Herpes 1 is an infection that causes fever blisters located on or near the mouth. In the past it was less common than Herpes 2 but in recent years is now responsible for 30 to 50% of lesions found on or near the vaginal area. Herpes 2 is an infection that causes blister-type lesions in the genital area and is usually painful to touch. The first-time (or primary) infection is usually the worst and is associated with painful and burning urination, fluid-filled blisters in the genital area, fever and sometimes a headache. Any infection thereafter is called a recurrent infection which is usually milder and has fewer symptoms. Contrary to popular belief, most infections are spread from one person to another when there are NO lesions or what’s commonly called asymptomatic shedding.

A first-time infection is treated with a medicine called Acylovir taken three times a day for 7 to 14 days. If a pregnant woman has Herpes 2 and a fever, she has to be admitted to the hospital to decrease her chances of developing pneumonia. For pregnant patients with recurrent infection, it is recommended that they take acyclovir three times a day beginning at 36-weeks up until the time of birth. Valtrex medicine may also be taken twice per day if the patient can’t tolerate Acylovir.

If lesions are present during labor, a cesarean section MUST be done to avoid an infection of the newborn. One out of 3200 babies will be infected with Herpes that causes severe diseases of the eye, skin and mouth. 80% of babies will die of Herpes 1 and 2 if they are not treated.
Please inform your healthcare provider of any symptoms of active lesions or previous history of Herpes immediately to avoid preventable complications.

Remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.

Educate yourself by purchasing my latest book The Smart Mother’s Guide To A Better Pregnancy!

                Anyone who is remotely familiar with obstetrics knows that the APGAR score is a useful tool for determining the newborn’s status shortly after it is born. APGAR scores were developed by Dr. Virginia Apgar, a Columbia University trained anesthesiologist and evaluates the baby’s heart rate, muscle tone, respiratory rate, reflex response and color at one and five minutes of life. Each criterion is given either 0, 1 or 2 points. An APGAR score of 0 to 3 after five minutes is suspicious for a birth brain injury.

                When the baby does not receive enough oxygen in the womb, its brain cells becomes damaged causing permanent injury. However, that dismal prognosis has begun to change, thanks to hypothermia (cooling) therapy. According to a large medical study called Cochrane, “. . . parents should expect that cooling will decrease their baby’s chance of dying, and that if their baby survives, cooling will decrease his/her chance of major disability.” What a MAJOR breakthrough in medical science and a reason to celebrate for expectant parents.

                One of the first institutions to use this method was the University of California at San Francisco. I contacted the nurse in charge of the program and she was kind enough to share their protocol. In order for the cooling method to work, it must be used within the first six hours of life. Here’s how it works:

1. Your baby must be 36 weeks or greater
2. Must have an APGAR score of less than 5 at 10 minutes
3. Must have received chest compressions  and/or intubated or received a mask helping it to breathe at 10 minutes of life
4. Have a low blood gas within the first 60 minutes of life
5. Have signs suggesting HIE which include having a seizure, poor muscle tone, poor feeding or be in a coma.

                Although the cooling method is expected to become the standard of care in the future, there are hospitals that are already using it. Does your hospital use hypothermia? The answer could save your baby’s life.

1. A normal heart rate of 120 to 160 beats per minute. The heart rate of a sleeping newborn is between 85 to 90 bpm
2. A breathing rate of 40 to 60 breaths per minute. A fast breathing rate could indicate heart problems
3. Good muscle tone. Poor muscle tone could indicate possible Down Syndrome or a nerve condition
4. A temperature o between 97.7 to 99.5°F.  Temperatures too high or too low could indicate a serious infection
5. Appropriate color. Blue lips, tongue or chest could indicate a  heart condition
6. Spontaneous urination and passage of one stool
7. Two successful feedings and is able to swallow, breathe and suck while feeding
8. A normal hearing screen
9. Normal glucose (sugar) level if baby was premature, mother was a diabetic
10. Normal bilirubin level

In addition, it is recommended that breastfeeding begin very soon after the delivery and that the newborns are breastfed 8 to 10 times per day. Non-breastfed infants are given one-half to one ounce of formula every four hours. All infants are treated with an eye antibiotic gel to prevent an infection from gonorrhea. The hepatitis B vaccine is also given to the newborn and as well as Vitamin K to protect against bleeding disorders. All babies must be seen by medical professionals within 72-hours of its hospital discharge.

