May 28, 2012
As a young girl growing up in a small Long Island town called Amityville, Memorial Day was a huge holiday filled with parades and barbeques. I would inevitably end up at my friend Diane’s backyard eating a hotdog along with the rest of the kids on our block. It was also a day when we made our annual trip to the cemetery to place American flags on the graves of veterans and flowers on the graves of the deceased. Well, today, in honor of both Memorial Day and Preeclampsia Awareness Week, I’d like to take time to remember all mothers and their babies who died during childbirth, especially from preeclampsia.
What is preeclampsia and why is it so deadly? Preeclampsia is a condition of pregnancy in which there is high blood pressure; swelling of the ankles, feet, or face; protein in the urine; and abnormal kidney function. This condition requires the delivery of the baby in order to preserve the mother’s life and prevent seizures and strokes. The old fashioned term for preeclampsia was toxemia and it affects 1 out of 12 pregnancies each year. Approximately 76,000 women die annually from this disease and most people know of at least someone that it has affected during pregnancy.
When I think about preeclampsia, a woman name Dawn Fleming comes to mind. Dawn was 31 years old, a member of my sorority, Delta Sigma Theta and a popular radio personality in Orlando. Although I did not know her personally, she was from my former hometown of Queens. She was gregarious, a community activist who died unexpectedly from a preeclampsia related stroke. She had recently married and delivered a baby girl 6 days before her untimely birth. Her daughter is now approximately 8 years old and will never know her mother. When I attended Dawn’s wake, I was both angry and sad. I suspected someone had inevitably missed the diagnosis and by the time she was given treatment, it was too late. Such is the case of the vast majority of preeclampsia victims. By the time a diagnosis is made, the damage is already done. In her book, You Have No Idea, celebrity Vanessa Williams and her mother, Helen, discusses preeclampsia as the reason for her paternal grandmother’s death.
In my next blog, I will describe the signs, symptoms and treatment for preeclampsia that is also described in The Smart Mother’s Guide to a Better Pregnancy. But in the meantime, I urge all of us to take a few moments to remember all the moms and babies who are no longer with us and pray that a cure for preeclampsia will one day be found.
May 9, 2012
How can a pregnant woman be missing for more than 2 weeks and her husband not be a person of interest? Bibi Farruoq, a native of Guyana, South America and a U.S. citizen was a mother of four. She was a former real estte professional, loving soccer and stay-at-home mom according to her cousin. She was pregnant with her 5th child and was 41 years old. It’s not clear whether this was a planned pregnancy or if she had any prenatal complications. Certainly her advanced age would increase her risk factors but hopefully not to the point of death. Yet, Farrouq was found dead in her bathtub of her Pennsylvania vacation homes in the Poconos with a stillborn baby girl lying underneath her. She had been dead for at least 10 days although the exact time of death was indeterminate because of her severely decomposed body.
Her husband, Mohamed Farrouq was an interstate truck driver who was away from home at various times. The Farrouqs, like many New York City dwellers, lived in an apartment but owned a vacation home in the Poconos. Two weeks after his wife was missing, he brings their four children to their vacation home and discovers the bodies of his missing wife and unborn baby. I have many, many questions for both the husband and police department. Where was Mr. Farrouq during his wife’s 2-week absence and why did he not report her missing sooner or go to their vacation home when she went missing? Who took care of her four children during her absence and did anyone in her family not get suspicious that something was array?
Although the state police investigator doesn’t believe “there’s been foul play,” I am reminded of a folklore legend we heard during our residency training about a physician (more specifically, an anesthesiologist) who killed his wife using the paralyzing poison, Curare. He almost “got away with murder” but didn’t based on a toxicology report that the nurses insisted be done because of his alleged infidelity.
From 1990 to 2004, there were 1,367 pregnant women murdered. Studies show that physical abuse occurs in 7 to 20 percent of pregnant women, sometimes leading to death from homicide. Women with an unplanned pregnancy have a 3-fold higher risk of physical abuse than planned pregnancies. The toxicology reports on Farrouq are pending. A DNA test of mom, dad and stillborn might not be a bad idea either. This case certainly has more questions than answers.
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…
July 12, 2010
Every time I want to retreat from medicine, stories Like Angela Burgin Logan’s give me reasons to press on. Angela almost died having a baby because her physician was too careless to listen. Stories like Angela’s is what inspired me to write The Smart Mother’s Guide to a Better Pregnancy. I saw too many “near-miss” and “near-death” occurrences among pregnant women and decided to do something about it because most of them are preventable.
Angela is a 30-something year old African American alumnus of Syracuse University who has extensive business experience as a marketing executive for celebrities and is also married to one. She had an uneventful pregnancy up until her late second trimester when she developed signs and symptoms that any trained obstetrician would have immediately recognized as impending pre-eclampsia. She gained five pounds a week and developed swelling. She could only sleep propped up on a pillow because she couldn’t breathe pillow. She complained of shortness of breath and difficulty walking. All of her complaints were disregarded by her physician and staff in a condescending manner. It was only after she gained 15 pounds in one week did her physician reluctantly order lab tests based on her insistence.
