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She was raised in Flushing, Queens – in the nation’s most diverse zip code.","avatar":"https://secure.gravatar.com/avatar/6b4008f17ce91a2879e8733722f9018a?s=600&d=blank&r=g","twitter":null,"facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["subscriber"]},{"site":"science","roles":["author"]},{"site":"quest","roles":["subscriber"]}],"headData":{"title":"Aarti Shahani | KQED","description":"KQED Contributor","ogImgSrc":"https://secure.gravatar.com/avatar/6b4008f17ce91a2879e8733722f9018a?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/6b4008f17ce91a2879e8733722f9018a?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/aartishahani"},"jenniferhuber":{"type":"authors","id":"6360","meta":{"index":"authors_1591205172","id":"6360","found":true},"name":"Jennifer Huber","firstName":"Jennifer","lastName":"Huber","slug":"jenniferhuber","email":"jshuber@lbl.gov","display_author_email":false,"staff_mastheads":[],"title":null,"bio":"Jennifer Huber is a medical imaging scientist at the Lawrence Berkeley National Laboratory with more than 20 years of experience in academic science writing. She received her Ph.D. in Physics from the University of California Santa Barbara. She is also a freelance science writer, editor and blogger, as well as a science-writing instructor for the University of California Berkeley Extension. Jennifer has lived in the San Francisco Bay Area most of her life and she frequently enjoys the eclectic cultural, culinary and outdoor activities available in the area.\r\n\r\nRead her \u003ca href=\"http://science.kqed.org/quest/author/jenniferhuber/\">previous contributions\u003c/a> to \u003ci>QUEST\u003c/i>, a project dedicated to exploring the Science of Sustainability.","avatar":"https://secure.gravatar.com/avatar/ca897c62a710c0bf8c5f429c89331765?s=600&d=blank&r=g","twitter":null,"facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"science","roles":["author"]},{"site":"quest","roles":["subscriber"]}],"headData":{"title":"Jennifer Huber | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/ca897c62a710c0bf8c5f429c89331765?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/ca897c62a710c0bf8c5f429c89331765?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/jenniferhuber"},"mpeterson":{"type":"authors","id":"11223","meta":{"index":"authors_1591205172","id":"11223","found":true},"name":"Molly Peterson","firstName":"Molly","lastName":"Peterson","slug":"mpeterson","email":"mpeterson@kqed.org","display_author_email":false,"staff_mastheads":[],"title":null,"bio":"Molly Peterson reports for KQED science and news on climate change, catastrophe and risk. Previously she was environment correspondent at Southern California Public Radio. Her work has also appeared at The New York Times, The Guardian, on NPR, at High Country News, on Code Switch, and other national outlets. She has been honored with awards from Public Radio News Directors Incorporated, Investigative Reporters and Editors, the Society for Professional Journalists, the Los Angeles Press Club, and RTNDA Edward R. Murrow awards, among others.","avatar":"https://secure.gravatar.com/avatar/7908e2807131f776cc8165c649530b05?s=600&d=blank&r=g","twitter":"Mollydacious","facebook":null,"instagram":"https://www.instagram.com/radiomolly/","linkedin":null,"sites":[{"site":"news","roles":["subscriber"]},{"site":"futureofyou","roles":["editor"]},{"site":"science","roles":["editor"]}],"headData":{"title":"Molly Peterson | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/7908e2807131f776cc8165c649530b05?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/7908e2807131f776cc8165c649530b05?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/mpeterson"},"lesleymcclurg":{"type":"authors","id":"11229","meta":{"index":"authors_1591205172","id":"11229","found":true},"name":"Lesley McClurg","firstName":"Lesley","lastName":"McClurg","slug":"lesleymcclurg","email":"lmcclurg@KQED.org","display_author_email":false,"staff_mastheads":["news","science"],"title":"KQED Health Correspondent","bio":"\u003cspan style=\"font-weight: 400;\">Lesley McClurg is a health correspondent and fill-in host. \u003c/span>\u003cspan style=\"font-weight: 400;\">Her work is regularly rebroadcast on numerous NPR and PBS shows. She has won several regional Emmy awards, a regional and a national Edward R. Murrow award. The Association for Health Journalists awarded Lesley best beat coverage. The Society of Professional Journalists has recognized her reporting several times. The Society of Environmental Journalists spotlighted her ongoing coverage of California's historic drought. \u003c/span>\u003cspan style=\"font-weight: 400;\">Before joining KQED in 2016, she covered food and sustainability for Capital Public Radio, the environment for Colorado Public Radio, and reported for both KUOW and KCTS9 in Seattle. \u003c/span>\u003cspan style=\"font-weight: 400;\">When not hunched over her laptop Lesley enjoys skiing with her toddler, surfing with her husband or scheming their next globetrotting adventure. Before motherhood she relished dancing tango till sunrise. When on deadline she fuels herself almost exclusively on chocolate chips.\u003c/span>\r\n\r\n\u003cspan style=\"font-weight: 400;\"> \u003c/span>","avatar":"https://secure.gravatar.com/avatar/3fb78e873af3312f34d0bc1d60a07c7f?s=600&d=blank&r=g","twitter":"lesleywmcclurg","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["editor"]},{"site":"stateofhealth","roles":["author"]},{"site":"science","roles":["editor"]}],"headData":{"title":"Lesley McClurg | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/3fb78e873af3312f34d0bc1d60a07c7f?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/3fb78e873af3312f34d0bc1d60a07c7f?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/lesleymcclurg"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"news","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"science_1982448":{"type":"posts","id":"science_1982448","meta":{"index":"posts_1591205157","site":"science","id":"1982448","score":null,"sort":[1682446656000]},"guestAuthors":[],"slug":"uc-researchers-examine-how-smoke-from-californias-megafires-affects-pregnancy-and-children","title":"UC Researchers Examine How Smoke From California's Megafires Affects Pregnancy and Children","publishDate":1682446656,"format":"standard","headTitle":"UC Researchers Examine How Smoke From California’s Megafires Affects Pregnancy and Children | KQED","labelTerm":{},"content":"\u003cp>When wildfires spread through parts of Northern California wine country in 2017, they melted electronics, combusted cars and exploded propane tanks. The fires sent acrid smoke billowing into the sky, its footprint wafting over the state and extending for 500 miles into the Pacific Ocean.\u003c/p>\n\u003cp>At the time, Rebecca Schmidt, a molecular epidemiologist at UC Davis, was working on a study that followed families of children with autism who were expecting another child. When the fires spread, pregnant participants in the research started asking whether they should be worried about the air.\u003c/p>\n\u003cp>Schmidt and her collaborators didn’t know what to say. There wasn’t much existing research on how wildfire smoke affects pregnancy. “I would have been wondering the same thing,” she said. “We really couldn’t tell them how concerned they needed to be.”\u003c/p>\n\u003cp>She decided to try to find the answers herself. Over the last several years, Schmidt and a team of fellow scientists have collected biological samples like hair, saliva and blood from pregnant people in California to better understand the health effects of smoke exposure on babies and those who birth them.\u003c/p>\n\u003cp>The study’s timeline overlapped with numerous huge fires in the state, and researchers are still assessing the results. But the number of participants wasn’t large enough to fully understand the relationship between exposure and birth outcomes or developmental health.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Now, Schmidt and a team of researchers are expanding the scope, examining two decades of statewide health and birth records alongside wildfire smoke data to determine which pockets of California are bearing the brunt of the smoke and what effects that environmental exposure could be having on early life. The results could have wide-reaching implications for locations experiencing similar spikes in hazardous fires.\u003c/p>\n\u003cp>“It’s only going to get worse with climate change,” Schmidt said. “Learning about it is relevant for everybody.”\u003c/p>\n\u003cp>The team, which includes nine researchers from UC Davis and UCLA, will be led by Schmidt and Miriam Nuño, a UC Davis biostatistician who researches public health and health disparities. In addition to identifying communities where wildfire smoke may be causing harm and analyzing health impacts, the scientists will engage with community members on ways they can better protect themselves, like wearing N95 masks or installing relatively cheap indoor air filters.\u003c/p>\n\u003cp>Both Nuño and Schmidt have long studied human health. And both grew up in areas where air pollution was a part of daily life.\u003c/p>\n\u003cp>Born and raised in Iowa, Schmidt drove past agricultural fields where pesticides at times hung in the air like a “brown shroud” on her way to school. She lived in the state through graduate school, earning her Ph.D. in epidemiology at the University of Iowa. When she moved to California in 2008, the state was experiencing drought and a devastating fire year.\u003c/p>\n\u003cp>“I remember thinking, ‘Is it going to be like this every year?’” she said. “I’ve definitely had to modify my life around smoke exposure.”\u003c/p>\n\u003cp>Nuño moved to California from Guadalajara, Mexico, when she was 14, settling in Los Angeles and then the city of Riverside, about 60 miles east. In areas inland of Los Angeles, smog and pollution blow in from the west and sit there, with nearby mountains preventing dispersal. At the time, she didn’t realize poor air quality was a problem there, she said, and she didn’t expect to pursue health-related research.\u003c/p>\n\u003cp>“Those clouds of gray smoke — I never grew up realizing that was even an issue,” she said. “Often, you worry about other things, like do you have enough to eat and things like that.”\u003c/p>\n\u003cp>Nuño studied pure mathematics at UC Riverside, and planned on getting her Ph.D. in applied math and biostatistics, although she couldn’t entirely envision a future limited to studying mathematical concepts. Then, while in graduate school, she attended a lecture on math and HIV modeling. “That was really the change for me,” she said. “I want to do research that people can read about, and it can have some change.”\u003c/p>\n\u003cp>After studying math and computational biology during her Ph.D. work at Cornell University and completing fellowships in biostatistics at the Harvard School of Public Health and UCLA, Nuño increasingly focused her research on real-world health data.\u003c/p>\n\u003cp>When the COVID-19 pandemic arrived in 2020, she began working with the city of Davis to forecast infection rates. It was her “first taste,” she said, of how her skills could help focus resources, like testing and vaccination, to reduce the disproportionate health impacts in underserved communities. Mathematical modeling and statistical analysis are powerful, she said, “but if you’re not looking with the lens of equity and health equity, then you’re missing the picture.”\u003c/p>\n\u003cp>This study on wildfire smoke is Nuño’s first collaboration with Schmidt. Their work will be funded by a $1.35 million grant from the U.S. Environmental Protection Agency focused on environmental justice and climate-related health impacts on vulnerable populations and on life stages.\u003c/p>\n\u003cp>To date, only a few studies have looked at the impact of wildfire smoke on birth outcomes, such as a 2022 paper from scientists at Stanford University that \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S001393512101166X?via%3Dihub\">attributed nearly 7,000 preterm births from 2006 to 2012 in California to wildfire smoke exposure\u003c/a>.\u003c/p>\n\u003cp>Past research has largely focused on the years preceding California’s parade of record-breaking wildfires in the last decade. By focusing on a more recent time period that encompasses those extreme fires, the UCLA and UC Davis research may yield different findings from the earlier research, said Amy Padula, an epidemiologist at UCSF’s School of Medicine, who is using California birth records to conduct separate research on wildfire-related air pollution and birth outcomes from 2007 to 2020.\u003c/p>\n\u003cp>More research is needed, said Nuño, in part because of the size of climate-worsened fires but also because of where they’re burning. As people move into forested areas, and wildfires spread to inhabited zones, the flames are combusting not just trees and vegetation but also homes and all the objects inside them. That changes the chemical makeup of smoke and the dangers of exposure.\u003c/p>\n\u003cp>The team is currently mapping the parts of the state that are at high risk for smoke exposure. Then the group will determine where that exposure varies, and how that intersects with race, income level, exposure to pollutants and other factors. In addition to looking at birth weight and gestational age, the team will examine health data on developmental outcomes and autism diagnoses.\u003c/p>\n\u003cp>While data collected from birth records and from measuring wildfire smoke, birth outcomes and later development will guide their work, collaborators are paying close attention to communities where many people spend a lot of time outside, such as agricultural areas where many farmworkers live.\u003c/p>\n\u003cp>Communities of color and lower-income communities experience disproportionate air pollution, and the team expects the same will be true for wildfire exposure.\u003c/p>\n\u003cp>“All of this is systemic,” said Natalia Deeb-Sossa, sociologist and professor of Chicana/o studies at UC Davis, who is working on the team. “Wildfires are now every year more and more common because of climate change. I believe that is something that is affecting more and more of our more vulnerable communities and populations, and I think it’s really important that we do something about it.”\u003c/p>\n\u003cp>Past research has linked air pollution to lower birth weights and preterm births, which can have a negative impact on health later in life. The California study, which will run into 2025, could provide more clarity on the extent to which those effects also result from wildfire smoke, for those inside and outside the state.\u003c/p>\n\u003cp>“The whole world’s been impacted by wildfire smoke at this point,” Schmidt said. “It’s not easy to run from anymore.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://insideclimatenews.org/\">Inside Climate News\u003c/a> is a nonprofit, independent news organization that covers climate, energy and the environment. \u003ca href=\"https://insideclimatenews.org/newsletter/\">Sign up for the ICN newsletter here.\u003c/a>\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"The researchers are examining decades of birth records and wildfire smoke data to understand how wildfires affect pregnancy and children’s health.","status":"publish","parent":0,"modified":1704846034,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":29,"wordCount":1396},"headData":{"title":"UC Researchers Examine How Smoke From California's Megafires Affects Pregnancy and Children | KQED","description":"The researchers are examining decades of birth records and wildfire smoke data to understand how wildfires affect pregnancy and children’s health.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"source":"Inside Climate News","sticky":false,"nprByline":"\u003ca href=\"https://insideclimatenews.org/profile/emma-foehringer-merchant/\">Emma Foehringer Merchant\u003c/a> \u003cbr>Inside Climate News \u003cbr>","excludeFromSiteSearch":"Include","showOnAuthorArchivePages":"No","articleAge":"0","path":"/science/1982448/uc-researchers-examine-how-smoke-from-californias-megafires-affects-pregnancy-and-children","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>When wildfires spread through parts of Northern California wine country in 2017, they melted electronics, combusted cars and exploded propane tanks. The fires sent acrid smoke billowing into the sky, its footprint wafting over the state and extending for 500 miles into the Pacific Ocean.\u003c/p>\n\u003cp>At the time, Rebecca Schmidt, a molecular epidemiologist at UC Davis, was working on a study that followed families of children with autism who were expecting another child. When the fires spread, pregnant participants in the research started asking whether they should be worried about the air.\u003c/p>\n\u003cp>Schmidt and her collaborators didn’t know what to say. There wasn’t much existing research on how wildfire smoke affects pregnancy. “I would have been wondering the same thing,” she said. “We really couldn’t tell them how concerned they needed to be.”\u003c/p>\n\u003cp>She decided to try to find the answers herself. Over the last several years, Schmidt and a team of fellow scientists have collected biological samples like hair, saliva and blood from pregnant people in California to better understand the health effects of smoke exposure on babies and those who birth them.\u003c/p>\n\u003cp>The study’s timeline overlapped with numerous huge fires in the state, and researchers are still assessing the results. But the number of participants wasn’t large enough to fully understand the relationship between exposure and birth outcomes or developmental health.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now, Schmidt and a team of researchers are expanding the scope, examining two decades of statewide health and birth records alongside wildfire smoke data to determine which pockets of California are bearing the brunt of the smoke and what effects that environmental exposure could be having on early life. The results could have wide-reaching implications for locations experiencing similar spikes in hazardous fires.\u003c/p>\n\u003cp>“It’s only going to get worse with climate change,” Schmidt said. “Learning about it is relevant for everybody.”\u003c/p>\n\u003cp>The team, which includes nine researchers from UC Davis and UCLA, will be led by Schmidt and Miriam Nuño, a UC Davis biostatistician who researches public health and health disparities. In addition to identifying communities where wildfire smoke may be causing harm and analyzing health impacts, the scientists will engage with community members on ways they can better protect themselves, like wearing N95 masks or installing relatively cheap indoor air filters.\u003c/p>\n\u003cp>Both Nuño and Schmidt have long studied human health. And both grew up in areas where air pollution was a part of daily life.\u003c/p>\n\u003cp>Born and raised in Iowa, Schmidt drove past agricultural fields where pesticides at times hung in the air like a “brown shroud” on her way to school. She lived in the state through graduate school, earning her Ph.D. in epidemiology at the University of Iowa. When she moved to California in 2008, the state was experiencing drought and a devastating fire year.\u003c/p>\n\u003cp>“I remember thinking, ‘Is it going to be like this every year?’” she said. “I’ve definitely had to modify my life around smoke exposure.”\u003c/p>\n\u003cp>Nuño moved to California from Guadalajara, Mexico, when she was 14, settling in Los Angeles and then the city of Riverside, about 60 miles east. In areas inland of Los Angeles, smog and pollution blow in from the west and sit there, with nearby mountains preventing dispersal. At the time, she didn’t realize poor air quality was a problem there, she said, and she didn’t expect to pursue health-related research.\u003c/p>\n\u003cp>“Those clouds of gray smoke — I never grew up realizing that was even an issue,” she said. “Often, you worry about other things, like do you have enough to eat and things like that.”\u003c/p>\n\u003cp>Nuño studied pure mathematics at UC Riverside, and planned on getting her Ph.D. in applied math and biostatistics, although she couldn’t entirely envision a future limited to studying mathematical concepts. Then, while in graduate school, she attended a lecture on math and HIV modeling. “That was really the change for me,” she said. “I want to do research that people can read about, and it can have some change.”\u003c/p>\n\u003cp>After studying math and computational biology during her Ph.D. work at Cornell University and completing fellowships in biostatistics at the Harvard School of Public Health and UCLA, Nuño increasingly focused her research on real-world health data.\u003c/p>\n\u003cp>When the COVID-19 pandemic arrived in 2020, she began working with the city of Davis to forecast infection rates. It was her “first taste,” she said, of how her skills could help focus resources, like testing and vaccination, to reduce the disproportionate health impacts in underserved communities. Mathematical modeling and statistical analysis are powerful, she said, “but if you’re not looking with the lens of equity and health equity, then you’re missing the picture.”\u003c/p>\n\u003cp>This study on wildfire smoke is Nuño’s first collaboration with Schmidt. Their work will be funded by a $1.35 million grant from the U.S. Environmental Protection Agency focused on environmental justice and climate-related health impacts on vulnerable populations and on life stages.\u003c/p>\n\u003cp>To date, only a few studies have looked at the impact of wildfire smoke on birth outcomes, such as a 2022 paper from scientists at Stanford University that \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S001393512101166X?via%3Dihub\">attributed nearly 7,000 preterm births from 2006 to 2012 in California to wildfire smoke exposure\u003c/a>.\u003c/p>\n\u003cp>Past research has largely focused on the years preceding California’s parade of record-breaking wildfires in the last decade. By focusing on a more recent time period that encompasses those extreme fires, the UCLA and UC Davis research may yield different findings from the earlier research, said Amy Padula, an epidemiologist at UCSF’s School of Medicine, who is using California birth records to conduct separate research on wildfire-related air pollution and birth outcomes from 2007 to 2020.