This document summarizes an article about births at St. Paul's Hospital in Vancouver, Canada. It describes a caesarean section delivery of a baby girl named Isabella and focuses on her mother Lorena's experience. It then provides statistics about birth rates at St. Paul's, noting that it handles high-risk pregnancies and has higher C-section rates as a result. The summary concludes by describing the reaction of Isabella's family meeting her for the first time in the hospital.
The document provides information about upcoming events and charitable giving opportunities at Children's Hospital. A car seat inspection will be held on December 16 from 6-9 pm in Harriman. "Dancing with the Knoxville Stars" will take place on March 31 from 7-11 pm at the Knoxville Expo Center. Those aged 70.5 or older can make tax-free charitable gifts to Children's Hospital from their IRAs of up to $100,000.
Meet Gabby Seay, a young girl whose development was threatened by a rare condition called infantile spasms that started when she was just months old. Find out what inspired Casey Owens, a former patient, to be a second-floor nurse at Children's Hospital. See how we're using telemedicine to connect our pediatric experts with patients miles away in the Morristown area.
Several local women chose to have home births with the assistance of midwives instead of giving birth in hospitals. Shirley Robert, who had high-risk pregnancies in the past, gave birth to a healthy baby girl at home with midwife Nancy Wainer. Alba Cordero also had a positive home birth experience with Wainer's assistance. These women believed that home births allowed a calmer, more supportive environment compared to hospitals.
Find out how an experience at Children’s Hospital deeply impacted a young couple who’ll begin their journey as husband and wife this spring.
Meet Elise McDaniel, an energetic young woman who makes being healthy a priority.
Saying goodbye to Laura Barnes after nearly 41 years; welcoming Hella Ewing to Children’s Hospital.
Read more at http://www.etch.com/about_us/its_about_children.aspx
- The document describes a woman's highs and lows in 2011, including an amazing Christmas vacation in Austin, Texas followed by a miscarriage.
- She initially tried to recover at home but had to return to the emergency room on Christmas Day where she learned she needed immediate surgery or risk losing her ability to have children or even her life.
- She describes the excellent care she received at St. David's South Austin Medical Center, praising the doctors, nurses, cleanliness and service.
- She realizes her ego about natural medicine led her to initially ignore the doctor's advice and she could have died had she not gotten the medical intervention she received.
This document provides graphic details about abortions and their impact. It describes violent abortion procedures that tear babies limbs from their bodies and cause pain without anesthesia. It aims to show the brutality of abortions and influence the reader's stance on abortion rights by emphasizing the harm done to fetuses. The document questions whether women are fully informed of abortion risks and criticizes the concept of a woman's "choice" in the matter.
Research paper power point - the correct one(:Katymarie33
This document discusses neonaticide and filicide through the work of forensic scientist Phillip Resnick. It provides examples of cases where mothers killed their children and Resnick's testimony in court defending them by citing affective denial, mental illness, extreme depression, and postpartum depression. Resnick developed a classification system for these crimes including altruistic, psychotic, fatal maltreatment, unwanted child, and spousal revenge filicide. The document examines his influence in high profile cases and how he argues psychological factors can explain these acts of violence against children.
This document discusses neonaticide and filicide, the killing of newborns and children. Forensic scientist Phillip Resnick coined these terms and created a classification system to describe different motives, such as altruistic filicide where the mother kills out of love. Affective denial, where mothers deny their pregnancy, is a factor in neonaticide cases. Resnick has testified in many trials using mental illness as a defense for mothers who commit filicide. He believes conditions like postpartum depression and psychosis can cause mothers to snap and kill their children.
The document provides information about upcoming events and charitable giving opportunities at Children's Hospital. A car seat inspection will be held on December 16 from 6-9 pm in Harriman. "Dancing with the Knoxville Stars" will take place on March 31 from 7-11 pm at the Knoxville Expo Center. Those aged 70.5 or older can make tax-free charitable gifts to Children's Hospital from their IRAs of up to $100,000.
Meet Gabby Seay, a young girl whose development was threatened by a rare condition called infantile spasms that started when she was just months old. Find out what inspired Casey Owens, a former patient, to be a second-floor nurse at Children's Hospital. See how we're using telemedicine to connect our pediatric experts with patients miles away in the Morristown area.
Several local women chose to have home births with the assistance of midwives instead of giving birth in hospitals. Shirley Robert, who had high-risk pregnancies in the past, gave birth to a healthy baby girl at home with midwife Nancy Wainer. Alba Cordero also had a positive home birth experience with Wainer's assistance. These women believed that home births allowed a calmer, more supportive environment compared to hospitals.
Find out how an experience at Children’s Hospital deeply impacted a young couple who’ll begin their journey as husband and wife this spring.
Meet Elise McDaniel, an energetic young woman who makes being healthy a priority.
Saying goodbye to Laura Barnes after nearly 41 years; welcoming Hella Ewing to Children’s Hospital.
Read more at http://www.etch.com/about_us/its_about_children.aspx
- The document describes a woman's highs and lows in 2011, including an amazing Christmas vacation in Austin, Texas followed by a miscarriage.
- She initially tried to recover at home but had to return to the emergency room on Christmas Day where she learned she needed immediate surgery or risk losing her ability to have children or even her life.
- She describes the excellent care she received at St. David's South Austin Medical Center, praising the doctors, nurses, cleanliness and service.
- She realizes her ego about natural medicine led her to initially ignore the doctor's advice and she could have died had she not gotten the medical intervention she received.
This document provides graphic details about abortions and their impact. It describes violent abortion procedures that tear babies limbs from their bodies and cause pain without anesthesia. It aims to show the brutality of abortions and influence the reader's stance on abortion rights by emphasizing the harm done to fetuses. The document questions whether women are fully informed of abortion risks and criticizes the concept of a woman's "choice" in the matter.
Research paper power point - the correct one(:Katymarie33
This document discusses neonaticide and filicide through the work of forensic scientist Phillip Resnick. It provides examples of cases where mothers killed their children and Resnick's testimony in court defending them by citing affective denial, mental illness, extreme depression, and postpartum depression. Resnick developed a classification system for these crimes including altruistic, psychotic, fatal maltreatment, unwanted child, and spousal revenge filicide. The document examines his influence in high profile cases and how he argues psychological factors can explain these acts of violence against children.
This document discusses neonaticide and filicide, the killing of newborns and children. Forensic scientist Phillip Resnick coined these terms and created a classification system to describe different motives, such as altruistic filicide where the mother kills out of love. Affective denial, where mothers deny their pregnancy, is a factor in neonaticide cases. Resnick has testified in many trials using mental illness as a defense for mothers who commit filicide. He believes conditions like postpartum depression and psychosis can cause mothers to snap and kill their children.
The document discusses abortion and includes definitions, causes, symptoms, diagnosis, and treatment. It defines abortion as ending a pregnancy before 20 weeks or when the fetus weighs less than 500 grams. Common causes include fetal abnormalities, problems with the placenta, sudden illness in the mother, and uterine disorders. Symptoms can include late or light menstruation. Diagnosis involves examination, tests, and monitoring whether the uterus is growing as expected. Common treatments include medications to induce labor and surgery if needed.
AJ Cucksey was named the Children’s Miracle Network Hospitals (CMNH) Champion for the state of Tennessee. He and his family will spend the year sharing his journey with brain tumors and how East Tennessee Children’s Hospital, a CMNH affiliate, has helped him.
It’s About Children is a publication of the Marketing Department at East Tennessee Children’s Hospital.
East Tennessee Children's Hospital's mission is to improve the health of children through exceptional, comprehensive
family-centered care, wellness and education. Our School Nurse Conference puts that mission into action within the
community by enhancing the knowledge of school nurses about managing common childhood illnesses and injuries
and providing updated information about changes in care for children with chronic diseases.
Rains Malone spent two weeks of his life in the Children's Hospital Neonatal Intensive Care Unit while his brain healed. Learn about his journey and the treatment in this issue of It's About Children by East Tennessee Children's Hospital.
