Maternal-Fetal Medicine Archives | Norton Healthcare Mon, 03 Feb 2025 16:12:03 +0000 en-US hourly 1 https://nortonhealthcare.com/wp-content/uploads/cropped-NHC_V_2CPOS_CMYK-32x32.jpg Maternal-Fetal Medicine Archives | Norton Healthcare 32 32 Midwife finds underdiagnosed condition, helping expectant mom safely deliver her newborn son https://nortonhealthcare.com/news/midwife-finds-underdiagnosed-condition-helping-expectant-mom-safely-deliver-her-newborn-son Wed, 13 Mar 2024 06:00:00 +0000 https://nortonhealthcare.com/news/ Taylor and Micah Spears wanted to start a family but were concerned there was something wrong. With the recommendation of a friend who was a doula, they drove from Cecilia, Kentucky, near Elizabethtown, to Norton Clark Hospital in Jeffersonville, Indiana, for help. Knowing they also wanted their first birth experience to include a midwife, they...

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Taylor and Micah Spears wanted to start a family but were concerned there was something wrong.

With the recommendation of a friend who was a doula, they drove from Cecilia, Kentucky, near Elizabethtown, to Norton Clark Hospital in Jeffersonville, Indiana, for help. Knowing they also wanted their first birth experience to include a midwife, they initially met with a certified nurse midwife, Alison Reid, R.N., CNM, CLC. Their conversation was informative and eye-opening. Alison suspected Taylor could have polycystic ovary syndrome, and transferred her care to Christopher Grady, M.D., an OB/GYN in Jeffersonville.

“Our midwives are very good. Alison immediately recognized the symptoms of PCOS and did the right thing by recommending testing and reassigning care to me. PCOS is frequently underdiagnosed due to the variety of symptoms that present,” Dr. Grady said.

According to the Centers for Disease Control and Prevention, women with PCOS are insulin-resistant and prone to Type 2 diabetes. It is one of the most common causes of infertility. Women with PCOS can develop serious health issues, especially if they are overweight. These issues include diabetes, gestational diabetes, heart disease, high blood pressure, high cholesterol, sleep apnea and stroke.

“Having PCOS places an expectant mother and her baby at high risk for complications during pregnancy and delivery similar to having gestational diabetes,” Dr. Grady said.

“Dr. Grady was honest and caring. He listened and knew all about PCOS to prevent me from developing more issues,” Taylor said. “He explained everything clearly, and I was confident we were in the right place.”

Taylor’s pregnancy was going well. At 34 weeks, she had started undergoing twice-weekly fetal non-stress tests. During the second week, it showed an increase in amniotic fluid. Taylor learned from Ronald Wright, M.D., another OB/GYN at the same practice as Dr. Grady, that the condition could cause early labor.

High-quality neonatal care in Southern Indiana

For more information, visit NortonClarkHospital.com.

The next day, Taylor’s family held a baby shower. Everyone was excitedly anticipating the birth of a grandchild and great-grandchild. The following day, as Taylor was bending over to start the bath, her water broke.

Taylor called Dr. Grady’s office and was told to come to Norton Clark Hospital make sure everything was OK. The concern was that she could develop an infection. Dawn Moravec, R.N., was Taylor’s nurse and monitored her nearly the entire time she was in the labor and delivery unit. Neonatal nurse practitioner Christine Cooper, APRN, MSN, NNP-BC spoke with Taylor frequently.

“My birth team, especially my nurse Dawn, made me feel calm; they were capable and gave it to me straight without scaring me,” Taylor said. “I appreciated that.”

“My little Graham was already big at a little over 6 pounds and nearly 35 weeks along, and they wanted to go ahead and deliver him to avoid potential infection.”

Taylor knew that the hospital had a Level II neonatal intensive care unit affiliated with Norton Children’s Hospital and that the baby would receive excellent care once he arrived. Hospitals with a Level II NICU can care for babies born at 32 to 35 weeks who may have moderate medical issues and are expected to recover relatively quickly.

After Graham Thomas Spears entered the world, he did not take that first, big breath. The NICU team took over and helped him do just that.

“After they helped him breathe and cleaned him up, they brought him to me. When he opened his eyes and looked at me, I knew he was OK,” Taylor said.

With Taylor’s hormones in high gear, her nurse Dawn made sure to move her into a room right across from the NICU so she could see baby Graham often.

“The entire team of NICU nurses were all so caring and accommodating,” Taylor said.

“Baby Graham had trouble eating and stayed in the NICU 17 days until he was able to maintain his weight,” Dr. Grady said.

“The lactation consultants helped me try to breastfeed but were not pushy.

