April 16, 2012
Imagine that you delivered a premature baby at 26 weeks, was informed that it was a stillbirth and then 12 hours later, you discover that it is alive. That is exactly what happened to Bouter, after delivering a baby girl via a C. Section. Bouter’s daughter was pronounced dead at the time of birth and quickly whisked away to the morgue where it remained in a refrigerated room. Twelve hours later, Bouter and her husband visited the morgue to say a final farewell and take pictures to be sent to the funeral home. Bouter’s husband attempted to open the coffin with great difficulty and once opened, he stepped aside so that Bouter could see the baby. She moved the coverings aside, touched the baby’s hand and then uncovered her face. She then heard a cry and at first thought she was imaging things. As she stepped back, the baby woke up and let out a weak cry. Bouter fell to her knees crying and laughing simultaneously. The baby was quickly taken to the neonatal intensive care unit and is presently on a ventilator. A news conference was held and five healthcare workers were suspended pending an investigation. Bouter plans to sue.
How could this possibly be, one might ask? There are a few possibilities. Perhaps the baby had a weak heartbeat that went undetected or it was the cold temperature that kept it alive. Almost 2 years ago to the exact date, I wrote a blog about hypothermia, (see 5 “Cool” Ways to Save a Newborn’s Life), an innovative way to keep critically ill newborns alive. This process was initiated at the University of California in San Francisco, had specific protocols that were used on babies greater than 36 weeks and must be implemented within the newborn’s first 6 hours of life. Bouter’s baby was only 26 weeks but the process still worked.
In 2005, there was a case of tourist Dan O’Rielly who drowned in Mexico and was airlifted to Houston where he was given a cooling blanket with a temperature of 90 and the man came back to life 12 hours later. He went without oxygen for 45 minutes before he was intubated. There IS something to this freezing stuff and I hope medical science will research the matter further. In the meantime, may the story of Luz Milagros (Little Miracle) continue to inspire us all. Obviously she was meant to be here.
April 27, 2011
As insurance companies become more aggressive regarding restricting care in the name of profit, patients will have to be more proactive in order to avoid unnecessary and preventable complications. You’ve just had a baby 24 hours ago and the hospital wants to send you home. Is your baby ready to leave the hospital? Here is your checklist of things that should occur prior to the discharge of your baby:
- Their vital signs and physical exam should be normal for at least 12 hours prior to discharge
- They should breathe less than 60 breaths in a minute and the heart rate should be between 100 to 160 beats per minute
- Their temperature should be between 97 to 99°F in an open crib
- They should have urinated and passed one stool spontaneously
- It can suckle, swallow and feed while breathing
- There is no evidence of jaundice
- You have a car safety seat appropriate for the baby’s age
- You’ve been given emergency instructions in the event of a complication and you understand them
- Both you and your baby’s blood type; Hepatitis and HIV status are known
- The baby has passed the hearing screening test
It is important for all mothers to make certain these things have been done on behalf of their newborn prior to being sent home. If they haven’t, you have every right to decline the discharge until it is determined that your baby is okay. Although our present healthcare system is on automatic pilot, someone should be alert at the wheel.
Until next time, remember . . . a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.
January 4, 2010
I read the Politics Daily article by Joanne Weiner, Preemies, Health Care Reform and the Cost-Benefit Conundrum and shook my head in frustration. It irks me when people attempt to place a dollar sign on the value of human life.
It is a well known fact that most hospital costs are over-inflated yet no one calls them to task. Premature babies may cost $26 billion dollars per year but how much money has been spent on prevention? We’ve done a lousy job in reducing the occurrence of premature labor or making pregnant moms aware of its dire consequences. For example:
• Back pain should not be ignored (because it could be a sign of early labor)
• Patients should be discouraged from drinking soda because they contribute to urinary tract infections
• Urinary tract infections should be treated aggressively because it can be a precursor to premature labor
• The cervix of pregnant women should be automatically measured after 14 weeks by ultrasound imaging to determine if it’s short (2.5 cm or less increases the incidence of preterm labor).
• Complaints of vaginal discharges should not be ignored (especially from lower socioeconomic women) because it could represent an sexually transmitted infection (another risk factor for premature labor)
• Pregnant women in stressful occupations (professional women included) should be given a leave of absence so their bodies are allowed to rest
• Steroids should be administered to women with preterm labor so their babies will be able to breathe
And the list could go on infinitum. The May 18th 2009 edition of People Magazine had a fabulous article about six amazing college students who were all born premature at less than 27 weeks. Their story not only brought me to tears but also inspired a blog, (see Miraculous Babies). The most premature baby of the group was born at 23 weeks and weighed 1.8 pounds. She is also a college student today.
So, unless you’ve worked as a nurse or a physician, please keep your untrained hands off the destinies our preemies. The “cost-benefits” of their future is priceless.
April 1, 2009
Of the 4 million babies born each year in the United States, one out of eight will be premature. Minority women carry the greatest risk and are usually caught off guard. Premature babies face multiple challenges and many die within the first year of life. These challenges include cerebral palsy, physical and intellectual disabilities in addition to emotional family trauma. Each year $26 billion dollars are spent taking care of premature babies in neonatal intensive care units and is a public health crisis.
The good news is that there are new methods of diagnosis that can identify women who are at risk and prolong their pregnancy as much as possible. Ladies please take note: Having your cervix measured at 22 weeks can predict who will be at risk for having babies too soon. If your cervix measures 20 to 25 centimeters, treatment with progesterone is offered that has been shown to reduce the rate of premature deliveries that occur before 32 weeks. An awareness of having risk factors can empower you to seek proper treatment early and improve your chances of having a healthy baby.
Please report pressure, back pain or abdominal pain to your healthcare provider immediately. Pain or pressure that occurs four or more times in one hour could indicate premature labor and can be treated if diagnosed in a timely manner. Also get tests for sexually transmitted infections, especially if you have a vaginal discharge, and get treated for urinary tract infections). Bacteria are not your friend during pregnancy however antibiotic therapy is priceless if given in time.
Pregnancy is one of the most important milestones of your life. A healthy pregnancy doesn’t just happen; it takes a SMART mother who knows what to do.