women

medicine

Are More Women Physicians Leaving Medicine as Pandemic Surges?

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

For mid-career oncologist Tanya Wildes, MD, the pandemic was the last straw. In late September, she tweeted: “I have done the academically unfathomable: I am resigning my faculty position without another job lined up.”

She wasn’t burned out, she insisted. She loved her patients and her research. But she was also “100% confident” in her decision and “also 100% sad. This did not have to happen,” she lamented, asking not to disclose her workplace for fear of retribution.



Dr Tanya Wildes and family

Being a woman in medicine “is a hard life to start with,” Wildes told Medscape Medical News. “We all have that tenuous balance going on and the pandemic made everything just a little bit harder.”

She describes her pre-pandemic work-life balance as a “Jenga tower, with everything only just in place.” But she realized that the balance had tipped, when after a difficult clinic she felt emotionally wrung-out. Her 11-year-old son had asked her to help him fly his model airplane. “I told him, ‘Honey, I can’t do it because if it crashes or gets stuck in a tree…you’re going to be devastated and I have nothing left for you.’ “

This was a eureka moment, as “I realized, this is not who I want to be,” she says, holding back tears. “Seventy years from now my son is going to tell his grandchildren about the pandemic and I don’t want his memory of his mom to be that she couldn’t be there for him because she was too spent.”

When Wildes shared her story on Twitter, other women oncologists and physicians responded that they too have felt they’re under increased pressure this year, with the extra stress of the pandemic leading others to quit as well.

The trend of doctors leaving medicine has been noticeable. A July survey from the Physicians Foundation found that roughly 16,000 medical practices had already closed during the pandemic, with another 8000 predicted to close within the next year.

“Similar patterns” were evident in another analysis by the Larry A. Green Center and the Primary Care Collaborative, as reported by The New York Times. In that survey, nearly one fifth of primary care clinicians said “someone in their practice plans to retire early or has already retired because of COVID-19,” and 15% say “someone has left or plans to leave the practice.” About half said their mental exhaustion was at an all-time high, the survey found.



Dr Monica Bertagnolli

“COVID-19 is a burden, and that added burden has tipped people over the edge of many things,” acknowledges Monica Bertagnolli, MD, chief of the Division of Surgical Oncology at Brigham and Women’s Hospital in Boston and former president of the American Society of Clinical Oncology (ASCO).

“It has illustrated that we do have a lot of people who are working kind of on the edge of not being able to handle everything,” she says.

While many

Read More
medicine

What Kamala Harris Can Teach Women in Medicine

No matter which presidential candidate you voted for or which political party you belong to, we women should stand together unified and proud in knowing that for the first time, a woman is going to Washington, D.C., to serve as the vice president of our great nation.

It is truly a historic moment for all American women and makes the possibility of a woman as president of the United States one day so much more plausible. (It’s something I’ve dreamt of seeing ever since I was a little girl.) And even more historic is that Vice President-elect Kamala Harris is a Black woman with a multicultural background, the daughter of an Indian mother and a Jamaican father.

In an interview, Harris quoted her mother as saying, “Kamala, you may be the first to do many things, but make sure you’re not the last.”

While Kamala Harris has shattered the glass ceiling for women all the way to the vice-presidency, we can’t allow there to be only the occasional unicorns who make it to positions of power.

As her mother advised Kamala, the same thing applies to us in medicine. Just because we have a few women doctors in national, regional, and organizational leadership positions or in traditionally male-dominated fields within medicine, such as neurosurgery, for example, we must be careful not to think women in medicine have arrived.

We must continue to work to create gender equity as here is where we stand today: A significant gender pay gap still exists in medicine where women doctors earn up to 33% less than their male counterparts. Even though women make up 36% of practicing doctors in the country, only 15% of women doctors are department chairs. Among women doctors who are also mothers, 78% felt discrimination. All of this is leading to 48% of women doctors reporting burnout, and 22% of female physicians admitted thoughts of suicide this year right before the pandemic hit our shores.

