Maternal Mental Health Matters

MAY 3, 2017 IS WORLD MATERNAL MENTAL HEALTH AWARENESS DAY
#maternalMHmatters

Today is World Maternal Mental Health Awareness Day, and we’re helping to bring attention to an important health issue and available treatment options.

Worldwide, as many as one in five women experience some type of perinatal mood and anxiety disorder (PMAD). PMADs include postpartum depression, postpartum anxiety, postpartum obsessive compulsive disorder and others.

“There is still this myth that pregnancy is blissful and if you don’t enjoy pregnancy and having your baby, there’s something wrong with you,” says Patricia Widra, MD, assistant professor of psychiatry with the University of Maryland School of Medicine and a psychiatrist at University of Maryland Medical Center.

“But fifteen to twenty percent of women have this experience, and there are ways to treat it.”

Because of the stigma that often surrounds mental health disorders, many women hide or downplay their symptoms. Not getting support or treatment can have a devastating impact on the woman affected as well as on her partner and family. It’s important to treat a PMAD like any other health problem so that families can thrive.

“Most people don’t realize it, but post-partum depression (PPD) is the most common serious complication after delivery,” says Dr. Widra.

Women whose pregnancies end in miscarriage or stillbirth often experience not only grief but also postpartum depression. In addition, giving birth to a premature child, or having a child spend extended time in a neonatal intensive care unit (NICU) can also take a toll on a mother’s mental health.

Why is PMAD so prevalent? “We don’t know,” says Dr. Widra. “Part of it is depression in women in this age group is already more prevalent than in men anyway, even without pregnancy. Pregnancy is a major change-of-life event. Sometimes a woman doesn’t have enough social or financial support or doesn’t have a partner. Hormonal changes also have an effect – this is where a lot of current research is focusing. Somehow these shifts seem to trigger PMADs. We don’t know specifically why it happens in some people and not others.”

Symptoms of PMAD can appear any time during pregnancy and the first 12 months after childbirth. The good news is there are effective and well-researched treatment options available to help women recover.

“It’s important that a woman is medically screened for a mood or anxiety disorder at least once during her pregnancy – preferably in the second or third trimester,” says Dr. Widra. “Just as we screen women for diabetes and thyroid disorders during pregnancy, it is just as critical to screen for mood and anxiety disorders. Currently this is not the standard of care. There is a lot of push federally and in Maryland to make it the standard.”

What you can do: If you are a new mom, be aware of how you’re feeling, and seek help if you’re experiencing symptoms of PMAD. If you know someone who is a new mom, ask her how she is really feeling and encourage her to seek help if she needs it.

“Some women think that because they’re discouraged from taking most medications during pregnancy that there isn’t anything their doctor can do to help with an anxiety or mood disorder,” says Dr. Widra. This is not the case. “We now have research to show that there are non-medical treatments that are evidence-based to help women with mental health problems during pregnancy. It’s also considered relatively safe to use some antidepressants during pregnancy.” The bottom line, says Dr. Widra, is there are effective medical and non-medical treatment options available to women even during pregnancy.

Life changes around pregnancy make women more vulnerable to mental illness. Mental healthcare provides the necessary support to empower women to identify resources and personal capabilities. This can enhance their resilience to difficult life circumstances and support them to nurture their children optimally. Caring for mothers is a positive intervention for long-term social development.

Here are some mental health tips for women during their reproductive years:

  • If you are feeling blue, anxious or depressed, don’t wait. Talk to your doctor or a mental health professional about it as soon as possible.
  • If you’re taking medications for a mood or anxiety disorder and you become pregnant, don’t stop taking them without talking to a mental health professional.
  • Eating well, regular exercise, and a good night’s sleep are important during this period of your life as they are at any time in your life.
  • Do things that are good for brain health such as meditation and yoga.
  • If you have a history of depression, be proactive and aware of any signs and symptoms.

For more information or to make an appointment with a doctor who specializes in women’s emotional health and reproductive psychiatry, call 410-328-6091.