\u003c/p>\n\u003cp>More research is needed, said Nuño, in part because of the size of climate-worsened fires but also because of where they’re burning. As people move into forested areas, and wildfires spread to inhabited zones, the flames are combusting not just trees and vegetation but also homes and all the objects inside them. That changes the chemical makeup of smoke and the dangers of exposure.\u003c/p>\n\u003cp>The team is currently mapping the parts of the state that are at high risk for smoke exposure. Then the group will determine where that exposure varies, and how that intersects with race, income level, exposure to pollutants and other factors. In addition to looking at birth weight and gestational age, the team will examine health data on developmental outcomes and autism diagnoses.\u003c/p>\n\u003cp>While data collected from birth records and from measuring wildfire smoke, birth outcomes and later development will guide their work, collaborators are paying close attention to communities where many people spend a lot of time outside, such as agricultural areas where many farmworkers live.\u003c/p>\n\u003cp>Communities of color and lower-income communities experience disproportionate air pollution, and the team expects the same will be true for wildfire exposure.\u003c/p>\n\u003cp>“All of this is systemic,” said Natalia Deeb-Sossa, sociologist and professor of Chicana/o studies at UC Davis, who is working on the team. “Wildfires are now every year more and more common because of climate change. I believe that is something that is affecting more and more of our more vulnerable communities and populations, and I think it’s really important that we do something about it.”\u003c/p>\n\u003cp>Past research has linked air pollution to lower birth weights and preterm births, which can have a negative impact on health later in life. The California study, which will run into 2025, could provide more clarity on the extent to which those effects also result from wildfire smoke, for those inside and outside the state.\u003c/p>\n\u003cp>“The whole world’s been impacted by wildfire smoke at this point,” Schmidt said. “It’s not easy to run from anymore.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://insideclimatenews.org/\">Inside Climate News\u003c/a> is a nonprofit, independent news organization that covers climate, energy and the environment. \u003ca href=\"https://insideclimatenews.org/newsletter/\">Sign up for the ICN newsletter here.\u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1982448/uc-researchers-examine-how-smoke-from-californias-megafires-affects-pregnancy-and-children","authors":["byline_science_1982448"],"categories":["science_31","science_35","science_39","science_40","science_4450"],"tags":["science_512","science_112","science_5181","science_616","science_3463","science_113"],"featImg":"science_1982449","label":"source_science_1982448"},"science_1946243":{"type":"posts","id":"science_1946243","meta":{"index":"posts_1591205157","site":"science","id":"1946243","score":null,"sort":[1565723431000]},"guestAuthors":[],"slug":"pregnant-moms-who-breathe-dirty-air-have-children-with-lower-iqs-study-finds","title":"Pregnant Moms Who Breathe Dirty Air Have Children With Lower IQs, Study Finds","publishDate":1565723431,"format":"standard","headTitle":"Pregnant Moms Who Breathe Dirty Air Have Children With Lower IQs, Study Finds | KQED","labelTerm":{"site":"science"},"content":"\u003cp>A new study focusing on mothers who breathe soot-laden air adds to a growing body of research into how air pollution affects cognitive development.\u003c/p>\n\u003cp>Fine particles of pollution, small enough to breathe deep into lungs, come from coal plants, burning fuel in cars and trucks, and airborne dust. Pregnant women exposed to more of this pollution had children with lower IQs compared to women who breathed cleaner air, according to new analysis \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0013935119302944?via%3Dihub\">published\u003c/a> in the journal \u003cem>Environmental Research\u003c/em>.\u003c/p>\n\u003caside class=\"pullquote alignright\">Prenatal nutrition may help buffer against the damaging effects of air pollution.\u003c/aside>\n\u003cp>The study focused on a group of Tennessee mothers who researchers began to monitor while they were pregnant. As their children grew, researchers gave the kids IQ an test.\u003c/p>\n\u003cp>“It’s a very long battery that poor small children have to sit through,” says Kaja LeWinn, one of ten research team members and professor of psychiatry at UCSF. “It’s a long time to have a four-to-five year old sitting still.”\u003c/p>\n\u003cp>Children of mothers exposed to the worst soot pollution scored lower on IQ tests by about two-and-a-half points compared to mothers in cleaner neighborhoods.\u003c/p>\n\u003cp>“[Fine particulate] pollution is less well-studied as a neurodevelopment toxicant, so I think that makes it particularly interesting to have these results,” says Catherine Karr, a study author and pediatric environmental medicine doctor at the University of Washington.\u003c/p>\n\u003cfigure id=\"attachment_1946439\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1946439\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/08/GettyImages-1160305879-800x506.jpg\" alt=\"\" width=\"800\" height=\"506\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2019/08/GettyImages-1160305879-800x506.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/08/GettyImages-1160305879-160x101.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/08/GettyImages-1160305879-768x486.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/08/GettyImages-1160305879-1020x645.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/08/GettyImages-1160305879.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Visitors gather on a path in Los Angeles’ Griffith Park in July 2019 on a day of high air pollution. \u003ccite>(Mario Tama/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Unlike many cities in California, Memphis tends to meet federal pollution standards for most days of the year.\u003c/p>\n\u003cp>\u003cstrong>Nutrition vs. Air Pollution?\u003c/strong>\u003c/p>\n\u003cp>“I think this work really highlights that low-level exposure might be important and that we need to do more work to know what a safe level is,” says Megan Herting, a neuroscientist at USC who was not involved in the research.\u003c/p>\n\u003cp>Herting says the work does a good job controlling for other factors that might influence cognitive development, like family economics. “It really narrows down and says there’s something about air quality that seems to be driving this decrease.”\u003c/p>\n\u003cp>The research team also has found something novel: evidence that nutrition buffers the impacts of air pollution. Pregnant women are told to eat foods rich in folate like leafy greens and citrus, or take prenatal vitamins, like folic acid.\u003c/p>\n\u003cp>“Women with the lowest folate levels, for their children the association between our measure of air pollution and IQ was much stronger,” LeWinn says.\u003c/p>\n\u003cp>The children of mothers who breathed dirtier air and carried less folate in their bodies scored about seven points lower on IQ tests than children in the top cohort.\u003c/p>\n\u003cp>“The effect there was about twice as strong as what we saw in the full sample,” she says.\u003c/p>\n\u003cp>LeWinn and other authors acknowledge the folate results haven’t been replicated. But they say that their work can help identify groups of mothers more vulnerable to pollution’s ill effects. Though doctors already recommend folate as a preventative measure against birth defects, among the cohort of mothers in Tennessee, researchers saw that not all pregnant women took enough of it.\u003c/p>\n\u003cp>“We as individuals might have ways to better our own outcomes of ourselves and our children,” Herting says. “This suggests that’s going to really help offset some of these other things we might not be able to control.”\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/science/1933748/air-pollution-is-the-new-tobacco-warns-world-health-organization\">More than 9 out of 10 children in the world are exposed to unsafe levels of air pollution, according to the World Health Organization, which calls it a ‘silent public health emergency.’\u003c/a>\u003c/h3>\n\u003c/aside>\n\u003cp>Researchers in this area stress they don’t yet know the exact way air pollution might affect the brain.\u003c/p>\n\u003cp>The California Air Resources Board \u003ca href=\"https://ww2.arb.ca.gov/resources/fact-sheets/air-pollution-and-brain\">points out\u003c/a> that air pollution may affect brains directly and indirectly, but also says that associations between air pollution and the brain are “just beginning to emerge.”\u003c/p>\n\u003cp>In recent years, scientists have been amassing evidence connecting air pollution to neurodevelopmental impacts. Last summer, research focused on China \u003ca href=\"http://www.pnas.org/cgi/doi/10.1073/pnas.1809474115\">found\u003c/a> that polluted air is linked to lower intelligence in adults, and worsens with age. A study published in \u003cem>The Lancet\u003c/em> \u003ca href=\"https://www.thelancet.com/journals/landia/article/PIIS0140-6736(16)32399-6/fulltext\">found\u003c/a> that people living near busy roads in Ontario, Canada were more likely to be diagnosed with dementia, though whether that’s a consequence of respiratory and cardiac problems remains unclear.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n","blocks":[],"excerpt":"Children of mothers exposed to more soot scored lower on IQ tests compared to mothers in cleaner neighborhoods. However, good prenatal nutrition may buffer pollution's effects.","status":"publish","parent":0,"modified":1704848405,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":21,"wordCount":755},"headData":{"title":"Pregnant Moms Who Breathe Dirty Air Have Children With Lower IQs, Study Finds | KQED","description":"Children of mothers exposed to more soot scored lower on IQ tests compared to mothers in cleaner neighborhoods. However, good prenatal nutrition may buffer pollution's effects.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"audioUrl":"https://www.kqed.org/.stream/anon/radio/science/2019/08/PetersonPollutionEffects.mp3","sticky":false,"audioTrackLength":169,"path":"/science/1946243/pregnant-moms-who-breathe-dirty-air-have-children-with-lower-iqs-study-finds","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>A new study focusing on mothers who breathe soot-laden air adds to a growing body of research into how air pollution affects cognitive development.\u003c/p>\n\u003cp>Fine particles of pollution, small enough to breathe deep into lungs, come from coal plants, burning fuel in cars and trucks, and airborne dust. Pregnant women exposed to more of this pollution had children with lower IQs compared to women who breathed cleaner air, according to new analysis \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0013935119302944?via%3Dihub\">published\u003c/a> in the journal \u003cem>Environmental Research\u003c/em>.\u003c/p>\n\u003caside class=\"pullquote alignright\">Prenatal nutrition may help buffer against the damaging effects of air pollution.\u003c/aside>\n\u003cp>The study focused on a group of Tennessee mothers who researchers began to monitor while they were pregnant. As their children grew, researchers gave the kids IQ an test.\u003c/p>\n\u003cp>“It’s a very long battery that poor small children have to sit through,” says Kaja LeWinn, one of ten research team members and professor of psychiatry at UCSF. “It’s a long time to have a four-to-five year old sitting still.”\u003c/p>\n\u003cp>Children of mothers exposed to the worst soot pollution scored lower on IQ tests by about two-and-a-half points compared to mothers in cleaner neighborhoods.\u003c/p>\n\u003cp>“[Fine particulate] pollution is less well-studied as a neurodevelopment toxicant, so I think that makes it particularly interesting to have these results,” says Catherine Karr, a study author and pediatric environmental medicine doctor at the University of Washington.\u003c/p>\n\u003cfigure id=\"attachment_1946439\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1946439\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/08/GettyImages-1160305879-800x506.jpg\" alt=\"\" width=\"800\" height=\"506\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2019/08/GettyImages-1160305879-800x506.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/08/GettyImages-1160305879-160x101.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/08/GettyImages-1160305879-768x486.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/08/GettyImages-1160305879-1020x645.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/08/GettyImages-1160305879.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Visitors gather on a path in Los Angeles’ Griffith Park in July 2019 on a day of high air pollution. \u003ccite>(Mario Tama/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Unlike many cities in California, Memphis tends to meet federal pollution standards for most days of the year.\u003c/p>\n\u003cp>\u003cstrong>Nutrition vs. Air Pollution?\u003c/strong>\u003c/p>\n\u003cp>“I think this work really highlights that low-level exposure might be important and that we need to do more work to know what a safe level is,” says Megan Herting, a neuroscientist at USC who was not involved in the research.\u003c/p>\n\u003cp>Herting says the work does a good job controlling for other factors that might influence cognitive development, like family economics. “It really narrows down and says there’s something about air quality that seems to be driving this decrease.”\u003c/p>\n\u003cp>The research team also has found something novel: evidence that nutrition buffers the impacts of air pollution. Pregnant women are told to eat foods rich in folate like leafy greens and citrus, or take prenatal vitamins, like folic acid.\u003c/p>\n\u003cp>“Women with the lowest folate levels, for their children the association between our measure of air pollution and IQ was much stronger,” LeWinn says.\u003c/p>\n\u003cp>The children of mothers who breathed dirtier air and carried less folate in their bodies scored about seven points lower on IQ tests than children in the top cohort.\u003c/p>\n\u003cp>“The effect there was about twice as strong as what we saw in the full sample,” she says.\u003c/p>\n\u003cp>LeWinn and other authors acknowledge the folate results haven’t been replicated. But they say that their work can help identify groups of mothers more vulnerable to pollution’s ill effects. Though doctors already recommend folate as a preventative measure against birth defects, among the cohort of mothers in Tennessee, researchers saw that not all pregnant women took enough of it.\u003c/p>\n\u003cp>“We as individuals might have ways to better our own outcomes of ourselves and our children,” Herting says. “This suggests that’s going to really help offset some of these other things we might not be able to control.”\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/science/1933748/air-pollution-is-the-new-tobacco-warns-world-health-organization\">More than 9 out of 10 children in the world are exposed to unsafe levels of air pollution, according to the World Health Organization, which calls it a ‘silent public health emergency.’\u003c/a>\u003c/h3>\n\u003c/aside>\n\u003cp>Researchers in this area stress they don’t yet know the exact way air pollution might affect the brain.\u003c/p>\n\u003cp>The California Air Resources Board \u003ca href=\"https://ww2.arb.ca.gov/resources/fact-sheets/air-pollution-and-brain\">points out\u003c/a> that air pollution may affect brains directly and indirectly, but also says that associations between air pollution and the brain are “just beginning to emerge.”\u003c/p>\n\u003cp>In recent years, scientists have been amassing evidence connecting air pollution to neurodevelopmental impacts. Last summer, research focused on China \u003ca href=\"http://www.pnas.org/cgi/doi/10.1073/pnas.1809474115\">found\u003c/a> that polluted air is linked to lower intelligence in adults, and worsens with age. A study published in \u003cem>The Lancet\u003c/em> \u003ca href=\"https://www.thelancet.com/journals/landia/article/PIIS0140-6736(16)32399-6/fulltext\">found\u003c/a> that people living near busy roads in Ontario, Canada were more likely to be diagnosed with dementia, though whether that’s a consequence of respiratory and cardiac problems remains unclear.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1946243/pregnant-moms-who-breathe-dirty-air-have-children-with-lower-iqs-study-finds","authors":["11223"],"categories":["science_30","science_31","science_35","science_39","science_3890","science_43"],"tags":["science_505","science_194","science_3370","science_5181","science_813","science_616"],"featImg":"science_1946247","label":"science"},"science_1945448":{"type":"posts","id":"science_1945448","meta":{"index":"posts_1591205157","site":"science","id":"1945448","score":null,"sort":[1563906027000]},"guestAuthors":[],"slug":"pregnancy-tech-is-growing-but-women-and-their-doctors-remain-wary","title":"Pregnancy Tech is Growing. But Women and Their Doctors Remain Wary","publishDate":1563906027,"format":"standard","headTitle":"Pregnancy Tech is Growing. But Women and Their Doctors Remain Wary | KQED","labelTerm":{},"content":"\u003cp>Pregnancy care is poised for a 21st century upgrade.\u003cbr>\n[pullquote align='right' citation='Dr. Thomas McElrath']‘Frequently people want the reassurance that it’s fine, but they haven’t thought through what happens if something isn’t fine. ‘[/pullquote]\u003c/p>\n\u003cp>Algorithms promise to detect the difference between real labor and a false alarm. Wearables give women a way to track contractions. Apps relay home blood pressure readings directly to doctors, offering a possible way to cut down on prenatal visits — and catch certain pregnancy complications before they become full-blown crises.\u003c/p>\n\u003cp>Doctors say the new technologies have the potential to transform prenatal care. But for all the promise, doctors caution that some direct-to-consumer devices might cause anxiety or unnecessary trips to the clinic — without strong evidence that they offer any real benefits to pregnant women.\u003c/p>\n\u003cp>“Prenatal care is burdensome. It requires patients to be in at minimum, once a month. People have jobs. It’s hard to get in… You could imagine some kind of virtual substitute would be very welcome,” said Dr. Thomas McElrath, an obstetrician-gynecologist at Brigham and Women’s Hospital in Boston. “But we would have to figure out and think carefully about how to do that,” he added.\u003c/p>\n\u003cp>Obstetrician-gynecologists are particularly worried about direct-to-consumer devices that aren’t woven into the fabric of prenatal care. Among their concerns: Faulty or confusing data might send women to their doctors when they don’t need to go. And for some devices, doctors say the lack of research or a true need to use them means they’re simply a waste of money.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I [sometimes tell] my patients to save their money, because babies are expensive,” said Dr. LaVonne Simmons, an obstetrician-gynecologist at the University of Washington.\u003c/p>\n\u003cp>Their fears aren’t completely unfounded. Some women say they bought devices to give them more data about their pregnancy, but ultimately felt they were more of a headache than a help. Others say they raised false alarms or made them second-guess their gut instincts about what was happening in their bodies.\u003c/p>\n\u003cp>But other women say DTC devices have given them peace of mind and the feeling of more control during a time that can be biologically overwhelming. That’s fueling a growing tension: As pregnancy tech grows more popular with patients, doctors are left to figure out if and how such devices fit into a woman’s prenatal care.\u003c/p>\n\u003cp>“It’s clearly the way of the future,” said Dr. Nathaniel DeNicola, an OB-GYN at George Washington University “This is an enormously popular, highly utilized field … It’s not going away.”\u003c/p>\n\u003cp>\u003cstrong>A New Kind of Prenatal Care\u003c/strong>\u003c/p>\n\u003cp>The field of pregnancy tech has grown rapidly in recent years, from home ultrasounds that capture kicks to wearable belts that play music to the womb.\u003c/p>\n\u003cp>One popular device is Bloomlife, a sensor that’s designed to pick up uterine activity. Women stick the sensor three fingers below their belly buttons, sit still, and watch as uterine activity pops up in spiky peaks on the Bloomlife app. More than 10,000 women have rented Bloomlife’s $20-a-week “smart pregnancy tracker” to count millions of contractions since the company launched in 2014.\u003c/p>\n\u003cp>Bloomlife’s office is in downtown San Francisco, situated in a coworking space that doubles as a retail store, with space-age phone pods lined up next to vintage furniture for sale. The basement is a lab space that was repurposed from a photo processing lab once run for Ansel Adams. Now, Bloomlife is using it as home base as it tries to do for pregnancy what its Silicon Valley peers are doing in other areas of health: Give it the tech treatment.\u003c/p>\n\u003cp>“The way that we manage prenatal care fundamentally hasn’t changed in decades,” said Eric Dy, Bloomlife’s president and a biomedical engineer by training. “That’s our North Star — we believe we can define a new standard within prenatal care,” he added.\u003c/p>\n\u003cp>Because Bloomlife’s device hasn’t been approved by the FDA, the company is careful not to veer into medical advice. Many women use it simply to see what’s happening in their bodies. It’s popular among women who might live far from their providers — nearly half of users live in rural areas, according to a Bloomlife breakdown of users’ ZIP codes.\u003c/p>\n\u003cp>Going direct-to-consumer has allowed the company to collect a massive amount of data, Dy said. While the company only relays contraction data to users, the device also tracks maternal heart rate. Bloomlife now has what it says is the world’s biggest physiological data set during pregnancy, with more than 500,000 hours of data.