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Pregnant in a time of coronavirus - the changing risks and what you need to know

Pregnant in a time of coronavirus - the changing risks and what you need to know

"So, being pregnant and delivering in a pandemic … what's that gonna look like?"

That question, sent to me by a colleague who is both a registered nurse and an expectant mother, stopped me in my tracks. As an OB-GYN physician, I naturally focus on the science of health care. Her email reminded me of the uncertainty expectant mothers now face as health risks and the health care system around them change amid this coronavirus pandemic.

While knowledge about the new coronavirus disease, COVID-19, is rapidly evolving and there are still many unknowns, medical groups and studies are starting to provide advice and answers to questions many expecting families are asking.



Do pregnant women face greater risk from COVID-19?

So far, the data on COVID-19 does not suggest pregnant women are at higher risk of getting the virus, according to the American College of Obstetricians and Gynecologists. However, as we have seen from the flu they are at greater risk of harm if they get respiratory infections. Pregnancy causes a variety of changes in the body and results in a slight immunocompromised state which can lead to infections causing more injury and damage.

Does having the coronavirus create a greater risk of miscarriage or preterm labor?

Studies have not yet been done to show if having COVID-19 during pregnancy increases the chance of miscarriage, but there is some evidence from other illnesses. During the SARS coronavirus epidemic in 2002-2003, women with the virus were found to have a slightly higher risk of miscarriage, but only those who were severely ill.

Having respiratory viral infections during pregnancy, such as the flu, has been associated with problems like low birth weight and preterm birth. Additionally, having a high fever early in pregnancy may increase the risk of certain birth defects, although the overall occurrence of those defects is still low.

Can a mother with COVID-19 pass the virus to her baby in the womb?

This data is evolving fast. Two papers published March 26 describe finding coronavirus antibodies in three newborns of mothers with COVID-19. That could suggest they had been exposed to the virus in the womb, though the virus itself was not detected in their umbilical cord blood and researchers have raised questions about the type of test used. Researchers in an earlier study found no evidence of COVID-19 in the amniotic fluid or cord blood of six other infants born to infected women. While the research papers include only a small number of cases, a lack of vertical transmission – from the mother to child in utero – would be consistent with what is seen with other common respiratory viral illnesses in pregnancy, such as influenza.

There have been a few reports of newborns as young as a few days old with infection. But in those cases, it is believed that the mother or a family member transmitted the infection to the infant through close contact after delivery. The virus can be transmitted through a cough or sneeze, which could spread virus-laden droplets on a newborn.

How are prenatal checkups changing?

Prenatal care may look different for a while to control the spread of COVID-19 among patients, caregivers and medical staff.

Typically, a pregnant woman has about 14 prenatal visits. That may be reduced by approximately half, with telemedicine playing a larger role. Telemedicine is already endorsed by the American College of Obstetricians and Gynecologists for patients in rural settings. Now, the pandemic is making virtual care solutions an indispensable tool. Pregnant women are able to do some at-home monitoring, such as for high blood pressure, diabetes and contractions, and telemedicine can even be used by pregnancy consultants, such as endocrinologists and genetic counselors.

The frequency of sonogram appointments may also change. The Society of Maternal Fetal Medicine says it is safe to reduce "routine" ultrasounds at this time without jeopardizing the health and safety of the pregnancy. Of course, some patients with specific conditions like twins or babies with suspected birth defects may require more traditional follow up.


images.theconversation.com

What should I expect during delivery?

Hospitals are doing what they can to minimize person-to-person transmission, and that may mean delivery looks different, too. Some hospitals are screening all medical staff, including with temperature checks, at the start of shifts.

Visitors are also being restricted. Recently, a hospital in New York enforced a no visitor policy, including partners, for patients about to give birth, citing coronavirus risk. This is definitely not what laboring women envision for their delivery, but in times of widespread communicable disease, it is reality.

If I have COVID-19, will I need a cesarean section?

