Communicating Your Way Through Pregnancy

“A grand adventure is about to begin.” –From Winnie the Pooh, by Alan Alexander Milne

As we all know, life has its ups and downs, and emotional states are in constant flux. There is never a guarantee that moments of bliss shall endure, but there is always the possibility that joy may arise from the depths of any sadness.  Life produces very few moments with an emotional clean slate, let alone an event that starts from its highest pinnacle. There is one instance, however, that provides a nearly universal potential for happiness, that moment you hear the words: “You’re going to have a baby.”

When most people first hear this news, they experience euphoria, full of the richness of what the future holds.  First steps, spelling bees, little league games, and valedictorian speeches all serve to mark the way in the minds of the parents for the creation and maturation of this newest addition.  Gender is guessed, family and friends are notified, names are discussed. Excitement rules the day.

Then, suddenly, the second wave hits.  The one in which parents turn to one another and ask: “What do the next nine months hold in store?” This is where panic sets in.

Pregnancy should be one of the happiest periods in a couple’s life, a time to build upon the bonds of commitment and forge new traits within their relationship as they learn together what it means to become parents. All too often, however, the stress brought about by uncertainty of what is to come, changes in the roles within the family, and questions raised by advances in modern medicine can place undue stress on a partnership, just when it most needs a strong foundation on which to build.

As a hospital administrator and expectant father, I have had the privilege of witnessing the stages of pregnancy from both a medical and personal viewpoint. What follows are tips I have learned in my attempt to maintain an even keel both in my own mind and in my relationship with my wife throughout the challenging, often tumultuous process of creating a child.

Work Together in Separate Roles

Though expectant parents often focus on the mental and physical trauma of delivery, pregnancy is an endurance run, not a sprint, and it is important to set the stage early for a relaxed and healthy overall experience.  One of the keys to maintaining as happy and stress-free a pregnancy as possible is to remember that a positive outlook goes a long way toward reducing the hills and valleys inherent in the journey.  To do so, it is imperative for each partner to communicate his or her needs and respect the changes in the other that begin to take place as new roles are defined and redefined throughout the coming months.

From the moment the good news is handed down each parent assumes a specific persona, one which may last a full nine months. Incorporating as they do the physical as well as the mental, women undoubtedly face the greater challenge. Nesting, mood swings, and cravings are all part of the biological process, which can be difficult to understand from the outside looking in. A wise man would do well to remember that his partner’s hormones are in flux as her body regulates itself to accommodate another life force. Though they may make her moods a bit quixotic, this is an essential step in the process of creating a healthy child, and its effects are temporary.  What is needed now is patience, plain and simple.

To this effect, the father-figure must try to recognize and accept that though his part in the pregnancy is largely secondary, it is by no means unnecessary.  While the father-to-be will never fully realize the physical trauma of childbirth, this is no reason to discount him or send him shuffling off to the waiting room.  Many men of today who are used to some semblance of control now find themselves forced to the sidelines just as they want desperately to take as active a role as possible, which can easily result in frustration and feelings of being superfluous.

While his role may not be as instrumentally “hands-on” as that of the female, the male is largely responsible for providing, even during the early stages.  This is not limited to the traditional notions of food and shelter, mind you, but includes comfort, understanding, and creating a feeling of security for the mother that is in many ways essential to the smooth development of the child.  For their part, expectant mothers should keep in mind that it is not their partner’s fault that they alone must carry the child.  When you feel compelled to yell at him because you’re doing all the work, Mother Nature just smiles.

Go Easy on the Research

As in all things, it is good to be prepared when entering pregnancy.  Understanding what lies ahead can go a long way toward warding off irrational fears and maintaining a level head throughout.  However, the Modern Age has placed so much information at the click of a mouse that Wives’ Tales now rub elbows with medical certainties at virtually every turn, and it is nearly impossible to know who or what to believe.  Even the most casual web surfer can find something to worry about in a matter of seconds, and a research-oriented prospective parent can find contradictory evidence to practically any argument or study with a few quick queries.