This document lists the board of directors, medical staff, and administration of East Tennessee Children's Hospital. It also provides biographical information on Dr. Clarisa Cuevas, a new pediatric gastroenterologist joining the hospital. Dr. Cuevas completed her medical training and fellowship in pediatric gastroenterology. She is excited to join her colleague Dr. Youhanna Al-Tawil in practice at East Tennessee Children's Hospital.
The document summarizes Sarah McTaggart's struggle with a mysterious medical disorder and her faith-fueled journey. As a teenager, Sarah began forgetting things and experiencing seizures, and she was eventually diagnosed with anti-NMDA receptor encephalitis, a rare autoimmune disease. She underwent intensive treatment at Loma Linda University Children's Hospital for over a year, including chemotherapy and a stem cell transplant. Due to her family's strong faith and the support of doctors, nurses, and staff, Sarah recovered from the disorder and is now healthy and active.
This annual report from Children's Hospital provides key statistics from the past fiscal year (FY13):
- 148,140 total patient visits
- 790 babies treated in the Neonatal Intensive Care Unit (NICU)
- 559 children cared for in the Pediatric Intensive Care Unit (PICU)
- 10,918 surgeries performed
- 313 babies treated for drug dependency, reflecting the opioid epidemic
The report highlights the hospital's role as the major pediatric provider in East Tennessee and its work to pioneer new treatments. It features everyday child heroes who demonstrate bravery in their health battles as the most celebrated patients.
This document lists the board of directors, medical staff, and administration of East Tennessee Children's Hospital. It also provides the hospital's statement of philosophy which emphasizes that children deserve specialized care that considers their emotional, informational, and developmental needs as the total child. The hospital aims to provide this specialized care through a well-trained staff solely focused on pediatric health and well-being.
This document discusses the differences between hospital births and home births. It notes that the cesarean section rate in the US has risen dramatically since the 1970s. One woman shares her negative experience with a rushed c-section in the hospital. In contrast, another woman describes her positive home birth experience, immediately bonding with her baby. The document argues that midwife-attended births at home or in birth centers have better outcomes than hospital births in the US, citing lower infant and maternal mortality rates in other countries where midwives attend most births. It questions the American College of Obstetricians and Gynecologists' opposition to home births.
The Experiences of Mothers as They Suppress Lactation Following Late Miscarri...Irish Hospice Foundation
The Experiences of Mothers as They Suppress Lactation Following Late Miscarriage, Stillbirth or Neonatal Death' (Presentation by Denise McGuiness from Maternity and Neonatal Network Meeting, April 2015) (MNN11)
Sarah Seeley-Dick is a 32-year-old pediatrician at Pediatric Clinic, P.C. in West Knoxville, Karns, and Seymour. She has a 4-year-old daughter named Kathryn and a 15-month-old son named Jamison. Sarah enjoys outdoor activities and spending time with her family. Joel Knapper is a 1-year-old boy who was treated at Children's Hospital for recurrent ear infections and respiratory issues. Though not seriously ill, he has made several visits to Children's Hospital for his medical needs. The Knapper family is thankful for the excellent care and compassion Joel has received from all the staff at Children's Hospital.
Helping Angels will be hosting a Christmas party on December 17th for the children staying at Colleen's Place of Hope in Mitchell's Plain. The party will provide the children with lunch, gifts, snacks, and supplies for the home. Activities like visits from Father Christmas and a jumping castle are planned to bring smiles to the children's faces. Background information is provided on some of the children currently staying at Colleen's Place of Hope, many of whom have suffered neglect or abuse. Donations are requested to help make the party a success and bring joy to the children.
This is a presentation that was given at the Lost in Translation 2013: Exploring the Origins of Addiction conference that took place on March 25 - 26, 2013 in Vancouver, British Columbia, Canada.
Linda and Douglas Norris filed a $38 million lawsuit against Sinai Hospital for negligence after their 2-day old son Avery was kidnapped from the hospital by a woman dressed as a nurse. The couple allege the hospital failed to provide adequate security to protect their child. While the hospital denies any wrongdoing, the couple want to send a message that hospitals need to improve security measures to prevent such incidents. Karleane Wilkinson was convicted of kidnapping Avery and sentenced to 30 years in prison after she faked a pregnancy and home birth in an attempt to pass the baby off as her own. Experts say infant kidnappings are usually committed by women seeking to have a baby due to an inability to conceive or carry their own
The document provides information about three letters sent to Children's Hospital thanking them for the care provided.
The first letter thanks the hospital for the care their son received while hospitalized, particularly praising nurse Caley for her efforts in helping the son with pain and comforting both him and his mother during a difficult night after spinal fusion surgery.
The second letter thanks the hospital for the care their daughter received while hospitalized over Christmas, noting how the gifts from Santa that the hospital provided lifted their spirits during a difficult time in the hospital over the holidays.
The third letter thanks the hospital for the care their daughter received while hospitalized from December 23rd to 26th, noting how the hospital was fantastic and
'The Butterfly Room, A Space for Bereaved Familes, at Our Lady of Lourdes Hos...Irish Hospice Foundation
'The Butterfly Room, A Space for Bereaved Familes, at Our Lady of Lourdes Hospital, Drogheda' (Presentation by Fiona Mulligan at the Maternity and Neonatal Network Meeting, July 2014) (MNN 7)
The document discusses ACKSYS's rugged WiFi solutions for communication on buses, trams, and at depots. It describes how ACKSYS's products allow vehicles to automatically load and offload operating data through a wireless network at depots. It also discusses providing real-time communication on vehicles in motion through ACKSYS's WiFi devices that offer fast roaming and high data rates to ensure seamless connectivity. ACKSYS offers a complete solution of devices tailored for both onboard and ground use to enable dynamic data transfers and smart deployment of wireless networks for public transportation.
Understanding land use influence to coastal ecosystems in the Rio Grande de M...Loretta Roberson
The document summarizes a research study on sediment dynamics in the Rio Grande de Manati Watershed and how land use influences riverine inputs to coastal ecosystems. The goals are to relate land use to sediment inputs in the river, analyze river contributions to the coast through suspended sediment, and establish relationships between suspended sediment, turbidity, and sunlight attenuation in the coast. Methodologies include generating a land use map using remote sensing, collecting suspended sediment samples at sites along the river and coast, and using satellites to measure the outfall influence on the coast. The study will help understand sediment generation and transport in the watershed to inform management practices that control sediment inputs to coastal zones.
This document provides examples of different time expressions in English including days of the week, months, seasons, years, and other temporal expressions. It shows how to use prepositions like "in", "on", "at" correctly with time expressions. For example, "in" is used with seasons, months and years, "on" is used with specific dates and days of the week, and "at" is used with times of day. It also lists other time expressions like "twice", "once", "last", "next", and "every".
Este documento presenta una secuencia didáctica para una clase de 6° grado sobre circuitos eléctricos. La clase comenzará con una revisión de conceptos previos y luego los estudiantes usarán un programa de computadora para armar circuitos eléctricos virtuales en grupos de hasta tres personas. Al final, los grupos presentarán sus circuitos ante la clase explicando qué herramientas utilizaron para construirlos.
The document discusses abortion and includes definitions, causes, symptoms, diagnosis, and treatment. It defines abortion as ending a pregnancy before 20 weeks or when the fetus weighs less than 500 grams. Common causes include fetal abnormalities, problems with the placenta, sudden illness in the mother, and uterine disorders. Symptoms can include late or light menstruation. Diagnosis involves examination, tests, and monitoring whether the uterus is growing as expected. Common treatments include medications to induce labor and surgery if needed.
AJ Cucksey was named the Children’s Miracle Network Hospitals (CMNH) Champion for the state of Tennessee. He and his family will spend the year sharing his journey with brain tumors and how East Tennessee Children’s Hospital, a CMNH affiliate, has helped him.
It’s About Children is a publication of the Marketing Department at East Tennessee Children’s Hospital.
East Tennessee Children's Hospital's mission is to improve the health of children through exceptional, comprehensive
family-centered care, wellness and education. Our School Nurse Conference puts that mission into action within the
community by enhancing the knowledge of school nurses about managing common childhood illnesses and injuries
and providing updated information about changes in care for children with chronic diseases.
