#gestational hypertension

[neosciencehub]

The Impact of Twin Pregnancies on Maternal Heart Health @neosciencehub #TwinPregnancies #Impact #MaternalHeartHealth #Bloodpressure #neosciencehub

[wellhealthhub]

Exploring the Intricacies of Type 4 Diabetes: Gestational Diabetes Mellitus

Greetings, esteemed readers, and welcome to this all-encompassing, highly detailed guide centered on the elucidation of Type 4 Diabetes, an intriguing and somewhat less ubiquitous entity compared to its better-known counterparts, Type 1 and Type 2 Diabetes. Our paramount objective within the confines of this article is to embark on a comprehensive exploration, traversing the labyrinthine…

[thisisthevoice]

alsoooo even in my own cohort i know theres at least one person whos pro-life and, last i knew, wanted to go into labor & delivery. i mean if youre a fucking nurse you shouldnt be "pro-life" (pro forced birth, anti maternal health) but im fucking scared for her patients if she goes down that route

[melted-heart-of-ice]

Reblogging to add pre-eclampsia and hyperemesis gravidarum

wild how like PCOS, endometriosis, vaginismus & hell, even frequent yeast infections are “mysterious” with no well known cause and little to no decent treatment, but we have tons of supposedly well researched body fat removal methods, about 20 different kinds of breast implants, laser hair removal, and 100 different dermatologist recommended anti aging creams. we sure had the money and brainpower to cure those “diseases”

[thelovebudllc]

Study: Pregnant women who skip dental care may face higher risks of gestational diabetes, hypertension

Pregnant women who skip dental checkups may face a higher risk of gestational diabetes and high blood pressure, researchers find. (iStock) Women who do not seek preventive dental care during pregnancy may have a higher risk of developing gestational diabetes and hypertensive disorders, according to a new study analyzing U.S. health data. The research, published in The Journal of the American…

[vs-griffin]

Pregnancy Rox: Positive Progress

I am over the moon excited. So last night, I was moved from my room in L&D to the extended stay antepartum wing. That means that I am not at risk for immediate delivery and that my outlook for reaching 34 weeks is higher in probability. All I can say is THANK GOD! This pregnancy has been a total journey into the unknown for sure. No, it’s not my first pregnancy however, it is my first pregnancy…

[mariacallous]

There is an inherent tension between two basic facts about childbirth. On the one hand, it has happened billions and billions of times in the course of human history and it has been successful in a wide range of settings, from neolithic caves to state-of-the-art hospitals. On the other, it is objectively dangerous in many cases.

This tension can be felt in much of the modern popular discourse on birth. On my Instagram feed, there are depictions of unmedicated home births in a bathtub surrounded by flowers and a caption about how birth has got too medicalised. Some commenters are quick to note that, in their case, having that medical help was life-saving. To put it most starkly: yes, people have been giving birth at home for millions of years, but a lot of them died.

I wrestle with this tension in my writing on pregnancy. I’m an economist and have written two books designed to help women navigate their pregnancy experience by giving them a better understanding of what the data says. In the first, Expecting Better, I cover largely uncomplicated pregnancy. I talk about the decisions that arise when all is going well – whether to eat sushi, for example, and how to write a birth plan for an uncomplicated delivery. In the second, The Unexpected, I cover complicated pregnancy. With my co-author, Dr Nathan Fox, we talk about miscarriage, pre-eclampsia, stillbirth, gestational diabetes, postpartum depression, and other tough things.

These are issues I care passionately about largely because I think we do not discuss complicated pregnancy enough. Perhaps 50% of pregnancies are affected by at least one of the complications covered in the book – that’s half of pregnancies, but more than half of people who have been pregnant. In many cases, until this complication happens to someone they have no idea that it could. They feel alone, sometimes dismissed, scared.

A core problem with lack of discussion is it leads to lack of treatment or preventive activities. The lead pregnancy organisation in the US, the American College of Obstetricians and Gynecologists, has put out a recent push for more discussion of pre-eclampsia, a serious complication that affects 5 to 8% of pregnancies. The risk of pre-eclampsia can be brought down about 20% with the use of baby aspirin beginning in the second trimester of pregnancy. This treatment has virtually no risks, so it’s increasingly clear that pregnant women with any risk factors – older age, higher weight, hypertension and many others – should be treated. If people are unaware of this risk, they are less likely to seek treatment. Even if offered treatment, if they do not understand the condition, they may be reluctant to take it up.