No. Having COVID-19 is not a reason for a cesarean. There's no evidence that either method, vaginal birth or cesarean, is safer when it comes to COVID-19. Although data is still limited, other coronavirus infections have not been known to pass to the child from vaginal birth.

Both the American College of Obstetricians and Gynecologists and the Society of Maternal Fetal Medicine believe, in most cases, the timing of delivery should not be dictated by the mother's COVID-19 diagnosis. Women infected early in pregnancy who recover should see no change to their delivery schedule. For women infected later in pregnancy, it is reasonable to attempt to postpone the delivery, as long as no other medical reason arises, until the mother receives a negative test result.

How long will I be in the hospital after I give birth, and what if I have COVID-19?

Expect a faster discharge from the hospital. To limit the risk of inadvertent exposure and infection, the ACOG says discharge may be considered after 12 to 24 hours, rather than the usual 24 to 48 hours for women with uncomplicated vaginal births, and after two days for women with cesarean births, depending on their health status.

For mothers with confirmed COVID-19, the Centers for Disease Control and Prevention advises that infants be isolated from them, which understandably is not ideal. That could mean drawing a curtain between the mother and newborn and keeping them at least six feet apart. The CDC suggests continuing that separation until 72 hours after the mother's fever is gone. If no other healthy adult is present in the room to care for the newborn, a mother who has confirmed or suspected COVID-19 should put on a facemask and practice hand hygiene before each feeding or other close contact with her newborn.

Is home birth safer than a hospital right now?

If a woman chooses to have her baby in a hospital or birthing center, she will have a dedicated team of health care providers trained to protect her and her baby from COVID-19 and handle any unforeseen complications. There is some concern regarding person-to-person exposure with COVID-19 in a home birth setting due to fewer restrictions on visitors. Although the ACOG has not made a statement specifically on this risk, the United Kingdom's Royal College of Obstetricians and Gynaecologists has a statement advising against home birth for women who have been exposed to COVID-19.

Can I breastfeed my baby if I have COVID-19?

In limited cases reported to date, no evidence of virus has been found in the breast milk of women infected with COVID-19; however, precautions are still recommended. Breastfeeding is encouraged and is a potentially important source of antibody protection for the infant. The CDC recommends that during temporary separation, women who intend to breastfeed should be encouraged to pump their breast milk to establish and maintain milk supply. The mother should wash her hands before touching any pump or bottle parts. If possible, it is also recommended to have someone who is healthy feed the infant.

Having a child is a momentous occasion that should be celebrated, including during a pandemic. Do your part to keep yourself healthy. Wash your hands, maintain social distance and keep in close contact with your health care providers throughout the pregnancy. It may not be what you envisioned, but you will have quite a story to tell your children.

Hector Chapa is Clinical Assistant Professor, Director of Interprofessional Education, College of Medicine, Texas A&M University.

This article originally appeared on The Conversation. You can read it here.

Planet

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True

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Here’s how to enter:

  • Go to ocean.org/date and complete the quick form for a chance to win - it’s as easy as that.
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@dr.mattmcglasson/Instagram

Pretty sure every cat person feel the same way.

No one would get a dog expecting it to not bark, try to eat human food or need daily walks. And yet people regularly get flummoxed when their just-as-loveable cat exhibits completely natural behaviors like climbing tabletops or scratching at furniture.

Of course, cat people, who delight in adapting their life to make it as enriching as possible for their feline fur babies, know the flaws of this logic. After all, most cats spend more time in the house than their human counterparts. So shouldn’t the house belong just as much to them?

If you answered yes—then this clapback video (from a vet, no less), should have you feeling pretty vindicated. And if you answered no—prepare to see the error of your ways.

Dr. Matt McGlasson is a veterinarian in Kentucky, who also happens to be the proud dad of a 5-year-old special needs cat named Rupaul.

McGlasson recently was told by a viewer that it’s "disgusting" that he allows Rupaul on his furniture (as opposed to human butts only, which are okay, I guess?).

McGlasson’s response to this comment recently racked up over 11.8 million views, with good reason.

