Health

(BIRMINGHAM, Ala.) — She delivered a healthy child, but left the maternity ward traumatized and ashamed.

“The most happy moment in my life is at the same time the most terrible moment in my life because of what they did to me,” said a California mother who alleges hospital staff physically restrained her against her will and coerced her into accepting interventions to expedite her delivery at a hospital last year.

“I said, ‘No, I don’t want to. I’m full of energy,'” said the woman, who spoke to ABC News only on condition of anonymity to protect her family’s privacy. “I said, ‘No.’ Nobody cared.”

This patient is one of a growing number of women who advocates say are challenging a culture of silence and stigma around mistreatment during pregnancy and birth. The Centers for Disease Control and Prevention says the experiences are not uncommon and may contribute to the nation’s maternal mortality rate — one of the highest among the richest countries in the world.

Earlier this year, the agency launched an awareness campaign with a notice to American health systems to be more respectful in providing maternity care. ABC News spoke with a number of women across the country who said the guidance was overdue.

“If the CDC has to tell you to respect patients’ rights and to respect the medical ethics of autonomy, I think we’ve really gone off the rails,” said Julie Cantor, a women’s rights advocate and attorney who is representing Doe.

The CDC analysis of a recent survey of 2,400 new mothers includes reported cases of ignored requests for help; being shouted at or scolded; violations of physical privacy; and threats to withhold treatment, or made to accept unwanted treatment.

“This mistreatment is very troubling,” said CDC Chief Medical Officer Dr. Debra Houry in an interview. “This is why we need hospital systems, providers and communities to really be aware of this, because there’s many things we can do.”

Houry says cases of mistreatment are especially concerning at a time when maternal deaths in the U.S. are on the rise, especially among Black and Hispanic women. In 2021, the latest year for which data is available, 1,205 women died of maternal causes in the U.S. with a rate of 32.9 deaths per 100,000 live births — up from a rate of 23.8 in 2020 and 20.1 in 2019, according to CDC data. Black and Hispanic women had higher rates in 2021, at 69.9 per 100,000 and 28 per 100,000, respectively. That’s compared to 26.6 per 100,000 for white women.

“Potentially, in a stressful moment, there can be unconscious bias that comes out,” Houry said. “This is why we need to be more cognizant of it and make sure that women feel empowered to come forward as well when they’re experiencing this.”

Mistreatment in maternity care, while not a new phenomenon, has historically been underreported and unaddressed, advocates for pregnant persons say. Some women say they are reluctant to raise concerns with providers, especially after an otherwise successful pregnancy.

“Cases are generally very hard to litigate and they’re expensive, and so one of the issues that is a cultural phenomenon is, ‘Well, if the mom’s harmed, but the baby’s fine, why is that worth any money?'” said Cantor. “It’s a system that’s built around moving money, not just fixing problems.”

In 2016, the case of Caroline Malatesta of Birmingham, Alabama, helped put mistreatment of birthing persons in the national spotlight.

A jury delivered Malatesta a landmark $16 million judgment in her favor after claims of medical negligence and reckless fraud against Brookwood Baptist Medical Center, where she delivered her fourth child.

After devising a natural birth plan with her doctor that emphasized autonomy and freedom of movement, Malatesta said she was subjected to physical restraint.

“They pulled me to my back, flipped me over, and I remember the pressure on my back being so intense that I lifted my right leg and even pushed against the nurse’s [hair net], just trying to fight to get back over,” she said in an interview.

“The hard part came after, when everything’s quiet, everyone goes away, and there’s a sense of betrayal,” Malatesta said. “I know that sounds unusual, but you have put your trust in these doctors, into this — these people who are supposed to be looking out for your care.”

In the months that followed, Malatesta says numbness turned into debilitating pelvic nerve pain and PTSD. All of it taking a toll on her ability to parent and on her relationship with her husband.

“One of the biggest roadblocks is that women feel like, ‘Well, if I talk about what happened to me, it shows I’m just selfish because I wanted my birth to be a certain way when really I should have been thinking about the safety of the baby,'” said Malatesta. “Women have these birth plans because they care about the safety of their babies.”

The jury’s decision in Malatesta’s case might have been rare, but instances of birth trauma are not, public health experts and pregnancy advocates told ABC News.

“I’ve heard thousands of those stories,” said Cristen Pascucci, a birth advocate in Kentucky who supported Malatesta through the trial and whose site, Birth Monopoly, archives stories of mistreatment nationwide.

“There’s a lot of gaslighting that goes on when anybody has anything to say about their birth other than ‘it was beautiful,’ ‘it was wonderful,’ ‘it was great,'” Pascucci said. “But the bottom line is mistreatment is not necessary for safety.”

Kimberly Turbin of Los Angeles, whose traumatic 2014 hospital delivery of her son has more than a million views on YouTube, said each woman’s experience is unique.

“A lot of obstetric violence can be very kind. You don’t even know you’re being done a disservice because obstetric violence doesn’t always look like my horrific birth video,” said Turbin.

As her own mother recorded the scene with a cellphone, Turbin is heard questioning the need for an episiotomy, a cut made to the vaginal area to ease delivery, which she says her doctor then performed against her will.

“He doesn’t tell me what my options are. He never mentions that the baby or I am in distress,” Turbin said. “I’m getting a contraction. He comes near me with the scissors and starts slicing up my vagina 12 times.”