Rains Malone spent two weeks of his life in the Children's Hospital Neonatal Intensive Care Unit while his brain healed. Learn about his journey and the treatment in this issue of It's About Children by East Tennessee Children's Hospital.
This document lists the board of directors, medical staff, and administration of East Tennessee Children's Hospital. It also provides biographical information on Dr. Clarisa Cuevas, a new pediatric gastroenterologist joining the hospital. Dr. Cuevas completed her medical training and fellowship in pediatric gastroenterology. She is excited to join her colleague Dr. Youhanna Al-Tawil in practice at East Tennessee Children's Hospital.
The document summarizes Sarah McTaggart's struggle with a mysterious medical disorder and her faith-fueled journey. As a teenager, Sarah began forgetting things and experiencing seizures, and she was eventually diagnosed with anti-NMDA receptor encephalitis, a rare autoimmune disease. She underwent intensive treatment at Loma Linda University Children's Hospital for over a year, including chemotherapy and a stem cell transplant. Due to her family's strong faith and the support of doctors, nurses, and staff, Sarah recovered from the disorder and is now healthy and active.
This annual report from Children's Hospital provides key statistics from the past fiscal year (FY13):
- 148,140 total patient visits
- 790 babies treated in the Neonatal Intensive Care Unit (NICU)
- 559 children cared for in the Pediatric Intensive Care Unit (PICU)
- 10,918 surgeries performed
- 313 babies treated for drug dependency, reflecting the opioid epidemic
The report highlights the hospital's role as the major pediatric provider in East Tennessee and its work to pioneer new treatments. It features everyday child heroes who demonstrate bravery in their health battles as the most celebrated patients.
This document lists the board of directors, medical staff, and administration of East Tennessee Children's Hospital. It also provides the hospital's statement of philosophy which emphasizes that children deserve specialized care that considers their emotional, informational, and developmental needs as the total child. The hospital aims to provide this specialized care through a well-trained staff solely focused on pediatric health and well-being.
This document discusses the differences between hospital births and home births. It notes that the cesarean section rate in the US has risen dramatically since the 1970s. One woman shares her negative experience with a rushed c-section in the hospital. In contrast, another woman describes her positive home birth experience, immediately bonding with her baby. The document argues that midwife-attended births at home or in birth centers have better outcomes than hospital births in the US, citing lower infant and maternal mortality rates in other countries where midwives attend most births. It questions the American College of Obstetricians and Gynecologists' opposition to home births.
The Experiences of Mothers as They Suppress Lactation Following Late Miscarri...Irish Hospice Foundation
The Experiences of Mothers as They Suppress Lactation Following Late Miscarriage, Stillbirth or Neonatal Death' (Presentation by Denise McGuiness from Maternity and Neonatal Network Meeting, April 2015) (MNN11)
Sarah Seeley-Dick is a 32-year-old pediatrician at Pediatric Clinic, P.C. in West Knoxville, Karns, and Seymour. She has a 4-year-old daughter named Kathryn and a 15-month-old son named Jamison. Sarah enjoys outdoor activities and spending time with her family. Joel Knapper is a 1-year-old boy who was treated at Children's Hospital for recurrent ear infections and respiratory issues. Though not seriously ill, he has made several visits to Children's Hospital for his medical needs. The Knapper family is thankful for the excellent care and compassion Joel has received from all the staff at Children's Hospital.
Helping Angels will be hosting a Christmas party on December 17th for the children staying at Colleen's Place of Hope in Mitchell's Plain. The party will provide the children with lunch, gifts, snacks, and supplies for the home. Activities like visits from Father Christmas and a jumping castle are planned to bring smiles to the children's faces. Background information is provided on some of the children currently staying at Colleen's Place of Hope, many of whom have suffered neglect or abuse. Donations are requested to help make the party a success and bring joy to the children.
This is a presentation that was given at the Lost in Translation 2013: Exploring the Origins of Addiction conference that took place on March 25 - 26, 2013 in Vancouver, British Columbia, Canada.
Linda and Douglas Norris filed a $38 million lawsuit against Sinai Hospital for negligence after their 2-day old son Avery was kidnapped from the hospital by a woman dressed as a nurse. The couple allege the hospital failed to provide adequate security to protect their child. While the hospital denies any wrongdoing, the couple want to send a message that hospitals need to improve security measures to prevent such incidents. Karleane Wilkinson was convicted of kidnapping Avery and sentenced to 30 years in prison after she faked a pregnancy and home birth in an attempt to pass the baby off as her own. Experts say infant kidnappings are usually committed by women seeking to have a baby due to an inability to conceive or carry their own
The document provides information about three letters sent to Children's Hospital thanking them for the care provided.
The first letter thanks the hospital for the care their son received while hospitalized, particularly praising nurse Caley for her efforts in helping the son with pain and comforting both him and his mother during a difficult night after spinal fusion surgery.
The second letter thanks the hospital for the care their daughter received while hospitalized over Christmas, noting how the gifts from Santa that the hospital provided lifted their spirits during a difficult time in the hospital over the holidays.
The third letter thanks the hospital for the care their daughter received while hospitalized from December 23rd to 26th, noting how the hospital was fantastic and
'The Butterfly Room, A Space for Bereaved Familes, at Our Lady of Lourdes Hos...Irish Hospice Foundation
'The Butterfly Room, A Space for Bereaved Familes, at Our Lady of Lourdes Hospital, Drogheda' (Presentation by Fiona Mulligan at the Maternity and Neonatal Network Meeting, July 2014) (MNN 7)
The document discusses ACKSYS's rugged WiFi solutions for communication on buses, trams, and at depots. It describes how ACKSYS's products allow vehicles to automatically load and offload operating data through a wireless network at depots. It also discusses providing real-time communication on vehicles in motion through ACKSYS's WiFi devices that offer fast roaming and high data rates to ensure seamless connectivity. ACKSYS offers a complete solution of devices tailored for both onboard and ground use to enable dynamic data transfers and smart deployment of wireless networks for public transportation.
Understanding land use influence to coastal ecosystems in the Rio Grande de M...Loretta Roberson
The document summarizes a research study on sediment dynamics in the Rio Grande de Manati Watershed and how land use influences riverine inputs to coastal ecosystems. The goals are to relate land use to sediment inputs in the river, analyze river contributions to the coast through suspended sediment, and establish relationships between suspended sediment, turbidity, and sunlight attenuation in the coast. Methodologies include generating a land use map using remote sensing, collecting suspended sediment samples at sites along the river and coast, and using satellites to measure the outfall influence on the coast. The study will help understand sediment generation and transport in the watershed to inform management practices that control sediment inputs to coastal zones.
This document provides examples of different time expressions in English including days of the week, months, seasons, years, and other temporal expressions. It shows how to use prepositions like "in", "on", "at" correctly with time expressions. For example, "in" is used with seasons, months and years, "on" is used with specific dates and days of the week, and "at" is used with times of day. It also lists other time expressions like "twice", "once", "last", "next", and "every".
Este documento presenta una secuencia didáctica para una clase de 6° grado sobre circuitos eléctricos. La clase comenzará con una revisión de conceptos previos y luego los estudiantes usarán un programa de computadora para armar circuitos eléctricos virtuales en grupos de hasta tres personas. Al final, los grupos presentarán sus circuitos ante la clase explicando qué herramientas utilizaron para construirlos.
The film Warm Bodies utilized various promotional strategies including posters showing the romantic plot between protagonists, merchandise like t-shirts and mugs, and an eye-catching trailer with the hashtag #ZombieLove. They also leveraged social media with an official Facebook page and Twitter hashtag to promote to teenagers. Word of mouth spread further with fans discussing the film online and wearing merchandise. Premieres and preview screenings generated revenue and media coverage. Actor Nicholas Hoult appeared on talk shows to bring more attention to the film. Editorial reviews were mostly positive with an average 6.8/10 rating on Rotten Tomatoes.
