The other day I was asked if I expected an increase in the number of babies that I will be delivering in 2009 and I said “Absolutely, I expect an Obama baby boom.”

Now this is a topic that I know a lot about. Pregnancies come in cycles. I mean let’s face it, some pregnancies are accidental, some pregnancies are planned. But the trend has always been that life-changing events tend to bring people together. And you know what happens when we bring people together―nine months later, we have a blessed child.

I don’t know what it is about these life-changing events―maybe fear or euphoria is the most attractive indicator―but nonetheless, as someone who runs a hospital that delivers more than 6,000 babies a year, I have a pretty good idea when we can expect our birth rates to go up.

Now let’s talk about those life-changing events. Politics in and of itself does not make a very sexy scenario to plan a pregnancy. But I can go as far back as 1961 with the election of John F. Kennedy to tell you that following his election cycle, we saw an increase in births. The last four Republican presidents have also seen a spike in the birth rate during their presidencies. So if the trend continues, I do expect president-elect Obama to give us a significant increase in the national birth rate.

However, I think that this Obama baby boom might be more significant than others. The reason? There are two key factors president-elect Obama is bringing to the table that we have not seen on a national level in many years. Number one: Obama has such a positive optimism in some of the changes he has offered, which have resonated in the psyche of many Americans. And two: One of the top priorities on president-elect Obama’s agenda that he would like to try to accomplish in the early phases of his presidency is healthcare reform.

So I hope that president-elect Obama sets his sights on women’s healthcare with a focus on giving women the access to prenatal care that they truly deserve. Yes, this is going to be “change that you can believe in.”

Do you avoid two-piece bathing suits and cover up entirely when you go to the beach or pool, because of aggravated red stretch marks on your abdomen?  Do you avoid certain clothing styles because you don’t want people seeing the silvery stretch marks that appear on your upper arms or décolletage? It doesn’t have to be that way anymore!

Why do I have stretch marks?

Stretch marks are the result of a loss of the body’s normal structural components, including collagen and elastin.  There are five main causes of stretch marks:  pregnancy, growth spurt during adolescence, heavy weight lifting, extreme weight gain/weight loss and medications such as steroid creams or oral steroids. Unfortunately, genetics are also responsible for determining whether you’ll develop them.
  
How can I prevent stretch marks?

Prevent stretch marks during pregnancy by keeping your skin well moisturized at all times.  If you’re genetically susceptible to stretch marks, stay away from oral steroid medications as much as possible and don’t use potent topical steroid creams for conditions like psoriasis and eczema for prolonged periods.
  
What can be done about stretch marks?

While stretch marks have been difficult to treat in the past, we are fortunate to be in an age where there are finally some great treatments available.  There is no magic wand, but now we finally have options that are effective in diminishing the appearance of unwanted stretch marks.  Only topical vitamin A derivatives like Retin-A or Tazorac have shown to be effective in improving the appearance of stretch marks.  However, we do have some new and exciting laser-based technologies, such as the new generation fractional lasers, which after one-to-three treatment sessions can markedly improve the depressed skin, whiteness and redness associated with stretch marks.

Other laser technologies, including pulsed dyed lasers and advanced light source technologies, have also proven helpful in making stretch marks much less visible – giving back the confidence needed to wear that bikini on any upcoming vacations.

Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at www.sadickdermatology.com.

After reading the story about the couple in Arkansas that is suing the doctor and hospital because the wife became pregnant and miscarried after her husband had undergone a vasectomy, I understand how a patient could get upset and disappointed about having had that outcome happen to them.

But I’m also disappointed by the fact they’re rushing to sue the healthcare establishment for negligence and defamation and are seeking unspecified monetary damages.

Now, I don’t know of any procedure that is risk-free. If you go up and down the medical literature, you will always find that there is certain percentage of patients that will experience complications and/or contribute to failure rates. Therefore it seems that we must always sue any doctor who has a complication or a failure in the procedure.

My friends, if this trend continues, we will further weaken our healthcare system.

If you read medical articles written on failure rates of vasectomies, you will find that each and every one of them quotes a small but real risk of a subsequent pregnancy. I think that many folks hear “small risk” and somehow translate it into “no risk.” Failure to communicate this type of information to patients does represent a negligent act on the part of the physician, but if the information is given, then there is a mutual responsibility among doctor and patient of understanding the reality of medicine. A vasectomy can fail within the first 3 months after surgery, and even though the chances are much less, it can also fail one year after surgery.

Yes, I know I don’t have all the facts in this case, but let’s be fair about what medical science is: not always perfect.

Last week, I hosted a charity art auction in the Hamptons to benefit United Cerebral Palsy.  In addition to raising funds, this event helped spread the word about what can be done to prevent birth defects.  As the father of three, I know there is nothing more wonderful than a healthy new baby, but unfortunately, not all babies are born that way.   

The good news is that today, there are things that pregnant moms can do to increase their chances for a normal, healthy little one and that means carrying their baby to term.  Pre-term, low-weight babies (PLWB) who are born before their time are at much higher risk for a wide variety of mild to severe health problems because they have not had time to fully mature.  These include everything from minor developmental and motor disorders to cerebral palsy and other problems, some of which can be fatal. 