To maintain a level head, there is no harm in talking with your partner about your mutual expectations for the process and begin your research early.  By finding a few sources or authors whose philosophies and principles suit your own or come reasonably close, and sticking with them, you can greatly reduce the fear factor that necessarily comes along with such an important life event.  When it comes to the philosophy of childbirth, too much information can have a crippling effect on the prospective parent, adding undue emotional stress at the worst possible time.

Trust Your Doctor

For most of us, gone are the days of local midwives, hot water and torn bed sheets. Advances in medical gynecology and obstetrics have greatly increased the chances of giving birth to a healthy child or saving one who is potentially in danger.  And yet, in some respects, this very progress comes with its own set of worries, which can compound as the big day draws nearer and overwhelm even the most level-headed parent-to-be.

With so much at stake, it is only natural that prospective parents fear the worst.

Nowadays, couples in the first months of pregnancy find themselves confronting an array of diseases they have never before encountered.  The science of fetal testing has advanced so rapidly that an OB/GYN can give a couple estimated chances on a number of conditions by simply factoring the age of the mother against the results of a few minimally intrusive tests.  While these statistics are meant to inform the parents and warn them in the unlikely event of potentially life threatening conditions, the numbers often get buried beneath the newfound paranoia of a couple who has just learned that they are expecting.  At this point it is important for partners to talk over concerns with one another and then address these issues with their doctors. Should you and your mate feel overwhelmed or confused by the information presented to you, listen to your physicians and follow their lead.  Though this may be your first time down this path, rest assured they have done it all before, and their primary goal is to make sure mother and baby are healthy throughout each stage.

As the big day draws nearer, keep in mind that modern medicine has also come a long way in combating infection and improving conditions for birth. While the maternal instinct has remained constant over time, medical science has made great strides in learning how to control many of the most important variables in delivery, thereby greatly reducing risk.  Though in the end the process itself is more or less the same as it was for your great-great-grandparents, now is no time to harbor the fears of a pioneer.

Take it Step by Step

The nine months of pregnancy are convoluted, to be sure, and often involve navigating unfamiliar territory.  For this reason it is important for partners to counterbalance one another when paranoia or fear sets in. To best do so, focus on all stages, not just the upcoming delivery.  By breaking the process down into manageable steps, a path is made clear and the big picture does not seem nearly as daunting. What’s more, when you go through each stage of the process together, the bond at time of delivery is apt to be that much stronger.

Each trimester offers a new set of questions and presents a new round of decisions to be made, from whether or not to receive certain tests to scheduling maternity leave to debating c-sections versus natural birth. Whenever possible, talk over each subject and weigh the options together. The psychological bond between parents is in many ways as important to the child’s future well-being as the physical bond is between mother and unborn child.

When at last the time comes and the expectant mother is on the hot-seat, it is of great consolation to her to see her partner’s face and hear his voice as delivery begins.  Often, the reassurance of knowing that she is not alone during this life–changing experience can go a long way toward bolstering her spirits for the grueling yet rewarding task that she must physically undergo by herself.  Never more is the union between two people so apparent as in that one joyous instant in which you and your partner realize that life will never be the same.

This article was originally posted on PBS This Emotional Life.

Report On Seismic Safety For California Hospitals

California’s Office of Statewide Health Planning and Development (OSHPD) published a status report on hospital seismic compliance for California (pursuant to SB 499). The preliminary results indicate that 80 percent of California hospitals with buildings considered “at risk” during a major earthquake will meet the state-mandated building standards by 2015.

According to the report, 129 hospitals with 403 buildings will meet California’s seismic requirement by January 2013. Another 55 hospitals with 153 buildings will follow by 2015. OSHPD has a disclaimer on its website that some information may require updating. OSHPD has committed to work with the Hospital Building Safety Board to conduct a complete analysis of the reports. OSHPD will allow hospitals to correct any errors in their data.

The full report can be found HERE.

The Opposite of Healing

Capital punishment (also known as the death penalty or execution) is the infliction of death upon an individual as a punishment for an a specific crime.

Currently 58 nations actively practice it, and 95 countries have abolished it. The following are the most common methods of capital punishment in American History.