A STUDY OF STEEL, BAMBOO AND RATTAN AS REINFORCING BARSarjst
The post-first crack residual flexural strength was 41% for BB and SB, while RB was 25%. Moreover, the moment capacities
of BB and RB corresponded to 51% and 21% respectively of the capacity of steel RC beams. The remarkable
gap between the flexural capacities of the natural rebars and that of steel can be traced not only to the tensile strength
but also the weak bonding at the bar-concrete interface. It can be concluded that the bamboo bars are suitable rebars
for non-load bearing and lightweight RC flexural structures, while more pre-strengthening treatment is required more
importantly for rattan for improved interfacial bonding and load-carrying capacity.
This document provides an overview of various latest technologies including nano-technology, sixth sense technology, 4G technology, and blue eyes technology. It describes nano-technology as the study of controlling matter on an atomic or molecular scale and discusses some medical applications. Sixth sense technology is described as a wearable gesture interface that augments the physical world with digital information using hand gestures. It works by using a camera, projector, and mirror coupled in a pendant to capture gestures, process the information, and project images onto surfaces. 4G technology is defined as an extension of 3G providing higher bandwidth and more services through high quality audio/video streaming over the internet. Blue eyes technology aims to build machines that can observe and identify user actions
Brainstorming guidelines include generating as many ideas as possible without criticism, focusing on quantity over quality and encouraging wild ideas. Ideas should be written down as they come and build upon each other while staying focused on the topic at hand, with the goal of combining ideas and recording all suggestions.
1
DOES THE UNITED STATES NEED MORE MIDWIIVES?
Does the United States need more Midwives?
Madison Courtney
Georgetown College
Author Note
This paper was prepared for English 125, taught by Professor Burch
Abstract
Does the United States need more midwives? This is the question this paper will explore by looking at the fact that the US has a very high newborn mortality rate and that we use more OB-GYNs for deliveries than any other country. I find that there is a correlation between OB-GYNs and the high infant mortality rate due to the fact that OB-GYNs are surgeons and they use surgery (cesarean sections) that is a lot more risky than a vaginal birth. Midwives only use surgery when necessary and their less risky tactics lead to lower newborn death rates or labor complications. Therefore, I concluded that the United States does need more midwives.
Does the United States need more Midwives?
The United States newborn death rate is the second highest in the world, this is a fact that many people are unaware of today. With the amount of money the US spends on healthcare, we should not have a rate this high. Because OB-GYNs are used more in the US than any other country, you have to wonder if there was a correlation between the two. After research, I have found a correlation between OB-GYNs and newborn death rate because of labor interventions that lead to cesarean sections. Midwives don’t have the same outcome as OB-GYNs. Midwives aren’t as quick to use interventions and their cesarean section rate is a lot lower than OB-GYNs leading to lower risk labors and therefore a lower newborn death rate. Therefore, the US needs more midwives.
Literature Review
In a documentary by Lake it is said that among 33 industrialized nations, the United States is tied with Hungary, Malta, Poland and Slovakia with a death rate of nearly 5 per 1,000 babies, according to a report from Save the Children (April 2006). This is the second worst newborn death rate in the developed world. The five countries with the lowest infant mortality rates (Japan, Singapore, Sweden, Finland and Norway) midwives were used as their main source of care for 70 percent of the birthing mothers (2008).
Cesarean sections have many more risks than vaginal births. C-sections are more likely to occur because of the interventions during labor. Pitocin is a common intervention that puts the baby in stress during labor, which leads to a cesarean section. OB-GYNs are a lot more likely to use these interventions than midwives. Lewis Mehl-Madrona, MD, PhD, coordinator of Integrative Psychiatry and Systems Medicine at the University of Arizona College of Medicine Program in Integrative Medicine, comparing 1,046 home births to 1,046 hospital births found negative outcomes consistently higher in hospital births. These included a fetal distress rate six times higher in hospitals, a respiratory distress rate 17 times higher in hospitals, babies requiring resuscitatio.
This document discusses the differences between hospital births and home births. It notes that the cesarean section rate in the US has risen dramatically since the 1970s. One woman shares her negative experience with a rushed c-section in the hospital. In contrast, another woman describes her positive home birth experience, immediately bonding with her baby. The document argues that midwife-attended births at home or in birth centers have better outcomes than hospital births in the US, citing lower infant and maternal mortality rates in other countries where midwives attend most births. It questions the American College of Obstetricians and Gynecologists' opposition to home births.
Ruptured ectopic pregnancy in non-communicating right rudimentary horn: A cas...Apollo Hospitals
Rudimentary horn is a developmental anomaly of the uterus, and pregnancy in a non-communicating rudimentary horn is very difficult to diagnose before it ruptures. As the fetus enlarges in the rudimentary horn, the chances of rupture in the first or second trimester are increased. Catastrophic hemorrhage results in increased maternal and
perinatal mortality and morbidity. To date, management of such cases remains a challenge due to diagnostic dilemma. Expertise in ultrasonography and early resort to surgical management are lifesaving in such cases. A case of undiagnosed rudimentary horn pregnancy presented to our department in shock with features of acute abdomen, and the diagnosis was confirmed at laparotomy that revealed ruptured rudimentary horn pregnancy. And excision of the accessory horn was done.
Screening for heart defects in the first trimesterTony Terrones
This document discusses two studies on screening for heart defects in the first trimester of pregnancy. The first study measured cardiac axis in 100 pregnancies between 11-14 weeks and found an abnormal axis in 4 cases that were later diagnosed with congenital heart disease. However, the study excluded women with high BMI and nearly 20% required additional imaging, calling into question its applicability for widespread screening. The second study found measuring ductus venosus pulsatility index could help predict heart defects, but obtaining a clear measurement may be difficult and half of postnatally diagnosed cases were missed prenatally. The document concludes that while identifying high-risk cases early is important, screening also needs to allow for timely diagnostic imaging and accurate diagnosis
This document summarizes two cases that occurred simultaneously in a neonatal intensive care unit (NICU) to illustrate cultural influences on complex medical decision making. Case 1 involved a neonate with severe genetic anomalies born to first cousins from South Asia. Case 2 involved a neonate prenatally diagnosed with campomelic dysplasia born to an unmarried African American couple with an unstable relationship. Both cases involved communication barriers between families and NICU staff due to misunderstandings of cultural and social factors, resulting in delayed care decisions and potential exacerbation of suffering. The document discusses the impact of consanguinity, social and family structures, and suggests strategies for improving communication and decision making in similar complex cases.
The document summarizes stories from two mothers who had babies in the neonatal intensive care unit (NICU) at Richmond University Medical Center. Both mothers went through difficult pregnancies and deliveries, with their babies requiring months of care in the NICU. The mothers praise the exceptional and supportive care provided by the doctors, nurses, and staff in the NICU, who were always available to answer questions and reassure the mothers during their babies' treatment and recovery. Thanks to the care at the NICU, both babies are now thriving one year later.
Case StudyInfections of the Cardiovascular and Lymphatic Syste.docxtroutmanboris
Case Study
Infections of the Cardiovascular and Lymphatic System
Toxoplasmosis……………..Don’t Blame Fluffy!
As part of their commitment to “going green,” Layla and Steve Jackson lived on a small farm in rural northwest Pennsylvania. Steve chopped wood from their forest to burn in their Franklin stove, and about 25% of their electricity was generated by the wind turbines on top of their mountain. They raised almost all of their own food between their small apple orchard, huge vegetable garden, and a berry patch. The couple reared numerous sheep, a few pigs, and one dairy cow. These animals plus the rabbit, turkey, and deer Steve hunted more than covered their meat and milk needs. Although the young couple loved working their farm, to make ends meet financially, they also taught at the local high school. Layla was a 10th grade math teacher and Steve served as both the choral and band directors for grades 7–12. Unless the roads were icy in the winter, the “green team” biked the four miles to work every day. While this lifestyle kept them extremely busy, Layla and Steve felt great satisfaction knowing their carbon footprint was significantly less than that of the average American.
