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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
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"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.


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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.

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Teacher goes above and beyond for a biology lesson by wearing an anatomically correct suit

That's one way to keep students engaged!

@mikemoratinos/X

Veronica Duque wearing her famous anatomy suit

Being an educator in the American public school system is one of the hardest jobs in our nation. Not only is the work itself challenging, but with constant battles for educational funding and a student body increasingly tethered to their electronic devices, most teachers in America and around the world are navigating uncharted territory when it comes to finding ways to keep their students engaged in their studies.

And that's why when Verónica Duque came across a form-fitting, anatomical bodysuit while doing some online shopping, she thought it would be perfect visual aid to convey vital information (pun intended) to her students in Spain, in a way they'd actually remember.

Turns out, the entire internet would remember it too.

Duque's husband tweeted a collage of images from the classroom lesson, which quickly went viral, with nearly 70,000 likes. Loosely translated, the tweet from her husband Michael reads: "Very proud of this volcano of ideas that I am lucky to have as a wife. Today she explained the human body to her students in a very original way. Great Veronica !!!"

In an interview with Bored Panda, Duque explained the thought process that led her to presenting her third-grade-class with a unique approach to learning.

"I was surfing the internet when an ad of an AliExpress swimsuit popped up," she said. "Knowing how hard it is for kids this young to visualize the disposition of internal organs, I thought it was worth giving it a try."

anatomy, anatomical suit, teachers, science, cool teachers, science class, amazonThis is a teacher who cares. assets.rebelmouse.io

Online retailers like Amazon have a number of similar anatomical bodysuits for sale. While most people apparently purchase them for Halloween costumes or as gag gifts, it's now likely that Duque's viral moment will inspire some other educators around the world to take a similar approach to teaching the body basics to their students.

anatomy, anatomical suit, teachers, science, cool teachers, science class, amazonHalloween costume, check. Amazon

While some on Twitter were critical of the suit, the vast majority have praised Duque for her innovative approach to teaching. And the anatomical bodysuit is reportedly far from her first creative endeavor in the classroom.

"I decided long ago to use disguises for history lessons," she told Bored Panda. "I'm also using cardboard crowns for my students to learn grammatical categories such as nouns, adjectives, and verbs. Different grammar kingdoms, so to say."

And when it comes to the inevitable, made-up controversy that tends to latch itself onto virtually anyone that goes viral, Duque said she says there's another far more controversial stereotype she hopes her brief moment of fame will help address.

"I'd like society to stop considering teachers to be lazy bureaucratic public servants," she said. "We're certainly not." Get this teacher a raise!

What really works about Duque's presentation is that it engages students in a sensorial experiences, which helps lessons stick (and let's face it, anything that engages he sense nowadays is a godsend). But there are other methods teachers/parents can try that don't involve wearing a suit with guts on 'em.

Here are some suggestions for hands-on "DIY experiments", courtesy of the Little Medical School website:

1. Building the respiratory system by creating a model lung with straws, balloons, bottles, and duct tape

- YouTubewww.youtube.com

2. Sculpting Body parts with Play Doh

(Grab free printable mats on 123Homeschool4Me)

- YouTubewww.youtube.com

3. Build a functioning heart model

- YouTubewww.youtube.com

Of course, these lessons are a little more geared towards younger students, but at the same time, it could provide some inspiration for how to get students more involved in their own learning, just like Duque did.

This article originally appeared six years ago.

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Humor

Comedian Josh Johnson perfectly describes what it's like to be broke in today's America

"My friend turns to me and says, 'Josh, you must not mind the rain.'"

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Josh Johnson.

Income inequality isn't exactly new. However, it seems more people are aware of it than ever. In fact, according to a Pew Research poll that surveyed 36 countries, a "median of 54% of adults across the nations surveyed say the gap between the rich and the poor is a very big problem in their country."

Money, hundred dollars, hundred dollar bills, wealth, richWealth Inequality is a rampant problem. Photo by Giorgio Trovato on Unsplash

The good news is people are learning to educate themselves—from financial planning to paying attention to where special interest money goes in terms of political leaders. But still, for many of us, it's hard to understand what it must be like to be wealthy when we've never had real wealth. Without having a lived-in experience, even the concept of money itself can be difficult to grasp.

Comedian Josh Johnson, who is also a correspondent and writer on The Daily Show, is an expert at taking complex notions and putting them into hilarious context through his long-form comedic storytelling. In a TikTok clip labeled "That Time I Almost Drowned," Josh begins by talking about the literal fabric of money. "We look at money as paper, right? At least when it's in its physical form, it's this paper thing. But it's more than paper. There's fabric that weaves into it. There's linen, there's cotton."