Fertility: 12 things you didn’t know (and 1 to never ask)

By Katrina Mark, MD

1. Fertility naturally declines as we age

That alone doesn’t mean you should start to worry. The general advice I give a woman is if she has been trying to become pregnant for a full year with no luck, she might consider a fertility evaluation. For a woman over age 35, she might consider it after six months. If a woman is younger and has irregular periods, it’s likely she isn’t regularly ovulating, so she might want to be evaluated sooner.

2. Sometimes there’s a reason for infertility – and sometimes, there’s not

There are some things we know cause infertility. About 20 percent of the time, we find no reason for it. For a woman, infertility can be due to a condition that causes you to not ovulate regularly such as diabetes, thyroid disease and polycystic ovaries. It can also be caused by blocked fallopian tubes or a history of ectopic pregnancy. For men, it can be due to semen issues such as a low sperm count.

Early menopause in women under the age of 40 is rare, but it can run in families and cause infertility. Lifestyle factors such as smoking and obesity contribute to infertility in both women and men.

3. Taking birth control for long periods of time does not hurt fertility

No, taking birth control stops you from getting pregnant, but it doesn’t hurt fertility once you stop taking them.

4. If you are having trouble conceiving, consider these culprits:

  • Lifestyle factors: If you smoke, try to quit. If you are obese, try to lose weight. Vigorous exercise and low body weight can also cause ovary issues. Marathon runners and gymnasts have this issue frequently. Luckily, increasing body fat percentage or decreasing exercise a small amount can often correct it.
  • Chronic conditions: If you suffer from a chronic condition such as diabetes or hypertension, make sure you are managing it and keeping it under control.
  • Ovulation issues: For women who aren’t ovulating regularly, the first line is usually Clomid, a pill that makes a woman’s body produce eggs and ovulate each month. Many OB-GYNs will prescribe this, so you don’t necessarily need to see a fertility specialist.

If there’s no known reason trouble conceiving, your OB-GYN may refer you to a fertility specialist for treatment. Fertility specialists and even some OB-GYNs perform intrauterine insemination (IUI), where sperm are placed directly in the uterus around the time the ovary releases one or more eggs to be fertilized. In vitro fertilization (IVF) is when the sperm and egg fertilize outside the woman’s body and then the fertilized egg is implanted in the uterus.

5. Your OB-GYN can often provide some fertility assistance

If a woman is trying to conceive, she should share this with her OB-GYN. If she is having trouble, an OB-GYN can provide a general evaluation to look for causes, as well as provide education, which often is very helpful.

6. Don’t worry if it’s been a month or two and you’re not pregnant

Ninety percent of couples get pregnant within a year. Don’t worry if it’s only been a few months. This is normal and usually there’s nothing wrong with you.

7. The overall rate of infertility hasn’t changed

Although more are seeking treatment. In this age, more women may be delaying fertility because of better access to education and career opportunities. The average age of a woman when she has her first child has gone up over the last few decades. Delaying childbearing increases the likelihood for a woman to experience fertility issues. There also may be more people pursuing fertility treatment now because there is better access to treatment.

8. Egg freezing is much better than it used to be

Typically, egg freezing is recommended for those who desire it when a woman is between the ages of 35 and 38. If a woman is interested in having eggs frozen, she should speak with a fertility specialist. This technology has gotten better in the last several years and there has been better success. Fertility specialists can now freeze eggs without having to fertilize them. Insurance generally doesn’t cover egg freezing unless there is a medical reason.

9. Fertility treatments have come a long way

Overall, fertility treatment has high success rates these days. In vitro fertilization (IVF) has a very high success rate. Even for women who have premature ovarian failure, which is loss of ovary function before the age of 40, can opt for a donor egg and carry a pregnancy. Sometimes it depends on what a person is willing to go through and what you can afford, although many insurances cover some fertility treatment. Most don’t cover everything and it can be expensive.

10. There are reasons not to consider fertility treatment

Some treatments can be quite expensive. Some people may have moral objections. In some cases, a woman may have a chronic condition that it wouldn’t be recommended or safe to pursue pregnancy, such as certain heart conditions. Sometimes if either partner has a genetic disorder that is hereditary, they may not want to risk passing it along to a child. If a couple chooses not to pursue fertility treatment but still wants to have children, adoption or a donor egg are also options.