The first 24-hours of a newborn’s life is critical and helps set the stage for the rest of its life.

Asthma occurs when the air in the lungs are reversibly blocked because of infections, allergies, cigarette smoke, pets, cold weather and severe exercise. Its symptoms include coughing, wheezing and shortness of breath that becomes worse at night. Poorly controlled asthma can cause severe complications for both mother and unborn child and it is now recommended that all pregnant women with asthma have peak flow studies.

A peak flow meter is a small, hand-held device used to monitor a person’s ability to breathe out air. It measures the airflow through the lungs and the degree of obstruction or blockage in the airways. Peak flow readings are higher when patients are well and lower when the airways are narrowed. The meter is also color coded: Green means everything is okay. Yellow means “caution” or some of the airway is blocked and medication is required. Red indicates a medical emergency dictating immediate medication and a phone call to a physician. Readings in the yellow and red zone have been associated with prenatal complications such as preterm labor and babies weighing less than five pounds.

Pregnant women should avoid asthma triggers such as mold, dust, rodents, pollens and cigarette smoke. Certain pets might have to be avoided as well. If symptoms of asthma become worse during pregnancy, medications might have to be changed or adjusted and a consultation from a high-risk obstetrician and/or an asthma specialist is recommended. Do not increase the frequency of your medication without the supervision of a physician as some asthma medication can cause complications, including irregular heartbeats and uncontrolled diabetes if taken improperly. It is also not recommended that pregnant patients take over-the-counter antihistamines such as Loratadine or Cetirizine before 12-weeks because of its increased association with birth defects.

Pregnant women with well-controlled asthma should anticipate a favorable outcome. When mom can breathe, the baby can breathe as well. What a wonderful sigh of relief.

1. Invite your husband and/or family to a restaurant and then ask the server to bring a baby’s high-chair for the future family addition.
2. Create an announcement card from your first prenatal sonogram picture.
3. Send a stork or baby balloon to your husband  while he’s at work
4. Announce it in the form of a Chinese fortune cookie
5. Buy a baby’s outfit and give send it to your parents
6. Hand out pink and blue carnations the next time you visit your parents
7. Give your parents and husband a new family tree with an additional branch
8. If greater than 12-weeks, record the sound of the fetal heart tones at your ob provider’s office and then play it for your husband and/or family members  as a surprise
9. Put your positive pregnancy test in an obvious place where your husband won’t miss it
10. Buy greeting cards that refer to your parents and grandparents and your husband as “Dad”

Whether it’s your first pregnancy or the nineteenth as in the case of reality show mom Michelle Duggar, every pregnancy is meaningful so make sure you make the grand announcement it in a unique and special way.

Kisha Jones was arrested for allegedly tricking Monique Hunter, her husband’s pregnant lover into taking an abortion-inducing drug. Jones allegedly forged a physician’s prescription and prescribed a medication that would induce early labor. She told the pharmacist that the medicine was for “a procedure.” She then called Hunter and convinced her that her physician had prescribed an important medication and she should pick it up and take immediately.  Hunter complied.  Shortly thereafter, she was soon rushed to the hospital and delivered a premature baby boy two months early.

While Hunter’s baby was still in the intensive care unit, an unknown man brought what he claimed to be breast milk for the baby and it was later determined to be poison. The hospital staff called the police and Jones was arrested on a host of charges including criminal impersonation. The facts of this case suggest that either Jones was familiar with labor inducing medications or knew someone who was. The “abortion-inducing drug” referred to by CNN was probably Mifepristone.

Mifepristone is a medication that’s used for early first-trimester abortions and to induce labor with fetal demises. Since its inception back in the late ‘80’s, I have disagreed with it being prescribed as an outpatient medication. Any medicine that causes bleeding and the evacuation of the uterus should be done in a controlled environment under the supervision of medical staff to avoid complications.  Unfortunately, the FDA has reported several deaths of women who had taken this medication at home.

