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Tag: Prenatal care

  • Early prenatal care, considered best for moms and babies, is on the decline in the US, data shows

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    Early prenatal care improves the chances of having a healthy pregnancy and baby. But a new federal report shows it’s been on the decline.The share of U.S. births to women who began prenatal care in the first trimester dropped from 78.3% in 2021 to 75.5% in 2024, according to data released by the Centers for Disease Control and Prevention on Thursday.Meanwhile, starting care later in pregnancy or getting no care at all has been on the rise. Prenatal care beginning in the second trimester rose from 15.4% to 17.3%, and starting care in the third trimester or getting no care went from 6.3% to 7.3%.“We know that early engagement in prenatal care is linked to better overall health outcomes,” said Dr. Clayton Alfonso, an OB-GYN at Duke University in North Carolina. When patients delay medical care during pregnancy, “we’ve missed that window to optimize both fetal and maternal care.”While the trend identified in the report held for nearly all racial and ethnic groups, the decrease in early prenatal care was higher for moms in minority groups. For example, first-trimester care dropped from 69.7% in 2021 to 65.1% in 2024 for Black mothers. Getting late or no prenatal care raises the risk of maternal mortality, which is much higher among Black mothers.Michelle Osterman, lead author of the report, said the overall findings represent a shift. Between 2016 and 2021, the timing of when U.S. women started prenatal care had been improving.The earlier prenatal visits begin, doctors said, the earlier problems can be caught. Visits give doctors a chance to share health guidance, and can include blood pressure checks, screenings, blood tests, physical exams and ultrasound scans.The report doesn’t provide reasons why prenatal care is starting later. But the proliferation of maternity care deserts across the nation is a growing concern, said Dr. Grace Ferguson, an OB-GYN in Pittsburgh.Many hospitals have shut down labor and delivery units “and the prenatal care providers that work at those hospitals also have probably moved,” said Ferguson, who was not involved with the report.A 2024 March of Dimes report found that more than 35% of U.S. counties are maternity care deserts, meaning there’s no birthing facility or obstetric provider. Women living in these areas receive less prenatal care, the report showed.Ferguson, who provides abortions as part of her OB-GYN care, said post-Roe v. Wade abortion restrictions may play a part because some obstetricians are choosing not to practice in states with more restrictive laws.Alfonso, who was not involved in the CDC report, said he also suspects that access issues for patients are pushing prenatal care later, particularly in rural areas. Patients may have to travel farther to get to appointments and may struggle to find a practice that accepts their insurance, particularly if they have Medicaid.Doctors fear that things could get worse.“If this trend continues,” Alfonso said, “I worry about kind of what that would mean for morbidity and mortality for our moms.”

    Early prenatal care improves the chances of having a healthy pregnancy and baby. But a new federal report shows it’s been on the decline.

    The share of U.S. births to women who began prenatal care in the first trimester dropped from 78.3% in 2021 to 75.5% in 2024, according to data released by the Centers for Disease Control and Prevention on Thursday.

    Meanwhile, starting care later in pregnancy or getting no care at all has been on the rise. Prenatal care beginning in the second trimester rose from 15.4% to 17.3%, and starting care in the third trimester or getting no care went from 6.3% to 7.3%.

    “We know that early engagement in prenatal care is linked to better overall health outcomes,” said Dr. Clayton Alfonso, an OB-GYN at Duke University in North Carolina. When patients delay medical care during pregnancy, “we’ve missed that window to optimize both fetal and maternal care.”

    While the trend identified in the report held for nearly all racial and ethnic groups, the decrease in early prenatal care was higher for moms in minority groups. For example, first-trimester care dropped from 69.7% in 2021 to 65.1% in 2024 for Black mothers. Getting late or no prenatal care raises the risk of maternal mortality, which is much higher among Black mothers.

    Michelle Osterman, lead author of the report, said the overall findings represent a shift. Between 2016 and 2021, the timing of when U.S. women started prenatal care had been improving.

