Pregnant Mother Who Drove into the Ocean Will Remain in Hospital

ebony wilkerson

Thank God for common sense. For once, the state of Florida has done something right and kept Ebony Wilkerson, (the 32 year old pregnant mom who drove her kids into the ocean) into a hospital where she rightfully belongs. Wilkerson is 7 months pregnant and certainly doesn’t need to be in a jail where the chances of her having a healthy baby are greatly diminished. Had it not been for good Samaritans who ran into the Atlantic Ocean and rescued Wilkerson, three innocent children and an unborn baby would have met an untimely demise.
What is it about our country that prevents us from recognizing mental illness when it smacks us dead in the face? The fact that Wilkerson was interviewed and released by law enforcement agents three hours before she drove into the ocean is troubling. Mental illness is a public health disease and yet it’s treated as an afterthought in a “too-busy-society” that focuses more on entertainers’ wardrobes and scandals as opposed to its citizens that need immediate attention and intervention.
Pregnancy can bring out the best in women but it can also provoke anxiety, depression, social isolation, rejection, substance abuse and changes in economic status. Pregnant women who have mental illness might be reluctant to take their medications, which only makes their illness worse. Or, they might become victims of domestic violence because of their partners’ lack of desire to have children.
Thank goodness we can learn from our mistakes. Unless law enforcement officers have mental health training, they need to bring patients to an Emergency Department for further evaluation whether they appear to be “normal” or not. Psychiatrists should be alerted before a patient signs out against medical advice (as in the case of Wilkerson) to determine whether the patient needs medication and a possible court ordered stay.
It’s tragic that no one (with the exception of her sister) believed Wilkerson had a mental health problem until she drove her car into the ocean. How many more families will suffer before we finally get it right?

“Help! Our (Pregnant) Mommy is Trying to Kill Us!”

Pregnant mom drives car into the ocean

The three children (ages 3, 9 and 10) and the unborn baby of Ebony Wilkerson are lucky to be alive, despite the fact that she drove her van into the frigid Atlantic Ocean. Two hours prior to this horrific event, the Daytona Police interviewed her, deemed that she was sane and left. The day before, a local hospital kept her overnight for mental health observation for 24 hours and then sent her home. If I were the sister of Ebony Wilkerson, I’d speed-dial liability attorneys and then immediately request Wilkerson’s medical records because obviously someone dropped the proverbial ball.

Wilkerson’s sister knew something wasn’t right because Wilkerson exhibited paranoia and kept discussing Jesus and demons that she felt were controlling her. She had fled South Carolina because she believed that her ex-husband was attempting to kill her. Eerily, Wilkerson is from the same state where Susan Smith drove her children into the ocean 20 years ago and blamed the crime on an unknown man. Unlike Smith, whose children died; Wilkerson and her three children were gratefully rescued by a heroic group of men who selflessly plunged into the water to save them.

Kudos goes to Wilkerson’s sister who had the wisdom to call law enforcement and report her sister’s bizarre behavior and hide her car keys. Unfortunately Wilkerson had another set of keys. What’s troubling about this case is how Wilkerson was able to sign herself out of the hospital and how she fooled the police to thinking that she was sane which meant that didn’t have to “Baker Act” her or commit her to the hospital . I find it hard to believe that Wilkerson could walk out of a hospital after seeing a psychiatrist which leads me to speculate that perhaps the hospital didn’t have a psychiatrist on duty at the time.
Law enforcement officers are not trained mental health specialists. In the future, when they are called for a suspected mental health issue, a better approach might be to take the individual to the hospital, despite the appearance of a person’s “calm demeanor” and let the experts make or rule out the diagnosis of mental illness.

Mental illness is not a joke, America. It claims innocent lives every day.

Please share your thoughts with me on Twitter (Yourobgyn@twitter.com ) or Facebook (www.smartmothersguide@facebook.com ).

Brain Dead and Pregnant: A Moral Dilemma

Courtesy of politix.topix.com

Courtesy of politix.topix.com

The contradictions of life can be maddening. On one hand, we have the case of Jahi McMath, a 13-yearold girl who is brain dead on a mechanical ventilator that her family fought to maintain and on the other hand, there is Marlise Munoz, a 33 year-old mother of a 15 month old son, who collapsed on her kitchen floor from what appeared to be a blood clot to the lungs back in November. Munoz, according to her husband and family, never wanted to be on life support but the state of Texas ordered it when they discovered that she was 14-weeks pregnant. Should state law override the wishes of a patient because of her pregnancy?