In a clip posted to his Instagram, McGlasson holds up Rupaul, who can’t use her hind legs, and shamelessly lists off all the other things he would allow for his kitty, including:

-Cosigning a loan for Rupaul

-Letting Rupaul do his taxes

-Giving Rupaul the passwords to all of his accounts.

-Capital Punishment, which he’s not normally a support of. But if someone hurts Rupaul, “that’s another story."

-Going into a business with Rupaul

-Giving Rupaul $20,000 for bringing him a dead mouse

-Making Rupaul the beneficiary on my life insurance policy.

And last, but certainly not least…letting Rupaul on the furniture.

Put simply: “My cat can do whatever she wants. It's her world. I'm just living in it.”

Down in the comments, fellow cat owners couldn’t agree more with McGlasson’s sentiment.

“My husband picked his new chair based on the cat , the arm had to be wide enough for her to sit whenever she chooses to have quality time with him.”

“I would donate my kidneys to Square if she needed them. Yes… I mean both 😂”

“‘You let your cat sleep with you?’ Ma’am, I’d let him represent me in court.”

“I bought my house for my senior kitties. I wanted to get out of our apartment so they could feel grass beneath their paws again before their time was up.”

Others reiterated how it’s a gift to be able to create a healthy, happy life for a pet, and freaking out about furniture is kind of missing the joint.

“Like I don't understand ppl who r so against cats on furniture. If ur against pets on furniture probably don't have them. Treat your pets with love and respect. When you take an animal into ur home it becomes their home and safe place. All of the things in ur house become a part of their world and cats like to naturally be elevated. My cats do what they want because they aren't pets they are family. They own the place I just live here. Lol,” wrote one person.

Bottom line: climbing is part of a cat’s inherent programming. And if cat owners truly want their home to be a safe space for their kitty, then this should be taken into consideration.

The good news is, there are plenty of cat-friendly ways you can coax them off of furniture, like making sure there are plenty of dedicated cat trees to climb and scratching posts to sink their claws into, or opting for furniture with fabrics that cats don’t love as much, like microfiber.

And as a general rule, cats respond to positive reinforcement, rather than punishment. Contrary to outdated, yet still popular belief, cats don’t “know” when they're being bad. And they will learn to associate their own with negative attention. That’s not fun for anyone.

As McGlasson, or any other pet owner can attest, having their presence in our homes provides so much fulfillment and connection, that small compromises—or large bank loans—are well worth it.

By the way, McGlasson’s TikTok and Instagram are full of hilarious cat content, so be sure to give him a follow.


This article originally appeared last year.

Wellness

What parents are teaching kids when we allow them to take a 'mental health day'

With zero hesitation—just a simple, "OK"—he turned the car around and took me home, and it's a lesson I've never forgotten.

Photo by Darwin Vegher on Unsplash

With one turn of the wheel, my dad taught me a lesson about self-care in high school that I'll never forget.

When I was in high school, I woke up one morning feeling overwhelmed. I was an honors student, I was involved in various activities and clubs, and for whatever reason, I felt thoroughly unprepared for the day. I don't recall if I had a test or a presentation or if it was just a normal school day that I couldn't face—I just remember feeling like I'd hit a wall and couldn't make my mental gears turn right.

I usually walked the mile and a half to school, but I was running late so my dad offered to drive me. In the car, I tried to keep it together, but halfway to school, the tears started to fall. My dad looked over and asked if I was OK.

"I don't know," I sobbed. "I feel like … I just … I need a day."

He knew I wasn't sick. He could have told me to tough it out. He could have given me a pep talk. He could have forced me to go. But he didn't do any of those things.

With zero hesitation—and just a simple "OK"—he turned the car around and took me home.

I have no memory of what I did the rest of that day. Three decades later, the only thing that sticks out is the basic-but-profound lesson my dad instilled in me the moment he turned that steering wheel: It's totally OK to take care of yourself.