    The earlier prenatal visits begin, doctors said, the earlier problems can be caught. Visits give doctors a chance to share health guidance, and can include blood pressure checks, screenings, blood tests, physical exams and ultrasound scans.

    The report doesn’t provide reasons why prenatal care is starting later. But the proliferation of maternity care deserts across the nation is a growing concern, said Dr. Grace Ferguson, an OB-GYN in Pittsburgh.

    Many hospitals have shut down labor and delivery units “and the prenatal care providers that work at those hospitals also have probably moved,” said Ferguson, who was not involved with the report.

    A 2024 March of Dimes report found that more than 35% of U.S. counties are maternity care deserts, meaning there’s no birthing facility or obstetric provider. Women living in these areas receive less prenatal care, the report showed.

    Ferguson, who provides abortions as part of her OB-GYN care, said post-Roe v. Wade abortion restrictions may play a part because some obstetricians are choosing not to practice in states with more restrictive laws.

    Alfonso, who was not involved in the CDC report, said he also suspects that access issues for patients are pushing prenatal care later, particularly in rural areas. Patients may have to travel farther to get to appointments and may struggle to find a practice that accepts their insurance, particularly if they have Medicaid.

    Doctors fear that things could get worse.

    “If this trend continues,” Alfonso said, “I worry about kind of what that would mean for morbidity and mortality for our moms.”

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  • Parenting 101: Namaste, baby! Studies show mental health benefits of yoga for moms-to-be

    Parenting 101: Namaste, baby! Studies show mental health benefits of yoga for moms-to-be

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    Michelle Cadieux, 36, sets up her yoga blocks, strap and bolster, and settles onto her cushioned yoga mat at Morpho Bleu, a yoga studio located in Notre-Dame-de-Grâce.

    As the sunlight streams through the large window, a glow is cast over the space. Soft instrumental music plays at a distance and the scent of eucalyptus and lavender fills the air, evoking a sense of relaxation.

    With a hand placed on her growing belly, Cadieux watches as more expecting mothers gather on their mats.

    “Welcome, everyone,” says prenatal yoga instructor Lauren Enright. “So, how are we feeling? Are there any new developments from last week?”

    The women take turns sharing their thoughts and experiences for 15-minutes before diving into adaptations of the cat and cow, the warrior, and various other yoga poses for the remaining hour.

    “What I do in my classes is beyond just yoga,” Enright says. “It also serves as a community where we have discussion circles.”

    Enright explains that her students appreciate this format – especially those who struggle with pregnancy-related anxiety or depression, like Cadieux.

    “Pregnancy can be stressful, especially if you’re already an anxious person,” Cadieux says. “It’s a very fragile time. There’s a lot of uncertainty.”

    And many expecting mothers can relate to this feeling.

    According to a research review article, 20 to 40 per cent of pregnant women have reported feelings of anxiety or depression during pregnancy, typically related to worry about fetal wellbeing, maternal illnesses, social and financial support and mortality. This is concerning as perinatal anxiety and depression can contribute to fetal growth restriction, preterm delivery, or low birth weight.

    Yoga is one way that Cadieux, and many other moms-to-be, choose to manage their symptoms of mental illness during the perinatal period – and research proves its effectiveness.

    A systematic review from 2020 found that prenatal yoga may decrease stress levels, anxiety scores and depression scores, and may increase maternal immunity and emotional-wellbeing.

    Another research study found that prenatal yoga classes are helpful in self-managing psychological distress and in developing a sense of community among other pregnant women.

    The study’s corresponding author Dr. Patricia Kinser explains that prenatal yoga involves focused movements, breathing exercises, mindfulness practice and a sense of community.

    “All of that together can be helpful mechanisms by which yoga practice could decrease symptoms not only of depression, but also of anxiety,” she says.

    According to Dr. Kinser, anxiety and depression share a common theme: the sense of overwhelm. With anxiety, this may look like an overwhelming sense of concern or fear; whereas with depression, this may look like an overwhelming sense of sadness or generalized blue.

