Friday, February 1, 2019

It Didn't Have To Be That Way

Editor's Note: The following article is the fourth of six stories TMA's Healthy Vision 2025 advocacy plan, highlighting TMA's priorities for the 86th Legislative session. In this piece, Eugene Hunt, MD,  shares a tragic experience with a mother of a newborn, and the need to improve overall maternal health in Texas. 

Eugene Hunt, MD, estimates he’s attended the delivery of thousands — “three, four, five thousand?” — of infants in his 35 years of practice as a Dallas obstetrician.

Two “sad, sad, sad” cases stick in his mind. In one, the mother died just before going into labor; Dr. Hunt performed a cesarean section and saved the twins inside her body.

The other case has changed the way he monitors and cares for his patients weeks and months after they’ve taken their newborns home.

“You bet your boots,” Dr. Hunt said as he recounted the tragedy. “I have gone out and picked up patients from their homes and taken them to psych wards. I’ve brought them back to my office and called psychiatrists. The idea that one day after I talk to a lady she commits suicide is an experience that I can never ever forget.”

After a routine pregnancy and delivery, the lady — we’ll call her Sharon — took home a “beautiful baby girl.” Some six to eight weeks later, she called Dr. Hunt to talk and shortly after showed up at his office.

“She seemingly looked fine, she didn’t look all distraught,” he said. “She began telling me about some of the challenges of the baby and how the baby seems to cry a lot. … She was overwhelmed, and it was kind of difficult.”

Dr. Hunt says he offered Sharon reassurance, telling her that her experience is common among new mothers and won’t last. “A better day is coming,” he said.

Then the conversation turned in a way that Dr. Hunt unfortunately recognized only in hindsight.

“She at one point made that little suggestion that someone, maybe family, had actually shot themselves. And then she said ‘I would never actually do anything like that.’ Forever, if anybody tells you they will never do something, you perk up.”

After more supportive conversation, he sent Sharon home, where her husband and mother were helping her care for the baby. Early the next morning, Dr. Hunt recounts, she put the infant in bed with her husband, walked to the garage, took a pistol from the glove compartment of her car, and shot herself.

Initially angry and disappointed at Sharon’s suicide, Dr. Hunt says a conversation with a colleague helped him understand the catastrophe. “He was thinking from her perspective, ‘She is so overwhelmed, she is so distraught, and post-partum depression can certainly put her there.’”

Post-partum depression is not the “baby blues” that 50 to 60 percent of mothers experience in the first few months after delivering a baby. As many as one in seven new mothers acquire the serious psychiatric disorder known as post-partum depression. It’s the tipping point where the physical, emotional, hormonal, and psychological changes surrounding pregnancy and birth gang up to create a dangerous mental illness in the mother.

“It is so overwhelming to the individual with the multitude of changes going on in every bit of their being that you’ve got to watch them,” Dr. Hunt said. “We must address every lady who has a baby, when we’re discharging them from the hospital, we better talk about post-partum depression. It’s recognized. This is real. And you can save lives when it’s talked about properly.”

Sharon’s story is a regular reminder. “I had to wonder, what might I have said? What might I have done? This is part of the medical profession’s burden when we have patients who do such things as this,” he said. “What would have kept this tragedy from happening?”

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