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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.

Health

4 simple hacks to help you meet your healthy eating goals

Trying to eat healthier? Try these 4 totally doable tricks.

Photo by Anna Pelzer on Unsplash

Most of us want to eat healthier but need some help to make it happen.

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When it comes to choosing what to eat, we live in a uniquely challenging era. Never before have humans known more about nutrition and how to eat for optimal health, and yet we’ve never been more surrounded by distractions and temptations that derail us from making healthy choices.

Some people might be able to decide “I’m going to eat healthier!” and do so without any problem, but those folks are unicorns. Most of us know what we should do, but need a little help making it happen—like some simple hacks, tips and tricks for avoiding pitfalls on the road to healthier eating.

While recognizing that what works for one person may not work for another, here are some helpful habits and approaches that might help you move closer to your healthy eating goals.

man pulling chip out of a chip bagOur mouths loves chips. Our bodies not so much.Photo by Bermix Studio on Unsplash

Goal: Snack on less junk food

Tip: Focus your willpower on the grocery store, not your home

Willpower is a limited commodity for most of us, and it is no match for a bag of potato chips sitting on top of the fridge. It’s just a fact. Channeling your willpower at the grocery store can save you from having to fight that battle at home. If you don’t bring chips into your house in the first place, you’ll find it a lot easier to reach for something healthier.

The key to successful shopping trips is to always go to the store with a specific list and a full stomach—you’ll feel much less tempted to buy the junky snack foods if you’re already satiated. Also, finding healthier alternatives that will still satisfy your cravings for salty or crunchy, or fatty foods helps. Sugar snap peas have a surprisingly satisfying crunch, apples and nut butter hit that sweet-and-salty craving, etc.

slice of cakeYou can eat well without giving up sweets completely.Photo by Caitlyn de Wild on Unsplash

Goal: Eat less sugar

Tip: Instead of “deprive,” think “delay” or “decrease and delight”

Sugar is a tricky one. Some people find it easier to cut out added sugars altogether, but that can create an all-or-nothing mindset that all too often results in “all.” Eating more whole foods and less processed foods can help us cut out a lot of ancillary sugar, but we still live in a world with birthday cakes and dessert courses.

One approach to dessert temptation is to delay instead of deprive. Tell yourself you can have any sweet you want…tomorrow. This mental trick flips the “I’ll just indulge today and start eating healthier tomorrow” idea on its head. It’s a lot easier to resist something you know you can have tomorrow than to say no to something you think you’ll never get to have again.

Another approach when you really want to enjoy a dessert at that moment is to decrease the amount and really truly savor it. Eat each bite slowly, delighting in the full taste and satisfaction of it. As soon as that delight starts to diminish, even a little, stop eating. You’ve gotten what you wanted out of it. You don’t have to finish it. (After all, you can always have more tomorrow!)

colorful fresh food on a plateA naturally colorful meal is a healthy meal.Photo by Anna Pelzer on Unsplash

Goal: Eat healthier meals

Tip: Focus on fresh foods and plan meals ahead of time

Meal planning is easier than ever before. The internet is filled with countless tools—everything from recipes to shopping lists to meal planning apps—and it’s as awesome as it is overwhelming.

Planning ahead takes the guesswork and decision fatigue out of cooking, preventing the inevitable “Let’s just order a pizza.” You can have a repeating 3-week or 4-week menu of your favorite meals so you never have to think about what you’re going to eat, or you can meal plan once a week to try new recipes and keep things fresh.

It might help to designate one day a week to “shop and chop”—getting and prepping the ingredients for the week’s meals so they’re ready to go in your fridge or freezer.

woman holding blueberries in her handsOrganic foods are better for the Earth and for us.Photo by andrew welch on Unsplash

Goal: Eat more organic/humanely raised food

Tip: Utilize the “dirty dozen” and “clean 15” lists to prioritize

Many people choose organic because they want to avoid pesticides and other potentially harmful chemicals. Organic food is also better for the planet, and according to the Mayo Clinic, studies have shown that organic produce is higher in certain nutrients.

Most people don’t buy everything organic, but there are some foods that should take priority over others. Each year, researchers from the Environmental Working Group (EWG) analyze thousands of samples of dozens of fruits and vegetables. From this data, they create a list of the “Dirty Dozen” and “Clean 15” fruits and vegetables, indicating what produce has the most and least pesticide residue. These lists give people a good place to start focusing their transition to more organic foods.

To make organic eating even simpler, you can shop O Organics® at your local Albertsons or Safeway stores. The O Organics brand offers a wide range of affordable USDA-certified organic products in every aisle. If you’re focusing on fresh foods, O Organics produce is always grown without synthetic pesticides, is farmed to conserve biodiversity, and is always non-GMO. All animal-based O Organics products are certified humane as well. Even switching part of your grocery list to organic can make a positive impact on the planet and the people you feed.

Healthy eating habits don’t have to be all or nothing, and they don’t have to be complicated. A few simple mindset changes at home and habit changes at the grocery store can make a big difference.

