The force that moves the air within our lungs, the blood within our veins, is the same force that has created the life within your womb. The most important key to a healthy pregnancy is the consciousness that lies within. Your child will be shaped by your thoughts, your dreams, your values, your energy. You are the ship that will carry the baby to the shores of its pre-ordained human experience. Please let the journey be smooth. Do not create a storm from worry, a tornado from doubt, a cloud from fear, a disaster from envy. The majority of patients who end up with emergency cesarean sections are those with “fetal distress.” What was causing the distress? Who was causing the distress? Let it not be you, its mother.

Because of the advent of 4-D ultrasound technology, we can actually observe fetal behavior in the womb. We can see babies yawning, sucking their thumbs, stretching their arms and legs, even playing with their umbilical cords. They respond to music, the rhythm of your heartbeat, a touch from your partner, the sound of your voice. You are literally filled with the miracle of life. There is no gift on Earth more precious than that.

You are smarter, stronger, and more brilliant that you can ever imagine. You have been selected, yes, selected, to be this child’s mother. That is the Divine Connection.

I wish you a healthy, joyous pregnancy and a prosperous and blessed New Year.

This excerpt is taken from The Smart Mother’s Guide® to a Better Pregnancy. All Rights Reserved.

“A newborn baby abandoned in a Kenyan forest was saved by a stray dog who apparently carried her across a busy road and through a barbed wire fence to a shed where the infant was discovered nestled with a litter of puppies.”  CBS News covered this story as well.

This baby girl was dressed in a torn shirt and wrapped in a plastic bag when the dog found her in a poor neighborhood near a forest in Nairobi.  She was approximately two days old.  “When the dog picked up the baby in a dirty bag, it came and dropped her behind the wooden building where the dog has its puppies,” stated an eyewitness.  The baby was found by children who had heard her cry and was eventually taken to the hospital where, with the exception of an infected umbilical cord, was doing well.  This story gave me reason to pause.  Obviously, the act of abandonment was superseded by the will of a higher power who proclaimed that this baby would live.  What amazed me the most was the compassion and bravery of the dog.   It had risked its own life by crossing a busy street while holding on to the baby, faced physical harm as it crawled underneath a barbed wired fence and shared its resources by placing the baby alongside its own litter of puppies.  Perhaps the dog understood how miraculous this newborn baby was even if its own mother didn’t.

In a world of infinite possibilities, miracles can occur under the most unusual circumstances. And yes, we can gain profound insight, even from a dog.

This excerpt is taken from The Smart Mother’s Guide® to a Better Pregnancy. All Rights Reserved.

 Shaniya’s senseless death is a tragedy of epic proportions and an horrific awakening.   She was allegedly conceived via a “one-night” fling between her parents, Antoinette Davis and Bradley Lockhart. Lockhart raised Shaniya for years but decided to allow her to live with her mother who had recently found a job and obtained new housing. Several weeks later, his precious child is dead.

 Hotel surveillance footage shows 29 year-old Mario McNeill carrying bare-foot Shaniya in his arms. I was sickened by his image.  McNeill admitted kidnapping the girl but is expected to plead not guilty to any other charges.

 So here are the questions: Where was the community in the midst of all this madness? Did anyone not see something awry in Davis’s home?  Did anyone not think it was strange that a wiry-haired dude was checking into a hotel room carrying a barefoot five-year old girl in his arms WITHOUT ANY LUGGAGE? Was he afraid she was going to run away? Was she drugged?

 The days of informality are over. Child custody should be done under the protection of Family Law.  Lockhart did the right thing without anyone forcing him to do so. However, for better or for worse, we have social service agencies that are mandated to protect children. Had there been a formal court relationship, Davis would have been subjected to a formal investigation before Shaniya was placed in her home.

 As an African-American woman, I am outraged at Davis and McNeill’s behaviors. As a mother I grieve for Bradley Lockhart’s loss.

 Rest well, dear sweet Shaniya. You have returned home to the angels. Rest knowing that no one will ever hurt you again.

In recognition of September as the National Infant Mortality Awareness Month, I’d like to share some SMART tips to pregnant women:

S = Seek prenatal care early.  Problems in pregnancy cannot be fixed at the last minute. Tests for genetic problems can only be detected in the early first and second trimesters.  A first trimester ultrasound is also the MOST accurate in terms of a due date. 

M = Mention all high-risk factors such as family history of diabetes, high blood pressure or bleeding. Do not omit information such as smoking or “recreational” drugs.  It will come back to haunt you.