They conveyed sensitivity showing me how to hold Graham to feed,” Taylor said. “I had to pump to feed him at first, but because of their help, I was able to start exclusively breastfeeding when he was around 2 months old.

“While no one wants a NICU stay, ours was a bit of a blessing in disguise as we learned so much from the nurses. We brought him home with a sense of relief and the comfort of feeling prepared to take care of him.”

Taylor’s family had recently experienced dark times with severe illness and had family members pass away.

“This precious boy has breathed new life into our families,” Taylor said. “Graham has become their new light.”

“I tell anyone who is trying to get pregnant or looking for a place to have their baby, there is an incredible place with a stellar staff in Jeffersonville, Indiana.

Our birth experience at Norton Clark Hospital was one we will never forget, and the staff hold a special place in our hearts.”

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Norton Clark Hospital recognized for excellence in infant and maternal health https://nortonhealthcare.com/news/norton-clark-hospital-recognized-for-excellence-in-infant-and-maternal-health Fri, 26 Jan 2024 21:13:40 +0000 https://nortonhealthcare.com/news/ Norton Clark Hospital recently was recognized by the Indiana Hospital Association, in partnership with Gov. Eric J. Holcomb and Indiana State Health Commissioner Lindsay Weaver, M.D., FACEP, for its commitment to infant and maternal health at the fourth annual INspire Hospital of Distinction recognition program. INspire, funded by the Indiana Department of Health’s Safety PIN...

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Norton Clark Hospital recently was recognized by the Indiana Hospital Association, in partnership with Gov. Eric J. Holcomb and Indiana State Health Commissioner Lindsay Weaver, M.D., FACEP, for its commitment to infant and maternal health at the fourth annual INspire Hospital of Distinction recognition program.

INspire, funded by the Indiana Department of Health’s Safety PIN (Protecting Indiana’s Newborns) grant, was developed to implement best practices for care of Hoosier moms and babies, and to recognize hospitals for excellence in addressing key drivers of infant and maternal health.

Norton Clark Hospital earned a Hospital of Distinction recognition based on implementing best practices in seven key areas: infant safe sleep, breastfeeding, tobacco use prevention and cessation, perinatal substance use, obstetric hemorrhage, maternal hypertension and social determinants of health.

 “We are honored to be recognized again by the Indiana Hospital Association for our work in infant and maternal health,” said Judy Stewart, director, women’s health services and neonatal intensive care unit, Norton Clark Hospital. “Norton Clark Hospital celebrated its Level II NICU five-year anniversary this year. We are proud to offer education in newborn safe sleep and our NEST (Nurture. Encourage. Stabilize. Treat.) program that helps support mothers and babies affected by substance use disorder. We celebrate our team and are happy to receive recognition from the state of Indiana. At Norton Clark Hospital, we believe there is no limit to what our care can do.”

“The daily work of our delivering hospitals makes a monumental impact on the lives of so many Hoosier moms and infants in every corner of our state,” Gov. Holcomb said. “These caregivers are much needed and appreciated, and we will continue to partner with them to support our shared goal of a healthy Hoosier tomorrow.”

“Our birthing hospitals work tremendously hard to make sure all babies born in Indiana have the best start at life, while caring for the mothers who delivered them,” Dr. Weaver said. “Reducing infant and maternal mortality requires a continued multipronged approach over the course of many years to see impactful change. It is heartening to see the progress we’ve made, but we must continue to adopt best practices so that we can celebrate more first birthdays in Indiana.”

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How to lower blood pressure during pregnancy https://nortonhealthcare.com/news/how-to-lower-blood-pressure-during-pregnancy Mon, 04 Dec 2023 17:24:04 +0000 https://nortonhealthcare.com/news/ Having high blood pressure while pregnant can lead to health complications for both mom and baby, but making certain lifestyle choices can help lower blood pressure during pregnancy. “High blood pressure during pregnancy, or gestational hypertension, is when a blood pressure reading is greater than or equal to 140/90 mm Hg,” said Whitney E. Jamie,...

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Having high blood pressure while pregnant can lead to health complications for both mom and baby, but making certain lifestyle choices can help lower blood pressure during pregnancy.

“High blood pressure during pregnancy, or gestational hypertension, is when a blood pressure reading is greater than or equal to 140/90 mm Hg,” said Whitney E. Jamie, M.D., maternal-fetal medicine specialist with Norton Children’s Maternal Fetal-Medicine, part of Norton Women’s Care. “This condition can lead to preeclampsia, a serious pregnancy complication that usually occurs after the 20th week of pregnancy and can be harmful to a pregnant person and their baby.”