    Some describe anxiety as being trapped in a dark room, unable to find the exit as a heavy rock sits on your chest; while depression is often described as feeling like you’re buried inside a deep, dark pit.

    Women will usually experience an overlap between the two during the perinatal period, explains Dr. Kinser.

    “Most people are not just depressed or just anxious, but there’s going to be some flow between those symptoms,” she says. “It’s the constellation of symptoms that can be debilitating.”

    Dr. Kinser notes that prescription medication and psychotherapy are “powerful” and “important” tools for mental health, but she argues that prenatal yoga can act as a complementary treatment that is accessible, safe and effective for pregnant women.

    Mindful Movements & Breathing for Two

    As the moms-to-be mindfully move their bodies through different yoga poses – which help strengthen their muscles and keep their bodies mobile – they root themselves in their breath, according to Enright.

    In yoga, breath is an anchor: it pulls the mind away from past regrets or future anxieties, and instead, it focuses on the mind in the present moment.

    This has been proven to positively impact autonomic nervous system imbalances and stress-related disorders, according to a review article.

    Yogic breathing refers to breathing into the diaphragm, the belly and then upper chest and breathing out in the reverse order – through the nose for both the inhale and exhale.

    Enright – who has an undergrad degree in Biology and a graduate degree in Neuroscience – explains that breathing in this way can help regulate the nervous system and reduce anxiety.

    “It helps put the gas on the parasympathetic nervous system, which is responsible for down regulation and the rest and digest response,” she says.

    She adds that focusing on breathing is especially important for pregnant women as they often experience shortness of breath.

    As a baby grows inside the human body, it pushes up on the diaphragm – the main muscle responsible for respiration. This makes breathing more challenging as it results in less space for the lungs to expand, according to Enright.

    “When we work on breathing, it’s really helpful to create more space in the body and it’s helpful to just bring a little bit more calm if there’s anxiety,” she says.

    But beyond the yoga poses and breathing exercises, prenatal yoga fosters a sense of community for women who often feel isolated and alone.

    Nama-Stay Together: A Sense of Community

    The National Alliance on Mental Health states that a sense of community and connection provide three benefits that are critical for mental health: belonging, support and purpose.

    According to Dr. Kinser, ‘connection’ is one of the most important components of participating in prenatal yoga classes – and Cadieux agrees.

    “Pregnancy can be very isolating,” Cadieux says. “It’s really nice to connect with other people who are going through the exact same thing.”

    Nathalie Ouellet, a new mom who practiced yoga during pregnancy, shares a similar experience.

    “Although many of my friends had been pregnant or had babies, I didn’t have a friend who was exactly in the same spot as I was at that specific time,” she says. “It definitely made me feel welcome and made me feel that I was in a safe space.”

    While many community-based activities may exist for expecting mothers, Dr. Kinser argues that prenatal yoga is the most effective as it helps pregnant women “in a very holistic realm.”

    “It wasn’t just hitting the physical. It wasn’t just hitting the mental. It wasn’t just a breathing practice. It wasn’t just a relaxation,” she says. “It was the whole package. It’s that combination that can be so powerful for people.”

    And the real benefit of yoga translates outside the class, according to Cadieux.

    “You start to take that mindset shift and do those breathing techniques in your real life, every day,” she says.

    As Cadieux rolls up her cushioned yoga mat and walks out the door alongside other moms-to-be at the end of the class, she leaves feeling less anxious and more supported.

    “I always feel a sense of peace and calm,” she says.

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    By Melissa Migueis

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  • Boston mayor will formally apologize to Black men wrongly accused in 1989 Carol Stuart murder

    Boston mayor will formally apologize to Black men wrongly accused in 1989 Carol Stuart murder

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    BOSTON — It was a notorious murder that rattled Boston to its core, coarsened divisions in a city long riven along racial lines, and renewed suspicion and anger directed at the Boston Police Department by the city’s Black community.