A= Ask to have your cervix measured during your ultrasound if there is a previous history of premature contractions or delivery.  A cervical length of 2.5 centimeters or less is a risk factor for preterm labor. 

R= Research your hospital and prospective physician or midwife carefully.  Is the physician or midwife skilled in managing high-risk conditions?  Will they continue to see you even if you lose your insurance?  Has the hospital had any recent outbreaks of antibiotic-resistant – infections in the newborn nursery?  Is there 24-hour anesthesia? 

T= Test for potential problems such as Gestational Diabetes, Sickle Cell Trait or sexually transmitted infections.

The U.S. is one of the most industrialized countries in the world, yet we rank below Cuba and Taiwan, with respect to our national infant mortality rate.  The health of a nation is judged by its national infant mortality rate. We can do better.  We must do better.  The health of our future generation is depending on it.

Like most Americans, I admired the Kennedy family from afar and  their compassion had far-reaching effects.  President John Kennedy sent troops to the Deep South and protected the civil rights of my relatives.  Senator Robert Kennedy transformed my beloved Bedford Stuyvesant Brooklyn community into a successful economic empowerment zone that created jobs and stability.  We always looked forward to the annual ice skating party that was organized by Mrs. Ethel Kennedy even after that horrendous assassination.  Because of Kennedy’s vision, the price of a Bed Stuy brownstone in today’s market begins at one-half-million dollars. 

My introduction to the magic of Senator Edward Kennedy began in medical school during the early eighties when my former Assistant Dean, Dr. Van Dunn, resigned from BU to become the senator’s Senior Policy Advisor.  Senator Kennedy was full engaged and committed to healthcare reform and Dr. Dunn had the privilege of helping him.  Kennedy’s name re-emerged during the early nineties when I was working in a small southwest Louisiana community.   Towns were buzzing for miles around about the marriage of Kennedy and a Cajun woman named Victoria Reggie.

I love walking through the congested WIC (Women, Infant and Children) department at work and beam with pride at the sight of beautiful, healthy babies and children.   They are truly Kennedy’s legacy.  If you’ve ever received a Medicare benefit, a WIC check, SHIP benefits, a Family Medical Leave, the right to vote or a COBRA benefit, you can thank Senator Ted Kennedy.  He served “the least among us” nobly.

I hope more legislators and physicians will do the same.

An ultrasound report came across my desk the other day that made me scratch my head. On the first page, the fetus was listed as head down and on the second page it was listed as breech (feet first).  Well, what was it?  The patient was almost ready to have her baby and I needed accurate information in order to make a clinical decision.   It wasn’t the first time I had received a conflicting report of that nature and I was becoming highly annoyed.

A few days later I received two PAP reports printed in large font that included an apology for the “discrepancy” of the original reports.  A technician had originally read them as “normal”, but after they were re-read by a physician, they were in fact, abnormal.  I had the unpleasant duty of reporting to my patients that they were now at risk for developing cancer.

In an effort to “cut costs”, professional standards are cast to the wind.  The radiology department in question reverted to a voice-recognition system, eliminating transcriptionist jobs.  Because the computer can’t recognize certain words the ultrasound reports are often riddled with mistakes.   The problem is further compounded by a revolving door of radiologists who are hired as temps and read the reports remotely (outside of the hospital).  As a result of an absence of physician leadership, the radiology technicians have inadvertently “taken over.”

Yes, you can nickel-and-dime health care services, but you will also get what you pay for.    Voice-recognition software can never replace qualified human beings and neither can improperly trained technicians replace pathologists.  Physicians love to scream about tort reform, however how about putting some of these hospitals in check?  I wish my colleagues would get their complacent heads out of the sand and DO SOMETHING to promote patient safety.

 I’m tired of fighting this battle alone.

Get the Facts!

I don’t care how many times you repeat the same refrain some patients still don’t get it.  A significant number of pregnant women begin prenatal care at the eleventh hour because they’re waiting for insurance approval but others simply procrastinate without rhyme or reason.  As a public health physician, I can’t reject difficult patients like my counterparts in private practice.  I am obligated to see them for better or for worse.  Obstetricians usually steer clear of women who begin prenatal care late and for good reason:  they usually present with a host of problems.  Quite often I can foresee these problems but on rare occasion, I get duped.