@joshjohnsoncomedy

I Almost Drowned At A Party

Josh likens the actual fabric of money to society. "It works the same way that society works. There's fabric that weaves all of us together." He adds, "But there are people who have not been able to participate in the opportunities of making money...so when you tell them a recession is coming, they're like, 'What? Okay. I was already broke.'"

He proceeds to illustrate with a story. "One time, I was at a party with my friends, and I fell in the pool." He makes sure to note that it wasn't a "pool party" and, therefore, deeply embarrassing. But more than that, "terrifying," because he reveals, "I can't swim. And when you don't swim, being surrounded by water out of nowhere is very concerning."

swim, pool, water, party, story, Summer Fall GIF by Mark RoberGiphy

He describes the sudden shock of the water. "I feel like I turned around, and water surrounded me." What he did next was not so much swim, but rather "drown," and he hilariously describes his friend fishing him out of the pool like a cat picking up its kitten. Wet and still in shock, Josh understandably wanted to leave immediately. But "the dude who saved me was my ride... and now has 'mack points' and begins to use them to hit on people."

When they finally try to leave, alongside a few other friends, his car won't start. "Luckily, he did live close enough to the party that we could walk. It was maybe a mile and some change. And as we start walking, it starts drizzling... and then really starts raining." After describing how his various friends responded to the rain (one hunched into "turtle" position and another put one hand over his head), Josh has an epiphany: "My friend turns to me and says, 'Josh, you must not mind the rain.' And I was like, I almost drowned 20 minutes ago. And THAT'S what it's like when you're broke. You're almost drowning all the time. So when people try to scare you with talks of a recession, you're like, 'Why would I... what?'” He puts a hand over his head. "You're doing this... I'm already WET!"

rain, drowning, drown, downpour, metaphorRaining Stick Figure GIF by State ChampsGiphy

Many in the comment section truly empathize, and there seems to be comfort in being "seen." One fan wrote, "This is incredible. You're the Kendrick Lamar of comedy." Another said, "This is such a good way to explain it."

One top commenter perfectly sums it up: "What is loss to a man who has nothing? What's a little rain to a drowning man?"

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Education

American English includes one of the rarest sounds on Earth, but we use it all the time

Er…this is odd.

Photo credit: Canva

Learning to make sounds we didn't grow up with can be tricky.

When (or if) kids learn phonics at school, they're taught the symbols that go with sounds of their country's native language or languages. People all around the world grow up learning to make specific sounds with their mouths by imitating the language(s) they are immersed in, which can leave us completely unaware of how many other sounds there are until we hear a language that's far different from our own.

Even the common foreign languages that American school kids learn have sounds that can be tricky to get down. The rolled "r" in Spanish. The nuances of French vowel pronunciations. The glottal stops in German. The sound that's a mix between "r" and "l" in Japanese. And for people learning English, one of the trickiest sounds to get down is "er," as in the American pronunciation of "bird," "world," "summer," or "percent."

Oddly enough, for as common as the "er" sound is in English, it's linguistically rare. According to the Linguistics Channel @human1011, the "er" sound is found in less than 1% of the world's languages, rarer than the click consonants found in some languages in East and Southern Africa.

- YouTubewww.youtube.com

As rare as the sound is, there are a lot of people in the world who use it, mainly because it's also used in Mandarin Chinese, or at least many variations of it. So, while there aren't many languages that use it, by sheer numbers of people, it's not that uncommon.

"So, a sound that's so rare that it's in less than 1% of the world's languages just happens to exist in the two most spoken languages on Earth? Can that really be a coincidence?" the @human1011 video asks. Well, yes. English and Chinese don't share a common linguistic root, so those sounds just happened to evolve in very different parts of the planet. According to some people in the comments of the video, there are regional dialects in Brazil where the "er" sound is used and in certain parts of the Netherlands as well.

Pronouncing the "er" sound is hard if you don't grow up with it, largely because it's all about the placement and shape of the tongue inside the mouth combined with the way the lips are positioned. That combination is physically tricky to show someone. This video, from a non-native-English-speaker does a good job of explaining the mouth movements that create the sound.

- YouTubewww.youtube.com

What's particularly interesting about the "er" sound in American English is that it functions as a vowel sound. Most of us learned that the vowels in English are a, e, i, o, u, and sometimes y, and that's true as far as written vowels go, but vowel sounds are different. In the word "bird," the letter "i" is a vowel, but doesn't make any of the "i" sounds that we learned in school. Instead, the "ir" combine to make the "er" vowel sound. It's called an r-controlled vowel, and we see it in tons of words like "work," "were," "burn," "skirt," etc.