A lack of attention given to these complications leads to a lack of information, and without a basic understanding of what happened to them (or is happening to them) in their pregnancy, patients are not able to engage as much as they should with their condition. In doing interviews when this book came out, one mother told me: “I had a postpartum haemorrhage with my second child, but until I read your book I didn’t really understand what that was, let alone how to treat or prevent it.”

I want to shout this information from the rooftops. I want to tell everyone I know that, yes, your uterus can fall into (or even come partially out of) your vagina, and that if that happens there is help. And yet: I can see the danger of focusing too much on these complications. If 50% of pregnancies are affected, then 50% are not. Where should we draw the line between making sure pregnant women are well-informed without scaring them to death? After all, a lot of times, everything does go smoothly. Giving birth in a tub at home can be a good option for some people. And I would hate more than anything for someone to decide not to have a wanted family because they are worried about pregnancy and birth.

We need to find a balance between giving women the information they need, telling them the truth about risks, and not creating unnecessary panic. I wish I could say I knew for sure what this balance looks like. What I do believe strongly is that keeping information hidden, and doling it out only after it is needed – or never – is not the right answer. We need to strike a balance between giving people information and allowing them to put the risks in context. So they can take solace in the hope – and likelihood – that all will be well, but prepared if it is not.

[covid-safer-hotties]

Also preserved in our archive

"Just a cold" that increases intercranial abnormalities

By Nikhil Prasad

Medical News: A groundbreaking study conducted at San Marco University Hospital in Catania, Sicily, Italy, has revealed new insights into the potential impacts of SARS-CoV-2 on newborns. Researchers from this hospital and the University of Ferrara carried out an ultrasonographic analysis on newborns exposed to the virus, highlighting a significant incidence of minor intracranial abnormalities compared to unexposed infants. The findings raise important questions about the long-term neurological implications for children born during the COVID-19 pandemic.

The Study at a Glance This Medical News report delves into the research conducted by Bruna Scalia, Marco Andrea Nicola Saporito, and their colleagues, investigating cranial ultrasonography (cUS) findings in infants born to mothers who tested positive for SARS-CoV-2 during pregnancy or at delivery. The team analyzed data from 278 newborns, evenly split between exposed and unexposed cohorts. The study adhered to stringent observational protocols to ensure the reliability of results.

Key Findings Among the 139 newborns exposed to SARS-CoV-2, 23% exhibited intracranial abnormalities on cUS, compared to 16.5% in the unexposed group. Minor abnormalities were most prevalent and included subependymal cysts (SEPCs), choroid plexus cysts (CPCs), frontal horn cysts (FHCs), and lenticulostriate vasculopathy (LV). Major abnormalities, such as cerebellar hemorrhages and arachnoid cysts, were rare but noteworthy.

Interestingly, infants exposed to SARS-CoV-2 during pregnancy had a higher rate of abnormalities (38.4%) than those exposed at birth (19.5%). The second trimester emerged as a particularly critical period, with the majority of abnormalities observed in this subgroup.

Why These Findings Matter The study's results are alarming for public health professionals and expectant mothers. While SARS-CoV-2's immediate risks to newborns have been considered minimal, this research suggests subtle yet significant neurological effects. These abnormalities, although classified as minor, may carry long-term implications for cognitive and behavioral development.

The link between maternal inflammation and fetal development is not new, but the cytokine storm induced by SARS-CoV-2 appears to heighten this risk. The researchers hypothesize that inflammatory markers like interleukin-6 could cross the placenta, affecting the fetal brain and potentially disrupting synaptogenesis.

Methodology Details All newborns in the study underwent cranial ultrasonography within their first week of life. The scans were conducted using standardized equipment by experienced neonatologists. The findings were categorized as normal, minor, or major abnormalities. To exclude confounding factors, the study excluded infants with other infections or genetic disorders.