We talked about it briefly on the way home. As it turned out, he was also taking a "mental health day." My dad was a social worker, and as an adult, I can totally understand why he would need to take a random day off sometimes. But it didn't really matter what he did for a living. Most of us need an occasional mental health day—adults, teens and kids alike.

man and woman lying on grassPhoto by Clem Onojeghuo on Unsplash

Some schools have begun incorporating this understanding into their school attendance policies. Utah passed a bill in 2018 that allows a mental health day to count as an excused absence from school. Oregon enacted a similar law in 2019 and Arizona, Colorado, Connecticut, Illinois, Maine, Nevada and Virginia have followed suit.

“Mental health days are not only good for the practical aspect of giving young people a break," psychologist Caroline Clauss-Ehlers, Ph.D., told Healthline, "but they also validate that the community and society are saying, ‘We understand and we’re supporting you in this way.”

Occupational therapist Shelli Dry concurs, telling Healthline that acceptance of mental health days can help eliminate the stigma that often comes with mental illness.

“For schools to recognize that sometimes it’s better to take a mental health day than push through when you cannot seem to cope, is a tremendous support for students to feel understood and accepted, and [this, in turn, encourages] students to understand and accept themselves more,” she said.

closed eye boy laying on brown maple leavesPhoto by Annie Spratt on Unsplash

Sometimes we forget how hard it is being a kid. In some ways, I think it's way harder than being an adult. Considering the fact that 1 in 6 kids between the ages of 6 and 17 experience a mental health disorder each year, we need to acknowledge that a lot of kids have days where they're struggling. But even kids who don't deal with mental illness sometimes need a down day. Modern life is busy and complex, no matter our age. Managing it all daily—and then also handling whatever extra stuff life throws at us—is a lot.

Part of good parenting is teaching kids to persevere through challenges, but encouraging perseverance has to be balanced with insight and wisdom. Sometimes kids might cry wolf, but it's important for parents to understand that kids might be dealing with more than we know. Sometimes kids need to be encouraged to dig deep for resilience. Sometimes kids have already been resilient for a long time and need a little time and space to just be.

My dad knew me. He understood that I wasn't just being lazy or trying to get out of doing something hard. He trusted me to know what I needed, which in turn taught me to listen to my inner alarm and trust myself. As a result, I've spent my adult life with a good sense of when I need to push through and when I need to pause and reset—a gift I'm immensely grateful for.

three children sitting on grassPhoto by Charlein Gracia on Unsplash

All of that said, this advice does come with a caveat. As a parent of kids who are learning to manage anxiety, mental health days can be a mixed bag. There's a difference between taking a mental health day because you really need it—which happens—and taking a mental health day to avoid facing fears—which also happens. Avoidance feels good in the moment but fuels anxiety in the long run, so parents and kids have to be aware of how the idea can be misused and unintentionally make certain mental health issues worse.

The bottom line, however, is that kids need breaks sometimes. And when you allow them to take an occasional day here and there to breathe, to do some self-care, to reconnect with themselves and reset their mental and emotional barometer, you teach them that their well-being matters. You teach them that it's OK to acknowledge when they've hit a limit and pause to recoup their strength.

It's OK to turn the car around when you know you need to. That's a lesson we all need to learn, and one we need to support with work and school policies in addition to internalizing individually. We're making some good strides toward that goal, and the sooner we all get on the same page, the better everyone's well-being will be.


This article originally appeared three years ago.

From Your Site Articles
@petermorely_sle/Youtube

Williams was great at everything he did.

Sure, we all know and love the late, great Robin Willams for his work in movies, television shows, Saturday Night Live, and standup. But let’s not forget he also has a slew of commercials under his belt as well. Because honestly, what medium wouldn’t benefit without his signature charm and humor?

Even the biggest Robin Williams fans might be surprised to find this recently unearthed commercial he did for the Illinois Bell phone company (later known as AT&T) back in the 1970s.

In the clip, where Williams unsurprisingly plays a mischievous husband making voices while his wife shops around for the perfect landline phone, we see a delightful foreshadowing of his alien character Mork from the sitcom Mork & Mindy—it certainly helps that the woman playing his wife resembles Pam Dawber, who played Mindy in the show. And the fact that he says "people of Earth” with that perfect alien voice.