As a nation, we cannot afford to lose doctors to professional burnout and suicide, especially in the midst of a global pandemic worsening and hitting record numbers throughout our country in recent weeks.

There is no doubt that a leaky leadership pipeline in medicine exists, and the physician community needs to make sure that more women come through the ranks. We need #HeForShe allies to ensure that any qualified and interested women should have leadership opportunities available to them. And for those women doctors in leadership positions already, they have a responsibility to see that more women can serve in those roles in the future.

There certainly is much healing that needs to happen in our country after a polarizing and bitter election cycle, but because of Vice President-elect Kamala Harris, what I have is hope for the future of women and people of color. As President-elect Joe Biden did with Harris, it will take men and women doctors working together to bring about gender equity in medicine. But that path is possible if we

Read More
health

Five female fighter pilots test G-force suits modified for women

Nov. 3 (UPI) — Five female fighter pilots have recently tested G-force suits modified to better fit the frames of women and other body types besides the typical man, the U.S. Air Force said Tuesday.

The women pilots tested the modified version of the Advanced Technology Anti-Gravity Suit, from Oct. 26-30, at Eglin Air Force Base in Florida, according to a U.S. Air Force statement.

The suits have been in use since 2001 to protect pilots from G-force induced loss of consciousness during maneuvers in fighter aircraft, but it was developed primarily for standard men’s body types.

Along with women, pilots with “shorter” or “hard-to-fit” frames often struggled with the suits limited adjustability, according to the statement.

The suits were modified to include wider lacing panels in the waist, thigh and calf, which allow the suit to be easily adjusted for different body proportions.

An option was also added for a “darted,” tailored, custom waist that does not reduce performance of the waist bladder that inflates during high-G maneuvers.

“In the past, some pilots with a shorter torso have had issues with ATAGS that were too large riding up and causing bruising on the rib cases, while pilots who are hard-to-fit may have had one size that fits through the legs, but need a smaller size in the waist,” Charles Cruze, Air Force Life Cycle Management Center Human Systems Division engineer, said in a press release.

“Now, the waist can be darted up 3.75 inches, allowing for a more custom and accurate fit, preventing both of those issues,” Cruze said.

The flight testing began with the 46th Test Squadron at Eglin Air Force Base after the AFLMC successfully conducted endurance testing. The 96th Test Wing provided engineering and test planning expertise.

The 85th Test and Evaluation Squadron executed nearly 20 sorties in F-16 D-model aircraft to test the modified ATAGS.

One of the pilots in each of the sorties wore standard ATAGS in case there was an issue with the modified one. Pilots did low- and high-G maneuvers to evaluate the modified ATAGS.

“These tests are important because they will ultimately increase the lethality of those who no longer have their mask slip down during a sortie, their G-suit crunch under their waist, or the extra fabric of a too big anti-exposure suit get in the way of their movements in the jet,” said Capt. Brittany Trimble, an F-16 Fighting Falcon instructor pilot.

“These don’t seem like big issues, but everything counts in the air, and having gear that fits and works as intended should be the standard,” Trimble said.

Pilots were also asked to evaluate the modified ATAGS “during regular activities like sitting, standing, walking and climbing into and out of the aircraft,” 46th Test Squadron lead test engineer Sharon Rogers said.

Rogers said the squadron will provide test reports once flight testing is finished.

The modified ATAGS are expected to be given to the pilots and aircrew who need it within a year or two.

Maj. Shanon Jamison,

Read More
health

Pregnant women with coronavirus at higher risk of severe illness, death, CDC finds

Pregnant women who contract the coronavirus are more at risk for severe illness and death than non-pregnant women, a Centers for Disease Control and Prevention (CDC) analysis found. The agency has previously warned that pregnant people might be at an increased risk for severe illness from COVID-19, but research is ongoing.

The new report, issued Monday, analyzed data collected from over 400,000 women ages 15-44 with symptomatic COVID-19.