As Layla picked the green beans and weeded around the squash one July morning, she pondered how their lifestyle would change in November when their first child was due to be born. She was pleased to be able to raise their child in the unpolluted environment of their country farm and nourish him with homegrown foods free of the pesticides and preservatives found in many commercially produced items. “Of course,” Layla said to herself while patting her belly, “I think we’ll have to break down and drive a little more this winter. You’ll be a bit too small for my baby bicycle seat.” As if on cue, the baby started “dancing.” Laughing, Layla collected the baskets of produce she had harvested and headed to the kitchen to start making lunch. After rinsing the fresh-picked fruits and vegetables, Layla used her garden’s bounty to assemble a delicious salad and homemade strawberry shortcake with cream from Josie, their cow. Later that afternoon, the couple went to Dr. Schneider’s office for Layla’s monthly prenatal examination. They watched with amazement as the obstetrician used ultrasound to measure the baby’s growth, confirming that Layla was 23 weeks pregnant. Dr. Schneider pointed out different features of their developing child. They saw a tiny beating heart and learned it was time to paint the nursery blue!
Layla’s pregnancy progressed normally until her next appointment at 27 weeks gestation. Dr. Schneider was surprised to find Layla hadn’t gained any weight in four weeks. “At this stage of your pregnancy, you should be gaining about 0.5 to 1 pound per week,” Dr. Schneider said with concern. “Are you eating enough nutritious foods?” Layla was happy to report a healthy appetite that she regularly indulged with the foods she and Steve raised. “I bet it’s the extr.
The document summarizes the renovations made to the birthing center at St. Mary's Hospital. It describes the updated facilities including 13 birthing rooms decorated for the four seasons and equipped with private showers. Medical staff can now monitor patients without leaving the room. The $2.6 million renovations were funded by key donors. The summary also introduces midwifery services now available and their woman-centered approach to care before, during and after birth.
The document discusses the reproductive health challenges faced by populations affected by humanitarian crises. It notes an increase in gender-based violence and pressure on women to have more children to replenish lost populations. This can increase obstetric risks from short birth intervals and lack of access to family planning. Traditional practices increase and the needs of men, adolescents, and minorities are neglected. Loss and trauma can increase risky behaviors. Young, widowed, or disabled women face higher risks. The document outlines the "three delays" model for maternal health care: delay in deciding to seek care, reaching a facility, and receiving treatment. It describes the services and equipment needed at various levels of care.
This document provides information about ectopic pregnancies, including:
- Ectopic pregnancies occur when a fertilized egg implants outside of the uterus, most commonly in the fallopian tubes.
- Risk factors for ectopic pregnancy include previous tubal surgery, infertility, sexually transmitted infections, IUD use, smoking, and more.
- Symptoms often include abdominal pain, vaginal bleeding, and a missed period. Diagnosis involves ultrasound examination, hCG level testing, and sometimes culdocentesis.
- Treatment options are medical management using methotrexate or surgical intervention like laparoscopy or laparotomy. The type of ectopic pregnancy such as tubal, cervical, or heter
Nursing Case study nsvd normal spontaneous deliverypinoy nurze
The document provides details about a case of normal spontaneous vaginal delivery (NSVD). It describes the four stages of labor: stage 1 involves cervical dilation from 0-10 cm over 3 phases; stage 2 is the pushing stage until the baby is delivered; stage 3 involves delivery of the placenta; and stage 4 is the recovery period. It then provides a nursing case study of a 15-year old patient who experienced an unwanted pregnancy from rape and underwent NSVD, including assessments, orders, and progression of labor and recovery.
Agnesian HealthCare, an integrated health system in the southern part of the Fox Vally in Wisconsin, shares provider updates, patient stories, health tips and much more in its Spring 2015 edition.
This document provides information on the history and indications of cesarean section (CS). It discusses how CS has evolved over time from ancient practices to modern techniques. The key points are:
1. CS has been performed for thousands of years by various ancient civilizations but modern antiseptic techniques increased survival rates in the late 19th century.
2. Common medical indications for CS include cephalo-pelvic disproportion, fetal distress, placenta previa, and failure to progress in labor.
3. Rates of CS have been increasing worldwide, reaching over 30% in some countries, due to various factors like previous CS, maternal request, and medico-legal fears. However, high rates
The summary provides an overview of the Teen Conference attended by volunteens at Northside Hospital:
- Two professionals spoke about their careers in medicine, including Dr. Assia Stepanian, a gynecologist and professor who shared her journey from Moscow to working in Northside.
- A session on self-defense techniques was led by the head of security, where volunteens learned defensive moves and reactions.
- A respiratory therapist discussed their important role in emergencies and with various patients, including demonstrating intubation on a fake baby.
- Activities included checking oxygen saturation and a tour led by the Volunteer Manager, where volunteens learned a patient interacts with over 35 staff before surgery.
This document provides information about various classes, blood drives, and events happening at Children's Hospital and in the local community in January, February, and March. It also provides updates on the new neonatal intensive care unit, recognition of the Chief Quality Officer, and a story about a baby who received cooling blanket treatment after a traumatic birth.
USMLE GENERAL EMBRYOLOGY 017 Twins monozygotic monozygotic monozygotic.pdfAHMED ASHOUR
Twins are siblings born during the same pregnancy and are classified into different types based on how they develop.
The two primary types of twins are identical (monozygotic) twins and fraternal (dizygotic) twins.
The experience of having twins can vary, and each pregnancy is unique.
Expectant parents of twins should work closely with healthcare providers to ensure a healthy and well-managed pregnancy.
Medical student aimee alphonso what i learned during my rotation in ghanaArchzilon Eshun-Davies
A Yale medical student, Aimee Alphonso, completed her four-week obstetrics-gynecology clinical rotation in Accra, Ghana. She found the experience confirmed her passion for OB-GYN and taught her important lessons. She observed extreme poverty in Ghana and how it impacted patient care, as family members had to pay for medications and procedures. Doctors worked long hours with few resources but strong relationships between patients and a sense of community supported women's health. The rotation solidified Alphonso's desire to practice OB-GYN and to consider each patient's full context and needs.
Precautions after ivf pregnancy , lifecare centre ,IVF icsiLifecare Centre
PREGNANCY Outcome following
IVF-ICSI
HURDLES IN EARLY PREGNANCY
lifecare IVF centre
lifecare centre ,Multiple Pregnancy
Pregnancy
&
Co-morbidity
obestetric & neonatal outcome following IVF-ICSI
Non-invasive prenatal testing (NIPT) uses a blood test to screen for chromosome abnormalities like Down syndrome early in pregnancy. Some women use positive results to terminate pregnancies or prepare for a child with disabilities, while critics argue it degrades the value of disabled children. Most women (over 90%) terminate if prenatal testing shows Down syndrome. As genetic testing becomes more widespread and affordable, it raises debates around abortion, disability rights, and eugenics.
1. SUNDAYT H E P R O V I N C E . C O M
AUGUST 26, 2012
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in outlying areas
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FINAL EDITION
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Dr. Nancy Mitenko delivers Isabella Marie Truqui by caesarean section at St. Paul’s Hospital Aug. 15. JENELLE SCHNEIDER / PNG
St. Paul’s
babiesOur special series
returns with vivid
coverage in the
maternityward
VAN01098101_1_1
2. beatheart
Inside St. Paul’s
Hospital
Oneminutetheyareone.
In an instant, there are
two.Thesuddencleav-
ing of baby from mother in the
operating room is shocking
and sudden, both frightening
and beautiful.
As the doctor lifts the baby
aloftandeveryoneturnstosee
her,foraheartbeat,itfeelslike
no one in the room is breath-
ing. That is the split-second
magic of a surgical caesarean-
section delivery.
Then the spell is broken as
the little girl fills her lungs and
withherfirstcryexclaims:“I’m
here!”
“Happy birthday, girl, wel-
come to the world,” coos a
nurseassherubsthenewchild
with a cloth.
Her mother, Lorena Truqui,
lies back quietly beyond a
drape, unable to witness this
birth. But tears slip out of the
sides of her eyes as she listens
to her baby.
