Maternal Mortality Issues

Goals come with challenges. Federal and state government, teaching hospitals, and OB clinics are working to improve maternal health risks. Using the World Health organization ‘s definition, maternal death is death during pregnancy or related to the pregnancy and up to 42 days following delivery. However, other definitions (like the September 2016 issue of Obstet Gynecol) define maternal mortality as “the death of a woman while pregnant or during the one-year period following the date of the end of pregnancy.”  So who is right?  And although many stats show a steady increase in maternal death “the provisional number of births for the United States in 2017 was 3,853,472” (per CDC); therefore women are taking on the challenges of pregnancy with its possible risks and are reaching their goal of carrying and delivering a new little person.

Here are some risks occurring in South Carolina (2011-2015):

—- There are demographic disparities including a “substantial racial disparity” for care.  Non-Hispanic Black women were 3.7 times more likely to die in pregnancy and child birth compared to non-Hispanic White women.

—-Women of all categories 35 years of age or older were at higher risk.

—-South Carolina’s 64 total deaths’ causes were broken down into seven categories:  Medical conditions complicating pregnancies tops the list at 21 deaths.

Cardiovascular disease and hypertension were the next two causes, followed by complications of labor and delivery, ectopic pregnancy issues, disease of the cerebral vascular system and last was other unspecified causes.

In California, the state with the highest number of babies born, the researchers and clinicians have found ways needed to decrease the risk of death from hemorrhaging and pre-eclampsia. Treating hypertension aggressively is one. Educating nurses and doctors to know what preventative actions to use quickly and to use special online toolkits an OB professor developed is another. (See California Quality Care Collaborative)

Still awaiting passage by the US Congress, The Maternal Health Accountability Act S-112 facilitates states’ maternal care and also provides federal funding for their maternal care review boards to prevent deaths from occurring because of flawed care or lack of care.

Another important issue is caring for women considering abortion, during abortion and after abortion is vital. Medical issues directly related to an abortion exist such as hemorrhage. Others are difficulties with future pregnancies, lowering of mental health (including PTSD, accidents, and higher suicide rate) and even a lower life expectancy. Women who’ve had multiple abortions may have a higher risk developing breast cancer.

Care given for both a woman wanting to carry her pregnancy or one that does not is life-giving. Hopefully success in care will help more goals to be attained for both mother and baby.

Sources:

MacDorman M, Declercq E, Cabral H, Morton C.  Is the United States Maternal Mortality Rate Increasing?  Disentangling trends from measurement issues.  U.S. Maternal Mortality Trends.  Obstet Gynecol. 2016 Sep; 128 (3): 447-455.

www.ncbi.wlm.nih.gov/pmc/articles

NCHS is the principal agency of the US Federal statistical system and operates under the CDC

http://www.reviewtoaction.org/sites/default/files/portal_resources/South

%20Carolina%20VR%20Data_Maternal%20Mortality%202011-

2015%20Poster.pdf

Maternal Health Accountability Act of 2017

“Lost Mothers” N. Martin, R. Montagne NPR/Propublica article

Elliot Institute. (2003). “Our Mission & Ministry.” Elliot Institute. N.p.,

2003. Web. 18 Jun 2011. http://afterabortion.org/2011

Rue et. al. (2004). “Induced abortion and traumatic stress: A preliminary comparison of American and Russian women,” Medical Science Monitor 10(10): SR5-16 (2004) http://www.artsenverbond.nl/abortion.pdf

Abortion Breast Cancer Coalition. (2010). “Stop the Cover-up!” Abortion Breast Cancer Coalition,  http://www.abortionbreastcancer.com/

ps/bhb 11/2018

Marijuana Use During Pregnancy

Marijuana (also known as pot or weed) is formally known as cannabis sativa. It is used in a variety of ways to obtain a pleasant feeling or even encourage food intake. The active part of the drug, tetrahydrocannabinol (THC), passes easily into the body’s bloodstream. It makes its way into the brain to cause the high and other sometimes not so desired effects. In a pregnant user, besides affecting her, it also affects the unborn child. If you have questions regarding marijuana use, please contact us for a FREE appointment. Our women’s clinic can educate you on health factors related to marijuana use in pregnancy.

As more is desired, the woman may be led to more potent drugs with even more dangerous effects. Addiction leads to poor performance and the risk of auto accidents increases. The high becomes very costly to the woman in every way possible, including her normal responsibilities. More physically dangerous actions occur, and effects become uncontrollable. The little person in the womb needs only nourishment from his/her mother, but he/she does not need the likely negative effects from a questionable drug.