Demographic factors, such as gestational age and birth weight, were comparable across both groups. However, premature birth and maternal complications, such as gestational diabetes and hypertension, were noted as potential contributors to the observed abnormalities.

Implications for Future Research The findings call for more extensive, longitudinal studies to understand the long-term effects of these abnormalities. Current evidence suggests a potential association between minor abnormalities like SEPCs and neuropsychiatric conditions such as autism and ADHD. Further investigation could clarify whether these cUS findings are precursors to such outcomes.

What Experts Are Saying The study's authors emphasize caution, noting that minor intracranial abnormalities do not necessarily predict adverse outcomes. However, they recommend routine cranial ultrasonography for newborns exposed to SARS-CoV-2 as a precautionary measure. "The cost-effectiveness and non-invasive nature of cUS make it a valuable tool in monitoring these infants," said lead researcher Bruna Scalia.

Limitations and Strengths of the Study One limitation of the study was its relatively small sample size, particularly for subgroups like prenatally exposed infants. Additionally, the lack of serological testing for unexposed mothers could have introduced undetected cases into the control group. However, the study's rigorous methodology and use of a well-matched control group lend credibility to its conclusions.

Study Conclusions The research underscores a statistically significant increase in minor intracranial abnormalities among SARS-CoV-2-exposed newborns. These findings are particularly pronounced in infants exposed during the second trimester of pregnancy. While the abnormalities observed in the study were predominantly minor, their potential impact on long-term neurological outcomes cannot be overlooked. The researchers advocate for the following:

-Routine cUS Screening: Cranial ultrasonography should be performed on all newborns exposed to SARS-CoV-2 to identify abnormalities early.

-Long-Term Follow-Up: Exposed infants should be enrolled in neurodevelopmental follow-up programs to monitor their progress and intervene if necessary.

-Expanded Research: Larger, multicenter studies are needed to confirm these findings and explore the mechanisms behind SARS-CoV-2's impact on fetal brain development.

By highlighting these abnormalities, the study adds a critical layer to our understanding of COVID-19's broader implications, particularly for future generations.

The study findings were published in the peer-reviewed Italian Journal of Pediatrics. link.springer.com/article/10.1186/s13052-024-01826-3

[ottovonruthie]

Pregnancy complications can include conditions such as anemia, cholestasis of pregnancy, gestational diabetes, preeclampsia, ectopic pregnancy, placenta previa, placental abruption, preterm labor, hyperemesis gravidarum, miscarriage, stillbirth, infections, Rh incompatibility, gestational hypertension, and cervical insufficiency. And this isn’t even all of it. It’s beyond disrespectful to suggest a woman would go through all of that just to wait nine months to abort. No one endures the physical, emotional, and mental toll of pregnancy for nine months only to make that decision at the end.

[allthebrazilianpolitics]

Premature birth rate above global average in Brazil

The commonly cited "nine months" of pregnancy oversimplifies a much more complex process: human gestation lasts about 40 weeks, with a "full-term" pregnancy considered to be between 37 and 42 weeks. However, in 2023, nearly 12 percent of births in Brazil occurred before reaching this milestone, totaling around 300,000 premature babies. These infants face varying health risks, depending on how early they were born. Brazil not only exceeds the global average of around 10 percent but is also one of the top ten countries with the highest number of premature births annually.

According to Denise Suguitani, executive director of the Brazilian Association of Parents, Families, Friends, and Carers of Premature Babies, most of these cases are preventable. She explains, "In Brazil, these rates are closely linked to social factors, including access to healthcare and education. Adolescent pregnancy, for instance, is a risk factor for premature birth because the girl’s body is not yet fully prepared. On the other hand, a planned pregnancy is less likely to result in premature birth, making family planning crucial. And, of course, access to prenatal care is essential. It’s not just the number of appointments that matters, but the quality of care and the information provided."

Obstetrician Joeline Cerqueira, a member of the Prenatal Care Commission of the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo), highlights some conditions that can be detected and treated during prenatal care to prevent premature birth and other complications. She explains, "Infections, premature rupture of the amniotic sac, and hypertensive disorders during pregnancy are among the leading causes of premature birth."

