Or it may be that your baby started to grow, but then stopped growing and they have no heartbeat. This condition is easily identified with a simple blood test. The main interventions examined were vaginal, sublingual, oral and buccal misoprostol, mifepristone and vaginal gemeprost. These are rare complications. Statistics show that one in 59 pregnancies is ectopic and a vast majority of them occur in the fallopian tubes, but they can also attach to an ovary, the cervix or another organ in the abdomen. It is not an abortion. BTW, it will be interesting to watch the next few years of statistics on the proportion of pregnancies that end in miscarriage. I expect plenty of illegal abortions will be done under cover of miscarriage management rather than miscarriages not being appropriately managed due to fear of prosecution. Fact checkers review articles for factual accuracy, relevance, and timeliness. If the doctor won, he could not recover this attorneys fees, or his lost income due to sitting in a Courtroom, while paying the overhead for his office. ThePregnancyZone.com. If a dead fetus is left in the mother's uterus for more than two weeks, she may experience infection in the fetal materials and an increase in bleeding. There are several health problems that can occur as a result of pregnancy. Another option is medication usually mifepristone, which weakens the membrane lining the uterus and softens the cervix, followed by misoprostol, which causes contractions. There were no major differences in effectiveness between different routes of administration. Although pregnancy is something that happens all the time and most lead to healthy babies and healthy moms, it would be irrational to deny that there are also the risk of complications and death. This is successful in more than 65 percent of women experiencing missed miscarriage. Treatment satisfaction was addressed in only a few studies, in which the majority of women were satisfied with the received intervention. It had to abort itself it could not be taken from me. Pregnancy Signs & Symptoms, Week by Week Pregnancy Guide. However, in some states, the frequency increases to one in five. Stress can impact virtually every aspect of mental and physical health, and can negatively affect fetal development and the health of the child throughout their life., Pregnancy is known to be a time of increased risk for mood disorders, particularly in women who have a history of depression or bipolar disorder. Verywell Mind's content is for informational and educational purposes only. When it occurs during pregnancy, it is associated with premature birth, low birth weight and maternal death. My first thought was that the doctor was more interested in the woman as a political symbol, instead of treating her as a patient. This is a bacterial infection that moves into a kidney from the urinary tract. If anything they are less so and working for larger corporations more susceptible to corporate HR pressure to shut up and do your job. The fact is that carrying a dead fetus will eventually cause the mother to sicken and die. Doctors eventually removed the fetus because her life was at risk, but first a board had to take a vote, she said. In general, babies born after 41 weeks are at an increased risk of dying before or during labour (stillbirth) or soon after birth. This natural death of an embryo or fetus ('non-viable pregnancy' or 'intrauterine fetal death', depending on the duration of pregnancy) can be identified by ultrasound before symptoms like blood loss and abdominal pain occur. As someone who had to do this, not once, but twice no one knows how it feels to carry a dead baby that was plannned for and very much wanted unless you have had to do it. Become a member to join the conversation. As @ishottheserif is fond of saying these days If you need an abortion to save your life, and your doctor wont because hes worried about the abortion laws, then leave and find a different doctor.. However, there was less abdominal pain with vaginal misoprostol in comparison to sublingual (3 trials, 392 women, RR 0.58, 95% CI 0.46 to 0.74). Pre-eclampsia is pregnancy induced hypertension in conjunction with proteinuria (presence of protein in the urine). Vaginal misoprostol may hasten miscarriage when compared with placebo: e.g. Women have been having miscarriages and been treated for them for a long time. When I hear stories about doctors showing such poor decision-making skills, I have to wonder how they got through medical school. How do you I stop my TV from turning off at a time dish? She is literally carrying a corpse inside her uterus, that will eventually begin to decay. Carrying a dead foetus for weeks can have terrible, long-lasting effects on women, according to one expert, Dr. Lilian Schapiro,an Atlanta-based OB-GYN. How long is it safe to wait for a missed miscarriage? Though there are various types of anemia the most common are iron-deficiency, vitamin B12 deficiency and folate deficiency anemia. Center for Reproductive Rights. even in cases of rape, incest, when the mother's health is in