Mamas on Bedrest: Don’t let your baby be born too soon!

January 27th, 2011

Too Many Babies Born Too Soon!

I just came across alarming articles reporting that at some US hospitals, elective labor induction and early birth (before 39 weeks gestation) is as high as 40%. The really alarming factor is that there is no evidenced-based medically necessary reason for these inductions and early births. This is mind boggling! Why would some in the obstetrical community intentionally initiate preterm labor and premature birth when research and medical evidence has clearly shown that there is significant risk to maternal and fetal/neonatal morbidity and mortality?

Before moving forward, I want to make a clear point. There are times when labor and delivery do have to be induced. In these cases, continuing the pregnancy would increase the risk of serious complications, perhaps even death, to the mother, the baby or both. But this is not what the articles I am reading are talking about. These articles and reports are talking about inducing labor and creating premature infants when there  is no medically indicated reason.

The Reporting Source

The articles are citing data presented by LeapFrog Group a non-profit patient advocacy and medical watch dog organization. LeapFrog was surprised to find in its annual hospital survey that as many as 40% of hospitals have high (medically unnecessary) early induction rates. LeapFrog noted that some 50% of hospitals had induction rates of 12% or below, LeapFrog’s target goal for 2010. Additionally, LeapFrog found that 29% of hospitals had induction rates below 5% indicating that low induction rates are achievable for all hospitals.

What Pregnancy and Prematurity Experts Have To Say

“The last few weeks of a pregnancy are critical to the development of the baby’s brain, lung and liver,” said Dr. Alan Fleishman, senior vice president and medical director of The March of Dimes Foundation. “Babies born just a few weeks early have feeding problems, jaundice, inability to hold temperature and tremendous increased costs. Every week counts.”

Babies delivered early also face a higher risk of death, spending time in a neonatal intensive care unit and life-long health problems, according to a statement from the Leapfrog Group.

According to Maureen Corry, Childbirth Connection’s executive director, a recent survey found that the leading reason (accounting for about 25 percent of early births) was caregiver concern that the mother was overdue. About 19 percent were medical inductions, another 19 percent were due to the mother’s desire “to get the pregnancy over with,” and the final one (17 percent) came from concern about the size of the baby. According to Fleischman, large babies aren’t a valid reason for early delivery.

Mamas on bedrest, don’t let your baby be born too soon. If your obstetrician recommends an early induction and there doesn’t seem to be a good reason why, have a frank discussion and ask them to explain clearly and give medical evidence as to why you should be induced.  LeapFrog also recommends that you get the induction rates of your Obstetrician and hospital and also gives additional resources to learn about your provider or hospital.

Stay tuned to our next blogs which will give more frank information from ChildBirth Connection and the March of Dimes on labor induction.

Mamas on Bedrest: Affordable care is very affordable-when you’re not paying for it!

January 24th, 2011

The Republican Majority in the House of Representatives voted last week to repeal The Affordable Care Act (aka The “ObamaCare” Law).

While the repeal in the house in and of itself isn’t likely to stand, the House of Representatives and Republicans in the Senate have vowed to dismantle the law item by item or to withhold funding so that it essentially dies.  If this action occurs, I am very worried that mamas on bed rest and others won’t have access to safe, effective, affordable health care.

One of the Republicans’ biggest complaints is the insurance mandate issue. They feel that it is be a burden on tax payers and states for people to HAVE to purchase insurance or be fined. What they neglect to mention (in addition to a suitable alternative to this item) is the fact that when people are uninsured and need to see a doctor, even for something as mundane as a cold, they go to emergency rooms where the fees to just walk through the door are about $500. As people are uninsured and often unable to pay, their health care (including prescriptions) is provided gratis (actually those of us who have health care end up footing the bill in the form of higher premiums with less coverage but I digress…). This is a situation that could have been avoided if we had gone to a single payer system, but many Americans are so afraid of “socialized medicine”, worrying that they wouldn’t be able to get what they want when they want,  that they would rather suffer premium hikes and our current barriers to care than to make sure that everyone has basic health care.

