Latest news with #PPCM
Miami Herald
2 days ago
- Health
- Miami Herald
HHS eliminates CDC staff who made sure birth control is safe for women at risk
For Brianna Henderson, birth control isn't just about preventing pregnancy. The Texas mother of two was diagnosed with a rare and potentially fatal heart condition after having her second child. In addition to avoiding another pregnancy that could be life-threatening, Henderson has to make sure the contraception she uses doesn't jeopardize her health. For more than a decade, a small team of people at the Centers for Disease Control and Prevention worked to do just that, issuing national guidelines for clinicians on how to prescribe contraception safely for millions of women with underlying medical conditions - including heart disease, lupus, sickle cell disease, and obesity. But the Department of Health and Human Services, which oversees the CDC, fired those workers as part of the Trump administration's rapid downsizing of the federal workforce. It also decimated the CDC's larger Division of Reproductive Health, where the team was housed - a move that clinicians, advocacy groups, and fired workers say will endanger the health of women and their babies. Clinicians said in interviews that counseling patients about birth control and prescribing it is relatively straightforward. But for women with conditions that put them at higher risk of serious health complications, special care is needed. "We really were the only source of safety monitoring in this country," said one fired CDC staffer who worked on the guidelines, known as the U.S. Medical Eligibility Criteria for Contraceptive Use, or MEC. "There's no one who can actually do this work." KFF Health News agreed not to name this worker and others who were not authorized to speak to the press and feared retaliation. The stakes are high for people like Henderson. About six weeks after having her second baby, she said, her heart "was racing." "I feel like I'm underwater," Henderson said. "I felt like I couldn't breathe." She eventually went to the hospital, where she was told she was "in full-blown heart failure," she said. Henderson was diagnosed with peripartum cardiomyopathy, an uncommon type of heart failure that can happen toward the end of pregnancy or shortly after giving birth. Risk factors for the condition include being at least 30 years old, being of African descent, high blood pressure, and obesity. The CDC contraception guidelines say that combined hormonal contraception, which contains both estrogen and progestin to prevent pregnancy, can pose an "unacceptable health risk" for most women with peripartum cardiomyopathy, also known as PPCM. For some women with the diagnosis, a birth control injection commonly known by the brand name Depo-Provera also carries risks that outweigh its benefits, the guidelines show. Progestin-only pills or a birth control implant, inserted into an arm, are the safest. Henderson said her cardiologist had to greenlight which contraception she could use. She uses a progestin-only birth control implant that's more than 99% effective at preventing pregnancy. "I didn't know that certain things can cause blood clots," Henderson said, "or make your heart failure worse." Heart failure is a leading cause of maternal mortality and morbidity in the U.S., with PPCM accounting for up to 70% of heart failure cases during pregnancy. Sweeping HHS layoffs in late March and early April gutted the CDC's reproductive health division, upending several programs designed to protect women and infants, three fired workers said. About two-thirds of the division's roughly 165 employees and contractors were cut, through firings, retirements, or reassignments to other parts of the agency, one worker said. Among those fired were CDC staffers who carried out the Pregnancy Risk Assessment Monitoring System, a survey established nearly 40 years ago to improve maternal and infant health outcomes by asking detailed questions of women who recently gave birth. The survey was used "to help inform and help reduce the contributing factors that cause maternal mortality and morbidity," a fired worker said, by allowing government workers to examine the medical care people received before and during pregnancy, if any, and other risk factors that may lead to poor maternal and child health. The firings also removed CDC workers who collected and analyzed data on in vitro fertilization and other fertility treatments. "They left nothing behind," one worker said. U.S. contraception guidelines were first published in 2010, after the CDC adapted guidance developed by the World Health Organization. The latest version was published last August. It includes information about the safety of different types of contraception for more than 60 medical conditions. Clinicians