Learn something new every day, right?

Here's another video that explains the physical aspects of articulating the r-controlled vowel sound.

- YouTubewww.youtube.com

Most of us don't think about the fact that sounds we pronounce without even thinking about it have to be specifically learned and practiced by people who didn't grow up with them. It's not until we start trying to learn a language that's different from our own that we see how many sounds we have to work hard to make, sometimes even having to train our mouth muscles in ways they've never been used before.

It's also a good reminder to be patient and kind with people who are learning a language. It's not easy, and anyone making an effort to communicate in someone else's language deserves our grace and kudos.

You can follow @human1011 on YouTube for more interesting linguistics trivia.

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Sustainability

Mother and daughter duo transform their boring backyard into a breathtaking plant paradise

They also show how just about anyone can easily do it themselves.

TikTok

"Here's the story of how we created a lush habitat garden."

Nature is healing. After a century of rampant urbanization—deforestation, invasive species, paving paradise and putting up a parking lot—we’re finally coming back to our roots. In Southern California, a mother-daughter design team is leading the way, teaching the public and their clients how to transform ordinary outdoor areas into extraordinary plant sanctuaries. In a viral TikTok video, Donna and Caitlin Whelan demonstrate how they created a lush habitat garden out of an ordinary backyard. It’s captured the hearts of green-thumbed viewers and offers an inside look into the process of eco-friendly landscaping.

Trust the process

Donna and Caitlin run Whelan Design House, a boutique interior design firm that specializes in high-end projects. Drawing on their combined talents and impeccable taste, this mother-daughter team create beautiful living spaces with a human-centered approach. Their commitment to healthy environments shines through in their design philosophy. As they state on their website, "Our world is full of synthetic materials, but we believe there are other options. We guide our clients toward sustainable and environmentally respectful choices and away from chemical-laden fabrics and unhealthy materials."

grass, backyard space, bare, old, before pictureWhere we started.TikTok

Which brings us to the viral backyard renovation. This was more than just a design project: it’s a masterclass in the power of family bonds and environmental innovation. The 18-part video begins with a plain, unremarkable yard. “This is how it looked when we started,” they write. “The grass wasn’t providing anything for the local [ecosystem], and it required way too much water to maintain.”

America has a “perfect lawn” problem. Dreams of white picket fences and a manicured lawn have driven the country into a “green, monoculture carpet,” and our human-dominated landscape is no longer equipped to support functional ecosystems. Like everything else in life, our front lawns do not exist in a vacuum. Everything, from the trees to the flowers to the grass to the soil, all work harmoniously to create a thriving home for insects, birds, and other wild creatures. But when native species are replaced with alien ones, these exotic plants disrupt the flow of life, wreaking havoc and degrading the natural habitat.

So, Donna and Caitlin tore it up. All of it. They removed the neatly cut grass and trees from unknown origins. Ripped up swaths of concrete (“concrete suffocates the soil, preventing the growth of microbes that are essential for healthy soil,” they write).

after photo, pebbles, backyard, green space, oasisParadise in the backyardTikTok

California’s natural beauty

Once the land was returned to ground zero, Caitlin and Donna got to work, replacing the non-native species with ones that were suited to the environment. “Native plants are adapted to the timing of the seasons, harshness of the weather, and water availability of the particular area they evolved within,” describes Defenders of Wildlife, a premier U.S.-based conservation organization. “They are also typically adapted to surviving local pests and, therefore, do not need chemical pesticides.”

So, the dynamic duo began anew, carefully planning and selecting the right plants. They chose drought-tolerant flora that was either native to the area or regionally appropriate, like the wattle-leaf acacia, whose delicate yellow blooms and fern-like leaves added a wonderful splash of splendor to the landscape. Plus, it’s known for its resiliency and minimal water needs—an especially crucial component in Southern California, where droughts are unfortunately quite commonplace. The orange-hued apricot mallow, another star of their garden, brings another pop of color and radiance and attracts butterflies to the space. “The flowers smell like honey,” write the Whelans.


nature. yard, large plants, makeover, native plantsWelcome to Whelan Design House.TikTok

Beyond the lush wildlife, the mother-daughter team also drew upon their impressive art experiences to design the garden of their dreams. They installed a lovely wooden bench, shaded beneath a Palo Verde tree. Small tables that look like sculptures dot the yard. Rustic Saltillo tiles, made of gorgeous terracotta, were used to create a mosaic patio floor. Suddenly, everything clicked. The resulting space is nothing short of awe-inspiring: truly one with nature.