    On Wednesday, Boston Mayor Michelle Wu plans to formally apologize on behalf of the city to two Black men, Alan Swanson and Willie Bennett, for their wrongful arrests following the 1989 death of Carol Stuart, whose husband, Charles Stuart, had orchestrated her killing. The Stuarts were white.

    Stuart blamed his wife’s killing — and his own shooting during what he portrayed as an attempted carjacking — on an unidentified Black gunman, leading to a crackdown by police in one of the city’s traditionally Black neighborhoods in pursuit of a phantom assailant.

    Charles Stuart said a Black man forced his way into their car as the couple left a birthing class at a city hospital on Oct. 23. The man ordered them to drive to the city’s Mission Hill neighborhood and robbed them before shooting Carol Stuart in the head and Charles in the chest, according to Charles.

    Carol Stuart, 29, died the following morning at the same hospital where the couple had attended birthing classes. The baby, delivered by cesarean section, survived just 17 days.

    Charles Stuart survived the shooting, with his description of a Black attacker eventually sparking a widespread Boston police “stop and frisk” crackdown of Black men in the neighborhood, even as some investigators had already come to doubt his story.

    During the crackdown, police first arrested Swanson before ruling him out, and then took Bennett into custody. Stuart would later identify Bennett in late December. But by then, Stuart’s story had already begun to fall apart. His brother, Matthew, confessed to helping to hide the gun used to shoot Carol Stuart.

    Early in the morning of Jan. 4, 1990, Stuart, 30, parked his car on the Tobin Bridge that leads in and out of Boston and jumped, plunging to his death. His body was recovered later that day.

    The aggressive handling of the investigation created deep wounds in the city and further corroded relations between Boston police and the Black community.

    Bennett, who denied having anything to do with Carol Stuart’s death, unsuccessfully sued the police department, claiming that officers violated his civil rights by coercing potential witnesses against him.

    A recent retrospective look at the murder by The Boston Globe and an HBO documentary series has cast a new spotlight on the crime, the lingering memories of the Black community, and their treatment by the hands of police who dragged innocent residents into a futile search.

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  • Volunteer medical students are trying to fill the health care gap for migrants in Chicago

    Volunteer medical students are trying to fill the health care gap for migrants in Chicago

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    CHICAGO — Using sidewalks as exam rooms and heavy red duffle bags as medical supply closets, volunteer medics spend their Saturdays caring for the growing number of migrants arriving in Chicago without a place to live.

    Mostly students in training, they go to police stations where migrants are first housed, prescribing antibiotics, distributing prenatal vitamins and assessing for serious health issues. These student doctors, nurses and physician assistants are the front line of health care for asylum-seekers in the nation’s third-largest city, filling a gap in Chicago’s haphazard response.

    “My team is a team that shouldn’t have to exist, but it does out of necessity,” said Sara Izquierdo, a University of Illinois Chicago medical student who helped found the group. “Because if we’re not doing this, I’m not sure anyone will.”

    More than 19,600 migrants have come to Chicago over the last year since Texas Gov. Greg Abbott began sending buses to so-called sanctuary cities. The migrants wait at police stations and airports, sometimes for months, until there’s space at a longer-term shelter, like park district buildings.

    Once in shelter, they can access a county clinic exclusively for migrants. But the currently 3,300 people in limbo at police stations and airports must rely on a mishmash of volunteers and social service groups that provide food, clothes and medicine.

    Izquierdo noted the medical care gap months ago, consulted experienced doctors and designed a street-medicine model tailored to migrants’ medical needs. Her group makes weekly visits to police stations, operating on a shoestring budget of $30,000, mostly used for medication.

    On a recent Saturday, she was among dozens of medics at a South Side station where migrants sleep in the lobby, on sidewalks and an outdoor basketball court. Officers didn’t allow the volunteers in the station so when one patient requested privacy, their doctor used his car.

    Abrahan Balizario saw a doctor for the first time in five months.

    The 28-year-old had a headache, toothache and chest pain. He recently arrived from Peru, where he worked as a driver and at a laundromat but couldn’t survive. He wasn’t used to the brisk Chicago weather and believed sleeping outdoors exacerbated his symptoms.