said it is the premier source of evidence about the safety of birth control. "It gave us so much information which was not available to clinicians at their fingertips," said Michael Policar, a physician and professor of obstetrics, gynecology, and reproductive sciences at the University of California-San Francisco School of Medicine. "If you've got a person with, let's say, long-standing Type 2 diabetes, someone who has a connective-tissue disease like lupus, someone who's got hypertension or maybe has been treated for a precursor to breast cancer - something like that? In those circumstances," Policar said, "before the MEC it was really hard to know how to manage those people." The CDC updates the guidelines comprehensively roughly every five years. On a weekly basis, however, government workers would monitor evidence about patients' use of contraception and the safety of various methods, something they were doing when HHS abruptly fired them this spring, two fired workers said. That work isn't happening now, one of them said. Sometimes the agency would issue interim changes outside the larger updates if new evidence warranted it. Now, if something new or urgent comes up, "there's not going to be any way to update the guidelines," one fired worker said. In 2020, for example, the CDC revised its contraception recommendations for women at high risk of HIV infection, after new evidence showed that various methods were safer than previously thought. HHS spokesperson Emily Hilliard declined to say why CDC personnel working on the contraception guidelines and other reproductive health issues were fired, or answer other questions raised by KFF Health News' reporting. Most women of reproductive age in the U.S. use contraception. CDC data from 2019, the most recent available, shows that more than 47 million women ages 15 to 49 relied on birth control. About 1 in 10 used long-acting methods such as intrauterine devices and implants; 1 in 7 used oral contraception. The latest guidelines included updated safety recommendations for women who have sickle cell disease, lupus, or PPCM, and those who are breastfeeding, among others. Clinicians are now being told that combined hormonal contraception poses an unacceptable health risk for women with sickle cell disease, because it might increase the risk of blood clots. "It can really come down to life or death," said Teonna Woolford, CEO of the Sickle Cell Reproductive Health Education Directive, a nonprofit that advocates for improved reproductive health care for people with the disease. "We really saw the CDC guidelines as a win, as a victory - they're actually going to pay attention," she said. The 2024 guidelines also for the first time included birth control recommendations for women with chronic kidney disease. Research has shown that such women are at higher risk of serious pregnancy complications, including preeclampsia and preterm delivery. Their medical condition also increases their risk of blood clots, which is why it's important for them not to use combined hormonal contraception, fired CDC workers and clinicians said. The CDC information "is the final say in safety," said Patty Cason, a family nurse practitioner and president of Envision Sexual and Reproductive Health. Having only static information about the safety of various types of birth control is "very scary," she said, because new evidence could come out and entirely new methods of contraception are being developed. Henderson said it took her heart two years to recover. She created the nonprofit organization Let's Talk PPCM to educate women about the type of heart failure she was diagnosed with, including what forms of birth control are safe. "We don't want blood clots, worsening heart failures," Henderson said. "They already feel like they can't trust their doctors, and we don't need extra." ____ Copyright (C) 2025, Tribune Content Agency, LLC. Portions copyrighted by the respective providers.
Scottish Sun
03-05-2025
- Health
- Scottish Sun
Docs said my heart was failing at 31 – I was terrified my 5 kids would grow up without a mum so I lost 8st WITHOUT jabs
