Health

(NEW YORK) — Earlier this week, a federal judge in Colorado temporarily exempted a Catholic healthcare clinic from having to follow the state’s recent ban on abortion pill “reversal” treatment.

Gov. Jared Polis signed the ban as part of a series of bills Friday, becoming the first state in the U.S. to ban use of the treatment and furthering enshrining abortion access in Colorado.

However, Bella Health + Wellness, an anti-abortion clinic, sued, arguing the ban violates its constitutional rights, including the right to free speech and equal protection under the law.

Judge Daniel Domenico, a Trump appointee, agreed and issued the temporary halt as the litigation unfolds in court.

Even before the Supreme Court overturned Roe v. Wade this past summer, some states had enacted laws requiring doctors to inform patients that medical abortions could be reversed.

Experts say this so-called “reversal” is unfounded and could be potentially dangerous.

“It’s not just that [patients are] being sold snake oil, that somebody is giving them something in bad faith in an effort to somehow persuade them that they can save their pregnancy,” Dr. Spencer McClelland, an OBGYN at Denver Health, told ABC News. “It’s actually that the best data we have has raised enough concerns about it.”

How does medication abortion work?

To induce an abortion, or manage an early miscarriage, a combination of two pills — mifepristone and misoprostol — is used.

Mifepristone works by blocking progesterone, a hormone that the body needs to continue a pregnancy.

This causes the uterine lining to stop thickening and to break down, detaching the embryo. The second drug, misoprostol, taken 24 to 48 hours later, causes the uterus to contract and dilates the cervix, which will expel the embryo.

The Food and Drug Administration authorized mifepristone for medication abortion in September 2000 for up to seven weeks’ gestation, which was then extended to 10 weeks’ gestation in 2016.

However, the World Health Organization says the two drug-regimen can be taken up until the 12-week mark of pregnancy.

Medication abortions currently make up more than half of all abortions performed in the U.S., according to the Guttmacher Institute, a research group focusing on sexual and reproductive health.

McClelland says evidence shows that medication abortions are safe and effective.

“The two being used together makes the process over 95% effective in terms of just completing the abortion process and more importantly, has a really, really, really, really, really, really, really low complication rate,” he said.

What is abortion ‘reversal’?

So-called abortion pill “reversal” is heralded by anti-abortion groups as a tool for pregnant women who regret deciding to end their pregnancy.

The process involves giving the hormone progesterone — orally, vaginally or by injection — after it was blocked by mifepristone in an attempt to “outcompete” the effects of the pill.

Medical groups, including the American College of Obstetrics and Gynecologists and Planned Parenthood, do not support the regimen.

Why is it considered unsafe?

The ACOG has spoken against so-called “reversal,” calling the treatment “not backed by science” as well as “unproven and unethical.”

“As opposed to mifepristone, which has an amazing amount of studies about its usage, showing its safety and efficacy, the high-dose progesterone for the purpose of abortion reversal has a real paucity of evidence,” McClelland said.

The ACOG referenced a 2012 case study that proponents of abortion pill reversal have used, in which six women took mifepristone to end their pregnancies and then took varying doses of an injection of progesterone.

Of those women, four continued their pregnancies.

However, the ACOG says this is not evidence that giving progesterone allowed the pregnancies to continue because it is well-documented that mifepristone is effective with misoprostol, not on its own.

McClelland said this type a case study is different from a randomized controlled trial, in which something — in this case, a medication — is compared against a placebo to show that what scientists are seeing is in fact a result of this medication.

“The abortion reversal pill has a lot of case theories or case reports, and those are essentially just some groups of people publishing reports about what happened to their patients when they took this without being able to say that the reason that pregnancies continued at a certain rate was actually because of this medication,” he said. “Because if you compare them to people who didn’t take it, maybe you’d find out those pregnancies continued at the same rate. And it’s just a weaker study design.”

Another study, in 2019, examining medication abortion reversal was ended early due to safety concerns.

“A really surprising number of women experienced threatening hemorrhage and having to come to the hospital for emergency care after they were enrolled in this,” McClelland said. “What we can say for sure is they terminated the study early because they didn’t feel comfortable continuing the study.”

ACOG has also argued laws that require physicians to tell patients that medication abortion can be reversed “represent dangerous political interference and compromise patient care and safety.”

McClelland said these kinds of laws, which include a pregnant person being required to look at an ultrasound before they have an abortion, often have a façade as being in a patient’s best interest when it can be just the opposite.

“It’s definitely coercive or it implies some lack of support or lack of expertise in the person who’s counseling them about their abortion,” he said. “There are many, many techniques in this effort to reduce the number of people having abortions.”

With mifepristone potentially set to be restricted by the Supreme Court after a ruling from a federal judge in Texas reversed the FDA’s approval of the pill — although it has been temporarily stayed — McClelland says it’s important for experts to do what they can to combat medical misinformation.

Opponents to mifepristone have argued that the FDA did not do enough due diligence before approving the medication, but McClelland says its abortion “reversal” treatment that is unproven.

“What is triggering for the medical community is yet another moment where medical expertise is devalued and reproductive rights are devalued, and we honestly feel like we’re screaming into the wind to convince people that we know what we’re doing and can be trusted,” he said. “When that particularly involves infringing on the rights of people and we can’t seem to do our best to advocate based on the evidence we have, and that’s paralyzing.”