After speaking with more than 80 attorneys who declined to take her case, Kimberly filed a lawsuit against her doctor on her own; she settled her case in 2017 and now helps other women seek justice.

The American College of Obstetricians and Gynecologists (ACOG) says a pregnant patient’s autonomy should be a doctor’s top priority, saying “it is never acceptable” for a provider to use “duress, manipulation, coercion, physical force or threats” to compel a recommended treatment for a patient or unborn child.

While life-or-death emergencies often require urgent medical intervention, ACOG says “it is imperative that pregnant and postpartum patients feel comfortable communicating” their wishes.

“Listen to your patients when they tell you they have questions. Listen to them when they have concerns about what’s going on. And, listen to them when they say ‘no.’ You cannot force care on people,” Cantor said.

The CDC says women should feel empowered to speak up about concerns with their experience in the maternity ward and that providers should be more sensitive to them.

“Certainly training helps to understand what are some of those biases that we all have,” Houry said.

Training medical professionals is something Pascucci, the CDC, and women’s health advocates are working to expand, but many say there also needs to be a fundamental shift in how society thinks about birthing persons at their most vulnerable moment.

“We can’t keep saying, ‘Well, this is just, you know, this must just be how it has to be.’ It doesn’t have to be this way. It does not have to be this way,” Pascucci said. “It’s just a matter of making the decision to change what we do.”

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(NEW YORK) — A surge of respiratory illnesses related to flu, respiratory syncytial virus (RSV) and other infections has been sweeping across some parts of China and mainly infecting children, as the country experiences its first full winter since easing COVID-19 restrictions.

Amid media reports of “undiagnosed pneumonia” cases overwhelming hospitals over the past few weeks, health authorities have insisted that the uptick is linked to common illnesses.

Since May, China has been experiencing an increased number of children sick with mycoplasma pneumoniae – bacteria that causes mild infections of the respiratory system – as well as pediatric cases of RSV, adenovirus, influenza and COVID-19 since the fall, according to the World Health Organization (WHO).

Last week, the WHO submitted an official request to China for information on “an increase in respiratory illnesses and reported clusters of pneumonia in children.”

No new viruses or unusual conditions have been identified, according to Mi Feng, spokesman for China’s National Health Commission, who spoke at a press conference on Sunday.

“According to the analysis, acute respiratory diseases in China have continued to rise recently, which is related to the superposition of multiple respiratory pathogens,” he said.

Mi Feng said that with the coming of winter and the increased number of respiratory illnesses, China’s National Health Commission and the National Administration of Disease Control and Prevention are continuing to monitor these diseases, promote vaccination, dispatch medical resources, and make sure people receive treatment.

Following a meeting with local health authorities, the WHO noted that while the increase was earlier in the season than unusual, it was “not unexpected given the lifting of COVID-19 restrictions, as similarly experienced in other countries.”

Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital and an ABC News contributor, agreed with the WHO assessment that the surge is likely due to the lifting of COVID-19 restrictions. “These known pathogens are causing a rise in cases, particularly among children, but there have been no reports of unusual or novel viruses, and hospital capacities remain manageable,” he said.

When COVID-19 began spreading across the world in January 2020, China initiated some of the harshest restrictions anywhere in an attempt to prevent outbreaks. Known as the “zero COVID” policies, they included lockdowns and mass testing. The country officially lifted its zero COVID policies in January 2023, and ended the last of its primary pandemic-era measures this past summer.

Brownstein said a seasonal increase in respiratory illnesses occurring as COVID-19 restrictions are being lifted is not exclusive to China, but is something seen globally. When the U.S. lifted many restrictions last year it experienced a very similar pattern, with most states reporting high levels of flu-like activity.

“The co-circulation of respiratory viruses and bacteria during the colder months often places additional burden on healthcare facilities, making it crucial for public health measures, including vaccination and enhanced surveillance, to be in place to manage these expected spikes in respiratory cases,” Brownstein said.

Photos and videos have shown overcrowded areas at hospitals in China, including Beijing Children’s Hospital. Reported cases among children are especially high in northern areas like Beijing and Liaoning province, where hospitals are warning of long waits to be seen.

Mi Feng said hospitals in densely populated areas with long wait times can lead to a risk of cross-infection, and urged parents to instead take their children, if they have mild symptoms, to grassroots medical and health institutions or general hospitals for pediatric care.

He also advised people to follow known and proven mitigation measures, including wearing masks, increased ventilation, and frequent hand washing.

On Sunday, China’s health ministry also urged local authorities to increase the number of fever clinics.

ABC News’ Karson Yiu contributed to this report.

 

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(NEW YORK) — A record number of people are expected to travel during the upcoming holiday season, starting with Thanksgiving — just as respiratory illnesses are rising around most of the United States.

Currently, kids under 5 years old are being hospitalized with respiratory illnesses at a higher rate than any other age group, according to the Centers for Disease Control and Prevention. One of the most common types of respiratory viruses that circulates this time of year is called respiratory syncytial virus, or RSV.

“RSV is a very common virus. Most children in the United States get infected by the time they’re 2 years of age,” Dr. Jeffrey Kahn, chief of infectious diseases at Children’s Health, Dallas, and professor of pediatrics at the University of Texas Southwestern Medical Center, told ABC News.