\u003c/p>\n\u003cp>Bloomlife is using that data to train artificial intelligence algorithms to not just track contractions, but identify labor. That could have a big impact, given the high cost of hospital trips for false labor.\u003c/p>\n\u003cp>The company recently wrapped up an observational study to test the accuracy of a “digital biomarker” — specifically, data on uterine activity and heart rate variability — in 150 pregnant women who used Bloomlife’s device.\u003c/p>\n\u003cp>At a medical conference earlier this year, Bloomlife’s team presented an abstract on results from the first 50 women in the study. The company reported that it is able to detect if a woman is in labor with 80% sensitivity and 93% specificity. Bloomlife says that shows its device is as accurate as the current standard of tracking contraction patterns and conducting a pelvic exam.\u003c/p>\n\u003cp>But outside experts still have questions, starting with the results from the other 100 women in the study. McElrath, the OB-GYN in Boston, said the analytic technique used to crunch the data wasn’t as rigorous as it needs to be to prove the test is valid. He also pointed out many women don’t have contractions in a clear pattern until the end stages of preterm labor and delivery. At that point, he said, it’s likely too late for a tool like Bloomlife’s to be useful in identifying the onset of preterm labor.\u003c/p>\n\u003cp>Bloomlife says it is preparing the full results of the study for publication in a peer-reviewed journal. The company plans to apply for clearance from the FDA next year and wants to run more studies on the device’s potential use in prenatal care.\u003c/p>\n\u003cp>For now, though, the device continues to gain traction among women who say they like seeing data on their pregnancies.\u003c/p>\n\u003cp>“I thought this would be a good way to track things at home without staring at the clock,” said Christine Hall, a 32-year-old woman who lives in Fayetteville, Tennessee. Hall, who Bloomlife identified as a customer who could speak about her experience with its tracker, rented the device while pregnant with her fifth child. She started having contractions earlier than expected with previous pregnancies.\u003c/p>\n\u003cp>“For me, it really just brought peace of mind,” she said.\u003c/p>\n\u003cp>\u003cstrong>‘To a Patient, a False Positive Feels Very Real’\u003c/strong>\u003c/p>\n\u003cp>Despite the potential peace of mind, some doctors are wary about what might happen when patients are flooded with health data from devices that aren’t part of their medical care.\u003c/p>\n\u003cp>“Frequently people want the reassurance that it’s fine, but they haven’t thought through what happens if something isn’t fine,” said McElrath, the OB-GYN in Boston.\u003c/p>\n\u003cp>McElrath and other providers said they’re worried that direct-to-consumer pregnancy tech might cause unnecessary anxiety, particularly if they’re not reliable and sometimes signal something is wrong when it actually isn’t. Some devices, like home heart rate monitors or ultrasounds, are also prone to user error if a patient isn’t trained properly.\u003c/p>\n\u003cp>“The tact I take with [patients] is that this might actually increase anxiety. That’s my biggest concern with these devices,” said Simmons, the University of Washington OB-GYN.\u003c/p>\n\u003cp>Faulty results could also send women to their health care providers when they might not need to make the trip. OB-GYNs said they see patients who were using home fetal heart rate or activity monitors when they couldn’t pick up a heartbeat or saw less fetal movement than normal. The woman calls up a doctor, who isn’t sure how to interpret data she isn’t looking at from a device she isn’t familiar with. She asks the patient to come in, only to find that everything is fine.\u003c/p>\n\u003cp>“Then we’ve had a hospital visit and created an anxious patient. To a patient, a false positive feels very real. They don’t know it’s false,” said McElrath.\u003c/p>\n\u003cp>Doctors also noted that in the case of many pregnancy tech products, there’s not much data to show whether the tools can even improve health outcomes.\u003c/p>\n\u003cp>“All of this [risk] is acceptable if we know it’s for a good reason,” said McElrath. “When we’re not sure, it becomes a potential burden.”\u003c/p>\n\u003cp>That’s been the case for some women who have turned to tech while pregnant. Leah Hutson kept seeing Facebook ads for Bloomlife when pregnant with her first child. “I was like, this seems like it would be really cool. This is my first child, I want to be as informed as possible,” said Hutson, a 31-year-old who lives in San Antonio.\u003c/p>\n\u003cp>She started using the monitor in January 2018, about a month before her due date. It picked up some uterine activity she felt. But a few days before her daughter was born, Hutson started feeling uncomfortable and wasn’t sure what was going on. She put on her Bloomlife, but it didn’t pick up any contractions.\u003c/p>\n\u003cp>She bounced on a birth ball. She went to work. She took a trip to Target, hoping she could walk off the discomfort and grab some snacks for when she did go into labor. Hutson tried Bloomlife a few more times, but said she saw no activity.\u003c/p>\n\u003cp>“Turns out, during that time, I was actually in the beginning of labor,” she said. By the time she went to the hospital, Hutson was already 7 centimeters dilated.\u003c/p>\n\u003cp>“Bloomlife made me second guess myself. It wasn’t showing any contractions,” she said.\u003c/p>\n\u003cp>\u003cstrong>Tech Companies Court Providers as Customers\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>By and large, health care providers and patients all agree on one thing: Tech does have the potential to make pregnancy care far better — if it’s done the right way.\u003c/p>\n\u003cp>“It [should be] an entry to interacting with the medical environment, rather than having patients do this on their own,” said McElrath.\u003c/p>\n\u003cp>But McElrath and other clinicians said new tools demand more research. They want evidence that at-home devices are as good as existing care or even better. Providers also say device makers need to think carefully about how new technology will fit into a woman’s overall care.\u003c/p>\n\u003cp>“We’re going to [need] more integration with clinical oversight to help make it safer to manage all this patient-generated data,” said DeNicola, the George Washington University OB-GYN. DeNicola also serves as the chair of the telehealth committee at the American College of Obstetricians and Gynecologists.\u003c/p>\n\u003cp>Several companies are developing tech tools for clinicians that they hope will one day fit seamlessly into prenatal care. Rather than being shipped right to a pregnant woman’s door, the products would be “prescribed” by providers who send women home with the tools, monitor their data remotely, and help patients interpret it.\u003c/p>\n\u003cp>DeNicola has conducted research on one such system, called Babyscripts. Women measure their blood pressure, glucose levels, and weight at home, then log that information in the Babyscripts app. The app also asks users questions about their mental health during pregnancy.\u003c/p>\n\u003cp>Providers can see that data on a dashboard and call patients anytime something seems amiss. Women can keep using the app after birth, potentially giving providers a new way to see dangerous blood pressure problems after birth. An added bonus for clinicians, per the company’s website: “By automating elements of care, you can reduce the need for routine in-office visits while capturing the same global fee.”\u003c/p>\n\u003cp>Another company, Nuvo, has developed a wearable belt that doctors send home with women to keep tabs on maternal and fetal heart rate, along with uterine activity. A woman can’t use the device to see data outside of the scheduled times and tests set by her provider, which Nuvo hopes will prevent patients from poring over data on their own.\u003c/p>\n\u003cp>“We really believe in making the mother the point of care, and having the data seamlessly travel between the doctor’s office and the home,” said Debra Bass, the chief marketing officer of Nuvo.\u003c/p>\n\u003cp>Nuvo’s customer is the provider, not the patient. The company is eyeing maternal-fetal medicine specialists who care for women with high-risk pregnancies as its first target audience. The company knows it’s critical for its success to not only score the endorsement of clinicians, but also get them to adopt the technology.\u003c/p>\n\u003cp>To win over doctors — and demonstrate its efficacy — Nuvo has applied for FDA approval for its device, called Invu. As part of its application, the company ran two studies: one to demonstrate that the device works as well as existing tools to monitor heart rate, and one to show that it’s safe and simple for patients to use at home.\u003c/p>\n\u003cp>“We could have been another gadget that launched at the [Consumer Electronics Show and started selling on our website or Buy Buy Baby,” Bass said. “It’s been harder, longer, and a lot more expensive, but we believe [running trials] is the right and responsible approach,” she added.\u003c/p>\n\u003cp>Nuvo is expecting a decision from the agency later this year. Clinicians, meanwhile, are watching with anticipation as more research unfolds and regulators begin to review the new tools that have the potential to make prenatal care easier and more effective.\u003c/p>\n\u003cp>“The whole idea is to protect against the potential hazards, so then we can take advantage of all the benefits,” DeNicola said. “This has much more promise than peril.”\u003c/p>\n\u003cp>\u003cstrong> \u003cem>This \u003ca href=\"https://www.statnews.com/2019/07/23/pregnancy-tech-help-headache/\">story\u003c/a> was originally published by \u003ca href=\"https://www.statnews.com/\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"Wearable technologies could transform prenatal care, but doctors caution that some direct-to-consumer devices may not offer any real benefits to pregnant women.","status":"publish","parent":0,"modified":1704848479,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":55,"wordCount":2510},"headData":{"title":"Pregnancy Tech is Growing. But Women and Their Doctors Remain Wary | KQED","description":"Wearable technologies could transform prenatal care, but doctors caution that some direct-to-consumer devices may not offer any real benefits to pregnant women.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"source":"STAT News","sticky":false,"nprByline":"Megan Thielking \u003cbr/>STAT News \u003cbr>","path":"/science/1945448/pregnancy-tech-is-growing-but-women-and-their-doctors-remain-wary","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Pregnancy care is poised for a 21st century upgrade.\u003cbr>\n\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘Frequently people want the reassurance that it’s fine, but they haven’t thought through what happens if something isn’t fine. ‘","name":"pullquote","attributes":{"named":{"align":"right","citation":"Dr. Thomas McElrath","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Algorithms promise to detect the difference between real labor and a false alarm. Wearables give women a way to track contractions. Apps relay home blood pressure readings directly to doctors, offering a possible way to cut down on prenatal visits — and catch certain pregnancy complications before they become full-blown crises.\u003c/p>\n\u003cp>Doctors say the new technologies have the potential to transform prenatal care. But for all the promise, doctors caution that some direct-to-consumer devices might cause anxiety or unnecessary trips to the clinic — without strong evidence that they offer any real benefits to pregnant women.\u003c/p>\n\u003cp>“Prenatal care is burdensome. It requires patients to be in at minimum, once a month. People have jobs. It’s hard to get in… You could imagine some kind of virtual substitute would be very welcome,” said Dr. Thomas McElrath, an obstetrician-gynecologist at Brigham and Women’s Hospital in Boston. “But we would have to figure out and think carefully about how to do that,” he added.\u003c/p>\n\u003cp>Obstetrician-gynecologists are particularly worried about direct-to-consumer devices that aren’t woven into the fabric of prenatal care. Among their concerns: Faulty or confusing data might send women to their doctors when they don’t need to go. And for some devices, doctors say the lack of research or a true need to use them means they’re simply a waste of money.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I [sometimes tell] my patients to save their money, because babies are expensive,” said Dr. LaVonne Simmons, an obstetrician-gynecologist at the University of Washington.\u003c/p>\n\u003cp>Their fears aren’t completely unfounded. Some women say they bought devices to give them more data about their pregnancy, but ultimately felt they were more of a headache than a help. Others say they raised false alarms or made them second-guess their gut instincts about what was happening in their bodies.\u003c/p>\n\u003cp>But other women say DTC devices have given them peace of mind and the feeling of more control during a time that can be biologically overwhelming. That’s fueling a growing tension: As pregnancy tech grows more popular with patients, doctors are left to figure out if and how such devices fit into a woman’s prenatal care.\u003c/p>\n\u003cp>“It’s clearly the way of the future,” said Dr. Nathaniel DeNicola, an OB-GYN at George Washington University “This is an enormously popular, highly utilized field … It’s not going away.”\u003c/p>\n\u003cp>\u003cstrong>A New Kind of Prenatal Care\u003c/strong>\u003c/p>\n\u003cp>The field of pregnancy tech has grown rapidly in recent years, from home ultrasounds that capture kicks to wearable belts that play music to the womb.\u003c/p>\n\u003cp>One popular device is Bloomlife, a sensor that’s designed to pick up uterine activity. Women stick the sensor three fingers below their belly buttons, sit still, and watch as uterine activity pops up in spiky peaks on the Bloomlife app. More than 10,000 women have rented Bloomlife’s $20-a-week “smart pregnancy tracker” to count millions of contractions since the company launched in 2014.\u003c/p>\n\u003cp>Bloomlife’s office is in downtown San Francisco, situated in a coworking space that doubles as a retail store, with space-age phone pods lined up next to vintage furniture for sale. The basement is a lab space that was repurposed from a photo processing lab once run for Ansel Adams. Now, Bloomlife is using it as home base as it tries to do for pregnancy what its Silicon Valley peers are doing in other areas of health: Give it the tech treatment.\u003c/p>\n\u003cp>“The way that we manage prenatal care fundamentally hasn’t changed in decades,” said Eric Dy, Bloomlife’s president and a biomedical engineer by training. “That’s our North Star — we believe we can define a new standard within prenatal care,” he added.\u003c/p>\n\u003cp>Because Bloomlife’s device hasn’t been approved by the FDA, the company is careful not to veer into medical advice. Many women use it simply to see what’s happening in their bodies. It’s popular among women who might live far from their providers — nearly half of users live in rural areas, according to a Bloomlife breakdown of users’ ZIP codes.\u003c/p>\n\u003cp>Going direct-to-consumer has allowed the company to collect a massive amount of data, Dy said. While the company only relays contraction data to users, the device also tracks maternal heart rate. Bloomlife now has what it says is the world’s biggest physiological data set during pregnancy, with more than 500,000 hours of data.\u003c/p>\n\u003cp>Bloomlife is using that data to train artificial intelligence algorithms to not just track contractions, but identify labor. That could have a big impact, given the high cost of hospital trips for false labor.\u003c/p>\n\u003cp>The company recently wrapped up an observational study to test the accuracy of a “digital biomarker” — specifically, data on uterine activity and heart rate variability — in 150 pregnant women who used Bloomlife’s device.\u003c/p>\n\u003cp>At a medical conference earlier this year, Bloomlife’s team presented an abstract on results from the first 50 women in the study. The company reported that it is able to detect if a woman is in labor with 80% sensitivity and 93% specificity. Bloomlife says that shows its device is as accurate as the current standard of tracking contraction patterns and conducting a pelvic exam.\u003c/p>\n\u003cp>But outside experts still have questions, starting with the results from the other 100 women in the study. McElrath, the OB-GYN in Boston, said the analytic technique used to crunch the data wasn’t as rigorous as it needs to be to prove the test is valid. He also pointed out many women don’t have contractions in a clear pattern until the end stages of preterm labor and delivery. At that point, he said, it’s likely too late for a tool like Bloomlife’s to be useful in identifying the onset of preterm labor.\u003c/p>\n\u003cp>Bloomlife says it is preparing the full results of the study for publication in a peer-reviewed journal. The company plans to apply for clearance from the FDA next year and wants to run more studies on the device’s potential use in prenatal care.\u003c/p>\n\u003cp>For now, though, the device continues to gain traction among women who say they like seeing data on their pregnancies.\u003c/p>\n\u003cp>“I thought this would be a good way to track things at home without staring at the clock,” said Christine Hall, a 32-year-old woman who lives in Fayetteville, Tennessee. Hall, who Bloomlife identified as a customer who could speak about her experience with its tracker, rented the device while pregnant with her fifth child. She started having contractions earlier than expected with previous pregnancies.\u003c/p>\n\u003cp>“For me, it really just brought peace of mind,” she said.\u003c/p>\n\u003cp>\u003cstrong>‘To a Patient, a False Positive Feels Very Real’\u003c/strong>\u003c/p>\n\u003cp>Despite the potential peace of mind, some doctors are wary about what might happen when patients are flooded with health data from devices that aren’t part of their medical care.\u003c/p>\n\u003cp>“Frequently people want the reassurance that it’s fine, but they haven’t thought through what happens if something isn’t fine,” said McElrath, the OB-GYN in Boston.\u003c/p>\n\u003cp>McElrath and other providers said they’re worried that direct-to-consumer pregnancy tech might cause unnecessary anxiety, particularly if they’re not reliable and sometimes signal something is wrong when it actually isn’t. Some devices, like home heart rate monitors or ultrasounds, are also prone to user error if a patient isn’t trained properly.\u003c/p>\n\u003cp>“The tact I take with [patients] is that this might actually increase anxiety. That’s my biggest concern with these devices,” said Simmons, the University of Washington OB-GYN.\u003c/p>\n\u003cp>Faulty results could also send women to their health care providers when they might not need to make the trip. OB-GYNs said they see patients who were using home fetal heart rate or activity monitors when they couldn’t pick up a heartbeat or saw less fetal movement than normal. The woman calls up a doctor, who isn’t sure how to interpret data she isn’t looking at from a device she isn’t familiar with. She asks the patient to come in, only to find that everything is fine.\u003c/p>\n\u003cp>“Then we’ve had a hospital visit and created an anxious patient. To a patient, a false positive feels very real. They don’t know it’s false,” said McElrath.\u003c/p>\n\u003cp>Doctors also noted that in the case of many pregnancy tech products, there’s not much data to show whether the tools can even improve health outcomes.\u003c/p>\n\u003cp>“All of this [risk] is acceptable if we know it’s for a good reason,” said McElrath. “When we’re not sure, it becomes a potential burden.”\u003c/p>\n\u003cp>That’s been the case for some women who have turned to tech while pregnant. Leah Hutson kept seeing Facebook ads for Bloomlife when pregnant with her first child. “I was like, this seems like it would be really cool. This is my first child, I want to be as informed as possible,” said Hutson, a 31-year-old who lives in San Antonio.\u003c/p>\n\u003cp>She started using the monitor in January 2018, about a month before her due date. It picked up some uterine activity she felt. But a few days before her daughter was born, Hutson started feeling uncomfortable and wasn’t sure what was going on. She put on her Bloomlife, but it didn’t pick up any contractions.\u003c/p>\n\u003cp>She bounced on a birth ball. She went to work. She took a trip to Target, hoping she could walk off the discomfort and grab some snacks for when she did go into labor. Hutson tried Bloomlife a few more times, but said she saw no activity.\u003c/p>\n\u003cp>“Turns out, during that time, I was actually in the beginning of labor,” she said. By the time she went to the hospital, Hutson was already 7 centimeters dilated.\u003c/p>\n\u003cp>“Bloomlife made me second guess myself. It wasn’t showing any contractions,” she said.\u003c/p>\n\u003cp>\u003cstrong>Tech Companies Court Providers as Customers\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>By and large, health care providers and patients all agree on one thing: Tech does have the potential to make pregnancy care far better — if it’s done the right way.\u003c/p>\n\u003cp>“It [should be] an entry to interacting with the medical environment, rather than having patients do this on their own,” said McElrath.\u003c/p>\n\u003cp>But McElrath and other clinicians said new tools demand more research. They want evidence that at-home devices are as good as existing care or even better. Providers also say device makers need to think carefully about how new technology will fit into a woman’s overall care.\u003c/p>\n\u003cp>“We’re going to [need] more integration with clinical oversight to help make it safer to manage all this patient-generated data,” said DeNicola, the George Washington University OB-GYN. DeNicola also serves as the chair of the telehealth committee at the American College of Obstetricians and Gynecologists.