Lethal Injection: State laws provide: “The punishment of death must be inflicted by continuous, intravenous administration of a lethal quantity of an ultrashort-acting barbiturate in combination with a chemical paralytic agent until death is pronounced by a licensed physician according to accepted standards of medical practice.”

The protocol for lethal injection includes three separate injections: sodium thiopental or sodium pentothal (rendering the individual unconscious); pancuronium bromide (a muscle relaxer and paralytic agent); and potassium chloride (causing cardiac arrest). Notwithstanding this trifecta of injections, each by itself is lethal.

In 1888, lethal injection was first considered (but rejected) in New York. In 1977, Oklahoma became the first state to use lethal injection. Texas had the first execution in 1982. Today, 16 states and the federal government authorize lethal injection as the only way to enforce the death penalty, and 20 other states as the primary method of execution.  Between 1976 and 2008, approximately 85% of executions were by lethal injection.

Electrocution: By law this method provides: “The sentence shall be executed by causing to pass through the body of the convict a current of electricity of sufficient intensity to cause death, and the application and continuance of such current through the body of such convict shall continue until such convict is dead.”

Death by electrocution typically requires the use of a wooden chair with restraints and connections to an electric current. The cycle for electrocution starts with about 2,300 volts (9.5 amps) for eight seconds, followed by 1,000 volts (4 amps) for 22 seconds, followed by 2,300 volts (9.5 amps) for eight seconds. Complications are not uncommon.

New York was the first state to use this method in 1888. It was the most common method of execution between 1930 and 1980. Today, only Nebraska uses electrocution as the sole method of execution, and 9 other states provide this option. Between 1976 and 2008, 14.0% of executions were by electrocution.

Lethal Gas:  State laws provide: “The punishment of death must be inflicted by the administration of a lethal gas.”

This method uses a steel airtight execution chamber, equipped with a chair and attached restraints. Cyanide pellets are placed  in a container beneath the chair. Death generally occurs between 6 and 18 minutes. Finding its origin in World War I, Nevada was the first state to use this method in 1924. Before 1999 when it was no longer used, this method was used 31 times.

Hanging: Hanging is the oldest method of execution in the United States, but there have been only three executions by hanging since 1977. It is the lethal suspension of a person by a ligature.

Firing Squad: The traditional firing squad is made up of three to six shooters per prisoner. Shooters typically aim at the chest. The Utah statute provides: “If the judgment of death is to be carried out by shooting, the executive director of the department or his designee shall select a five-person firing squad of peace officers.”

In recent history only two people have been executed by firing squad (1977 and 1996, both in Utah). Only 3 states (Idaho, Oklahoma, and Utah) currently authorize shooting as a method of execution.

Lost Hospital — DC General Hospital, Washington, DC

The Washington Infirmary was the first public hospital established in 1806. The facility moved its location in 1846 (known as the Washington Asylum at the time).

The hospital housed the city’s indigent patients, as well as serving as a work house for convicted criminals (for minor crimes).

Over the years DC General Hospital was a smallpox hospital, a quarantine station, a disinfection plant, and crematory. In 1922, Gallinger Municipal Hospital was built at the location, and in 1953 officially changed its name to District of Columbia General Hospital.

DC General Hospital closed in May 2001 after serving the community for almost two hundred years. Although hospital inpatient services ended in 2001, the campus still offers a variety of services such as a Women’s Services Center, Detoxification Center, and Southeast Sexually Transmitted Diseases Clinic. The city Jail is located to the south of this historic health care facility.

Before DC General Hospital closed, those wishing to keep the hospital open made the following arguments against its closure:

  • The hospital was strategically located in the eastern half of the city, which was an area already feeling the impact of other hospital closings.
  • Closing the hospital would increase the risk of shortages in the city’s ability to deliver health care.
  • Closing the hospital would create even greater problems in the future, as it would deprive the city of having the right hospital in the right place.

