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1/ A few thoughts on how disruptions to our health systems are impacting birthing people 
(taken from today's public @NIH_ORWH committee meeting)
VIDEO: https://orwh.od.nih.gov/about/newsroom/events/51st-meeting-nih-advisory-committee-research-womens-health
(taken from today's public @NIH_ORWH committee meeting)
VIDEO: https://orwh.od.nih.gov/about/newsroom/events/51st-meeting-nih-advisory-committee-research-womens-health
2/ So far, it is unclear whether pregnant people are more likely to be severely INFECTED by COVID-19
Regardless, pregnant people are definitely more likely to be severely AFFECTED by COVID-19
Regardless, pregnant people are definitely more likely to be severely AFFECTED by COVID-19
3/ Pregnant people do not appear more likely to become severely infected but early data suggests possibly more likely to have prolonged symptoms -- see data from @yafshar and the @UCSFMedicine PRIORITY team in @greenjrnl
read @edyong209 on #longhaulers
https://www.theatlantic.com/health/archive/2020/06/covid-19-coronavirus-longterm-symptoms-months/612679/
read @edyong209 on #longhaulers
https://www.theatlantic.com/health/archive/2020/06/covid-19-coronavirus-longterm-symptoms-months/612679/
4/ COVID-19 can cause respiratory illnesses, but also theoretically has potential to infect the placenta, fetus, or newborn
Fortunately, infection of the placenta, fetus, and newborn seems rare and this is very reassuring
Breastfeeding is safe
Fortunately, infection of the placenta, fetus, and newborn seems rare and this is very reassuring
Breastfeeding is safe
5/ all of the data on COVID-19 and pregnancy needs to be interpreted with caution -- @apoorva_nyc did an excellent job of reporting on the some of the interpretation challenges earlier this summer https://www.nytimes.com/2020/06/24/health/coronavirus-pregnancy.html
6/ @RoniNYTimes reported more recently on the suggestion that COVID-19 could be linked with prematurity, with all the caveats of limited data, and also helped make clear why pregnant people require prioritization and protection https://www.nytimes.com/2020/09/17/health/covid-pregnancy-premature-birth.html
7/ which leads to the main point...regardless of what we learn about the biology of COVID-19, attention to the way the biology and sociology interact is critical
the pandemic has taken every inequity in our society and thrown it into a pressure cooker https://www.nytimes.com/2020/08/06/nyregion/childbirth-Covid-Black-mothers.html
the pandemic has taken every inequity in our society and thrown it into a pressure cooker https://www.nytimes.com/2020/08/06/nyregion/childbirth-Covid-Black-mothers.html
8/ During every humanitarian disaster, whether a war, weather event, or a pandemic -- pregnant people suffer disproportionately
@EmilyBobrow vividly described the chaos in NYC earlier this Spring https://www.newyorker.com/science/medical-dispatch/a-chaotic-week-for-pregnant-women-in-new-york-city
@EmilyBobrow vividly described the chaos in NYC earlier this Spring https://www.newyorker.com/science/medical-dispatch/a-chaotic-week-for-pregnant-women-in-new-york-city
9/ during disruptive moments like this, the needs of pregnant people are often taken for granted or de-prioritized
this means
-less access to care and support
-more financial strain, isolation and violence
this means
-less access to care and support
-more financial strain, isolation and violence
10/ COVID-19 has divided the world into people who are able to protect themselves and those who are not, across geopolitical borders and across neighborhood blocks
It has put the injustices of who has access to opportunity into stark relief, and placed racism front and center
It has put the injustices of who has access to opportunity into stark relief, and placed racism front and center
11/ pregnant people are a bellwether for the wellbeing of all of us
particularly critical to understand the degree to which where people live determines how safe they are, how likely they are to be exposed, infected, cared for
and why anti-black racism is particularly deadly
particularly critical to understand the degree to which where people live determines how safe they are, how likely they are to be exposed, infected, cared for
and why anti-black racism is particularly deadly
12/ there is an opportunity here - to vision through this moment to a better normal, to seize the way disruptions are spurring advocacy and innovation...and listening
I hope this means more midwives and doulas, more care settings, better care models...and that last point...
I hope this means more midwives and doulas, more care settings, better care models...and that last point...
13/ going forward the focus of my professional efforts will be building systems for childbirth that are worthy of trust, particularly among communities that have been historically marginalized and oppressed, who our existing systems have failed to uplift
big disclaimer:
big disclaimer:
14/ I'm not an expert in building trustworthy systems--I am a member of the very systems that, fundamentally, take good care of some but not others
I am committed however to doing my part as an ally to achieve a more just future--not via tweets or words--but actions and time
I am committed however to doing my part as an ally to achieve a more just future--not via tweets or words--but actions and time
@JanineClaytonMD for inviting me to present, and colleagues @mcgregormd @DrMWHooper on the @NIH_ORWH whose own brilliant presentations shaped these thoughts and can be watched via the link above