Causes of high blood pressure during pregnancy

There are several causes and risk factors for high blood pressure during pregnancy, including preexisting conditions and a family history of high blood pressure during pregnancy. Other causes may include:

  • Obesity or overweight
  • Sedentary or inactive lifestyle
  • First-time pregnancy
  • Carrying multiples
  • Age 35 and older
  • Smoking
  • Drinking alcohol
  • Personal or family history of high blood pressure during pregnancy
  • Preexisting conditions, including diabetes and autoimmune disorders

Norton Children’s Maternal-Fetal Medicine

Our team, which is part of Norton Women’s Care, specializes in high-risk pregnancies and works with patients to manage their blood pressure during pregnancy.

How to lower blood pressure during pregnancy

Making healthy choices for yourself and your baby could help lower your blood pressure during pregnancy, which can help avoid serious health conditions and complications. Here are a few ideas.

Healthy diet. Eat foods that are rich in potassium, calcium and magnesium, including fruits, vegetables, nuts, whole grains, legumes, fish and vegetable oils. Avoid salty foods, including canned goods and processed foods that are high in sodium.

Hydrate. Drinking water throughout the day can be a piece of the puzzle when it comes to managing blood pressure. Aim for at least six to eight glasses of water per day. Do not drink alcohol.

Stay active. Check in with your provider about how much movement and exercise you should be getting during pregnancy. Exercise can help manage stress, which can lower blood pressure.

Follow the doctor’s orders. This includes attending every checkup that is scheduled with your provider and taking any medications if you are prescribed them. Stay on top of checking your blood pressure at home and check in with your provider to help manage your readings. If you want to lower your blood pressure during pregnancy, you must make conscious and proactive choices that prioritize your health — and your baby’s — every single day.

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Experts recommend screening for high blood pressure while pregnant https://nortonhealthcare.com/news/high-blood-pressure-while-pregnant Wed, 16 Aug 2023 12:03:36 +0000 https://nortonhealthcare.com/news/ The risks of high blood pressure while pregnant have prompted a panel of medical experts to recommend all pregnant people get blood pressure screenings at every prenatal visit. The draft recommendation by the U.S. Preventive Services Task Force, an independent panel that makes evidence-based recommendations about ways to prevent disease, advises that all pregnant people,...

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The risks of high blood pressure while pregnant have prompted a panel of medical experts to recommend all pregnant people get blood pressure screenings at every prenatal visit.

The draft recommendation by the U.S. Preventive Services Task Force, an independent panel that makes evidence-based recommendations about ways to prevent disease, advises that all pregnant people, regardless of hypertension history, have their blood pressure measured throughout their pregnancy.

“It’s very important for women to have their blood pressure monitored, especially during pregnancy,” said Li Zhou, M.D., Ph.D., medical director, Norton Heart & Vascular Institute Women’s Heart Program. “Having hypertension, also known as high blood pressure, during pregnancy can cause a life-or-death situation for both mother and baby.”

Norton Women’s Care

Choose an OB/GYN who works closely with specialists with expertise in women’s heart conditions and complex pregnancies.

Issues caused by high blood pressure, including preeclampsia, and eclampsia, are among the top causes of the rising maternal mortality rate in the United States. High blood pressure while pregnant also increases the risk of low birth weight and possibly can lead to preterm delivery.

In addition, high blood pressure increases the risk of heart attack, congestive heart failure, stroke, and kidney injury. Over the long term, high blood pressure during pregnancy can lead to a life time of hypertension and resulting in an increased risk of having cardiovascular diseases.

Hypertension that begins during pregnancy is defined as systolic pressure equal to or greater than 140 millimeters of mercury (mmHg) or diastolic blood pressure equal to or greater than 90 mmHg.

“If a woman is planning to become pregnant and she has a history of hypertension, there are important measures that can be taken,” Dr. Zhou said. “Talking to her OB/GYN and even establishing a relationship with the Norton Heart & Vascular Institute Women’s Heart Program can be very important to ensure a successful pregnancy.”

Norton Women’s Care OB/GYNs work closely with the Women’s Heart Program, Norton Children’s Maternal-Fetal Medicine and other specialists, so patients benefit from multiple viewpoints and areas of expertise.

A hypertension disorder affects 1 out of every 7 deliveries in the United States, according to the Centers for Disease Control and Prevention. Patients who are Black, American Indian or Alaska Native, as well as those who are older, are more at risk.

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Fetal transfusions give unborn baby lifesaving blood https://nortonhealthcare.com/news/fetal-transfusions-give-unborn-baby-lifesaving-blood Fri, 21 Jul 2023 14:02:52 +0000 https://nortonhealthcare.com/news/ Every three weeks, Katrina Crume and Aaron Dean Calloway made the nearly two-hour journey from their home near Owensboro, Kentucky, to Louisville so their baby, Phoebe, could receive a lifesaving blood transfusion. What made these transfusions remarkable was Phoebe was still in the womb. What made them necessary was incompatibility between Katrina’s and Phoebe’s blood....