“I’m so happy,” she tells
her husband, Juan, who has
been at her side soothing her
through the surgery.
“We’re so blessed,” he tells
her, lovingly.
When her just-born seven-
pound girl is brought to her
minutes later and laid on her
chest, the tears fall faster.
“Hi, sweetie. Don’t cry, my
baby,” her mother whispers,
gazing at her daughter.
Isabella Marie reaches out
a tiny hand, opens her eyes
and then instinctively tries to
suckle, hungry for life as well
as food.
■
More than 1,660 babies were
born at St. Paul’s Hospital last
year.Manyofthem,likeIsabel-
la,tooktheirfirstbreathsinthe
operating room.
That’s because St. Paul’s,
unlike other community hos-
pitals, is a centre for treating
anddeliveringthehighest-risk
mothersintheprovince.These
complex cases can involve
heart and kidney disease or
multiple medical conditions
and often require surgical
deliveryforthehealthofmoth-
er and baby.
But those factors aside,
C-sectiondeliveriesareonthe
rise worldwide. The medical-
izationofbirthisafactofmod-
ern medicine.
Last year, more than 371,000
babies were born in Canadi-
an hospitals, according to the
Canadian Institute for Health
Information.About18percent
of Canadian women birthing
for the first time in 2011 had
C-sections. In the 1960s, the
rate was just five per cent.
B.C. has among the highest
primary C-section rates in the
country,at23percent.Among
B.C. women 35 and older, that
figure jumps to more than 28
per cent.
At St. Paul’s, the C-section
rate is higher still.
‘Welcome
to the world’
Safe in the hands of Dr. Nancy Mitenko, Isabella Marie Truqui makes her debut in the world after a caesarean section
was performed on her mother, Lorena Truqui. PHOTOS BY JENELLE SCHNEIDER — PNG
A fierce and
beautiful love
If you want proof of the extraor-
dinary lengths to which women
will go to bring new life into the
world, spend a week in a mater-
nity ward. Here, a steady stream
of women brave pain and illness,
endure weeks of bedrest and diag-
nostic tests, and undergo sur-
gery and sleepless nights — all
to birth their babies safely. They
may end up in intensive care, in
the operating room or have their
newborns sent to intensive care.
But they get through it, drawing
strength from a fierce and beauti-
ful love for a child they have nev-
er met. And every time it gets hard,
the staff of St. Paul’s Hospital are
there: holding their hands, calm-
ing their fears, coaching them
through labour and treating com-
plicated conditions with stunning
expertise. It’s hard work over long
hours, but staff say their job has
its own rewards. Every day, they
bear witness to that perfect, sacred
moment of birth — the stunning
split-second when a baby takes a
breath and announces itself to the
world.
This week, The Province brings
you the intimate stories of new
families created at St. Paul’s and
of the dedicated care that makes
it possible, sometimes against all
odds.
Thisweek:
Thematernityward
Heartbeat is an eight-month special series for which The Province has been granted
special access to St. Paul’s Hospital. The series runs for a week each month until November.
A12 SUNDAY, AUGUST 26, 2012| SPECIAL SERIES | THEPROVINCE.COM
Elaine O’Connor
SUNDAY
REPORTER
eoconnor@
theprovince.com
twitter.com/
elainereporting
theprov.in/
bcwithoutborders
3. In 2011-12, it was 40.3 per cent
forallmothers.Thehospital’spri-
maryC-sectionrate—theelective
procedures of first-time mothers
— for that period is 27.4 per cent.
Butthosehighnumbersbeliethe
unusualcomplexityofmanyofSt.
Paul’smaternitypatients,explains
Dr.ElisabetJoa,headofobstetrics
and gynecology for Providence
HealthCareandchairofSt.Paul’s
renal obstetric clinic.
“It’s higher than most hospi-
tals because we take care of the
really critical-care mothers,” she
stresses.
Also,womennowarebecoming
mothers later and using in-vitro
fertilization methods more fre-
quently, so that maternal age and
multiple births are other contrib-
uting factors to C-section rates.
“As women get older, unfortu-
nately, we labour differently and
not as successfully,” says Joa, who
delivered three of her own five
children at St. Paul’s.
St. Paul’s also offers elective
C-sections — not all hospitals do
— and some women, even when
theyknowthatC-sectionsinvolve
higherrisktothemotherthanvag-
inal deliveries and can result in
complications such as infection
and hemorrhaging, will choose
to go under the knife for person-
al or cultural reasons.
C-sectionscanberiskyforbaby,
too: without the aid of pressure
from labour, their lungs retain
water and often don’t function as
well at birth.
Critics and advocates of natural
childbirth often lay the blame for
high C-section rates on the over-
use of interventions early on in
labour, namely, premature med-
ical induction of labour and the
use of oxytocin to augment con-
tractions, which can stress the
fetus. Obsessive monitoring of
fetal heart rate and the resulting
impeded ability of a woman to
move during labour is also cited,
as is the use of epidurals — pain-
killing spinal injections — which
often stall labour progress.
■
In Lorena’s case, she’s at St.
Paul’s because she’d previously
had C-sections for medical rea-
sons and thought it prudent to do
so again with her third.
Her choice is one most mothers
in her situation make. Although
vaginal birth after caesarean sec-
tion (VBAC) is possible, the over-
allrepeatC-sectionrateinCanada
isanastonishing82percent,with
B.C. just slightly under the aver-
age.It’sclearthatinmanyofthese
casespatientsandphysicianspre-
fer or feel it safer to deliver surgi-
cally.
Lorena had few reservations,
and as she lay in the surgical day-
careunitwaitingherturn,shewas
morefocusedontheendthanthe
means of her daughter’s birth.
“I just kept dreaming all night
about holding the baby.”
Herhusbandwasmorecautious.
“I’m not nervous, but it’s quite an
operation. It’s done every day,
thousands of times a day, but it’s
still major surgery.”
However their daughter came
intotheworld,onceshewasthere,
it was not the surgery on her par-
ents’ mind, but celebration.
The next afternoon, there is a
party in room 20.
The Truquis’ two children are
there to see their newest sibling,
as are two grandparents who’ve
come all the way from Mexico to
meet their ninth grandchild.
The children plaster the room
with hand-drawn welcome signs
that read: “Welcome Bebe.”
“We used to be just four, so it’s
weird to be five,” Anna Paula, 8,
says thoughtfully.
The siblings waste little time
squabbling affectionately over
their newest addition.
“I’m going to burp her,” Anna
says proudly.
“I’mgoingtochangeherdiaper,”
chimes her younger brother, Ian,
perhaps not fully understanding
what he’s in for.
“I’m going to teach her to walk,”
Anna one-ups him.
“I’m going to teach her how to
do the monkey bars,” he shoots
back.
Lorena and Juan smile indul-
gently.
One day Isabella, too, will have
to learn to find her own place in
their family. But for now, swad-
dled and sleeping on her moth-
er’s chest, she’s simply the quiet
centre of it all.
Juan and Lorena Truqui with daughter Ana Paula, son Ian Paul and the newly arrived Isabella Marie
Truqui in the maternity ward of St. Paul’s.
onlinetheprovince.com/heartbeat
Photos videos your feedback
See more stunning photos of
Isabella’s C-section birth
Activity in the St. Paul’s
maternity ward during
the week of TheProv-
ince’s visit Aug. 13-17:
Monday
Total births: 7
C-sections: 4
Boys: 2
Girls: 5
Tuesday
Total births: 5
C-sections: 2
Boys: 4
Girls: 1
Wednesday
Total Births: 7
C-sections: 5
Boys: 3
Girls: 4
Thursday
Total births: 7
C-sections: 3
Boys: 2
Girls: 5
Friday
Total births: 5
C-sections: 1
Boys: 3
Girls: 2
Baby boom
Dr. Elisabet Joa says the C-section rate at St. Paul’s reflects
the high percentage of critical-care pregnancies the
hospital takes on.
SUNDAY, AUGUST 26, 2012 A13| THEPROVINCE.COM | SPECIAL SERIES |
4. It was June of 1961. My mother was
very pregnant with me. My dad was out
of town working as a boilermaker.
