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By Roni Caryn Rabin
KOKOMO, Ind. – Tammy Cunningham doesn’t forget the birth of her son. She was not seven months pregnant when she became seriously ill with covid-19 in May 2021. When she was flown by helicopter to an Indianapolis hospital, she was coughing and panting.
The baby wasn’t expected until 11 weeks from now, but Cunningham’s lungs were failing. The medical team, fearing that neither she nor the fetus would do so while she was pregnant, asked her fiancé to authorize an emergency C-section.
“I asked, ‘Are you going to make it?'” recalls Matt Cunningham. And they said they couldn’t answer that. “
New government data suggests scenes like this will spread frequently into 2021, the current year of the pandemic.
The National Center for Health Statistics reported Thursday that 1205 pregnant women died in 2021, representing a 40 percent increase in maternal deaths from 861 deaths in 2020 and a 60 percent increase from 754 in 2019.
The count includes deaths of women who are pregnant or who have been pregnant in the past 42 days, from any similar or bothersome cause during pregnancy. A separate report from the Government Accountability Office cited Covid as a contributing factor to at least 400 maternal deaths in 2021, explaining much of the increase.
Even before the pandemic, the United States had the maternal mortality rate of any industrialized country. The coronavirus has exacerbated an already dire situation, raising the rate to 32. 9 consistent with 100,000 births in 2021 from 20. 1 consistent with 100,000 live births in 2019.
Racial disparities have been particularly acute. The maternal mortality rate for black women rose to 69. 9 deaths consistent with 100,000 live births in 2021, 2. 6 times the rate for white women. From 2020 to 2021, death rates doubled among American Native and Alaska Native women who were pregnant or gave birth last year, according to an article published Thursday in Obstetrics.
The dead tell only one component of the story. For each and every woman who has died from a pregnancy-related complication, many others, like Cunningham, have experienced the kind of serious illness that affects preterm birth and can compromise the long-term health of mother and child. Lost wages, medical expenses and mental trauma add to the strain.
Pregnancy makes women vulnerable to infectious diseases like covid. The heart, lungs, and kidneys make pregnancy difficult. The immune system, although not exactly depressed, readjusts to adapt to the fetus.
Abdominal tension reduces upper lung capacity. Blood clots more easily, a trend amplified by Covid, increasing the threat of harmful lockdowns. eclampsia.
Pregnant women with covid are seven times more likely to die than uninfected pregnant women, according to a giant meta-analysis tracking unvaccinated people. The infection also makes it more likely that a woman will give birth and that the baby will require extensive neonatal care.
Fortunately, the existing variant of Omicron appears to be less virulent than the Delta variant, which appeared in the summer of 2021, and now more people have gained immunity to the coronavirus. Preliminary figures suggest that maternal deaths have fallen to roughly pre-pandemic degrees in 2022.
But pregnancy is still something that makes even young women vulnerable to serious illness. Cunningham, now 39, who was obese when she became pregnant, had just been diagnosed with gestational diabetes when she became ill.
“It’s anything I communicate to all my patients,” Dr. Brown said. Torri Metz, a maternal-fetal medicine specialist at the University of Utah. “If they have some of those underlying medical situations and they’re pregnant, any of which are high-threat categories, they want to be especially careful not to expose themselves to the threat of exposure to any kind of respiratory virus, because we know that other pregnant women get sicker from those viruses.
As of summer 2021, scientists had doubts about the protection of mRNA vaccines during pregnancy; Pregnant women were excluded from clinical trials, as they are. It wasn’t until August 2021 that the Centers for Disease Control and Prevention issued unequivocal rules in favor of vaccinating pregnant women.
Most of the pregnant women who died of covid had been vaccinated. Today, more than 70% of pregnant women have gained covid vaccines, but only about 20% have gained bivalent boosters.
“We definitely know that vaccination prevents serious illness and hospitalizations and prevents poor maternal and infant outcomes,” said Dr. Brown. Dana Meaney-Delman, chief of CDC’s Child Outcomes Surveillance, Research, and Prevention Branch. “We will have to keep insisting on this one. “
Cunningham’s obstetrician had encouraged her to get vaccinated, but she hesitated. “It had almost arrived” when he suddenly started having unusually heavy nosebleeds that produced blood clots “the length of a golf ball,” he said.
