February 3, 2010
The Universe is speaking to Michelle Duggar and hopefully she’ll take a moment to listen. Duggar is a 43 y.o. housewife whose life is chronicled on TLC’s TV reality series, 19 Children and Counting. While it’s admirable to watch Duggar and her husband, Jim Bob, navigate life raising a plethora of children, pregnancy and giving birth is not an entirely benign act.
The February 8th issue of People Magazine (The Duggar Baby: Her Fight for life) gave an exclusive account of Duggar’s most recent delivery that was complicated by both preterm birth at 25-weeks and pre-eclampsia. If the truth be told, both mom and baby are lucky to be alive. Duggar had delivered her 18th child just six months prior to conceiving her 19th. Her body did not have ample time to heal. Profound changes occur in the heart, lungs and kidneys of pregnant women. The body has more fluid circulating and the lungs have less air present at the end of each breath. The gallbladder also does not process fat properly and some pregnant women develop gallstones which is exactly what happen to Duggar. She had a gallstone attack and developed pre-eclampsia that warranted an emergency cesarean section. Her premature baby weighed 1lb 6oz.
It is not clear whether Duggar has received properly counseling from her ob healthcare practitioner, so let me jump in.
- Ms. Duggar, you are 43 years old and have what’s known in obstetrics as Advanced Maternal Age. This condition predisposes you to several high-risk conditions including pre-eclampsia, preterm labor and a host of other issues.
- You’ve carried 19 children in your uterus and its muscles are stretched to the max. Post-partum hemorrhage lies high on the list as a future complication.
- You’ve also had a cesarean section and now have the potential to have a placental abruption (early placenta separation from the uterus) as well as a placenta accreta (the placenta sticks to the uterine incision and is extremely difficult to remove).
The Bible says to go forth and multiply and you’ve followed directions well. Now pat yourself on the back and give your body a well deserved rest. You escaped serious harm because of Divine Intervention and a skilled medical staff. Please, do not push the envelope.
January 25, 2010
Former U.S. Senator John Edwards’ admission of paternity regarding a child not conceived by his wife brings to mind Ruth Padawer’s New York Times Magazine article, Who Knew I was NOT the Father, published a few months back. Padawer described the dilemma of Mike L. whose DNA proved he was not the biological father of a girl that he had raised from birth. Mike was extremely conflicted because he still loved his daughter deeply. However, upon learning that his former wife was about to marry the alleged biological father of their child, he asked the courts to relinquish his child support payments. Surprisingly, they refused. Mike continues to pay child support to his former wife and his daughter’s biological dad and he is not happy.
DNA tests have proven that 40% of children are born outside of marriage and the number of paternity tests has increased by 60% in the past decade. With a swab from the cheek, life can change dramatically. Most states require an unmarried couple to complete an Acknowledgement of Paternity (AOP) before the baby’s birth certificate is signed. However, there is a growing movement to have mandatory paternity tests done, even for married couples.
Life is indeed, messy. Most state-appointed judges will NOT let non-biological fathers to stop paying child support in the “best interest of the child.” According to the courts, if a man acknowledges paternity and a bond has been established with the child, it would be disruptive for that relationship to disappear. It is now recommended that a presumed father, biological mother or biological father challenge paternity before the child turns 2. This would allow for any discrepancies to be resolved before deep parental bonds have formed. However, there are men who dispute this proposal stating a man may not discover he is not the child’s biological father until years later.
As an obstetrician, I have witnessed the heart break on both sides of the fence. Sex is not a benign act. It can and DOES bring forth creation. It is therefore prudent that everyone act responsibly and HONESTLY. Children shouldn’t suffer because of misguided adults.
January 18, 2010
Whether you’ve been trying to conceive for years or immediately became pregnant after the first try, how do you tell your loved ones when that moment finally arrives? Listed below are ways that patients have shared regarding announcing that special news:
- Invite your husband and/or family to a restaurant and then ask the server to bring a baby’s high-chair for the future family addition.
- Create an announcement card from your first prenatal sonogram picture.
- Send a stork or baby balloon to your husband while he’s at work
- Announce it in the form of a Chinese fortune cookie
- Buy a baby’s outfit and give send it to your parents
- Hand out pink and blue carnations the next time you visit your parents
- Give your parents and husband a new family tree with an additional branch
- If greater than 12-weeks, record the sound of the fetal heart tones at your ob provider’s office and then play it for your husband and/or family members as a surprise
- Put your positive pregnancy test in an obvious place where your husband won’t miss it
- Buy greeting cards that refer to your parents and grandparents and your husband as “Dad”
Whether it’s your first pregnancy or the nineteenth as in the case of reality show mom Michelle Duggar, every pregnancy is meaningful so make sure you make the grand announcement in a unique and special way.