The bill was from Cigna, which paid out the sum to Mount Sinai West hospital in Manhattan in error for the care of Alexandra, who was born 13 weeks prematurely and lived for less than a month.
In reality, the care had already been covered by UnitedHealthcare, which the couple switched to just before she was born. But while trying to get the money from the hospital, Cigna pursued the grieving parents.
Alexandra was born prematurely at the Mount Sinai West hospital in midtown New York 18 months earlier, a few days before Christmas 2018, The New York Times reported.
She died on the morning of Jan 15, 2019, per the Times. But it took around 18 months longer for the first demand to arrive.
“For them, it’s just business, but for us it means constantly going through the trauma of reliving our daughter’s death,” Clayton Lane told the Times.
“It means facing threats of financial ruin. It’s so unjust and infuriating.”
According to The Times, Lane switched her healthcare after giving birth. Cigna was supposed to cover the bill for the 2018 care, while UnitedHealthcare was supposed to take on the bill for care provided in 2019, the Times reported.
But Cigna covered the whole bill, overpaying by $257,000. UnitedHealthcare also paid, meaning that the bill was paid twice in full, per the Times.
Although Cigna was already in talks with the hospital to get a refund, the couple received a notice asking them to pay the amount in full in the summer of 2020. They contacted the hospital, who said it would be dealt with, only to receive another notice in July 2021.
The Lanes have filed a complaint against Cigna.
In a statement, Mount Sinai said: “It is normal business practice to reconcile accounts with insurers in this manner. It is not typical for an insurer to pursue a patient in this way,” the Times reported.
Her husband Clayton also tweeted on Tuesday: “The power these billion-dollar corps hold over people’s lives is unreal. But we hope our story encourages @Cigna @MountSinaiNYC Admin and other providers to approach families with kindness and compassion.”
When Ramos started showing mild symptoms of the disease, she drove herself to the hospital. Her husband, who was also sick with COVID-19, stayed home to care for their children, who are two and seven years old.
Over the next few weeks, Ramos’ symptoms worsened, and she was put on a ventilator, The Post reported. On Sunday, the baby’s heart stopped, the outlet said.
The unborn baby was going to be called Jonathan Julius, The Post reported. Ramos had a stillbirth the same day as his heart stopped.
As of Wednesday, Ramos was still in a “very critical” state, the Post reported.
Guevera hopes his story can encourage others to get vaccinated, per NBC Los Angeles. The CDC on August 11 published new guidelines urging pregnant people to get vaccinated, saying it is “safe and effective.”
Pregnant people are at higher risk of death and miscarriage if they catch COVID-19.
more than five times as likely to be admitted to the ICU.
more than 14 times as likely to need intubation or mechanical ventilation.
more than 15 times as likely to die.
A CDC analysis found that vaccination in pregnant people does not increase the risk of miscarriage. There is no evidence that vaccines pose a risk to the pregnant person’s life, fertility, or the safety of the fetus, per CDC.
“Unfortunately, right now, it’s too late for me: I already lost my son,” Guevara said, NBC Los Angeles reported, adding that he was going to get vaccinated.
“Wear your mask and get vaccinated as soon as possible. Don’t even think about it,” he told the Post “People are going to regret it just like me.”
White House press secretary Jen Psaki on Wednesday dismissed Gov. Greg Abbott’s vow to “eliminate all rapists” amid criticism of Texas’ new law that bans abortions after six weeks of pregnancy with no exceptions for rape or incest.
“If Governor Abbott has a means of eliminating all rapists or all rape from the United States, then there’d be bipartisan support for that,” Psaki told reporters during a White House press conference. But “there has never in history of the country and the world been any leader who’s ever been able to eliminate rape, eliminate rapists from our streets.”
Psaki reacted to comments Abbott made on Tuesday in Texas, when he was asked by a reporter: “Why force a rape or incest victim to carry a pregnancy to term?”
The governor responded that rape victims are given “at least six weeks” to get an abortion and pledged that “Texas will work tirelessly to make sure that we eliminate all rapists from the streets of Texas by aggressively going out and arresting them and prosecuting them and getting them off the streets.”
“So goal No. 1 in the state of Texas is to eliminate rape so that no woman, no person, will be a victim of it,” Abbott added.