But those are all issues for another post. Here, I want to remind folks what Mamas on Bedrest and those mamas beyond pregnancy stand to lose if The Affordable Care Act is repealed or “inactivated”. Many of these benefits have been covered in the blog post “Improvements in Insurance Funding for Mamas on Bedrest”. But here are the highlights:

  • Coverage of preventive screenings and services for pregnant women at no extra charge. Yes, many women were charged additional fees to their insurance premiums for certain prenatal screening tests and treatments like folic acid supplements and smoking cessation programs, both known to improve the health of mother and baby.
  • The new law will require that employers offer paid time off/breaks so that mothers can go express breastmilk and the law requires that a designated place be made available-other than the bathroom. It’s about time!
  • Funds will be allotted for research on post partum depression. Again, it’s about time!
  • A pregnancy assistance fund, which will provide $25 million annually for 10 years for housing, child care and other needs. (Here is emergency funding for mamas on bed rest!!!)
  • $1.5 billion over five years will be dedicated to expanding home-visiting programs in which nurses and other providers visit pregnant teenagers and young mothers. While I can appreciate helping young mothers, I think that the program should be expanded to include ALL new mothers of ALL ages. As any mom knows, having a new baby is overwhelming. If there isn’t sufficient support the stress can contribute to post partum depression. (See April 30th Blog post, Austinwoman Magazine Article on Post Partum Depression)

In addition to these benefits, Mamas on Bedrest who develop chronic conditions will not lose their health care. That means,

  • Mamas who develop peripartum cardiomyopathies (enlarged hearts and heart failure) as a result of their pregnancies will continue to receive health care. To bring this point home, Brenda Torigiani, one of our featured mamas who is now living with peripartum cardiomyopathy, won’t lose health care coverage nor be denied health care coverage if her husband changes jobs because she now has a “pre-existing condition.”
  • Mamas who develop hypertension and gestational diabetes that becomes chronic hypertension or Type I or II diabetes mellitus post partum won’t lose health care coverage or be denied health care coverage due to pre-existing conditions. That means my friend who had an intracranial bleed (bleeding in her brain post partum due to high blood pressure) can’t be denied health care coverage.

The Affordable Care Act also removes the caps (limits) that can be placed on health care. This is great news for parents and families who have premature infants who will require lifelong medical care and medical resources.

While I could go on about the myriad of benefits that the Affordable Care Act will provide to Mamas, their babies and their families, none of it really matters if the bill is repealed or dismantled. Mamas on Bedrest, if you see your self in any of the above scenarios, I implore you to contact your federal legislators and tell them that you don’t want them to repeal or to dismantle or not fund The Affordable Care Act. Or perhaps you are in favor of our current system. If  that is the case then by all means do nothing because then we can all be sure that we will continue with more of the same.

I want to leave you all with one final thought. The legislators, the people who are working feverishly to repeal The Affordable Care Act or at the very least to inactivate it, all have comprehensive health insurance. Yes, as federal “employees”, they are entitled to some of the best health care that this country has to offer! And since they “work for us,” guess what, We’re paying for it! The very people who are trying to deny you health care coverage have health care coverage funded by your tax dollars!! Furthermore, many of them who “retire” from public service will continue to have this same comprehensive health care for the rest of their lives. They won’t have to worry about Medicare going bankrupt or supplemental insurances.  Again to make the point real, we have paid for every one of Dick Cheney’s cardiac stents and his most recently implanted heart pump. If he needs a heart transplant, we’ll pay for that too! When John Boehner starts needing treatment for emphysema (He’s an avid smoker and so is President Obama), we will pay for his oxygen, his inhalers and any other treatments that he may need. We’ve paid for Arlen Spector’s Prostate cancer treatments as well as for his lymphoma treatments. We paid for Ted Kennedy’s brain tumor treatments, Ronald Reagan’s Alzheimer’s Treatments, Supreme Court Judge Ruth Ginsberg’s Colon cancer treatments….I could go on but you get my point. As federal employees, all of these individuals received some of the best medical care the United States has to offer all while several of them don’t even want to pay for you to get a flu shot.

I guess affordable care is very affordable-when you’re not paying for it.  No wonder they see no need for The Affordable Care Act.

Mamas on Bedrest: I really blew it and you will too!

January 18th, 2011

It happened yesterday, MLK Day, when the kids were off from school. They had been bickering all day, all weekend in fact, and I had had my fill of, “Mom, he touched me”, “Mom, she called me a beanhead”, “I’m first! No me”! All the bickering combined with a day of multiple minor irritations and getting little to nothing  done on my “to do” list combined to create the perfect storm. Coming out of my daughter’s dance class, I erupted in an explosion the likes neither one of them had ever seen.