\u003c/p>\n\u003cp>Several companies are developing tech tools for clinicians that they hope will one day fit seamlessly into prenatal care. Rather than being shipped right to a pregnant woman’s door, the products would be “prescribed” by providers who send women home with the tools, monitor their data remotely, and help patients interpret it.\u003c/p>\n\u003cp>DeNicola has conducted research on one such system, called Babyscripts. Women measure their blood pressure, glucose levels, and weight at home, then log that information in the Babyscripts app. The app also asks users questions about their mental health during pregnancy.\u003c/p>\n\u003cp>Providers can see that data on a dashboard and call patients anytime something seems amiss. Women can keep using the app after birth, potentially giving providers a new way to see dangerous blood pressure problems after birth. An added bonus for clinicians, per the company’s website: “By automating elements of care, you can reduce the need for routine in-office visits while capturing the same global fee.”\u003c/p>\n\u003cp>Another company, Nuvo, has developed a wearable belt that doctors send home with women to keep tabs on maternal and fetal heart rate, along with uterine activity. A woman can’t use the device to see data outside of the scheduled times and tests set by her provider, which Nuvo hopes will prevent patients from poring over data on their own.\u003c/p>\n\u003cp>“We really believe in making the mother the point of care, and having the data seamlessly travel between the doctor’s office and the home,” said Debra Bass, the chief marketing officer of Nuvo.\u003c/p>\n\u003cp>Nuvo’s customer is the provider, not the patient. The company is eyeing maternal-fetal medicine specialists who care for women with high-risk pregnancies as its first target audience. The company knows it’s critical for its success to not only score the endorsement of clinicians, but also get them to adopt the technology.\u003c/p>\n\u003cp>To win over doctors — and demonstrate its efficacy — Nuvo has applied for FDA approval for its device, called Invu. As part of its application, the company ran two studies: one to demonstrate that the device works as well as existing tools to monitor heart rate, and one to show that it’s safe and simple for patients to use at home.\u003c/p>\n\u003cp>“We could have been another gadget that launched at the [Consumer Electronics Show and started selling on our website or Buy Buy Baby,” Bass said. “It’s been harder, longer, and a lot more expensive, but we believe [running trials] is the right and responsible approach,” she added.\u003c/p>\n\u003cp>Nuvo is expecting a decision from the agency later this year. Clinicians, meanwhile, are watching with anticipation as more research unfolds and regulators begin to review the new tools that have the potential to make prenatal care easier and more effective.\u003c/p>\n\u003cp>“The whole idea is to protect against the potential hazards, so then we can take advantage of all the benefits,” DeNicola said. “This has much more promise than peril.”\u003c/p>\n\u003cp>\u003cstrong> \u003cem>This \u003ca href=\"https://www.statnews.com/2019/07/23/pregnancy-tech-help-headache/\">story\u003c/a> was originally published by \u003ca href=\"https://www.statnews.com/\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1945448/pregnancy-tech-is-growing-but-women-and-their-doctors-remain-wary","authors":["byline_science_1945448"],"categories":["science_39","science_40"],"tags":["science_5181","science_3838","science_616","science_1504"],"featImg":"science_1945452","label":"source_science_1945448"},"science_1937137":{"type":"posts","id":"science_1937137","meta":{"index":"posts_1591205157","site":"science","id":"1937137","score":null,"sort":[1549530008000]},"guestAuthors":[],"slug":"im-having-a-baby-is-a-home-birth-or-the-hospital-safer","title":"I’m Having a Baby: Is a Home Birth or the Hospital Safer?","publishDate":1549530008,"format":"audio","headTitle":"I’m Having a Baby: Is a Home Birth or the Hospital Safer? | KQED","labelTerm":{"site":"science"},"content":"\u003cp>As my belly grows, I’m more and more stressed by a decision that’s weighed on me for the last eight months.\u003c/p>\n\u003cp>Where should I birth my baby?\u003c/p>\n\u003caside class=\"pullquote alignright\">In the U.S., studies show that women planning to deliver at home have fewer medical interventions like induced labor or cesarean delivery, and their babies have a higher rate of death, seizure or other serious medical conditions.\u003c/aside>\n\u003cp class=\"p1\">Last summer, when I found out I was pregnant, I initially envisioned, like most American women, a hospital delivery. In fact, that’s where 99 percent of U.S. children are born. That’s not a surprise: The American College of Obstetricians and Gynecologists recommends hospitals or accredited birth centers as the\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24594003\" target=\"_blank\" rel=\"noopener\"> \u003cspan class=\"s1\">safest\u003c/span>\u003c/a> option for having a baby.\u003c/p>\n\u003cp>In fact, infant mortality plummeted in the last century as hospital births became more common. In 1900, when almost all U.S. births \u003ca href=\"https://www.cdc.gov/nchs/data/databriefs/db84.pdf\" target=\"_blank\" rel=\"noopener\">took place at home\u003c/a>, 100 babies \u003ca href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm#fig1\" target=\"_blank\" rel=\"noopener\">died\u003c/a> for every 1,000 born. By 1997, modern medicine had reduced that rate by a whopping 93 percent, to seven infant deaths out of every 1,000.\u003c/p>\n\u003cp class=\"p1\">Today, only about\u003cspan class=\"Apple-converted-space\"> \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24594003\" target=\"_blank\" rel=\"noopener\">one percent\u003c/a> of babies are born at home each year. \u003c/span>\u003cspan style=\"font-weight: 400\">Yet to judge by my particular social group here in the Bay Area, you’d think home birth was by far the norm. L\u003c/span>ast year, six of my friends gave birth in their living rooms. Afterwards they shared powerful photos from the experience, of birthing tubs surrounded by candles. And they warned me that physicians and nurses in a hospital would push me to have medical treatments I might not want, such as drugs to speed my labor, an \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2018/10/12/656198429/rate-of-c-sections-is-rising-at-an-alarming-rate\" target=\"_blank\" rel=\"noopener\">unnecessary C-section\u003c/a> or pain meds.\u003c/p>\n\u003cp class=\"p3\">\u003cb>Friends on One Side, Family on the Other\u003c/b>\u003c/p>\n\u003cfigure id=\"attachment_1937387\" class=\"wp-caption alignright\" style=\"max-width: 630px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1937387\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/01/RS34863_McClurgBirth_017-qut-800x576.jpg\" alt=\"\" width=\"630\" height=\"453\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/RS34863_McClurgBirth_017-qut-800x576.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/RS34863_McClurgBirth_017-qut-160x115.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/RS34863_McClurgBirth_017-qut-768x553.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/RS34863_McClurgBirth_017-qut-1020x735.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/RS34863_McClurgBirth_017-qut-1200x864.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/RS34863_McClurgBirth_017-qut.jpg 1920w\" sizes=\"(max-width: 630px) 100vw, 630px\">\u003cfigcaption class=\"wp-caption-text\">Lesley McClurg holds her pregnant belly as she contemplates where to give birth. \u003ccite>(Lindsey Moore/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p3\">But when I shared the possibility of a home birth with my mother, she basically freaked.\u003c/p>\n\u003cp class=\"p5\">“You could have a complication or something happen where you would need to be in a hospital,” said my mom. “If there’s a problem, I want you to be where you need to be.”\u003c/p>\n\u003cp class=\"p5\">Just to make sure she landed her point, she told me about my older brother’s birth.\u003c/p>\n\u003cp class=\"p5\">“He came out blue,” she said, shuddering. “They whisked him away to the intensive care unit. And I was afraid that he’d gone a long time without breathing, to the point where he might be brain damaged.”\u003c/p>\n\u003cp>Fortunately, my brother was fine, and my mom credits the hospital for saving his life.\u003c/p>\n\u003caside class=\"aligncenter\">\u003cstrong>BY THE NUMBERS\u003c/strong> \n\u003cul>\n\u003cli>\u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth?IsMobileSet=false\" target=\"_blank\" rel=\"noopener\">Nationwide\u003c/a>, 1 in 1,000 babies die in hospital births, and 2 in 1,000 die in home births.\u003c/li>\n\u003cli>\u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMsa1501738?query=featured_home\" target=\"_blank\" rel=\"noopener\">Babies in planned home births\u003c/a> are significantly more likely to have seizures or neurological problems, although this happens to fewer than 1 in 1,000 babies.\u003c/li>\n\u003cli>Of first-time moms choosing to give birth at home, \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth?IsMobileSet=false\" target=\"_blank\" rel=\"noopener\">up to 37 percent\u003c/a> transfer to a hospital, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4069085/\" target=\"_blank\" rel=\"noopener\">largely because \u003c/a>the baby is unable to move through the birth canal.\u003c/li>\n\u003cli>Planned home births end up in \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth?IsMobileSet=false\" target=\"_blank\" rel=\"noopener\">fewer cesarean deliveries\u003c/a>; California hospitals report a \u003ca href=\"https://www.chcf.org/project/reducing-unnecessary-c-sections/\" target=\"_blank\" rel=\"noopener\">wide range\u003c/a> in the rate of cesarean births, from 15 percent to more than 60 percent.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>\u003cstrong>What a Hospital Offers\u003c/strong>\u003c/p>\n\u003cp class=\"p5\">I decided to consult a woman who specializes in high-risk pregnancies.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003c/aside>\n\u003cp>\u003ca href=\"https://obgyn.ucsf.edu/maternal-fetal-medicine/neda-ghaffari-md\" target=\"_blank\" rel=\"noopener\">\u003cspan class=\"s2\">Dr. Neda Ghaffari\u003c/span>\u003c/a>, a perinatologist at UCSF, says delivering in the hospital is probably safer than being at home, because a team of practitioners is always available in case of emergency, which any woman can experience during labor. A mother may begin hemorrhaging, for instance, or the baby may become blocked in the birth canal.\u003c/p>\n\u003cp>“It’s very hard to determine which patients are going to have an obstetric emergency,” Dr. Ghaffari said.\u003c/p>\n\u003cp>Plus, she notes that neonatal seizures are three times more common at home, and that twice as many babies die in home births as hospital births, \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth?IsMobileSet=false\" target=\"_blank\" rel=\"noopener\">according to\u003c/a> the American College of Obstetricians and Gynecologists.\u003c/p>\n\u003cp>Nationwide, 1 in 1,000 babies die in hospital births, and 2 in 1,000 die in home births.\u003c/p>\n\u003cp>If a woman with a low-risk pregnancy does choose a home birth, Ghaffari recommends the \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth?IsMobileSet=false\" target=\"_blank\" rel=\"noopener\">same precautions\u003c/a> as ACOG. She should live within 15 minutes of a hospital, for example.\u003c/p>\n\u003cp>I’ll admit the conversation with Dr. Ghaffari stoked my fears about home birth.\u003c/p>\n\u003cp>\u003cb>Why Home Birth Appeals to Some Women\u003c/b>\u003c/p>\n\u003cp>For a home birth perspective, I talked to \u003ca href=\"http://www.wisewomanchildbirth.com/aboutmaria/\" target=\"_blank\" rel=\"noopener\">Maria Iorillo\u003c/a>, a state-licensed midwife in San Francisco. She’s attended births for three decades, and says she’s tallied 1,400 births, most of which unfolded safely at home.\u003c/p>\n\u003cfigure id=\"attachment_1937455\" class=\"wp-caption alignright\" style=\"max-width: 736px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1937455 \" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/01/UCSF-1-14-1-800x584.jpg\" alt=\"\" width=\"736\" height=\"537\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-14-1-800x584.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-14-1-160x117.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-14-1-768x561.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-14-1.jpg 834w\" sizes=\"(max-width: 736px) 100vw, 736px\">\u003cfigcaption class=\"wp-caption-text\">KQED’s Lesley McClurg tours labor and delivery at UCSF Benioff Children’s Hospital with Vanessa Tilp, a certified nurse-midwife. \u003ccite>(Samantha Shanahan/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Birth is not a medical procedure,” Iorillo said. “It is a process of you becoming a mother. Of this little person meeting you on the outside for the first time, and continuing that relationship.”\u003c/p>\n\u003cp>If a mom chooses to take that journey at home instead of the hospital, she will feel the full brunt of the experience, because no pharmaceutical pain relief will be available. Though Iorillo does carry medical items like an oxygen tank, numbing agents, suturing materials, acupuncture needles and herbs.\u003c/p>\n\u003cp>“I have three big bags of stuff,” she said. “And my hope is that when I come to your birth, I won’t have to use any of it.”\u003c/p>\n\u003cp>Iorillo says her clients desire a birth with the least amount of medical intervention possible. She describes the appeal of home birth by comparing it to running a marathon, in the sense that they’re both arduous, excruciating and rewarding.\u003c/p>\n\u003cp>“You can really kind of tap into what’s a woman’s body’s made for,” Iorillo said.\u003c/p>\n\u003cp>One thing I learned: I’m a good candidate for home birth. I don’t have diabetes, high blood pressure or other conditions that could complicate delivery. I only have one baby inside my belly, and I live close to a hospital. So I found myself rethinking home birth.\u003c/p>\n\u003cp>I needed someone who knew both worlds.\u003c/p>\n\u003cp>\u003cb>The Risks Depend on Each Woman’s Situation\u003c/b>\u003c/p>\n\u003cp>\u003ca href=\"https://www.ucsfhealth.org/robyn.lamar\" target=\"_blank\" rel=\"noopener\">Dr. Robyn Lamar\u003c/a> is an OB-GYN at UCSF. Despite her profession, she chose home births for both of her children. She’s now pregnant with her third child, whom she also plans to birth at home, because she wants to labor at her own pace in a familiar setting, without medical intervention.\u003c/p>\n\u003cfigure id=\"attachment_1937453\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1937453\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/01/UCSF-1-20-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-20-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-20-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-20-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-20-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-20.jpg 1100w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">KQED’s Lesley McClurg consults with Dr. Robyn Lamar to learn more about the differences between birthing at home or at the hospital. \u003ccite>(Samantha Shanahan/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The underlying belief in midwifery is that birth is a physiological process, which makes sense to me,” said Dr. Lamar. “Versus the more medical view, which I’m trained in and I practice, that birth is something that can be high-risk at any moment and it’s sort of a disaster waiting to happen.”\u003c/p>\n\u003cp>Dr. Lamar emphasizes that, at the hospital, a mother is at a higher risk for an \u003ca href=\"https://www.npr.org/sections/health-shots/2016/07/04/483945168/episiotomies-still-common-during-childbirth-despite-advice-to-do-fewer\" target=\"_blank\" rel=\"noopener\">\u003cspan class=\"s2\">episiotomy \u003c/span>\u003c/a>and infection.\u003c/p>\n\u003cp class=\"p5\">Lamar recognizes that what’s best for one woman may not be right for the next.\u003c/p>\n\u003cp class=\"p5\">“Some of us feel more at ease in the hospital because they know the experts are there. It gives them a lot of security and assurance,” said Lamar. “But, a lot of us feel like a duck out of water in the hospital. It’s very unfamiliar. When you’re on your home turf, and you’re there with your family, it really does change the dynamic.”\u003c/p>\n\u003cp class=\"p5\">When I asked Dr. Lamar directly to advise me on my own decision, she answered very neutrally, with a smile.\u003c/p>\n\u003cp class=\"p5\">“Oh, there’s no right answer,” she said. “I think it’s such an individual journey for everybody. Whether you give birth in a hospital, or at home, or in a birth center, everyone’s story is going to be completely unique.”\u003c/p>\n\u003cp class=\"p5\">\u003cb>Weighing the Cost\u003c/b>\u003c/p>\n\u003cp class=\"p5\">Another big factor to consider is cost. If I choose a home birth, I’ll pay completely out of pocket. In the Bay Area that’s $4,000 to $8,000. If I choose a hospital, my insurance will pay everything except my $100 copay.\u003c/p>\n\u003cp class=\"p5\">This frustrates Dr. Lamar.\u003c/p>\n\u003cp class=\"p5\">\u003ci>“\u003c/i>In terms of reproductive justice, it makes sense for all women to have the same array of options around birth like you would in a country like England, where there’s national insurance,” she said. “One should be able to choose their place of birth based on preferences and risk level rather than financial means.”\u003c/p>\n\u003cp class=\"p5\">She hopes insurance companies will consider the benefits of home-birth and future plans will cover the costs.\u003c/p>\n\u003cp class=\"p5\">I tried to prevent money from influencing my decision by continuing to talk to friends and experts, reading studies and\u003cspan class=\"Apple-converted-space\"> \u003c/span>touring hospitals. But after eight months of searching, I still find myself on the fence.\u003c/p>\n\u003cp class=\"p5\">Either way, this baby is coming … and soon!\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"My Bay Area friends are on the one side. My worried mom is on the other. What’s a pregnant science reporter to do? ","status":"publish","parent":0,"modified":1704848857,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":1584},"headData":{"title":"I’m Having a Baby: Is a Home Birth or the Hospital Safer? | KQED","description":"My Bay Area friends are on the one side. My worried mom is on the other. What’s a pregnant science reporter to do? ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"audioUrl":"https://www.kqed.org/.stream/anon/radio//2019/02/HomeBirthwithFunder.mp3","sticky":false,"audioTrackLength":350,"path":"/science/1937137/im-having-a-baby-is-a-home-birth-or-the-hospital-safer","audioDuration":350000,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>As my belly grows, I’m more and more stressed by a decision that’s weighed on me for the last eight months.\u003c/p>\n\u003cp>Where should I birth my baby?\u003c/p>\n\u003caside class=\"pullquote alignright\">In the U.S., studies show that women planning to deliver at home have fewer medical interventions like induced labor or cesarean delivery, and their babies have a higher rate of death, seizure or other serious medical conditions.\u003c/aside>\n\u003cp class=\"p1\">Last summer, when I found out I was pregnant, I initially envisioned, like most American women, a hospital delivery. In fact, that’s where 99 percent of U.S. children are born. That’s not a surprise: The American College of Obstetricians and Gynecologists recommends hospitals or accredited birth centers as the\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24594003\" target=\"_blank\" rel=\"noopener\"> \u003cspan class=\"s1\">safest\u003c/span>\u003c/a> option for having a baby.\u003c/p>\n\u003cp>In fact, infant mortality plummeted in the last century as hospital births became more common. In 1900, when almost all U.S. births \u003ca href=\"https://www.cdc.gov/nchs/data/databriefs/db84.pdf\" target=\"_blank\" rel=\"noopener\">took place at home\u003c/a>, 100 babies \u003ca href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm#fig1\" target=\"_blank\" rel=\"noopener\">died\u003c/a> for every 1,000 born. By 1997, modern medicine had reduced that rate by a whopping 93 percent, to seven infant deaths out of every 1,000.\u003c/p>\n\u003cp class=\"p1\">Today, only about\u003cspan class=\"Apple-converted-space\"> \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24594003\" target=\"_blank\" rel=\"noopener\">one percent\u003c/a> of babies are born at home each year. \u003c/span>\u003cspan style=\"font-weight: 400\">Yet to judge by my particular social group here in the Bay Area, you’d think home birth was by far the norm. L\u003c/span>ast year, six of my friends gave birth in their living rooms. Afterwards they shared powerful photos from the experience, of birthing tubs surrounded by candles. And they warned me that physicians and nurses in a hospital would push me to have medical treatments I might not want, such as drugs to speed my labor, an \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2018/10/12/656198429/rate-of-c-sections-is-rising-at-an-alarming-rate\" target=\"_blank\" rel=\"noopener\">unnecessary C-section\u003c/a> or pain meds.\u003c/p>\n\u003cp class=\"p3\">\u003cb>Friends on One Side, Family on the Other\u003c/b>\u003c/p>\n\u003cfigure id=\"attachment_1937387\" class=\"wp-caption alignright\" style=\"max-width: 630px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1937387\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/01/RS34863_McClurgBirth_017-qut-800x576.jpg\" alt=\"\" width=\"630\" height=\"453\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/RS34863_McClurgBirth_017-qut-800x576.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/RS34863_McClurgBirth_017-qut-160x115.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/RS34863_McClurgBirth_017-qut-768x553.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/RS34863_McClurgBirth_017-qut-1020x735.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/RS34863_McClurgBirth_017-qut-1200x864.