The young mum received the devastating diagnosis after spotting a terrifying symptom while getting her kids out of the bath and says 'I knew I had to do something'. Here, she reveals the life-saving steps she took MUM'S AGONY Docs said my heart was failing at 31 – I was terrified my 5 kids would grow up without a mum so I lost 8st WITHOUT jabs AFTER giving birth to her fifth baby, Georgie Cook never imagined anything could burst her newborn bubble. But in the weeks after Edward was born, the mum-of-five noticed some alarming differences compared to her four previous pregnancies. Advertisement 8 Georgie Cook, who was told she had heart failure, pictured before her drastic weight loss Credit: Georgie Cook 8 The mum-of-five says she was terrified her kids would grow up without her Credit: Georgie Cook 8 She now feels amazing, and her heart issues have almost disappeared Credit: Georgie Cook She struggled to breathe on walks in the park with her young family and climbing the stairs - and getting her children out of the bath left her feeling exhausted. Weighing 17.5st and developing worsening heart palpitations, the 32-year-old visited her GP. Advertisement After weeks of back and forth, tests eventually revealed she had developed a condition called peripartum cardiomyopathy (PPCM), which caused her heart to become enlarged during her pregnancy. The rare form of heart failure tends to strike in the last month of pregnancy or immediately after delivery, but can develop up to five months after a woman gives birth. Georgie, who lives with her husband Matt, 34, a carer, and their five kids, Anabelle, 11, Zachary, six, Roy, five, Percy, four, and three-year-old Edward, tells Sun Health: 'I'd suffered with heart palpitations for years, but it got worse in my last pregnancy, especially after I had the Pfizer Covid jab four months in. 'I had another top-up vaccine over the next few months, and my chest pains became unbearable. 'I went back and forth to the doctor, but my symptoms were just put down to stress and anxiety. Advertisement 'I even went to A&E with chest pains but medics told me it was a normal pregnancy symptom and looked at me as if I was crazy.' At 37 weeks, Georgie finally had an ECG at the hospital, which confirmed she had PPCM. 'It was devastating news, a massive shock,' she says. 'My heart had enlarged during my pregnancies and it couldn't pump the way it was meant to. 'Secret eater' mums show off their incredible 28 STONE transformation 'It was made even worse because I was so overweight. I was struggling to catch my breath even on a short walk to the park. 'My consultant told me it could be linked to the Covid jab, and I believe that 100 per cent too. I've never had another one since.' Advertisement The risk of heart issues after a Covid-19 vaccine is very low, according to the British Heart Foundation. 'I was embarrassed to go out' Doctors prescribed Georgie medication - ramipril then ivabradine - but the palpitations and her breathlessness continued. She gave birth to Edward in October 2021, and carried on as best she could. But her health only continued to decline. And it wasn't just her racing heart that stopped her from going out. I hated the way I looked and was always trying to cover up under baggy clothes. I was embarrassed to go out Georgie Cook 'Climbing the stairs or lifting the kids out of the bath made my heart race,' Georgie says. Advertisement 'Even getting them ready to leave the house could trigger palpitations, and often I would have to cancel going out. 'They would take their coats and wellies off because I wasn't feeling well, I felt so awful. 'But it wasn't just that. I was hugely overweight, at 17st 8lb and a size 24 and just 5ft 3ins. 'Even though I cooked healthy meals for the kids, I found myself wolfing down leftovers. 'Then there was junk food and takeaways, I couldn't resist. Advertisement 'I hated the way I looked and was always trying to cover up under baggy clothes. 'Whenever we did make it to the park, I'd imagine other mums staring at me. I was embarrassed to go out.' 8 Georgie, who weighed 17st 8lb at just 5ft 3ins, in hospital for weight loss surgery Credit: Georgie Cook 8 The 32-year-old underwent gastric sleeve surgery, where 80 per cent of her stomach was removed Credit: Georgie Cook 8 Georgie lost almost 8st and now weighs 9st 1lb Credit: Georgie Cook Advertisement Georgie, from Kingston upon Thames, South West London, says she had always struggled with her weight, even as a child. As a teenager, she felt she couldn't walk around in crop tops like her friends, and got bullied as a result. 'I remember being at the swimming pool with a friend aged eight, wearing a costume, and a boy called me fat and laughed at me,' Georgie says. 'I've never forgotten it, it upset me so much. I've been so self-conscious ever since. 'I tried lots of diets, like Slimming World, Weight Watchers and meal replacement plans, but nothing worked for me.' Advertisement After discussing everything with Matt, Georgie decided she needed to take drastic action - for the sake of her health. 'I knew I had to do something,' she says. 'After trying and failing at diets for years, I knew I couldn't do it alone.' 'I felt exhausted and sick for days' Georgie began to research her options online and came across a clinic in Turkey that offered gastric sleeve surgery, where 80 per cent of a patient's stomach is removed, for £2,850. Given it was a fraction of the cost of the op at home (which can cost between £7,000 and £11,000), supported by her husband, Georgie dipped into the couple's savings to pay for it. Advertisement In September 2022, Georgie flew to Turkey for £350 return. 