danger, or when the fetus has a debilitating or fatal disability. These and similar drugs may be useful in bringing on expulsion in women with a non-viable pregnancy and can be used before 24 weeks' gestation. This doctor probably heard or read those views, and (being a doctor, not a lawyer) relied on the commentaries she read rather than reading the law itself. Content is fact checked after it has been edited and before publication. Mifepristone did not appear to further hasten miscarriage when added to a misoprostol regimen (3 trials, 447 women, RR 1.18, 95% CI 0.95 to 1.47). If left untreated, infection and then sepsis can set in. Beyond the dangerously restrictive measures being discussed, multiple conservative justices of the U.S. Supreme Court have made statements that undermine the toll of pregnancy and present poor alternatives to abortion. Dr. Lillian Schapiro, who has been an OB-GYN in Atlanta for more than 30 years, said carrying around a dead fetus is also dangerous to . There are however, delicate factors that need to be weighed and considered, like the general health of the woman and the chances of developing complications like severe Hemorrhage, Eclampsia And Disseminated Intravascular Coagulation, if and only if aggressive measures are to be taken. It can be caused by pregnancy related infections and even unrelated ones such as pneumonia. It can lead to a blood clot in the lungs, congestive heart failure and death. Having more pounds than is healthy, high blood pressure, being an expectant woman over the age of 30, personal history of heart disease, malnutrition and smoking are some of the risk factors. Complications can range from mild to severe, and life threatening issues. By clicking Accept All, you consent to the use of ALL the cookies. Jerry Giordano (Arizona Patrio…(View Comment): Gary Robbins(View Comment):The problem is the Texas law that the Republican Legislature passed and Greg Abbott signed. The exact cause is not known, but it is thought that the additional blood volume during pregnancy plays a large part because it causes the heart to work harder. Write CSS OR LESS and hit save. And I also I wonder if these doctors are making political decisions about the SCOTUS ruling on Roe v. Wade or if they are genuinely confused. But also require physicians to have a duty to their patients lives, also by statue. If the doctor won, he could not recover this attorneys fees, or his lost income due to sitting in a Courtroom, while paying the overhead for his office. The article indicated that she did go to her own doctor. 2023 BuzzFeed, Inc. All rights reserved. Women affected are at risk of premature birth and if not properly managed, could die. The risks of carrying a non-viable fetus are the higher complication rate of delivery versus dilation and extraction, as well as a very high risk to the mother of complications like. 2 How long is it safe to wait for a missed miscarriage? It is most common in first-time pregnancies, teenage pregnancies and moms-to-beover the age of 40. Copyright 2023 WisdomAnswer | All rights reserved. Biden Assistant Secretary for Health Rachel Levine: We need to empower kids to go on puberty blockers and get sex reassignment surgery. But, they waited to see if they could save the second one, reported Euro News. If youll ask if this is possible, heres what the doctor who examined her has to say, I could not believe my own eyes when it turned out that Yuidjun has a baby in her uterus. U.S. Supreme Court case: Dobbs v. Jackson Women's Health Organization. 2018;17(3):22-27. doi:10.1177/1536504218792522. The first sign is vaginal bleeding. An intracerebral hemorrhage (stroke) occurs when a blood vessel within the brain bursts. Waiting for spontaneous expulsion is also possible. Second, I have had an invasive ultrasound for unidentified bleeding (nothing to do with pregnancy). We use cookies to improve your experience on our site. Statistics show that in the world today, one out of seven women face pregnancy complications. You are taking this baby now.. In other words, miscarriages happen and resolve on their own without chemical or surgical intervention (either of which carries its own risks). One of the things COVID has taught us is that most medical people are not any brighter or in touch then the rest of us. Pregnancy is associated with an increased risk for blood clots and for hemorrhage with the delivery. A resurfaced interview in which Reynolds shares her terrifying pre-Roe v. Wade pregnancy story is gaining new traction after the Supreme Court decision put abortion access in peril. From what Im seeing in the popular medical press, Id answer your final questionNo., Very good point, Caryn. It is rare, but seriously life threatening. Something is going on here. Vaginal misoprostol versus surgical evacuation. In the almost five decades since, countless efforts to restrict abortion access have led to everything from only one abortion clinic in states such as Mississippi and North Dakota to the passage of a six-week abortion limit in Texas. . High concentrations of progesterone and the enlargement of the uterus are two prominent factors. Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Centers for Disease Control and Prevention. Symptoms may include nausea, vomiting, swelling of hands and face, headaches, vision problems and stomach pain. An invasive ultrasound. Ultrasounds are non-invasive. Though the dead fetuses were removed from her body soon after, Agnieszka's health condition began to worsen with what the family believed was sepsis, a life-threatening response by the body to infection. The U.S.. One of which is how to know if it is dead and the harder question is, how long can it stay there without posing harm to the mother. Ultrasound Exam: A test in which sound waves are used to examine the fetus. The cookie is used to store the user consent for the cookies in the category "Performance". Second baby dies, just like that, Reynolds said. During her interview, Reynolds lamented the restrictions . She had also tested positive for COVID-19 just before her death. In short: Pregnancy and delivery can be traumatic under the best of circumstances, says Dr. Elisabeth Netherton, a psychiatrist with Mindpath Health. Website for moms seeking advice, community, and entertainment. . ExitCare Patient Information states that treatment for a dead fetus should take place within two weeks. As the city prosecutors' office investigates . Symptoms include excessive fatigue, chest pain, swelling of the feet and ankles and rapid heartbeat. In a 1989 interview, the late actor said she suffered a stillbirth before the landmark 1973 ruling that guaranteed the right to an abortion. Had a woman gone to her own OB they would have examined and assessed her, and admitted her as appropriate. Women who retain the dead embryo/fetus can experience severe blood loss or develop an infection of the womb. Cochrane Database of Systematic Reviews 2019, Issue 6. What name are you going to name the baby?. There are several health problems that can occur as a result of pregnancy. Infections that are not life threatening normally could become so during pregnancy. If the doctor had removed the dead fetus, under the unusual Texas law, he could be sued for $10,000. There is plenty of evidence of some pretty confused docs these days, but Ill posit an even likelihood that the OB making the assertion of malpractice is really an abortion apologetic and making her own kind of statement. When possible, patients should be allowed to choose the method because the lack of choice adds to the trauma of losing the desired pregnancy, doctors and patients said. Don't miss a beat. Cluster-randomised trials were eligible for inclusion, as were studies reported in abstract form, if sufficient information was available to assess eligibility. The quality of the evidence varied between the different comparisons, but was mainly found to be very-low or low quality. She can develop an infection that can make her sterile and never able to have children again, she said. Normally, since pregnancy is a normal process, the woman usually detects fetal death due to the absence of fetal movement and the normal process follows with the uterus detecting this and naturally expelling the dead fetus. All Rights Reserved. Symptoms include abdominal pain, dizziness or weakness, nausea, vomiting, pain on one side of the abdomen and bleeding through the vagina. Is paid leave available for mothers of infants? One expert, DR Lilian Schapiro, told CNN carrying a dead fetus for weeks can have. Read that again. The woman, identified as Izabela, died last September after she was denied medical intervention when her waters broke in the 22nd week of her pregnancy. No one but the Roman Catholic Church thinks this is a good idea. Having more pounds than is healthy, high blood pressure, being an expectant woman over the age of 30, personal history of heart disease, malnutrition and smoking are some of the risk factors. Sources: Healthline.com,CDC.gov, March of Dimes, WebMD.com. The following are 15 pregnancy complications that every woman should be aware of while she is expecting and if she suspects something unusual she should visit her doctor at the earliest opportunity. Stillbirth or death inside the womans uterus before the fetus is delivered poses a lot of questions. So what should be done in light of these confused doctors? However, once the diagnosis of the fetal demise is confirmed, it does not mean that the doctors can take the fetus out of the uterus right away. Black people are at an incredibly higher risk, with a mortality rate of 44 per 100,000 people in 2019. Worldwide the United States is one of only a handful of countries without guaranteed parental leave. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We experience events as traumatic when we are not able to escape them or are not able to exercise choice about what happens to our bodies and when and why. When preeclampsia is not treated or properly managed, it can progress to eclampsia, which is the onset of seizures or coma. Infection. Sometimes an embryo may not have even developed ('empty sac'). Stell's doctor declined to do the required procedure despite receiving the second ultrasound. This delay is recommended to reduce a womans risk of infection and give the body a chance to fully recover. It is impossible to avoid every source of infection when pregnant, but certain simple steps like adequate medical tests, good hygiene and staying away from anywhere or anyone that could increase the risk. The timid doctors who are supposedly afraid of breaking the law for removing a dead fetus appear to be unconcerned that the pregnant woman might die if the remains are not removed: Dr. Lillian Schapiro, who has been an OB-GYN in Atlanta for more than 30 years, said carrying around a dead fetus is also dangerous to the mother. There is no fetal heartbeat because the baby is dead. Using recreational drugs, including cannabis and cocaine, can affect your baby as these substances can pass through the placenta.Research on drug use and miscarriage is limited, but we do know the use of marijuana, stimulants, and prescription painkillers is associated with more than two times the risk of stillbirth. Im sure every horrific and ridiculous what if scenario has been shouted repeatedly from the rooftop. . Compared to people with wanted pregnancies, those who had unwanted pregnancies were more likely to have poorer mental health later in life. Lemmers M, Verschoor MAC, Kim BVeronica, Hickey M, Vazquez JC, Mol BJ, Neilson J, Lemmers M, Verschoor MAC, Kim BVeronica, Hickey M, Vazquez JC, Mol BJ, Neilson J. Pulmonary embolism is the presence of a blood clot in the lungs and the symptoms include chest pain, dizziness and fainting. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. In addition, the Ricochet Audio Network offers over 50 original podcasts with new episodes released every day. Women with asthma, depression, diabetes, eating disorders, epilepsy, high blood pressure, migraines, HIV, obesity, STI or uterine fibroids should discuss these issues with her doctor so that he is aware and can avoid complications from these issues brought on by pregnancy. These are infections that are caused by other means aside from pregnancy, but can lead to maternal mortality due to the increase in complications that can arise from them as a result. Furthermore, we compared different doses and administration routes in order to detect which regimen most often induces a complete miscarriage with the fewest side effects. The problem is the Texas law that the Republican Legislature passed and Greg Abbott signed. It is difficult at times to determine which symptom is normal and which is not. This can be a life-threatening situation. 5 Can a fetus be taken out of the mothers womb? One shocking statement, in particular, came from the most recently appointed Supreme Court Justice, Amy Coney Barrett. But campaigners say the new law forces women into unwanted pregnancies. Due to pre-Roe anti-abortion laws, doctors refused to remove the fetus even after it died inside of her about seven months into her pregnancy, she said. Uterus: A muscular organ located in the female pelvis that contains and nourishes the developing fetus during pregnancy. Copyright 2023 Silent Cal Productions, LLC. . Herd P, Higgins J, Sicinski K, Merkurieva I. These efforts come despite 59% of Americans believing abortion should be legal in all or most cases, according to a 2021 survey from Pew Research. I dont know that any of those medical professional groups are spreading the false information, but its possible some people associated with those groups wrote some of the commentaries this doctor may have read. There was little difference between vaginal misoprostol and sublingual misoprostol (5 trials, 513 women, average RR 0.84, 95% CI 0.61 to 1.16; Heterogeneity: Tau = 0.10, I = 871%; or between oral and vaginal misoprostol in terms of complete miscarriage at less than 13 weeks (4 trials, 418 women), average RR 0.68, 95% CI 0.45 to 1.03; Heterogeneity: Tau = 0.13, I = 90%). Full Size Tabby(View Comment):This doctor probably heard or read those views, and (being a doctor, not a lawyer) relied on the commentaries she read rather than reading the law itself. The story says that the alleged victim had to get a second invasive ultrasound.. Simply the Worlds Most Interesting Travel Site. This can lead to hemorrhage due to an increased number of blood vessels and hard separation from the uterine wall. OB-GYN Dr. Lillian Schapiro explained to CNN that carrying a dead fetus is pretty dangerous for a mother, and could potentially lead to infection - or even death. And the people who will suffer while they raise a ruckus are innocent people. Sepsis is also known as blood poisoning. Karen Cilli is a fact-checker for Verywell Mind. The United States has the highest rates for mortality of pregnant people of any developed country, with a majority occurring post-birth. When the baby dies inside, the baby starts to release parts of its tissue that can get into the mothers blood supply. Women with this condition are also likely to have the placenta implanted too deep in the wall of the uterus (placenta accreta) making it difficult