The family of Munoz is concerned and angry about the state of Texas’s decision for a number of reasons. Munoz was without oxygen for over an hour before her husband found her on the floor which meant that the fetus was without oxygen as well. Medical experts believe this could cause serious problems for the unborn baby. Munoz’s father describes his daughter has having “rubbery arms that feel like a mannequin” which makes it difficult for him to visit her in the hospital. Munoz was very early in her second trimester (14 weeks), remote from delivering a baby, yet forced to be, as her father states, “a host for the fetus.” Who will have the ultimate responsibility of raising the child once the physicians intervene and deliver it via C. Section?

When John Peter Smith Hospital was confronted regarding their decision, they emphatically state that they are merely following the rule of law; however some medical ethics experts disagree and state that the hospital is misinterpreting the law. According to the New York Times, at least 31 states have adopted restrictive laws prohibiting physicians for ending life support for “terminally-ill pregnant women regardless of the patient’s wishes or her family’s.”

Should a brain dead pregnant woman lose her rights under the United States Constitution in order for the benefit of her unborn baby? I’d love to know what you think.

What Will Prenatal Care Look Like in the Future?

In today’s tough U.S. economy, healthcare is in the forefront because of the three trillion dollars spent each year. Patients are not seeing their money’s worth and neither is the U.S. government who writes the check for a large percentage of it. The cost of women having babies too early or prematurely costs our society $26 billion dollars each year. Something has to give.

Women’s health is the topic of great political debate as you may well be aware if you listen to the news or watched both political parties’ national conventions during the past two weeks. Do women control their destinies? Do we and will we continue to have control over our bodies? These are the questions at hand. While there’s great chatter about this topic as the U.S. election nears, there’s also a quiet revolution occurring in our healthcare system that will directly affect pregnant women.

Prenatal care as we know it will begin to change, especially if you receive Medicaid or government sponsored insurance. The current trend is to visit your healthcare provider’s office individually and wait to be seen. In the future, you will be seen by your healthcare provider as a member of a group, not as an individual. This is called enhanced prenatal care with group appointments and will be the wave of the future.

Groups of 10 pregnant women will be seen at the same time for approximately 10 prenatal visits that will last approximately 90 minutes. It is anticipated that 2 healthcare providers will not only take your vital signs, listen to your baby’s heartbeat, but will also allow you to interact with the other patients in this group setting to discuss prenatal issues, receive health education information and any concerns that you may have. Believe it or not, this model of care is not new.  The concept was called Centering Pregnancy and was developed by nurse midwife Sharon Shindler-Rising in 1989.

In the future, doulas and social workers along with midwives will become more prominent in terms of prenatal care as things continue to evolve. Are you ready for group prenatal visits?

What Pregnant Women Can Learn From a Cabbage

ImageIn the Native Americans culture it is said: “If you want to learn the lessons of life, please observe Nature.”

My oldest son brought home a cabbage seedling from school to enter in a contest.  If his plant grew the largest, he would win a $1,000.00 scholarship. For the first 2 weeks he faithfully nurtured the plant but then his attention span decreased as basketball and track gained more prominence on his radar screen. His father felt sorry for the abandoned plant and sat it on top of soil in a larger pot so that it could receive some sunlight. The larger pot represented a burial ground of a deceased plant that had met its untimely demise due to unintended neglect.

A few weeks passed. We assumed the plant was dead. On a lazy Sunday afternoon a hint of spring was in the air as flowers blossomed. The sun shone brightly and my spouse stepped into the backyard to get some fresh air. A few minutes later, he beckoned my son to come outside in a voiced filled with excitement. The cabbage plant was miraculously resurrected. Although still confined to its original container it had somehow dug its way into the soil of the larger pot and was now firmly attached. It was thriving with large, thick green leaves and had a significant growth spurt. What a teachable moment. Ignoring the confines of its container, the cabbage plant sensed a window of opportunity in the form of fertile soil and literally – dug in. We cut away its first container to allow it to thrive even more.