'Everything went to plan and five days later I was back home to recover,' she says. 'I felt exhausted and sick for days.' For two weeks, Georgie had to survive on a liquid diet before moving on to pureed food. When she was able to eat proper food again, her diet consisted of Weetabix for breakfast, meat and salad for lunch, and a small dinner. Advertisement 'My smaller stomach meant I always felt full, so I didn't snack,' she explains. And the results were instantaneous. What are the risks of getting surgery abroad? IT'S important to do your research if you're thinking about having cosmetic surgery abroad. It can cost less than in the UK, but you need to weigh up potential savings against the potential risks. Safety standards in different countries may not be as high. No surgery is risk-free. Complications can happen after surgery in the UK or abroad. If you have complications after an operation in the UK, the surgeon is responsible for providing follow-up treatment. Overseas clinics may not provide follow-up treatment, or they may not provide it to the same standard as in the UK. Also, they may not have a healthcare professional in the UK you can visit if you have any problems. Source: NHS In the first week, Georgie lost 12lb, and in the weeks that followed she shed 4lb to 5lb each week. A scan in January 2023 - four months after her procedure - still showed signs of heart failure but it was improving as she started to lose weight. 'For the first time I felt happy in my body. I had more energy too,' Georgie says. Advertisement 'At the park I didn't lurk at the side hiding from the other mums. 'Instead I was pushing the kids on the swings and chasing them about. I even joined a gym. 'I was down to a size 12 and for the first time I could go clothes shopping and pick out anything I wanted. It felt amazing. 'I still look at myself in the mirror now and it doesn't hit home that it's actually me looking back.' 8 Georgie had the support of her husband Matt, 34 Credit: Georgie Cook Advertisement 8 The mum started experiencing symptoms while pregnant Credit: Georgie Cook By September 2023, Georgie had shed 8.4 stone and was down to 9st 1lb. But better than the number staring back at her on the scales was the realisation her heart palpitations had almost completely stopped, only surfacing while exercising at the gym. 'The cardiologist told me that I was in heart failure, and that I was lucky to be alive,' she says. 'They said if I hadn't lost the weight then I might not have been here today. Advertisement 'Shedding more than 8st took a lot of strain off my heart.' In June 2024 an ECG revealed Georgie's heart function was good. 'It was such a relief,' she says. 'Although I still need regular check-ups, I'm doing well and I feel really lucky to be here with my kids. 'Having the surgery was the best decision I ever made. Getting healthy was the key to sorting my heart troubles.'
The Sun
03-05-2025
- Health
- The Sun
Docs said my heart was failing at 31 – I was terrified my 5 kids would grow up without a mum so I lost 8st WITHOUT jabs
AFTER giving birth to her fifth baby, Georgie Cook never imagined anything could burst her newborn bubble. But in the weeks after Edward was born, the mum -of-five noticed some alarming differences compared to her four previous pregnancies. 8 8 8 She struggled to breathe on walks in the park with her young family and climbing the stairs - and getting her children out of the bath left her feeling exhausted. Weighing 17.5st and developing worsening heart palpitations, the 32-year-old visited her GP. After weeks of back and forth, tests eventually revealed she had developed a condition called peripartum cardiomyopathy (PPCM), which caused her heart to become enlarged during her pregnancy. The rare form of heart failure tends to strike in the last month of pregnancy or immediately after delivery, but can develop up to five months after a woman gives birth. Georgie, who lives with her husband Matt, 34, a carer, and their five kids, Anabelle, 11, Zachary, six, Roy, five, Percy, four, and three-year-old Edward, tells Sun Health: 'I'd suffered with heart palpitations for years, but it got worse in my last pregnancy, especially after I had the Pfizer Covid jab four months in. 'I had another top-up vaccine over the next few months, and my chest pains became unbearable. 'I went back and forth to the doctor, but my symptoms were just put down to stress and anxiety. 'I even went to A&E with chest pains but medics told me it was a normal pregnancy symptom and looked at me as if I was crazy.' At 37 weeks, Georgie finally had an ECG at the hospital, which confirmed she had PPCM. 