Of the 409,462 women with symptomatic coronavirus, 23,434 were pregnant.

CORONAVIRUS FACE MASKS AT POLLS ENCOURAGED, BUT NOT REQUIRED IN SOME STATES

“After adjusting for age, race/ethnicity, and underlying medical conditions, pregnant women were significantly more likely than were non-pregnant women to be admitted to an intensive care unit, receive ventilation, receive extracorporeal membrane oxygenation and die,” the report said.

The CDC said the findings may be due to the physiologic changes associated with pregnancy.

The CDC said the findings may be due to the physiologic changes associated with pregnancy.
(iStock)

The CDC said the findings may be due to the physiologic changes associated with pregnancy, including increased heart rate and oxygen consumption, decreased lung capacity, immunity changes and increased risk for thromboembolic disease.

POSTPARTUM DEPRESSION MAY LAST 3 YEARS AFTER CHILDBIRTH, STUDY FINDS

Separately, the analysis also found racial and ethnic disparities in both risks for infection and disease severity among pregnant women, “indicating a need to address potential drivers of risk in these populations,” the report said.

The health agency said pregnant women should be counseled about the importance of seeking prompt medical care if they develop symptoms of coronavirus, and that there should be a strong emphasis on coronavirus prevention for pregnant women at each medical appointment.

OVER HALF OF CORONAVIRUS-INFECTED PREGNANT WOMEN SHOWED NO SYMPTOMS, CDC FINDS

“To minimize the risk for acquiring SARS-CoV-2 infection, pregnant women should limit unnecessary interactions with persons who might have been exposed to or are infected with SARS-CoV-2, including those within their household, as much as possible,” the CDC said. “When going out or interacting with others, pregnant women should wear a mask, social distance, avoid persons who are not wearing a mask, and frequently wash their hands.”

CLICK HERE FOR COMPLETE CORONAVIRUS COVERAGE 

The CDC also advised pregnant women stay up to date with flu shots and prenatal care.

Source Article

Read More
health

Pregnant women with Covid-19 face higher risk of severe illness and death, study says

Pregnant women infected with the coronavirus are more likely to become severely ill and die from Covid-19, and they’re at increased risk for premature delivery, according to a pair of reports released Monday by the US Centers for Disease Control and Prevention.





© Shutterstock


Although the overall risk of severe illness or death remains low, CDC researchers found that pregnant women with coronavirus are more likely to need intensive care, ventilation and heart and lung support than non-pregnant women with the virus.

A separate report found that the rate of preterm birth, when a baby is born before 37 weeks of pregnancy, is 12.9% among women with coronavirus, compared to 10.2% among the general population.

The new research adds to a growing body of evidence that pregnant women are at increased risk when it comes to coronavirus, said Dr. Denise Jamieson, chair of the gynecology and obstetrics department at Emory University School of Medicine.

“It also demonstrates that their infants are at risk, even if their infants are not infected, they may be affected,” Jamieson noted on a call with reporters Monday.

Increased risk for severe illness and death

For one of the reports, researchers reviewed data on 461,825 women between the ages of 15 and 44 who tested positive for Covid-19 between January 22 and October 3. They focused only on those who experienced coronavirus symptoms.

The team adjusted for outside factors and found that pregnant women were more likely to need intensive care, with 10.5 per 1,000 pregnant women admitted to the ICU, compared to 3.9 per 1,000 women who aren’t pregnant.

Pregnant women were 3 times more likely to need help breathing with invasive ventilation than women who aren’t pregnant. Similarly, they were at greater risk of requiring lung and heart support with oxygenation.

They were also more likely to die, with 1.5 deaths per 1,000 pregnant women, compared to 1.2 per 1,000 women who aren’t pregnant.

In keeping with trends seen across the general population, researchers found some racial and ethnic minorities had an even greater potential for infection or severe disease. Among pregnant women, Hispanic women were 2.4 times more likely to die and Asian and Native Hawaiian/ Pacific Islander women had a more pronounced risk for ICU admission, they found.