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(NEW YORK) — More than one-third of Americans live in places with unhealthy levels of air pollution, according to an annual report published by the American Lung Association. The 24th iteration of the State of the Air report determined 19 million fewer Americans live in these areas.

Unhealthy levels of pollution were defined as receiving a failing grade for one of the three metrics.

The annual report looked at three air quality measures: Particle pollution, broken into daily averages and daily spikes, and ozone levels, which are tracked by the Environmental Protection Agency (EPA).

As defined by the report, particle pollution, also known as soot, is a mixture of tiny bits of solids and liquids in the air that can come from many sources that emit fine particles. Sources can include factories, power plants, motor vehicles, and burning of wood, including forest fires.

Ozone, also known as smog, is a gas compound composed of three oxygen atoms that is formed in the lower atmosphere when pollutants, often from burning fossil fuels, interact with sunlight and heat.

“120 million people were living in places that got unhealthy grades, but that’s quite a bit fewer than we saw last year, and that’s largely because we’ve seen improvements in ozone air pollution which is really good news,” says Katerine Pruitt, the national senior director for policy at the American Lung Association.

Since the initial publication of the annual report, there has been a shift of the most polluted cities from the East Coast to the West Coast. This has been attributed to the improvement in ozone pollution and the rise of particle pollution.

“Because we’ve seen improvements in ozone air pollution which is really good news. Ozone air pollution is still the most widespread of the pollutants that we track,” said Pruitt. “On the flip side of that is particle pollution, which is continuing to get worse. And we found that the number of people living with unhealthy levels of fine particle pollution has almost doubled in the last five years.”

Pruitt credits the drop in ozone pollution to the improving standards and regulations following the Clean Air Act.

Unfortunately, these positive impacts have been negated by climate change in the West.

“The impact of climate change is undermining the progress that’s been made,” Pruitt told ABC News.

Wildfires have also been a driving force in the shifting to air pollution.

“I can tell you that in California, where I have been practicing more frequently for the past 25 years because of the wildfire smoke 20 years ago, maybe 20 to 30 days of the year, you would expect to have coverage of wildfires. Now it’s about 100,” said Dr. Kari Nadeau, John Rock Professor of Climate Science and Population Studies and Chair, Environmental Health at Harvard University, and Allergy, Asthma, and Immunology clinical specialist, who currently practices in both California and Massachusetts.

“Ozone in particular can make asthma worse, but it has also been shown to increase the risk of cardiovascular disease, increase the risk of stroke and increase the risk of premature birth,” Dr. Nadeau said.

“People with preexisting lung disease like asthma and COPD definitely can experience exacerbations that require them to use more medication to open their airways and it can also lead to them going to the emergency department, or even getting hospitalized,” said Dr. John Balmes, professor emeritus of pulmonary and critical care at the University of California- San Francisco and a spokesperson for the American Lung Association.

Americans can learn more about the air quality in their own communities by visiting the EPA website AirNow.gov or download the AirNow.gov app.

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(NEW YORK) — With summer and swim season just months away, one mom is warning other parents not to buy blue swimsuits for their kids.

Nikki Scarnati, a mom of two and swim instructor in Spring Hill, Florida, shared in a recent video post on her TikTok page why she doesn’t recommend them.

“This is not a regular bathing suit my daughter wears on a regular basis. I bought it on clearance specifically for this example for parents who wanted to learn,” the 32-year-old says in the video, turning the camera on her 2-year-old daughter Claire, who is seen treading water in a pool while wearing a light blue swimsuit.

“Look how difficult it is to see her under the water — and this is in calm water,” Scarnati continued. “This is not with a whole bunch of other kids playing, splashing around and having a good time. Even look in the sunlight, look how difficult it is to see her with that bathing suit on ’cause it’s the same color as our environment. So, do not buy a blue bathing suit guys.”

Scarnati, a Florida native who specializes in teaching children between the ages of 6 months and 6 years old, said this simple piece of advice was one she learned from her family growing up.

“My mom had three kids so she wanted us to be easiest to spot because we were always in different places at one time. But as I’ve gotten into the teaching role and working with students, I discovered it wasn’t as widely known as I thought it was,” Scarnati explained to ABC News’ Good Morning America.

“In the industry, it’s kind of widely known that blue bathing suits are problematic in pools and open water. So it was just one of the many things that I could help educate parents on, that would be applicable to really everyone,” she said.

Scarnati said she has noticed blue children’s swimsuits are widely available and very easy to find.

“Blues are very common in bathing suit color and I think that [fuels] the frustration for a lot of professionals that work with children, especially in a pool setting,” Scarnati said.

Water safety tips for parents

Adam Katchmarchi, executive director of the National Drowning Prevention Alliance and an assistant professor in sport management at Indiana University of Pennsylvania in Indiana, Pennsylvania, agreed that avoiding blue swimsuits is one way to prevent water dangers like drowning.

“After someone does experience a drowning incident, they can submerge below the water and whether that’s in a pool or in a natural body of water, that can really distort what we’re able to see surface level, to even see that there may be a situation we need to respond to,” Katchmarchi told GMA. “So wearing bright colors, no matter what the age, is really a good safety recommendation.”

The National Drowning Prevention Alliance recommends parents practice five layers of protection to keep kids safe in the water. Those five layers are:

1. Barriers and alarms, like fencing around pools and alarms on doors and windows that open to the pool so an adult is alerted when they’re opened.

2. Supervision that is “close, constant and capable” is critical for water safety, according to the Alliance.

3. Water competency, meaning that both adults and children should know how to swim. The Alliance recommends talking to your child’s pediatrician about when to start water safety or swimming lessons.