Most pregnant women know that smoking, alcohol consumption and drug use are risk factors that science has shown contributes to PLWB.  Recently researchers have cited a new culprit –periodontal disease.   Studies show that pregnant women with this condition (which is the technical name for gum disease) are seven times more likely to have a baby that is born too early.   It is thought that periodontal disease

I recommend to all my patients who are considering getting pregnant that they have a complete periodontal checkup.  During pregnancy, it’s important to step up oral care.  This means seeing your dentist for a comprehensive cleaning once a trimester.  Then at home, using a soft brush and toothpaste that is not alcohol or chemical based, brush and floss after each meal — a minimum of three times a day. Finally, follow what I call the Four Cornerstones for Oral Health.  These are important for everyone but twice as important during pregnancy because moms are maintaining the health of two (or sometimes more!)

1) Stop using any oral care products that contain harmful chemicals or are alcohol and/or detergent based.

2) Eat healthy with an emphasis on natural foods that have alkalizing, anti-inflammatory and antioxidant-rich properties like salmon, blueberries and other fruits and vegetables.

3) Reduce stress, which can negatively impact both the mouth and body.

4) Exercise regularly, which will help improve circulation, strengthen the 

Dr. Bassett

In the July issue of American Journal of Respiratory and Critical Care Medicine researchers found “consistent positive associations” between the amount of nuts eaten during pregnancy, including peanuts, and respiratory symptoms (i.e. shortness of breath, wheezing) in their children through the first 8 years of age. 

The study which took place at Utrecht University in the Netherlands interviewed over 4,000 pregnant women with and without a history of allergy and asthma.  Daily ingestion of nuts in these women increased the likelihood that their child would have “wheezing” and shortness of breath, compared to those mothers who rarely consumed nuts.  The researchers felt it was too soon to recommend a nut restricted diet during pregnancy, and agreed these results should be confirmed by future research. 

I have generally adopted the practice of recommending that women with a strong history of asthma and allergic conditions (i.e. hives, food allergy, seasonal allergies, eczema) should consider a nut restriction during pregnancy. 

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended to diagnose or treat any condition.

Her parents were told she was stillborn, but less than a day later, a baby girl born in Bombay was heard making gurgling noises at the cemetary where her family had brought her to be buried.

Is it a miracle? Or is it malpractice? The hospital where the infant was birthed has launched an investigation to see if medical staff erred when they pronounced the baby dead.

More than 12 million U.S. women use the combined oral contraceptive pill, more commonly referred to as the pill.

The pill is 99 percent effective in preventing pregnancy. Even so, between 2 and 8 percent of women become pregnant each year while using it.

And doctors say it’s not the pill that’s failing women, but women failing the pill. (continue)

A teenager, described by her mother as a devout Christian, died after taking the powerful abortion pill RU-486.

Manon Jones sought an abortion because she was afraid her Muslim boyfriend’s family would be angered by the pregnancy.

A 30-year-old woman was at a friend’s costume party when she unexpectedly gave birth.

Normally, that might not seem so unusual – except Ally Ashwell had no idea she was pregnant; it is being reported by BBC News.

Ashwell, of Newcastle, England, was bar hopping with friends – in a bumblebee costume – when she began to feel sick, according to the BBC News.

Recently, two very interesting cases making headlines have brought to light some of the greatest advances in modern medicine. These stories, touted as ‘Medical Miracles’ remind us why we as doctors keep searching for answers and of the gift that makes it all worth while; the gift of life.
 
There are many conditions that can arise during the course of pregnancy that may cause concern. At one time, we would have to wait until the baby was born in order to try to save the baby or to save the limb. But now, more and more research is being done and more interest is being taken in an effort to fix these issues in-utero.
 
In the first case, Australian surgeons are being credited for saving the leg of an unborn child by operating on her while the mother was just 22 weeks pregnant. 
 
This baby had a condition called amniotic band syndrome. This is a condition where the limbs, hands or feet of a fetus become entangled in bands of tissue, cutting off blood flow. And in this particular case, both legs were in danger of being naturally amputated in the womb. Luckily, surgeons were able to use a very thin, telescopic instrument to zap away at those adhesions with a laser and free the limbs of baby Leah.
 
This shows you how far we have come in using minimally invasive procedures to deal with a problem that in the past would have meant major complications for this child.
 
The other case is even more interesting because it’s more aggressive. At a hospital in Texas, Little Macie McCartney was welcomed into the world not once — but twice. 

Macie had a benign tumor of the lower spine, probably something that we call a teratoma; a soft tissue tumor that’s benign, but very vascular. When these tumors grow in a small child, they begin to take away the blood supply from the fetus, which often results in congestive heart failure. Remarkably, surgeons were actually able to partially remove Macie from her mother’s womb to perform the surgery that saved her life. When they were done, they put her back in her mother’s womb to grow for another 10 weeks, with no further complications.
 
However, field of prenatal surgery is still in its infancy stage. For years we’ve been trying to tackle these issues, but we have encountered many problems. One of the major risks when performing surgery on a fetus is premature delivery. Sometimes, when doctors attempt to do an operation while the baby is still in the womb, they ultimately end up doing more damage because the baby is born prematurely or they lose the pregnancy completely.
 
These kinds of life-threatening complications make our access to research and outcomes in this area of surgery quite limited.  In order to get to the baby, you have to go through the mother, so there are 2 lives at risk here, and ethical implications often come into play. Other limitations are evident in the instruments available for the types of procedures necessary to repair the damage caused by a congenital anomaly.
 
But none-the-less, the field continues to grow. In fact, there are many facilities around the country that are currently doing these procedures under very strict protocol and criteria.
 
So these are the kinds of surgical miracles that are shaping the face of reproductive medicine. But again there are still going to be limitations. Not every malformation can be repaired in-utero. We as doctors must make decisions by closely examining both the physical health of the mother and the benefits of performing prenatal surgery when a life—or possibly 2 lives—hang in the balance.