A week before I was due, my mother
went into labour. My sister was dropped
off at a neighbour’s house and a friend
took my mother to St. Paul’s Hospital. I
was a breech case and it was a difficult
labour. As my mom was trying to deliver,
she went into cardiac arrest.
When the hospital finally reached my
dad, they told him on the phone they
had called the priest in and were not
sure if she would make it through the
night. My dad got to the hospital as soon
as he could.
Luckily for my mother, she was at St.
Paul’s Hospital.They opened up her
chest while I was being born and mas-
saged her heart.They got it started and
delivered me at the same time.That was
on June 7, 1961. My mom survived and
eventually was able to bring me home.
Needless to say, there are no baby pic-
tures of me.
My formula recipe that the nurses gave
my mother was Carnation evaporated
milk diluted with water and with a tea-
spoon of sugar added.
My mom died of cancer in 1985. I am so
happy I was able to have 56 years with
my mother. If it wasn’t for the doctors at
St Paul’s Hospital, I don’t think she would
have made it.
My husband’s mother was also born
at St Paul’s. Of course, both my children
were born there, too: my daughter Emily
in 1997 and my son Dane in 1999.
Thank you, St. Paul’s Hospital, from
three generations of babies.
— Diana Fiola, Vancouver
Diana Fiola, at about 10 months, with
her mother, Irene Charun.
By Elaine O’Connor
THE PROVINCE
It’s a strange place for a baby to
sleep — in a bassinet hidden in a
cupboard at a busy ambulance
entrance.
But the Angel’s Cradle at St.
Paul’s isn’t meant to offer infants
sweet dreams, rather to give des-
peratemothers asafe place toact
on the heart-wrenching decision
to give up their babies.
The program was launched
in May 2010 at the urging of Dr.
Geoffrey Cundiff, then the hospi-
tal’s head of obstetrics and gyne-
cology, the field he now oversees
fortheVancouverCoastalHealth
region. He’d been troubled by
news reports of a mother who’d
abandoned her dead newborn.
Surely, he thought, there must be
a way to help women who are too
distraught to give their children
up through traditional methods
such as adoption.
Herecalledthefoundlingwheels
usedinthe12thcenturytoaccept
unwantedbabiesandthoughtthe
idea a good match for St. Paul’s
mission of compassionate care.
“It was a good opportunity to
reach women in crisis,” Dr. Cun-
diffsaid.“Thereareotheroptions
out there, but the difference with
this is it allows for anonymity.”
At least one mother agreed.
Because just months after the
Angel’s Cradle opened, one
afternoon in mid-July, someone
opened the door on the outside
ofthehospitalandplacedadays-
oldbabyboysafelyinsidethebas-
sinet, leaving him to his new life.
A minute later, an alert rang out
in the emergency department.
Nurse Kirsten Fuller thought it
wasjustanotherfalsealarm.Para-
medics had been known to open
thedooroutofcuriosity.Butwhen
sheandaco-workerlookedinthe
cupboard, they got a shock.
“There was this beautiful, per-
fect baby boy,” Fuller recalled.
With the baby were bottles, dia-
pers and notes about his birth
date, health and background.
“If you had wanted to trace that
child, it would have been easy
withtheinformationtheyhadgiv-
enus,”Fullersaid.“Butourpolicy
is not to trace them.”
Indeed, Vancouver police have
assured hospital staff they will
not attempt to locate parents of
Angel’s Cradle babies. In Cana-
da, child abandonment is only a
criminaloffenceifthechildisleft
alone in a way that causes inju-
ry or endangers its health. The
purpose of the Angel’s Cradle
— unique in the country — is to
ensure the child’s safety.
“For whatever reason, they
couldn’t look after this child,”
Fuller said. “This was their safe
place to drop him off. But clear-
ly, he was loved.”
Thechildwasquicklyexamined
by paramedics, then taken to the
neonatalintensivecareunit.Staff
camefromallovertogetaglimpse
of the foundling.
“Itwasawholemixofemotions,”
Fullerrecalled.“Wewerehappya
baby had got dropped off healthy
that might have otherwise been
neglected.Weweresadthatbaby
was now going into foster care.”
Severaltroublingcasesofinfan-
ticide and child abandonment
have also made headlines in the
province.ButwhileSt.Paul’sstaff
know they can’t protect every
child,they’regladthey’vehelped
at least one.
“It can’t save every baby,” Dr.
Cundiff said, “but my hope is this
will give us a way to save some.”
eoconnor@theprovince.com
The day an angel came calling
Kirsten Fuller was one of two nurses who found the Angel’s Cradle baby at St. Paul’s Hospital in 2010. The cradle has a door that
can be opened from the outside and is located at the emergency department entrance. JENELLE SCHNEIDER — PNG
Your memories
Do you have a St. Paul’s story? Submit it at
theprovince.com/stpaulsstories
HEARTBEAT CONTINUES TOMORROW
beatheart
Inside St. Paul’s
Hospital
Heart stopped
while baby
was en route
“For whatever reason, they couldn’t look
after this child. This was their safe place to
drop him off. But clearly, he was loved.”
KIRSTEN FULLER—
ST. PAUL’S NURSE
“It can’t save every
baby, but my hope
is this will give
us a way to save
some.”
DR. GEOFFREY CUNDIFF—
REGIONAL HEAD
OF OBSTETRICS AND GYNECOLOGY
SUNDAY, AUGUST 26, 2012A14 | SPECIAL SERIES | THEPROVINCE.COM
5. A12 MONDAY, AUGUST 27, 2012| THEPROVINCE.COM
beatheart
Inside St. Paul’s
Hospital
Spend a week in a maternity ward and you’ll see the
extraordinary lengths to which women will go to
bring new life into the world. Here, women brave pain
and illness, bedrest and diagnostic tests, surgery and
sleepless nights to birth their babies safely. And when
it’s hard, the staff of St. Paul’s are there. This week,
The Province tells the intimate stories of new families
created here and the care that makes it possible.
ELAINE O’CONNOR
THE PROVINCE
T
he day after giving birth to
her first child should have
been one of the best days of
LindsayEpp’slife.YetfortheLad-
ner mother “it was the worst day
of my life. It was horrible.”
Instead of cuddling her new-
bornbabygirl,AnnaMarieGrace
Epp, mother and baby were split
apart due to separate medical
emergencies.
Epp developed a life-threaten-
ing condition called HELLP syn-
dromeandwassenttotheinten-
sive-care unit at St. Paul’s, while
herdaughterstruggledtobreathe
andwastransferredtoB.C.Chil-
dren’s Hospital.
Epp had already been at St.
Paul’sonbedrestforweeksdueto
high blood pressure and a risk of
pre-eclampsia, a form of hyper-
tension. Her baby was delivered
prematurely by C-section at 34
weeks and was sent to the neo-
natal intensive-care unit.
But because her lungs were so
immature, she needed to go on
a ventilator, which required a
transfer to a higher-level NICU
at Children’s Hospital (a Level 3
NICU; St. Paul’s is Level 2).
That same day, her mother’s
systems started to fail. HELLP
syndrome involves a cascade of
symptoms:hemolysis(thebreak-
down of red blood cells), elevat-
ed liver enzymes and low blood
platelet count. The condition
occursinjustoneortwoofevery
thousand pregnancies. Women
often present with simple head-
aches, nausea and vomiting, but
theconditioncanleadtohemor-
rhaging and liver failure.
With the expertise of St. Paul’s
staff, Epp was stabilized and dis-
charged on Aug. 4, finally able
to travel to visit her daughter.
Her baby’s breathing improved
enough for her to come back to
St. Paul’s four days later.
OnlyEpp’shealthtrialsweren’t
over. On Aug. 10, she suffered
excessive postpartum bleeding
andhadtoundergoanemergen-
cy procedure.
“It’satoughone,”chiefmaterni-
tyresidentDr.MinaWesasaysof
theneedtoseparatesickmothers
from their infants. “A big part of
our discharge planning and the
goal of our patient care is mini-
mizing the separation between
mom and baby.”