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Every three weeks, Katrina Crume and Aaron Dean Calloway made the nearly two-hour journey from their home near Owensboro, Kentucky, to Louisville so their baby, Phoebe, could receive a lifesaving blood transfusion. What made these transfusions remarkable was Phoebe was still in the womb.

What made them necessary was incompatibility between Katrina’s and Phoebe’s blood.

Phoebe is Rh positive, while Katrina is Rh negative. Known as Rh incompatibility, the condition meant that antibodies in Katrina’s body were attacking her baby’s blood. The incompatibility doesn’t affect the pregnant person, but can cause anemia in the fetus as red blood cells die faster than new ones are created. Jaundice is also a common result.

In the most severe cases, Rh incompatibility can cause liver failure, heart failure and death of the baby.

The condition isn’t common, and the need for fetal transfusions is even rarer. In mild cases no fetal transfusion is necessary, and most recover from a mild case.

In Phoebe’s case, the Norton Children’s Maternal-Fetal Medicine and Norton Hospital labor and delivery teams went into action to save the unborn baby.

“Using an ultrasound to guide us, we insert a needle into the baby’s umbilical cord,” said Kristin E. Reeve, M.D., a specialist with Norton Children’s Maternal-Fetal Medicine. “We can then transfuse the necessary blood product directly to the baby to reverse the anemia.”

Norton Children’s Maternal-Fetal Medicine, a part of Norton Women’s Care

If you’ve found out you have a complicated pregnancy, ask your obstetrician about a referral to our maternal-fetal medicine specialists

Call (866) 574-4111 for information

When the transfusions began, Phoebe was around the size of a hand and the umbilical cord the diameter of a pencil. The needle is inserted into a tiny vein in the umbilical cord.

“The goal is to get the baby to the point where he or she can safely be delivered,” said W. Vance Cuthrell, M.D., also a specialist with Norton Children’s Maternal-Fetal Medicine. “In this case, our work was able to safety bring Phoebe to nearly full term.”

The delicate and complicated transfusion procedure carries several risks, but Katrina described being in good hands with her care team.

“I had to do this during a previous pregnancy so I knew it was a possibility,” Katrina said. “But it was still tough and a bit scary. Dr. Cuthrell, Dr. Reeve and everyone at Norton Hospital made it as easy as possible, and they became like family.”

Fetal transfusions require a large team: maternal-fetal medicine specialists, nurses and technologists — plus ultrasound, laboratory and blood bank staff — and even security. The blood bank staff prepared the blood the baby needed. After the team targeted the location of the baby’s umbilical cord, a blood sample was collected.

With help from the security team, the sample was literally run down four flights of stairs to the laboratory. A rapid test on the sample determined how much blood the baby needed. After the blood slowly was given to the baby through the umbilical cord, another sample was rushed to the laboratory to ensure the baby had received enough.

A team from the Norton Children’s Hospital neonatal intensive care unit also was on standby for a possible emergency delivery.

“These procedures do have risk to them,” Dr. Reeve said. “These include infection, bleeding of the baby, blood clots and even the need to perform an emergency cesarean section.”

With careful planning and expertise, these were avoided.

“We had times during Katrina’s pregnancy that the entire team had to be called in to do an emergency transfusion,” Dr. Cuthrell said. “Each person’s role was incredibly important to the success of the procedure, and everyone was willing to commit to helping.”

The specialists with Norton Children’s Maternal-Fetal Medicine, part of Norton Women’s Care, have training and expertise to care for moms and babies during high-risk pregnancies, such as the condition that required transfusions to treat baby Phoebe in the womb.

“We are so happy that Phoebe is here and happy and healthy,” Katrina said. “We’re so grateful to everyone for working to save our baby.”

Rh incompatibility and Rh disease

In blood typing, positive or negative denotes the presence or absence of a protein known as Rh factor.

When a person with Rh-negative blood becomes pregnant with an Rh-positive fetus, there is Rh incompatibility. While mother and baby don’t share blood, the blood can mix for various reasons during pregnancy or labor.

If the two blood types come into contact, the pregnant person’s body reacts to the Rh-positive blood as foreign and creates antibodies in an immune response to fight it. Often, an injection of immune globulin is enough to prevent the reaction.

It’s unlikely for fetal blood to mix with the pregnant person in a first pregnancy until delivery. Future pregnancies, however, raise a risk that the pregnant person’s Rh-negative blood will come into contact with an Rh-positive fetus, triggering an immune reaction — Rh disease — that could be severe.