The team noted that regardless of whether they were pregnant, women over 35 were more likely to experience severe illness.

The researchers said that the greater probability for severe illness among pregnant women might be due to physiological changes in pregnancy, including increased heart rate and decreased lung capacity.

“To reduce the risk for severe illness and death from COVID-19, pregnant women should be counseled about the importance of seeking prompt medical care if they have symptoms and measures to prevent SARS-CoV-2 infection should be strongly emphasized for pregnant women and their families during all medical encounters, including prenatal care visits,” the team wrote.

Risk of preterm delivery and infant infection

Pregnant women with coronavirus infection were also more likely to deliver babies

Read More
health

CDC: Pregnant women with COVID-19 have higher risk for preterm birth

Nov. 2 (UPI) — Pregnant women infected with COVID-19 are about 25% more likely to deliver their babies preterm, according to data released Monday by the U.S. Centers for Disease Control and Prevention.

About 13% of babies born to mothers with the disease were delivered preterm, or at less than 37 weeks, the data showed.

Just over 10% of babies in the United States are born preterm, according to the CDC.

“The proportion of preterm live births among women with [COVID-19] infection during pregnancy was higher than that in the general population in 2019, suggesting that pregnant women with [the disease] infection might be at risk for preterm delivery,” agency researchers wrote.

Still, the findings are “preliminary and describe primarily women with second and third trimester infection, and … subject to change pending completion of pregnancy for all women in the cohort,” they said.

For the analysis, the CDC researchers reviewed data on pregnancy and infant outcomes among 5,252 women with laboratory-confirmed COVID-19 from 15 states and Puerto Rico reported between March 29 and Oct. 14.

Among 3,912 live births with known gestational age, 12.9% were preterm, the agency said.

However, fewer than 3% of infants for whom test results were available had evidence of the virus, and most of them were born to mothers who had been infected within one week of delivery, the agency said.

Among 610 infants with reported test results, 2.6% tested positive for COVID-19, the data showed.

Previous studies have shown that pregnant women are unlikely to pass the disease on to their children.

However, data released by the CDC in June indicated that expecting mothers may be at increased risk for severe illness from the virus.

These concerns appear to have been confirmed in a separate analysis the agency released Monday, which found that pregnant women infected with COVID-19 were more than twice as likely to require treatment in a hospital intensive care unit and nearly three times as likely to need mechanical ventilation than “non-pregnant” women.

However, “the absolute risks for severe outcomes for women were low,” according to the CDC.

“Pregnant women were at increased risk for severe COVID-19-associated illness,” the CDC researchers said.

“To reduce the risk for severe illness and death from COVID-19, pregnant women should be counseled about the importance of seeking prompt medical care if they have symptom sand measures to prevent [coronavirus] infection should be strongly emphasized for pregnant women and their families,” they said.

Source Article

Read More
health

Pregnant Women Should Be Extra Careful Against COVID-19 | Healthiest Communities

A recent story in The Washington Post reported on the more than 700 women who’d tested positive for the novel coronavirus and given birth at the BYL Nair Charity Hospital in Mumbai, India. The hospital is a part of a group called PregCovid, which collects data regarding pregnancy and COVID-19.

Here in the United States, health departments reporting cases of COVID-19 during pregnancy to the Centers for Disease Control and Prevention can provide additional information to help us understand its effects during this critical period in a woman’s – and her child’s – life. Yet despite the growing pool of data about the coronavirus, our understanding of the effects of COVID-19 on pregnant women remains limited, which is troubling given that many states are struggling with the pandemic and the high stakes involved for mothers.

While researchers continue to collect and interpret available data, it is important that pregnant women be especially vigilant to protect themselves and their babies, including by – at minimum – taking basic precautions such as practicing social distancing and wearing masks.

