December 28, 2011
It’s an obstetrician’s worst nightmare and it continues to happen on a daily basis. The story of Michal Lura Friedman brings tears to my eyes. After 7 years of trying, the 44 year old songwriter finally became pregnant –with twins. Her husband, Jay Snyder, a free-lance voice-over artist, describes the 9 months of Friedman’s pregnancy as pure bliss. However towards the end, her blood pressure became elevated so she was scheduled to have a C. Section the day after Thanksgiving.
Snyder accompanied his wife to the hospital and witnessed the birth of his babies. Then Friedman began to bleed. And bleed. And bleed. At 9:30 p.m., she became yet another U.S. maternal mortality statistic.
At least 2 women die from complications of childbirth in the US daily. Some celebrities such as Christy Turlington Burns have become a Maternal Health Advocate as a result of first-hand experience. She had a near-miss childbirth experience but lived to tell the story. Many women, including Friedman, don’t. The American Congress and College of Obstetrician-Gynecologists (ACOG), will have both Burns and Tonya Lewis Lee, the wife of renowned director, Spike Lee as spokeswomen on the topic of maternal mortality at the 2012 Annual Conference in San Diego. However, we need much more. There are obstetricians who have worked on the front-lines managing high-risk patients for years who can’t get a seat on ACOG’s policy committees and it is frustrating. Here are a few questions that should be asked at the hospital where Friedman expired:
- She had a short stature with a uterus stretched to the max with two babies. Was the possibility of hemorrhage considered?
- When her blood pressure became elevated, was it controlled prior to doing the C. Section knowing the risk of possible HELPP Syndrome that is associated with pre-eclampsia?
- Was there an OB Rapid Response Team?
- Was a Bakri balloon used once the bleeding couldn’t be controlled with uterine massage or meds?
- Was the prospect of a problem anticipated BEFORE it occurred or was there chaos trying to find appropriate meds and equipment as the tragedy unfolded?
Pregnancy is not a benign act contrary to what most people believe. Things can and do happen, most often when the hospital staff is unprepared and ill-equipped to handle an emergency. My heart bleeds for Jay Snyder. He is 41 years old, a new father and now a widow who must take care of two beautiful children, who will never know their mother. With all due respect ACOG, talk is cheap. More action must be taken to stop this.
Remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do…
October 24, 2011
Infertility or the inability to have a baby can be devastating and affects approximately 10 percent of the female population. There are many conditions that prevent women from having children including and Mayer Rokitansky Kuster Hauser syndrome (or MKHS). MKHS is a rare disorder that affects a woman’s ability to conceive. At present, for every 10,000 women, only 1 to 2 will be affected. Both Sara Ottoson of Sweden and Melina Arnold of Australia have this condition. MKHS is characterized by the absence of a vagina and part of the cervix. Patients with this condition have normal breast development and functioning ovaries. Genetically, they also have female or double X-chromosomes and look like normal women. The problem comes to light during adolescence when a teen fails to have a period. The condition is also known as Vaginal Agenesis because they are born without a true vagina, a problem that can be corrected through surgical and non-surgical procedures. Unfortunately, they are unable to have children and usually adopt or use a surrogate mother. Those options, however, might soon change.
Both Ottoson and Arnold plan to have biological children using those mothers’ transplanted wombs next year. The wombs that these women resided in prior to their birth will potentially be used to nurture their unborn babies. Ottoson and Arnold will be making history in the same manner as Louise Brown did in 1978 when she became the first successful “test tube” or In Vitro Fertilization (IVF) baby. Has a womb transplant been attempted before? Yes, about 10 years ago in Saudi Arabia but it was an unsuccessful procedure. After four months, the 25-year-old patient’s body rejected the transplanted uterus of a 46-year old woman. Ottoson will receive the uterus of her 56 year old mother but will not be able to conceive through IVF until she has waited a full year to make certain that her body will not reject the donated organ.
If womb transplant becomes successful, it will also be a powder keg regarding ethical and legal issues. It would also provide an option to women who are cancer survivors and desire fertility. All eyes will be on Ottoson and Arnold next year. It will be history in the making.