Continue reading.

[ginontherox]

Pregnancy Rox: Positive Progress

I am over the moon excited. So last night, I was moved from my room in L&D to the extended stay antepartum wing. That means that I am not at risk for immediate delivery and that my outlook for reaching 34 weeks is higher in probability. All I can say is THANK GOD! This pregnancy has been a total journey into the unknown for sure. No, it’s not my first pregnancy however, it is my first pregnancy…

[teenage-preggy-orlando]

Growing Up and Growing a Baby

Teenage pregnancy refers to a situation when a girl between the ages of 13 and 19 becomes pregnant. This usually happens during the teenage years, which is a time of significant physical, emotional, and mental growth. There are many reasons why teenage pregnancy occurs, such as not having access to birth control, peer pressure, engaging in sexual activity at a young age, and insufficient sex education. It can cause health risks for both the teenage mother and her baby, and it leads to social and economic issues, like delayed education and financial problems.

It's important not to normalize teenage pregnancy because it has a huge impact on individuals, families, and communities. This has an impact on health, education and the economy, and is a serious social issue. When young mothers don’t have access to prenatal care, both they and their children can develop health problems. Stigma and social barriers can also affect the mental health of teenage mothers. By focusing on education, ensuring access to health care and supporting young mothers in the community, we can help to ensure better futures for teen mothers and their children, and in turn, for everyone in society.

According to the World Health Organization, each year, approximately 21 million girls aged 15 to 19 in developing regions become pregnant, with about 12 million giving birth. In 2023, the global adolescent birth rate was 41.3 births per 1,000 women aged 15 to 19, a decline from 64.5 per 1,000 in 2000 (WHO, 2024). In sub-Saharan Africa, approximately 25% of young women give birth before age 18, while in South Asia, Latin America, and the Caribbean, the figure is about 10% (UNICEF, 2024).

Now in the Philippines, Statista declared that The adolescent fertility rate in the Philippines was approximately 48.2% births per 1,000 women aged 15 to 19 in 2021, reflecting a decrease from previous years. According to data, in 2022, 3,135 girls under 15 years old gave birth in the Philippines, a 35% increase from 2,320 in 2021 (Save the Children, 2024). While, in 2023, adolescent mothers comprised 9.82% of the total 1.45 million births among all ages in the country (Rappler, 2025). These statistics reveal the existing issues surrounding teenage pregnancy, signifying the urgent need for sex education, accessible reproductive health services, and supportive policies to tackle the problem effectively. It shows that this issue is not only seen nationwide but also internationally. Though discussions about teenage pregnancy can be controversial among Filipinos, it's important to admit the importance of addressing this topic. Talking about teenage pregnancy is a necessity and a need. By increasing awareness, we can help prevent cycles of poverty, boost community engagement, and support better policies that aid adolescent reproductive health.

What are the effects of teenage pregnancy?

Teen mothers experience some health risks during pregnancy and even after giving birth. Teenagers' bodies are still in development, and pregnancy may put added pressure on their physical well-being. Teen mothers are at greater risk of complications like gestational hypertension, preeclampsia (a severe pregnancy condition), and anemia. There is also an increased risk of preterm birth and low birth weight babies, which can lead to developmental issues and chronic illness for the child. These health risks are also increased by the reality that teens may not always receive adequate pre-natal care, either due to ignorance or unavailability of healthcare, and this can lead to further complications. Postpartum recovery can also be harder for teen mothers since they might not be physically prepared to cope with the recovery process, which entails healing from childbirth and adjusting to the needs of having a newborn.

The emotional and psychological effects of teen pregnancy can be intense. Teens are still in the process of developing emotionally and mentally, and the pressure of pregnancy and motherhood can have long-term impacts on their mental well-being. Teenage mothers are also more prone to being socially isolated because they may be stigmatized by their friends or families for having become pregnant early. Additionally, teen mothers can also struggle to balance the child's and their own needs, which creates emotional tensions and affects their psychological well-being in a negative manner. This may lead to the poor development of good relationships or individual development aspirations as their focus is typically drawn to child rearing.