Even though exposure to RSV may be inevitable in a child’s early life, families can take steps to minimize its effects this holiday season. Experts say avoiding people who are sick, good handwashing, getting preventive shots and breastfeeding all minimize the risk of severe complications from RSV for babies.

Here’s what you need to know to help protect your child from RSV this season:

Thousands of kids a year are hospitalized with RSV

RSV is the most common cause of bronchiolitis, a breathing problem that affects young children. It’s caused by inflammation in the smallest airways of the lungs that leads to mucous buildup, making it hard for babies to breathe, according to the CDC. In severe cases, infants may need to be hospitalized for breathing support or they may not be able to eat properly, leading to dehydration. Each year, RSV is responsible for 58,000-80,000 hospitalizations and between 100 and 300 deaths in children less than 5, the CDC says.

Among all age groups, babies less than 6 months old are at the highest risk of being hospitalized with RSV, especially those under 3 months old, according to the CDC. Babies who were born prematurely, or those with underlying heart, lung or neuromuscular problems, are also at high risk.

Doctors say that people visiting babies should consider wearing a mask during or after traveling, should wash their hands before holding a baby and, if someone is sick, they should stay away while having symptoms.

New preventive RSV shots are available

“For the first time in decades, really, maybe since the virus was discovered, we have some very useful tools now to prevent RSV infection,” Kahn said.

There are three new preventative RSV products this season, giving doctors four total options against the disease. Doctors say they hope these shots can help turn the tide against severe RSV cases.

There are two protective shots available for babies, and both contain antibodies against the virus. Nirsevimab is new this season, while palivizumab has been on the market for nearly two decades.

Nirsevimab is a single seasonal shot for all babies less than 8 months old and some other high-risk kids up to 19 months old. Palivizumab is a monthly injection given in October through March to children less than 2 years old who have certain high-risk health problems and meet specific criteria.

There is currently a supply shortage of nirsevimab, so the CDC is encouraging that it only be given to babies less than 6 months old and some other high-risk kids who don’t qualify for palivizumab this season.

There are also two RSV vaccines available for adults 60 and older. Additionally, Pfizer’s RSV vaccine is also recommended for pregnant people in the third trimester to protect babies. When this shot is given at least two weeks before birth, it passes on about six months of protection to the newborn.

“If you’re an older person, or pregnant, you need to remember that vaccinating yourself could go a long way to protecting our youngest, most at risk,” Dr. Julia Arana, medical director of the hospitalists team and chief of staff at East Tennessee Children’s Hospital, told ABC News.

Breastfeeding has a protective effect against severe RSV

Breastfeeding isn’t an option for all parents, as some may choose not to breastfeed or cannot breastfeed for a variety of reasons. But for those who do, a number of research studies have shown that breastfed babies are less likely to have complications of RSV. Experts believe this may be because components in breast milk help boost a baby’s immune system for added RSV protection.

“Breastfeeding clearly decreases the baby’s chance of having to have an outpatient visit or go to the hospital or worse, go to the intensive care unit,” Dr. Paul Offit, director of the vaccine education center and pediatrician in the division of infectious diseases at Children’s Hospital of Philadelphia, told ABC News.

Some babies may still need to seek care

Despite best efforts, some babies may still need medical care.

Doctors say any baby who is struggling to breathe, has difficulty waking up, or has blue discoloration of the face or lips needs to be evaluated by a medical professional right away. Parents should also get medical help if their baby isn’t feeding well or has signs of dehydration, such as dry lips or few wet diapers, according to the CDC.

Fever in some babies can also be a medical emergency, even if they appear to be well, so parents should talk to their pediatrician about when to seek care for a fever based on an infant’s age.

While there’s no specific treatment for RSV, hospitals can support babies through the illness with things like oxygen and IV fluids.

Dr. Jade A. Cobern, M.D., M.P.H., is a pediatrician, specialized in preventive medicine, and a member of the ABC News Medical Unit.

 

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(NEW YORK) — Abortion rates increased by 5% in the United States in 2021, the final year the procedure remained a constitutional right under Roe v. Wade, according to new federal data.

In 2021, there were 625,978 abortions reported, according to an annual report published Wednesday by the Centers for Disease Control and Prevention (CDC). This is a rate of 11.6 abortions per 1,000 women between ages 15 and 44.

This is a decrease from a decade earlier when there were 669,202 abortions reported in 2012 with a rate of 13.1 per 1,000 women. However, it is up from the 620,327 abortions reported in 2020 with a rate of 11.1 per 1,000 women.

The report also looked at some demographics of who is receiving abortions in the U.S. In 2021, women in their 20s accounted for more than half of abortions at 57%.

Comparatively, adolescents under age 15 and adults aged 40 and older made up the lowest percentages of abortions at 0.2% and 3.6%, respectively.

The authors also noted the percentage changes may show the continuing decrease in adolescent pregnancies in the United States.

“From 2012 to 2021, national birth data indicate that the birth rate for adolescents aged 15–19 years decreased 53%, and the data in this report indicate that the abortion rate for the same age group decreased 41%,” they wrote. “These findings highlight that decreases in adolescent births in the United States have been accompanied by large decreases in adolescent abortions.”