11. Fertility treatments aren’t just physically demanding

They’re also mentally draining. There have been studies that have shown a woman going through fertility treatments may experience the same level of depression as someone going through cancer treatment. The psychological aspect of fertility treatments is under-recognized. We view pregnancy as a positive thing because you get a baby at the end, but fertility treatment can make a person anxious and terrified – while trying to conceive and also during pregnancy and after the baby is born. Some women are traumatized from the experience and develop an anxiety disorder. Women often go through these struggles in private because they often don’t want to tell anyone. The same is often true with miscarriages. Many women experience very real grief and depression during these times. It’s important to make sure people are getting counseling because a lot of times they aren’t even talking to their friends or family about it. If you have breast cancer, people bring you food. There is no greeting card for infertility.

12. Don’t shy away from a friend who’s having trouble conceiving

If you someone close to you who is going through fertility issues, don’t completely ignore it or become distant. Be a friend, act normal and open yourself up to the person for conversation if he or she wants to talk. A lot of times people want to talk about it but don’t know how. Give them the hope and space to talk as much or as little as they want. Everyone deals with a loss and struggles differently; some are private about it and don’t want to talk about it, but others do.

Don’t ever ask a woman when she’s going to have a baby

For someone who is going through fertility treatment, being constantly asked when they’re going to have a baby can be devastating. You don’t know what someone may be going through.

Dr. Katrina Mark is an OB-GYN at University of Maryland Medical Center and Assistant Professor of Obstetrics, Gynecology and Reproductive Sciences at the University of Maryland School of Medicine.

 

 

 

What Can Women Do to Prevent Early Menopause?

About Early Menopause

The average age a woman goes into menopause is 51. Menopause is considered abnormal when it begins before the age of 40 and is called “premature ovarian failure.” Common symptoms that come with menopause include hot flashes, night sweats, sleep problems, sexual issues, vaginal dryness, pain during sex, pelvic floor disorders (urine, bowel leakage, pelvic organ prolapse), losing bone mass, and mood swings.

Menopause is mostly genetically predetermined, which means you generally can’t do much to delay it from happening. What you can do is work to counter-balance or prevent the symptoms and effects that tend to develop during menopause.

What You Can Do

Women can do a lot of things to prepare themselves for changes that will come with menopause. These include modifying your lifestyle so you are eating a healthy diet and exercising regularly.

Diet and Exercise

Related to diet, women should look into their caloric intake and make adjustments like eating smaller meal portions, and eating a well-balanced diet that includes lots of fiber and protein and less carbohydrates. Avoid eating late at night or snacking, which means no eating two to three hours before bed time.

Take calcium and vitamin D supplements for bone health to prevent osteoporosis. Well-balanced food with decreased caffeine intake also helps to decrease night sweats.

Exercise is one of the most important and modifiable factors that all women must take advantage of. Cardio workouts including walking or jogging three times a week will boost your cardiovascular system and endurance, and also help you control your weight. It’s also important to do weight-bearing exercises regularly to build up bones and prevent osteoporosis.

Kegels

Kegel exercises can help prevent pelvic floor disorders (urine, bowel leakage, pelvic organ prolapse). Kegel exercises should ideally be done every day three times a day. Every woman needs to know how to do Kegel exercises properly. Unfortunately, many women think they do Kegel exercises when, in fact, they do not, because the muscles are hidden inside the body. Your physician should be able to help you with it. You can do long squeezes for 10 seconds, or fast squeezes. This helps to maintain strength and endurance of the pelvic muscles in order to prevent urinary or bowel leakages in the future.

Mental Health

If possible, I recommend having regular sex. It improves vaginal lubrication and helps to prevent vaginal dryness and pain with intercourse. It is also good for your overall mood.
Finally, every women should work on developing a positive attitude, and spending time in a healthy environment helps – for example, taking frequent walks in a park or whatever makes you feel good; finding a way to de-stress and/or control any stress in your life. This will improve your mental health.