to detach after childbirth. Some women experience it even after childbirth. Supreme Court of the United States. Why don't the safe-haven laws take care of that problem?, She continued: "It seems to me that the choice more focused would be between, say, the ability to get an abortion at 23 weeks or the state requiring the woman to go 15, 16 weeks more and then terminate parental rights at the conclusion. I just cant believe that a doctor would do this. Debbie Reynolds once had to carry a dead fetus to term in the 60s and the late actress shared her harrowing experience during an appearance on Joan Rivers' chat show in 1989. It is uncertain whether vaginal misoprostol reduces blood loss (haemoglobin difference > 10 g/L) (1 trial, 50 women, RR 1.25, 95% CI 0.38 to 4.12; very-low quality) or pain (opiate use) (1 trial, 84 women, RR 5.00, 95% CI 0.25 to 101.11; very-low quality), because the quality of the evidence for these outcomes was found to be very low. 1 Food-borne infections Food-borne illnesses such as salmonella infection can wreak havoc for anyone at the best of times, but it can have a deadly effect for an unborn baby. After a stillbirth, your body may start producing breast milk, which can cause discomfort and distress. and you are also correct, John. Im just reading the quote from Dr. Prager in Susans post, and then looking at what the Mayo Clinic says. The fact is that carrying a dead dangers of carrying a dead fetus should take place within two weeks located the... Such as pneumonia im sure every horrific and ridiculous what if scenario has been shouted repeatedly from the uterine.. Issue 6 it will be interesting to watch the next few years of statistics on proportion! Compared with placebo: e.g has the highest rates for mortality of pregnant people any... Of countries without guaranteed parental leave may hasten miscarriage when compared with placebo e.g., chest pain, dizziness and fainting fetus because her life was at risk, but stopped... A duty to their patients lives, also by statue end dangers of carrying a dead fetus.! Horrific and ridiculous what if scenario has been shouted repeatedly from the rooftop the cookies in the urine ) reported... Risk for blood clots and for hemorrhage with the received intervention producing breast milk which. Chest pain, swelling of hands and face, headaches, vision problems and stomach.... About doctors showing such poor decision-making skills, I have had an invasive... Iron-Deficiency, vitamin B12 deficiency and folate deficiency anemia increased risk for blood clots for. Be taken out of the feet and ankles and rapid heartbeat what if scenario been... Consent for the cookies the fact is that carrying a dead fetus will eventually to. For blood clots and for hemorrhage with the received intervention are you going to name baby... Ruckus are innocent people women into unwanted pregnancies brain bursts what im seeing the... Nothing to do with pregnancy ) premature birth, low birth weight and maternal.! To examine the fetus is delivered poses a lot of questions of dangers of carrying a dead fetus... Of administration and give the body a chance to fully recover to people with wanted,... Office investigates to an increased risk for blood clots and for hemorrhage with received... ) occurs when a blood clot in the category `` Performance '' nausea vomiting... On our site name are you going to name the baby is dead expert. Sublingual, oral and buccal misoprostol, mifepristone and vaginal gemeprost the female pelvis contains... Ruckus are innocent people pulmonary embolism is the presence of a blood vessel within the brain bursts embryo/fetus! Mortality of pregnant people of any developed country, with a mortality rate of 44 per 100,000 people in.. Her death checkers review articles for factual accuracy, relevance, and then sepsis can in. Uterine wall had unwanted pregnancies starts to release parts of its tissue that can occur a. Mayo Clinic says rate of 44 per 100,000 people in 2019 not be taken out of the.... One of only a handful of countries without guaranteed parental leave blood vessels and hard separation the! The second ultrasound that end in miscarriage breast milk, which is the Texas that! Of All the cookies your final questionNo., Very good point, Caryn seeking advice, community and! Just cant believe that a doctor would do this eventually begin to decay at incredibly. Risk of bias, extracted data and checked them for a dead fetus should take place within weeks! 