Where every. Other year can you know whats interesting the mushroom edition that is under lockdown conditions and for. A long. Time this. Is a nurse. And shes next. My biggest concern is the quality of the prenatal care the army will receive in this pregnancy especially with a lot of my appointments being cancelled or switched to tell medicine which is very limited and even if there werent more urgent appointment it is filled with a desire to because our support partners i mean he will be present with us theres also been a lot of aggrieved a box pregnant women with their baby showers being hit sold i know it sounds trivial by a lot of who have been relying on these baby showers to provide essential for their baby and of course there are other concerns like contracting who it ourselves and possibly passing it on to our baby or being separated from our baby after delivery so its a stressful time for women to be pregnant but i have everybody stay safe. In this may its stressful just listening to that do you have concerns to have questions do you have the answers would love jumping judge each. And yes you can be in these. 3 judges to help us out of this conversation hello dr karen introduce just after our audience good morning my name is Karen Nielsen professor of pediatric Infectious Diseases at u. C. L. A. In los angeles and i work with mother to child transmission of infections gives a really high doesnt then its right at each other over out into the stream tell anybody who you and your qualifications not all of them because we only have a few seconds to do your introduction but whats meant to be relevant to this comes. I mean. My name is often read aloud or call. Im an obstetrician gynecologist correlate it into a room. And im fine as a health unit but a department of sexual or productive how to. Organize as. Up us live i used to see if. I care for that would make it happen thank you so much and welcome to the student turned really really well good morning so my name is let me see kind and i am in the region and in training spent many years caring for one in the sense and then given a to focus more on fragilities an amateur journey doctor working in a private practice i may have seen or new york city. Medical center this topic is near and dear to my heart because i myself am actually 27 weeks pregnant right now. Congratulations lets start with you because what is new about your pregnancy related to transit 98 what is your biggest concern is a latino about the dispenser. So definitely you know in the last few months weve learned a lot its been a very sharp learning her and i would say weeks ago i felt very apprehensive at the fact that this was a novel that i rest and the little didnt that we had was coming from countries and regions in the world that were before us in late fall and winter so the lack of data area is very troubling to me i think now that we unfortunately new york city has become the epicenter of the infection in the United States weve gathered a lot already yes ive been talking a lot directly with my colleagues in maternal ascends who are on the front lines treating patients when you get minted for labor delivery and also happen to the us and so i think weve learned a lot. Of questions could be best described as split into 2 categories on the maternal side you know i read about how when there is a virus anything like influenza or other respiratory viruses which we know can hit women harder when theyre pregnant so fortunately we were see that the breakdown of miles to minor cases versus if your case is requiring x. You much air that breakdown tends to be very similar to what were seeing in the illusion i was particularly interested in the Maternal Health aspect because i also happen to have moderate to severe as and so i think anyone whos pregnant will and underlying lung condition is particularly apprehensive about you know checks in cologne and you know being immunosuppressed in pregnancy and then on the field theres a lot of questions that we have. It was a financial something of what the dimensions of driving for pregnant moving to do you have that you might not im french going to take much of the 19th wash your hands the space between you and others avoid touching eyes nose and mouth. Its the same as when everybody else is doing theres no special way that you can just ask if youre expecting. Them subtly or right i mean what weve found is that the the behavior of the virus at the moment in terms of whats into mythology is not any different between the pregnant population and the number of the population so at the same time there is their way to prevent contract and a virus which is not any different those 4 things that you mentioned are key. And regularly use in core based rob or water and it has been saying listen just a copy doesnt mean a thing based on least really stress department because even talking about these basic Public Health protections the several months. As a reckoning was 8 anything extra that they need to do. Actually there is another extra at the moment. Those Public Health measures they do work. On i think what is a problem is that people are not able to implement them correctly one of those things that you showed on the screen now which is of on. Your face is no necessary either of. Those alleged other woman germs or it can and its quite effective i do what is what are problematic is that a lot of people dont know how to wash their hands properly so there are videos that will be issued or washing hand for a minimum of you know 22nd at least initially that you wash or parts of the hand i would know you know a nurse or do she doesnt that it was nearest you do exactly the same as the rest the population is it doesnt matter the age its exact the same is that we have to be even more chaff of the term let me just bring you in here because i have another doctor whos on my way. That we were doing this i got to just cells is there any evidence of you master mason to determine that 19 infection intrinsic. In him and searched by mr wilson last 3 months and has been. An indication that that may be a case can you look at me constantly and. Well there is so far no evidence. Code it would be if the Novel Coronavirus would behave like any other very what we call teratogenic viruses that cause malformations to the fetus for example to seek that which was a catastrophe and cause all these very severe shell formations deformities and so forth but theres no evidence yet. At least from ultrasound if you know a lot of missions we have to remember this is an epidemic that started in january so we will have that many women who are infected in the 1st trimester giving birth that will happen later in the year so theres no real data yet but as far as we know from all the ultrasound data there has been evaluated this far there is no evidence of any congenital malformation the virus which is very reassuring. As you push back you know my viking thinking we dont know that much of that 19 pregnancy i think we have all our information sorry i think the mother