There were also significant racial/ethnic disparities in abortion rates. Black women were the most likely group to obtain an abortion at 41.5%. White women were the second most likely group at 30.2% and Hispanic women were the third most likely at 21.8%.

In other terms, white women had the lowest abortion rate at 6.4 abortions per 1,000 women and Black women had the highest abortion rate at 28.6 abortions per 1,000 women.

The report also found that most patients getting an abortion have already had children.

When looking at what stage of pregnancy abortions were occurring in, the report found that an overwhelming majority occurred before 13 weeks’ gestation, which is around the beginning of the second trimester.

Data showed 80.8% occurred at 9 weeks’ gestation or earlier and 93.5% occurred before 13 weeks’ gestation.

Additionally, 53% of those first-trimester abortions relied on medications. Medication abortions are a non-surgical form of abortion in which someone usually takes two pills to end a pregnancy.

Experts have previously stated that few abortions happen in the second and third trimesters and the data showed just that. Just 5.7% of abortions occurred between 14 and 20 weeks’ gestation and 0.9% occurred at or after 21 weeks’ gestation.

The CDC did not include data in the report about why patients opt for abortions at various stages of pregnancy.

However, the federal health agency said there are many reasons that determine the incidence of abortions including “access to health care services and contraception; the availability of abortion providers and clinics; state regulations, such as mandatory waiting periods, parental involvement laws, and legal restrictions on abortion providers and clinics; and changes in the economy and the resulting impact on family planning decisions and contraceptive use.”

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(NEW YORK) — Millions of people are getting ready to gather with their family and friends for Thanksgiving, celebrating the holiday in a way that most closely resembles pre-pandemic ways for the first time in more than three years.

However, respiratory illness activity — defined as people going to the doctor with symptoms of any respiratory illness such as fever, cough or sore throat — is increasing across some areas of the United States, according to the latest data, updated Friday by the Centers for Disease Control and Prevention (CDC).

Additionally, emergency department visits due to flu, COVID and RSV are increasing. Hospitalizations for flu and COVID are increasing, but remain lower than the same time last year. RSV hospitalizations are increasing in areas tracking new admissions.

Experts said there are a few well-known mitigation measures you can follow to keep yourself and your loved ones safe during the holidays.

“There are safe and effective ways to prevent the bad outcomes of these diseases and it relies very much on the ABCs, staying up to date with vaccinations, testing yourself, staying home if you’re sick, contacting your primary health care provider if you test positive to know if you’re eligible for getting treatments, and then doing the everyday things to protect your loved ones,” Dr. Albert Ko, a professor of public health, epidemiology and medicine at Yale School of Public Health, told ABC News.

Exercise caution when traveling

While most people will be traveling by car, AAA projects 4.7 million travelers will fly over Thanksgiving, which would be the highest number since 2005.

There will also likely be millions of people traveling by train or by bus to holiday gatherings.

Although it is not required by any transportation companies, experts said people may consider wearing well-fitting masks, that cover their noses and mouths, if they are in crowded or poorly ventilated areas.

This is coupled with good hand hygiene, including washing hands with warm water and soap for at least 20 seconds, or using hand sanitizer when hand washing isn’t available.

However, the most important thing someone can do is stay home when sick, said Dr. Perry Halkitis, dean and professor of biostatistics and urban-global public health at Rutgers School of Public Health.

“The number one responsibility that we all have is that if we’re feeling ill or slightly feeling ill or even beginning to feel ill, that we question whether or not we should travel,” he told ABC News. “The number one thing that I would encourage people to do, if you’re feeling ill, if you are potentially infectious, try not to go into large crowds, into situations where you can infect people.”

Be up to date on vaccinations

Experts say one of the best ways that people can best protect themselves is to stay up to date on vaccinations.

For COVID-19, there is an updated vaccine formulated to target variants currently circulating that are related to XBB, an offshoot of the omicron variant, for those aged 6 months and older.

Halkitis said he often has conversations with people who ask why they should get the updated vaccine when they already got the primary series. He replies that it’s similar to the flu vaccine, which is updated every year to target circulation.

For the majority of those aged 6 months and older, the CDC recommends receiving the standard quadrivalent flu vaccine, which protects against four different strains of the virus. High doses are available for those aged 65 and older.

For adults over age 60, two vaccines are available. For babies under 8 months old, and some babies between 8 months and 24 months, there are two monoclonal antibody shots available. The right one depends on a child’s age and underlying health conditions. People can also get an RSV vaccine during pregnancy that protects their infant after birth.

“As we’re going into this winter season, we’re actually getting back to normal,” Ko said. “So, getting back to normal means that we’re going to be having, during the winter season, increases in many of the respiratory diseases that we had in the past, and we have ways to immunize people against many of these threats that we’re going to face in the winter.”

Consider taking a rapid test

Currently, rapid at-home tests are available for COVID-19. Tests for flu and RSV require visiting a health care provider.

Experts told ABC News that people should take a rapid test before attending a gathering if they are experiencing symptoms. If it’s positive, stay home and follow CDC isolation guidelines. If it’s negative, you should not necessarily assume you don’t have COVID and should consider taking another test 48 hours later.

Ko said that people can also consider taking a test if they will be gathering with people at high risk for severe complications from COVID-19, including those who are elderly, having underlying conditions or who are immunocompromised.