A patient came to see me in her early third trimester and there was nothing unusual about her medical history.  She appeared pleasant, cooperative and all of her labs had returned normal, including her fetal ultrasound.  Two weeks later, during a routine visit I was unable to hear her baby’s heartbeat. When she stated that the baby had not moved for over a week, my heart sank. 

Exhaling a sigh of frustration, I wrote the order for an emergency ultrasound and warned her that things did not look good.  Two hours later, a stillbirth was confirmed.

The on-call physician who had delivered the baby gave me an update the next day.  The baby had multiple abnormalities and the patient’s lab tests were positive for cocaine. And of course, she initially denied taking it.  Her previous ultrasound was allegedly “normal” and although I’m far from being naïve, I would have never suspected the possibility of drugs.  

She subsequently refused consent for an autopsy so the official cause of death remains unknown.  Earlier prenatal care and a level of honesty might have changed the outcome of this pregnancy. Do  I now have to resort to performing drug screens on ALL late prenatal registrants? 

What do you think?

 When the smoke cleared (no pun intended), my beloved desktop computer was fried; our water heater demolished; garage opener– gone; landline phones silenced; alarm system deadened and an extinguished fluorescent light in the laundry room.  The cable repairman stayed for four hours today yet we are STILL without phone and Internet service.  Whew, is Murphy is having a field day!

 When events of Biblical magnitude occur in my life, I immediately look for the lesson.  What did I do wrong NOW, God, I pondered and the answer was self-neglect.  I’ve been averaging three hours of sleep as I juggle a full-time stressful job, market a wonderful book, prepare for radio interviews, provide monthly consultations for an intense federal committee, take care of my active 7 and 8-year old sons and often neglected husband.  I doze off in the middle of dinner and have had to pay a punitive $30.00 late fee for detaining the staff of my children’s daycare center as a result of taking a much needed and unexpected “nap.” 

 Lord, I have duly received the message to slow down.  But did you have to be so dramatic?

Joanne Fowler’s article, When Miracle Babies Grow Up, demonstrates what every obstetrician and neonatologist prays for:  a successful life for a premature baby, despite it stormy beginning.  The smiling faces and incredible stories of April Palo, Charlie Debeck, Alicia Shuman, Jonathan Engholm, Katie Kenefick, and Chris Cremons rekindled my diminishing love for medicine.

All six of these amazing men and women are now college students with academic achievements.  They were all born before 27 weeks, weighed no more than two pounds and as Fowler aptly describes, were “no longer than a dollar bill.” April was the most premature baby born at 23 weeks and weighed 1b. 8 ounces.  The statistics regarding preterm outcomes are usually dismal, but not so at Children’s Hospital of Minnesota-Minneapolis.  A dedicated medical servant and neonatologist, Dr. Ronald Hoekstra proved fate wrong.  According to Fowler, nearly 90 percent of Dr. Hoekstra’s patients born with extreme prematurity finished high school and approximately 60 percent have gone to college.  What a sigh of relief.

In my book, The Smart Mother’s Guide to a Better Pregnancy, there is a section entitled Preserving Your Miracle which encourages readers to view their pregnancies as miraculous as opposed to the mundane.  Everyone is born with a gift according to the world of Dr. Galloway.  The parents of these talented six never gave up nor wavered in their faith and emphasized an attitude of gratitude.

“I survived against terrific odds,” says Charlie Debeck, a college senior, rock climber and possible future senator. 

You certainly did, young man.  You certainly did.

 Everyone responds to infertility differently.  Some choose IVF, others use surrogate mothers and then there are those like me who simply wait.  And wait.  And wait for the miracle of conception that never arrives.   The biological clock begins to tick so loud it deafens you with the reality that if you don’t move your feet quickly, the opportunity for parenthood will be gone.

I had conjured my sons in my mind, long before I met them.  I would visualize them running in our backyard and hear their invisible squeals of delight.   Yet, I had no idea that they would come from Africa, a place I had traveled to before.

The adage that “When you take one step, God takes two,” held true and thus began our indelible journey.  We found the perfect adoption agency; met an online support group of multicultural adoptive parents of Ethiopian children, and prepared for our travel abroad.  Yet nothing seemed real until we arrived at our children’s residence and they ran straight into our waiting arms.

I can’t comment on why Oprah built a school in South Africa or what Madonna and Angelina’s agendas were regarding African children.  I only know that unconditional love has no geographic boundaries or borders.  The most important decisions made in our lifetimes are usually those that come from the heart.