October 5, 2011
It’s a sad commentary when human beings have to be reminded how to act like human beings, especially when they’re in the helping profession. Loni Hildebrandt was a 29 year old certified nursing assistant who was pregnant with her first baby. Make that two babies because she was pregnant with twins. Hildebrandt considered her pregnancy miraculous because she had infertility and was a diabetic since the age of one. Together, she and her boyfriend saved their money and obtained fertility treatments. Her mother, Jo Novtny, a nurse of 30 years was ecstatic when she saw the ultrasound of her two grandbabies but her happiness was short-lived. One day after the procedure, Hildebrandt began to bleed so they went to Sarasota Memorial Hospital in Florida.
Sarasota Memorial Hospital has an excellent maternal fetal medicine (aka high-risk obstetrics) department but Hildebrandt never made it there. She got as far as the hospital’s emergency room where she was attended to by one of its physicians. Despite repeated requests to have her blood sugar checked, Hidebrandt had to wait six hours before it was done. An ultrasound at the hospital revealed a blood clot that was causing the contractions and the ER doctor told her that he could probably save one by “suctioning the clot so the labor would stop.” According to The Herald Tribune, the physician suctioned the clot and one of the twins as well. Hildebrandt allegedly began bleeding more, passing bright red blood clots. They called for help but no one came. According to the newspaper report, a nurse put the afterbirth in a bedpan and left it near Hildebrandt’s head where she was lying. Her mother moved it and placed it under her daughter’s bed. Novtny ultimately delivered the second twin because no one else was around. The ER doctor returned to the room saw the fetus in Novotny’s hand took it from her and put it in a bucket.
Novtny states her daughter did not receive proper treatment until her personal physician arrived and remained in a pool of blood for over 10 hours. Hildebrandt’s iron count was dangerously low because of the bleeding. Her mother’s request to speak with the hospital administrator was met with no response so she wrote a letter to the governor instead. An investigation was done, gross negligence was found, the ER doctor resigned and Hildenbrandt’s nurse was cited for “lack of critical thinking skills.” The hospital will now have unannounced federal inspections in order to keep their Medicare payments. The hospital administrator issued a public apology.
Perhaps one day hospitals will do the right thing, even when no one is watching. Hopefully, Hildebrandt will become pregnant again and have a better outcome.
April 11, 2011
Olympic winner and motivational speaker, Jim Stovall once said “Integrity is doing the right thing, even when no one is looking.” In September 2009, I wrote about a blog about Carolyn Savage, a 40 year old woman with a poor obstetrical history. Savage married her college sweetheart and had an uncomplicated first pregnancy. However, her second child was born prematurely. She had 4 subsequent miscarriages and ten years later she became pregnant through in-vitro fertilization (IVF). Because the Savages wanted a large family, they tried IVF again. Unfortunately, Savage was impregnated with the wrong embryo. To their credit, everyone rose to the highest level of integrity. The infertility clinic informed the Savage family as soon as the mistake was discovered and then gave them the option of terminating the pregnancy or continuing it. The Savage family then had to inform the rightful parents of the embryo that were not expecting to have a baby any time soon but was now faced with that dilemma. Savage ultimately delivered the baby and then handed it over to its rightful parent, the Morrell family.
When bad things happen to good people, we are perplexed and often wonder why. I remember feeling despondent as I wrote the blog. A woman had delivered a healthy baby but was leaving the hospital with empty arms. A blatant systems error had reared its ugly again reminding physicians that we are all fallible, despite our years of strenuous training and hard-earned credentials. Yet, the book of wisdom reminds us that everything works for our highest good despite the tragedies that are seen through the lens of our human experience.
Fast-forward 2 years later: the Savages hired a surrogate mother (aka gestational carrier) who was pregnant with their baby but subsequently had a miscarriage. However the Savages didn’t give up and they are now pregnant again, through their gestational carrier with . . . . twins. When Carolyn Savage leaves the labor and delivery suite this time, her arms will be filled with not just one baby, but two. Who says life can’t have a happy ending? We wish the Savage family the very best as they prepare for their joyous occasion.
December 29, 2010
The holiday season is a time of both joy and sorrow. Tomorrow a childhood friend will be laid to rest; one of my favorite artists, Teena Marie, died unexpectedly two days ago and at least six other people have made their transitions as well. My own father died unexpectedly on Christmas Eve in 1981 leaving a great void in our family life. Why do people leave us during the holiday season? It has been said because they want to be remembered.
