She experienced massive organ failure, and then lapsed into a coma. Katy had Group A streptococcal disease which causes strep throat or mild soft tissue disease. However if this bacteria gains access into the blood stream its effects can be devastating. It causes necrotizing fasciitis or the “flesh eating bacteria.” It is also responsible for Streptococcal Toxic Shock Syndrome, commonly referred to as either “Toxic Shock Syndrome” or TTSS. This infection has been on the rise in the U.S. since the 1980’s with 8 to 10 thousand cases occurring annually and 30% of people affected still die each year.
Katy’s husband faced a major dilemma. The physicians informed him that the only way to save Katy’s life was to remove the source of the infection which was her uterus. In addition, all four of her legs and arms had to be surgically removed as well as her ovaries, stomach and part of her intestines. And there was still the possibility that she might die. Al made the heart-wrenching decision for Katy to have the surgery.
Katy regained consciousness on March 12th and is on a slow but steady road to recovery. She will have to be fitted for prosthesis of her arms and legs and her greatest desire is to hold her baby and return to her family. Her friends and family are conducting fund raisers to pay for her hospital bills.
Some schools of thought will argue that Katy should have never had a home birth. Others will defend her right to do so. I hope Katy did not opt to deliver at home because she lacked healthcare insurance. That would be a moral tragedy. I wish I could turn back the hands of time because here’s what Katy should have known:
- Older women (those over 35) have an increased risk of birth complications. Katy was 41.
- There are federally funded community health centers to take care of the uninsured.
- A fever after childbirth needs PROMPT attention. Katy had a fever for four days before she was taken to the hospital.
Let’s all pray for Katy’s continued recovery and a swift return home to her baby.
Join the FB page created for Katy by clicking here http://www.facebook.com/group.php?gid=343063085090
March 10, 2010
Electronic fetal monitoring was first used at Yale University in the 1950s and is a great asset in terms of checking fetal well being. Unless a woman delivers at home, most pregnant women will have fetal monitoring during the time that they’re in labor. The fetal monitor measures both the baby’s heart rate and the mother’s uterine contractions. Why is this important? Because the vein in the baby’s umbilical cord receives oxygen which is necessary for growth and development, especially in the brain. When the uterus contracts, the blood flow to the baby is reduced, then increases once the contraction is over. The fetal monitor essentially tells us two important things: (1) whether the baby is tolerating labor and (2) whether it’s receiving enough oxygen.
Of four million babies born in the US each year, approximately 875,000 will experience birth injuries. What is a birth injury? It’s any type of injury suffered by an infant as a result of the birthing process. Most birth injuries can be avoided if someone is paying attention. Babies can’t tell us when they’re in trouble with their mouths, but they can certainly do so with their hearts. The signs of normal and abnormal fetal heart tracings are included in The Smart Mother’s Guide to a Better Pregnancy. Fetal tracings are either reassuring (meaning good) or nonreassuring (not good). If the fetal tracing is nonreassuring, then the baby needs to be delivered as quickly as possible.
Despite our current healthcare challenges, babies will continue to be born. I therefore encourage all pregnant women, childbirth educators and doulas to take these bold new steps:
- Become familiar with fetal tracings and the distinction between reassuring and nonreassuring traces (pages 201 and 202 of The Smart Mothers Guide®)
- Doulas should become Labor Room Advocates who can be another set of eyes and ears that can address any issues during labor and make certain that appropriate communication of hospital staff (including the status of the fetal tracing) is known during a shift change
- Become familiar with a high-risk specialist who can offer a second opinion in case there is a disagreement regarding labor room management
When your baby’s fetal monitor attempts to “talk” to you, everyone should understand what it’s saying.
December 30, 2009
According to Answers.com, there is a baby born in the U.S. every 8 seconds, a figure that is both staggering and exhilarating. As an obstetrician, my greatest desires is for all 11,803 babies born each day to arrive healthy and safely. I would like to dedicate my last blog post of 2009 to all the beautiful moms-in-waiting and share some pearls from my 22-year professional journey.
The force that moves the air within our lungs, the blood within our veins, is the same force that has created the life within your womb. The most important key to a healthy pregnancy is the consciousness that lies within. Your child will be shaped by your thoughts, your dreams, your values, your energy. You are the ship that will carry the baby to the shores of its pre-ordained human experience. Please let the journey be smooth. Do not create a storm from worry, a tornado from doubt, a cloud from fear, a disaster from envy. The majority of patients who end up with emergency cesarean sections are those with “fetal distress.” What was causing the distress? Who was causing the distress? Let it not be you, its mother.
Because of the advent of 4-D ultrasound technology, we can actually observe fetal behavior in the womb. We can see babies yawning, sucking their thumbs, stretching their arms and legs, even playing with their umbilical cords. They respond to music, the rhythm of your heartbeat, a touch from your partner, the sound of your voice. You are literally filled with the miracle of life. There is no gift on Earth more precious than that.
