When Megan Miller found out she was pregnant in 2020, she had no reason to believe she would have anything but an easy pregnancy.
At 27, she was young and healthy, and she had no issues conceiving. Everything should have gone off without a hitch. But it didn’t.
“When I had my 19-week scan—the anatomy one—they saw some genetic abnormality,” Miller recalls. “She had shorter limbs, a hole in her heart, and a pushed-back chin. They also saw some chromosomal abnormality consistent with Down syndrome.”
Doctors said that her baby had a condition called intrauterine growth restriction, meaning she wasn’t growing to a normal weight while in the womb. Miller, who had planned to deliver with the help of a midwife, now needed specialized care for the remainder of her pregnancy. Thankfully for her and her unborn baby, the exact care she needed was available under the supervision of Sean Daneshmand, MD, the medical director of the maternal-fetal medicine program at Scripps Clinic, who’s recognized as one of the region’s leaders in treating high-risk pregnancies.
Recognizing the growing need for this specialized care, Scripps invested in ramping up its perinatology program in 2018. It’s an investment that has continued to grow under Daneshmand’s purview and an executive leadership committed to the cause.
“When I hear the stories of these high-risk moms and the support they need, it emphasizes the need to escalate the program even higher,” says Ghazala Sharieff, MD, chief medical officer at Scripps. “Over the past three years we’ve been rolling out the perinatology program from south to North County, putting together a comprehensive program to take care of moms and their families. We are seeing more people with diabetes, hypertension, and mental health issues that are impacting their pregnancies. This has really highlighted the importance of meeting their needs.”
And the needs are growing. A 2020 study by Blue Cross Blue Shield found that pregnancy and childbirth complications have risen 31.5 percent in recent years as more Millennial parents-to-be enter pregnancy with preexisting conditions that increase their chances of having a high-risk pregnancy. Millennials make up 85 percent of all pregnancies in the United States, and according to the Blue Cross Blue Shield Health of Millennials report, this age group has experienced a double-digit increase in eight of the top 10 health conditions—conditions like depression, hypertension (high blood pressure), and Type 2 diabetes, which can lead to high-risk pregnancies and childbirth complications. The study reported that since 2014, women age 18 to 44 have seen a 35 percent increase in major depression, a 31 percent increase in hypertension, and a 28 percent increase in Type 2 diabetes.
Add these growing numbers to the uncertainty COVID-19 has brought into the physical and mental health picture, and it creates the perfect storm for challenging pregnancies.
“The trends reported in the Blue Cross Blue Shield study are things we are seeing locally in San Diego,” Daneshmand says. “We don’t want to see these trends anymore, so we are developing a comprehensive program, adding ancillary staff to help these moms navigate through the tough time, bringing in people who can provide care with compassion and respect, making sure access is available to patients scattered throughout the region, and working in parallel with community groups on prevention programs to reduce the mom’s risk before she even gets pregnant. A lot of babies’ health complications can be optimized if the mom is healthy first.”
As Daneshmand and his team continue to develop a first- class perinatology program, current patients like Miller are grateful the specialized care was available when they needed it most. Under the care of Daneshmand and her OBGYN, Stephen DiMarzo, MD, at Scripps Memorial Hospital La Jolla, Miller was monitored closely for the remainder of her pregnancy.
“When you’re high risk, it’s the perinatologist who’s really looking out for you and calling the shots,” she says. “Dr. Daneshmand saw me twice a week for four to five months, monitoring the baby and seeing how she was doing. He kept an eye on my amniotic fluid because it was getting low. He sent me to a cardiologist to observe the hole in my baby’s heart. He was so encouraging the whole time, telling me, ‘I’m rooting for you.’ When you’re a scared new mom and don’t know what’s going to happen with your baby, having someone encouraging you and rooting for you is huge.”
Despite many bumps in the road—thinking she’d have to have an emergency cesarean-section delivery early—Miller’s water broke at 37 weeks. She delivered a 3.5-pound baby girl named Galilee on June 27, 2021.
“She was a long, skinny little thing, and yes, she was small, but she didn’t have anything wrong with her!” Miller marvels. “They did the genetic test and didn’t find any chromosomal abnormalities like they had in the ultrasound, and the hole in her heart closed. She had to stay in the NICU because she was born early, but three weeks later we got sent home early, healthy and happy.”
That’s Daneshmand’s goal for Miller and every other future parent he sees. “Every mom wants to have a healthy pregnancy,” he says. “To do that, we have to believe in what we’re doing and have that drive and passion for our patients. We are committed to making sure all women and children are well taken care of, and we are invested in changing outcomes for every mom and baby in our care.”
Future parents in San Diego have another superpower on their side, in the form of a hospital exclusively devoted to the care of people who can become pregnant at all stages of their life. Sharp Mary Birch Hospital for Women & Newborns is not just the only women’s hospital in San Diego, it also welcomes more babies each year than any other hospital in California—nearly 8,000. It’s widely recognized as a leader in patient- centered labor and delivery services and advanced treatment for high-risk pregnancies.
“The highlight of Sharp Mary Birch is that it’s a freestanding hospital dedicated solely to women and children, with the highest volume of both high- and low-risk deliveries in California,” says Joanna Adamczak, MD, perinatologist and chief medical officer at Sharp Mary Birch. “Our NICU is top notch, we’re a leader in groundbreaking neonatal research, and we have the benefit of geography, being attached to Rady Children’s Hospital. That means mom and baby are never separated.”
Sharp Mary Birch made headlines in late 2018 when “Baby Saybie” was born. At just 23 weeks, she weighed 8.6 ounces at birth, the world’s smallest baby who survived. Saybie spent five months in the NICU and went home at the end of May 2019, healthy and growing.
While Saybie’s case is extremely rare, Adamczak says that Sharp Mary Birch is no stranger to treating cases of a high- risk nature: “We specialize in multiples—twins, triplets, and quads—and we truly specialize in the fetal aspect of maternal-fetal medicine: babies with complex cardiac issues or other complications diagnosed antenatally. Due to our proximity to Rady Children’s, other hospital systems will ultimately transfer these extremely high-risk moms to us for delivery. We also have the largest maternal-fetal medicine groups in San Diego that specialize in treating moms with dangerous preexisting conditions, like lupus, cancer, and now COVID.”
Sharp Mary Birch even houses a perinatal special care unit, where high-risk patients who require hospitalization for the duration of the pregnancy, most often for placental complications, receive round-the-clock care. Adamczak explains that before the pandemic, they offered group activities, like book club and pet therapy, to make these patients feel as comfortable as possible during an uncomfortable time.
And she would know. “Speaking from both a professional standpoint and a personal standpoint, Sharp Mary Birch really is the best high-risk pregnancy hospital in California,” she says. “As a doctor and a mom who conceived via IVF at an advanced maternal age and ultimately had to have an emergency C-section, I wouldn’t deliver anywhere else.”