    “It is very cold,” he said. “We’re almost freezing.”

    The volunteers booked him a dental appointment and gave him a bus pass.

    Many migrants who land in Chicago and other U.S. cities come from Venezuela where a social, political and economic crisis has pushed millions into poverty. More than 7 million have left, often risking a dangerous route by foot to the U.S. border.

    The migrants’ health problems tend to be related to their journey or living in crowded conditions. Back and leg injuries from walking are common. Infections spread easily. Hygiene is an issue. There are few indoor bathrooms and outdoor portable toilets lack handwashing stations. Not many people carry their medical records.

    Most also have trauma, either from their homeland or from the journey itself.

    “You can understand the language, but it doesn’t mean you understand the situation,” said Miriam Guzman, one of organizers and a fourth-year medical student at UIC.

    The doctors refer patients to organizations that help with mental health but there are limitations. The fluid nature of the shelter system makes it difficult to follow-up; people are often moved without warning.

    Chicago’s goal is to provide permanent homes, which could help alleviate health issues. But the city has struggled to manage the growing population as buses and planes arrive daily at all hours. Mayor Brandon Johnson, who took office in May, calls it an inherited issue and proposed winterized tents.

    His administration has acknowledged the heavy reliance on volunteers.

    “We weren’t ready for this,” said Rey Wences Najera, first deputy of immigrant, migrant and refugee rights. “We are building this plane as we are flying it and the plane is on fire.”

    The volunteer doctors also are limited in what they can do: Their duffle bags have medications for children, bandages and even ear plugs after some migrants wanted to block out sirens. But they cannot offer X-rays or address chronic issues.

    “You’re not going to tell a person who has gone through this journey to stop smoking,” said Ruben Santos, a Rush University medical student. “You change your way of trying to connect to that person to make sure that you can help them with their most pressing needs while not doing some of the traditional things that you would do in the office or a big academic hospital.”

    The volunteers explain to each patient that the service is free but that they’re students. Experienced doctors, who are part of the effort, approve treatment plans and prescribe medications.

    Getting people those medications is another challenge. One station visit prompted 15 prescriptions. Working from laptops on the floor — near dozens of sleeping families — the doctors mapped out which medics would pick up medications the following day and how they’d find the recipients.

    Sometimes the volunteers must call for emergency help.

    Thirty-year-old Moises Hidalgo said he had trouble breathing. Doctors heard a concerning “crackling” sound, suspected pneumonia and called an ambulance.

    Hidalgo, who came from Peru after having left his native Venezuela more than a decade ago, once worked as a chef. He’s been walking around Chicago looking for jobs, but has been turned away without a work permit.

    “I’ve been trying to find work, at least so that I can pay to sleep somewhere, because if this isn’t solved, I can’t keep waiting,” he said.

    To stay warm while sleeping outside, he wore four layers of clothing; his loose pants cinched with a shoelace.

    The medics hope Chicago can formalize their approach. And they say they’ll continue to keep at it — for some, it’s personal.

    Dr. Muftawu-Deen Iddrisu, who works Advocate Illinois Masonic Medical Center, said he wanted to give back. Originally from Ghana, he attended medical school in Cuba.

    “I come from a very humble background,” he said. “I know how it feels. I know once sometime back someone did the same for me.”

    ___

    Associated Press video journalist Melissa Perez Winder contributed to this report.

    ___

    The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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  • EXPLAINER: Next steps for Black reparations in San Francisco

    EXPLAINER: Next steps for Black reparations in San Francisco

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    SAN FRANCISCO — San Francisco supervisors have backed the idea of paying reparations to Black people, but whether members will agree to lump-sum payments of $5 million to every eligible person or to any of the more than 100 other recommendations made by an advisory committee won’t be known until later this year.

    The idea of Black reparations is not new, but the federal government’s promise of granting 40 acres and a mule to newly freed slaves was never realized. It wasn’t until George Floyd, a Black man, was killed in police custody in 2020 that reparations movements began spreading in earnest across the country.