When DC General Hospital closed, many questioned the future of public hospitals in cities across the United States.  A July 2001 article in Health Affairs offered the following:

Public general hospitals like Bellevue (in New York City), Philadelphia General Hospital, and Boston City Hospital were once staples of urban America. Bellevue remains active today, but Philadelphia General closed more than twenty years ago, and Boston City has melded into the quasi-private Boston Medical Center. The expense, complexities, and “marketization” of health care have combined to cause cities to consider alternatives to the public management of large medical centers. Protracted debate over the closing of D.C. General Hospital in the nation’s capital is the latest high-profile battle over a public hospital. Paul Offner, a former health care finance commissioner, writes of his skepticism about the public hospital as the best buy for local taxpayers—a position that seems to have influenced subsequent events in Washington. As the CEO of Denver Health and a thirty-year veteran of public hospitals, Patricia Gabow writes from a very different vantage point. Civic will and clinical commitment, she argues, are the key ingredients to making a public hospital work. Where they exist together, public institutions can be powerhouses of service, education, and research.

District officials closed DC General Hospital because they could no longer afford to keep it open. At the time this was, and continues to be, a common pattern across the country.  In the seven years before DC General Hospital closed, the number of facilities with emergency departments decreased by 15%.

The FDA Discusses the Future of Electroshock Treatment

Next week the United States Food and Drug Administration (FDA) will meet to discuss the future of electroshock devices, whether to downgrade the restrictions on its use or make the treatment more available. Each year an estimated 100,000 Americans undergo the treatment for major depression and other conditions. Two-thirds of these patients are women.

Electroshock therapy is a historically controversial, psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect.  The American Psychiatric Association and other leading experts are recommending that the FDA downgrade the devices, making the now “high-risk” treatment “medium-risk.”  If this occurs, equipment for such treatment would be regulated like syringes and surgical drills.

According to Dr. Matthew V. Rudorfer, a psychiatrist and top specialist at the National Institute of Mental Health: “These tend to be mom-and-pop operations. So I think the dilemma might be that undergoing new expensive clinical trials might be too expensive.” According to Vera Hassner Sharav, president of the Alliance for Human Research Protection, an advocacy group in New York: “It’s all trial and error — it’s all experimental. All the years it’s been controversial and there have not been clinical trials. Why not?”

The FDA review was recommended by the U.S. Government Accountability Office in 2009 as part of an examination of the treatment’s regulatory status, as well as other less controversial medical devices (such as pacemaker electrodes and implanted blood access devices).

More information about the FDA’s review can be found at

The Living Dormant: MicroZombies

There’s life.  There’s death.  And there is dormancy. Somewhere in between a zombie and a hibernating bear, dormant microorganisms potentially have a profound impact on the natural environment.

A recent study in Nature Reviews: Microbiology examines the cellular mechanisms that allow these microbes to exist in a dormant state.  The study also explores the impact these dormant microbes can have on larger ecosystems, including the ground, the oceans, and humans.

Study author Jay Lennon, Michigan State University assistant professor of microbiology and molecular genetics, explained:  ”Only a tiny fraction is metabolically active at any given time. How would our environment be altered, in terms of carbon emissions, nutrient cycling and greenhouse gases such as nitrous oxide, by dramatic increases or decreases in the dormancy of microbes?”

“Dormancy” has properties of low metabolic activity, and it is considered a reversible state. Organisms sometimes enter into this state in response to freezing temperatures or lack of food. These organisms do not follow a linear growth pattern, and dormancy could occur at any time.

Lennon added: “However, it does take a certain level of commitment, a certain energy investment to make it happen. Just as people don’t run out and winterize their homes if it gets cool in August, microbes want to be sure that truly hard times have set in before shifting into a dormant phase.”

Lennon and his co-author, Stuart Jones at the University of Notre Dame contend that 90 percent of microorganisms in the ground are usually dormant and only half of bacterial species are active, creating an enormously large “seed bank” that could have profound implications.  According to Lennon: ”The idea of a microbial seed bank is a rather novel concept, but from our research we found that dormancy and seed banks are prevalent in most ecosystems. What’s fascinating is that there’s only a small fraction that are active, which means there’s a large reservoir that could potentially be activated at any given time.”