Hormone Therapy

Hormonal treatment for early menopause and menopause has been out of favor because of concerns with breast cancer, cardiovascular disease, and stroke. With that said, it is still gold-standard treatment especially for hot flashes and night sweats. Hormonal therapies could offer significant benefits to women especially those going through early menopause. Talk to your doctor about what is right for you.

Fertility

A woman going through early menopause is still fertile. Unless you don’t have periods at all anymore, there is still a risk that you can get pregnant, so it’s important to use some form of contraception to avoid pregnancy.

Harry Johnson, MD, is Assistant Professor of Obstetrics, Gynecology and Reproductive Sciences at University of Maryland School of Medicine and Division Head of Urogynecology at University of Maryland Medical Center.

 

 

Double Divas Visit UMMC Breast Center

The Breast Center at the University of Maryland Medical Center (UMMC) welcomed two very special guests on Wednesday, September 16: Lifetime TV’s “Double Divas,” Molly Hopkins and Cynthia Decker of LiviRae Lingerie, offered their unique custom bra fittings to the women of Maryland. The event was sponsored by the Department of Diagnostic Radiology and Nuclear Medicine, with a portion of proceeds donated to the Breast Center. Each woman in attendance received a bra fitting and LiviRae Lingerie merchandise.

Big-name stores simply don’t carry the array of sizes most women need, which makes bra shopping difficult and the final purchase disappointing. Even with tape-measured fittings, many stores sell women incorrect sizes. LiviaRae Lingerie is working hard to change the way women shop for bras. With a visual fitting, backed by years of product knowledge and experience, customers are sent away with a great-fitting bra and often a new perspective on undergarments.

To give back, Molly and Cynthia offered free bra fittings to several breast cancer fighters and survivors. As they waited for their turns, they shared their breast cancer stories. Linda Adamson, a 49-year-old woman living with stage IV metastatic breast cancer, was in good spirits and rocking some seriously stylish heels. She credits her optimism to her family, who is her biggest support system.

Linda PosingWomen like Linda who live in the Baltimore area have another support system too: The Baltimore City Cancer Program (BCCP), a community-based initiative of the UM Greenebaum Cancer Center that seeks to reduce the city’s rates of cancer morbidity and develop a framework for delivering cancer care to uninsured and underinsured populations. BCCP also provides free breast and cervical cancer screenings. Linda is a beneficiary of BCCP’s services. Her treatment, which included chemotherapy, radiation, and surgery, was completely covered.

Linda’s turn finally came, and Molly and Cynthia set her up in the dressing room with a few options to try on. When she emerged, Linda triumphantly threw her old bra into the trash can. “This bra fits like a dream—and it‘s cute too! I finally feel like myself again,” she raved.

Each woman left confident, comfortable and with a smile on her face. We’ll consider this visit from the Double Divas a much-needed mid-week lift.

Group Shot Double Divas

Recovering Cancer Patient Takes Control of Health and Weight

Verna Prehn, before and after

My Story of Getting Healthy

By Verna Prehn

Three years ago I was diagnosed with ovarian cancer. At the time of my diagnosis, I was a very large woman (weighing more than 300 lbs) with a very high “at-rest” heart rate and (we would find out later) severely malnourished.

I went through tough but successful treatment, including two surgeries, chemotherapy, artificial feedings with a nasogastric tube, and blood transfusions, under the care of Dr. Sarah Temkin at the University of Maryland Marlene and Stewart Greenebaum Cancer Center.

Chemo had many side effects, including bone pain, hair loss and weight loss (97 pounds), but it has successfully freed me from cancer for now, and Dr. Temkin keeps a close watch on my health, vigilant for a recurrence that would require additional treatment. Dr. Temkin told me that keeping the weight off that I had lost with chemotherapy treatments would be healthy for me and increase my survivorship.

After treatment was complete, I began to put on weight, but Dr. Temkin said not to worry too much because everyone puts on a bit of weight after they have completed treatment. But my little bit of weight became a lot more weight until I had put on all 97 pounds I had lost.

I went to Dr. Tais Baig in UM Family Medicine as my primary care physician to have her regulate medication for my high blood pressure and rapid heart rate. She ran tests and found that my blood glucose was high enough to suspect diabetes. Dr. Baig talked with me for a while, getting to know me and asked how she could best help me with my health.

