August 30, 2012
In 2009, the Dominican Republic passed a law stating life begins at conception and Rosa Hernandez buried her 16 year old daughter (also named Rosa), as a result.
Rosa was 10 weeks pregnant when she discovered that she had leukemia. Hernandez wanted Rosa to receive chemotherapy in order to save her life. Instead, her doctors were reluctant to give chemotherapy because it would have caused a termination of pregnancy. So both Rosa and unborn grandchild died instead.
Hernandez pleaded with the physicians to no avail. They did not want to be accused of provoking an abortion if the fetus had died. The Dominican government allegedly stated that chemotherapy could be given to pregnant women as long as it’s not given for the purpose of causing an abortion. What an impossible situation. Of course chemotherapy is not given for the purpose of causing an abortion. It’s given for the purpose of killing cancer cells and saving someone’s life. Cancer affects 1 in 1500 pregnancies. Does that mean that all those women have to die?
Rosa’s doctors admitted her into the hospital at approximately 13 weeks but her body rejected the chemotherapy and she had significant bleeding. Despite heroic attempts, she died in the 14th week of her pregnancy and Hernandez’s life will never be the same again.
Insurance companies and government policy should not and cannot treat acute or chronic illness. They are not doctors or nurses. If the U.S. adopts the same policy as the Dominican Republic and 1 in 1500 pregnant women have cancer each year, then 2,667 women could potentially die each year in the same manner as Rosa. Do we really want that?
October 31, 2011
I normally refrain from discussing the subject of abortions. In my humble opinion, it’s a private matter between a woman, her physician and her God. Have I ever performed a termination of pregnancy? No, I have not. But would I judge a woman who had one? No I would not. And let me tell everyone a quiet little secret. When a baby is supposed to be born, Fate steps in and handles the situation. I recall an acquaintance that was scheduled to have a termination. She developed pneumonia before the procedure, it was cancelled and she went on to deliver a healthy set of twins who are in middle school thriving. So you can imagine the shock I experienced when a friend sent me an article from Time Magazine, entitled The Next Abortion Battleground: Fetal Heart Beats, by Adam Cohen. It appears that certain politicians are proposing a law that would force a pregnant woman to have an ultrasound and listen to the fetal heart beats before she terminates a pregnancy. I would hope that our political candidates would make better use of time than to attempt to practice medicine without a license.
I’m not going to discuss the issue of Roe vs. Wade or whether the fetus has rights or if those rights take priority over the rights of its mother. I will yield to the American Civil Liberties Union and other advocacy groups regarding those issues. However, I cannot and will not allow politicians to tell me what I should or should not do in my own examination room. Nor should they bully my patients by dictating policy and procedures. Perhaps we need to review the definition of coercion. According to the Legal Dictionary, coercion means: The intimidation of a victim to compel the individual to do some act against his or her will by the use of psychological pressure, physical force, or threats. Psychological pressure. Has it come down to that?
Auscultation or listening to a fetal heart beat is a clinical examination, not a political tool. Please keep your political agendas out of my exam room.
August 24, 2011
What would you do if you discovered early in your pregnancy that you were pregnant with a girl when you wanted a boy? Would you terminate the pregnancy? With the advent of a new DNA test that can determine the sex of a fetus at 7 weeks gestation with a simple blood or urine test, fetal sex selection is now possible. However, before you proceed to pop the cork on your bottle of champagne, a word of precaution is warranted. The Chinese and India dilemmas present a global warning regarding the perils of fetal sex selection. Boys now outnumber girls in China and India and competition is fierce regarding finding a wife or a mate. According the Chinese Academy of Social Sciences (CASS), by the year 2020, there will be between 30 to 40 million more boys than girls in China and the statistics in India is equally as alarming. In her book, Sobs In The Night, by Xinran, she describes a scene where a baby girl is born and the father cries out, “Useless thing” and then the baby is dropped in a bucket and dies. This “son preference” is what has caused the unusually large amount of U.S. adoptions of baby Chinese girls.
Clinically, the gender of a baby is only important if you are screening for gender-related diseases such as Muscular Dystrophy or Hemophilia that has adverse effects on males. Barring those exceptions, testing for fetal sex determination is merely an exercise of curiosity and desire. One of America’s greatest poets was a delightful young man name Mattie Stepanek who had Muscular Dystrophy and lived 13 short but brilliant and magnificent years on this planet. He died 3 weeks before his 14th birthday and was eulogized by former President Jimmy Carter. His words touched the hearts of millions including Oprah Winfrey. What would have happened had his mother decided to terminate her pregnancy because Mattie was a boy who was born with a disease?
According to the Fertility Institute, clinics in Los Angeles, New York and Guadalajara, Mexico, 85% of 500 American couples chose fetal sex determination although 75% of these couples lived abroad. The question is not whether a mother has or does not have the right to terminate a pregnancy. The question is should a pregnancy be terminated because of a fetus’s gender?
Native Americans perhaps said it best: “Nature hangs in balance. It is man that creates the imbalance.” Please be careful what you ask for because you just might get it.