4. Life jackets are needed whenever “on or around open and natural bodies of water and when boating,” according to the Alliance.

5. Emergency preparation includes keeping a phone poolside to be able to quickly call 911 and learning and practicing how to perform CPR, according to the Alliance.

Katchmarchi noted that when it comes to supervision, bright bathing suits make a difference.

“Part of the supervision element is … making sure that you can actively supervise your child anytime they’re around or in the water,” he said. “And one of those ways is to make sure that they have a bright colored swimsuit.”

Both Scarnati and Katchmarchi recommend parents seek out neon-colored swimsuits, such as neon yellow and orange that “are going to stand out in the environment.”

According to the Centers for Disease Control and Prevention, drowning is a leading cause of death for children between the ages of 1 and 4.

Scarnati said she hopes her TikTok post, which has so far racked up more than six million views and nearly half a million likes, can prevent future drowning deaths.

“At the end of the day, drowning is the No. 1 cause of death in children under 4 and the second in children 5 to 12, so if I can give as many tips as possible to parents to help them make better decisions … just to help drowning statistics lower a little bit, then I’ve done my job,” she said.

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(SILVER SPRING, Md.) — The Food and Drug Administration authorized a second omicron-targeted bivalent COVID-19 booster vaccine for people over 65 or who are immunocompromised, the agency announced Tuesday.

The agency also said any adult who has not yet been vaccinated will get one dose of an updated bivalent shot, rather than starting with the original vaccine and receiving the bivalent shot as a booster. The FDA is withdrawing authorization for those older COVID-19 vaccines targeting the original strain of the virus.

It’s part of an overall move to simplify the COVID-19 vaccination process, the agency said in a statement. United States regulators are shifting towards a flu shot-like model for COVID-19 vaccines, where people get a single shot every year that’s updated annually to match the virus strain predicted to be in circulation.

“At this stage of the pandemic, data support simplifying the use of the authorized mRNA bivalent COVID-19 vaccines and the agency believes that this approach will help encourage future vaccination,” Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said in a statement.

The original COVID-19 vaccine was matched against the first strain of the virus first identified in Wuhan, China. That strain of the virus is no longer circulating — the omicron variant and its sub variants are the predominant strains throughout the world. The bivalent shots target both that original strain and the omicron variant. They were first authorized as booster doses in fall 2022 and research shows they offer stronger protection against infection and serious illness from omicron than the original shot.

Now, they’ll be the only vaccines available in the US. Adults who haven’t been vaccinated and who want to get vaccinated can get just a single dose of that vaccine, rather than a series of multiple shots. Unvaccinated children will still get multiple shots. Children 6 months through 5 years of age can either get two doses of the Moderna bivalent vaccine or three doses of the Pfizer-BioNTech vaccine.

Vaccine uptake has slowed to a crawl in the U.S. Only 16.7% of people in the US overall and less than half of people over 65 have received a bivalent booster shot, according to data from the Centers for Disease Control and Prevention. Even though FDA is making a second bivalent booster shot available to people over 65, it’s not clear how widely it’ll be used.

But a single, annual shot could help encourage more vaccination, says ABC News contributor Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital

“Simple and clear messaging is critical when it comes to ensuring vaccine uptake,” he said. “Moving to a model that resembles the yearly flu shot campaign will help focus messaging and help increase population immunity ahead of a potential fall surge.”

FDA advisors will meet in June to discuss updating the vaccine composition for fall 2023.

“COVID-19 is not influenza,” Marks said during a press briefing Tuesday. “But that said, we’re using that public health model where we’ll look to do our best to select what we believe to be likely to circulate the following fall and winter season, and use that in the vaccine composition to try to protect as many people during the season in which respiratory viruses tend to wreak havoc.”

Despite these steps, research on COVID-19 is ongoing and scientists are still working to understand the seasonal patterns and evolution of the virus. The new approach to COVID-19 vaccination may not be the last change, Brownstein said.

“We still have to recognize that the future of covid remains uncertain and this trial vaccination strategy may have to be modified,” he says.

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(WASHINGTON) — A new report from Senate Republicans doubles down on the theory that COVID-19 emerged from an accidental lab leak in Wuhan — and possibly, even more than one leak.

While their investigation concedes that “both hypotheses are plausible,” the nearly 300-page document released by the minority on the Senate health subcommittee makes a circumstantial case that the “preponderance of circumstantial evidence” points to “an unintentional research-related incident” — an undetected aerosol leak — likely at the Wuhan Institute of Virology (WIV), as the first spark which would ultimately ignite the pandemic.

The WIV has long been known for not just its extensive research on bat coronaviruses, but also poor biosafety conditions while dealing with risky contagion samples which need proper containment, investigators wrote.

The document says an initial leak may have occurred “sometime before September 2019” and began circulating in Wuhan. Then, once WIV and Chinese government authorities realized what had happened, officials scrambled to quickly and quietly develop a vaccine that could be deployed to contain the outbreak — all before the world could learn the truth, according to the authors.

That rush to develop a vaccine may have led to a second accidental lab leak — one which, in turn, would lead to the global pandemic, the investigators believe.

No definitive conclusion has yet been reached on the origins of COVID but the intelligence and scientific communities remain split on whether the most likely scenario is a natural spillover or an accidental lab leak.

How, where and when the pandemic began that has killed nearly seven million people still remains a highly contentious and unsolved geopolitical debate.