I told her that I wanted to get the weight off because I wanted to increase my survivorship and I knew that being so heavy is a threat to my health. I told her that I didn’t know how to do it. I don’t know what good nutrition is, what’s good or bad to eat, and how to come up with a plan to lose weight. She told me about the University of Maryland Medical Weight Management Program through the Department of Family and Community Medicine. Dr. Baig helped me through getting an appointment to begin.

I met Dr. Verlyn Warrington at my first appointment. She explained the program, gave me lots of information and set me up for the group meetings with a licensed clinical social worker and behavior therapist. I was taking medication for high blood pressure and rapid heart rate, thyroid medication for an under active thyroid, an inhaler for asthma, and Dr. Warrington wanted to put me on medication for diabetes.

My first meeting with the support and accountability group was overwhelming. We talked about protein, protein, protein. We talked about portion size. We talked about eating several times a day and not skipping meals. Harriet told us that if we followed the plan we would lose 10 percent of our body weight in three months. It took me about a week-and-a-half before I gave the plan a try because I was afraid and overwhelmed. In three months, I did indeed lose 10 percent of my body weight. In fact, I lost 35 pounds that first three months.

Additionally, Dr. Warrington explained that I needed to increase my activity level. I had some restrictions on what I could do because of my knees and asthma. I began walking. I started walking around the perimeter of my neighborhood, which measures out to just over a mile. At first, I couldn’t walk and talk at the same time and I had to stop frequently to rest and catch my breath. As I have lost more weight and have increased my cardiovascular endurance, I have started exercising to on-line walking videos

I have learned so much from Harriet, Dr. Warrington, Dr. Vivienne Rose and the people in our support and accountability group. I know how to think and make good choices about eating. HALT is a good motto to follow because my emotions drive my eating habits. So I think: HALT – am I HUNGRY? Or am I ANGRY? or am I LONELY? or am I TIRED? Actually, I add an “S” to it (HALTS) – am I STRESSED?

I read the labels on food and check them for calories, fat and sugar content. I measure my food so that I keep healthy portion sizes. (Portion size was a huge surprise to me. I had an unrealistic concept of what an individual serving was and what was actually food for two or three people.)

I keep track of my food in a food journal through MyFitnessPal.com. It also keeps track of my exercise and activity level. Dr. Warrington told me about this tool to use because I had gone about two months and had only lost one pound. Dr. Warrington and the food journal help me to realize that I was eating too few calories – I wasn’t eating enough food.

Dr. Vivienne Rose and Harriet Mandel present Mrs. Verna Prehn with a congratulatory plaque marking her 100 pound weight loss

Dr. Vivienne Rose and Harriet Mandel present Mrs. Verna Prehn with a congratulatory plaque marking her 100 pound weight loss

 

It has been 14 months since Dr. Warrington, Dr. Rose and Harriet helped me make a lifestyle change that is healthier for me and increases my rate of survivorship. At my last appointment and weigh-in, I had lost 100 pounds. It took 13 months. I am no longer on medication for my heart or blood pressure or thyroid. My blood glucose is no longer in the diabetic or pre-diabetic range. I have walked two 8k walks. I walk to videos or outdoors five times a week. I do strength training exercises with weights and bands. I am starting a faith and fitness class with a trainer and will begin a gym membership soon. I can walk my entire neighborhood in 20 minutes without stopping and while carrying on a conversation at the same time.

I still have a considerable amount of weight to lose to get to a healthy weight that I am comfortable with. I feel so much better already. I take the steps instead of the elevator and it doesn’t hurt my knees! I know so much more about what is a healthy food choice and portion size. The University of Maryland Medical Weight Management program, Dr. Warrington, Dr. Rose and Harriet have helped me claim a new healthier way of living.

Verna Prehn

Elkridge, Md.