As an infectious disease physician who recently gave birth to my new daughter, being pregnant during the coronavirus pandemic posed significant challenges both physically and intellectually. In my field, we practice evidence-based medicine, but with the novel coronavirus, we continue to learn more each day and to update our recommendations based on new information. For now, the evidence indicates that the best tools to help contain the spread of COVID-19 are social distancing and mask-wearing.

As states have opened up and restrictions have been relaxed, however, people may believe that the risks posed by the coronavirus are diminished and go about their lives without taking these precautions. Doing so may be particularly dangerous for pregnant women: Data published in a CDC report just this week found that expectant mothers with symptomatic COVID-19 were more likely than other infected women to end up in the ICU, to require invasive ventilation and to die.

In addition, the coronavirus may cause poor pregnancy outcomes such as preterm birth. While the CDC may update its information as more becomes available, these possibilities are concerning.

Meanwhile, one of the growing hopes to prevent the coronavirus’ spread is a vaccine. Yet the release of one may not be a panacea for pregnant women, who have been excluded from clinical trials. Given this, it will take some time before we understand if these vaccines are safe for mothers and their babies, so pregnant women may be advised against getting a vaccine should one otherwise become available.

Expectant mothers who previously had COVID-19 also aren’t necessarily in the clear, as the current science is still evolving regarding immunity from COVID-19 once a person has recovered from the disease. Though rare, there have been cases of people reportedly becoming reinfected, and even a recent reported case of someone who died after reinfection.

Given the potential risk associated with the virus, some health care professionals have separated moms from their newborns

Read More
health

Social Isolation Tied to High Blood Pressure in Women

Women who are socially isolated have an increased risk for high blood pressure, researchers report. But men, not so much.

Scientists used data on 28,238 Canadian men and women aged 45 to 85 who are participating in a large continuing study on aging.

The researchers found that compared with married women, single women had a 28 percent higher risk of hypertension, divorced women a 21 percent higher risk, and widowed women a 33 percent higher risk.

Social connections were also significant. Compared with the one-quarter of women with the largest social networks — which ranged from 220 to 573 people — those in the lowest one-quarter, with fewer than 85 connections, were 15 percent more likely to have high blood pressure.

The associations were different, and generally weaker, in men. Men who lived alone had a lower risk of hypertension than men with partners, but the size of men’s social networks, or their participation in social activity, was not significantly associated with high blood pressure.

The study, in the Journal of Hypertension, controlled for many factors that affect blood pressure, including age, education, smoking, alcohol use and depression.

The senior author, Annalijn I. Conklin, an assistant professor at the University of British Columbia, said that the most important finding is that social ties seem to be more meaningful for women than for men. “Social ties matter for cardiovascular health,” she said, “and they matter more for women.”

Source Article

Read More
health

Polish Pro-choice Campaigner Helps Women Bypass Abortion Law

Seven years ago, Natalia Broniarczyk had an abortion despite stringent Polish legislation against it.

Now, she is helping other women do the same and taking part in mass protests against a further tightening of an already highly restrictive law.

“I’m angry,” the 36-year-old campaigner told AFP as she prepared for the latest demonstration in Warsaw.

Protests have been raging nationwide since a ruling from the Constitutional Court on October 22 that would allow abortions only in cases of rape, incest and when the mother’s life is at risk.

Until then, terminations had also been allowed in case of severe foetal anomalies but the court ruled that was “incompatible” with the constitution.

“The verdict made me feel like my country was spitting in my face. I broke down in tears, powerless,” Broniarczyk said.

Natalia Broniarczyk had an abortion seven years ago Natalia Broniarczyk had an abortion seven years ago Photo: AFP / Wojtek RADWANSKI

The campaigner adds she was surprised by the timing of the verdict, as well as by the government’s warnings to stop people taking to the streets in protest.

“We expected a more restrictive law, but we did not expect it to happen right in the middle of a pandemic.

“Or that they would treat us and our lives and problems like objects. That they would ask us to stay home, to make decisions for us without us,” she said.