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/RS34863_McClurgBirth_017-qut.jpg 1920w\" sizes=\"(max-width: 630px) 100vw, 630px\">\u003cfigcaption class=\"wp-caption-text\">Lesley McClurg holds her pregnant belly as she contemplates where to give birth. \u003ccite>(Lindsey Moore/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p3\">But when I shared the possibility of a home birth with my mother, she basically freaked.\u003c/p>\n\u003cp class=\"p5\">“You could have a complication or something happen where you would need to be in a hospital,” said my mom. “If there’s a problem, I want you to be where you need to be.”\u003c/p>\n\u003cp class=\"p5\">Just to make sure she landed her point, she told me about my older brother’s birth.\u003c/p>\n\u003cp class=\"p5\">“He came out blue,” she said, shuddering. “They whisked him away to the intensive care unit. And I was afraid that he’d gone a long time without breathing, to the point where he might be brain damaged.”\u003c/p>\n\u003cp>Fortunately, my brother was fine, and my mom credits the hospital for saving his life.\u003c/p>\n\u003caside class=\"aligncenter\">\u003cstrong>BY THE NUMBERS\u003c/strong> \n\u003cul>\n\u003cli>\u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth?IsMobileSet=false\" target=\"_blank\" rel=\"noopener\">Nationwide\u003c/a>, 1 in 1,000 babies die in hospital births, and 2 in 1,000 die in home births.\u003c/li>\n\u003cli>\u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMsa1501738?query=featured_home\" target=\"_blank\" rel=\"noopener\">Babies in planned home births\u003c/a> are significantly more likely to have seizures or neurological problems, although this happens to fewer than 1 in 1,000 babies.\u003c/li>\n\u003cli>Of first-time moms choosing to give birth at home, \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth?IsMobileSet=false\" target=\"_blank\" rel=\"noopener\">up to 37 percent\u003c/a> transfer to a hospital, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4069085/\" target=\"_blank\" rel=\"noopener\">largely because \u003c/a>the baby is unable to move through the birth canal.\u003c/li>\n\u003cli>Planned home births end up in \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth?IsMobileSet=false\" target=\"_blank\" rel=\"noopener\">fewer cesarean deliveries\u003c/a>; California hospitals report a \u003ca href=\"https://www.chcf.org/project/reducing-unnecessary-c-sections/\" target=\"_blank\" rel=\"noopener\">wide range\u003c/a> in the rate of cesarean births, from 15 percent to more than 60 percent.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>\u003cstrong>What a Hospital Offers\u003c/strong>\u003c/p>\n\u003cp class=\"p5\">I decided to consult a woman who specializes in high-risk pregnancies.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003c/aside>\n\u003cp>\u003ca href=\"https://obgyn.ucsf.edu/maternal-fetal-medicine/neda-ghaffari-md\" target=\"_blank\" rel=\"noopener\">\u003cspan class=\"s2\">Dr. Neda Ghaffari\u003c/span>\u003c/a>, a perinatologist at UCSF, says delivering in the hospital is probably safer than being at home, because a team of practitioners is always available in case of emergency, which any woman can experience during labor. A mother may begin hemorrhaging, for instance, or the baby may become blocked in the birth canal.\u003c/p>\n\u003cp>“It’s very hard to determine which patients are going to have an obstetric emergency,” Dr. Ghaffari said.\u003c/p>\n\u003cp>Plus, she notes that neonatal seizures are three times more common at home, and that twice as many babies die in home births as hospital births, \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth?IsMobileSet=false\" target=\"_blank\" rel=\"noopener\">according to\u003c/a> the American College of Obstetricians and Gynecologists.\u003c/p>\n\u003cp>Nationwide, 1 in 1,000 babies die in hospital births, and 2 in 1,000 die in home births.\u003c/p>\n\u003cp>If a woman with a low-risk pregnancy does choose a home birth, Ghaffari recommends the \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth?IsMobileSet=false\" target=\"_blank\" rel=\"noopener\">same precautions\u003c/a> as ACOG. She should live within 15 minutes of a hospital, for example.\u003c/p>\n\u003cp>I’ll admit the conversation with Dr. Ghaffari stoked my fears about home birth.\u003c/p>\n\u003cp>\u003cb>Why Home Birth Appeals to Some Women\u003c/b>\u003c/p>\n\u003cp>For a home birth perspective, I talked to \u003ca href=\"http://www.wisewomanchildbirth.com/aboutmaria/\" target=\"_blank\" rel=\"noopener\">Maria Iorillo\u003c/a>, a state-licensed midwife in San Francisco. She’s attended births for three decades, and says she’s tallied 1,400 births, most of which unfolded safely at home.\u003c/p>\n\u003cfigure id=\"attachment_1937455\" class=\"wp-caption alignright\" style=\"max-width: 736px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-1937455 \" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/01/UCSF-1-14-1-800x584.jpg\" alt=\"\" width=\"736\" height=\"537\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-14-1-800x584.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-14-1-160x117.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-14-1-768x561.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-14-1.jpg 834w\" sizes=\"(max-width: 736px) 100vw, 736px\">\u003cfigcaption class=\"wp-caption-text\">KQED’s Lesley McClurg tours labor and delivery at UCSF Benioff Children’s Hospital with Vanessa Tilp, a certified nurse-midwife. \u003ccite>(Samantha Shanahan/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Birth is not a medical procedure,” Iorillo said. “It is a process of you becoming a mother. Of this little person meeting you on the outside for the first time, and continuing that relationship.”\u003c/p>\n\u003cp>If a mom chooses to take that journey at home instead of the hospital, she will feel the full brunt of the experience, because no pharmaceutical pain relief will be available. Though Iorillo does carry medical items like an oxygen tank, numbing agents, suturing materials, acupuncture needles and herbs.\u003c/p>\n\u003cp>“I have three big bags of stuff,” she said. “And my hope is that when I come to your birth, I won’t have to use any of it.”\u003c/p>\n\u003cp>Iorillo says her clients desire a birth with the least amount of medical intervention possible. She describes the appeal of home birth by comparing it to running a marathon, in the sense that they’re both arduous, excruciating and rewarding.\u003c/p>\n\u003cp>“You can really kind of tap into what’s a woman’s body’s made for,” Iorillo said.\u003c/p>\n\u003cp>One thing I learned: I’m a good candidate for home birth. I don’t have diabetes, high blood pressure or other conditions that could complicate delivery. I only have one baby inside my belly, and I live close to a hospital. So I found myself rethinking home birth.\u003c/p>\n\u003cp>I needed someone who knew both worlds.\u003c/p>\n\u003cp>\u003cb>The Risks Depend on Each Woman’s Situation\u003c/b>\u003c/p>\n\u003cp>\u003ca href=\"https://www.ucsfhealth.org/robyn.lamar\" target=\"_blank\" rel=\"noopener\">Dr. Robyn Lamar\u003c/a> is an OB-GYN at UCSF. Despite her profession, she chose home births for both of her children. She’s now pregnant with her third child, whom she also plans to birth at home, because she wants to labor at her own pace in a familiar setting, without medical intervention.\u003c/p>\n\u003cfigure id=\"attachment_1937453\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1937453\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/01/UCSF-1-20-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-20-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-20-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-20-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-20-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/UCSF-1-20.jpg 1100w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">KQED’s Lesley McClurg consults with Dr. Robyn Lamar to learn more about the differences between birthing at home or at the hospital. \u003ccite>(Samantha Shanahan/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The underlying belief in midwifery is that birth is a physiological process, which makes sense to me,” said Dr. Lamar. “Versus the more medical view, which I’m trained in and I practice, that birth is something that can be high-risk at any moment and it’s sort of a disaster waiting to happen.”\u003c/p>\n\u003cp>Dr. Lamar emphasizes that, at the hospital, a mother is at a higher risk for an \u003ca href=\"https://www.npr.org/sections/health-shots/2016/07/04/483945168/episiotomies-still-common-during-childbirth-despite-advice-to-do-fewer\" target=\"_blank\" rel=\"noopener\">\u003cspan class=\"s2\">episiotomy \u003c/span>\u003c/a>and infection.\u003c/p>\n\u003cp class=\"p5\">Lamar recognizes that what’s best for one woman may not be right for the next.\u003c/p>\n\u003cp class=\"p5\">“Some of us feel more at ease in the hospital because they know the experts are there. It gives them a lot of security and assurance,” said Lamar. “But, a lot of us feel like a duck out of water in the hospital. It’s very unfamiliar. When you’re on your home turf, and you’re there with your family, it really does change the dynamic.”\u003c/p>\n\u003cp class=\"p5\">When I asked Dr. Lamar directly to advise me on my own decision, she answered very neutrally, with a smile.\u003c/p>\n\u003cp class=\"p5\">“Oh, there’s no right answer,” she said. “I think it’s such an individual journey for everybody. Whether you give birth in a hospital, or at home, or in a birth center, everyone’s story is going to be completely unique.”\u003c/p>\n\u003cp class=\"p5\">\u003cb>Weighing the Cost\u003c/b>\u003c/p>\n\u003cp class=\"p5\">Another big factor to consider is cost. If I choose a home birth, I’ll pay completely out of pocket. In the Bay Area that’s $4,000 to $8,000. If I choose a hospital, my insurance will pay everything except my $100 copay.\u003c/p>\n\u003cp class=\"p5\">This frustrates Dr. Lamar.\u003c/p>\n\u003cp class=\"p5\">\u003ci>“\u003c/i>In terms of reproductive justice, it makes sense for all women to have the same array of options around birth like you would in a country like England, where there’s national insurance,” she said. “One should be able to choose their place of birth based on preferences and risk level rather than financial means.”\u003c/p>\n\u003cp class=\"p5\">She hopes insurance companies will consider the benefits of home-birth and future plans will cover the costs.\u003c/p>\n\u003cp class=\"p5\">I tried to prevent money from influencing my decision by continuing to talk to friends and experts, reading studies and\u003cspan class=\"Apple-converted-space\"> \u003c/span>touring hospitals. But after eight months of searching, I still find myself on the fence.\u003c/p>\n\u003cp class=\"p5\">Either way, this baby is coming … and soon!\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1937137/im-having-a-baby-is-a-home-birth-or-the-hospital-safer","authors":["11229"],"categories":["science_39","science_40"],"tags":["science_3370","science_3833","science_616","science_3830"],"featImg":"science_1937393","label":"science"},"science_1934930":{"type":"posts","id":"science_1934930","meta":{"index":"posts_1591205157","site":"science","id":"1934930","score":null,"sort":[1543500042000]},"guestAuthors":[],"slug":"rethinking-bed-rest-for-pregnancy","title":"Rethinking Bed Rest for Pregnancy","publishDate":1543500042,"format":"audio","headTitle":"Rethinking Bed Rest for Pregnancy | KQED","labelTerm":{},"content":"\u003cp>The couch is dark brown corduroy with lumpy cushions. There are a few telltale smears of food, maybe yogurt or a banana, and some crumbs here and there. It’s a well-loved piece of furniture.\u003c/p>\n\u003cp>Margaret Siebers plops herself down in the center and reaches out to baby daughter Frances, who climbs onto her mother’s lap to breastfeed.\u003c/p>\n\u003cp>“This is where I spent several months,” says Siebers, with a shrug. Her 4-year-old, Violet, runs around nearby. “I could come downstairs and sit on the couch.”\u003c/p>\n\u003cp>Siebers was about halfway through her pregnancy with Frances, when health professionals guiding her care told Siebers she should be on bed rest. And the subsequent months, spent confined to a bed and couch in her small home in Milwaukee, turned her family’s life upside down.\u003c/p>\n\u003cp>“My husband immediately quit his full time job,” Siebers says, “and he took care of me. I wouldn’t even get my own glasses of water. So I like to say that ‘I was on bed rest, and he was on house arrest,’ because he really couldn’t leave either.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Siebers is just one of thousands of pregnant women who are put on bed rest by their doctors, nurses or midwives each year. The stated reason: Going to bed will help prevent a premature birth, or worse, a miscarriage. But there’s a major problem with this advice — there is no solid, scientific evidence that bed rest improves outcomes for pregnant women and their babies.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://www.npr.org/player/embed/669229437/670752963\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>“The bottom line is that there’s never been any proven benefit of bed rest,” says\u003ca href=\"https://www.med.unc.edu/socialmed/people/anne-lyerly/\"> Dr. Anne Drapkin Lyerly\u003c/a>, an OB-GYN and professor of bioethics at the University of North Carolina at Chapel Hill. Lyerly and colleagues in 2013 did a \u003ca href=\"https://insights.ovid.com/crossref?an=00006250-201306000-00023\">review of the scientific research\u003c/a> on bed rest as it relates to a variety of conditions, from early contractions to high blood pressure to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28262917\">carrying twins\u003c/a>. They found no benefit.\u003c/p>\n\u003cp>In fact, women put on bed rest can suffer harm — physical, psychological and economic. “It doesn’t seem like a dangerous intervention in the same way we think about surgeries or medications,” Lyerly says. “But in fact it can be very dangerous.”\u003c/p>\n\u003cp>Siebers was about 22 weeks pregnant when she visited a radiologist for a routine ultrasound. It was a standard screening at that point in her pregnancy — one that checks the baby’s growth, proportions and organs to ensure the fetus is developing properly. The baby was doing great, the doctor told her. The fetal heartbeat was strong and the ultrasound looked perfect. But there was one point of concern: Siebers’ \u003ca href=\"https://www.marchofdimes.org/complications/cervical-insufficiency-and-short-cervix.aspx\">cervix was ‘shortened,’\u003c/a> which can be a sign that a woman is at risk of preterm labor.\u003c/p>\n\u003cp>“So that was really scary for us,” she says. “We’re at this appointment and the doctor’s looking at the baby and saying, ‘You’ve got a beautiful heart.’ And I’m thinking, ‘Oh great, they’ve got a beautiful heart and they might die.’ ”\u003c/p>\n\u003cp>Siebers’ health care team at that point included a midwife, who was her primary caregiver, an obstetrician consulting on her case, and the doctors who performed the ultrasound. Because she’d had a miscarriage the year before, the team recommended she undergo a procedure called a \u003ca href=\"https://www.mayoclinic.org/tests-procedures/cervical-cerclage/about/pac-20393435\">cerclage\u003c/a> to help keep her cervix closed. And they wanted her to stay in bed.\u003c/p>\n\u003cfigure id=\"attachment_1934932\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de.jpg\" alt=\"\" width=\"2000\" height=\"1333\" class=\"size-full wp-image-1934932\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-1920x1280.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-1180x786.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-520x347.jpg 520w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Margaret and Alex Siebers say they struggled make ends meet during the weeks Margaret was confined to bed rest during her pregnancy with Frances, who is now 1 year old. Alex had to quit his paid job for a time to take care of Margaret and their older daughter, Violet, who is now 4. \u003ccite>(Sara Stathas for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Deb Studey, \u003ca href=\"https://www.choicemattersmidwifecollective.com/deb-studey\">Siebers’ midwife,\u003c/a> had cared for her during her previous pregnancy, which had ended in miscarriage at the end of the first trimester. Studey says she believes the bed rest may have helped Siebers carry this second child — Frances — to term.\u003c/p>\n\u003cp>“I know that being on bed rest was hard for Margaret. But I also knew, on the flip of that, having a 24-week baby in an ICU wasn’t going to be an easy outcome either. So, in my mind,” Studey says, “bed rest let her get to term.”\u003c/p>\n\u003cp>Studey is aware that the research doesn’t show bed rest to be beneficial. In fact, a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4019312/\">2013 study\u003c/a> that specifically addressed the issue of a shortened cervix found that women who were prescribed activity restrictions during their pregnancy were actually \u003cem>more\u003c/em> likely to give birth early.\u003c/p>\n\u003cp>“I think studies are always of interest,” Studey says. “I guess I pay attention just as equally to how things are working for women — and that doesn’t always fit a study. I think we’re all different.”\u003c/p>\n\u003cp>But Lyerly, the UNC bioethicist, tells NPR bed rest is not a benign intervention, and doctors and others who work with pregnant women need to think hard before prescribing it. And the American College of Obstetricians and Gynecologists \u003ca href=\"https://www.acog.org/About-ACOG/ACOG-Departments/Patient-Safety-and-Quality-Improvement/Did-You-Know-Video-Series/Preterm-Birth-Patients/Cautioning-Against-Bed-Rest-and-Why\">cautions against it\u003c/a>, for several medical reasons.\u003c/p>\n\u003cp>“One of the most dangerous things that can happen when a woman is on bed rest is having a blood clot,” Lyerly says. “You can have blood clots in your legs or in your pelvis. And if those clots travel to your lungs, it’s life threatening.”\u003c/p>\n\u003cp>She says women also risk losing muscle tone, becoming weak — just before they’re about to go through labor and then care for a child. And lying in bed can weaken bones, and reduce lung capacity. Some women become depressed.\u003c/p>\n\u003cp>“Women who are pregnant are not just ‘women who are pregnant,’ ” Lyerly says. “They are oftentimes mothers of other children. They are \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/01/24/580182083/sen-tammy-duckworths-pregnancy-set-to-be-another-first-for-the-illinois-democrat\">senators\u003c/a>; \u003ca href=\"https://www.npr.org/2012/07/17/156933071/all-eyes-on-yahoos-new-female-ceo\">CEOs\u003c/a>; \u003ca href=\"https://variety.com/2014/tv/news/could-savannah-guthries-pregnancy-herald-even-more-personal-chatter-at-today-gma-1201136302/\">journalists\u003c/a>; professors. They work in restaurants. They have jobs and they need their jobs.”\u003c/p>\n\u003cp>On a mid-November evening, the Siebers family is celebrating Frances’ first birthday. Margaret and her husband Alex have come home from work, where Alex had just injured his finger with a miter saw and was trying to clean and bandage the wound. Margaret made popcorn and peeled mandarins for the kids, as 4-year-old Violet twirled around the house in a whirlwind of red sparkles, and Frances climbed everything she saw.\u003c/p>\n\u003cp>It wasn’t a scene that lent itself to quiet time on the couch.\u003c/p>\n\u003cp>That’s why, when Margaret Siebers was told to stop moving, to go to bed, Alex Siebers, 33, quit his job to care for the family for several months.\u003c/p>\n\u003cfigure id=\"attachment_1934933\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde.jpg\" alt=\"\" width=\"2000\" height=\"1333\" class=\"size-full wp-image-1934933\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-1920x1280.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-1180x786.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-520x347.jpg 520w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">“It felt kind of like ‘knocked out of society’ for a while,” Alex Siebers remembers, of the time his wife was confined to the couch. “Our daily routine, our lives and our connections with people — we lost touch. Because we were, you know, trapped in here just trying to make it.” \u003ccite>(Sara Stathas for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Her mobility was extremely limited,” he says, “and the fact that we live in this house where the bathroom’s upstairs, you know, wasn’t helpful.”\u003c/p>\n\u003cp>His wife would get up in the morning, use the bathroom and go downstairs to the brown corduroy couch. She’d write letters, watch Netflix, read books.\u003c/p>\n\u003cp>“I could go upstairs to use the bathroom,” Margaret recalls. “I tried not to go too often, just because I didn’t want to be up and down the steps too much. I would sit on the porch sometimes. But whenever I moved, I would try to stay where I landed for hours, if I could.”\u003c/p>\n\u003cp>She was able to continue working from bed, 24-hour a week, for her family’s company, \u003ca href=\"http://www.bagtagsinc.com/\">Bagtags Inc.\u003c/a>, which makes lanyards and custom name tags for big events. But that was hardly enough to make ends meet.\u003c/p>\n\u003cp>The Siebers went on Medicaid. They also \u003ca href=\"https://www.dhs.wisconsin.gov/foodshare/eligibility.htm\">qualified for FoodShare\u003c/a>, Wisconsin’s food stamp program, and WIC, the \u003ca href=\"https://www.fns.usda.gov/wic/women-infants-and-children-wic\">federal nutrition program\u003c/a> for women, infants and children. Friends from church got organized to bring the family meals. And their landlord gave them a break on their rent.\u003c/p>\n\u003cp>Margaret received a small inheritance of $1,000, along with a tax return of about $800 that gave her some unexpected money.\u003c/p>\n\u003cp>“All of those things together helped us to get through,” she says, “but barely. If any of those things were missing, I don’t really know what we would have done. Maybe move in with relatives.”\u003c/p>\n\u003cp>And the family became isolated, says her husband.