Teacher starts period in front of class, turns into a lesson

Teachers are almost always teaching even when it's not in their lesson plan.

Those that were born to be teachers find teachable moments everywhere and one woman found herself in one of those moments. Though this one was likely just a bit more personal than she probably would've liked.

Emily Elizabeth posted a TikTok video about how she found herself in a predicament in front of her classroom full of 10 and 11-year-old kids. The teacher explained that she was noticing a lot of commotion and whispering among the little girls in her class while she was wearing white pants. After reminding the girls to stay on task, the whispering continued, prompting Emily to be more direct.

That's when one of the girls asked to speak with her privately dropping the bomb that no one that gets periods wants to hear in public.

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Mario Mirante criticizes a mom he saw at the park.

TikTokker Mario Mirante is going viral for his video that brings up two significant issues: smartphone addiction and whether people without children have the right to criticize parents.

It all started when Mirante saw a young boy playing alone in the park.

“The kid is just playing quietly, not being annoying. I don’t hear a peep from him; he's just doing his thing on the playground,” Mirante said in a video that has nearly 6000,000 views. “The mom the entire time is on her phone, staring right down at her screen. Doesn’t look up one time.”

The boy climbed up to the top of the slide and called down to his mother, who didn’t even look up from her phone. “I hear, ‘Hey mom, watch. Watch, Mom,’” Mirante recalled. “And at the top of her lungs, shrieking like a Velociraptor, this mother screams, ‘One second!”

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Angelina Jordan blew everyone away with her version of 'Bohemian Rhapsody."

At Upworthy, we've shared a lot of memorable "America's Got Talent" auditions, from physics-defying dance performances to jaw-dropping magic acts to heart-wrenching singer-songwriter stories. Now we're adding Angelina Jordan's "AGT: The Champions" audition to the list because wow.

Jordan came to "AGT: The Champions" in 2020 as the winner of Norway's Got Talent, which she won in 2014 at the mere age of 7 with her impressive ability to seemingly channel Billie Holiday. For the 2020 audition, she sang Queen's "Bohemian Rhapsody," but a version that no one had ever heard before.

With just her Amy Winehouse-ish voice, a guitar and a piano, Jordan brought the fan-favorite Queen anthem down to a smooth, melancholy ballad that's simply riveting to listen to.

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Identity

Watch this 104-yr-old woman break the world tandem skydiving record

Dorothy Hoffner tried skydiving for the first time on her 100th birthday and loved it.

Dorothy Hoffner is pure #agingoals.

If you're looking for some aging inspiration, look no further, because Dorothy Hoffner is about to blow your mind.

At 104, Hoffner just became the oldest person to parachute out of an airplane in a tandem skydive. That's right, skydive. At 104 years old—or to be exact, 104 years and 289 days old—beating the previous world record set by a 103-year-old in Sweden in May of 2022.

But it's actually even more impressive than that. It's not like Hoffner is someone who's been skydiving since she was young and just happened to keep on doing it as she got older. She actually didn't go on her first skydiving adventure until her 100th birthday.

On Oct 1, 2023, she joined the team at Skydive Chicago in Ottawa, Illinois, for the world-breaking tandem skydive. Though she uses a walker to get around, she manages the physical toll of plummeting through the air at 10,000+ feet before parachuting to a skidding stop strapped to a certified U.S. Parachute Association (USPA) tandem instructor with impressive ease.

“Let’s go, let’s go, Geronimo!” Hoffner said after she boarded the plane, according to the Chicago Tribune.

Watch her do what many of us would be too terrified to attempt:

The way she rolls right out of that plane cool as a cucumber! Hoffner told the Tribune that on her first skydive, at age 100, she had to be pushed out of the plane. But this time, knowing what she was in for, she took charge with calm confidence.

“Skydiving is a wonderful experience, and it’s nothing to be afraid of," Hoffner shares. "Just do it!”

That's some seriously sage advice from someone who knows firsthand that age really is just a number. Learn more about skydiving with Skydive Chicago here.

Education

Unearthed BBC interview features two Victorian-era women discussing being teens in the 1800s

Frances 'Effy' Jones, one of the first women to be trained to use a typewriter and to take up cycling as a hobby, recalls life as a young working woman in London.

Two Victorian women discuss being teens in the 1800s.

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Can we bring back some 50s fridge features, please?

There are very few things that would make people nostalgic for the 1950s. Sure, they had cool cars and pearl necklaces were a staple, but that time frame had its fair share of problems, even if "Grease" made it look dreamy. Whether you believe your life would've been way more interesting if you were Danny Zuko or not, most would agree their technology was...lacking.

All eras are "advanced" for their time, but imagine being dropped off in the 50s as someone from the year 2023. A recent post by Historic Vids on Twitter of a 1956 commercial advertising a refrigerator, however, has some people thinking that when it came to fridges, maybe they were living in the year 2056. I don't typically swoon over appliances, yet this one has me wondering where I can purchase a refrigerator like this.

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