While this story has all of the makings of daytime drama, the bigger tragedy is that an innocent newborn was almost killed. I think the FDA should reexamine its policy regarding Mifepristone. People like Kisha Jones should never be allowed to strike again.

The federal government is paying researchers $2.2 million dollars over a 4-year period in an attempt to prevent obese pregnant women from gaining any weight during the course of their pregnancy.  If the participants gain weight, it is to be limited to 3 percent of their baseline weight.  While this appears to be a noble endeavor, the goal of zero weight gain during pregnancy is unrealistic. The average pregnancy requires 80,000 additional calories over pre-pregnancy requirement which amounts to approximately 300 additional calories per day. The study recommends an intake of 100 to 300. If we take the lower recommendation of 100 additional calories per day, that would amount to an 8 pound weight gain during pregnancy because 3500 calories equals one pound. The Institute of Medicine’s recommendation is a total weight gain of eleven pounds for obese pregnant moms. This appears to be more practical.

The greater concern is what effect will calorie restrictions have on the fetus and newborn? The additional 300 calories is needed for proper fetal development and growth. Will there be risks of fetal growth restriction (the baby not growing properly)? Nutritional deficits based upon increased fetal demands and less calories? The majority of pregnant women complain of having an increased appetite when taking prenatal vitamins which is necessary for proper fetal development. How will that issue be addressed?

We are well aware of the adverse consequences that obesity can have on pregnancy outcomes. However, zero prenatal weight gain is pushing the envelope.  What long-term neurological or developmental effects will this diet have on babies? Let’s keep a close eye on the developments of this study as they unfold.

I’ve loved writing for as long as I can remember thanks to my late Aunt Dot, who instilled this passion at an early age.  She would proudly tell her friends that I had been reading the New York Times since the age of 8.  While I don’t know how true that is, I do have an intimate relationship with the written word and know that it is mightier and stronger than man-made weapons. 

For the past five years, I’ve tried to put words on paper that would empower pregnant women to take control of their pregnancies and thus my book, The Smart Mother’s Guide to a Better Pregnancy Was Born.  The landscape of healthcare as changed dramatically since I stepped out of residency training.  Physicians no longer control the healthcare profession.

Right now, we’re in the midst of a pitched battle to reclaim our profession but in the meantime, four million babies will be born each year in the U.S.  Those babies and their moms must be protected.  Please read my interview with Carol Borthwick of the Qean Group below to find out how.

http://www.qeangroup.com/blog/2009/07/te-questions-linda-burke-galloway/

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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• Doctors Versus Midwives: The Birth Wars Rage On (time.com)

2009 could possibly be called the year of miracles.  First, the election of President Barack Hussein Obama, the Orlando Magic are in the NBA playoffs and now the nomination of Justice Sonia Sotomayor.  Somebody quick, hand me another tissue.

The tears of joy that I cry are for all of the pregnant women who step out in faith, not knowing what the future holds for their unborn children.  Out of humble wombs emerge some of our greatest gifts and it never ceases to amaze me.  As a physician who once lived in a New York City housing project (the same former home of entertainment mogul, Jay-Z) I can attest to the inordinate amount of courage, tenacity and stamina it takes to excel in an Ivy League institution.  Thank you Columbia University and BU School of Medicine for believing in me.  Sotomayor’s ascent from the South Bronx to Princeton and Yale makes her nomination to the highest court in the land that much sweeter. She will not render justice with an inflated sense of entitlement.

As a public health servant, I have dedicated my professional career caring for the least among us who deserve the most.  My patients are from every corner of the globe and while some may be “undocumented,” all are carrying jewels.  We thank the mothers of President Obama and Justice Sotomayor for giving us such sacred gifts. 

The Latino presence was clearly felt during the 2008 election and as the landscape and demographics of America continues to change, we celebrate its diversity.   We are a blended family bound by a desire for the common good of all. 

Thank you Justice Souter for holding down the fort.  Please enjoy your well deserved retirement.  The spirit of Thurgood Marshall can finally rest in peace.  Who is Sonia Sotomayor, CNN asks?   She’s a Latina from the Bronx who will definitely watch our backs.