Vice President Kamala Harris on Wednesday also ripped into Abbott’s comments, saying: “To arrogantly dismiss concerns about rape survivors and to speak the words that were empty words, that were false words, that were fueled with not only arrogance but bravado, that is not who we want in our leaders.”
The White House has sharply rebuked Texas’ six-week abortion ban since it took effect last Wednesday. President Joe Biden said the law directly violates the Supreme Court’s 1973 landmark decision, Roe v. Wade, which legalized abortion nationwide.
The law is one of the most restrictive in the nation and prohibits nearly all abortions after the six-week mark of pregnancy, a time when many people do not yet know they are pregnant. It took effect after the Supreme Court denied a request from abortion providers in Texas to block it. The court’s majority argued the ruling was technical and not based on the substance of the law, which could still be legally challenged.
Psaki reiterated on Wednesday that the White House is committed to helping women in Texas get access to safe and legal abortions.
“This law is a violation of your rights,” Psaki said. “We are going to do everything we can to provide assistance as quickly as we can.”
The restraining order bans the anti-abortion group from suing abortion providers and health care workers under Texas’ new restrictive abortion law, which the Supreme Court refused to block in a 5-4 ruling issued Wednesday.
In the filing asking for the restraining order, Planned Parenthood said the anti-abortion group’s “threatened implementation of the six-week ban and its enforcement scheme, as well as S.B. 8’s fee-shifting provision, would cause imminent, irreparable injury” to abortion providers.
Judge Maya Guerra Gamble of the Texas District Court for Travis County said the law created a “probable, irreparable, and imminent injury in the interim” to abortion providers, who would have no legal remedy if subjected to private enforcement lawsuits under the new law.
Duke: Oh, boy. It’s a tough myth for patients to hear.
Eleswarapu: “Eating pineapple can increase fertility.”
Duke: Oh, that’s a good one. Pineapple by itself, if you have infertility, is unlikely to reverse your infertility.
I’m Dr. Cindy. I am a fertility specialist based in Las Vegas, Nevada. Hello,
Eleswarapu: I’m Dr. Sriram Eleswarapu, and I’m a urologist at UCLA. And today we’ll be debunking myths about infertility.
Duke: “Tight underwear is bad for sperm count.”
Eleswarapu: So, there’ve been a number of studies looking at this issue for many decades, and the inevitable question is boxers versus briefs. In truth, it doesn’t matter a whole lot, and we know that if the testicles are a little bit warmer that they are more at risk of having sperm-count issues or sperm-motility issues, but, in general, it shouldn’t matter too much. Just pick what’s comfortable.
Duke: “Sex position matters.”
Eleswarapu: So, that is a myth. No matter what position you engage in, if you ejaculate, you have the sufficient propulsion of the semen to make it up to the cervix, any way you do it.
Duke: People around the world have actually studied it, and no one position has been proven to be better than another.
Eleswarapu: “IVF guarantees pregnancy.”
Duke: Oh, boy. Yes, that is definitely a myth. And it’s a tough myth for patients to hear. IVF does present the highest chances of pregnancy, absolutely. There are a number of factors that play into IVF success. One of them has to do with the age of the eggs being used. It also has to do with the quality of the sperm and the egg when they come together. It has to do with the embryo that is ultimately formed. It also has to do with the genetics of the embryo. But then, on top of that, it has to do with the womb in which the embryo will be placed, and a number of factors are not yet fully known. So, we know the immune system plays a role. Diet, exercise probably play a role, but we’re still investigating that. Biggest thing to know is it’s not 100%.
Eleswarapu: “Stress causes miscarriages.”
I think we’re starting to get away from the term “miscarriages.” We’re starting to use the term “early pregnancy loss.” Is that right?