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Doula program helping improve health of pregnant patients https://nortonhealthcare.com/news/doula-program-helping-improve-health-of-pregnant-patients Tue, 20 Jun 2023 17:43:55 +0000 https://nortonhealthcare.com/news/ Jamia Singleton was 29 weeks pregnant and in labor when in walked Keisha Yates, a doula with Norton Women’s care. “I was very nervous and hadn’t heard of a doula,” Jamia said. “I’m so glad she was there. I was more calm and relaxed and could actually breathe. She held my hand the whole time.”...

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Jamia Singleton was 29 weeks pregnant and in labor when in walked Keisha Yates, a doula with Norton Women’s care.

“I was very nervous and hadn’t heard of a doula,” Jamia said. “I’m so glad she was there. I was more calm and relaxed and could actually breathe. She held my hand the whole time.”

Norton Women’s Care launched the Norton Women’s Doula Program — the first program of its kind in Kentucky — in late 2021, with a goal of improving the long-term health of new mothers. This includes helping reduce the impacts of social determinants of health, as well as reduce the risks for pregnancy loss, health complications and even death.

The U.S. Department of Health and Human Services, as part of its Healthy People 2030 initiative to improve health and well-being, has listed social determinants of health as one of its priorities. These are conditions in a person’s environment that lead to risks and outcomes related to health and quality of life.

The role of a doula traditionally has been to serve as a birth coach and provide postpartum support, but the Norton Women’s Doula Program expands upon that. In addition to providing physical, emotional and partner support, doulas connect patients with resources to assist with access to healthy food, housing issues and transportation to and from provider visits. They also provide services after delivery, including home visits during the early part of the fourth trimester — the time following childbirth. Many keep in touch beyond this time.

Eligible patients deliver at Norton Hospital and are patients at Norton OB/GYN Associates, Norton Women’s Specialists or Norton Children’s Maternal-Fetal Medicine, which is part of Norton Women’s Care; they can live in any ZIP code. The program currently employs five doulas, with more being added. The doula program has a unique ability to serve minorities.

“The doula program is focused on providing important services to the community’s most at-risk minority patients,” said Kenneth J. Payne, M.D., OB/GYN with Norton OB/GYN Associates. “The doulas have helped bridge cultural gaps. They’ve helped improve patients’ access to health care and helped increase patients’ willingness to engage with health care.

“They have created strong community connections with patients, which has facilitated better birth experiences and improved health outcomes in the most vulnerable populations.” 

According to a 2021 report from the Centers for Disease Control and Prevention, Black patients are 2 1/2 times more likely to die from a pregnancy-related cause than white women. Women of color are disproportionally at risk for high blood pressure and diabetes, which can lead to issues with pregnancy and childbirth, including developing a heart condition and blood clots.

Doulas can help watch for pregnancy-related health issues and provide a connection to the obstetrician. They’re often also a support person and advocate.

“Keisha is emotional support for me since I wasn’t at all ready to have my son, Arlo, at that time,” Jamia said. “She even helped Arlo’s dad, helping him relax. He was as grateful as I was.”

After Arlo’s birth, Keisha has been there to follow up, helping Jamia prepare for her baby’s discharge from the Norton Children’s Hospital neonatal intensive care unit by getting her set up with a car seat. The entire doula program is made possible through the Norton Healthcare Foundation and Norton Children’s Hospital Foundation, with gifts from Edie Nixon and Aetna Better Health of Kentucky.

Make a donation now to support this important program.

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What’s the normal blood pressure for a pregnant woman? https://nortonhealthcare.com/news/normal-blood-pressure-for-pregnant-women Tue, 25 Apr 2023 06:00:00 +0000 https://nortonhealthcare.com/news/ If you’re pregnant and have a blood pressure of 140 systolic/90 diastolic or higher, you should see a specialist, as untreated high blood pressure can risk your health as well as the unborn baby’s. A healthy blood pressure for women and men is below 120/80. The U.S. Preventive Services Task Force now recommends women who...

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If you’re pregnant and have a blood pressure of 140 systolic/90 diastolic or higher, you should see a specialist, as untreated high blood pressure can risk your health as well as the unborn baby’s.

A healthy blood pressure for women and men is below 120/80.

The U.S. Preventive Services Task Force now recommends women who are pregnant have their blood pressure checked at their prenatal visits, even if you don’t have a history of high blood pressure

“It’s very important to have a specialist treating you so you receive a medication that improves your blood pressure without interfering with the baby’s development,” said Li Zhou, M.D., Ph.D., medical director of the Norton Heart & Vascular Institute Women’s Heart Program.

Checking for high blood pressure during every prenatal visit allows health care providers to intervene early to help prevent a bad outcome, according to Dr. Zhou.