The latest report unpacks the theories the committee originally shared last November which, they say, requires further investigation. The investigators said they were “concerned” that possible vaccine experiments at the WIV were conducted under “inadequate biosafety containment conditions” and “may be the proximate cause of the initial outbreak in Wuhan.”

And while they “could not determine whether the SARS-CoV-2 virus was a product of nature alone or possible genetic manipulation,” the “preponderance of information affirms the plausibility of a research-related incident that was likely unintentional resulting from failures of biosafety containment during vaccine-related research,” investigators continued.

“The nature of the identified biosafety vulnerabilities increased the likelihood that such containment failures were not immediately recognized,” and, combined with COVID’s propensity for asymptomatic spread, the initial outbreak may have gone unnoticed at first, according to the report.

“Such initial unrecognized infections could serve as the nidus of the outbreak of COVID-19 in Wuhan and is a plausible proximate cause of the pandemic,” the report said.

The Huanan wet market in Wuhan has long been viewed as a potential early epicenter of the pandemic — the place where an animal disease jumped to humans. But the team that worked on this new report said they believe the market could well have been a “super spreader,” where the virus exploded once it was already coursing through the region.

This is not a peer-reviewed scientific study. It is a report released by Republicans on the Senate health subcommittee.

The report says their core investigative team was comprised of two attorneys, three research assistants, a China foreign area specialist along with one medical and one veterinarian epidemiologist.

That core group was “supported by an outside scientific advisory group consisting of three former U.S. national high- containment laboratory directors, a medical infectious disease physician, medical epidemiologist, two veterinarians, two biosafety experts, and two molecular biologists. Additionally, technical experts were consulted on topics ranging from specific biosafety equipment and processes, vaccine development and production and animal experimentation.”

The core team on this report — which numbered 60 experts — cite several parallel timelines indicating that COVID infections may have begun to swirl in the population months before the Chinese government told the World Health Organization or the world.

That timeline puts initial infections far earlier than December clusters at the wet market — suggesting an animal spillover from there may not have been the origin. Additionally, the report says, the outbreak began to gather steam at the same time as Chinese scientists were beginning to develop a vaccine, according to their experts’ analysis of early Chinese vaccine patents.

Among the clues this report cites that COVID was brewing months earlier than has been publicly admitted, it nods to some of ABC’s early reporting:

• Satellite data from the fall of 2019 showing a dramatic and unusual spike in auto traffic around major hospitals in Wuhan.

• Keyword queries on Chinese search engines substantially increasing in October and November 2019 for symptoms of COVID, like “cough.”

• A “significant” and “abnormal increase” in mysterious flu-like illnesses confirmed by Chinese epidemiologists. Public schools began to close.

• Officials on the ground began to worry, according to the report, and the team at the American embassy in Beijing may have received early word of that concern.

• As far back as late November, U.S. intelligence officials were warning that a contagion was sweeping through China’s Wuhan region, changing the patterns of life and business and posing a threat to the population.

• By mid-October 2019, the “dedicated team at the U.S. Consulate General in Wuhan knew that the city had been struck by what was thought to be an unusually vicious flu season. The disease worsened in November. When city officials began to close public schools in mid-December to control the spread, the team passed the word to Embassy Beijing and continued monitoring,” the report says.

Congressional investigators spent 18 months interviewing dozens of subject matter experts, digging into hundreds of peer-reviewed articles, public reports and documents obtained through the Freedom of Information Act.

This report does not include the still-classified intelligence that may shed more light on the pandemic’s origins but that intelligence is due to be released within the next two months.

The investigation was originally commissioned as a bipartisan effort but ended up becoming a Republican document after the leadership of the Senate HELP Committee changed, said Dr. Robert Kadlec, the lead investigator who ran the pandemic response in 2020-2021 as assistant secretary of HHS.

Sen. Roger Marshall tells ABC News he has reviewed some of that classified intelligence and thinks it will not contradict the conclusions in this report.

“I think number one is that the facts are solid in this investigation,” Marshall told ABC News, adding the team had set out to pressure-test and “shoot down” both theories. Having done that, he said, “a preponderance of evidence” points to that unintentional lab leak, he claims.

“I think that this– if it was a civil lawsuit, I think that the jury would say, ‘Yes, indeed, we think that this came from a laboratory, an unintentional laboratory leak in Wuhan, China,'” he said.

When pressed by ABC News, Marshall conceded the case might not stick in criminal court.

“These are theories, these are not facts,” Kadlec told ABC News, but acknowledged there are potential telltale clues that point to the possibility of an accidental lab incident.

“I would fully expect that there may be some insights that can be shared with the American public that would give them greater confidence as to what was known, when it was known, and provide, hopefully — at least some — collaboration or corroboration of our study,” Kadlec said. “I think to move onto the next phase of this conversation, which is, how do we work collectively with China and other countries around the world to prevent the next pandemic, whether it be deliberate, accidental or natural?”

Said John Brownstein, Chief Innovation Officer at Boston Children’s and an ABC News Medical Contributor: “We have to remember that most evidence still is circumstantial and inconclusive. And unfortunately, the scientific community has had its hands tied because of the lack of data. So we need more data to unlock this mystery, to really for once and for all figure out what took place in Wuhan.”

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(NEW YORK) — YouTube , the largest video-sharing platform, announced Tuesday a new policy framework for eating disorder-related content, in the company’s latest effort to address the growing mental health crisis, especially among teens, who can often be “vulnerable viewers.”