Pregnant teenagers need to be educated about the importance of fetal movements and what to do if there is a change in the pattern of fetal movements. The earlier a baby is born, the more risk there is of respiratory, digestive, vision, cognitive, and other problems. Teens are at higher risk of having low-birth-weight babies. Pre-mature babies are more likely to weigh less than they should. In part, that’s because they've had less time in the womb to grow. A low-birth-weight baby weighs only 3.3 to 5.5 pounds. A very low-birth-weight baby weighs less than 3.3 pounds. Babies that small may need to be put on a ventilator in a hospital's neonatal care unit for help with breathing after birth. According to the National Institute of Health, teenage pregnancy can have a major effect on the baby in the short term, including risks for: anemia, toxemia (also known as pre-eclampsia), high blood pressure, placenta previa (placenta blocks the cervix), and pre-mature birth of the baby.

Many teen mothers end up dropping out of school, which hurts the amount they can earn long term. According to the Center of Disease Control, households with teen parents are more likely to be raised in single-parent families, with money being at the center of many other issues. These challenges include getting less education and worse behavioral and physical health outcomes. One area where peer pressure can have a particularly strong effect is in the realm of teenage pregnancy. With the desire to fit in and be accepted by their peers, young people may find themselves succumbing to the pressures of their social group and engaging in risky sexual behavior. Teenage pregnancy is a complex issue that can be influenced by various factors, including cultural norms and values. In many cultures around the world, there are specific beliefs and customs that may contribute to the higher rates of teenage pregnancy. Adolescent pregnancies are a global problem –they occur in high-, middle-, and low-income countries.

What can we do to combat this growing issue?

Complete sex education in communities and schools is one of the best strategies to stop teen pregnancy. Teenagers are better prepared to make decisions when they are given accurate and age-appropriate information on human sexuality, reproductive health, and responsible decision-making. Responsible decision-making and self-awareness are fostered by teaching about consent, healthy relationships, and respect for individual limits. By discussing the negative effects of unprotected sex, such as STIs and unintended pregnancies, teens are more equipped to understand the dangers and adopt the appropriate safety measures. Young people are better equipped to negotiate complicated social dynamics and make wise decisions when candid conversations regarding peer pressure and cultural impacts on sexual behavior are promoted.

In order to lower birth rates, teens must have easy access to private contraception treatments. Making educated decisions is made possible by educating them about the several forms of contraception, including IUDs, birth control pills, and condoms. Healthcare professionals should provide encouraging, non-judgmental advice, and government initiatives can help make contraception accessible and accessible for all teenagers. A strong support system plays a critical role in preventing teenage pregnancies and assisting young mothers. Families, educational institutions, and community organizations must collaborate to create an environment where teenagers feel supported and guided. Families encourage open communication and guidance, which has an impact on teens' decisions about relationships and reproductive health. Teens can make responsible decisions and concentrate on their schooling and future objectives if their parents talk to them about values, expectations, and the dangers of being pregnant too young.

Adolescent pregnancy is still a significant problem that impacts not just young mothers, but also their offspring and community at. As mentioned, the reasons for teenage pregnancy arise from multiple factors, such as inadequate sexual education, social pressure, and restricted availability of contraception. The effects can be significant, affecting the physical and emotional health of teenage mothers, along with the welfare and future prospects of their offspring. To tackle this problem, it is vital to emphasize thorough sex education, enhance access to contraceptives, and bolster community and family support networks. By raising awareness and offering essential resources, we can help lower the incidence of teenage pregnancy and assist young mothers in tackling the difficulties they encounter.

Let’s collaborate to disrupt the cycle by promoting improved education, minimizing stigma, and providing assistance to those who require it. By working together, we can build a community that enables every teenager to make knowledgeable decisions for a healthier and more promising future!

[wishingforatypewriter]

Pregnant Lin head cannons ? Was conceiving easy for her or was she infertile ? What symptoms does she experience ? What cravings does she have ? Any complications ? How does the birth go ? After birth what is her postpartum experience like ? Does she experience ppd ? Is breastfeeding easy for her ?