Open windows or doors for ventilation

Experts said that, if it’s possible and not too cold, to host Thanksgiving outdoors. If that’s not possible, they suggest opening windows and doors for ventilation.

The CDC says that improving ventilation can reduce virus particles in the home to keep respiratory diseases, such as COVID-19, from spreading.

“Ventilation is an important way that we can control infections,” Ko said. “Not all infectious diseases are the same. They’re not all transmitted in the same way … Ventilation is particularly important in those types of diseases where we have a lot of aerosol transmission and COVID is one good example.”

Another option is buying air filters, particularly high efficiency particulate (HEPA) air filters. HEPA filters can remove at least 99.97% of airborne particles, according to the Environmental Protection Agency.

Importance of staying vigilant

Halkitis said over the last year or so, he has seen, from many people, a tendency to want to go back to the way things were prior to COVID-19.

“That’s okay because there are vaccines available for several of these respiratory viruses,” he said. “The problem, of course, is that the uptake of [some of] these vaccines is dismal at best and, as a result, going back to normal, when you’ve added COVID-19 to the mix and RSV to the mix, above flu and the common cold, creates a condition where a lot more people are going to get sick.”

CDC data currently shows that hospital bed occupancy and capacity remain stable, but the more people that get sick and need medical care, the more a burden is placed on the health care system, Halkitis said. He said it’s important to stay vigilant when it comes to preventing the spread of illnesses.

“If you look at the numbers, all of the numbers are moving in the wrong direction. There’s increases in RSV, there’s increases in flu, there’s increases in COVID,” he said. “So, keep your eyes on what’s happening with the trends and make your decisions about where to go and what to do based on what you’re seeing. Let the science direct your behavior.”

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(NEW YORK) — When Tara Rothenhoefer sits down at the Thanksgiving table this year, she said she envisions being able to enjoy herself rather than feel stressed about the food on the table.

Rothenhoefer said she attributes that change to Mounjaro, a medication that she said has helped her lose more than 200 pounds.

Prior to taking Mounjaro, Rothenhoefer said at a holiday like Thanksgiving, centered around a big meal, she would be worried about being able to “make good choices” when it comes to food.

“You’re just really focused on the food as a whole rather than the holiday,” Rothenhoefer told ABC News’ Good Morning America, adding of the change she’s seen since starting the medication, “I’ve been able to turn that fear and anxiety into more enjoyment and making sure that you know, I’m still eating the foods that I enjoy. I’m just making sure that I’m not eating as much.”

Likewise, Joe Sapone, who has lost more than 100 pounds on Mounjaro, told GMA that for him, gathering at holidays like Thanksgiving is now more about the company he’s around than the food.

“My enjoyment has not really decreased,” he said. “Because it’s as much about being with family and friends as it is about eating food.”

Mounjaro and other drugs used for weight loss like Ozempic and Wegovy have skyrocketed in popularity over the past year as they have proven successful in changing some people’s eating habits and helping people who are overweight and obese lose weight.

Clinical studies show users of the medications can lose between 5% and 20% of their body weight on the medications over time.

The active ingredient in Mounjaro, tirzepatide, works by activating two naturally produced hormones in the body: glucagon-like peptide-1, known as GLP-1, and glucose-dependent insulinotropic polypeptide, or GIP. The combination is said to slow the emptying of the stomach, making people feel full longer, and suppress appetite by slowing hunger signals in the brain.

Mounjaro — made by Eli Lilly and Co. — is approved by the U.S. Food and Drug Administration to treat Type 2 diabetes. Earlier this month, the FDA approved the drug Zepbound to treat obesity, which contains the same active ingredient, tirzepatide, as Mounjaro.

The drug is similar to semaglutide, the active ingredient in the medications Ozempic and Wegovy — both made by Novo Nordisk — but works slightly differently because it targets two hormones involved in blood sugar control rather than just one.

Ozempic is currently approved by the FDA as a treatment for Type 2 diabetes alongside diet and exercise if other medications cannot control blood sugar levels well enough.

Wegovy is essentially the same injectable drug as Ozempic prescribed at a higher dosage. The FDA has specifically approved Wegovy for patients with severe obesity, or who are overweight and have one or more weight-associated conditions like high blood pressure or high cholesterol.

Possible side effects of all three medications — Mounjaro, Ozempic and Wegovy — include nausea and stomach pain.

Dr. Katherine Saunders, clinical assistant professor of medicine at Weill Cornell Medicine in New York City, said people who are taking medications used for weight loss should be prepared to manage their expectations when it comes to big holiday meals, like Thanksgiving.

“It doesn’t completely remove the pleasure that comes from food,” Saunders told GMA. “It enables people to have a couple of bites and then say, ‘I don’t need to eat a large portion of this. That was enough.'”

Saunders noted too that it can take time for people to adjust to eating different amounts and different varieties of foods when on medications like Ozempic and Mounjaro.

“It can definitely take some time for people to get used to eating differently and selecting food differently when they’re on these medications,” she said. “So, if you don’t change your eating behavior, or the content of your diet at all when you take these medications, that’s when people can get into trouble.”

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(NEW YORK) — More than two dozen premature, low-birthweight babies have been evacuated from Gaza to Egypt to receive specialized care amid the ongoing Israel-Hamas war.