“Mental health issues like eating disorders can be isolating and stigmatizing for people around the world. YouTube is an important platform for raising awareness and understanding of eating disorders from a variety of perspectives, and we want to empower creators to continue to share their stories,” Dr. Garth Graham, director of YouTube Health, said in part of a statement Tuesday.

The new policies outline prohibiting content that features “imitable behavior” for “at-risk viewers,” including content that shows or describes behavior like restricting calories, setting age restrictions on content that discusses disordered eating behavior and adding information about mental health resources under videos related to eating disorders.

The Google-owned global video-sharing platform, which boasts over two billion users, said it worked with the National Eating Disorder Association (NEDA) and Asociación de Lucha contra la Bulimia y Anorexia to expand the scope of Community Guidelines.

“In developing the new policies, we worked closely with NEDA and other groups to enhance understanding of what constitutes imitable behavior, how it can show up in content, and how it can impact vulnerable viewers,” said Graham.

Disordered eating behaviors include binge-eating, purging, laxative abuse and fasting for weight loss, are nearly as common among males as they are among females. Nearly 28.8 million Americans will suffer from an eating disorder at some point in their lives, according to NEDA .

The updated policy comes nearly a month after researchers reported that an increased time spent on social media platforms, like YouTube, was identified as a risk factor for disordered eating.

Andrea Vazzana, a child psychologist who specializes in the treatment of eating disorders in children, adolescents and adults at NYU Langone, spoke to ABC News’ Good Morning America about young social media users and eating disorders last month. She said the negative influence of social media is largely due to the social comparisons that are part of engaging in these social media platforms, including filtered photos, weight loss challenges and videos of purging techniques.

However, social media can be helpful and used to educate and provide resources to those who may need them.

“We know from the data that YouTube had over 1.4 billion views on mental health content in the US in 2021 and we know that the earlier a person with an eating disorder reaches out and seeks treatment, the greater the likelihood of physical and emotional recovery,” said Sarah Chase, the vice president of communication for NEDA, in part of a statement. “YouTube is taking a further step in the right direction toward helping NEDA with our mission.”

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(NEW YORK) — Early on in her pregnancy, Tori Wapsheli made plans to deliver her second child in the same hospital where she had her first — Astria Toppenish Hospital on the Yakama Indian Reservation in Washington State.

But with just three months left in her pregnancy, the hospital suddenly shut down its Family Maternity Center, leaving Wapsheli and others in the community scrambling. In a news release, the hospital cited higher costs, reduction of Medicaid reimbursement from 150% to 100%, inability to recruit enough staff and a 50% decrease in deliveries as the reason for the closure.

“Just being so far out here, Toppenish was the place that would have worked easier,” Ciera Wheeler, who was more than 7 ½ months along when the pregnancy ward closed, told ABC News.

Patients in active labor who come to Astria Toppenish when there’s no time to stabilize and transfer them before delivery will now have their babies delivered in the emergency room and then, after being stabilized, transferred by ambulance to another hospital, the release said.

For Wheeler, the closest hospital with a maternity ward was now 45 minutes away, she said.

Options for maternity care on the reservation, which spans more than a million acres, have gone from bad to worse. Pregnant women looking for care are often forced to travel roads that can become dangerous in poor weather, according to the women ABC News spoke to on the reservation.

“This area is very rural. It is isolated. So the traveling distance plus the resources that are needed to get quality care not there,” said Jessica Whitehawk, who founded the Ttáwaxt Birth Justice Center with the help of fellow advocates Leslie Swan and Semone Dittentholer.

The Yakama Indian Reservation is just one of many U.S. communities dealing with a shortage of obstetric care.

Over a third of all U.S. counties are what’s known as maternity care deserts, which translates to more than 2.2 million women of childbearing age and 146,000 babies born in areas without obstetric providers, hospitals or birth centers offering obstetric care, according to a recent March of Dimes report.

It’s an issue that’s contributing to the high U.S. maternal death rate, said March of Dimes chief medical officer Dr. Elizabeth Cherot.

In 2021, there was a 40% increase in the death rate from maternal causes compared to the year before, according to the Centers for Disease Control and Prevention. After a spike during the pandemic, preliminary data suggests the number of maternal deaths began dropping in 2022, but numbers are still higher than experts would advise.

One of the states with the highest number of maternal deaths, according to the CDC, is Mississippi, where Byron Stribling lost his pregnant wife, Harmony, and their unborn child while on the way to the hospital in July 2021.

“We don’t have a hospital. We don’t have an emergency room. The nearest hospital was about 15, 20 miles away, give or take,” Stribling told ABC News.

Harmony was five days away from delivering her baby when she developed complications from preeclampsia. On the drive to the hospital, Stribling pulled over to perform CPR as directed by a 911 dispatcher. By the time first responders arrived around 15 minutes later, she and their unborn child were dead. They were about three minutes from the hospital, according to Stribling. Stribling believes that if there had been an emergency room or hospital in closer proximity to their home, his wife or child might have been saved.

There are no obstetric providers in more than 50 counties in Mississippi, according to Rachael Morris, a maternal fetal medicine specialist at the University of Mississippi Medical Center. She and her team have been trying to fill the gap by training hundreds of first responders in parts of the state that lack maternal care on what to do if there’s an emergency.

“We teach you how to intubate a baby. We teach you how to deliver a baby,” Morris said.