Comments flooded in, with viewers praising Donna and Caitlin for their work. “You created your own slice of paradise while considering the wildlife and native plant species. I’m in awe,” someone wrote. “Thank you for planting native plants in CA, it’s so helpful. So many people buy houses here and plant non-native plants,” another user replied. Their viral TikTok even motivated some to rethink their own backyards. “My house is also a small older Spanish-style with a big backyard,” writes another. “This just inspired me to take action. Even my patio is just like yours, it’s coming down now lol.”

Change is always possible

Tired of mowing the grass and applying harmful pesticides? There are countless ways to incorporate native vegetation into your life, whether you have sprawling acres or a simple, small plot out front. For those interested in following in the Whelans’ footsteps, here’s what you need to know about starting your own native plant oasis:

  • Take stock. Before planning your beautiful new garden, examine your surroundings and evaluate what makes this particular area special and unique. How much sun does the yard typically get? Does it snow here? What’s the elevation like? Is the soil drainage poor?
  • Research, research, research. This is a great excuse for an excursion and to explore your local surroundings! Find a park near you with native plants or a botanical garden. Really get to know your local ecosystem—every region has its own personality and specific native plants that are meant to thrive there.
  • The fun part: Shopping spree. Find a nursery that specializes in native plants. And be curious! Ask questions, like “Where did this plant come from?” “Do I need to fertilize it?” “What soil and soil pH is best?” To create a native plant garden is to become a steward of the land, and the more information you know, the better.
  • Don’t stress. Caitlin and Donna are professionals. You don’t need to transform your entire backyard overnight. Start small, beginning with just a section of the garden. This will take time. In fact, the Whelans note, “patience is incredibly important. The beauty of [the garden] reached new depths with time and only time.”

yard, table, backyard, oasis, makeoverBeauty is possible!TikTok

By choosing native plants and working with nature rather than against it, the Whelans remind us that environmental stewardship is always possible—and can even start in your own backyard. With some careful planning, the correct plants, and an eye for design, anyone can take a step towards contributing to a natural, thriving ecosystem.

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Joy

Woman asks her Uber driver if he'll pretend to be her dad at the mechanic and he nailed it

He understood the assignment. No question.

Photo credit: Canva

This guy deserves 5 stars, for sure.

When we think of 5-star Uber drivers, we might picture someone who knows how to read a room (or a car, in this case), maybe someone who has an assortment of charger cables, or a bomb playlist. One Uber driver, however, is getting glowing praise for giving more like 20-star service.

Here’s what happened: A woman named Catalina (@catalinamascochina), presumably on her way to a mechanic, had lamented to her driver how she was worried the mechanic would overcharge her for unnecessary things.

This concern is not unwarranted, of course. While anyone can be ripped off by a mechanic, it's fairly well known that women are often, but not always, charged more than men for auto repairs when they appear uniformed about the going rates for certain parts and services. Shady? Yes. But a reality, no doubt about it.

- YouTubewww.youtube.com

Catalina’s driver fully understood her plight, and in the video posted to her TikTok, we can hear him saying “I know how these guys are.” That’s when Catalina seems to joke, “Tell em’ you’re my dad!”

The Uber driver must have been totally onboard with this plan, because next thing you know, we see him in full Dad stance at the shop deftly waving off the mechanic's attempt to upsell, saying “We keep an eye on it; don’t worry about it. We’ll do it next time.”

Getting even more into character, he then demanded Catalina to “pay for the oil change and let’s get out of here. Come on, follow me.” Somebody give this guy an Oscar already.

“Thaaaaanks, Dad,” Catalina cooed as they shared a hug. In the onscreen caption she also joked that “the acting skills are a little [too] good cuz why he actually yelling at me like a dad?”

@catalinamascochina LMAOOOO
♬ original sound - catalina

While viewers did note that, ideally, women wouldn’t have to conspire with their Uber drivers in order to get fair treatment, that it was really nice to see a man willing to help out in such a cool way.

“Now THIS is the masculinity we need,” one person wrote.

“What a sweetheart,” echoed another. “You definitely got in the right uber.”

Another even suggested, “they should have a service like this for girls that don’t have fathers and need to get their cars serviced worry-free.”

Others just chimed in to give the guys kudos for his acting chops. That, and many suspected he must be a dad IRL.

dad, mechanic, dads, help, strangers, favorsDads are gonna be dads.media0.giphy.com

“He activated dad mode and immediately became frustrated.”

“You gave him a story to share at dinner with his actual kids.”

“Acting? He’s clearly a dad.”

‘He wasn’t acting. In the moment you were his child.”

The world is not a perfect place, and likely never will be. But sometimes all it takes is one act of kindness to make it all that much easier—and more enjoyable—to navigate.

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