Women’s Heart Program

The Norton Heart & Vascular Institute Women’s Heart Program provides specialized care for women’s unique heart concerns.

Very high blood pressure can cause heart failure, heart attack, stroke and kidney failure. It also can put the baby’s life in danger.

High blood pressure also can cause preeclampsia, which stresses the heart and other organs and can lead to serious complications, such as impaired liver and kidney function and seizure. Preeclampsia also can affect the blood supply to the placenta or cause fluid to build up in your lungs.

If there are signs of organ damage in the mother, she may need to deliver the baby early, which can result in a preterm birth and a low birth weight, according to Dr. Zhou. Dr. Zhou and her colleagues at the Women’s Heart Program work closely with the complex pregnancy specialists, including those at Norton Children’s Maternal-Fetal Medicine, part of Norton Women’s Care, through your pregnancy, labor and delivery.

READ MORE: When to worry about breathing issues during pregnancy — what to watch for and what it might mean

Blood pressure typically drops for the first two trimesters of pregnancy and then increases in the third trimester. For women who have high blood pressure before they become pregnant, they should discuss having their medications adjusted during pregnancy.

Women who have had a heart attack, were born with a heart defect or have another heart condition should see a doctor at the Women’s Heart Program before they become pregnant.

Disorders related to high blood pressure are rising in the United States. Moderate risks include being pregnant more than 10 years apart, being 35 or older, having a body mass index (BMI) over 30, family history of preeclampsia, and in vitro fertilization prior to pregnancy.

High risks are having preeclampsia in a prior pregnancy, being pregnant with more than one baby, or having diabetes, kidney disease, chronic high blood pressure or autoimmune diseases such as lupus. In addition, people who are Black, American Indian or Alaska Native are much more likely to have a disorder related to high blood pressure in pregnancy and to die from it.

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A mother’s gestational diabetes success story https://nortonhealthcare.com/news/gestational-diabetes-success-story Wed, 19 Apr 2023 13:08:36 +0000 https://nortonhealthcare.com/news/ Even though a gestational diabetes diagnosis felt scary at the time, for Jenna Wilson, support from Norton Children’s Maternal-Fetal Medicine made her high-risk pregnancy much less intimidating. The practice’s maternal-fetal medicine specialists, part of Norton Women’s Care, helped her feel empowered. “They always put a positive spin on everything and cheered me on, telling me...

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Even though a gestational diabetes diagnosis felt scary at the time, for Jenna Wilson, support from Norton Children’s Maternal-Fetal Medicine made her high-risk pregnancy much less intimidating. The practice’s maternal-fetal medicine specialists, part of Norton Women’s Care, helped her feel empowered.

“They always put a positive spin on everything and cheered me on, telling me I was doing great and everything was going to be fine,” Jenna said. “They gave me the tools, and I used them and was pretty successful.”

Jenna was diagnosed with gestational diabetes in 2021, while pregnant with her second child. When her obstetrics provider ordered a glucose test when she was 15 weeks pregnant, she assumed she would pass with flying colors, as she had done before. This time, however, her numbers were slightly elevated.

“My blood sugar level was always good, but my fasting numbers weren’t the best, so I was referred to Norton Children’s Maternal-Fetal Medicine” to consult with a maternal-fetal medicine (MFM) specialist, she said.

An MFM physician is an obstetrician/gynecologist (OB/GYN) who specializes in high-risk pregnancy.

Norton Children’s Maternal-Fetal Medicine

Whether it’s gestational diabetes or another complex condition, we support, treat and care for mothers during their high-risk pregnancy.

It was a stressful time, but the providers Jenna met immediately made her feel at ease.

“Everyone I met at the MFM office was great,” Jenna said. “I was scared at first, because I was high-risk, and I feel like diabetes sometimes has a negative connotation, but they made me feel like everything was fine. I felt very comfortable.”

Jennifer “Jenny” R. Willis, APRN, a nurse practitioner with Norton Children’s Maternal-Fetal Medicine, went above and beyond, with enthusiasm, patience and care, to explain Jenna’s new treatment plan during her pregnancy.

“Jenny was so nice and explained everything so well. She made me feel confident about everything,” said Jenna, who also appreciated Jenny’s realistic approach when she would check in weekly with her updated blood sugar numbers.

“Jenny was always understanding with pregnancy, cravings and making adjustments. If a number was high, we would investigate and figure out the cause,” Jenna said. “She was always available. I could text her anytime with a question.”

Jenna made the necessary adjustments to her diet, lifestyle and insulin injections, and delivered a healthy baby girl, named Maggie, who weighed 7 pounds, 12 ounces.