UMMS “Spring Into Good Health” Event Gets Shoppers Dancing in the Center Court at Mondawmin Mall

By Sharon Boston

UMMC Media Relations Manager

Each spring, the University of Medical System (UMMS) hosts “Spring Into Good Health,” a free event attended by hundreds of people who receive medical screenings (such as blood pressure and cholesterol), talk one-on-one with University of Maryland Medical System health professionals and pick up information on men’s and women’s health, child safety, nutrition and more.

This year, the UMMS Community Outreach and Advocacy Committee wanted to put a focus on fitness and hosted a dance party right in the middle of Mondawmin Mall!

Several guests commented that they didn’t realize that fitness could be so fun, and that they plan to try to exercise more and eat better, thanks to the information that they picked up at the UMMS event.

Take a look at the some of the line dancing that got people of all ages up and moving.

 “The dancing was really upbeat and lively, it really got people moving,” said Donna Jacobs, UMMS senior vice president for government relations. “Several people told us that they’d like to see even more fun physical activities next year.”

Five of the 12 hospitals in the University of Maryland Medical System took part in the event — the University of Maryland Medical Center, Maryland General Hospital, Kernan Orthopaedics and Rehabilitation Hospital, University Specialty Hospital and Mt. Washington Pediatric Hospital. The event was also sponsored by Maryland Physicians Care, Total Health Care, Coppin State University School of Nursing and Radio One, Baltimore.

Back to Reality

By Sharon Boston
Media Relations Manager

Vivenne Rose talks with Shanice during her baby’s check up as the video crew records the action.

The University of Maryland Medical Center goes primetime on Tuesday, October 19 at 9:00 p.m. when the Discovery Health Channel airs “I’m Pregnant And…Morbidly Obese,” a show that followed one of our patients before and after her delivery.

The program tells the story of Shanice Glenn, a 26-year-old Baltimore woman who had a Body Mass Index of 53 (30 is considered obese) when she gave birth to her second daughter earlier this year. Shanice is a patient of Family Medicine physicians Dr. Vivienne Rose and Dr. Ada Orisadele.

The crew spent many hours with us, videotaping in several different locations including Family Medicine and the Mother/Baby unit. Watch the show to see if you can spot any places you recognize.

The show was originally scheduled to air in September, but the Discovery Health Channel postponed it until October 19.

Check out our previous blog with behind-the-scenes details of what happened when “Reality TV Came to UMMC.”

Other Posts By Sharon Boston:

Dr. Ahmet Baschat Becomes Couple’s Hero After Performing Surgery to Save Twins

After being diagnosed with Twin to Twin Transfusion Syndrome at a local hospital, Liz Tarallo was referred to Dr. Ahmet Baschat at the University of Maryland Medical Center’s Center for Advanced Fetal Care (CAFC). Dr. Baschat performed laser ablation surgery that saved the lives of Liz’s twin boys. In this video, Liz talks about her experience at the Medical Center and the excellent care she received from the entire CAFC staff, and explains why she and her entire family consider Dr. Baschat to be their hero.

UMMC Hosts First-Ever Online Video Chat

By Michelle Murray
UMMC Assistant Web Site Editor

Are you expecting twins? Wondering what you can do to minimize risks in complicated pregnancies?

It’s easy to get the answers: just log on and post your questions live on Friday, September 24 at 1 p.m. during our first-ever video chat with Dr. Ahmet Baschat, head of fetal therapy at UMMC’s Center for Advanced Fetal Care.

You can chat directly with Dr. Baschat, who will cover topics such as twin pregnancies, complicated fetal conditions and other maternal/fetal issues. Visit our video chat page to send in questions ahead of time and receive e-mail reminders, or just submit your questions live on the day of the chat.

Details:

When: Friday, September 24 at 1 p.m.
Where: www.umm.edu/webchat

In the coming months, we plan to feature other UMMC doctors, who will answer your questions on a variety of health topics. If you have ideas for topics you’d like to see covered, let us know by e-mailing us at: (webmaster.umms.org) And remember to tune in live on September 24th!

Reality TV Comes to UMMC

By Sharon Boston
Media Relations Manager

Kendra Johnson
Kendra Johnson was born at UMMC on April 25, weighing 7 lbs, 9 oz.

