Considering Pertussis

If you are in your last trimester, your doctor might be mentioning that you need to get a tetanus booster shot.  Because I also work in public health, I get many questions about the why, the need,  the safety of this vaccine. Tetanus, Diphtheria and Pertussis has been around since I was a child when it was called DPT.  It did a pretty good job of protecting me from getting the whooping cough.  As I grew older, that vaccine became a shot I got for stepping on nails or needing to get it to participate in boy scouts.  Over the years, there have been pertussis outbreaks through the Oneida County area.  The recommendations have change because of that and now any child going into 6th grade is required to get a Tdap vaccine.

from  London School of EconomicsPrinter: Mospoligraf Publisher: Gosmedizdat Place of Production: Moscow Date: 1930


Two sepia illustrations, the first showing a breast-feeding mother with a cloth
wrapped around her nose and mouth; the second showing a mother pushing
another woman away from the baby on her lap.

But now the researchers are realizing just how "bad" this pertussis situation has become.  Not just in our county and state but around the nation.  It is now being recommended that parents to be get protected from pertussis.  CDC has released the following regarding Tdap in pregnant women.

On February 22, ACIP published its October 2012 recommendation stating that pregnant women should receive Tdap vaccine during each pregnancy, irrespective of the patient’s prior history of receiving Tdap. Receiving a Tdap vaccine during pregnancy allows for maternal pertussis antibodies to be transferred to the newborn and likely provides protection to the baby against pertussis early in life, before the baby is able to receive diphtheria, tetanus and acellular pertussis(DtaP) vaccines. Tdap will also protect the mother, making her less likely to transmit pertussis to her infant after birth. Optimal timing for Tdap administration is between 27 and 36 weeks gestation although Tdap may be given at any time during pregnancy. Pregnant women not previously vaccinated with Tdap and who did not receive Tdap during the pregnancy should receive Tdap immediately postpartum.

To read the recommendation,

Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and

Acellular Pertussis Vaccine (Tdap) in Pregnant Women

Advisory Committee on Immunization Practices (ACIP),2012

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6207a4.htm

This image depicts a female infant who presented to a clinic
suffering from what was diagnosed as pertussis.
provided by CDC. 

Pertussis is a highly communicable, vaccine-preventable disease due to

 Bordetella pertussis, a gram-negative coccobacillus, 

lasting for many weeks and typically afflicts children with severe

coughing, whooping, and posttussive vomiting. 

 So - to sum it up. 

If you are pregnant - consider getting a Tdap vaccine between 27 and 36 weeks gestation.  This way the baby gets the benefit of receiving protection early in their life.  Plus, it is good to make sure that the people who will be around the baby on a regular basis - father, older siblings, grandparents get this vaccine to keep them from getting whooping cough. 

The sneaky thing about pertussis is that when an adult gets this, they shrug it off as a bad cough or bronchitis.  Their symptoms aren't that strong.  BUT, now they have passed it on to an infant that has NO protection from whooping cough and 50% of all infants who contract pertussis will be hospitalized. 

 

Office for Emerency Management.
1943-45

And this is how it is spread.  Of course, we can't see our coughs this way -- thank goodness,
but how many times have you been sitting next to someone who turns their head to
sneeze or cough and misses his shoulder and you get the full blast of - yup -  his germs.
  Or coughs into his hands and then --- horrors, reaches out to shake yours and introduce himself.  

Having babies makes me think

One of the things I appreciate about my clients is what I learn from them by being their doula.  When I am asked to be someones doula, I always research such things as posterior babies, transverse babies, placenta abnormalities and the list can go on and on.  Every birth is so different from any of the others I have witnessed, from the 30 hour plus to the 3 hour, vbacs and cesarean,  each is one of a kind.

So today, I was asked by a fellow doula if I would help her teach a couple that because of hospital restrictions is only allow so many people in the birthing room.  After some thought I said, sure why not.  So now I am doing my research as to the best way to present to someone how they can be a doula for the women who will be having her baby.  The more I thought about it, the more I realized - what an honor.  To be able to have the support of your husband and the support of the couple who would be adopting their baby. What greater joy could there be.  So now I am excited because I get to teach a soon to be mom how to be a doula for her baby's mother.  Is that cool or what.

Birth Surveys

Today I was asked to look over a birth survey.  I thought,  that's a bit odd.  But then I gave it some more thought and realized that - it's not so odd at all.  if hospital don't know what they are doing either positive or negative, how will they know how to make improvements in their care.   Except for say plastic surgery, going to the hospital to have a baby is the one time your aren't sick or in need of special care to make you better. So, why do doctors, nurses, hospital administrators make you seem "sick".

You get wheeled in, you get removed of your clothes,  given a  hospital gown, you are hooked up, and on and on.  Sounds like a patient to me and not a mom to be.

So, I am looking over this survey and tweaking it here and there and praying that when parents fill this out and send it to the hospital administrators as well as the maternity wards a difference will be made.