Watching Epp calmly rock her
four-pound, five-ounce girl and
caress her wispy gold hair in
the NICU days later, it’s hard to
imagine the tribulations they
suffered to be together.
“She was worth every moment
ofhorribleness,”Eppsays,gazing
at her fragile daughter adoring-
ly. Having her safe, she says, “is
an incredible joy. There are no
words. I would do it all again in
a heartbeat for her.”
■
As frightening as Epp’s ordeal
sounds,treatingdesperatelysick
mothers like her is routine at St.
Paul’s.
“We take care of the high-risk
mothersintheprovince,”explains
maternity and NICU operations
leader Jackie Koufie.
There is certainly no shortage
of cases. In their daily morning
meeting, maternity doctors and
residents troubleshoot the preg-
nancies of women with multi-
ple complications, among them
patients with heart disease, dia-
betes, arthritis and pacemak-
ers. The residents speak in cryp-
tic code; acronyms fly. It sounds
every bit like the script of a med-
ical drama.
But these cases are very real
and in some cases these moth-
ers’conditionsarelifeanddeath
matters.
Todealwiththem,St.Paul’shas
establishedanumberofspecial-
ized clinics that bring specialist
care and additional oversight to
bear on their pregnancies.
Amongthemareinnovativecar-
diac obstetrics and renal obstet-
rics clinics, where patients are
referred from across the prov-
ince.
“It’s very frequent that patients
withheartdiseasehavebeentold
thattheycan’tbecomepregnant,”
sayscardiacobstetricclinicdirec-
B.C.’s haven
for sick moms
Lindsay Epp kisses daughter Anna in the neonatal intensive-care unit. Both mother and
baby had medical emergencies after Anna’s birth. JENELLE SCHNEIDER PHOTOS/PNG
Little Anna Epp’s wrists are as
thick as her mother’s fingers.
Heartbeat is an eight-month special series for which The Province has been granted
special access to St. Paul’s Hospital. The series runs for a week each month until November.
6. A13THEPROVINCE.COM |MONDAY, AUGUST 27, 2012
“I rarely get the simple consultations. Most patients who see me have three or four medical problems.”
— Dr. Duncan Farquharson
Dr. Marla Kiess listens to the heart of Sarah Bare, 27,
who is pregnant and suffers from tachycardia.
ELAINE O’CONNOR
THE PROVINCE
Sarah Bare’s heart is racing, and it’s
not because she’s nervous about her
first pregnancy.
The 27-year-old suffers from tachy-
cardia — an inefficient, rapid heart-
beat that reduces blood flow to the
body — which came on unexpected-
lyin2009duringabreathlessepisode
at work.
Luckily, the Squamish resident —
herself a trained cardiac care nurse
— was working in an Edmonton hos-
pital at the time. She knew enough to
gototheemergencydepartment,and
they found her heart racing at up to
180beatsperminute.Foranadult,100
is the upper threshold for normal.
Her condition was controlled with
medication,butBareworrieditwould
bar her from having a family.
“My doctor always said there might
beanissuegettingpregnant,”shesays,
sitting in an exam room in St. Paul’s
cardiac obstetric clinic with her hus-
band, Bryan, by her side.
So she was referred here, and her
baby,nowgrowingwelland21weeks
along, is being carefully monitored.
With this clinic, cardiologists Dr.
Marla Kiess and Dr. Jasmine Grewal
are helping mothers with heart con-
ditions who would once be warned
against pregnancy to fill their hearts
with joy.
“It’s kind of a unique area,” says
clinic director Dr. Kiess.
These days, women with heart dis-
ease, women who have had heart
attacksorcongenitalheartmalforma-
tions or even past transplant recipi-
entscangivebirthsafelywiththeright
kind of care — something unheard of
agenerationago,whensuchpregnan-
cies could be fatal.
“Ithinkthatwe’vereducedthemor-
tality rate since we started the clinic,”
Dr. Kiess says proudly. “We’ve defi-
nitely seen a significant reduction in
the number of complications.”
The cases they see are remarkably
complex. Some women have pulmo-
nary hypertension, a condition with
a mortality rate of up to 50 per cent.
Others will need valve replacement
surgery before pregnancy.
In rare cases, they have even per-
formedheartsurgeryonwomenwho
are pregnant, although the hospi-
tal stresses that this happens only in
extreme cases where circumstances
absolutely necessitate it.
The clinic runs three times a month
andhasbeengrowingquickly—they
have seen some 400 patients from
acrossB.C.overtheyears—butitruns
on a shoestring.
With more funding they’d like to
expand to help more women like
Bare, who, with luck and with extra
care from St. Paul’s, will get the gift of
a healthy baby boy this December.
Heart problems not the
barrier they once were
torDr.MarlaKiess,whofounded
the program in 2004. “And that’s
generally not the case.”
Obstetrician Dr. Elisabet Joa
established a similar clinic for
renalpatientsin2010withneph-
rologistDr.MonicaBruner,help-
ingaboutadozenwomendialy-
sispatientsandtransplantrecip-
ients achieve healthy pregnan-
cies each year.
Maternal fetal medicine con-
sultant Dr. Duncan Farquhar-
son monitors women with con-
ditionssuchasobesity,diabetes,
advanced maternal age, a histo-
ryofmiscarriage,geneticcondi-
tions and hypertension, as well
as those with heart and kidney
issues.
“Irarelygetthesimpleconsul-
tations. Most patients who see
me have three or four medical
problems,” says Dr. Farquhar-
son, who has spent 30 years
in obstetrics.
Many of the women he sees
arealiveduetoadvancesinfetal
medicine a generation ago.
“We see so many women now
who would not have been able
to achieve a pregnancy 20 years
ago,” he says. “Now some of
those fetuses I saw are becom-
ing moms, so full circle.”
As part of their care plan,
almostallthesehigh-riskmoth-
erswillvisitthefetalmonitoring
clinic, where nurses attach sen-
sors to their bellies and listen to
theirbabies’heartratestoensure
theyarefaringwelldespitetheir
mothers’ health issues. Patients
visit regularly, in the most seri-
ous cases even several times a
week,togiveclinicianstheassur-
ance they need.
“These ladies are the ones
who have pregnancy-induced
complications, for example,
gestational diabetes, gestation-
al hypertension, obese patients,
post-dates patients . . . it’s a very
busy clinic,” says nurse Roman
Djene.
Because of its high-risk
patients,thecliniccanbeahigh-
stakes environment.
Onewoman,Djenesaid,came
inforroutinefetalmonitoringat
34weeksonherlunchbreak.Her
strips were abnormal and she
needed a STAT C-section. So
much for returning to work.
■
Desiree Gano likely owes her
life to the specialized care at
St. Paul’s.
The 39-year-old mother had a
baby boy, Jonree Nathan Gano,
via C-section at 35 weeks ear-
lier this month, and she’s still
recovering. But she’s not in the
maternityward.She’sinthecar-
diaccareunit,onacarefulcock-
tailofmedicationthatiskeeping
her potentially life-threatening
condition — pulmonary hyper-
tension — in check.
She was diagnosed after com-
plaining of shortness of breath
in July. Her condition can be
fatal for pregnant women and
their babies, and Gano, who
had no history of heart disease,
is extremely lucky it was caught.
“I was shocked,” Gano said of
herdiagnosis,whichwillrequire
follow-up care. “My first preg-
nancy was normal, no prob-
lems.”
The nurse brings in her four-
pound, nine-ounce baby from
the NICU for his feeding and
Gano carefully holds a tiny bot-
tle to his lips, cradling him in
herarms,whicharestillcovered
in IVs.
“You’re a good boy, my baby”
she murmurs down at himas he
sucks. Then she turns him over
and gently pats his back until he
gives up an adorable burp.
Gano smiles.
“He’s cute.”
eoconnor@theprovince.com
twitter.com/elainereporting
onlinetheprovince.com/heartbeat
Photos videos your feedback
Desiree Gano’s son Jonree gets a cuddle from his mom, who
was diagnosed with pulmonary hypertension while pregnant.