Pregnant moms, a tree is known by the fruit that it bears. The seed within you has the potential to blossom into infinite possibilities if given the proper nourishment. When the challenges of life attempt to intimidate or discourage you be like the cabbage plant and ignore the external barriers. Deflect negativity. It cannot do you harm if you ignore it. Focus instead, on the potential within.

What can we learn from the cabbage plant? We learn that the will to live is far greater than any external challenge.

Down Syndrome: Is It Wrong To Be Born?

Is it wrong to be born? That question was asked in front of an Oregon jury who responded in a resounding yes with a guilty verdict of 12 to 0 against Legacy Center for Maternal Fetal Medicine and the Legacy Lab. The jury awarded nearly 3 million dollars to Ariel and Deborah Levy for the wrongful birth of their daughter, Kalanit who was born with Down syndrome although the prenatal tests said that she was normal. Levy was 34 years old at the time of her pregnancy with Kalanit and requested genetic tests. She had two previous deliveries of healthy boys and thought she had completed childbearing. Her pregnancy with Kalanit was a total surprise and she wanted to make sure the baby was normal. A chorionic villus sampling (CVS) was done at 13 weeks and the results were good.  Levy breathed a sigh of relief, but not for long.

Although the CVS result was normal, Levy’s two ultrasounds weren’t. They were suspicious for Down syndrome but her physician assured her that she had a normal baby and did not bother to do an amniocentesis.  When Kalanit was born, a hospital worker informed Levy that she appeared to have Down syndrome. One week later, the diagnosis was confirmed. Levy and her husband were devastated. How could this happen? Kalanit has a rare form of Down syndrome called Mosaic Down syndrome meaning some of her cells do not have abnormal chromosomes.

The Levys initiated a lawsuit in 2007 for a wrongful birth. They contend that although they love their daughter, had they known she had Down syndrome, they would have terminated the pregnancy. The trial languished for 10 days. The Levys received death threats. The Pro-Life and the Pro-Choice supporters squared off in predictable fashion and I shake my head in frustration. The ultrasound didn’t lie. An amniocentesis was warranted. The Levys did not make an informed decision regarding the birth of their daughter because they were not given the correct data.

Physicians don’t walk on water. On some regretful occasions, we will make mistakes. If for any reason you’re not comfortable with your physician or the diagnosis given, please get a second opinion; or even a third. And above all, trust your instincts.

Was it wrong for Kalanit Levy to be born? I’ll let you be the judge.

You’re Pregnant and Your Local Hospital Closed. Now What?

Today will be a day of mourning for pregnant women who are uninsured and receiving Medicaid in Houma, Louisiana. Their local hospital closed its maternity and neonatal units because of a $2.9 million dollar budget cut. Over 100 employees will lose their jobs, many whom have held their positions for over 20 years.  This closing will have a ripple effect and is an increasing phenomenon that has besieged many hospitals across our nation. Over thirteen hospitals in Philadelphia closed their labor and delivery departments and in my own backyard, South Seminole Hospital in Florida did the same. What’s going on? Hospitals claim they’re losing money and government insured and non-insured pregnant women are feeling the aftermath. These are some very scary times.

The options for Houma’s uninsured pregnant women or women who receive Medicaid are quite limited. A few years ago, they could have gone to Lafayette Hospital in Lafayette; or Earl K. Long in Baton Rouge or Charity Hospital in New Orleans. Sadly, all of those hospitals have closed their labor and delivery department. I know those hospitals well, having worked and lived in Louisiana for almost four years as a community health physician.

Although Houma is a small, close-knit community, its hospital provided hundreds of prenatal visits for pregnant women in nearby parishes. They interacted like family. The nurses at Leonard J. Chabert Medical Center are devastated and apprehensive about the future of the pregnant women knowing that most cannot afford to go to private physicians and many have high risk problems. Consequently, many of these patients will be forced to travel over 300 miles on a 5-hour trip to Shreveport, Louisiana to receive prenatal care at its charity hospital.

I strongly encourage the State of Louisiana to brace itself for an increase in infant and perhaps even maternal deaths. Many high risk patients are simply not going to be able to make that 300-mile trek to Shreveport without adverse consequences. Any perceived benefit from that $2.5 million dollar budget cut will quickly dissipate based on the spike of NICU admissions that are sure to come.

The women and their unborn babies deserve better. Shame on the State of Louisiana.