October 10, 2011
The story of Tanya* is compelling. She was 24 weeks pregnant with her third child and the hospital was threatening to send her home. Two years ago, she faced similar circumstances and delivered a baby at 23 weeks. Luckily, the baby is now two years old but the one before that was not so lucky. Tanya presented to a local hospital during her first pregnancy because of complaints of abdominal pain. She was sent home because her contractions “weren’t regular.” Ten hours later, Tanya returned to the hospital because of a “nagging feeling that something was wrong” although her contractions were still not regular. Unfortunately, her cervix was dilated and the contractions could not be stopped. Her son was born alive but died one hour later because the hospital was not equipped to deal with premature newborns. Tanya’s second pregnancy was similar to her first because she developed premature contractions again, at 23 weeks. As with the first pregnancy, her contractions were not strong and regular so she was discharged home from the hospital with a monitor that was supposed to help. It didn’t. Luckily, she had an appointment with her high risk physician the next day who informed her that she was dilated although she did not have regular contractions. Her preterm labor could not be stopped but this time, her baby did not die.
Tanya contacted her Bedrest Coach, DarlineTurner-Lee, owner of Mamas On Bedrest that provides support to high risk pregnant moms and Lee contacted me. She asked for advice regarding Tanya who was 24 weeks and about to be inappropriately discharged home from a specialized teaching hospital. I offered strategies on Tanya’s behalf but there weren’t necessary. One of the physicians at the hospital convinced the staff to allow Tanya to remain in the hospital until 28 weeks. There are lessons to be learned from her case
- Trust your instincts. Tanya was correct in not wanting to be discharged home because of her previous history. Women who delivery preterm babies (especially at 23 weeks) are bound to do it again. The chances of survival are far greater at 28 weeks than at 24 weeks
- She obtained an advocate and sought a second opinion. 2 heads are always better than 1 especially when there is doubt about a diagnosis or treatment
- If you have a high risk problem, always attempt to be admitted to a Level 3 hospital where they have specialized care for newborns
Tanya expressed her gratitude by saying “. . . I thank God for people like you and the staff who fight for our little miracles.”
1 out of 8 pregnant women will deliver a premature baby in the US each year. Hopefully, this time, Tanya will not be one of them.
June 28, 2010
Last week I had the pleasure of being interviewed by Darline Turner-Lee, the owner of Mamas on Bed Rest. Darlene had reviewed The Smart Mother’s Guide to a Better Pregnancy and was taping our interview for her podcast (click http://bit.ly/bby1rC). During the interview, Darline asked what I thought the most important thing pregnant women should do in order to have a healthy pregnancy and I said “trust your instincts.” Last Friday, I had to practice what I preached.
Like millions of Americans, I have high blood pressure and am taking medication. Uncontrolled hypertension can lead to a perilous path that includes strokes, heart disease and possible death. However life style changes can improve the condition considerably and release us from the bondage of the pharmaceutical industry.
For the past two months, I’ve experienced a dry, hacking cough. When it became unbearable, I reviewed the side effects of a medicine I had been taking for over 2 years and lo and behold, I had found the culprit. I immediately contacted my cardiologist who changed my medicine. However, despite the change of medicine, the cough not only persisted but became worse. I was not only hacking and coughing, but now had wheezing. Enough was enough. I stopped taking the medicine. I checked my blood pressure and gratefully it was normal although I am acutely aware that it could “rebound” and become dangerously high. I contacted my cardiologist’s office again but was informed by his nurse that he would be away for two weeks. I described my symptoms but she stated that the medicine I was taking “shouldn’t have that type of effect.” I said it did and I was not going to take any more of it. When the nurse mentioned the medication’s category, I suddenly recalled a recent medical study that associated that type of medication with an increased risk of lung cancer. My instincts were correct. Although I trusted my cardiologist (who happens to be brilliant and a former med school colleague) I still needed to do my own research. And when my body was giving me signals that something was wrong, I was wise enough not to ignore them. As a pregnant mother, you MUST do the same. If something doesn’t “feel right” regarding your pregnancy, bring it to your provider’s attention immediately. Your persistence could very well save your life. And also the life of your baby.