BIRMINGHAM — Angelica Lyons knew it was dangerous for Black women to give birth in America.
Even more disheartening: Angelica worked at the University of Alabama at Birmingham, the university affiliated with the hospital that treated her. From birth to death, regardless of wealth or social standing, they are far more likely to get sick and die from common ailments. In the last week of October 2019, while she was giving her students a test, her stomach started to hurt badly.
She had an enema — a procedure where fluids are used to cleanse or stimulate the emptying of bowels — to alleviate her constipation, but Angelica continued to plead with them that she was in pain. She struggled to eat dinner that night. When she stood up to go to the bathroom, she felt a sharp pain ricochet throughout her body.
Sepsis in its early stages can mirror common pregnancy symptoms, so it can be hard to diagnose. Due to a lack of training, some medical providers don’t know what to look for. But slow or missed diagnoses are also the result of bias, structural racism in medicine and inattentive care that leads to patients, particularly Black women, not being heard.
Angelica’s son, Malik, was born eight weeks early, weighing under 5 pounds. He spent a month in intensive care. He received home visits through the first year of life to monitor his growth. Reproductive surgeries that were experimental at the time, like cesarean sections, were commonly performed on enslaved Black women.
“We have to recognize that it’s not about just some racist people or a few bad actors,” said Rana A. Hogarth, an associate professor of History at the University of Illinois, Urbana-Champaign. “People need to stop thinking about things like slavery and racism as just these features that happened that are part of the contours of history and maybe think of them more as foundational and institutions that have been with us every step of the way.
The state’s infant mortality rate for 2021 was 7.6 deaths per 1,000 live births. The disparities between Black and white babies is stark: The infant mortality rate in 2021 for white mothers was 5.8, while the infant mortality rate for Black mothers was 12.1, an increase from 10.9 from the prior year.A 2020 report by the Alabama Maternal Mortality Review Committee found that more than 55% of 80 pregnancy-related deaths that they reviewed in 2016 and 2017 could have been prevented.
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Fetal death as an outcome of acute respiratory distress in pregnancy, during the COVID-19 pandemic: a population-based cohort study in Bahia, Brazil - BMC Pregnancy and ChildbirthBackground Fetal loss is one of the most serious adverse outcomes of pregnancy. Since the onset of the COVID-19 pandemic, Brazil has recorded an unprecedented number of hospitalizations of pregnant women due to acute respiratory distress (ARD), thereby, we aimed to assess the risk of fetal deaths associated to ARD during pregnancy in Bahia state, Brazil, in the context of the COVID-19 pandemic. Methods This is an observational population-based retrospective cohort study, developed with women at or after 20 weeks of pregnancy, residents in Bahia, Brazil. Women who had acute respiratory distress (ARD) in pregnancy during the COVID-19 pandemic (Jan 2020 to Jun 2021) were considered 'exposed'. Women who did not have ARD in pregnancy, and whose pregnancy occurred before the onset of the COVID-19 pandemic (Jan 2019 to Dec 2019) were considered 'non-exposed'. The main outcome was fetal death. We linked administrative data (under mandatory registration) on live births, fetal deaths, and acute respiratory syndrome, using a probabilistic linkage method, and analyzed them with multivariable logistic regression models. Results 200,979 pregnant women participated in this study, 765 exposed and 200,214 unexposed. We found four times higher chance of fetal death in women with ARD during pregnancy, of all etiologies (adjusted odds ratio [aOR] 4.06 confidence interval [CI] 95% 2.66; 6.21), and due to SARS-CoV-2 (aOR 4.45 CI 95% 2.41; 8.20). The risk of fetal death increased more when ARD in pregnancy was accompanied by vaginal delivery (aOR 7.06 CI 95% 4.21; 11.83), or admission to Intensive Care Unit (aOR 8.79 CI 95% 4.96; 15.58), or use of invasive mechanical ventilation (aOR 21.22 CI 95% 9.93; 45.36). Conclusion Our findings can contribute to expanding the understanding of health professionals and managers about the harmful effects of SARS-CoV-2 on maternal–fetal health and alerts the need to prioritize pregnant women in preventive actions against SARS-CoV-2 and other respiratory
Source: BioMedCentral - 🏆 22. / 71 Read more »
How much do pregnant women know about the importance of oral health in pregnancy? Questionnaire-based survey - BMC Pregnancy and ChildbirthBackground Although pregnancy is a physiological process it causes hormonal changes that can also affect the oral cavity. Pregnancy increases the risk of gum disease inflammation and tooth caries which could affect the health of the developing baby. Proper oral health is crucial both for mother and her babies and is related with mothers’ awareness of this connection. The aim of this study was the self-assessment of women’s both oral health and oral health literacy as well as mothers’ awareness of the connection of oral health and pregnancy. Material and methods In the study anonymous questionnaire was prepared and provided to be filled in by 200 mothers at the age from 19 to 44 y.o. who gave birth in the gynecological clinic. The questionnaire included demographic, and concerning the areas of oral health before and during pregnancy and after the childbirth questions. Results Only 20% of the investigated women underwent the oral examination before the pregnancy and the next 38.5% underwent it intentionally when the pregnancy had been confirmed. As much as 24% of women pointed out lack of awareness of the importance of proper oral hygiene during pregnancy. 41.5% of investigated women declared complaints during the pregnancy concerning teeth or gums and 30.5% underwent dental treatment; 68%, brushed their teeth properly—twice a day; 32% of women observed deterioration of oral health state during the pregnancy. The knowledge of the importance of oral health during pregnancy presented by the majority of mothers was relatively proper, which was strongly connected with higher education status and living in big cities. A significant correlation between higher birth weight and more frequent daily tooth brushing was observed. Both higher frequency of problems concerning the oral cavity and dental treatment during pregnancy were significantly related to the younger age of mothers. Conclusions The knowledge of women concerning of oral health on the management of pregnancy and d
Source: BioMedCentral - 🏆 22. / 71 Read more »