Duke: That’s correct. And I think it’s because “miscarriage” also comes with certain connotations where blame is also ascribed, and the truth is, both early pregnancy losses, there’s nothing the individual could have done about it at all. So now we call it early pregnancy loss before the end of the first trimester, versus second- and third-trimester pregnancy loss. We do not believe stress causes loss. Many people around the world across millennia have gotten pregnant and remain pregnant despite tremendous stress. So we know it’s not simply stress. Nowadays, though, we know the No. 1 reason for pregnancy loss is chromosomal differences in the formed embryo. And so that’s called aneuploidy. 67% of first-trimester pregnancy losses are due to chromosomal issues within the embryo itself. Other reasons would be if the thyroid was not functioning well, if vitamin D is low, if there’s a fibroid in the uterus. If you have a uterus and you’ve had two or more pregnancy losses, you should be evaluated. We always expected that it would be the individual with the womb and the eggs to be the one that gets evaluated for a pregnancy loss. Now the tide is shifting, and individuals who contribute the sperm are also being evaluated when there’s a pregnancy loss in the couple. There’s emerging data that things like DNA fragmentation, where the DNA that are normally supposed to be very tightly wrapped up in the sperm are somehow unraveled and might have little breaks in the DNA strands, and those breaks can contribute to the pregnancy loss.
“Freezing your eggs guarantees that you can have kids later.”
Myth. And the myth is in the word “guaranteed.” If you freeze your eggs, you can stop the clock. And so you’re basically freezing the youngest version of yourself at that point. However, there’s no guarantee that eggs even when frozen will thaw and yield a live-born baby. So it’s really a conversation that needs to happen with your specialist based on your age, based on your egg number.
“Sperm quality doesn’t decline with age.”
Eleswarapu: There’s a lot of data now that is showing that individuals with sperm that is older, say in the fifth, sixth, seventh decades of life and beyond, is more at risk of forming embryos that have chromosomal abnormalities. Getting exercise, eating well are things that can improve the general biology of an individual. Certainly if it’s good for the heart and it’s good for the brain, then it’s probably good for the penis and the scrotum and the testicles as well. We talked about egg freezing, but sperm freezing has its role particularly for individuals who may not be in a relationship or may not be thinking of a family at this time but later on down the road they might want to produce a family.
“It’s impossible to get pregnant after 35.”
Duke: It is possible to get pregnant after 35. The truth is, though, that the chance of pregnancy progressively declines as the age of the egg increases. And so you might find greater and greater need for fertility treatments. When you’re born, if you’re someone born with ovaries, you’d have somewhere between 1 million to 2 million eggs in those ovaries, usually. By age 30, 70% of those eggs are gone, and by age 40, 97% of those eggs are gone. At the same time, those eggs are also aging. And so what we see is that the chance of pregnancy declines very quickly, and then for some people it declines even faster. So if you have endometriosis, if you’re someone who’s maybe had surgeries of the ovaries or needed to be on medications, chemotherapy, radiation, all of those things can also further the decline in the egg number. So my recommendation is, if you have ovaries, at age 30, you should at least be asking your doctor to do a check of your egg number, or what’s called your ovarian reserve.
“The best way to get pregnant is to have sex every day.”
Eleswarapu: It comes down to the ovulatory cycles and making sure that you’re sort of timing things and tracking things, particularly if you’re trying to conceive deliberately. We always get this question, and I want to know what your thoughts are. Should the couple be trying to conceive every other day during ovulation, or every day during ovulation? I say every other day. One, we need to give the sperm and semen enough time to sort of reaccumulate so we can get those millions of sperm. The other is sperm actually survive in the female genital tract for up to five days. So once the egg is released from the ovary, think of the fallopian tube as an arm with a catcher’s mitt at the end. The catcher’s mitt captures the egg, pulls it into the arm, and then the egg sits around there for 12 to 20 hours waiting for sperm. And then if you have intercourse anywhere within the next 24 hours, sperm will also get to the egg. So that’s why we say every other day around ovulation. There is this movement now, particularly on the internet, discussing what’s called abstinence from pornography, masturbation, and orgasm, or PMO. It’s also a movement called no NoFap. And those individuals say to have the best reserve of sperm or the best sort of power with erections or orgasm, that they should conserve for days, weeks, months at a time. This stuff is not scientific at all. And, in fact, after a week of storing up, the sperm may not necessarily be healthy.
“Eating pineapple can increase fertility.”