August 17, 2011
Twins. Oh how we adore them. They represent approximately 3.3% of all births in the U.S. and are associated with both joy and complications such as prematurity. When I saw the headlines of the August 14th edition of the Sunday New York Times, I paused to reflect. Have we gone too far?
The article, Unnatural Selection, Ruth Padawer reviews a growing trend among U.S. women who, when pregnant with twins requests that the twins be reduced to one pregnancy. We have grown accustomed to multiple births in our country based upon the increase in the use of fertility drugs. Indeed, 1% of all births and 16% of twin births are associated with the use of fertility drugs. Very few people complain when there is a request to reduce quadruplets (four babies) or quintuplets (five babies) to twins. And who doesn’t remember Nadya Suleman, the controversial “Octomom” who gave birth to 8 babies that were conceived with fertility drugs.
Padawer describes a woman who was pregnant with twins and sought a physician to reduce her pregnancy to one baby. She initially encountered difficulty because most physicians will not reduce a twin pregnancy unless they have a medical indication and feel that the mother is in jeopardy. The word “reduction” is a polite term for termination and very few physicians will terminate one-half of a twin pregnancy based solely upon maternal request. However since a termination of pregnancy is legal, some physicians will reduce a twin pregnancy to a single pregnancy based upon a mother’s request. According to Dr. Richard Berkowitz, a high-risk specialist at Columbia University Medical Center in New York City, “The overwhelming majority of women carrying twins are going to be able to deliver two healthy babies.” As a mother of two sons who are eleven months apart, I can understand the concerns one may have regarding raising twins. However, despite all of the perceived obstacles of raising two children who were born so close together, somehow my sons managed to thrive and their parents have maintained their sanity.
Should twin pregnancies be reduced to one? It’s an individual decision, so please — make it wisely.
April 25, 2011
Although morning sickness affects 75 percent of pregnant women, only 3 percent are affected by a severe form of morning sickness called Hyperemesis Gravidarum (HG). HG is associated with severe dehydration, electrolyte imbalance and significant weight loss. A blog post entitled Woman Has Abortion to Stop Morning Sickness describes Claire Barwell, a mother of two who was pregnant with her third child and decided to terminate the pregnancy because of debilitating nausea and vomiting. She was also estranged from her husband.
Barwell had three hospitalizations before deciding that she could not tolerate the nausea and vomiting. She consulted her estranged husband and together, they decided to terminate the pregnancy. Barwell subsequently remarried a man who did not have children, became pregnant and vomited up to 40 times a day. She terminated the pregnancy again to her new husband’s profound disappointment.
Although HG can be treated, sometimes it is not treated appropriately. Some of the signs and symptoms of HG are as follows:
- A weight loss of more than 10 pounds in a 2-week period that’s associated with severe vomiting
- Large amount of ketones which are substances found in the urine that the body makes when it is not receiving enough calories
Often, pregnant women will present to emergency departments with complaints of severe nausea and vomiting, be given intravenous fluids and sent home. This is not appropriate treatment if the patient has ketones in her urine which indicates a state of starvation. It is also important to rule-out other reasons for significant vomiting. Pregnant women with HG need to be hospitalized and given intravenous solutions that include Vitamin B12, multivitamins and special medications to help reduce their vomiting. Barwell was extremely dehydrated, had not eaten in three days, was at risk for tearing her esophagus and was admitted to a hospital for special care that included a feeding tube. Most cases of HG resolve by the second trimester but Barwell couldn’t tolerate the symptoms and terminated the pregnancy. Would you have done the same?
Until next time, remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.
January 11, 2010
Just when I think that I’ve seen and heard it all, I read yet another bizarre story that proves me wrong. Last month CNN reported a story about a woman who had attempted to end her rival’s pregnancy Woman Tried to End Rival’s Pregnancy, Prosecutor Say in a most deceptive way.
Kisha Jones was arrested for allegedly tricking Monique Hunter, her husband’s pregnant lover into taking an abortion-inducing drug. Jones allegedly forged a physician’s prescription and prescribed a medication that would induce early labor. She told the pharmacist that the medicine was for “a procedure.” She then called Hunter and convinced her that her physician had prescribed an important medication and she should pick it up and take immediately. Hunter complied. Shortly thereafter, she was soon rushed to the hospital and delivered a premature baby boy two months early.
While Hunter’s baby was still in the intensive care unit, an unknown man brought what he claimed to be breast milk for the baby and it was later determined to be poison. The hospital staff called the police and Jones was arrested on a host of charges including criminal impersonation. The facts of this case suggest that either Jones was familiar with labor inducing medications or knew someone who was. The “abortion-inducing drug” referred to by CNN was probably Mifepristone.
Mifepristone is a medication that’s used for early first-trimester abortions and to induce labor with fetal demises. Since its inception back in the late ‘80’s, I have disagreed with it being prescribed as an outpatient medication. Any medicine that causes bleeding and the evacuation of the uterus should be done in a controlled environment under the supervision of medical staff to avoid complications. Unfortunately, the FDA has reported several deaths of women who had taken this medication at home.
While this story has all of the makings of daytime drama, the bigger tragedy is that an innocent newborn was almost killed. I think the FDA should reexamine its policy regarding Mifepristone. People like Kisha Jones should never be allowed to strike again.