Meet Kendra Johnson, born at the University of Maryland Medical Center on Sunday, April 25, 2010, at 11:37 p.m. Kendra’s birth and her mother’s pregnancy are the subject of a Discovery Health Channel program called “I’m Pregnant And…,” a show that follows women facing particular challenges in their pregnancies.

For Kendra’s mother, 26-year-old Shanice Glenn, obesity put her at increased risk for complications in her pregnancy, such as diabetes and high blood pressure. Just before giving birth, Shanice weighed more than 270 pounds, with a Body Mass Index of 53. (A BMI of 30 or above is considered obese).

The program, called “I’m Pregnant And…Morbidly Obese,” follows Shanice through the final stages of her pregnancy and after delivery, as she works with Dr. Vivienne Rose and Dr. Adaku Orisadele from the Department of Family Medicine to have a healthy baby and then makes plans to get healthier herself by losing weight safely.

Here’s some behind-the-scenes scoop on what happened, including how the baby’s early arrival nearly sank the whole project. We’ll also let you in on what it takes to put together a half-hour reality show like this one and what you can look for when the program airs on Tuesday, October 19, on the Discovery Health Channel at 9 p.m.

Shanice Glenn with her sister
A videographer captures the action in the Mother/Baby unit the day after Shanice gave birth. In this photo, Shanice holds Kendra while talking to her sister.

How It All Got Started

In mid-April, our office received a call from the show’s production company, Sirens Media, with a request to follow Shanice, who was a patient of Dr. Rose and Dr. Orisadele. (They found Shanice when they put out a request to the American Society of Bariatric Surgeons, and a Family Medicine colleague forwarded the request to Dr. Rose).

Ideally, the crew wanted to videotape Shanice at her doctor’s appointments and in her hospital room before and after giving birth. They also wanted to videotape the delivery, which they would shoot discreetly. For a half-hour show, you need a lot of footage, and the delivery is often a key scene in the program.

Shanice, Dr. Rose and Dr. Orisadele were all on board for this. But, as you can imagine, a lot of other people needed to sign off on this before we would allow a crew in Labor & Delivery. (A member of the media relations team must always accompany any crew while they are in the hospital, so I had planned to be on-call and come in when Shanice gave birth if it happened at night or on a weekend).

For a production company like this one, there are also location release forms that need to be signed, so we had our legal department reviewing those while we worked on coordinating what we might be able to allow in terms of videotaping the delivery.

Can We Come Earlier?

Time is of the essence when you’re dealing with a pregnant mom. But, Shanice’s due date was May 4, so we thought we had some time. She had an appointment with Dr. Rose and Dr. Orisadele on April 30, so we were working to coordinate when the crew would arrive, where they would interview the doctors, etc. for that last day of April.

However, the week before, producer Diana Nolan called to say that Shanice had another doctor’s visit on April 23, and the crew wanted to come for that too. Could we make that happen?

Shanice would have a long day of tests and appointments, and the crew wanted to be there for any and all of it, and they kept coming up with more questions and more requests. Along with the doctor visit, could they videotape Shanice’s fasting glucose test? What about her ultrasound? How long would her appointment last? What kinds of things would she be doing in the appointment? Could they videotape outside the hospital? What do our signs say? And so on.

To make this happen with just a day or two’s notice, I was making dozens of phone calls and sending lots of e-mails. The appointment would take place at a different location than the delivery, requiring a separate location release and a different team of lawyers, and we were literally faxing the final forms while the crew was driving here from the D.C. area.

At the time, it seemed very last-minute and somewhat stressful, but with the help of the folks in Family Medicine, OB/GYN and two legal departments, we were able to get this arranged.

And, as you’ll read later, it’s a very good thing we pushed to get the appointment videotaped that day!

Taping Day

Even though Shanice’s appointment wasn’t until midday, the crew arrived in the morning so we could be outside filming “establishing shots,” such as the hospital exterior, the outside of Family Medicine and signs that say “University of Maryland Medical Center.” The producers could use them as transitions between scenes and as a way to establish where the action is taking place.

The interviews from this day would provide much of the main narrative for the show, so they had to look and sound great. The crew brought a huge cart of video equipment, which we needed to keep out of the way of the medical staff and other patients. Diana was there along with a videographer and sound technician. Later in the day, another producer joined the team.