Hospital studies have been done of marijuana users who were intoxicated and/or mentally impaired. Emergency room (ER) admissions show its most negative effects as some of these ER patients had dangerously combined marijuana with other drugs. Synthetic cannabinoids (synthetic marijuana) use has become another reason for ER visits. Dangerous results made by poor judgment were likely increased or caused by the marijuana’s effects. Younger age concerns exist in this picture. “Marijuana was the most commonly reported primary substance of abuse among admissions that initiated substance use at the age of 14 or younger” (SAMHSA Treatment Episode Data 2011).

What about brain formation concerns in the baby? Although findings are not all in, here is an example of what is known. A Swedish researcher’s finding was that circuit pathways in the brain can be permanently damaged from drugs. He explained that this damage occurs to a part (an axon) of a nerve cell. The process that sends impulses to another nerve cell does not happen in some pathways. Even if these pathways are not used for a long period of time, these axons can cause the brain’s nerves in those pathways to not properly communicate. Studies have shown increased incidence of mental illnesses and addiction tendencies in children that were exposed to cannabis while in the womb. For this reason, the respected medical researcher made the statement that “cannabis should be avoided during pregnancy” (Healthline News, 01/28/2014).

The British Medical Journal Open published an article earlier this year regarding effects of marijuana on fetal outcome, and from the 24 studies in this review, researchers concluded that exposure to marijuana in utero may affect the baby after delivery, although not structural birth defects, but effects such as low birth weight or need for NICU (BMJ Open, 04/05/2016).

The American Congress of Obstetricians and Gynecologists (ACOG) reported in July 2015 that 48-60% of female marijuana users continue their use of marijuana during pregnancy, because they may believe that marijuana use is not putting them or their baby in any danger. However, according to ACOG, studies suggest that marijuana exposure in utero may affect the child’s attention span and school performance, as well as possibly contributing to behavioral problems down the road. ACOG recommends that all pregnant women discontinue marijuana use.

Get OB care for your pregnancy, and follow your doctor’s guidance for going off drugs safely. Refusing marijuana and other drugs of abuse presented to you before and while pregnant is a major way to provide health for you, your pregnancy, and your child.

Source of information and quotes:

Barclay, Rachel; Healthline News (http://www.healthline.com/health-news/children-cannabis-impairs-fetal-brain-development-012814), quote by professor Tibor Harkany  at Karolinka Institutet in Stockholm, Sweden.

National Alliance on Mental Illness (http://www.nami.org/Learn-More/mental-health-Conditions/Related-Conditions/Dual-Diagnosis).

SAMHSA (www.samhsa.gov); this agency can offer help to deal with substance abuse and addiction.

Gunn, J.K.L., Rosales, C.B., Center, K.B., Nunez, A., Gibson, S.J., Christ, C., Ehirir, J.E. British Medical Journal Open. Prenatal exposure to cannabis and maternal and child health outcomes: a systematic review and meta-analysis. http://bmjopen.bmj.com/content/6/4/e009986.full?sid=695c8cf2-ab2f-4f33-834e-4898c16b6a3a), 04/05/2016.

The American Congress of Obstetricians and Gynecologists. Committee Opinion: Marijuana Use During Pregnancy and Lactation. Number 637, July 2015. http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Marijuana-Use-During-Pregnancy-and-Lactation.

Resources for parents to find specialized care for their children:

Child Development Services is a link between several different agencies in the City of Greenville, SC and Greenville County (http://www.cdservices.org).

SC First Steps (http://scfirststeps.com/babynet/)

Nurse-Family Partnership (www.nursefamilypartnership.org)

Substance Abuse and Mental Health Services Administration (SAMHSA, http://www.samhsa.gov/)

What is an ectopic pregnancy?

Also known as an extrauterine pregnancy, an ectopic pregnancy is a potentially life-threatening condition in which a fertilized egg implants outside of the
uterus—most often in the fallopian tubes. The morning-after pill won’t end an ectopic pregnancy. If you have severe abdominal pain three to five weeks after using the morning-after pill, see your health care professional to rule out an ectopic pregnancy. If an embryo is growing in a fallopian tube, you will need to seek emergency care.

what is ectopic pregnancy

 

 

Source: © 2009, 2012 Focus on the Family “The Morning-After Pill” pamphlet

Footnote 1: FDA Prescribing and Label Information for Plan B One-Step®, Rev. July 2009; pp. 13-14; www.accessdata.fda.gov/drugsatfda_docs/label/2009/021998lbl.pdf

Footnote 2: FDA Prescribing and Label Information for Plan B One-Step®, Rev. July 2009, p. 6 and 17; See footnote 1

Footnote 3: Picture from www.mayoclinic.org

My girlfriend’s pregnant. Now what?