While I lamented about all the transitions that occurred in the past two weeks, one of my best friends announced that she had a new granddaughter that was born on Christmas Day. She stated that this was part of the “Life Cycle or Circle of Life.” Her comments gave me reason to pause and reflect.
We recently had severe cold weather in Florida and my beautiful purple Morning Glory flowers immediately died. They were special because they were a gift from a friend with whom I no longer see and the only other place I saw them was in West Africa. Last year during a very cold freeze, I thought that I had lost them. Their purple flowers and stems had completely disappeared. But in early March, a green leaf appeared out of nowhere; followed by tiny white buds that culminated into purple blossoms. My Morning Glories were back, as if resurrected from the grave.
When a loved one departs, miraculously a family member becomes pregnant and a new loved one appears. This baby brings gifts that enhance our human experience. When my mother left us in 2002, I was childless and told that I couldn’t bear children. On Christmas in 2005, I felt a pang of loneliness that was palpable. I began to look at adoption websites and three years later, we brought home our glorious sons. Everything has a season.
As we bid farewell to 2010, let’s reflect on our roles as men and women. Life begins with us and within us. We each play an integral role in the circle of life; therefore, “in the time of your life — live.”
Happy New Year.
September 28, 2009
The MSNBC story, Wrong-Embryo Baby’s Parents Laud Guardian brings to mind a line from Tina Fey’s movie, Baby Mama: “Life is messy.” Fey plays the character of a thirty-seven year old woman who was informed that she only has a million-in-one chance of conceiving because of an abnormal uterus. She hires a surrogate who unknowingly is not pregnant with Fey’s child but her own. When the surrogate discovers the error, she must break the news to Frey who is of course, devastated. Art imitates life.
Carolyn Savage was a 40 y.o. woman who received in Vitro-Fertilization and on the third attempt, successfully conceived a baby. Unfortunately, it was the wrong baby; a nightmare no one should ever experience. Savage was carrying a baby who belonged to the Morrell family who had frozen embryos at the same infertility clinic.
As tragic as this may appear, all parties involved rose to the highest level of integrity regarding correcting this unfortunate error. The clinic informed Savage immediately upon discovering their mistake. As a physician who has witnessed my share of ethically-challenged administrators and colleagues in the medical profession, it took a tremendous amount of courage to claim ownership to an error of that magnitude. Savage was given the option of terminating the pregnancy or giving the baby to its biological parent. The Morrells had not planned to have a baby anytime soon but were informed that another woman was carrying theirs. What a moral dilemma.
As a former infertility patient and physician who became a mother after age 50 through the miracle of adoption, I truly felt their pain. Last week Savage delivered a healthy baby boy and gave it to the Morrells. There are no words that can articulate Savage’s valiant act.
To err is human but the effects are still shattering. May this level of incompetence never be allowed to recur again.
September 23, 2009
Three cheers for SCI International, the manufacturer of these super products.
After the tremendous positive response to my earlier post regarding the $1.00 pregnancy test, I received a phone call from SCI’s Vice President, Mr. Abedi. He was delighted that the blog was well received and I in turn was delighted with his product. He explained that the company’s only makes a few cents above its production cost but that they deal in volume. It was so refreshing to hear about a company that wasn’t going to bankrupt its customers in order to make a profit. Abedi continued to describe the company’s array of products including an ovulation kit for $1.00. You can only imagine how far my jaw dropped. As a former infertility patient, I am well-versed with ovulation kits and could not believe they were being sold for . . . a dollar? Abedi quickly added that the ovulation kits were only available at the Dollar Tree store. So, off I went to my local Dollar Tree store to see for myself.
Upon my arrival and to my utter delight, both pregnancy and ovulation tests were readily available. The pregnancy tests were behind the counter while the ovulation kits were displayed up front. The cashier must have read my mind and offered the following explanation: The pregnancy tests are a popular item among teens who attempt to steal them. And the ovulation kits are displayed in front of the cash register because “teens are not trying to get pregnant.” It made perfect sense. And just like their pregnancy test counterpart, the ovulation tests are 99% accurate.
Quality and at affordable prices. Who would want to pay more?