Morris said that almost 90% of the mortalities they’ve had over a 2-year period were deemed preventable.

“It’s frightening. Something’s got to change,” Morris said.

According to the CDC, the maternal mortality rate for Black women is three times higher than non-Hispanic white women, although all ethnicities saw an increase in 2021. For women over the age of 40, the mortality rate is seven times higher than for women under the age of 25.

At 38 years old, Dominique Armour is considered to be of advanced maternal age. She’s 8 months pregnant with her tenth child, putting her in a high-risk category. She told ABC News this will be her fourth time driving across state lines, from Arkansas to Mississippi, to give birth because of limited options.

“My last baby, I almost had on the side of the road,” Armour said.

The only hospital in Armour’s county hasn’t had a delivering physician in more than five years, according to Armour. Access to prenatal care is also limited, she said, and the last time she was able to see a doctor was months ago.

“It was hard. I had to go by myself. I don’t want to talk about it. I don’t,” Armour said in tears.

Alice Rogers Johnson of the Arkansas Birthing Project says she is exploring options like the March of Dimes mobile clinic to get women in the area access to more care.

“A lot of women do miss appointments because they don’t have transportation,” Johnson said.

Back at the Ttáwaxt Birth Justice Center, the founders are working to expand their services, hoping that one day they can build a new birthing facility on the Yakama Nation grounds.

“We’re trying to rebuild our kinship, our nationhood, our family strength, providing a safe place for our families and women and children to come to have more options, to be cared for and to heal,” Whitehawk said.

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(MICHIGAN) — Nearly 100 probable cases of a rare fungal infection, including one fatal, have been linked to a Michigan paper mill.

Public Health Delta & Menominee Counties (PHDM) said 21 cases of blastomycosis have been confirmed while another 76 are suspected. All cases are in employees, contractors or visitors of the Escanaba Billerud Paper Mill on the Upper Peninsula of Michigan.

Amid the outbreak, 12 people have been hospitalized and one person — a contractor who worked at the mill — has died due to blastomycosis, health officials said.

The department was notified about the first cases on Feb. 28 among workers with the mill.

“The health and safety of our Escanaba employees is our first priority,” Brian Peterson, vice president of operation at the mill, said in a statement. “Although the source of the infection has not been established, we continue to take this matter very seriously and are following recommendations from health and government officials.”

Public Health Officer Michael Snyder told ABC News the health department sees a few cases of the infection every year but rarely an outbreak of this magnitude.

Here’s what you need to know about blastomycosis and how it can be treated:

What is blastomycosis?
Blastomycosis is a fungal infection caused by a group of fungi known as Blastomyces.

“These are fungi that live in the environment as a mold and they make spores,” Dr. Teresa O’Meara, an assistant professor of microbiology and immunology at the University of Michigan, told ABC News. “And what happens is that when people inhale too many of those spores, they can sort of set up and evade some of these innate immune responses and cause pneumonia and spread throughout the body.”

The fungi are found in the environment, mainly in moist soil and in decomposing organic material such as wood and leaves, according to the Centers for Disease Control and Prevention.

Most cases of the infection occur in the United States and Canada but are very rare, with the annual incidence being about one to two cases per 100,000 people, the CDC said.

In the U.S., O’Meara said blastomycosis is most common in eastern parts of the Midwest — including states like Michigan, Minnesota and Wisconsin — the Great Lakes region and Southwest.

“On average over the past five years, only 26 cases have been reported for the entire state of Michigan annually,” PHDM said in a release. “However, the Upper Peninsula of Michigan is a known risk area for blastomycosis infection.”

The infection is not transmitted from person to person or from animals to people and can only be contracted by breathing in the microscopic spores, often after activity that disrupts the soil or the decomposing material.

What are the symptoms?
Symptoms can be wide-ranging, O’Meara said. Some patients are asymptomatic while others develop symptoms including coughing, fever, chest pain, muscle aches and fatigue.

Because symptoms resemble other types of infections, it can be hard to diagnose the illness in a person, O’Meara said.

“And so diagnosis is pretty hard, even in places where it’s endemic, just because it’s so rare,” she said.

O’Meara added that evidence suggests symptoms can appear anywhere from three weeks to three months after inhaling spores.

According to the CDC, the infection can spread from the lungs to other areas of the body, including the joints, bones, brain and spinal cord among those who are immunocompromised.

Which treatments are available?
Those infected with blastomycosis need to be treated with a prescription antifungal medication.

Those with mild to moderate cases can take a medication known as itraconazole, which stops the growth of fungi.

Patients with severe infections are usually given amphotericin B, an intravenous medication. Because it can have a wide range of side effects, it’s only given to critically ill patients or those who are immunocompromised.

Treatment can range from six months to a year and can depend on how severe a person’s infection is as well as the strength of their immune system.

“One of the really important problems I would like to highlight just for people to know is that we often think about antibiotic resistance as being a real problem,” O’Meara said. “But there’s actually dozens of classes of antibiotics and antifungals. There’s only three classes of antifungals available.”

She continued, “And so this is going to be a big problem going forward just because there are more and more fungal infections that are on the rise and we need to develop new antifungal treatments.”

Is blastomycosis deadly?
It is very rare for blastomycosis to result in death. According to the CDC, there have been 1,216 blastomycosis-related deaths between 1990 and 2010.

What’s more, the age-adjusted mortality rate is 0.21 per 1 million person-years, the federal health agency said.

How can I protect myself?
Because there is no vaccine and it is endemic in some environments, it may be hard to protect yourself against the fungus.