Get in the car and BE QUIET! I don’t want to hear another sound out of either of you!”

For the entire ride home I went on a rant. I don’t think that I’ve ever been so angry with my children in their entire lives (all 8 and 5 years of them) and I am pretty sure that they had never seen me so angry. They both sat speechless for the 15  or so minute ride home and went directly to their rooms when we got there. (Mind you, I had not sent anyone to his or her room. I think it was a retreat to safety!) I literally slapped some dinner together (complete with cabinets slamming) and when my husband got home welcomed him with, “Take your children!” before retreating to a quiet place to cool my jets.

I thought back to a little over 8 years ago, sitting in the NICU holding my tiny (preemie) infant daughter telling her,

“How precious you are. I love you so much!”

I was so overjoyed to have finally had a successful pregnancy that my heart was “overfilled“.  And when I had my son 3 1/2 years later I remember lying in the hospital bed holding him with him looking up at me and thinking, “It doesn’t get any better than this!”

Yet here I am, years later, screaming like a stark raving lunatic!

Mamas on Bedrest, I share this story with you to tell you that I really blew it-and you will too!. We all love our children and those of us who had difficulty conceiving or achieving a successful pregnancy know all too well how blessed we are to have our children. That doesn’t mean that everyday will be rosy. That doesn’t mean that parenting will be any more “anointed” for us than any other mom. That doesn’t mean that there won’t be times when we will wonder, “Was this trip really necessary??”

But mostly I share this story with you to absolve you of the guilt you will one day feel. Believe me, you’ll feel it. You’ll say to yourself,

“I wish you’d just shut up” or “I wish someone would come and take this kid!” Or some other equally “ungrateful” statement (fill in your own words here!). Then you’ll shrink at your own harshness and self flagellate for days at the mere remembrance of your thoughts. “How could I say such a thing?” you’ll ask your self. Easily. You were stressed, most likely tired, and your subconscious (your truest self) brought forth your immediate desire-without the filtering of your conscious (your outer persona you present to the world). You don’t want your child gone or wish you had never had them. It’s just that at that moment, you are beyond your ability to cope. If you can, ask for help-from a friend, a neighbor or family member. You need a break.

I remember so well the first time I had such a thought. It was during my daughter’s infancy.  She was an itty bitty thing, about 2-3 months old. For a period of about 6 weeks she had this habit of screaming every evening. These were no ordinary cries, but shrill, blood curdling wails that lasted about 2 hours each evening. My husband and I would pass her back and forth, rock her, pat her on the back, sit her up, lay her down, put her in the swing, the bouncy seat….nothing worked. After a couple of hours, she’d just tucker out. After about 6 weeks it all just stopped.

One evening when I was especially exhausted and frustrated I thought to myself, “Dear God I just want to get away from this kid!” I didn’t even voice the thought, but immediately felt guilty. How could I say such a thing, especially after all I had gone through to have a baby at all?! At the time, my husband and I believed that she would be our only child. Having been so blessed, how could I now be asking God to relieve me of her?

Once again I want to reiterate the point that this is normal. There will be days when your children, even those precious little infants, will tax every ounce of human strength that you have-both physical and emotional. They will throw and/or spit their food at you. They will squirm, kick and bite as you try to suction their noses or clip their fingernails. They’ll cry, throw a tantrum in the middle of the mall or as was my situation yesterday, relentlessly pick at one another until you cry out for someone-ANYONE-to take them. We mamas, no we parents all know that you don’t mean it. But you are stressed and irritated and just as with all noxious stimui, you want it to stop-IMMEDIATELY!

My children are now at the age when one or both of us can take a time out and regroup. Again, for those parents of infants, get help. Take a break. After an hour or so, you’ll be able to come back and face your child as the strong, competent, loving parent that you are. You’ll both be the better for it.

Remember, you’re not awful you’re a parent. Let me be one of the first to welcome you to our crazy, wacky world! If you are a mama on bed rest and you are carrying your first child, print this post, tuck it away and in a few months or even a few years, when you feel ready to rip your hair out by the roots over something your child has done, pull this out and know then as now, we’re right there with ya, mama!