Baby on board

“Driving under those conditions is obviously a bad idea," said David Teator of Amanda Norgaard McBride's incredible feat of delivering a baby while driving 70 miles an hour. Teator is senior director of transportation strategies and initiatives for the National Safety Council and an expert on distracted driving, Paul Stenquist reported on the New York Times' "Wheels" blog last week.

The Bemidji (Minn.) Pioneer reported that McBride , 29, who was in labor, and Joseph Phillips, 33, of Bagley, Minn., were on their way to North Country Hospital in Bemidji to deliver their baby when McBride's water broke. McBride was driving; Phillips was not able to drive because of a medical condition.

Phillips thought they should pull over but McBride was anxious to get to the hospital.

Phillips steered while McBride operated the pedals of their 2005 Chevy Cobalt — and delivered the baby, their first child together (each has two other children). Joseph Dominick Phillips was born at 12:20 a.m., weighing 8 pounds. Once the family reached the hospital, McBride and little Joseph were taken into the emergency room area to finish up the birth process, Bethany Wesley reported in the Pioneer. Both mother and baby appeared to be doing well.

Chevrolet announced that it was giving the family a stroller, a safety seat, a year's supply of diapers and other baby gear to celebrate the role of the family's Cobalt in getting everyone safely to the hospital.

Equine birth story

Humans aren’t the only ones who have the occasional difficult birth. Here’s a video from the University of Minnesota about Henry and William, a couple of little guys who beat the odds: Only 1 percent of twin births to horses end with two living foals.

(I can’t help wondering how any horses get born at all with those long pointy legs!)

Have preterm births peaked?

Preterm births in the United States went up steadily from 1981 to 2006, but now they seem to be going back down, according to a new report from the National Center for Health Statistics in Hyattsville, Md.

This is the first two-year downturn in nearly three decades, the report states.

The peak year for preterm births was 2006, when they accounted for 12.8 percent of all births. The rate in 2008 was 12.3 percent.

A preterm birth is one that occurs before 37 weeks of gestation. Babies born before this point are more likely to have serious health problems compared with infants born later in pregnancy. Even babies just shy of 37 weeks are more likely to have "neurodevelopmental problems," or to die before they turn one year old, than are babies born at term, the report states.

Preterm rates appear to be falling among women of all age groups younger than 40, among all ethnic groups, in all types of deliveries and in most parts the country. Several states saw a flat rate of preterm births over the last two years, but only Hawaii experienced an increase. The decrease was similar for singleton and multiple births.

However, the report notes that "the U.S. preterm birth rate remains higher than in any year from 1981 to 2002, with large differences still evident by race and Hispanic origin. Further research is necessary to explain the factors behind the current downturn and to develop approaches to help ensure its continued decline."

Ultimately, all bets are off

There is no arguing with death, except through art.

Here is a poem I found through an Art of Medicine essay by physician-writer Caroline Wellbery MD in the Lancet. She uses it to talk about the value of medical uncertainty.

Dr. Wellbery's article is worth reading, and so is the commentary that went with it in the May 15, 2010 issue.

My Father's Autopsy
by David Gewanter

The one he did, that is, and took me to
when I was 13. I turned as white as
the old woman lying naked there;

but as he clanked out tools I inspected her
quickly, the dead cinder of her nipples,
the stiff tuft at her crotch (“Still black?

Wouldn't it turn gray?”). Dad took stock
of her length, weight, muscle tone, telling me
or the microphone how she lived,

what made her sick. “Like being a detective,”
he said, “except I answer my own questions.
Here; touch this.” But I wouldn't, and

I wanted her body to resist interrogation,
prayed weirdly she never said “aah” for a doctor.
Then he slit and sawed her down the middle –

she opened as easily as a yam, or a duffel
bag; dipping delicately in, Dad scooped
out a handful of stuff, all jumbly

like underwear from Mom's dresser. He
read her guts like a priest: proving
the tubes, slicing wafers from her heart,

so thin they would glow under lens-light –
at last she yielded him a brown pebble
which I felt between his finger and thumb;

then he put it back. Death's story, deduced from
facts hard as bone – as he talked me through it,
I could hear the joyful lift in his voice….

He had little patience for his house,
its prattling unready anatomies,
his wife's “incompetent housekeeping”;

at night he sat over journals and drinks,
compact, severe, inward as a microscope.
Now he's home all day waiting for the mail,

hasn't cut a corpse for years. He calls
every weekend, his news familiar
as a backache, and we talk without fear.

Once I thought my pen would open him here
like the corpse on its single pan of judgment;
but as I cover this pan with pages

he is alive on another one.

David Gewanter, In the Belly, University of Chicago Press.

The latest edition of doctors’ book on birth

Often, the annual meeting of a medical group produces a flurry of scientific papers, but the meeting of the American College of Obstetricians and Gynecologists seems more like, say, a bunch of writers  getting together. (I attended the 2009 meeting in Chicago.) As a cohort, OB-GYNs seem to want to find out about the newest approaches, tools and techniques they might put to use in their practices, and perhaps exchange some stories from the trenches as well.

Happy babyBut here's something new for consumers from ACOG, which held its annual meeting in San Francisco this week. The fifth edition of Your Pregnancy and Childbirth: Month to Month was unveiled, along with a new companion website,  www.yourpregnancyandchildbirth.com.

While there are many pregnancy books, this one is "unique in the extent of the medical detail that it covers about all aspects of pregnancy, yet it is designed as an easy-to-read, helpful reference for all of those questions that inevitably pop up," said Hal Lawrence, MD, The College's vice president of practice activities in a press release on the ACOG website.

The latest edition of the book has a new chapter that addresses obesity and eating disorders, another devoted to diabetes during pregnancy, and a third covering other chronic diseases like hypertension, heart disease, celiac disease, lupus, and physical and mental disabilities.

"The majority of women do not experience severe complications, but we felt it was important to give a thorough overview so women will know if something's wrong and when to call a doctor," Dr. Lawrence said.

Another new chapter covers feeding the baby, and includes advice on both breastfeeding and the use of formula.