    The state of California and the cities of Boston and San Francisco are among jurisdictions trying to atone not just for chattel slavery, but for decades of racist policies and laws that systemically denied Black Americans access to property, education and the ability to build generational wealth.

    WHAT IS THE ARGUMENT FOR REPARATIONS IN SAN FRANCISCO?

    Black migration to San Francisco soared in the 1940s because of shipyard work, but racially restrictive covenants and redlining limited where people could live. When Black residents were able to build a thriving neighborhood in the Fillmore, government redevelopment plans in the 1960s forced out residents, stripped them of their property and decimated Black-owned businesses, advocates say.

    Today, less than 6% of Black residents in San Francisco are Black yet they make up nearly 40% of the city’s homeless population.

    Supporters include the San Francisco NAACP, although it said the board should reject the $5 million payments and focus instead on reparations through education, jobs, housing, health care and a cultural center for Black people in San Francisco. The president of the San Francisco branch is the Rev. Amos C. Brown, who sits on both the statewide and San Francisco reparations panels.

    WHAT IS THE ARGUMENT AGAINST REPARATIONS?

    Critics say California and San Francisco never endorsed chattel slavery, and there is no one alive today who owned slaves or was enslaved. It is not fair for municipal taxpayers, some of whom are immigrants, to shoulder the cost of structural racism and discriminatory government policies, critics say.

    An estimate from Stanford University’s Hoover Institution, which leans conservative, has said it would cost each non-Black family in San Francisco at least $600,000 in taxes to pay for the costliest of the recommendations: The $5 million per-person payout, guaranteed income of at least $97,000 a year for 250 years, personal debt elimination and converting public housing into condos to sell for $1.

    A 2022 Pew Research Center survey found 68% of U.S. respondents opposed reparations compared with 30% in favor. Nearly 80% of Black people surveyed supported reparations. More than 90% of Republicans or those leaning Republican opposed reparations while Democrats and those leaning Democratic were divided.

    HOW WILL SAN FRANCISCO PAY FOR THIS?

    It’s not clear. The advisory committee that made the recommendations says it is not its job to figure out how to finance San Francisco’s atonement and repair.

    That would be up to local politicians, two of whom expressed interest Tuesday in taking the issue to voters. San Francisco Supervisor Matt Dorsey said he would back a ballot measure to enshrine reparations in the San Francisco charter as part of the budget. Shamann Walton, the supervisor leading the charge on reparations, supports that idea.

    WHAT ARE SOME OF THE OTHER REPARATIONS RECOMMENDATIONS?

    Recommendations in education include establishing an Afrocentric K-12 school in San Francisco; hiring and retaining Black teachers; mandating a core Black history and culture curriculum; and offering cash to at-risk students for hitting educational benchmarks.

    Recommendations in health include free mental health, prenatal care and rehab treatment for impoverished Black San Franciscans, victims of violent crimes and formerly incarcerated people.

    The advisory committee also recommends prioritizing Black San Franciscans for job opportunities and training, as well as finding ways to incubate Black businesses.

    WHAT HAPPENS NEXT?

    There is no deadline for supervisors to agree on a path forward. The board next plans to discuss reparations proposals in September, after the San Francisco African American Reparations Advisory Committee issues a final report in June.

    WHAT ABOUT REPARATIONS FROM THE STATE?

    In 2020, California became the first state to form a reparations task force. But nearly two years into its work, it still has yet to make key decisions on who would be eligible for payment and how much. The task force has a July 1 deadline to submit a final report of its reparations recommendations, which would then be drafted into legislation for lawmakers to consider.

    The task force has spent multiple meetings discussing time frames and payment calculations for five harms experienced by Black people, including government taking of property, housing discrimination and homelessness and mass incarceration. The task force is also debating state residency requirements.

    Previously, the state committee voted to limit financial reparations to people descended from enslaved or freed Black people in the U.S. as of the 19th century.

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