Among other things, the authors contend that dormancy may explain the sudden outbreak of diseases, triggered by environmental changes.  Lennon noted:  ”One-third of world’s population carries dormant tuberculosis microbes. Obviously, you can live a long time with the dormant cell in your body, but it’s important to understand what can trigger its reanimation or what maintains its dormancy.”

Rodents: Uninvited Winter Guests

This time of year we should all be vigilant in our battle against influenza. The winter months, however, bring additional health concerns from some little creatures who roam freely throughout our communities and inside an estimated 21 million homes. This threat comes from rodents.

Rodent infestation can contaminate food sources, especially since rodent feces can spread Salmonella and Hantavirus. Food contamination aside, rodents can also bring lice, fleas, ticks, and mites into the home. And if that was not bad enough, mice can cause extensive damage to homes by  gnawing on wood, walls and wires.

According to Missy Henriksen, vice president of public affairs for National Pest Management Association, Inc. (NPMA): “Rodent infestations are cause for concern because not only do they pose risks for your home, but for your family’s health and safety as well. It is crucial to take steps to prevent rodent infestations and to recognize the signs that you might have one.”

NPMA offers some tips to identify and avoid rodent problems this winter:

  • Inspect wires, insulation and walls for any signs of gnaw marks, which may indicate an infestation.
  • Store boxes and containers off of the floor and organize items often to prevent rodents from residing in undisturbed areas.
  • Install gutters or diverts to channel water away from your home.
  • Seal cracks and holes on your home’s exterior, including areas where utilities and pipes enter.
  • If you find rodent feces, hear sounds of scurrying in the walls or observe other signs of an infestation, contact a licensed pest professional to inspect and treat the pest problem.

For additional information, visit the NPMA Website.

Rodents: Uninvited Winter Guests0

This time of year we should all be vigilant in our battle against influenza. The winter months, however, bring additional health concerns from some little creatures who roam freely throughout our communities and inside an estimated 21 million homes. This threat comes from rodents.

Rodent infestation can contaminate food sources, especially since rodent feces can spread Salmonella and Hantavirus. Food contamination aside, rodents can also bring lice, fleas, ticks, and mites into the home. And if that was not bad enough, mice can cause extensive damage to homes by  gnawing on wood, walls and wires. … Read more →

The World’s Largest Hospital — Chris Hani Baragwanath Hospital in South Africa

Chris Hani Baragwanath Hospital in South Africa is the largest hospital in the world. Located southwest of Johannesburg, the Hospital expands over 173 acres, consists  of 429 buildings, and has 2,964 beds.

The Hospital is the only public hospital providing medical care to approximately 3.5 million, and as a specialty hospital, patients travel there from all over the country and the surrounding African nations. The hospital employs almost 5,000 people, including 600 doctors and 2,000 nurses.

Patients pay according to income and marital status, with approximately 80% classified as “hospital patients”. There is no charge for maternity cases and all children under the age of 6 years old. Approximately 20% of patients are classified as “private patients,” which include medical aid plan members.

The Hospital dates back to 1939 when there was a great need to treat a backlog of patients in the British Empire, including military personnel. In September 1940, the Secretary of State in London formally asked the South African Government to provide health care facilities for the Imperial troops under command in the Middle East.  Two hospitals were suggested, and in November 1941 one was constructed near Johannesburg. The British Government paid 328,000 pounds for 1,544 hospital beds, and they named the facility “The Imperial Military Hospital, Baragwanath.”

Due to an urgency created by the Second World War, the Hospital admitted its first patients in May 1942, with an official opening in September 1942. The Hospital originally treated the casualties of the war, mainly from the Middle East. Toward the end of the war, the Hospital treated mostly Tuberculosis patients.

After the war, the South African Government had bought the hospital for one million pounds. Over the next 30 years the Hospital grew in size and status to its nearly 3,000 hospital beds today. In 1997, the hospital name changed to “Chris Hani Baragwanath Hospital” after the murder of the prominent activist, Chris Hani.