'It was devastating news, a massive shock,' she says. 'My heart had enlarged during my pregnancies and it couldn't pump the way it was meant to. 'It was made even worse because I was so overweight. I was struggling to catch my breath even on a short walk to the park. 'My consultant told me it could be linked to the Covid jab, and I believe that 100 per cent too. I've never had another one since.' The risk of heart issues after a Covid-19 vaccine is very low, according to the British Heart Foundation. 'I was embarrassed to go out' Doctors prescribed Georgie medication - ramipril then ivabradine - but the palpitations and her breathlessness continued. She gave birth to Edward in October 2021, and carried on as best she could. But her health only continued to decline. And it wasn't just her racing heart that stopped her from going out. 'Climbing the stairs or lifting the kids out of the bath made my heart race,' Georgie says. 'Even getting them ready to leave the house could trigger palpitations, and often I would have to cancel going out. 'They would take their coats and wellies off because I wasn't feeling well, I felt so awful. 'But it wasn't just that. I was hugely overweight, at 17st 8lb and a size 24 and just 5ft 3ins. 'Even though I cooked healthy meals for the kids, I found myself wolfing down leftovers. 'Then there was junk food and takeaways, I couldn't resist. 'I hated the way I looked and was always trying to cover up under baggy clothes. 'Whenever we did make it to the park, I'd imagine other mums staring at me. I was embarrassed to go out.' 8 8 Georgie, from Kingston upon Thames, South West London, says she had always struggled with her weight, even as a child. As a teenager, she felt she couldn't walk around in crop tops like her friends, and got bullied as a result. 'I remember being at the swimming pool with a friend aged eight, wearing a costume, and a boy called me fat and laughed at me,' Georgie says. 'I've never forgotten it, it upset me so much. I've been so self-conscious ever since. 'I tried lots of diets, like Slimming World, Weight Watchers and meal replacement plans, but nothing worked for me.' After discussing everything with Matt, Georgie decided she needed to take drastic action - for the sake of her health. 'I knew I had to do something,' she says. 'After trying and failing at diets for years, I knew I couldn't do it alone.' 'I felt exhausted and sick for days' Georgie began to research her options online and came across a clinic in Turkey that offered gastric sleeve surgery, where 80 per cent of a patient's stomach is removed, for £2,850. Given it was a fraction of the cost of the op at home (which can cost between £7,000 and £11,000), supported by her husband, Georgie dipped into the couple's savings to pay for it. In September 2022, Georgie flew to Turkey for £350 return. 'Everything went to plan and five days later I was back home to recover,' she says. 'I felt exhausted and sick for days.' For two weeks, Georgie had to survive on a liquid diet before moving on to pureed food. When she was able to eat proper food again, her diet consisted of Weetabix for breakfast, meat and salad for lunch, and a small dinner. 'My smaller stomach meant I always felt full, so I didn't snack,' she explains. And the results were instantaneous. In the first week, Georgie lost 12lb, and in the weeks that followed she shed 4lb to 5lb each week. A scan in January 2023 - four months after her procedure - still showed signs of heart failure but it was improving as she started to lose weight. 'For the first time I felt happy in my body. I had more energy too,' Georgie says. 'At the park I didn't lurk at the side hiding from the other mums. 'Instead I was pushing the kids on the swings and chasing them about. I even joined a gym. 'I was down to a size 12 and for the first time I could go clothes shopping and pick out anything I wanted. It felt amazing. 'I still look at myself in the mirror now and it doesn't hit home that it's actually me looking back.' 8 8 By September 2023, Georgie had shed 8.4 stone and was down to 9st 1lb. But better than the number staring back at her on the scales was the realisation her heart palpitations had almost completely stopped, only surfacing while exercising at the gym. 'The cardiologist told me that I was in heart failure, and that I was lucky to be alive,' she says. 'They said if I hadn't lost the weight then I might not have been here today. 'Shedding more than 8st took a lot of strain off my heart.' In June 2024 an ECG revealed Georgie's heart function was good. 'It was such a relief,' she says. 'Although I still need regular check-ups, I'm doing well and I feel really lucky to be here with my kids. 'Having the surgery was the best decision I ever made. Getting healthy was the key to sorting my heart troubles.'