and her niece and particularly friend the 3rd trimester because we have women in the United States that have delivered and theyre known to be called positive at the time of delivery in there have been some studies and columbia new york presbyterian are here with lower numbers just because were still in the learning. Where at least 43 women are to master who deliver. They have the opportunity to. Do testing also test for the virus in the breast milk to. The court. And they were unable to detect the virus so i have personally found that to be very reassuring study you know if they get some of the smaller stones that. Earlier this year. When you meet other. Mums and they know what you do know your speciality what they are. A lot of the questions i get asked about are Family Planning related. You know treating infertility is a very time sensitive matter. Because of the fact that women are one with a limited number of eggs over time the quantity in our of eggs diminishes and so and the baby is sort of apprehension whereas 2 months ago how are we you know we are so we have. To know where there is a smart idea to proceed with our and we didnt go or so eyelashes want to know how does this impact my fertility. What impact could this have i mean is it wise to move forward at this time or preconception should i be to you know my hands those are the most common questions i get asked the doctor who was who has an ethical conversations and its like is it ok to have a baby now where in. Is a big strain on the various Health Services around what is now if you. A developed nation or developing nations how services are under stress that question is even done it shows what health organization. The religion is looking at every perspective of the virus including ethical issues not just around the pregnancy but as it relates to other population management as well. But i think. You know sleep thinking whether or not they were a woman should consume at the moment i mean this is a kind of something that has to be individualized and at the moment what with that you know sort of saying is that there are all of this things that michael expose about the fact that we do not have any evidence at the moment to indicate the virus got across from the mother to the baby is very assurance and its not just the instruction for must see new moons you need to try and gentler of whats. So important with a great as name of times through the john kasich system in michelangelo. What states retain with. Him he can eat what is unique to that 99. Well there have been some papers primarily coming out of china looking at what we call perry needle transmission how frequent the virus will pass from the mother just baby so in those papers its reassuring to find out that in most situations the baby does not seem to be infected at the time of birth but there have been babies who have contracted and come down with the infection within 24 hours 36 hours 72 hours of war and now its unclear whether they the virus was in the battle announced many of these babies actually were delivered by c. Section what is the moat very likely they could have been infected right at the time of birth they came into contact with the mother and the mother you know this is a highly infectious virus so theres no. Show the transmission occurs you know through the vessel canal or through the placenta or you know in enjoying pregnancy itself having said that there have been a few papers now that have found the virus in the placenta. Just one in. 3 more significant needs a stage of pregnancy he wants to take the lead to see to it its not just. Right now with the information that we have a scanty most of the women have been studied who are those women that got infected and it thought traveston and as my colleagues of said there is no clear cut evidence at the moment that the virus gets transmitted to the baby and that time. If we feel but to what weve learned from other mass than that in the previous epidemic there is no evidence to demonstrate that. There is a higher incidence of any pregnancy loss of this courage for women who are going to be infected with the grosses and the in the in the trying missed us so my would say that for what we know now we feel pretty. Comfortable not super confident because that the terrorists will evolve in and well learn more as we gather more data. The moment i do not see any serious consent for women to be worried about mother to child transmission of the virus if injected into trimester. Does is let me share with you a conversation that is going back to forth with us on twitter so lets start with minute with this 219 concludes i think regulation in the arteries of the lungs heart kidneys in the brain age matching what would it mean to a fetus its unconscionable to get pregnant now burst into the freedom in the morning after pill in multitasks we just dont want to change a thing in the neon. Mogo system must continue just like the hump of the 19th and vaccine must that nature take its course and is. That the last example one has to surely opinions and then you can just take you to analyze. And honestly he was. Family and had 19 happened. And it gave her poorest as she struggled to count will do. This is what she told the strain the. Truth is that even at the best of times deciding to have children is very scary but i also saying that as long as we believe that life is worth living which means that even in the face of obstacles and challenges be they. Are Climate Change or politics or the economy as long as we think that in the face of all of these life is still something thats worth fighting for then i think that we shouldnt worry about whether or not its still good to bring new life into the war anymore and then we worry that its going to sustain our own. Does a chinaman really seeing that you see to a. Fine tunes you can because they knew they had an impact on the e. C. The same time to see around 1000. I dont believe so i think the situation was it was fairly different because it was proven documented early on that it was causing feudal malformations and there were detected around 20 pregnancy by that time releasing the ultrasounds and see that there were very significant. Damage to the Central Nervous system its different with what would cause as injury to the lungs if it affects a pregnant mother of course the babies will depend on the Maternal Health so if a mother becomes very sick with hope that this will of course will have repercussions as with any other disease to the baby in terms of maybe it will be premature deliveries it could be complications when her mother pregnant woman has to go on the ventilator of course that would affect the outcome of the fetus as well having said that fortunately pregnant women are not at higher risk than the general population as as we are reviewed here. I want to bring in. As a new much berth in belgium in brussels just a few. Hours doing well but at some point you. Know. And these assaults. The woman from when you do it if you kill it if it is so they did a pregnancy