\u003c/p>\n\u003cp>“It felt kind of like ‘knocked out of society’ for a while,” Alex Siebers says. “Our daily routine, our lives and our connections with people — we lost touch. Because we were, you know, trapped in here just trying to make it.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.american.edu/cas/faculty/kmjones.cfm\">Kelly Jones\u003c/a>, an economics professor at American University in Washington, D.C., and a senior research economist at \u003ca href=\"https://iwpr.org/\">the Institute for Women’s Policy Research\u003c/a>, says prescribing bed rest diminishes the role of women in society.\u003c/p>\n\u003cp>“If you’re telling a woman to undertake an activity that you’re not certain is going to be benefiting her, and yet it’s keeping her away from her job, what you’re saying to her is ‘Your participation in the economy is not important,’ ” Jones says.\u003c/p>\n\u003cp>The practice can also more generally harm the standing of women in the workplace.\u003c/p>\n\u003cp>“We know that the gender wage gap really starts when a woman has her first child,” Jones says. She says that’s partly because women take on more household work and child care. “But there are also aspects of that, that come from false assumptions, or [from] discrimination in the workplace surrounding childbirth and motherhood.”\u003c/p>\n\u003cp>Sending women to bed reinforces the notion that they are fragile or weak, Jones says. And those long-term absences from the workplace can have lasting effects on a woman’s earning power.\u003c/p>\n\u003cp>Siebers’ consulting obstetrician, \u003ca href=\"https://physicians.columbia-stmarys.org/details/65122/sheldon-wasserman-gynecology-obstetrics-obstetrics_gynecology-mequon-milwaukee\">Sheldon Wasserman\u003c/a>, says he’s seen women and men make huge sacrifices to ensure a successful pregnancy — including people who mortgage their homes to pay for fertility treatments and women who spend months in bed.\u003c/p>\n\u003cp>“The pursuit of having a child is one of the most fundamental desires,” he says.\u003c/p>\n\u003cp>Wasserman is chair of the Wisconsin section of ACOG. He knows what the research on bed rest says, and knows about ACOG’s recommendations against it.\u003c/p>\n\u003cp>“I’m kind of torn between the art and the science of medicine,” he says. “Have I seen over the years patients who were on bed rest who were able to have children when their previous obstetrical history is very poor? Yes, I have.”\u003c/p>\n\u003cp>It’s hard to quantify just how many pregnant women are ordered to bed each year by their doctors. A widely cited \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/8008308\">study from 1996\u003c/a> found that about 20 percent of women were prescribed bed rest at that time. A study two years later found that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/9580915\">as many as 90 percent\u003c/a> of maternal-fetal specialists order bed rest for some patients in high risk pregnancies.\u003c/p>\n\u003cp>The practice dates back to the time of Hippocrates, but became widespread in the late 1800s, when a British anatomist posited that if immobility heals broken bones, it likely could heal other ailments. The “rest cure” became standard medical care, according to \u003ca href=\"https://www.ohio.edu/cas/history/contact/profiles.cfm?profile=wolfj1\">Jacqueline Wolf\u003c/a>, a professor of the history of medicine at Ohio University, who has written books about the \u003ca href=\"https://www.amazon.com/Deliver-Me-Pain-Anesthesia-America/dp/1421405725/ref=sr_1_5?s=books&ie=UTF8&qid=1542647029&sr=1-5&refinements=p_27%3AJacqueline+Wolf\">history of pregnancy\u003c/a> and \u003ca href=\"https://www.amazon.com/Cesarean-Section-American-Technology-Consequence/dp/1421425521/ref=sr_1_1?s=books&ie=UTF8&qid=1542647029&sr=1-1&refinements=p_27%3AJacqueline+Wolf\">childbirth\u003c/a>.\u003c/p>\n\u003cp>Prescribing bed rest for pregnancy persisted in part, she says, because there was a notion that pregnant women were vulnerable to getting upset and hysterical.\u003c/p>\n\u003cp>“So, prenatal care brought out [among] obstetricians — virtually all of whom were men in the U.S. until the 1970s — a very intense and pervasive paternalism,” Wolf says. “If a woman had any sign of preterm labor or bleeding, she was to get complete rest. No visitors. No conversations. Darkened room — shades drawn. Even earplugs.”\u003c/p>\n\u003cp>The depth of research on the topic has changed since the 1970s. But bed rest is still widely prescribed. Today, \u003ca href=\"https://www.babble.com/pregnancy/understanding-and-surviving-bed-rest/\">women’s magazines\u003c/a>, \u003ca href=\"http://americanpregnancy.org/pregnancy-complications/bed-rest/\">consumer advice web sites\u003c/a> and \u003ca href=\"https://my.clevelandclinic.org/health/articles/9757-pregnancy-bed-rest\">even major medical centers\u003c/a> include information about bed rest as a common practice that anyone may expect to face.\u003c/p>\n\u003cp>When NPR asked listeners if they’ve been on bed rest in the last year, more than 200 women responded in just four days.\u003c/p>\n\u003cp>Some said they’d spent just a few days in bed, or were told simply to ‘lighten up’ on their physical activity. Others, like Margaret Siebers, were given strict orders to stay in bed.\u003c/p>\n\u003cp>Siebers says she was aware that the research showed little benefit to her staying in bed.\u003c/p>\n\u003cp>“You better believe I spent a lot of that time lying on my back reading articles about the effectiveness of it,” she says. “So that was something that came up a lot.”\u003c/p>\n\u003cp>She asked her doctors if she could travel to her family’s cabin, and lay on the couch there, just for a change of scenery. She questioned exactly how much she could do. Could she cook? Walk her daughter one block to the park? The caregivers didn’t always agree. But in general it came down to this: The baby is OK, so don’t change a thing.\u003c/p>\n\u003cp>That rationale is particularly troublesome to Anne Drapkin Lyerly with UNC, because it can induce unearned guilt in the mother if something goes wrong with her pregnancy.\u003c/p>\n\u003cp>“When bed rest is prescribed, the implication is that it is useful and that the immobilization is what is going to prevent whatever dreaded outcome — whether that’s preterm birth or miscarriage or preeclampsia,” Lyerly says. “If it ends up that a baby is born prematurely, or a woman develops preeclampsia, she is going to worry that she didn’t adhere to the recommendation well enough and will blame herself.”\u003c/p>\n\u003cp>Lyerly says she prescribed strict bed rest to one of her patients early in her career, and the pregnancy ended in miscarriage several hours after the woman took a shower.\u003c/p>\n\u003cp>“There was no amount of argument I could do to make her think it wasn’t her fault,” Lyerly recalls. “Because, after all, we had prescribed bed rest and she had gotten up.”\u003c/p>\n\u003cp>When Siebers’ pregnancy reached 37 weeks, a time when doctors believe it’s safe to give birth, the stitch that doctors had taken to hold her cervix closed was removed. She was allowed to get up and return to normal activity.\u003c/p>\n\u003cp>It was then a full three weeks before she went into labor, and gave birth to Frances.\u003c/p>\n\u003cp>“So maybe it worked really well, or maybe it wasn’t necessary,” Siebers says of her time spent on bed rest. But after all the family went through, she says, she doubts she’ll want to have another child.\u003c/p>\n\u003cp>Now, a year after Frances’ birth, both her parents have returned to full-time jobs.\u003c/p>\n\u003cfigure id=\"attachment_1934934\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe.jpg\" alt=\"\" width=\"2000\" height=\"1333\" class=\"size-full wp-image-1934934\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-1920x1280.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-1180x786.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-520x347.jpg 520w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Margaret Siebers sings \u003cem>Happy Birthday\u003c/em> to Frances on the baby’s first birthday. \u003ccite>(Sara Stathas for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The family gathers around a table, with little bowls of ice cream – one with a single candle for Frances. They sing an extra-long version of \u003cem>Happy Birthday\u003c/em>, Margaret Siebers’ family tradition, and mom blows out the candle as Frances dips her fingers tentatively into her first ice cream.\u003c/p>\n\u003cp>Alex Siebers ponders the whole experience.\u003c/p>\n\u003cp>“It would be very disheartening to learn later on in life — after there had been much more study and research done on this — to find out that that hadn’t been necessary,” he says. “Because that was a real hardship for us. I can’t, obviously, attribute the outcome to the bed rest completely. But, you know, there she is. You know — there’s the baby.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Copyright 2018 \u003ca href=\"https://www.npr.org\" rel=\"noopener\" target=\"_blank\">NPR\u003c/a>. \u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_1934935\" class=\"wp-caption aligncenter\" style=\"max-width: 1996px\">\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6.jpg\" alt=\"\" width=\"1996\" height=\"1333\" class=\"size-full wp-image-1934935\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6.jpg 1996w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-768x513.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-1020x681.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-1200x801.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-1920x1282.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-1180x788.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-960x641.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-520x347.jpg 520w\" sizes=\"(max-width: 1996px) 100vw, 1996px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Siebers family, now relaxed, on the living room couch that limited their world for several months when Margaret was on bed rest. Today both parents have returned to full-time paid work. \u003ccite>(Sara Stathas for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\n","blocks":[],"excerpt":"Research indicates bed rest does not improve birth outcomes and can be risky for the mom. So why is it still prescribed by many doctors and midwives in the U.S.?","status":"publish","parent":0,"modified":1704927278,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":65,"wordCount":2821},"headData":{"title":"Rethinking Bed Rest for Pregnancy | KQED","description":"Research indicates bed rest does not improve birth outcomes and can be risky for the mom. So why is it still prescribed by many doctors and midwives in the U.S.?","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"source":"NPR","sourceUrl":"https://www.npr.org/sections/health-shots/2018/11/26/669229437/rethinking-bed-rest-for-pregnancy","sticky":false,"nprByline":"Alison Kodjak\u003cbr>\u003cstrong>NPR\u003c/strong>","nprImageAgency":"Sara Stathas for NPR","nprStoryId":"669229437","nprApiLink":"http://api.npr.org/query?id=669229437&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/11/26/669229437/rethinking-bed-rest-for-pregnancy?ft=nprml&f=669229437","nprRetrievedStory":"1","nprPubDate":"Mon, 26 Nov 2018 11:24:00 -0500","nprStoryDate":"Mon, 26 Nov 2018 05:00:00 -0500","nprLastModifiedDate":"Mon, 26 Nov 2018 05:52:44 -0500","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/11/20181126_me_rethinking_bed_rest_for_pregnancy.mp3?orgId=1&topicId=1128&d=393&p=3&story=669229437&ft=nprml&f=669229437","nprAudioM3u":"http://api.npr.org/m3u/1670752963-13d7f0.m3u?orgId=1&topicId=1128&d=393&p=3&story=669229437&ft=nprml&f=669229437","audioTrackLength":393,"path":"/science/1934930/rethinking-bed-rest-for-pregnancy","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/11/20181126_me_rethinking_bed_rest_for_pregnancy.mp3?orgId=1&topicId=1128&d=393&p=3&story=669229437&ft=nprml&f=669229437","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The couch is dark brown corduroy with lumpy cushions. There are a few telltale smears of food, maybe yogurt or a banana, and some crumbs here and there. It’s a well-loved piece of furniture.\u003c/p>\n\u003cp>Margaret Siebers plops herself down in the center and reaches out to baby daughter Frances, who climbs onto her mother’s lap to breastfeed.\u003c/p>\n\u003cp>“This is where I spent several months,” says Siebers, with a shrug. Her 4-year-old, Violet, runs around nearby. “I could come downstairs and sit on the couch.”\u003c/p>\n\u003cp>Siebers was about halfway through her pregnancy with Frances, when health professionals guiding her care told Siebers she should be on bed rest. And the subsequent months, spent confined to a bed and couch in her small home in Milwaukee, turned her family’s life upside down.\u003c/p>\n\u003cp>“My husband immediately quit his full time job,” Siebers says, “and he took care of me. I wouldn’t even get my own glasses of water. So I like to say that ‘I was on bed rest, and he was on house arrest,’ because he really couldn’t leave either.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Siebers is just one of thousands of pregnant women who are put on bed rest by their doctors, nurses or midwives each year. The stated reason: Going to bed will help prevent a premature birth, or worse, a miscarriage. But there’s a major problem with this advice — there is no solid, scientific evidence that bed rest improves outcomes for pregnant women and their babies.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://www.npr.org/player/embed/669229437/670752963\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>“The bottom line is that there’s never been any proven benefit of bed rest,” says\u003ca href=\"https://www.med.unc.edu/socialmed/people/anne-lyerly/\"> Dr. Anne Drapkin Lyerly\u003c/a>, an OB-GYN and professor of bioethics at the University of North Carolina at Chapel Hill. Lyerly and colleagues in 2013 did a \u003ca href=\"https://insights.ovid.com/crossref?an=00006250-201306000-00023\">review of the scientific research\u003c/a> on bed rest as it relates to a variety of conditions, from early contractions to high blood pressure to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28262917\">carrying twins\u003c/a>. They found no benefit.\u003c/p>\n\u003cp>In fact, women put on bed rest can suffer harm — physical, psychological and economic. “It doesn’t seem like a dangerous intervention in the same way we think about surgeries or medications,” Lyerly says. “But in fact it can be very dangerous.”\u003c/p>\n\u003cp>Siebers was about 22 weeks pregnant when she visited a radiologist for a routine ultrasound. It was a standard screening at that point in her pregnancy — one that checks the baby’s growth, proportions and organs to ensure the fetus is developing properly. The baby was doing great, the doctor told her. The fetal heartbeat was strong and the ultrasound looked perfect. But there was one point of concern: Siebers’ \u003ca href=\"https://www.marchofdimes.org/complications/cervical-insufficiency-and-short-cervix.aspx\">cervix was ‘shortened,’\u003c/a> which can be a sign that a woman is at risk of preterm labor.\u003c/p>\n\u003cp>“So that was really scary for us,” she says. “We’re at this appointment and the doctor’s looking at the baby and saying, ‘You’ve got a beautiful heart.’ And I’m thinking, ‘Oh great, they’ve got a beautiful heart and they might die.’ ”\u003c/p>\n\u003cp>Siebers’ health care team at that point included a midwife, who was her primary caregiver, an obstetrician consulting on her case, and the doctors who performed the ultrasound. Because she’d had a miscarriage the year before, the team recommended she undergo a procedure called a \u003ca href=\"https://www.mayoclinic.org/tests-procedures/cervical-cerclage/about/pac-20393435\">cerclage\u003c/a> to help keep her cervix closed. And they wanted her to stay in bed.\u003c/p>\n\u003cfigure id=\"attachment_1934932\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de.jpg\" alt=\"\" width=\"2000\" height=\"1333\" class=\"size-full wp-image-1934932\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-1920x1280.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-1180x786.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-5_enl-4eee112a7658efa5bd49963d506633731116f1de-520x347.jpg 520w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Margaret and Alex Siebers say they struggled make ends meet during the weeks Margaret was confined to bed rest during her pregnancy with Frances, who is now 1 year old. Alex had to quit his paid job for a time to take care of Margaret and their older daughter, Violet, who is now 4. \u003ccite>(Sara Stathas for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Deb Studey, \u003ca href=\"https://www.choicemattersmidwifecollective.com/deb-studey\">Siebers’ midwife,\u003c/a> had cared for her during her previous pregnancy, which had ended in miscarriage at the end of the first trimester. Studey says she believes the bed rest may have helped Siebers carry this second child — Frances — to term.\u003c/p>\n\u003cp>“I know that being on bed rest was hard for Margaret. But I also knew, on the flip of that, having a 24-week baby in an ICU wasn’t going to be an easy outcome either. So, in my mind,” Studey says, “bed rest let her get to term.”\u003c/p>\n\u003cp>Studey is aware that the research doesn’t show bed rest to be beneficial. In fact, a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4019312/\">2013 study\u003c/a> that specifically addressed the issue of a shortened cervix found that women who were prescribed activity restrictions during their pregnancy were actually \u003cem>more\u003c/em> likely to give birth early.\u003c/p>\n\u003cp>“I think studies are always of interest,” Studey says. “I guess I pay attention just as equally to how things are working for women — and that doesn’t always fit a study. I think we’re all different.”\u003c/p>\n\u003cp>But Lyerly, the UNC bioethicist, tells NPR bed rest is not a benign intervention, and doctors and others who work with pregnant women need to think hard before prescribing it. And the American College of Obstetricians and Gynecologists \u003ca href=\"https://www.acog.org/About-ACOG/ACOG-Departments/Patient-Safety-and-Quality-Improvement/Did-You-Know-Video-Series/Preterm-Birth-Patients/Cautioning-Against-Bed-Rest-and-Why\">cautions against it\u003c/a>, for several medical reasons.\u003c/p>\n\u003cp>“One of the most dangerous things that can happen when a woman is on bed rest is having a blood clot,” Lyerly says. “You can have blood clots in your legs or in your pelvis. And if those clots travel to your lungs, it’s life threatening.”\u003c/p>\n\u003cp>She says women also risk losing muscle tone, becoming weak — just before they’re about to go through labor and then care for a child. And lying in bed can weaken bones, and reduce lung capacity. Some women become depressed.\u003c/p>\n\u003cp>“Women who are pregnant are not just ‘women who are pregnant,’ ” Lyerly says. “They are oftentimes mothers of other children. They are \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/01/24/580182083/sen-tammy-duckworths-pregnancy-set-to-be-another-first-for-the-illinois-democrat\">senators\u003c/a>; \u003ca href=\"https://www.npr.org/2012/07/17/156933071/all-eyes-on-yahoos-new-female-ceo\">CEOs\u003c/a>; \u003ca href=\"https://variety.com/2014/tv/news/could-savannah-guthries-pregnancy-herald-even-more-personal-chatter-at-today-gma-1201136302/\">journalists\u003c/a>; professors. They work in restaurants. They have jobs and they need their jobs.”\u003c/p>\n\u003cp>On a mid-November evening, the Siebers family is celebrating Frances’ first birthday. Margaret and her husband Alex have come home from work, where Alex had just injured his finger with a miter saw and was trying to clean and bandage the wound. Margaret made popcorn and peeled mandarins for the kids, as 4-year-old Violet twirled around the house in a whirlwind of red sparkles, and Frances climbed everything she saw.\u003c/p>\n\u003cp>It wasn’t a scene that lent itself to quiet time on the couch.\u003c/p>\n\u003cp>That’s why, when Margaret Siebers was told to stop moving, to go to bed, Alex Siebers, 33, quit his job to care for the family for several months.\u003c/p>\n\u003cfigure id=\"attachment_1934933\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde.jpg\" alt=\"\" width=\"2000\" height=\"1333\" class=\"size-full wp-image-1934933\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-1920x1280.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-1180x786.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-6_enl-993cb47fb5fbbbf769b1fa49b4cff85084cccdde-520x347.jpg 520w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">“It felt kind of like ‘knocked out of society’ for a while,” Alex Siebers remembers, of the time his wife was confined to the couch. “Our daily routine, our lives and our connections with people — we lost touch. Because we were, you know, trapped in here just trying to make it.” \u003ccite>(Sara Stathas for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Her mobility was extremely limited,” he says, “and the fact that we live in this house where the bathroom’s upstairs, you know, wasn’t helpful.”\u003c/p>\n\u003cp>His wife would get up in the morning, use the bathroom and go downstairs to the brown corduroy couch. She’d write letters, watch Netflix, read books.\u003c/p>\n\u003cp>“I could go upstairs to use the bathroom,” Margaret recalls. “I tried not to go too often, just because I didn’t want to be up and down the steps too much. I would sit on the porch sometimes. But whenever I moved, I would try to stay where I landed for hours, if I could.”\u003c/p>\n\u003cp>She was able to continue working from bed, 24-hour a week, for her family’s company, \u003ca href=\"http://www.bagtagsinc.com/\">Bagtags Inc.\u003c/a>, which makes lanyards and custom name tags for big events. But that was hardly enough to make ends meet.\u003c/p>\n\u003cp>The Siebers went on Medicaid. They also \u003ca href=\"https://www.dhs.wisconsin.gov/foodshare/eligibility.htm\">qualified for FoodShare\u003c/a>, Wisconsin’s food stamp program, and WIC, the \u003ca href=\"https://www.fns.usda.gov/wic/women-infants-and-children-wic\">federal nutrition program\u003c/a> for women, infants and children. Friends from church got organized to bring the family meals. And their landlord gave them a break on their rent.