Watch:

- YouTubewww.youtube.com

Of course, it wasn’t just nostalgia for Williams that people felt while watching this video, but also wistfulness for a bygone era…a simpler time when something like a landline was even a thing. Here’s a small smattering of comments from Youtube:

“You bought a phone and it sat on a desk or hung on the wall for decades and did its job, no updates, no 'starting it up', it was always on and always worked.”

“Miss the days when you could slam the phone.”

“The most surprising thing is that they repaired the broken phones rather than simply throwing them out and giving you a new one.”

“Oh, the times when we could make ourselves unavailable.”

“I remember having to go to the phone company. All the different color phones on display.”

“Our yellow kitchen wall phone had a cord like 12 ft long. It got knotted and tangled once and just stayed that way forever.”

“I remember being so excited about the new "pushbuttons" instead of the rotary dial.”

And last but not least, “I want to live in this time period.”

While we have two things to miss because of this video, it also, as one view put it, gave us “something to smile about.” And that’s never a bad thing.

By the way, thanks to the internet we have a few more archived Robin William commercials at our disposal, arguably more chaotic than the one for Illinois Bell.

- YouTubewww.youtube.com

- YouTubewww.youtube.com

Especially this rather notorious one, in which Williams drives director Howard Storm insane with his shotgun style improv skills.


Williams’ comedic genius continues to be something we marvel at, and its inexplicable blend of zaniness, tragedy, and existentialism will always be a mystery we can never fully solve. That’s part of what made it so magical, and why we can watch even one of his most seemingly insignificant works, and still be mesmerized. He was one of the greats, no doubt about it.

Pop Culture

People born before 1990 are sharing their now-useless but 100 percent nostalgic skills

For instance, recording songs on tape from the radio while yelling at the DJ to shut up during the intro.

From holding the phone on your shoulder to folding a map to knowing what "cornflower" and "goldenrod" are, here are pre-Y2K skills at their finest.

Hey there, millennials! Welcome to the "Holy crapoly, I have real-life memories from 20 years ago!" club. It's a strangely disorienting milestone to reach when you find yourself starting sentences with "When I was young…" or "Back in my day…" isn't it? Your Gen X elders have been here for a while, but even we have moments of incredulously calculating how the heck we've arrived at this place. Time is a tricky little jokester, isn't he?

To highlight how much has changed for middle-aged folks since we were young, a user on Reddit asked people born before 1990 what useless skills they possess that nobody has a need for anymore. It's both a hilarious trip down memory lane and a time capsule of life pre-Y2K. (Do kids these days even know what Y2K was? Gracious.)

If you're down for some good-old-days nostalgia, check out people's responses:

Making brown paper bag book covers

"I can cover a textbook with a brown paper bag." — sourwaterbug

Oh goodness yes. And there was always that one girl in class who had the art of the brown paper bag book cover perfected. (They're probably Pinterest influencers now.)

Folding a map—and knowing where to find a map

"I can re-fold a map correctly."JungleZac

"Man remember actually using maps…I had an atlas with the road system in my car to navigate other states during road trips. Crazy." – jagua_haku

How did we ever figure out how to get anywhere before GPS and Google Maps? (Two-inch thick road atlases in our car and stopping at gas stations to buy local maps while traveling, that's how. Positively primitive.)

Memorizing phone numbers and answering the house phone

For real, though, kids these days don't even know.

"Remembering phone numbers." — greatmilliondog

"Not only that, having to speak to your friend's parents for a few minutes when you call their house."  Logical_Area_5552

"How to take a message when the person they want to talk to isn't there." — Amoori_A_Splooge

How about dialing on a rotary phone, using a pay phone and making (or taking) a collect call?