Cunningham also felt shortness of breath, but attributed it to the advance of the pregnancy. (Many Covid symptoms can be overlooked as they resemble those that usually occur during pregnancy. )
A Covid test came back negative and Ms Cunningham was pleased to be back to work. He had already lost his salary after a past pandemic leave at the auto parts plant where he worked. On May 3, 2021, shortly after arriving, he converted. to a friend at the factory and said, “I can’t breathe. “
When he arrived at IU Health Methodist Hospital in Indianapolis, he had acute respiratory distress. Doctors diagnosed him with pneumonia and discovered asymmetrical shadows in his lungs.
Her oxygen levels continued to drop even after she put on undiluted oxygen, and even after the baby was born.
“It was clear that his lungs were incredibly ruptured and couldn’t function on their own,” said Dr. Omar Rahman, an intensive care physician who treated Cunningham. Bypass machine.
Jennifer McGregor, a friend who visited Cunningham in hospital, was surprised at how temporarily his condition had deteriorated.
But over the next 10 days, Ms. Cunningham began to recover. Once she disconnected from the heart-lung machine, she discovered she had missed one major occasion in her sedated life: she had a son.
She was born at 29 weeks and two days pregnant, weighing 3 pounds.
Preterm births declined in the first year of the pandemic, but rose sharply in 2021, the year of delta push, reaching the highest rate since 2007.
About 10. 5% of all births were preterm that year, 10. 1% in 2020 and 10. 2% in 2019, the year before the pandemic.
Although the Cunninghams’ baby, Calum, never tested positive for covid, he was hospitalized in the neonatal intensive care unit at Riley Hospital for Children in Indianapolis. He was hooked up to a breathing tube and stopped breathing for a few seconds at a time.
Doctors were involved in him gaining weight fairly temporarily: “stunted growth,” they wrote in their file. They were concerned about the imaginable loss of vision and hearing.
But after 66 days in the NICU, the Cunninghams would bring Calum home. They learned to use their feeding tube through education on a mannequin and prepared for the worst.
“From everything we were told, I was going to have developmental delays and be late,” Cunningham said.
After her discharge from the hospital, Ms. Cunningham was under strict orders to have a guard with her at all times and rest. He did not return to work for seven months, after obtaining approval from his doctors.
Mrs. Cunningham has 3 teenage daughters and Mr. Cunningham has another daughter from a past relationship. Shortage of money. Friends brought the purchases and the owner agreed to late payments. But the Cunninghams didn’t get help from the government: they were even turned away by food stamps.
“We had never asked for help in our lives,” Ms. Cunningham said. “We were painters. We used to paint seven days a week, 8 hours a day, 12. But when everyone went to a standstill in 2020, we depleted a lot of our savings, and then I got sick. We were never caught. “
Although he has returned to painting at the factory, Cunningham has persistent symptoms, migraines and short-term memory problems. He forgets about doctor’s appointments and why he went to the store. Recently, you forgot your card at an ATM.
Many patients are so traumatized by their stay in extended care sets that they expand what is known as post-extensive care syndrome. Cunningham has flashbacks and nightmares about his return to the hospital.
“I wake up feeling like I’m being suffocated in the hospital or that they’re killing my whole family,” she said. He was recently diagnosed with post-traumatic stress disorder.
Calum, however, surprised everyone. A few months after returning from the hospital, he reached the developmental milestones on time. It started a while after his first birthday and likes to sound with “What’s wrong?”and “Oh, oh!”
He returned to the hospital for viral infections, but his vocabulary is excellent, his father said. “If you ask him if he needs a bathroom, he will take off all his clothes and place you in the bathroom,” he said.
Louann Gross, owner of the daycare Calum attended, said she has a big appetite, asks for “third parties” and does more than get attached to her peers. He added, “I nicknamed him our ‘Superbathrough. ‘”
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