But that is only the beginning of their precarious journey back to health as they escape the conflict zone.

A joint mission between the United Nations and the Palestine Red Crescent Society, led by the World Health Organization, evacuated 31 babies from the embattled Al-Shifa Hospital in northern Gaza to Al-Helal Al-Emarati Maternity Hospital in southern Gaza over the weekend. On Monday morning, 28 arrived in Egypt, while three others who were in stable condition continued to receive care in Gaza, WHO officials said.

In total, 39 babies were removed from incubators when Al-Shifa ran out of fuel on Nov. 11. Gaza has been under siege since the Oct. 7 terror attack by Hamas in Israel, and hospitals in Gaza have run out of fuel and been bombed.

As of Monday, at least five of the 39 babies have died, including three when the power to the incubators was cut off and two prior to evacuation, according to hospital staff and the WHO. The condition of three of the premature babies who remained at Al-Shifa because they didn’t need emergency care remains unclear.

Many of the surviving babies were suffering from life-threatening health conditions including dehydration, vomiting, hypothermia and sepsis because they didn’t receive any medication, and had not been in “suitable conditions for them to stay alive,” Mohamed Zaqout, director of Gaza hospitals, said in a statement Sunday. Hypothermia can be a problem for premature babies who cannot regulate their own body temperature and can be a sign of several types of infections. The risk of hypothermia and sepsis can increase when premature babies are removed too soon from incubators and don’t have adequate access to treatment.

This is the care doctors say they will need in order to survive.

Dr. Erin Schofield, a neonatologist at the University of Maryland Children’s Hospital and an assistant professor at the University of Maryland School of Medicine, told ABC News that premature infants are the most vulnerable group of people in any hospital.

“They’re the most technology-dependent, they are the most resource-dependent, and even in the United States, where we have every means to take care of them, they’re still the biggest utilizers of medical technology,” she said. “Premature babies are a lot more fragile than people think, and keeping them warm is not just an issue of holding them or bundling them in blankets.”

Premature infants need the final months and weeks in the womb to adequately develop their organs including the brain, lungs and liver, according to the Centers for Disease Control and Prevention. Doctors said premature infants have unique health needs and their lives can be at risk without the right specialized care.

When babies are born several weeks early, they often need medical equipment to “support really every organ system, and that at its basis, at its core requires electricity. It requires heat, and if they don’t have those, they [can] very quickly die,” Schofield said.

This care requires more than wrapping them up in a warm blanket.

“Premature babies often rely on intensive monitoring and interventions performed under constant clinical supervision given how fragile they are, particularly those born at earlier gestational ages,” Dr. Nicholas Cuneo, a hospitalist in the department of pediatrics at Johns Hopkins School of Medicine, told ABC News. “Without this type of intensive care, coupled with the appropriate resources, they can be at risk of serious and disabling complications or in some cases death.”

All suffering ‘serious infections’

Eleven or 12 of the evacuated babies are critically ill while the others are seriously ill, according to Dr. Rick Brennan, regional emergency director of the WHO Mediterranean region. Babies who are seriously ill typically require medical treatment and hospitalization but are not yet suffering life-threatening conditions, while those with critical illness are suffering from life-threatening conditions.

“Each of them has serious infections and quite a few of them have low body temperature, so they really do need detailed specialist care,” Brennan said Monday. “Overnight, they received antibiotics, supportive therapy, oxygen. We are hoping that this will help stabilize all of them.” Premature babies are at increased risk of getting infections, even in ideal conditions. Incubators that provide temperature regulation help stabilize babies in a number of ways, helping reduce the risk of infections among premature babies, while early removal can have cascading effects that increase the risk of infections, including sepsis, experts said.

“These tiny, delicate humans are sensitive and any lack of medications, consistent nutrition, temperature control, or even the slightest uncontrolled infection [could] be the difference between life or death,” Dr. Alok Patel, a pediatrician at Stanford Children’s Health and an ABC News medical contributor, said.

“Adequate care for these patients involves a multidisciplinary health care team including neonatologists, nurses, technicians, respiratory therapists, pharmacists, social workers and more,” Patel added.

A team of 10 neonatal specialists took custody of the 28 premature babies at the Rafah border crossing on Monday and moved them to hospitals in Al-Arish, the largest city on the Sinai Peninsula in Egypt, according to Brennan. One group of babies is being taken to hospitals in Cairo.

“They are all, again, seriously ill. They have a long road to go,” Brennan said. “It will take a long time for many of them to recover given their current condition, but we do understand that they are getting very good care at this time.”

WHO officials said the remaining three babies were in stable condition and didn’t need to be transferred from Gaza for further treatment in Egypt. It’s unclear if they were suffering from serious infections, as well.

‘They didn’t ask for this’

Even transporting the premature babies to a safer area can exacerbate some of the health conditions they are facing, Schofield said.

“Transport is not a benign event, and we don’t want to have to transfer a fragile premature baby unless we absolutely have to, unless the benefit outweighs the risk,” she said. “In this case, getting fragile premature babies out of the conflict zone, it certainly outweighs the risks.”

Schofield said once the babies are in a stable environment, staff will need to check for electrolyte imbalances from dehydration, signs of continued infection and internal bleeding.