\u003c/p>\n\u003cp>Margaret received a small inheritance of $1,000, along with a tax return of about $800 that gave her some unexpected money.\u003c/p>\n\u003cp>“All of those things together helped us to get through,” she says, “but barely. If any of those things were missing, I don’t really know what we would have done. Maybe move in with relatives.”\u003c/p>\n\u003cp>And the family became isolated, says her husband.\u003c/p>\n\u003cp>“It felt kind of like ‘knocked out of society’ for a while,” Alex Siebers says. “Our daily routine, our lives and our connections with people — we lost touch. Because we were, you know, trapped in here just trying to make it.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.american.edu/cas/faculty/kmjones.cfm\">Kelly Jones\u003c/a>, an economics professor at American University in Washington, D.C., and a senior research economist at \u003ca href=\"https://iwpr.org/\">the Institute for Women’s Policy Research\u003c/a>, says prescribing bed rest diminishes the role of women in society.\u003c/p>\n\u003cp>“If you’re telling a woman to undertake an activity that you’re not certain is going to be benefiting her, and yet it’s keeping her away from her job, what you’re saying to her is ‘Your participation in the economy is not important,’ ” Jones says.\u003c/p>\n\u003cp>The practice can also more generally harm the standing of women in the workplace.\u003c/p>\n\u003cp>“We know that the gender wage gap really starts when a woman has her first child,” Jones says. She says that’s partly because women take on more household work and child care. “But there are also aspects of that, that come from false assumptions, or [from] discrimination in the workplace surrounding childbirth and motherhood.”\u003c/p>\n\u003cp>Sending women to bed reinforces the notion that they are fragile or weak, Jones says. And those long-term absences from the workplace can have lasting effects on a woman’s earning power.\u003c/p>\n\u003cp>Siebers’ consulting obstetrician, \u003ca href=\"https://physicians.columbia-stmarys.org/details/65122/sheldon-wasserman-gynecology-obstetrics-obstetrics_gynecology-mequon-milwaukee\">Sheldon Wasserman\u003c/a>, says he’s seen women and men make huge sacrifices to ensure a successful pregnancy — including people who mortgage their homes to pay for fertility treatments and women who spend months in bed.\u003c/p>\n\u003cp>“The pursuit of having a child is one of the most fundamental desires,” he says.\u003c/p>\n\u003cp>Wasserman is chair of the Wisconsin section of ACOG. He knows what the research on bed rest says, and knows about ACOG’s recommendations against it.\u003c/p>\n\u003cp>“I’m kind of torn between the art and the science of medicine,” he says. “Have I seen over the years patients who were on bed rest who were able to have children when their previous obstetrical history is very poor? Yes, I have.”\u003c/p>\n\u003cp>It’s hard to quantify just how many pregnant women are ordered to bed each year by their doctors. A widely cited \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/8008308\">study from 1996\u003c/a> found that about 20 percent of women were prescribed bed rest at that time. A study two years later found that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/9580915\">as many as 90 percent\u003c/a> of maternal-fetal specialists order bed rest for some patients in high risk pregnancies.\u003c/p>\n\u003cp>The practice dates back to the time of Hippocrates, but became widespread in the late 1800s, when a British anatomist posited that if immobility heals broken bones, it likely could heal other ailments. The “rest cure” became standard medical care, according to \u003ca href=\"https://www.ohio.edu/cas/history/contact/profiles.cfm?profile=wolfj1\">Jacqueline Wolf\u003c/a>, a professor of the history of medicine at Ohio University, who has written books about the \u003ca href=\"https://www.amazon.com/Deliver-Me-Pain-Anesthesia-America/dp/1421405725/ref=sr_1_5?s=books&ie=UTF8&qid=1542647029&sr=1-5&refinements=p_27%3AJacqueline+Wolf\">history of pregnancy\u003c/a> and \u003ca href=\"https://www.amazon.com/Cesarean-Section-American-Technology-Consequence/dp/1421425521/ref=sr_1_1?s=books&ie=UTF8&qid=1542647029&sr=1-1&refinements=p_27%3AJacqueline+Wolf\">childbirth\u003c/a>.\u003c/p>\n\u003cp>Prescribing bed rest for pregnancy persisted in part, she says, because there was a notion that pregnant women were vulnerable to getting upset and hysterical.\u003c/p>\n\u003cp>“So, prenatal care brought out [among] obstetricians — virtually all of whom were men in the U.S. until the 1970s — a very intense and pervasive paternalism,” Wolf says. “If a woman had any sign of preterm labor or bleeding, she was to get complete rest. No visitors. No conversations. Darkened room — shades drawn. Even earplugs.”\u003c/p>\n\u003cp>The depth of research on the topic has changed since the 1970s. But bed rest is still widely prescribed. Today, \u003ca href=\"https://www.babble.com/pregnancy/understanding-and-surviving-bed-rest/\">women’s magazines\u003c/a>, \u003ca href=\"http://americanpregnancy.org/pregnancy-complications/bed-rest/\">consumer advice web sites\u003c/a> and \u003ca href=\"https://my.clevelandclinic.org/health/articles/9757-pregnancy-bed-rest\">even major medical centers\u003c/a> include information about bed rest as a common practice that anyone may expect to face.\u003c/p>\n\u003cp>When NPR asked listeners if they’ve been on bed rest in the last year, more than 200 women responded in just four days.\u003c/p>\n\u003cp>Some said they’d spent just a few days in bed, or were told simply to ‘lighten up’ on their physical activity. Others, like Margaret Siebers, were given strict orders to stay in bed.\u003c/p>\n\u003cp>Siebers says she was aware that the research showed little benefit to her staying in bed.\u003c/p>\n\u003cp>“You better believe I spent a lot of that time lying on my back reading articles about the effectiveness of it,” she says. “So that was something that came up a lot.”\u003c/p>\n\u003cp>She asked her doctors if she could travel to her family’s cabin, and lay on the couch there, just for a change of scenery. She questioned exactly how much she could do. Could she cook? Walk her daughter one block to the park? The caregivers didn’t always agree. But in general it came down to this: The baby is OK, so don’t change a thing.\u003c/p>\n\u003cp>That rationale is particularly troublesome to Anne Drapkin Lyerly with UNC, because it can induce unearned guilt in the mother if something goes wrong with her pregnancy.\u003c/p>\n\u003cp>“When bed rest is prescribed, the implication is that it is useful and that the immobilization is what is going to prevent whatever dreaded outcome — whether that’s preterm birth or miscarriage or preeclampsia,” Lyerly says. “If it ends up that a baby is born prematurely, or a woman develops preeclampsia, she is going to worry that she didn’t adhere to the recommendation well enough and will blame herself.”\u003c/p>\n\u003cp>Lyerly says she prescribed strict bed rest to one of her patients early in her career, and the pregnancy ended in miscarriage several hours after the woman took a shower.\u003c/p>\n\u003cp>“There was no amount of argument I could do to make her think it wasn’t her fault,” Lyerly recalls. “Because, after all, we had prescribed bed rest and she had gotten up.”\u003c/p>\n\u003cp>When Siebers’ pregnancy reached 37 weeks, a time when doctors believe it’s safe to give birth, the stitch that doctors had taken to hold her cervix closed was removed. She was allowed to get up and return to normal activity.\u003c/p>\n\u003cp>It was then a full three weeks before she went into labor, and gave birth to Frances.\u003c/p>\n\u003cp>“So maybe it worked really well, or maybe it wasn’t necessary,” Siebers says of her time spent on bed rest. But after all the family went through, she says, she doubts she’ll want to have another child.\u003c/p>\n\u003cp>Now, a year after Frances’ birth, both her parents have returned to full-time jobs.\u003c/p>\n\u003cfigure id=\"attachment_1934934\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe.jpg\" alt=\"\" width=\"2000\" height=\"1333\" class=\"size-full wp-image-1934934\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-1920x1280.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-1180x786.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-2_enl-7e022462345d1a053231c05fb88e4a7681a4b6fe-520x347.jpg 520w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Margaret Siebers sings \u003cem>Happy Birthday\u003c/em> to Frances on the baby’s first birthday. \u003ccite>(Sara Stathas for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The family gathers around a table, with little bowls of ice cream – one with a single candle for Frances. They sing an extra-long version of \u003cem>Happy Birthday\u003c/em>, Margaret Siebers’ family tradition, and mom blows out the candle as Frances dips her fingers tentatively into her first ice cream.\u003c/p>\n\u003cp>Alex Siebers ponders the whole experience.\u003c/p>\n\u003cp>“It would be very disheartening to learn later on in life — after there had been much more study and research done on this — to find out that that hadn’t been necessary,” he says. “Because that was a real hardship for us. I can’t, obviously, attribute the outcome to the bed rest completely. But, you know, there she is. You know — there’s the baby.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Copyright 2018 \u003ca href=\"https://www.npr.org\" rel=\"noopener\" target=\"_blank\">NPR\u003c/a>. \u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_1934935\" class=\"wp-caption aligncenter\" style=\"max-width: 1996px\">\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6.jpg\" alt=\"\" width=\"1996\" height=\"1333\" class=\"size-full wp-image-1934935\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6.jpg 1996w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-768x513.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-1020x681.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-1200x801.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-1920x1282.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-1180x788.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-960x641.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2018/11/bed-rest-3_enl-fd934227e6b7e69d699e7a6967359060da8576c6-520x347.jpg 520w\" sizes=\"(max-width: 1996px) 100vw, 1996px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Siebers family, now relaxed, on the living room couch that limited their world for several months when Margaret was on bed rest. Today both parents have returned to full-time paid work. \u003ccite>(Sara Stathas for NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1934930/rethinking-bed-rest-for-pregnancy","authors":["byline_science_1934930"],"categories":["science_39"],"tags":["science_616"],"featImg":"science_1934931","label":"source_science_1934930"},"science_9862":{"type":"posts","id":"science_9862","meta":{"index":"posts_1591205157","site":"science","id":"9862","score":null,"sort":[1381762837000]},"guestAuthors":[],"slug":"infections-during-pregnancy-may-increase-autism-risk","title":"Infections During Pregnancy May Increase Autism Risk","publishDate":1381762837,"format":"aside","headTitle":"Infections During Pregnancy May Increase Autism Risk | KQED","labelTerm":{"site":"science"},"content":"\u003cfigure id=\"attachment_9865\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/10/PregnantWomanSitting_flickr_StuartHandy_3235768334_6beed51726_z_640x360.jpg\" rel=\"attachment wp-att-9865\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-9865\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/10/PregnantWomanSitting_flickr_StuartHandy_3235768334_6beed51726_z_640x360.jpg\" alt=\"Photograph courtesy of Stuart Handy via a Creative Commons license.\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Photograph courtesy of \u003ca href=\"http://www.flickr.com/photos/8274310@N07/3235768334/\" target=\"_blank\" rel=\"noopener\">Stuart Handy\u003c/a> via a Creative Commons license.\u003c/figcaption>\u003c/figure>\n\u003cp>Every day our brains help us make sense of the world around us, interpreting the experiences we see, hear, taste, touch and smell. But if someone’s brain has trouble processing this incoming information, it can be hard to communicate, understand or learn.\u003c/p>\n\u003cp>Autism spectrum disorders (ASD) are characterized by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. These disorders include \u003ca href=\"http://science.kqed.org/quest/video/autism-searching-for-causes/\" target=\"_blank\" rel=\"noopener\">autism\u003c/a>, \u003ca href=\"http://en.wikipedia.org/wiki/Asperger_syndrome\" target=\"_blank\" rel=\"noopener\">Asperger syndrome\u003c/a> and p\u003ca href=\"http://en.wikipedia.org/wiki/PDD-NOS\" target=\"_blank\" rel=\"noopener\">ervasive developmental disorder-not otherwise specified\u003c/a> (PDD-NOS).\u003c/p>\n\u003cp>About \u003ca title=\"CDC Fact Sheet for Autism Spectrum Disorders\" href=\"http://www.cdc.gov/ncbddd/autism/data.html\">one in 88 children\u003c/a> have been identified with an autism spectrum disorder, and over 2 million people are affected in the United States, according to the Centers for Disease Control and Prevention. Government statistics also suggest that the proportion of people with autism spectrum disorders have increased \u003ca title=\"Autism Speaks Frequently Asked Questions\" href=\"http://www.autismspeaks.org/what-autism/faq\">10 to 17 percent annually\u003c/a> in recent years. This is in part due to wider awareness and better screening, but the continued increase is not fully understood.\u003c/p>\n\u003cp>The cause of ASD is also not fully known, but current research indicates that it is likely due to a complex combination of genetic predisposition and environmental risk factors that influence early brain development. Significant environmental risk factors include the advance age of either parent at the time of conception, maternal illness during pregnancy, extreme prematurity and very low birth weight.\u003c/p>\n\u003cp>Over 40 years ago, \u003ca title=\"journal review article\" href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435446/pdf/nihms396261.pdf\">epidemiological studies\u003c/a> determined that the risk of having a child with ASD is increased when the mother has an infection early in the pregnancy. Since a wide range of bacterial and viral infections can increase the risk, studies suggest that activation of the mother’s general immune system is responsible. However, scientists do not completely understand how the activated immune system can disrupt normal brain development to cause ASD.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Research at the UC Davis’ Center for Neuroscience provides new insight. Recently \u003ca title=\"UCD journal article in Journal of Neuroscience\" href=\"http://www.jneurosci.org/content/33/34/13791.abstract\">published in the \u003cem>Journal of Neuroscience\u003c/em>\u003c/a>, their studies identify a new biological mechanism that links maternal immune activation to neurodevelopmental disorders.\u003c/p>\n\u003cp>Kimberley McAllister, a senior author of the study, explained in a \u003ca title=\"press release\" href=\"http://www.ucdmc.ucdavis.edu/publish/news/newsroom/8208\">press release\u003c/a>, “This is the first evidence that neurons in the developing brain of newborn offspring are altered by maternal immune activation. Until now, very little has been known about how maternal immune activation leads to autism spectrum disorder and schizophrenia-like pathophysiology and behaviors in the offspring.”\u003c/p>\n\u003cp>The researchers studied pregnant mice with immune systems that were activated halfway through gestation compared to pregnant control mice without activated immune systems. They found that the mice exposed to a viral infection had offspring with dramatically elevated levels of immune molecules called major histocompatibility complex 1 (MHC1) on their brain surface.\u003c/p>\n\u003cp>In the affected newborn mice, these high levels of MCH1 disrupted the development of neural cells in the brain. Specifically, the increase in MCH1 interfered with the neurons’ ability to form the synapses that allow neurons to pass electrical or chemical signals to other cells; consequently, these offspring had less than half as many synapses than the control offspring. When MCH1 were returned to normal levels in the neurons of maternal immune-activated offspring, the synapses density returned to normal.\u003c/p>\n\u003cp>However, MCH1 doesn’t work alone. In a series of additional experiments, the researchers identified the new biological signaling pathway that regulates synapses development caused by maternal immune activation. This signaling pathway requires calcineurin, myocyte enhancer factor-2 and MCH1 to limit synapses density.\u003c/p>\n\u003cp>A better understanding of the underlying biological mechanisms will hopefully lead to the development of improved prenatal health screening, diagnostic tests and eventually therapies for neurodevelopmental disorders.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Of course, not every child of a bacterially or virally infected mother develops a neurodevelopmental disorder like autism. The effect of maternal immune activation depends on a complex interaction involving the strength of the infection and \u003ca title=\"Autism Speaks fact sheet\" href=\"http://www.autismspeaks.org/what-autism/faq\">genetic predisposition\u003c/a>.\u003c/p>\n\n","blocks":[],"excerpt":"Research at UC Davis identifies a new biological mechanism that links maternal infections during pregnancy to increased risk of having a child with a neurodevelopmental disorder like autism. ","status":"publish","parent":0,"modified":1704934892,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":14,"wordCount":637},"headData":{"title":"Infections During Pregnancy May Increase Autism Risk | KQED","description":"Research at UC Davis identifies a new biological mechanism that links maternal infections during pregnancy to increased risk of having a child with a neurodevelopmental disorder like autism. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"sticky":false,"path":"/science/9862/infections-during-pregnancy-may-increase-autism-risk","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_9865\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/10/PregnantWomanSitting_flickr_StuartHandy_3235768334_6beed51726_z_640x360.jpg\" rel=\"attachment wp-att-9865\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-9865\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/10/PregnantWomanSitting_flickr_StuartHandy_3235768334_6beed51726_z_640x360.jpg\" alt=\"Photograph courtesy of Stuart Handy via a Creative Commons license.\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Photograph courtesy of \u003ca href=\"http://www.flickr.com/photos/8274310@N07/3235768334/\" target=\"_blank\" rel=\"noopener\">Stuart Handy\u003c/a> via a Creative Commons license.\u003c/figcaption>\u003c/figure>\n\u003cp>Every day our brains help us make sense of the world around us, interpreting the experiences we see, hear, taste, touch and smell. But if someone’s brain has trouble processing this incoming information, it can be hard to communicate, understand or learn.\u003c/p>\n\u003cp>Autism spectrum disorders (ASD) are characterized by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. These disorders include \u003ca href=\"http://science.kqed.org/quest/video/autism-searching-for-causes/\" target=\"_blank\" rel=\"noopener\">autism\u003c/a>, \u003ca href=\"http://en.wikipedia.org/wiki/Asperger_syndrome\" target=\"_blank\" rel=\"noopener\">Asperger syndrome\u003c/a> and p\u003ca href=\"http://en.wikipedia.org/wiki/PDD-NOS\" target=\"_blank\" rel=\"noopener\">ervasive developmental disorder-not otherwise specified\u003c/a> (PDD-NOS).\u003c/p>\n\u003cp>About \u003ca title=\"CDC Fact Sheet for Autism Spectrum Disorders\" href=\"http://www.cdc.gov/ncbddd/autism/data.html\">one in 88 children\u003c/a> have been identified with an autism spectrum disorder, and over 2 million people are affected in the United States, according to the Centers for Disease Control and Prevention. Government statistics also suggest that the proportion of people with autism spectrum disorders have increased \u003ca title=\"Autism Speaks Frequently Asked Questions\" href=\"http://www.autismspeaks.org/what-autism/faq\">10 to 17 percent annually\u003c/a> in recent years. This is in part due to wider awareness and better screening, but the continued increase is not fully understood.\u003c/p>\n\u003cp>The cause of ASD is also not fully known, but current research indicates that it is likely due to a complex combination of genetic predisposition and environmental risk factors that influence early brain development. Significant environmental risk factors include the advance age of either parent at the time of conception, maternal illness during pregnancy, extreme prematurity and very low birth weight.\u003c/p>\n\u003cp>Over 40 years ago, \u003ca title=\"journal review article\" href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435446/pdf/nihms396261.pdf\">epidemiological studies\u003c/a> determined that the risk of having a child with ASD is increased when the mother has an infection early in the pregnancy. Since a wide range of bacterial and viral infections can increase the risk, studies suggest that activation of the mother’s general immune system is responsible. However, scientists do not completely understand how the activated immune system can disrupt normal brain development to cause ASD.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Research at the UC Davis’ Center for Neuroscience provides new insight. Recently \u003ca title=\"UCD journal article in Journal of Neuroscience\" href=\"http://www.jneurosci.org/content/33/34/13791.abstract\">published in the \u003cem>Journal of Neuroscience\u003c/em>\u003c/a>, their studies identify a new biological mechanism that links maternal immune activation to neurodevelopmental disorders.