Broniarczyk had her abortion seven years ago because she was not ready to start a family.

“I didn’t feel financially secure and didn’t think it was the right time,” she said.

Warsaw's streets flooded with pro-choice demonstrators Warsaw’s streets flooded with pro-choice demonstrators Photo: AFPTV / Jaap ARRIENS

She did not qualify for a surgical abortion under the law and could not afford to go abroad for the procedure.

She tried to order abortion pills abroad but Polish customs blocked her order from going through.

Medical abortion is in a grey zone in Poland, neither authorised nor banned by law.

In the end, a Polish organisation helped her obtain the pills required.

“The woman I talked to had also had a medical abortion and told me how it had gone for her. She helped me prepare for it,” Broniarczyk said.

Today she is giving back by providing support to other women as a member of the organisation “Abortion Dream Team” — whose number is one of the ones being displayed prominently by protesters at demonstrations.

In the case of women seeking medical abortions, Broniarczyk provides them with the information required to obtain pills.

She also helps women who decide to terminate their pregnancies abroad, in countries such as Britain, Germany and the Netherlands.

Poland sees fewer than 2,000 legal abortions every year. Women’s groups estimate that an additional 200,000 women abort either illegally or abroad.

It took Broniarczyk a few years to be able to discuss the abortion.

But she does not regret it, saying that over time she has come to see it as a “liberating experience”.

“I understood that I could decide for myself about my life, even while living

Read More
health

Study: Postpartum depression can linger for years for some women

Many women have depression symptoms after giving birth, but for some postpartum depression hangs on for years, a U.S. government study finds.

Of nearly 4,900 new mothers researchers followed, one-quarter had depression symptoms at some point in their child’s first three years. And for about half of them, the symptoms either started early on and never improved, or took time to emerge.

It all suggests women should be screened for postpartum depression over a longer period, said lead researcher Diane Putnick.

“Based on our data, I’d say screening could continue for two years,” said Putnick, a staff scientist at the U.S. National Institute of Child Health and Human Development, in Bethesda, Md.

Right now, the American Academy of Pediatrics recommends pediatricians take on the task of postpartum depression screening. It says they should screen mothers for symptoms at their baby’s routine check-ups during the first six months of life.

That’s both because postpartum depression usually arises in that period, and because babies have frequent check-ups during those months, according to Putnick. So pediatricians are, in a sense, best positioned to catch moms’ depression symptoms, she said.

On the other hand, pediatricians are also limited in what they can do. Mothers are not their patients, so they do not have access to medical records to get the bigger picture — including whether a woman has a history of clinical depression. And they can only suggest that mothers follow-up with their own provider.

“What happens after women are screened?” said Dr. Rahul Gupta, chief medical and health officer for the nonprofit March of Dimes.

“The recommendation is excellent,” he said, referring to the AAP advice to pediatricians. “It’s a great starting point.”

But women’s primary care doctors need to be involved, Gupta said, particularly since postpartum depression can persist, or surface relatively later after childbirth.

For the new study, published online this week in Pediatrics, Putnick’s team used data on 4,866 women in New York state. All took part in a research project on infertility treatment and its impact on child development.

During the study, mothers completed a five-question survey on depression symptoms when their baby was 4 months old, and then again when their child was 1, 2 and 3 years of age.

The study was done before the AAP recommendations came out, Putnick said, and it’s not clear what kind of screening or follow-up women might have gotten from their own providers.

Based on the study screening, new mothers followed four different trajectories: Three-quarters had few depressive symptoms throughout the three-year period; almost 13% had symptoms when their baby was 4 months old, but improved afterward; 8% initially had few symptoms, but developed more as their child grew older; and 4.5% had persistent depression symptoms.

Putnick stressed that the women only screened positive for symptoms. They were not diagnosed with clinical depression, and it’s unclear how many would need treatment, such as talk therapy or medication.

But the findings show that postpartum depression symptoms can be long-lasting, or arise relatively

Read More