On the night of her delivery, she went to the hospital because she could not breathe. Her blood pressure was extremely high, her platelets were low and she had significant protein in the urine. Angela had a lethal variant of pre-eclampsia called the HELLP Syndrome. Against Angela’s wishes, she was forced to lie on her back for a nursing procedure and fluid seeped into her lungs. She lapsed into a coma. An emergency C. Section was performed and it was discovered that she had an enlarged heart. Her infant daughter was born in distress and there was an 80 percent chance that Angela would die. Thank God she didn’t. Angela is now on a mission to warn pregnant moms about pre-eclampsia and urges them to “trust their instincts.” I totally agree.
Arrogance and condescension have no place in a patient-physician relationship and is a sure-fire way to end up in court. I urge all pregnant women to become proactive regarding their prenatal care and above all, trust your instincts. The days of the passive patient are gone. A healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.
May 17, 2010
On February 10, 2010, Katy Hayes, a free lance massage therapist and mother of two, gave birth at home to her 10 pound daughter after 8 hours of labor without medication or intervention. (See AOL’s link http://alturl.com/8bh9). It is not known whether the home birth was attended to by a midwife.
Katy did not have health insurance, nor did her husband, Al. Four days later, Katy was rushed to the hospital because of increased excruciating pain and almost died shortly thereafter. She experienced massive organ failure, and then lapsed into a coma. Katy had Group A streptococcal disease which causes strep throat or mild soft tissue disease. However if this bacteria gains access into the blood stream its effects can be devastating. It causes necrotizing fasciitis or the “flesh eating bacteria.” It is also responsible for Streptococcal Toxic Shock Syndrome, commonly referred to as either “Toxic Shock Syndrome” or TTSS. This infection has been on the rise in the U.S. since the 1980’s with 8 to 10 thousand cases occurring annually and 30% of people affected still die each year.
Katy’s husband faced a major dilemma. The physicians informed him that the only way to save Katy’s life was to remove the source of the infection which was her uterus. In addition, all four of her legs and arms had to be surgically removed as well as her ovaries, stomach and part of her intestines. And there was still the possibility that she might die. Al made the heart-wrenching decision for Katy to have the surgery.
Katy regained consciousness on March 12th and is on a slow but steady road to recovery. She will have to be fitted for prosthesis of her arms and legs and her greatest desire is to hold her baby and return to her family. Her friends and family are conducting fund raisers to pay for her hospital bills.
Some schools of thought will argue that Katy should have never had a home birth. Others will defend her right to do so. I hope Katy did not opt to deliver at home because she lacked healthcare insurance. That would be a moral tragedy. I wish I could turn back the hands of time because here’s what Katy should have known:
- Older women (those over 35) have an increased risk of birth complications. Katy was 41.
- There are federally funded community health centers to take care of the uninsured.
- A fever after childbirth needs PROMPT attention. Katy had a fever for four days before she was taken to the hospital.
Let’s all pray for Katy’s continued recovery and a swift return home to her baby.
Join the FB page created for Katy by clicking here http://www.facebook.com/group.php?gid=343063085090
June 4, 2009
And there it was on the front page of the New York Times for the whole world to see. Where Life Starts Is a Deadly Risk, by Denise Grady, described a harsh reality that is often mentioned as a mere footnote. More than half a million pregnant women die from preventable deaths and over a quarter million occur in Africa. Of course there are not enough financial and human resources available and their stories are disheartening. For each woman who dies, 20 more encounter serious complications. Physicians state that more deaths occur outside the hospital because many try to give birth at home. This leads to my next point.
There are a growing number of women who want to give birth at home alone, without a midwife or birth attendant. I posted a blog about this “unassisted” phenomena a few weeks ago after one of their advocates’ baby ended up dead. I subsequently received a comment from a woman who discussed how “tribal” women would rather deliver without intervention and their biggest obstacle was poverty. Not so. There are millions of African women who would love to trade places with the “unassisted” crowd in a heartbeat. Yes, childbirth is a natural act but it is not exempt from danger.
Grady’s article reads like a litany of horror. A mother of six bled to death because the nurses did not know how to remove the placenta. A mother of quadruplets died leaving four beautiful babies in an orphanage. Two and three laboring women sharing one cot. America, we are so blessed. The cost to run a hospital in Tanzania costs $200,000 a year. I challenge the American College of Obstetricians-Gynecologists (ACOG), the American Board of Obstetrician-Gynecologists (ABOG) and all the rest of the deep-pocket women’s organizations to step up to the plate. We are our sisters’ keepers. When a mother and baby die, the whole world mourns.
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