\u003c/p>\n\u003cp>Kimberley McAllister, a senior author of the study, explained in a \u003ca title=\"press release\" href=\"http://www.ucdmc.ucdavis.edu/publish/news/newsroom/8208\">press release\u003c/a>, “This is the first evidence that neurons in the developing brain of newborn offspring are altered by maternal immune activation. Until now, very little has been known about how maternal immune activation leads to autism spectrum disorder and schizophrenia-like pathophysiology and behaviors in the offspring.”\u003c/p>\n\u003cp>The researchers studied pregnant mice with immune systems that were activated halfway through gestation compared to pregnant control mice without activated immune systems. They found that the mice exposed to a viral infection had offspring with dramatically elevated levels of immune molecules called major histocompatibility complex 1 (MHC1) on their brain surface.\u003c/p>\n\u003cp>In the affected newborn mice, these high levels of MCH1 disrupted the development of neural cells in the brain. Specifically, the increase in MCH1 interfered with the neurons’ ability to form the synapses that allow neurons to pass electrical or chemical signals to other cells; consequently, these offspring had less than half as many synapses than the control offspring. When MCH1 were returned to normal levels in the neurons of maternal immune-activated offspring, the synapses density returned to normal.\u003c/p>\n\u003cp>However, MCH1 doesn’t work alone. In a series of additional experiments, the researchers identified the new biological signaling pathway that regulates synapses development caused by maternal immune activation. This signaling pathway requires calcineurin, myocyte enhancer factor-2 and MCH1 to limit synapses density.\u003c/p>\n\u003cp>A better understanding of the underlying biological mechanisms will hopefully lead to the development of improved prenatal health screening, diagnostic tests and eventually therapies for neurodevelopmental disorders.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Of course, not every child of a bacterially or virally infected mother develops a neurodevelopmental disorder like autism. The effect of maternal immune activation depends on a complex interaction involving the strength of the infection and \u003ca title=\"Autism Speaks fact sheet\" href=\"http://www.autismspeaks.org/what-autism/faq\">genetic predisposition\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/9862/infections-during-pregnancy-may-increase-autism-risk","authors":["6360"],"categories":["science_30","science_39"],"tags":["science_807","science_616"],"featImg":"science_9865","label":"science"},"science_7712":{"type":"posts","id":"science_7712","meta":{"index":"posts_1591205157","site":"science","id":"7712","score":null,"sort":[1377885405000]},"guestAuthors":[],"slug":"congrats-its-an-app-family-planning-with-your-smartphone","title":"Congrats, It's an App! Family Planning with Your Smartphone","publishDate":1377885405,"format":"aside","headTitle":"Congrats, It’s an App! Family Planning with Your Smartphone | KQED","labelTerm":{"site":"science"},"content":"\u003cdiv class=\"audio-wrap\">\n\u003ch2>Listen:\u003c/h2>\n\u003cp>http://www.kqed.org/.stream/anon/radio/science/2013/09/2013-09-02-science.mp3\u003c/p>\n\u003c/div>\n\u003cp>More and more people are tracking sexual activity on their smartphones. We’re not talking about watching X-rated videos. Rather, we mean fertility apps for getting pregnant, the newest high-tech trend in helping people conceive.\u003c/p>\n\u003cp>At Natural Resources, a baby store in San Francisco’s Mission district, it’s not hard to find couples who track their sexual activity online. Lorraine Acosta is 15 weeks pregnant and attending her first pre-natal class. While the 30-year-old wants to give birth the old-fashioned way, she got pregnant with the help of an app called \u003ca href=\"https://play.google.com/store/apps/details?id=com.sleekbit.ovuview&hl=en&referrer=utm_source%3Dgoogle%26utm_medium%3Dorganic%26utm_term%3Dovuview+iphone\">OvuView\u003c/a>. “I’m an Android user,” Acosta says, “so I like this app for Android.”\u003c/p>\n\u003cp>OvuView has more than 18,000 reviews in the app store, and gets mostly five out of five stars.\u003c/p>\n\u003cp>When a woman is ovulating, her body temperature at rest goes up a degree or so. The app asks you to log that temperature before getting out of bed every morning.\u003c/p>\n\u003cp>“It synched with my alarm,” Acosta says. “So everyday when my alarm went on, the app also showed a notification.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The app also asks women to describe, on a daily basis, the quality of the mucus coming from their cervix. As the mucus goes from creamy and thick to clear like an egg white, a woman is getting more fertile.\u003c/p>\n\u003cp>While many women would feel anxious logging so much personal information, Acosta says the app made her feel more in control. The very month she and her husband Andres Ornelas wanted to conceive, she got pregnant.\u003c/p>\n\u003cp>Acosta says the app did not dictate when she and her husband should have sex. “It just told me when I was more fertile.”\u003c/p>\n\u003caside class=\"pullquote alignleft\">“Is it for fertility or sexual preferences? I don’t know!”\u003c/aside>\n\u003cp>Dozens of self-tracking apps have popped up on the market in the last few years to help women find their fertility window. One new high-profile app called \u003ca href=\"https://itunes.apple.com/us/app/glow-conceive-confidence/id638021335?mt=8\">Glow \u003c/a>is going a step further, and asking some very personal questions about sexual activity—questions like: Was the woman’s position on the bottom, in front, on top, other? Was there a female orgasm? Was there emotional discomfort? Sad, angry, or stressed?\u003c/p>\n\u003cp>Acosta laughs when she reads through the list. “Is it for fertility or sexual preferences,” she said, “I don’t know!”\u003c/p>\n\u003cp>Ornelas raises his eyebrows. “I’m kind of curious what it does with the answers that you give it,” he says. “Those seem like questions that I’ve never seen related to fertility.”\u003c/p>\n\u003cp>He’s mostly right.\u003c/p>\n\u003cp>Fertility specialists say there’s no consensus on how stress can impact pregnancy. Studies show female orgasm has little to no effect on pregnancy. As to the impact of sexual positions on fertility—there’s not much serious research there, either.\u003c/p>\n\u003cfigure id=\"attachment_7717\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/08/glowapp-e1377741180195-1024x813.jpg\" rel=\"attachment wp-att-7717\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-7717\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/08/glowapp-e1377741180195-1024x813.jpg\" alt=\"Glow Founder Max Levchin says he's asking personal questions because his start-up is a science experiment.\" width=\"1024\" height=\"813\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Glow Founder Max Levchin says he’s asking personal questions because his start-up is a science experiment.\u003c/figcaption>\u003c/figure>\n\u003cp>Glow is based in San Francisco. The founder, Max Levchin, is a computer scientist, and Levchin says his company is running a science experiment. “Part of our responsibility here,” he said, “is to actually gather enough data to run a study and say, ‘You know what? People conceived faster if they tried it on their back.’ Or not.”\u003c/p>\n\u003cp>Levchin is the same Big Data scientist who helped launch PayPal in 1999. The payment service looks at what people buy online to try to predict what they want next. Glow wants to use crowdsourcing to figure out if certain myths about pregnancy are actually facts.\u003c/p>\n\u003cp>“As soon as we have a couple hundred thousand data points,” Levchin says, “we’ll probably have the single largest study correlating sexual position to speed of conception.”\u003c/p>\n\u003cp>Glow stores all its data on the cloud. Sexual position is arguably more sensitive data than a credit card number, and this app does not\u003cstrong> \u003c/strong>strip people’s names from their responses. Levchin says that’s a service, if a Glow app user needs to visit a fertility doctor.\u003c/p>\n\u003cp>“You actually want to show up with a log that that person can understand,” Levchin says. “They can look at and say, ‘Oh, you’ve been tracking your data. Let me tell you what your options are.'”\u003c/p>\n\u003cp>Doctor Marcelle Cedars is a fertility specialist at the University of California San Francisco. She is skeptical of the medical value of fertility tracking apps.\u003c/p>\n\u003cp>Cedars says she tries to make things as simple and low stress as possible for couples early in the process. “The more sort of boxes you put around their sexuality, to me, tends to increase stress.”\u003c/p>\n\u003cp>Cedars points out the data that Glow is collecting may not end up being useful for science: the women who choose to use Glow may not represent women in general. And these women may not tell the truth about their sexual activity.\u003c/p>\n\u003cp>Cedars also says fertility apps have to be crystal clear about whom they cannot help. These apps assume a woman is ovulating regularly. “But if you’re having periods every two to three months,” she says, “you may not be ovulating at all. There need to be some windows saying, ‘maybe you should talk to your doctor.’”\u003c/p>\n\u003cp>The Glow app is free. Founder Max Levchin says he’s not worried about making money just yet. He’s focused on getting new users.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“As soon as we have a couple hundred thousand data points, we’ll probably have the single largest study correlating sexual position to speed of conception.”\u003c/aside>\n\u003cp>Levchin put a million dollars of his own money into Glow First, a non-profit fund offered as a premium service for app users who need to see a fertility specialist.\u003c/p>\n\u003cp>“That’s a strong way to drive adoption so people use the app,” says Andrew Farquharson, Managing Director of InCube Ventures, “but over time that approach isn’t going to be sustainable.”\u003c/p>\n\u003cp>Farquharson is a venture capitalist who invests in life science apps, but he says fertility apps are not ripe for investment because they don’t improve medical outcomes. With diabetes and heart patients, monitors that track blood sugar and heart rate “are better than going to a doctor once a day because they operate continuously.”\u003c/p>\n\u003cp>He’s waiting for products like Glow to integrate sensors. “When women don’t have to pee on a stick to know if they’re pregnant, I’ll reconsider.”\u003c/p>\n\u003cp>Levchin is toying with other ways to make his app profitable. Currently Glow has a companion edition for the partner of the woman trying to conceive. Using data about her mood and ovulation, Levchin says, Glow makes suggestions like, “This might be an excellent time to send a bouquet of flowers or book a spa trip.”\u003c/p>\n\u003cp>Levchin says he’s not yet planning to integrate such features with commercial websites like flowers.com or hotels.com. “But since I am on Yelp’s board,” he says, “I know exactly where to look for the best florists and spa. And we actually talked about it when we were designing this thing.”\u003c/p>\n\u003cp>Andres Ornelas, the father-to-be from the baby store, calls that idea “kind of creepy.”\u003c/p>\n\u003cp>Ornelas is a fan of self-tracking, but doesn’t want an app that intrudes on his marriage. “If an app told me, ‘Oh it’s that time of the month to buy flowers for your wife,’ then I feel like I’m not giving them the flowers. I feel like the app is doing it for me, so it’s pointless.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>But the guy who always forgets to buy flowers might just like that feature. Fertility apps are still seeking their niche. After all, they’re only in their infancy. The start-up Glow hasn’t even reached its first trimester.\u003c/p>\n\n","blocks":[],"excerpt":"Fertility apps are the newest high-tech trend in helping people conceive. There are dozens of apps on the market that help women find their fertility window. One high-profile app is going a step further, and asking some very personal questions. ","status":"publish","parent":0,"modified":1704935158,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":34,"wordCount":1411},"headData":{"title":"Congrats, It's an App! Family Planning with Your Smartphone | KQED","description":"Fertility apps are the newest high-tech trend in helping people conceive. There are dozens of apps on the market that help women find their fertility window. One high-profile app is going a step further, and asking some very personal questions. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"audioUrl":"http://www.kqed.org/.stream/anon/radio/science/2013/09/2013-09-02-science.mp3","sticky":false,"path":"/science/7712/congrats-its-an-app-family-planning-with-your-smartphone","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cdiv class=\"audio-wrap\">\n\u003ch2>Listen:\u003c/h2>\n\u003cp>http://www.kqed.org/.stream/anon/radio/science/2013/09/2013-09-02-science.mp3\u003c/p>\n\u003c/div>\n\u003cp>More and more people are tracking sexual activity on their smartphones. We’re not talking about watching X-rated videos. Rather, we mean fertility apps for getting pregnant, the newest high-tech trend in helping people conceive.\u003c/p>\n\u003cp>At Natural Resources, a baby store in San Francisco’s Mission district, it’s not hard to find couples who track their sexual activity online. Lorraine Acosta is 15 weeks pregnant and attending her first pre-natal class. While the 30-year-old wants to give birth the old-fashioned way, she got pregnant with the help of an app called \u003ca href=\"https://play.google.com/store/apps/details?id=com.sleekbit.ovuview&hl=en&referrer=utm_source%3Dgoogle%26utm_medium%3Dorganic%26utm_term%3Dovuview+iphone\">OvuView\u003c/a>. “I’m an Android user,” Acosta says, “so I like this app for Android.”\u003c/p>\n\u003cp>OvuView has more than 18,000 reviews in the app store, and gets mostly five out of five stars.\u003c/p>\n\u003cp>When a woman is ovulating, her body temperature at rest goes up a degree or so. The app asks you to log that temperature before getting out of bed every morning.\u003c/p>\n\u003cp>“It synched with my alarm,” Acosta says. “So everyday when my alarm went on, the app also showed a notification.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The app also asks women to describe, on a daily basis, the quality of the mucus coming from their cervix. As the mucus goes from creamy and thick to clear like an egg white, a woman is getting more fertile.\u003c/p>\n\u003cp>While many women would feel anxious logging so much personal information, Acosta says the app made her feel more in control. The very month she and her husband Andres Ornelas wanted to conceive, she got pregnant.\u003c/p>\n\u003cp>Acosta says the app did not dictate when she and her husband should have sex. “It just told me when I was more fertile.”\u003c/p>\n\u003caside class=\"pullquote alignleft\">“Is it for fertility or sexual preferences? I don’t know!”\u003c/aside>\n\u003cp>Dozens of self-tracking apps have popped up on the market in the last few years to help women find their fertility window. One new high-profile app called \u003ca href=\"https://itunes.apple.com/us/app/glow-conceive-confidence/id638021335?mt=8\">Glow \u003c/a>is going a step further, and asking some very personal questions about sexual activity—questions like: Was the woman’s position on the bottom, in front, on top, other? Was there a female orgasm? Was there emotional discomfort? Sad, angry, or stressed?\u003c/p>\n\u003cp>Acosta laughs when she reads through the list. “Is it for fertility or sexual preferences,” she said, “I don’t know!”\u003c/p>\n\u003cp>Ornelas raises his eyebrows. “I’m kind of curious what it does with the answers that you give it,” he says. “Those seem like questions that I’ve never seen related to fertility.”\u003c/p>\n\u003cp>He’s mostly right.\u003c/p>\n\u003cp>Fertility specialists say there’s no consensus on how stress can impact pregnancy. Studies show female orgasm has little to no effect on pregnancy. As to the impact of sexual positions on fertility—there’s not much serious research there, either.\u003c/p>\n\u003cfigure id=\"attachment_7717\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/08/glowapp-e1377741180195-1024x813.jpg\" rel=\"attachment wp-att-7717\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-7717\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2013/08/glowapp-e1377741180195-1024x813.jpg\" alt=\"Glow Founder Max Levchin says he's asking personal questions because his start-up is a science experiment.\" width=\"1024\" height=\"813\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Glow Founder Max Levchin says he’s asking personal questions because his start-up is a science experiment.\u003c/figcaption>\u003c/figure>\n\u003cp>Glow is based in San Francisco. The founder, Max Levchin, is a computer scientist, and Levchin says his company is running a science experiment. “Part of our responsibility here,” he said, “is to actually gather enough data to run a study and say, ‘You know what? People conceived faster if they tried it on their back.’ Or not.”\u003c/p>\n\u003cp>Levchin is the same Big Data scientist who helped launch PayPal in 1999. The payment service looks at what people buy online to try to predict what they want next. Glow wants to use crowdsourcing to figure out if certain myths about pregnancy are actually facts.\u003c/p>\n\u003cp>“As soon as we have a couple hundred thousand data points,” Levchin says, “we’ll probably have the single largest study correlating sexual position to speed of conception.”\u003c/p>\n\u003cp>Glow stores all its data on the cloud. Sexual position is arguably more sensitive data than a credit card number, and this app does not\u003cstrong> \u003c/strong>strip people’s names from their responses. Levchin says that’s a service, if a Glow app user needs to visit a fertility doctor.\u003c/p>\n\u003cp>“You actually want to show up with a log that that person can understand,” Levchin says. “They can look at and say, ‘Oh, you’ve been tracking your data. Let me tell you what your options are.'”\u003c/p>\n\u003cp>Doctor Marcelle Cedars is a fertility specialist at the University of California San Francisco. She is skeptical of the medical value of fertility tracking apps.\u003c/p>\n\u003cp>Cedars says she tries to make things as simple and low stress as possible for couples early in the process. “The more sort of boxes you put around their sexuality, to me, tends to increase stress.”\u003c/p>\n\u003cp>Cedars points out the data that Glow is collecting may not end up being useful for science: the women who choose to use Glow may not represent women in general. And these women may not tell the truth about their sexual activity.\u003c/p>\n\u003cp>Cedars also says fertility apps have to be crystal clear about whom they cannot help. These apps assume a woman is ovulating regularly. “But if you’re having periods every two to three months,” she says, “you may not be ovulating at all. There need to be some windows saying, ‘maybe you should talk to your doctor.’”\u003c/p>\n\u003cp>The Glow app is free. Founder Max Levchin says he’s not worried about making money just yet. He’s focused on getting new users.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“As soon as we have a couple hundred thousand data points, we’ll probably have the single largest study correlating sexual position to speed of conception.”\u003c/aside>\n\u003cp>Levchin put a million dollars of his own money into Glow First, a non-profit fund offered as a premium service for app users who need to see a fertility specialist.\u003c/p>\n\u003cp>“That’s a strong way to drive adoption so people use the app,” says Andrew Farquharson, Managing Director of InCube Ventures, “but over time that approach isn’t going to be sustainable.”\u003c/p>\n\u003cp>Farquharson is a venture capitalist who invests in life science apps, but he says fertility apps are not ripe for investment because they don’t improve medical outcomes. With diabetes and heart patients, monitors that track blood sugar and heart rate “are better than going to a doctor once a day because they operate continuously.”\u003c/p>\n\u003cp>He’s waiting for products like Glow to integrate sensors. “When women don’t have to pee on a stick to know if they’re pregnant, I’ll reconsider.”\u003c/p>\n\u003cp>Levchin is toying with other ways to make his app profitable. Currently Glow has a companion edition for the partner of the woman trying to conceive. Using data about her mood and ovulation, Levchin says, Glow makes suggestions like, “This might be an excellent time to send a bouquet of flowers or book a spa trip.”\u003c/p>\n\u003cp>Levchin says he’s not yet planning to integrate such features with commercial websites like flowers.com or hotels.com. “But since I am on Yelp’s board,” he says, “I know exactly where to look for the best florists and spa. And we actually talked about it when we were designing this thing.”\u003c/p>\n\u003cp>Andres Ornelas, the father-to-be from the baby store, calls that idea “kind of creepy.”\u003c/p>\n\u003cp>Ornelas is a fan of self-tracking, but doesn’t want an app that intrudes on his marriage. “If an app told me, ‘Oh it’s that time of the month to buy flowers for your wife,’ then I feel like I’m not giving them the flowers. I feel like the app is doing it for me, so it’s pointless.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But the guy who always forgets to buy flowers might just like that feature. Fertility apps are still seeking their niche. After all, they’re only in their infancy. The start-up Glow hasn’t even reached its first trimester.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/7712/congrats-its-an-app-family-planning-with-your-smartphone","authors":["1340"],"categories":["science_46","science_39","science_40","science_43"],"tags":["science_5181","science_616","science_461"],"featImg":"science_7730","label":"science"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.","airtime":"MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/all-things-considered/","meta":{"site":"news","source":"npr"},"link":"/radio/program/all-things-considered"},"american-suburb-podcast":{"id":"american-suburb-podcast","title":"American Suburb: The Podcast","tagline":"The flip side of gentrification, told through one town","info":"Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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