With gestational diabetes, babies are at a higher risk of being born prematurely, being very large (9 pounds and over), having low blood sugar or later developing Type 2 diabetes.

“I was worried about the baby’s sugars, but she had multiple blood sugar level checks, and all of hers were great,” Jenna said. “I also felt better and like I healed a lot faster from my C-section [cesarean section] from being on a healthy lifestyle.”

Jenna’s blood sugar numbers returned to normal after pregnancy. Although some pregnant people with gestational diabetes go on to develop Type 2 diabetes, Jenna did not. As her daughter, now a toddler, continues to grow, Jenna appreciates the care she received from the Norton Children’s Maternal-Fetal Medicine team.

“I would highly recommend them,” Jenna said. “Everyone was great and made what was a scary time much less scary for me. They made me feel validated as a patient and a person.”

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Alexis’ heart was giving out after her 3rd pregnancy — a long-term solution would have to wait for baby No. 4 https://nortonhealthcare.com/news/peripartum-cardiomyopathy-stories-alexis Wed, 22 Mar 2023 06:00:00 +0000 https://nortonhealthcare.com/news/ At age 25, Alexis Helm had been pregnant three times, and her heart was failing. The increased blood volume from her pregnancies and strain on her heart muscle had taken a toll, as it does with many women. With her fourth pregnancy, she knew she risked damaging her heart further but wanted to do all...

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At age 25, Alexis Helm had been pregnant three times, and her heart was failing. The increased blood volume from her pregnancies and strain on her heart muscle had taken a toll, as it does with many women.

With her fourth pregnancy, she knew she risked damaging her heart further but wanted to do all she could to carry the baby.

Alexis’ heart condition — advanced cardiomyopathy — was diagnosed just one year earlier, after the birth of her third child.

“At 25 years old I was struggling to do everyday things,” Alexis said. “I was short of breath. It was difficult to walk up stairs, and I struggled to carry my kids and play with them outside.”

Alexis started working with Kelly C. McCants, M.D., executive medical director of the Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program. Dr. McCants and Natalie K. Kendall, APRN, nurse practitioner with the Advanced Heart Failure & Recovery Program, started Alexis with intravenous infusions of medication. They would manage her symptoms for a time, but it became clear medication wouldn’t be a long-term solution.

Ready for an artificial heart pump, then a pregnancy is discovered

Dr. McCants, who is also executive director, Institute for Health Equity, a Part of Norton Healthcare, is board certified in cardiovascular disease, advanced heart failure and transplant cardiology. He and the team recommended Alexis turn to an increasingly common long-term solution.

“We felt that she was going to require more for her heart, which would be an artificial heart pump,” said Kendall.

The pump, otherwise known as a left ventricular assist device, or LVAD, would be surgically implanted into Alexis’ heart, taking over the work of the damaged left ventricle that was no longer pumping sufficient amounts of freshly oxygenated blood throughout her body.

On the day she was scheduled to get the LVAD, Alexis learned of her fourth pregnancy through pre-surgical testing. Alexis knew the risks this presented for herself as well as the baby. She was only about 10 weeks along in her fourth pregnancy and was faced with a very difficult decision.

READ MORE: When to worry about breathing issues during pregnancy — what to watch for and what it might mean

“I still wanted to have my baby,” she said. “When I told Dr. McCants and Natalie that I’d rather chance it and carry the baby to term, they were both supportive and ready to face the challenge with me.”

The team set up weekly appointments — some in person, some held via Norton Telehealth video visits. They managed her medications and monitored her heart rate, weight gain and blood pressure.

“We knew it was going to be a very big challenge to keep mom and baby healthy,” Natalie said. “Alexis’ situation was quite unique. There is little to no literature or research to reference such a case, which meant we were entering unknown territory.”

Norton Heart & Vascular Institute Women’s Heart Program

Women have unique heart needs. The Norton Heart & Vascular Institute Women’s Heart Program is dedicated to treating women, often around pregnancy or menopause.

Nearly seven months after canceling her LVAD surgery, Alexis gave birth to a baby girl.

The baby’s birth weight was low, and she was admitted to the Norton Children’s Hospital neonatal intensive care unit (NICU).

“The baby was very healthy and required minimal NICU intervention,” Natalie said. “And Alexis did very well during the delivery and recovery. We were able to support her heart with medications to manage the stress of carrying the baby and delivery.”

With a 5-month at home, Alexis gets an LVAD

Five months after the baby was born, Alexis was able to reschedule her LVAD surgery through the UK Gill Heart & Vascular Institute’s Gill Affiliate Network. Today, she is on the mend and better able to get back to being a mom.

“I’m able to take care of my kids; I’m able to play with them. I’m able to walk up the stairs — but I notice that I have to go slower,” she said.