Hi! Thanks for the ask! (I'd like to preface this post with a disclaimer that I have never been pregnant, so this may not be entirely accurate)

Lin conceived relatively easily and never had any fertility issues. Her pregnancy was actually unplanned.

She had pretty bad morning sickness during her first trimester. She was especially sensitive to smells and sometimes the scent of certain ingredients cooking would make her queasy. She also experienced a lot of fatigue during her pregnancy and needed a lot more sleep than she was used to.

Lin's biggest craving was for citrus fruits like tangerines and pomelos Her partner would always make sure the apartment was well stocked with them, and peel them for her when she wanted a snack. (I wrote a linzolt oneshot called Tangerines around this idea). Her pre-existing love of spicy foods was intensified while she was pregnant, so she ate a lot of fire noodles and fire flakes.

Because she was having twins, Lin was at a higher risk for preterm labor and gestational hypertension. However, her medical team (including Katara) monitored the situation and she ultimately didn't experience those effects.

Lin has a pretty high threshold for pain, but nothing could have prepared her for childbirth. She was in labor for fourteen hours and it was a bit of an ordeal. Her partner was with her the whole time, holding her hand and feeding her ice chips and sips of water.

When she came home from the hospital, Lin's partner did not let her lift a finger. She got to rest and recover from the birth, taking naps and listening to probending on the radio and just bonding with her new babies. Her partner took care of everything around the house so she could relax.

Lin doesn't have postpartum depression, but she does experience some anxiety around being a new mom.

Breastfeeding is relatively easy for her, but after a few weeks she switches to bottle feeding because she wants to start checking in with Saikhan at the RCPD.

[coochiequeens]

Ladies, being a surrogate carries a higher risk for complications. Don't let anyone try to guilt or pay you into being one if you don't want to.

By Will Pass September 26, 2024

Gestational carriers face a significantly higher risk for severe maternal morbidity and other pregnancy complications than those conceiving naturally or via in vitro fertilization (IVF), according to a recent Canadian study.

These findings suggest that more work is needed to ensure careful selection of gestational carriers, reported lead author Maria P. Velez, MD, PhD, of McGill University, Montreal, Quebec, Canada, and colleagues.

"Although a gestational carrier should ideally be a healthy person, with a demonstrated low-risk obstetric history, it is not clear whether this occurs in practice," the investigators wrote in Annals of Internal Medicine. "Moreover, the risk for maternal and neonatal adversity is largely unknown in this group."

Study Compared Gestational Carriage With IVF and Unassisted Conception

To address these knowledge gaps, Velez and colleagues conducted a population-based cohort study in Ontario using linked administrative datasets. All singleton births at more than 20 weeks' gestation with mothers aged 18-50 years were included from April 2012 to March 2021. Multifetal pregnancies were excluded, as were women with a history of infertility diagnosis without fertility treatment, and those who underwent intrauterine insemination or ovulation induction.

Outcomes were compared across three groups: Unassisted conception, IVF, and gestational carriage. The primary maternal outcome was severe maternal morbidity, defined by a validated composite of 41 unique indicators. The primary infant outcome was severe neonatal morbidity, comprising 19 unique indicators.

Secondary outcomes were hypertensive disorders, elective cesarean delivery, emergent cesarean delivery, preterm birth at less than 37 weeks, preterm birth at more than 32 weeks, and postpartum hemorrhage.

Logistic regression analysis adjusted for a range of covariates, including age, obesity, tobacco/drug dependence, chronic hypertension, and others. The final dataset included 846,124 births by unassisted conception (97.6%), 16,087 by IVF (1.8%), and 806 by gestational carriage (0.1%).

The weighted relative risk (wRR) for severe maternal morbidity was more than three times higher in gestational carriers than in those conceiving naturally (wRR, 3.30; 95% CI, 2.59-4.20) and 86% higher than in those conceiving via IVF (wRR, 1.86; 95% CI, 1.36-2.55). These stem from absolute risks of 2.3%, 4.3%, and 7.8% for unassisted, IVF, and surrogate pregnancies, respectively.

Moreover, surrogates were 75% more likely to have hypertensive disorders, 79% more likely to have preterm birth at less than 37 weeks, and almost three times as likely to have postpartum hemorrhage.