They should be placed in incubators with temperature probes to control their body temperature, Schofield said. Additionally, they may require feeding tubes if they can’t eat by mouth yet, as well as regular feedings of breast milk or specifically made infant formula they may not have had access to for days.

“Premature babies … they didn’t ask for this,” Schofield said. “They didn’t ask to be born in a conflict zone, and I think we really owe it to them to do our best to give them the best chance at survival.

She added, “It’s heartbreaking to see these babies who, if they had not been born into conflict zones, really wouldn’t face many challenges, and now being born in a conflict zone adds just heaps and heaps upon them, all of these challenges that really no child should have to face, so as much as we can, limit that in their exposure to this.”

Dr. Jade A Cobern, M.D., M.P.H., is a pediatrician in a neonatal intensive care unit and a member of the ABC News Medical Unit.

ABC News’ Will Gretsky contributed to this report.

 

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(NEW YORK) — The Centers for Disease Control and Prevention (CDC) issued a warning Monday about a listeria outbreak linked to recalled peaches, nectarines and plums after 10 hospitalizations and one death were reported in seven states.

The agency said the affected fruits, which were distributed nationwide and sold at retail stores, were branded “HMC Farms” or “Signature Farms.” The recall did not include organic fruit.

HMC Group Marketing has voluntarily recalled the fruit, sold between May 1 and Nov. 15, 2022, and the same dates in 2023, that have a sticker reading “USA-E-U.” The stickers have numbers 4044 or 4038 for yellow peach, 4401 for white peach, 4036 or 4378 for yellow nectarine, 3035 for white nectarine, 4042 for red plum and 4040 for black plum. The recall is also for the fruit sold in two-pound bags. The CDC confirmed an investigation is ongoing to determine if any additional fruit or products made with this fruit may be contaminated.

Listeria infection is especially harmful to people who are pregnant, aged 65 or older, or with weakened immune systems due to its likeliness to spread beyond their gut to other parts of their body, according to the CDC.

The symptoms, including fever, muscle aches and tiredness for those who had caught the disease, may begin within two weeks after consuming the contaminated food. They may also occur as early as the same day or as late as 10 weeks after exposure, the CDC notes on its website.

Although the recalled fruits are no longer available in stores, they may still exist in the homes of consumers for later use, the CDC said in its release, adding that consumers should check their freezers and discard or return the fruits that meet the criteria. The agency also urged consumers to clean surfaces and containers that have touched the fruit.

In a statement to ABC News on Monday, Amy Philpott, a spokeswoman for HMC Group Marketing said, “There is nothing more important to us than providing safe, high-quality fruit to consumers.”

“We never want anyone to become ill from eating fresh fruit, and our hearts go out to those affected by the outbreak,” she added. “We are working tirelessly with the FDA to investigate how the contamination happened.”

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(NEW YORK) — Ahead of the approaching holidays and a potential rise in cases this winter, the government is once again allowing households to order a fresh wave of four COVID-19 tests for free online.

The website, covidtests.gov, remains one of the last remaining ways Americans can secure free at-home rapid test after the end of the public health emergency last spring ended the requirement for insurance companies to cover eight tests per month.

Over the past three years, the return of winter has also brought a resurgence of COVID-19. According to modeling data from the Centers for Disease Control and Prevention, health officials are anticipating a similar number of hospitalizations this year as they saw last year, which topped nearly 45,000 per week at its peak.

The test ordering site relaunched last month, offering four tests per household, and will now offer an additional four tests per household for anyone who has already ordered — or eight tests per household for anyone who hasn’t placed an order yet this fall.

Since September, about 14.5 million households have ordered tests, for a total of 58 million tests shipped, according to the Administration for Strategic Preparedness and Response, or ASPR, a department within the Department of Health and Human Services.

Health officials said they are hopeful people will take advantage of the free tests to better prepare for gathering with other people, particularly those who are more vulnerable to the coronavirus, during the holiday season.

“We’re going to see families gather with older loved ones and younger loved ones and it’s important that they are able to protect their loved ones from COVID as we head into the winter months,” said Dawn O’Connell, head of ASPR.

“So we think opening [COVIDTests.Gov] up right before the winter holidays really kick in is going to be very important for the American people, to provide this access for the free four tests again,” she said.

Some of the free tests that the government has stockpiled are also up against impending expiration dates, another reason to move the tests along, O’Connell said. The Food and Drug Administration recently extended expiration dates for many at-home tests, but they still have a relatively short shelf life.

“We know that the tests are going to be good for the next several months. They’re not going to be good forever. And so we think it’s important that we go ahead and have them in the hands of the American people so they can use them and protect themselves as we head into the winter,” O’Connell said.

The website for free at-home tests has had an on-and-off presence since the winter of 2022, when the omicron variant was driving cases up across the country.

At the time, President Joe Biden pledged to give out 1 billion free rapid tests to ease soaring demand and an overwhelmed test manufacturing industry.

But the government site was temporarily shut down that fall as a political fight dragged on over COVID-19 funding. Administration officials said they had to conserve tests in case they didn’t get agreement from Republicans to allocate more money — which they didn’t.

Conservatives have become more skeptical of continually providing billions to respond to the pandemic, including by pointing to fraud that marred some of the aid.

The testing site relaunched again in December 2022 as cases began to climb again, then shut down this past June, before relaunching in September of this year.