Though her symptoms have vastly improved, this isn’t the end of Alexis’ heart-healing journey.

“The LVAD is currently allowing Alexis to have improvements to symptoms and quality of life but the best long-term solution for a young female would be a heart transplant,”  Natalie said. “This is our ultimate goal for her.”

Alexis continues working with the Advanced Heart Failure & Recovery Program team to strengthen her heart and take the steps necessary to qualify for a transplant.

“They’re really great,” she said of the heart team. “They call. They check up on me. They make sure I get to the doctor.”

If she needs transportation, they find a way for her to get to the clinic. If she doesn’t have child care, they make accommodations for her children to come along on her office appointments. And if she has other health questions or concerns, they provide resources.

“I feel like if I had gone somewhere else, they wouldn’t have given me the care that Norton has provided,” she said.

Photos courtesy of Mary Helen Nunn for Today’s Woman magazine

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Mother’s triumph over addiction gives her new purpose in life https://nortonhealthcare.com/news/pregnancy-and-addiction-recovery-story Wed, 08 Feb 2023 07:00:00 +0000 https://nortonhealthcare.com/news/ Teri Johnson works a full-time job, is a football and wrestling mom and works hard to be present for her children. While that may not seem out of the ordinary, it’s a complete 180-degree change from where she was just two years ago. In her early 20s, Teri found herself without a job and in...

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Teri Johnson works a full-time job, is a football and wrestling mom and works hard to be present for her children. While that may not seem out of the ordinary, it’s a complete 180-degree change from where she was just two years ago.

In her early 20s, Teri found herself without a job and in a bad relationship. She was using meth, moved on to heroin and then became an intravenous drug user. When she was in prison, she could only talk to her young son for 15 minutes at a time through a glass partition.

“I got out and I went right back to the same thing because I didn’t have any skills to stay sober,” Teri said. “You can be dry for long periods of time, but if you don’t have the skills to stay sober and the tools that you need, it won’t last, because you don’t know how to deal with life when it comes at you.”

Two years ago, while pregnant with her daughter, Teri knew what lay ahead if she didn’t get help and decided it was time to make a big change. She knew about the Norton Maternal Opiate and Substance Treatment (MOST) Program from a friend and made the call to (502) 559-4375.

Recovery for you and your baby’s future

“I wouldn’t be here, and I wouldn’t have that opportunity if it wasn’t for making that call to the MOST Program.”

Call (502) 559-4375

“Many feel that substance use disorder is a choice, and you are able to stop on your own,” said Tessa Wallingford, R.N., nurse navigator with the Norton MOST Program. “It is a disease of the brain that requires the same support and intervention as any other disease.”

As a nurse navigator, Tessa helps patients get started and stay with the program. She’s available to help work with insurance, share her knowledge about the condition and assist patients in getting the care they need with compassion and understanding.

“Our team recognizes the vulnerability, guilt and shame felt by patients who find themselves pregnant and struggling with substance use disorder,” Tessa said. “We’re here to provide a safe and supportive space for pregnant patients struggling with substance use disorder to receive the care they need and deserve.”

Medical providers with the Norton MOST Program seek to break the stigma and cycle of substance use disorder by serving and loving patients through their pregnancy, parenting and recovery journey.

While in the program at Norton Women’s & Children’s Hospital, Teri got the help she needed, including lining up a place to stay beyond her initial treatment.

“Inpatient stabilization is just the first step for our patients,” said Angie Adams, LCSW, social worker with Norton Children’s Maternal-Fetal Medicine.

“Patients start with medication-assisted treatment and outpatient behavioral health, but many need more support. For those patients, the team works with residential treatment centers that will treat pregnant patients and those with children.” 

“I went for 30 days, and then I realized that that wasn’t enough,” Teri said. “Angie and Tessa worked with me and found me a pregnant and parenting house in Shelbyville that I went to, and I stayed there. I turned a 90-day program into almost six months.”

2 years sober, now helping others

Now two years sober, Teri recalls feeling like she was drowning. The Norton MOST Program, according to Teri, gave her the opportunity and the skills to make it through each day.

Now, Teri has made it her mission to help others and let people know there is help available.

“In a 12-step program, the No. 1 goal is to help another person struggling. That’s how I stay sober,” Teri said. “When I see a girl who was in my situation and I just know how lost and broken she feels, I can’t help but send them to the MOST Program.”

Teri reminds herself and others that her worst day sober is better than her best day high. She now looks forward to living a life after addiction and seeing her children grow up.

“I wouldn’t be here, and I wouldn’t have that opportunity if it wasn’t for making that call to the MOST Program,” Teri said.

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