These same three secondary outcomes were also significantly more common when comparing surrogate with IVF pregnancies, albeit to a lesser degree. In contrast, surrogate pregnancies were associated with a 21% lower risk for elective cesarean delivery than IVF pregnancies (wRR, 0.79; 95% CI, 0.68-0.93).

Severe neonatal morbidity was not significantly different between the groups. These findings add to a mixed body of evidence surrounding both maternal and neonatal outcomes with gestational carriers, according to the investigators.

"Prior small studies [by Söderström-Anttila et al. and Swanson et al.] reported varying risks for preterm birth in singleton gestational carriage pregnancies, whereas a recent large US registry reported no increased risk for preterm birth compared with IVF, after accounting for multifetal pregnancy," they wrote. "This study excluded multifetal pregnancies, a common occurrence after IVF, with reported higher risks for adverse outcomes. Accordingly, adverse maternal and newborn outcomes may have been underestimated herein."

Causes of Worse Outcomes Remain Unclear

While the present findings suggest greater maternal morbidity among surrogates, potential causes of these adverse outcomes remain unclear.

The investigators suggested that implantation of a nonautologous embryo could be playing a role, as oocyte donation has been linked with an increased risk for hypertensive disorders of pregnancy.

"We don't know exactly why that can happen," Velez said in an interview. "Maybe that embryo can be associated with an immunological response that could be associated with higher morbidity during pregnancy. We need, however, other studies that can continue testing that hypothesis."

In the meantime, more care is needed in surrogate selection, according to Velez.

"In our study, we found that there were patients, for example, who had more than three prior C-sections, which is one of the contraindications for gestational carriers, and patients who had more than five [prior] pregnancies, which is also another limitation in the guidelines for choosing these patients," she said. "Definitely we need to be more vigilant when we accept these gestational carriers."

But improving surrogate selection may be easier said than done.

The quantitative thresholds cited by Velez come from the American Society for Reproductive Medicine guidelines. Alternative guidance documents from the Canadian Fertility and Andrology Society and American College of Obstetricians and Gynecologists are less prescriptive; instead, they offer qualitative recommendations concerning obstetric history and risk assessment.

And then there is the regulatory specter looming over the entire field, evidenced by the many times that these publications cite ethical and legal considerations — far more than the average medical guidance document — when making clinical decisions related to surrogacy.

Present Study Offers Much-Needed Data in Understudied Field

According to Kate Swanson, MD, a perinatologist, clinical geneticist, and associate professor at the University of California San Francisco, the present study may help steer medical societies and healthcare providers away from these potential sand traps and toward conversations grounded in scientific data.

"I think one of the reasons that the Society for Maternal-Fetal Medicine and the maternal-fetal medicine community in general hasn't been interested in this subject is that they see it as a social/ethical/legal issue rather than a medical one," Swanson said in an interview. "One of the real benefits of this article is that it shows that this is a medical issue that the obstetric community needs to pay attention to."

These new data could help guide decisions about risk and candidacy with both potential gestational carriers and intended parents, she said.

Still, it's hard — if not impossible — to disentangle the medical and legal aspects of surrogacy, as shown when analyzing the present study.

In Canada, where it was conducted, intended parents are forbidden from paying surrogates for their services beyond out-of-pocket costs directly related to pregnancy. Meanwhile, surrogacy laws vary widely across the United States; some states (eg, Louisiana) allow only altruistic surrogacy like Canada, while other states (eg, California) permit commercial surrogacy with no legal limits on compensation.

Swanson and Velez offered starkly different views on this topic.

"I think there should be more regulations in terms of compensating [gestational carriers]," Velez said. "I don't think being a gestational carrier should be like a job or a way of making a living."

Swanson, who has published multiple studies on gestational carriage and experienced the process as an intended parent, said compensation beyond expenses is essential.

"I do think it's incredibly reasonable to pay someone — a woman is taking on quite a lot of inconvenience and risk — in order to perform this service for another family," she said. "I think it's incredibly appropriate to compensate her for all of that."

Reasons for compensation go beyond the ethical, Swanson added, and may explain some of the findings from the present study.

