There are some patients that keep you humbled. Barbara Tate was one of those patients. With a shopping list of chronic conditions a mile long, she was told she could never carry a baby because she had miscarried two during her early 20’s. She suffered the hammer blows of diabetes, high blood pressure, congestive heart failure and asthma. And it doesn’t stop there. Tate also had a history of two slipped disks, a cellulitis infection and a non-cancerous tumor on her adrenal gland. In fact she was scheduled to have surgery until she discovered she was pregnant at the age of 43. She was strongly encouraged to terminate the pregnancy because of her multiple medical conditions but she didn’t. Tate viewed her pregnancy as a miracle and for all intent purposes, it was. After age 37, there is a rapid decline in the ability to conceive although not impossible.

Her baby was born three months early and it appears that she was unaware of the classic signs of premature labor. On the day of her child’s birth, she had been complaining about back pain but attributed it her adrenal tumor. She rested and then got up to use the bathroom thinking that she had an “accident” when most likely it was probably a case of ruptured membranes (or her water “breaking.”) At that point, the baby’s feet were emerging and Tate called for help. Luckily, the baby delivered spontaneously and did not require assistance perhaps because it only weighed 2-pounds-7 ounces. By the time the Emergency Medical Support team arrived, the only thing left to do was cut the umbilical cord. Both mother and baby were whisked to the local hospital initially but then the baby was transferred to a regional hospital 79 miles away in critical condition. Tate was discharged home the next day and the baby’s condition has improved.

Tate’s case is yet another example of a near-miss pregnancy and delivery disaster and she would certainly have benefited from someone performing a
• measurement of her cervical length by ultrasound during the early second trimester to determine her risk factors for preterm labor
• a referral to a maternal fetal medicine specialist given her complex medical history
• a referral to a Healthy Start Program to obtain social service support

Tate’s car is not in the best condition so friends have volunteered to drive her 160-miles in order to visit her baby and donation jars for gas money has been left in strategic locations. Her determination is commendable. Although the baby had a stormy beginning, hopefully it will continue to thrive. Miracles do happen. Hopefully Tate’s story will inspire infertility patients to please, keep the faith.