If you work in areas where the fungi is prevalent or you might disturb soil, O’Meara said you can consider wearing protective equipment.

If you think you’ve been exposed, get tested and — if positive — start antifungal treatment if needed.

Copyright © 2023, ABC Audio. All rights reserved.

(NEW YORK) — Spring has sprung and summer is around the corner which means long strolls and rolling strides outside to enjoy the warm weather months.

But with heat waves already setting in across parts of the country, ABC News’ Good Morning America tapped Dr. Liz Weinandy, lead dietitian at the Ohio State University Wexner Medical Center, to explain what to watch out for if dehydration hits, as well as the best things to drink and eat to keep your body nourished.

Symptoms of dehydration

“There are several signs a person might be dehydrated,” she said. “Headache or confusion, extreme thirst, very dark urine, infrequent urination, fatigue, muscle cramping and lightheadedness. In extreme cases of dehydration, it can lead to heatstroke or hyperthermia (abnormally high body heat).”

When it comes to preventative measures and staying hydrated, Weinandy said, “the best way to avoid dehydration is to drink before you get thirsty.”

“In some situations, it is easier to get dehydrated, like being active in hot temperatures,” she continued.

Best drinks for hydration besides water

While some supplements like hydration packets that are added to water can be helpful for some, Weinandy said H2O still reigns supreme for staying hydrated.

“Water is usually best and suitable for most people unless they are excessively sweating, then replacing electrolytes like potassium and sodium start to become more important,” Weinandy explained. “Sports drinks and electrolyte replacement solutions are very appropriate in this situation, although keep in mind most people do not need them.”

“As for food, most fruits and vegetables have a higher water content compared to other foods,” she said. “Melons, strawberries, pineapple, cucumbers, tomatoes and lettuce are especially high in water and can help prevent dehydration.”

Who’s at-risk for dehydration?

Weinandy said another factor to keep in mind is that “some groups are at a higher risk of becoming dehydrated.”

“Infants, elderly and people who cannot communicate clearly” can all be more prone to dehydration, she said. “Also, being dehydrated increases the risk of developing kidney stones because urine is more concentrated.”

How much water to drink to stay hydrated

ABC News chief medical correspondent Dr. Jennifer Ashton said the amount of water you should consume daily depends on your age, height and where you live.

Most guidelines call for the average woman to drink around 2.7 liters per day, and 3.7 liters for men.

One liter is equivalent to 33 ounces.

“Your body’s own systems will tell you when you need more water and it’s called thirst,” Ashton said. “A lot of times people think they’re hungry and they’re actually thirsty. See how it works for you.”

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(NEW YORK) — Five years ago, Shannel Perman nearly became a statistic in the growing Black maternal health crisis in the United States.

In the last week of her pregnancy with her first child, Perman, now 33, said she began to experience complications like swelling, high blood pressure and weight gain that she said were dismissed by her doctor.

Perman, who lives near Baltimore, went onto give birth to a healthy baby, a son named Jyace, 41 weeks into her pregnancy, and said she thought she was medically in the clear.

“As far as I was concerned, I was healthy. My baby was healthy,” Perman told ABC News’ Good Morning America. “That’s all my doctor kept telling me, was that I was OK and my baby was OK.”

It was not until a week after giving birth that Perman nearly lost her life.

She suffered a stroke while at home with her baby and husband, who rushed her to the hospital, where she eventually underwent two emergency brain surgeries.

“I wasn’t stroke-alerted when I came in to the hospital showing signs of a stroke,” said Perman, who added that it was her mom, who met them at the hospital, who demanded she get medical attention for a stroke. “I was failed multiple times.”

As a Black woman in the U.S., Perman is three times more likely to die during childbirth or in the months after than white, Asian or Latina women, according to data from the Centers for Disease Control and Prevention.

A recent CDC report found the majority of maternal mortality cases — about 53% — occur after the first week of childbirth.

Black women are also more likely than white, Asian or Latina women to die from pregnancy-related complications regardless of their education level or their income, data shows. And in cases of maternal death, Black women are more likely to die from cardiac conditions, like the high blood pressure complications that Perman described experiencing in her last week of pregnancy, according to the CDC.

Perman said that as an otherwise healthy 29-year-old at the time of her son’s birth, with no preexisting conditions, suffering a stroke came as a life-changing shock. She said she underwent several months of rehabilitation and continues to suffer from complications including memory loss, brain fog, migraines and light sensitivity.

Perman said it also came as a shock to learn the disparities Black women like herself face when it comes to giving birth, and how the maternal mortality rates have only continued to grow in the five years since she gave birth.

“A mom should be able to enjoy her pregnancy, enjoy her newborn and postpartum period and not have to worry about dying during childbirth or shortly after her child’s birth,” she said. “So it’s heartbreaking to think about, that this issue is still happening.”

For Perman, the decision to have a second child was one that took several years, a period of time that she said involved mental health therapy, prayer and finding the right medical team.

Last year, Perman gave birth to a healthy daughter, whom she and her husband named Jordyn.

She shared with GMA the things she did differently when giving birth to her second child, and what she wants other women to know.

1. I made sure I felt seen by my medical team.

Perman said she and her husband did their research on doctors, including meeting with several, to make sure they found the right fit.

“We wanted to find someone that made us feel comfortable and made us feel seen and heard. Someone that we didn’t feel rushed with. Someone that took the time to answer every and all of our questions,” Perman said. “And the team that we went with, they were great. If we showed any concerns, they were running tests and just doing all the things we would want from a doctor.”