My girlfriend’s pregnant. Now what?
Hearing the news that you’ve created your first child is bound to result in some powerful emotions. Some of them usually include:
1. Shock
2. Disbelief
3. Denial
4. Fear
5. Anger
6. My future is ruined
7. I’m too young
8. I just want to escape
If you think your emotions are crazy—just stop and think about what your girlfriend is feeling—probably the same very emotions.
Before either of you panics, gets angry, or lays the blame, just remember that it took both of you to create this pregnancy and it will take both of you being informed and thinking clearly to make a plan for what happens next.
Here are some things you should do:
1. Stay calm
2. Start to talk about and research all of your options together
3. Support your girlfriend emotionally
4. Pull together; don’t pull apart
5. Let her know you’ll work this out together
Here are some things you don’t want to do:
1. Get angry
2. Shout at your girlfriend
3. Say things like, “It’s not mine!”, “You’ve ruined my life”, “My parents will kill me!” “You’ll have to get an abortion!”, “It’s your decision, not mine!”
4. Pressure her to have an abortion.
Common fears about telling your parents:
1. They’ll be furious
2. They may kill me
3. I’ve got to finish school
4. They have such high hopes for me
5. They’ll be so disappointed
A gameplan for telling your parents
Before telling your parents, think for yourselves. Get the facts and have a plan. Your parents will likely have similar emotions you did when they first hear. It will be less traumatic for them and for you if you get your act together and present a united rational picture with your girlfriend.
We can help you prepare the facts and have a plan when it is time to tell your parents. Our confidential workers have given advice for years to couples that have found themselves in similar situations. We can help you stay calm, and support you through this emotional time in your life.

Parenting as an Alternative to Abortion

Becoming a parent is exciting and scary.

Parenting is a big responsibility, but it is one that comes with a lot of joy and satisfaction.

This pregnancy may not be planned, but that does not mean parenting isn’t the best option for you and your child.

A child needs love and stability, not perfection. Life may not be perfect right now, but that doesn’t mean you can’t be the “perfect” parent for your child.

We are here to help you sort through your concerns, fears, and hopes.

There are several parenting options for you to consider.

Marriage and parenting. You are ready to make a commitment to both your partner and the child, and choose to marry and raise the child together.
Things to consider: Have you been together for a while? Have you considered getting married? Do you have a good relationship? Are you committed to each other?

Joint parenting. Although not ready to make a marriage commitment, you and your partner choose to share responsibilities for raising the child in a joint custody arrangement.
Things to consider: Are you both committed to the child’s needs and best interests above your own? Are you able to work through scheduling, financial, commuting, and communication challenges?

Custodial parenting with visitation. One partner is fully committed to raising the child. The other partner is less than fully committed.
Things to consider: Is the custodial parent able to take on nearly all of the responsibilities for the child? Is the visiting parent able to provide financial child support and invest some time in the child? Do both parents have an additional support system of family and friends? Are you able to work through scheduling, financial, commuting, and communication challenges?

Custodial parenting. One partner is fully committed to raising the child. The other partner is either unable to participate in parenting, does not want to be a part of the child’s life, or has exited the relationship.
Things to consider: As custodial parent, do you understand that responsibility for the child will fall completely on you? Do you have an additional support system of family and friends? Are you prepared to have to petition for child support?

Things to think about when considering parenting
• Am I ready to accept responsibility for my baby’s needs?
• Will the other birth parent be supportive?
• Do I have family support?
• Am I too young? Am I too old?
• How will I support myself and my child? Do I have a job? Will I be able to finish school?
• Where will we live?
• Do I have access to affordable medical care?
• What kind of life can I offer my child?
• Do I have any physical, mental, or emotional health issues that could impact my parenting?
• Do I struggle with substance abuse?
• Am I in a safe situation?

As you consider the above questions, you may feel overwhelmed with options and which is the right way for you to proceed. We are here to help.

Parenting can be very rewarding, and our team is here to help you decide if this is the best path forward. We are confidential, and have years of experience helping those who have found themselves in the same situation that you are now in.