The skillful phone shoulder hold

"Using your shoulder to hold a telephone up to your ear while doing multiple other things at once. Now, the phones are so damned small I drop them." – Regular_Sample_5197

"100 ft phone cords 🤣" – mrch1ck3nn

"I got in sooooo much trouble for stretching the phone cord into the bathroom for some privacy. Accidentally clotheslined Grandma 😬 She laughed about it but Mom was pissed!" – AffectionateBite3827

Knowing the exact name of every Crayola color because we only had so many

"I know what the color “goldenrod” is." — ImAmazedBaybee

"That and burnt sienna were the crayolas of choice." — Signiference

"Cornflower would like a word." — cps12345

The art of the mixed tape—especially from the radio

I don't think kids these days fully grasp how revolutionary Spotify and the like are for those of us who spent hours in front of the radio with our cassette tape recorder queued up at just the right spot waiting for the song we wanted to record to come one. And they will never, ever know the frustration of the DJ yapping right up until the lyrics start.

"Record to tape from the radio. Trying to make sure to not get the DJ/presenter talking sh-t or an ad" – Gankstajam

"'Shut up, shut up, shut up!!! I'm trying to record my song!!!'" – tearsonurcheek

"Haha yeah and trying to tell others so they don't make random noise or knock on the door.

How about making cassette-based mix tapes, trying to figure out to the second, how many and which types of songs in which order, that would still fit perfectly on the length of tape per side.

People who make digital recordings do not have to worry about 'running out of tape.'

Having the first side be tempting enough that they'd flip the other side to continue listening. That's before continual playback machines existed. Had to flip the cassette." – CrunchyTeaTime

And there were many more, from rewinding a cassette tape with a pencil to writing in cursive to tearing the sides off of printer paper without tearing the paper itself. (Oh and of course the ability to count out change and understand what you're supposed to do if something costs $9.91 and someone hands you $10.01.)

Gotta love it when the things that used to be totally normal now sound like historic artifacts found in a museum. Kind of makes you wonder what normal things from today we'll be laughing about in another 20 or 30 years.


This article originally appeared two years ago.

via Pixabay

One of the most wonderful things about having a dog is how attached they become to their owners. I work from home and my Jack Russel terrier, Scout, lies next to me on his bed for most of the day. The only time he leaves my office is for a sip of water or to go outside and sun his belly on the porch.

That's why whenever I leave the house and can't take Scout with me, I wonder, "Does he miss me? Is he sad that he's alone?" Studies show that our dogs miss us the moment we leave the house and that feeling slowly intensifies until we are gone for about four hours and they have a "plateau of melancholy." That's why the longer you're away, the more excited your dog is when you return home.

The moment I pull up in my car Scout begins to howl like a wolf trying to contact someone who's miles away. It's like, "Dude, I'm 30 feet away. Give me a second to grab the groceries out of the trunk."

Researchers from the Universities of Pisa and Perugia, Italy have found that if you give your dog some affection before you leave the house they'll have less anxiety while you're away.

They conducted experiments with 10 dogs between the ages of one and 11 without attachment issues. The group was composed of seven mixed-breed dogs, one Labrador retriever, one Hovawart, and one Chihuahua.

Participants in the study walked their leashed dogs into a fenced area where they were greeted by a researcher who took their dog's heart rate. In the first test, after the owners walked their dogs into the area, they talked with a researcher for one minute then left without giving the dog any special attention.

In the second test, the dog owners petted the dog during their interaction with the researcher.

In both tests, the owners left the fenced area and hid far enough away so that the dog couldn't smell them.

After the owners left, the dogs looked for them for about three minutes on average. After the owners returned, the researchers measured the dogs' levels of the stress hormone cortisol as well as their heart rates.

The researchers found that whether the dogs were petted or not, their cortisol levels were unchanged. But their heart rate showed a marked decrease if the owners petted them before leaving. Researchers later watched videos of the dogs and found that the ones that were petted showed " behaviors indicative of calmness for a longer period while waiting for the owner's return."

Next time I'm ready to leave the house and Scout follows me to the front door after saying, "Sorry bud, you can't go with me on this trip," I'll kneel down and give him a little extra love and attention.

Maybe that way he won't howl like the house is on fire when I pull up in my car after a trip to the grocery store.

This article originally appeared four years ago.