The tests will come from a $600 million investment in domestic test manufacturers, which will yield around 200 million tests and replenish the federal stockpile. Tests ordered from covidtests.gov will be pulled from that stockpile.

The funding for the $600 million investment will come from money that was left over from a past supplemental COVID-19 bill. Though the debt ceiling deal reached over the summer between Biden and Republicans in Congress did claw back about $30 billion in unspent relief funds, administration officials said there was still enough left over to put toward replenishing the testing stockpile this fall.

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(NEW YORK) — When a recent federal report published last week showed routine childhood vaccination rates had fallen among kindergartners for the 2022-23 school year, public health experts were disheartened to see the drop.

However, there was one state that lagged behind the rest: Idaho.

For all four major vaccines — measles, mumps and rubella (MMR); diphtheria, tetanus and acellular pertussis (DTaP); poliovirus (polio) and varicella (chickenpox) — Idaho had the lowest percentage of kindergartners who met school requirements for vaccinations, all around 81% compared to a nationwide rate of 93%.

What’s more, Idaho was the state with the highest percentage of exemptions from one or more required vaccines at 12.1%. Comparatively, the rate of exemptions across the U.S. was about 3%.

“This is concerning not only at a state level but nationally, as well, because we’re not the only state experiencing this; we just appear to be experiencing it a little more than other states,” Dr. Bethaney Fehrenkamp, a clinical assistant immunologist at Idaho WWAMI — a partnership between the University of Washington School of Medicine and Washington, Wyoming, Alaska, Montana and Idaho — told ABC News.

Public health experts noted that clusters of unvaccinated or under-vaccinated children can lead to outbreaks of preventable diseases such as measles, which is exceptionally contagious and can lead to serious complications such as pneumonia, encephalitis — which is inflammation of the brain — and even death, according to the Centers for Disease Control and Prevention.

In one case, between November 2022 and February 2023, a measles outbreak swept across several schools and day cares in central Ohio, infecting 85 children, 80 of whom were unvaccinated.

In Idaho, there was a measles outbreak last month that infected 10 people, according to the Idaho Department of Health & Welfare. Prior to that, there had been just two cases reported in Idaho in 20 years.

When you have an under-vaccinated population and a contagious disease, “it’ll spread and it’ll spread more easily,” Dr. Kevin Cleveland, an associate professor at the College of Pharmacy at Idaho State University, told ABC News.

The type of exemptions allowed also may pose a problem. All 50 states and Washington, D.C. allow exemptions for medical reasons while 45 states and D.C. grant exemptions on religious grounds, according to the National Conference of State Legislatures (NCSL).

However, there are also 15 states that grant philosophical exemptions due to “personal, moral or other beliefs,” the NCSL says. This means that parents can ask for an exemption for their child for just about any reason.

Experts say there are a few reasons why rates might be low. One is access. Idaho is a state with 35 of its 44 counties being rural and 174 physicians per 100,000 people, which may make it hard for people to reach providers or schedule appointments.

Additionally, the rates may be an after-effect of the COVID-19 pandemic. Some of the hesitancy around COVID-19 vaccines may have inadvertently spilled into concerns about other vaccines.

“We’ve seen a slow but kind of steady increase in vaccine hesitancy but that was exasperated by COVID-19,” Fehrenkamp said. “While some of the decreased vaccination rates during the pandemic itself were probably likely due to access and availability and maybe a fear of bringing your child to a health care facility during a pandemic — potentially, like misinformation and some lack of trust as well as incomplete transparency has also just kind of exasperated that trust, and made it worse.”

Cleveland said people may also be experiencing vaccine fatigue after being recommended by health experts to get COVID-19 boosters and updated vaccines to help combat circulating variants at various times.

“Every time we talk about a vaccine, it goes back to COVID vaccine,” he said. “I think people are just a little tired. It’s like, ‘Oh, no, another vaccine.'”

Another reason may be that because these diseases have been circulating at low rates due to vaccines, people have forgotten how serious they were before the advent of vaccines.

For example, in the decade before the MMR vaccine became available, it was estimated that 48,000 people were hospitalized with measles each year and between 400 and 500 people died each year, according to the CDC.

“These diseases are really, really contagious and they’re really serious and I think potentially, we’ve forgotten how serious these diseases can be and we require a certain number of the population to be vaccinated in order to get that protection for those that can’t be vaccinated,” Fehrenkamp said. “We’ve previously eradicated these diseases in the U.S., which is why I think maybe, culturally we have forgotten how serious and how detrimental they can be.”

To try to increase these numbers, Fehrenkamp said it’s important for health care providers to have honest conversations with parents about why they’re hesitant or concerned about vaccines to try to assuage their fears.

“I want parents to choose to vaccinate their children, but I want them to feel really good about it and I want them to feel really informed about it and so we need to do a better job informing on vaccine safety,” she said.

At Idaho WWAMI, Fehrenkamp said they bring in students from Idaho that have links to underserved communities to help educate them with the hope they’ll go back and practice in those areas and fill a health care gap.

Cleveland, who specializes in immunization outreach to underserved populations in Idaho, said it’s also important to bring those vaccines into rural or underserved communities to make it easier for people to keep up with vaccine schedules.

“Taking the vaccines to the people, especially in the rural areas or even like workplaces or schools, we usually have really good success in vaccine uptake,” he said.

 

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