Dr. Pam Oliver , a board-certified OB-GYN and executive vice president of Novant Health in North Carolina, said she also encourages patients to look around to find a team of doctors with whom they connect.

“I think that patients should look at the team that’s taking care of them and make sure they feel that connection. They feel like this is a place, or this is a team that truly cares about me,” Oliver, who did not treat Perman, told GMA. “And that becomes part of how you choose the team that actually is going to take care of you when you deliver.”

Oliver, also president of the Novant Health Physician Network, said she also encourages patients to work with the same OB-GYN prior to pregnancy, when possible.

“I like to take care of my patients prior to pregnancy so that they understand that how they come into pregnancy matters some with their outcomes,” she said. “We start a nine-month journey once we have a positive pregnancy test, but some of the outcomes and, unfortunately, the deaths that we see may be related to health issues that started way before pregnancy.”

2. I used an at-home blood pressure monitor.

Perman said that with her second pregnancy, she used an at-home blood pressure reader, which can be purchased over-the-counter for as little as $20.

“That can be a life-changing method for so many moms, if they have a blood pressure reader where they can be testing or checking their own blood pressure throughout their pregnancy and even the postpartum period,” she said. “Because for a lot of moms, we don’t get a [postpartum] checkup until the six-week appointment, and so much can go wrong in those six weeks.”

High blood pressure, or hypertension, can put women at risk during and after childbirth, raising the risk of stroke, preeclampsia and preterm delivery, according to the CDC .

The CDC also recommends that women keep track of their blood pressure at home so they can notify their healthcare provider if their blood pressure is higher than usual.

3. I was my own biggest advocate.

Perman said her biggest piece of advice to other women is to speak up and be persistent if they feel anything is off with their body.

“You have to be your own biggest advocate,” she said. “If you feel any symptoms or anything is concerning, you have to speak up. If your doctor isn’t listening to you or you don’t feel seen or heard, you need to find someone else that’s going to hear you because you cannot take any chances when it comes to your life or your child’s life.”

Perman continued, “You have to trust your own intuition and if something something doesn’t feel right, you just have to follow that and speak up and advocate for yourself.”

Oliver said she encourages patients to be persistent with their doctor and proactive with their health.

“Advocating is really about being persistent and making sure that your provider, whether it’s a physician or a midwife, understands what your issue or your concern may be and that you get some answer, even if it means you have to seek another opinion or talk to someone else to make sure that you truly are getting an answer,” Oliver said. “Because there are a lot of things in pregnancy we can’t explain. There are a lot of aches and pains and things that happen.”

4. I was alert for warning signs after giving birth.

With Perman’s second pregnancy, she said she knew that even after she gave birth, she needed to advocate for herself and pay close attention to how she was feeling.

“The experience between the two pregnancies were night and day,” she said. “This time around, I was able to know what to look out for.”

Oliver echoed that once a new mom goes home from the hospital, it’s important that she knows to speak up when something feels off in their body.

Among the warning signs for women to watch for are shortness of breath, chest pain, weakness, severe headaches and excessive bleeding, according to Oliver.

“Those are just a few of the things that we look out for because they may be tied to the most common causes for women dying after childbirth,” she said. “You have to make sure that you you’ve gotten your symptoms out, that you’re heard and that you’ve had an evaluation that feels reasonable to say, ‘We’ve ruled out the bad stuff.'”

Oliver noted that women should listen to their intuition and feel confident telling their doctor, “Something just feels off.” She added that if a woman is told by her doctor that a symptom, like a headache, for example, is normal, she should ask the follow up question, “When should I be concerned about this headache?”

“That is something you can truly act on,” Oliver said. “You need your team to be able to tell you when do you get concerned? When do you follow up? How do you follow up and what should you expect from there?”

5. I knew that maternal mortality was a major crisis.

Perman described it as “difficult” and “heartbreaking” to know that so many women, particularly Black women, die during and after childbirth due to forces beyond their control.

Oliver, too, said she struggles as a doctor to know that outside of medical care, there are issues like poverty, bias and systemic racism that impact the rising maternal mortality rate.

One reason for the maternal mortality disparity is that more Black women of childbearing age have chronic diseases such as high blood pressure and diabetes, which increases the risk of pregnancy-related complications like preeclampsia and possibly the need for emergency C-sections, according to the CDC.

But there are also socioeconomic circumstances and structural inequities that put Black women at greater risk for those chronic conditions. Black women often have inadequate access to care throughout pregnancy which can further complicate their conditions, data shows.

Anecdotal reports also show that the concerns of Black women experiencing negative symptoms during pregnancy and postpartum are specifically ignored by some physicians until the woman’s conditions significantly worsen, at which point it may be too late to prevent a deadlier outcome.

Oliver said one of the most heartbreaking and frustrating things she hears as a doctor is Black women who are afraid to have children, or who have decided not to have children out of fear they will die.

“That hurts my heart because that’s not at all what we intend to do, is to scare people,” Oliver said. “It’s not about fear. It’s about empowering ourselves, advocating for things that we know help all women, getting legislators and others to understand what we need to do to get the data, to cover the services that need to be covered, to approach this from many angles.”

She continued, “It’s important for people to know it is still safe to have babies and every day millions of women are having safe childbirths, but the trouble is that Black women are dying at a rate that is three to four times that of White women.”

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