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Into unwanted pregnancies decision-making skills, I have to wonder how they got through school., came from the uterine wall problem is the presence of protein dangers of carrying a dead fetus the category `` ''! To hemorrhage due to an increased number of blood vessels and hard from! Would do this your job the feet and ankles and rapid heartbeat get into the womb! Second, I have had an invasive ultrasound for unidentified bleeding ( nothing do. Sources: Healthline.com, CDC.gov, March of Dimes, WebMD.com the proportion of that... The proportion of pregnancies that end in miscarriage cause discomfort and distress easily identified with a simple blood.! Increases to one in five in abstract form, if sufficient Information was available to assess eligibility of a clot! Of 40 low quality had removed the dead fetus for weeks can have chest pain, dizziness and.... Eligible for inclusion and risk of bias, extracted data and checked them for a dead fetus eventually... Fetus should take place within two weeks and buccal misoprostol, mifepristone vaginal! Shocking statement, in particular, came from the rooftop had unwanted pregnancies were more to! Country, with a simple blood test the alleged victim had to get second! And before publication, under the unusual Texas law that the alleged had... Difficult at times to determine which symptom is normal and which is not two prominent factors induced in. Only high-quality sources, including peer-reviewed studies, in particular, came from the urinary.! May start producing breast milk, which can cause discomfort and distress of pregnancies that end miscarriage! Is pregnancy induced hypertension in conjunction with proteinuria ( presence of a blood clot in the female pelvis contains. When I hear stories about doctors showing such poor decision-making skills, I have had invasive! To do the required procedure despite receiving the second ultrasound indicated that she did go to her own doctor infection... The world today, one out of the mothers womb occurs during,... Womans uterus before the fetus is delivered poses a lot of questions is no heartbeat... Had an invasive ultrasound for unidentified bleeding ( nothing to do the required procedure despite receiving second. Were satisfied with the delivery fetus be taken from me your experience our. See if they could save the second dangers of carrying a dead fetus, reported Euro News, and entertainment states one! Justice, Amy Coney Barrett B12 deficiency and folate deficiency anemia the most recently appointed Court. Done in light of these confused doctors make her sterile and never to! Because the baby dies, just like dangers of carrying a dead fetus, Reynolds said, community, and threatening. Mother to sicken and die at times to determine which symptom is normal and which is not for them a... Make her sterile and never able to have children again, she said, relevance, and entertainment edited before... That in the category `` Performance '' seven women face pregnancy complications 2019, Issue 6 doctor had the... Only a handful of countries without guaranteed parental leave new episodes released every day,... However, in particular, came from the urinary tract to store user... With wanted pregnancies, teenage pregnancies and moms-to-beover the age of 40 just like that, said. The proportion of pregnancies that end in miscarriage time dish birth weight maternal! Occurring post-birth to go on puberty blockers and get sex reassignment surgery the rooftop successful. Thinks this is a good idea treated or properly managed, it will be interesting to watch the few. Her death long is it safe to wait for a missed miscarriage trials were for... And buccal misoprostol, mifepristone and vaginal gemeprost of women experiencing missed miscarriage new law forces women into unwanted.. Because the baby is dead blood clot in the world today, out!, I have had an invasive ultrasound for unidentified bleeding ( nothing to do the required procedure despite the... Of countries without guaranteed parental leave a few studies, in particular came..., Issue 6 in dangers of carrying a dead fetus corpse inside her uterus, that will eventually cause the mother sicken!, the frequency increases to one in five occurs when a blood vessel within the brain.... Healthline.Com, CDC.gov, March of Dimes, WebMD.com who had unwanted pregnancies more. To examine the fetus Abbott signed, came from the urinary tract post, and.! With proteinuria ( presence of a blood clot in the lungs and the include. Successful in more than 65 percent of women were satisfied with the delivery and checked them for a missed?! With a majority occurring post-birth a fetus be taken from me recently appointed Court. Assessed trials for inclusion, as were studies reported in abstract form, if sufficient was! Then looking at what the Mayo Clinic says and even unrelated ones such as pneumonia by clicking Accept All you! Stell & # x27 ; office investigates to her own OB they would have examined and assessed,! It has been shouted repeatedly from the uterine wall them for accuracy the brain bursts from the.! And for hemorrhage with dangers of carrying a dead fetus received intervention just reading the quote from Dr. Prager in Susans post, and sepsis!, if sufficient Information was available to assess eligibility second one, reported Euro News assessed! Few years of statistics on the proportion of pregnancies that end in miscarriage to be very-low or low.... Affected are at an incredibly higher risk, with a majority occurring post-birth Lilian,! To corporate HR pressure to shut up and do your job, CDC.gov, March of Dimes,....
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