The crew interviewed both Dr. Rose and Dr. Orisadele separately. The producers commented that both doctors were fantastic and could explain, in simple language, why Shanice’s weight put her and her baby at increased risk for medical complications.

The doctors also talked about some of the social pressures that can make losing weight a challenge. After the interviews, the crew videotaped Shanice’s appointment with Dr. Rose and Dr. Orisadele. At one point, there were eight people, including Shanice, in the exam room!

With that Friday appointment and a long day of shooting behind us, we decided to regroup on Monday and talk about the plans to shoot Shanice’s next appointment and the delivery, which was still a week-and-a-half away. However, baby Kendra had other ideas.

Early Arrival

Monday morning I awoke to find two voicemails and a text message on my cell phone from Diana. Shanice had gone into labor the night before, and Kendra had been born without complication just before midnight.

Luckily, we had pushed to get the footage on Friday! Without that, the whole program would have been scrapped. Shanice’s family also had some home video from the night before, which they would give to the production company, so the producers thought they would have enough to continue the project.

By 9 a.m. on Monday, Diana and I were planning what to do next. The production team wanted to come that day to interview Shanice and get footage of her with Kendra. After a few phone calls, we had everything arranged, and Diana, her videographer and I spent several hours with Shanice, Kendra and their family in the Mother/Baby unit. The producers captured some wonderful interaction between Shanice and her nurses, but we’ll have to see how much of it makes the final cut.

Media Crew
The crew from Sirens Media documents Shanice and Kendra’s visit with Dr. Rose in Family Medicine. This appointment came just four days after Kendra’s birth and happened to be Shanice’s birthday.

Follow-up Visits

Just a few days after giving birth, Shanice was back for a check-up with Dr. Rose, and the Sirens Media crew and I were there right along with them. Dr. Rose checked on Kendra and talked to Shanice about breast feeding and eating right. They also talked about some strategies for losing weight long-term. Diana thought this would probably be the final day of shooting for Dr. Rose and the rest of us at UMMC.

Of course, the crew wanted to come back. They returned at the end of June to videotape another follow-up visit for Shanice and Kendra. One key scene for viewers will be to see if Shanice had been able to lose some weight in the two months after Kendra’s birth.

The Show

If you’ve ever watched “I’m Pregnant And…,” you know that the program takes a hard look at some difficult issues facing these pregnant women. We expect Shanice to be the main focus with Dr. Rose, Dr. Orisadele and the rest of staff playing supporting roles.

In watching all the interviews and spending time with Shanice, I was impressed by her openness, thoughtfulness and patience. She is an intelligent and caring woman, and I hope that comes across on the show.

Other Random Notes

If I had to estimate, I would say the crew spent about 15 hours with us for this production.

The producer told me some show topics they’ve covered include, “I’m Pregnant And… Homeless,” “I’m Pregnant And…Addicted” and “I’m Pregnant And…a Nudist.”

Kendra was born on a night with extremely strong thunderstorms, and Dr. Rose said she had a tough time driving to the hospital. In fact, Kendra came so fast that Dr. Rose did not make it in time for the delivery. Dr. Orisadele was there.

The production crew filmed Shanice’s baby shower. They also followed her as she went shopping for baby things.

Shanice has another daughter, a chatty 3-year-old named Kiyah, who kept us entertained with lots of questions and observations through two of the shoots. When asked who the new baby was, Kiyah emphatically told us, “That’s my sister!”

As a media relations manager, I am always there when a TV crew is videotaping. However, I do all I can to stay off-camera because, in reality, I wouldn’t be there. This time, I apparently didn’t do enough. Diana e-mailed about a month ago asking me to sign a release form because there is one shot where you can see me and our media relations intern in the waiting room of Family Medicine. The shot comes at the end of the show during Shanice’s final visit with Dr. Rose.

The episode of “I’m Pregnant and Morbidly Obese” featuring Shanice, baby Kendra and UMMC is scheduled to air Tuesday, October 19, at  9 p.m. on the Discovery Health Channel.

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