You are smarter, stronger, and more brilliant that you can ever imagine. You have been selected, yes, selected, to be this child’s mother. That is the Divine Connection.
I wish you a healthy, joyous pregnancy and a prosperous and blessed New Year.
This excerpt is taken from The Smart Mother’s Guide® to a Better Pregnancy. All Rights Reserved.
December 28, 2009
“A newborn baby abandoned in a Kenyan forest was saved by a stray dog who apparently carried her across a busy road and through a barbed wire fence to a shed where the infant was discovered nestled with a litter of puppies.” CBS News covered this story as well.
This baby girl was dressed in a torn shirt and wrapped in a plastic bag when the dog found her in a poor neighborhood near a forest in Nairobi. She was approximately two days old. “When the dog picked up the baby in a dirty bag, it came and dropped her behind the wooden building where the dog has its puppies,” stated an eyewitness. The baby was found by children who had heard her cry and was eventually taken to the hospital where, with the exception of an infected umbilical cord, was doing well. This story gave me reason to pause. Obviously, the act of abandonment was superseded by the will of a higher power who proclaimed that this baby would live. What amazed me the most was the compassion and bravery of the dog. It had risked its own life by crossing a busy street while holding on to the baby, faced physical harm as it crawled underneath a barbed wired fence and shared its resources by placing the baby alongside its own litter of puppies. Perhaps the dog understood how miraculous this newborn baby was even if its own mother didn’t.
In a world of infinite possibilities, miracles can occur under the most unusual circumstances. And yes, we can gain profound insight, even from a dog.
This excerpt is taken from The Smart Mother’s Guide® to a Better Pregnancy. All Rights Reserved.
September 7, 2009
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
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.
June 4, 2009
And there it was on the front page of the New York Times for the whole world to see. Where Life Starts Is a Deadly Risk, by Denise Grady, described a harsh reality that is often mentioned as a mere footnote. More than half a million pregnant women die from preventable deaths and over a quarter million occur in Africa. Of course there are not enough financial and human resources available and their stories are disheartening. For each woman who dies, 20 more encounter serious complications. Physicians state that more deaths occur outside the hospital because many try to give birth at home. This leads to my next point.
There are a growing number of women who want to give birth at home alone, without a midwife or birth attendant. I posted a blog about this “unassisted” phenomena a few weeks ago after one of their advocates’ baby ended up dead. I subsequently received a comment from a woman who discussed how “tribal” women would rather deliver without intervention and their biggest obstacle was poverty. Not so. There are millions of African women who would love to trade places with the “unassisted” crowd in a heartbeat. Yes, childbirth is a natural act but it is not exempt from danger.
Grady’s article reads like a litany of horror. A mother of six bled to death because the nurses did not know how to remove the placenta. A mother of quadruplets died leaving four beautiful babies in an orphanage. Two and three laboring women sharing one cot. America, we are so blessed. The cost to run a hospital in Tanzania costs $200,000 a year. I challenge the American College of Obstetricians-Gynecologists (ACOG), the American Board of Obstetrician-Gynecologists (ABOG) and all the rest of the deep-pocket women’s organizations to step up to the plate. We are our sisters’ keepers. When a mother and baby die, the whole world mourns.
Related articles by Zemanta
May 4, 2009
Just when I think I’ve heard and seen it all, something pops up that proves me wrong. Both Amy Gates” article, Home birth advocate’s baby dies during free birth: Do you blame or show compassion? And Cate Nelson’s Unassisted childbirth one woman’s story, gave me reason to pause. Both journalists discuss the March 27th death of Janet Fraser’s infant daughter and the controversy regarding unassisted childbirth.
Fraser is an Australian advocate of the unassisted childbirth movement that encourages pregnant women to deliver babies alone without the benefit of a midwife, a doctor, or a hospital. She used phrases such as “birth rape” to describe a delivery assisted by a healthcare provider. Please. As a descendent of a slave midwife and an obstetrician I am highly offended. Birthing is in my genes. There is nothing more satisfying than assisting in the delivery of a healthy and crying baby be it by midwife or physician. Heck, even a cow gets a c/section when necessary.
Cate’s article described a woman who had an “orgasmic” unassisted delivery during the birth of her daughter and then made frozen smoothies out of the placenta that she ate for the next thirty days. A placenta smoothie?
A reality check is in order. Forty percent of women died in childbirth during the 19th century but less than one percent, or 520 women today; and even those deaths are preventable. Do we really want to proceed in reverse? Perhaps members of the “unassisted” crowd would like to trade places with women in Sierra Leone and Afghanistan, who have the world’s highest number of childbirth deaths.
We need our babies born healthy and alive. All of them, without exception. The adverse outcome of the Fraser’s “unassisted” delivery speaks for itself. Here’s hoping she’ll never experience it again.