Celebrating 10 years of excellence: A candid conversation with Dr. Michael Belfort

Since taking the helm as OB/GYN-In-Chief in Jan. 2011, Dr. Michael Belfort has built a reputation for Texas Children’s Pavilion for Women as a world leader in obstetrics, gynecology and fetal intervention. As Dr. Belfort marks his 10-year milestone at Texas Children’s, he reflects on some of his team’s notable accomplishments over the last decade and shares his vision for the future.

What inspired you to pursue a career in medicine, particularly in obstetrics and gynecology?

My father was a family doctor, and from my earliest days, I only wanted to be a doctor. There was no second choice in my mind. I specifically chose obstetrics and gynecology because I wanted to dedicate my life to the beginning of life and provide care to the most vulnerable patients at a time of great risk. I spent most of my career focused on the critical care needs of the pregnant patient, and now my focus includes caring for the fetal patient and developing life-saving interventions to treat conditions early on in fetal development to ensure the best outcomes for the baby. The field of obstetrics and gynecology is plentiful and offers so many different avenues for specialization – maternal fetal medicine, reproductive endocrinology, ultrasound/diagnostics, surgery and more. For me, this branch of medicine offered the widest scope of interests and capability and I enjoy every aspect of it.

What are some accomplishments you are most proud of during your leadership?

As I reflect on my 10 years here at Texas Children’s Pavilion for Women, I can’t help but think about how much we have grown. Our growth is not measured only by the dedicated space we have to care for our neonates and women during every stage of their reproductive lives, but also by the tremendous growth in our faculty, and by the leadership and diverse expertise each one of them brings to our field. We have also seen growth in our fellowship programs, and the expanded services we provide to our patients and families.

When I arrived at Texas Children’s on Jan. 1, 2011 – one year before Texas Children’s Pavilion for Women opened – we had roughly 2,000 deliveries annually with our then partner, St. Luke’s Hospital. Today, we are delivering about 7,000 babies in the Pavilion. In 2011, we had 35 faculty in the department of Obstetrics and Gynecology at Baylor College of Medicine. We now have almost 200 faculty members. Besides creating our first Maternal-Fetal Medicine fellowship program, we added several new fellowships, including Reproductive Endocrine and Infertility, MFM Critical Care, MFM Genetics, Fetal Surgery, Ob/Gyn Hospitalist, Global Women’s Health, and Perinatal Surgery, which is the only one in the world where we train board certified Maternal-Fetal Medicine doctors and board certified Pediatric Surgeons to become Fetal Surgeons.

Last year, we elevated the standard for Maternal-Fetal Medicine in our region with the opening of our four-bed OB/GYN intensive care unit, which is another huge accomplishment. It’s staffed 24/7 by a Pulmonary Critical Care and Maternal-Fetal Medicine care team embedded in our hospital’s labor and delivery unit. We have 750,000-square-feet of space dedicated to women and neonates. We also have one of the only women’s mental health departments that Dr. Lucy Puryear has grown and led that is quite unique. We have five psychiatrists in the department of OB/GYN. These sorts of offerings are just remarkable in the field, and a source of admiration from other department chairs, quite frankly, when they see how well-resourced we are here and how we are able to deliver these innovative, comprehensive services to our patients.

Speaking of innovation, your team has led many innovative efforts to treat fetal complications early on in development to improve outcomes. What are some innovations that stand out to you?

Texas Children’s Fetal Center® is among the nation's leaders in providing high-risk maternal care and diagnosing and treating abnormalities in unborn and newborn infants. In 2014, our multidisciplinary team of fetal surgeons performed the first fetoscopic neural tube defect (NTD) repair surgery for spina bifida using an innovative approach that one of our pediatric neurosurgeons, Dr. William Whitehead, and I pioneered.

While other laparoscopic surgeries are performed using three ports, we developed a minimally invasive technique where only two, 4-millimeter incisions (ports) are made in the uterus. We believe the lower number of holes in the uterus, the better the outcomes – and this has actually proven to be true. We did our first case on a little boy named Grayson, who is now six years old and he is doing remarkably well. I will forever be grateful to his mother Althea. When I asked her, “Do you know you’re going to be the first person to have this surgery in the world?”, she looked at me and said, “There always has to be someone who goes first and we trust you and Texas Children’s.”

We are now coming up on our 100th fetoscopic NTD case! In Dec. 2019, we held our first simulation training course for fetoscopic spina bifida repair, with 12 international teams of fetal surgeons attending from virtually every continent to learn how to perform this two-port technique, which has been truly groundbreaking.

There are so many other fetoscopic innovations at Texas Children’s that I am very proud of. We have developed two surgical techniques to prevent massive blood loss when treating pregnant women with high-risk complications like placenta accreta, a life-threatening condition in which the placenta grows too deeply into the uterine wall leading to severe hemorrhage after delivery. Most recently, in July 2018, we performed the world’s first experimental, laser-assisted fetal atrial septal stent placement in a patient with hypoplastic left heart syndrome to improve blood flow through the heart. The surgery was a success.

We also did a quite remarkable case on a pregnant patient with amniotic band syndrome, where the amniotic band gets torn and twisted into a very strong band. In this case, it wrapped around the baby’s cord and the baby’s ankle so tightly that it was going to amputate the baby’s foot. Our fetal team successfully performed the first ever fetoscopic removal of the band and release of the amnion.

What advice do you have for young clinicians wanting to assume a leadership role in medicine?

Leadership is the ability to develop a vision and get others to realize, share and implement that vision. We are all leaders. It doesn’t matter what we do. Leadership is the ability to not just come up with great ideas, but to make those ideas happen. It’s about always keeping an open mind to innovation and working together to find new ways of doing things more effectively to maximize the best outcomes. When we hire people, we’re looking for not just somebody who has the physical capabilities of being a good clinician or being able to do the job. We want somebody who has vision and somebody who we can see as a leader.

Where do you see the Pavilion for Women in the next five to 10 years?

While we have accomplished so much in these last 10 years, I see more growth and expansion in our services to women and neonates. I see us increasing our inpatient and outpatient capacity and reaching 9,000 deliveries at the Pavilion for Women. I see an expanded reproductive endocrine family fertility center with some exciting new programs. I also see us moving to Austin and building a hospital there that will bring innovative, high quality care to the women and children there. There’s a lot to be done in the next five to 10 years. I’m excited to be part of it!

Besides caring for our patients, what do you like to do outside of work?

One of my favorite hobbies used to be running. I ran 12 marathons, but recently, my knees have stopped cooperating, so I have taken a break from running. The hobby I really enjoy most is aviation. I have both fixed wing and helicopter licenses and I love to fly around Texas with my wife Joanne and our dog Duncan.  

Click here to watch video of Dr. Belfort sharing some of his team’s outstanding achievements over the last decade at Texas Children’s Pavilion for Women.