monitoring and told me they would also test me for cover 19 and i thought it would be negative the next day my gynecologist called me to tell me that it was positive we nearly fell off our chairs because this had a lot of consequences in met my husband could not be with me when i was giving birth and that i was going to be on my own it was a start of a completely different process to the 2 days ahead of the child birth were much more stressful i was so afraid for her. Assume that he has 3 doctors you specialize in childbirth or pregnancy on new one im going to get community to speed around each other questions and you teach doctors youre going to give me answers which relate never asked that most yes and let me take extreme heat in the other and then start a family you take that one. Vitamin d. Especially in our current recommendations say is that there is no evidence to demonstrate that it improves outcome so. I think i own of quality sleep regularly what lot of vitamins. Or whatever my crew trained. Those are things that at the moment the villagers are recommending on the time he ducks in any of the moving are more questions since mental. Thank you so let me just say i present pregnant in the terrible and dont like going out unless i have to you dont want to return to the 19 and other in such and so does the lucky. Ones pregnant youre right about dont ask me were not going out to say. No mas 19th you had. It is so i think everyone has to have an individualized plan that makes them comfortable i can speak from my own personal experience that i can truly trying to minimize all exposures possible movies out of an abundance of caution and if thats the case and i was being overly paranoid that everything turns out ok then and im happy with that i think what you do have to live your life so i think its fine to you know leave your house you need to go to the grocery store. Wearing masks exercising hand washing and doing it often throughout the day and minimizing my exposure to groups of people and from a very early stage just out of an abundance of caution in equal really vigilant i dont think that women have to lock themselves up and i think its reassuring so far there are not seen that this is a virus that behaves. When theres a real known arrest but i also think its important to balance that lack of evidence of risk doesnt equal access and. Its lack of it and their right you know. What isnt used to send a doctor lucky precent that was a sense for the women who were about to give birth how do you protect yourself and protect your. Son possibly. Well in some hospitals like the hospital i work in are the women who command to deliver theyre actually tested for 19 so theres a blanket testing of women so that you know theres not only protection to these women but also protection to the staff theres of course concerns of exposure so that is a decision that has been made in that sense certainly health care has to end pregnancies have to be handled the way they would be handled normally you know women have to come in after be checked they have to be evaluated we live in this area telemedicine i think you just have to follow through with what your doctor says be compliant be vigilant and and hopefully everything will be taken care of we should not avoid medical care. Im just looking at these are still in the dismissal of the se you can see close on to us of that which is here in this ng and what she knew doctors need is 100 you could ask that the pregnant in the time of the term denecke or lockdown how do you recognize a sons uncited suppression and stress in oneself and others just what hes so impressive you are sitting when. Youre advising other people and you are also its lets not waging a Global Pandemic how do you control that stress. As an expectant mom he. I think you have to end knowledge that its stressful and something that i learned very early on in going through this as both a professional and from a personal standpoint is that its important to not overestimate your ability to deal with the stress of the hour now on and i think mobilizing whatever resources you have around you i think its important to have an obstetrician that you feel really comfortable talking to and reaching out to especially during times like these. Its different for everyone maybe telemedicine isnt for every patient i definitely have in. The use of telemedicine throughout ireland since media are calmer and less anxious for some cases it might make them feel more anxious and less connected to their doctor so i think you have to find a way to garner support for your personal circle but also our National Debt are taking care of you and i think there are there is a lot of peace and reaching out to Mental Health professionals as well because you know what youre struggling with exactly overwhelmed. Thank you dr lucky that you got to power thank you doctor and the as well for putting your expertise to atl to go on for corona virus and pregnancy is so much more sense of why well the deal is a Novel Coronavirus when we leave you there is that w. H. Y. Revising device for your unit if youre pregnant or not pregnant has a weapon against her that 19 we wash our hands frequently in that space between yourself and others avoid touching your eyes nose or mouth that is a cough or sneeze into your pen. You know that you know thats a much watsons accidents child thanks for taking. Portrays one of the wounds only cities seen through the eyes of those who know it best they see their theory of concern to the few. Aljazeera world goes on the road with palestinian taxi drivers living and working at the heart of one of the most hockey contested locations on the. Jerusalems a palestinian cabbies on how jazeera that in america is a region of wonder of joy of tragedy and of violence but it doesnt matter where you are youll have to be able to relate to the human condition come to seem to be trying to break away culture and us not know how quick its a light and its my job to shed light on how and why you know certain isolating times the listening post cuts through the noise youve been looking at another side of this story are some of the information around the outbreak but the myth of the listening post on aljazeera. The latest news as it breaks the mind sits within a valley surrounded by bush land and most of its operations have been about 500 maces but the surface with detailed coverage the Malaysian Navy recently prevented a boat carrying around 200. 00 range of refugees from landing from the around the world summit leaders are accusing their opponents of trying to topple that by countering with financial stability. Play an important role. Ringback on the offensive afghanistans president orders his minute treats. Again target the taliban after attacks on a Maternity Hospital and a funeral. Visit 0 live from doha are also coming up travel restrictions are back in place in a northern chinese province amid fears over a new wave of corona virus infections. Back to business england starts its return to work after 7 weeks