"A lot of these gestational carriers [in the present dataset] wouldn't necessarily meet criteria through the American Society of Reproductive Medicine," Swanson said, pointing out surrogates who had never had a pregnancy before or reported the use of tobacco or other drugs. "Really, it shows me that a lot of the people participating as gestational carriers were maybe not ideal candidates. I think one of the reasons that we might see that in this Canadian population is…that you can't compensate someone, so I think their pool of people willing to be gestational carriers is a lot smaller, and they may be a little bit less selective sometimes."

Velez acknowledged that the present study was limited by a shortage of potentially relevant information concerning the surrogacy selection process, including underlying reasons for becoming a gestational carrier. More work is needed to understand the health and outcomes of these women, she said, including topics ranging from immunologic mechanisms to mental health.

She also called for more discussions surrounding maternal safety, with participation from all stakeholders, including governments, surrogates, intended parents, and physicians too.

This study was funded by the Canadian Institutes of Health Research. The investigators disclosed no conflicts of interest. Swanson disclosed a relationship with Mitera.

Will Pass, DVM, is a veterinarian and freelance medical writer from Colorado.

[pgirija]

Finding the right maternity hospital in Wakad is a crucial decision for expectant parents. With expert gynecologists, advanced facilities, and a compassionate approach, Orion IVF Clinic stands out as a trusted choice for maternity care. Whether you are planning for childbirth, prenatal care, or postnatal support, Orion IVF Clinic ensures a safe and comfortable experience.

Why Choose Orion IVF Clinic for Maternity Care?

Experienced Obstetricians & Gynecologists At Orion IVF Clinic, highly skilled and experienced obstetricians provide personalized care throughout pregnancy, ensuring the health of both mother and baby.

Advanced Labor & Delivery Facilities Equipped with state-of-the-art labor rooms and neonatal care units, Orion IVF Clinic ensures a safe and smooth delivery process.

Comprehensive Antenatal Care Regular check-ups, ultrasound scans, and dietary guidance are part of the holistic maternity services offered at Orion IVF Clinic.

High-Risk Pregnancy Management For expectant mothers facing complications like gestational diabetes or hypertension, specialized care and monitoring are provided.

Postnatal & Lactation Support After delivery, expert lactation consultants and postnatal care specialists guide new mothers for a smooth recovery and baby care.

Services Offered at Orion IVF Clinic

Normal & C-Section Deliveries

Prenatal & Postnatal Care

Fertility Consultation & Treatment

Ultrasound & Diagnostic Services

Newborn Care & Pediatric Support

Book an Appointment Today!

If you are searching for a maternity hospital in Wakad that prioritizes your health and comfort, Orion IVF Clinic is the right choice. With a patient-centric approach, advanced medical care, and a supportive team, your journey to motherhood becomes safe and memorable.

For consultations and appointments, visit Orion IVF Clinic in Wakad today!

[vague-humanoid]

After the Supreme Court overturned Roe v. Wade in June 2022, 14 states have imposed near-total abortion bans. (Arizona may soon join them.) While all of these states include exemptions to save the life of the mother, the language is inherently vague. The abortion bans typically allow for emergency abortions to prevent "serious risk of substantial and irreversible impairment of a major bodily function" or "serious, permanent impairment of a life-sustaining organ." But the laws do not address "expectations regarding the most common obstetric complications that can lead to late-stage pregnancy loss, such as previable premature rupture of membranes, excessive bleeding, gestational hypertension, preeclampsia, or placental abruption."

The American College of Obstetricians and Gynecologists says that it is critical that hospitals "provide guidance that permits treatment to the full extent of applicable state law and support and defend their clinicians when they provide care to patients." 

In many hospitals, that is not happening. The result is that pregnant women are showing up at emergency rooms and are not receiving the care they need. An Associated Press report last week, based on federal documents, found that "[c]omplaints that pregnant women were turned away from U.S. emergency rooms spiked in 2022 after the U.S. Supreme Court overturned Roe v. Wade." Sara Rosenbaum, a professor of health law at George Washington University, says that pregnant patients have “become radioactive to emergency departments.”