Duke: That’s a good one. Pineapple by itself, if you have infertility, is unlikely to reverse your infertility. We know that pineapples have bromelain inside of them, which is a compound that is known to be a blood thinner to a certain degree, but it’s very, very weak, and you’d have to eat so much pineapple to even have enough bromelain to have a little effect. You should be having a meal balancing protein, complex carbohydrates, and fiber. So getting your usual multivitamins and folate into your diet, because folate is really important for once you’re pregnant. But technically, no, pineapple by itself does not boost fertility. Infertility, while a daunting thought, really there are lots of options available. The first step is actually an evaluation. Fertility and infertility constitute this huge spectrum, and there are many, many ways to get pregnant and many things one can do to help facilitate that. And you don’t have to stay at home feeling embarrassed about it. If you talk to a specialist like myself, like Dr. Eleswarapu, we are experienced with this and know how to treat you or direct you to the right person who can help.
The COVID-19 vaccines by Pfizer and Moderna are effective in pregnant women, bolstering their immune response to the disease and even passing protective antibodies to their babies, according to a new preprint study.
The study, published Thursday in the American Journal of Obstetrics and Gynecology, looked at 131 women who received one of the two vaccines between December and March, of whom 84 were pregnant and 31 were lactating.
Researchers, from centers including Harvard, MIT, and Brigham and Women’s Hospital, found pregnant and lactating women had as strong an immune response to the vaccines as the 16 women who were not pregnant or lactating.
What’s more, they found the vaccines were much better than exposure to the coronavirus at giving babies secondary antibodies. Testing umbilical cord blood and the placenta, they found babies born to women who received the vaccine had “strikingly higher” levels of COVID-fighting antibodies than babies born to women who previously had COVID-19, the researchers wrote.
The research supports vaccinating pregnant women
The research adds to a growing body of research that indicates getting a COVID-19 vaccine is a good idea for pregnant women. In March, the CDC said there were no adverse results in its study on 30,000 vaccinated pregnant women across the US.
Pregnant people were not included in the clinical trials studying any of the COVID-19 vaccines. As a result, when US regulators authorized the first COVID-19 vaccine in early December (by Pfizer BioNTech), health officials said it was a decision for pregnant women to make with their doctor.
As research mounts, that decision-making process is getting easier for pregnant people and OBGYNs, Dr. Andrea Edlow, a maternal-fetal medicine expert at Massachusetts General Hospital in Boston who co-authored the study, told NBC.
“This study is one piece of the puzzle that’s essential to try to give pregnant and lactating women evidence-based counseling around the vaccine,” Edlow said.
What we know about the Pfizer and Moderna shots in pregnancy
Studies are underway, both in clinical trial settings and real-world settings, as more and more pregnant people choose to get the shot.
Pending that data, the CDC notes that studies in pregnant animals found no safety issues tied to receiving mRNA vaccines – i.e. the vaccine technology used in both the Pfizer and Moderna COVID-19 shots.
There has been plenty of misinformation spread about mRNA vaccines, which uses messenger RNA (mRNA) to train the body to recognize the virus and mount an immune response.
Anti-vaccine activists like Robert F Kennedy, Jr. have promoted a myth that the vaccine interferes with DNA – a physiological impossibility since the vaccines do not enter your genetic material.
The American College of Obstetricians and Gynecologies (ACOG) issued an advisory to pregnant and lactating people debunking this myth: “These vaccines do not enter the nucleus and do not alter human DNA in vaccine recipients. As a result, mRNA vaccines cannot cause any genetic changes.”
Vaccines seem to protect babies, too
A small peer-reviewed study in January found that pregnant women vaccinated against COVID-19 passed antibodies onto their unborn babies.
In February, researchers said a baby born to a woman who had only received one of the two Moderna shots tested positive for protective antibodies.
Monica Ramirez didn’t touch her daughter, Emiliana, until the infant was six weeks old. Emiliana had been delivered via emergency C-section while Ramirez, who had a near-fatal case of COVID-19, was in a medically induced coma.
“I feel very blessed that I have made it,” Ramirez, a school staffer near Los Angeles, previously told Insider. “Not everyone has the same outcome.”
Had a vaccine been available and given to Ramirez when she was pregnant, her experience might have looked a lot different.
But pregnant people still have a complicated choice to make now that three vaccines are authorized for emergency use in the US. And now that President Joe Biden announced every American will be eligible by May 1, more pregnant people need to decide: Get the vaccine despite knowing little about its potential risks to them, or skip it and risk contracting COVID-19, which is more likely to lead to complications and death in pregnant people.
The Centers for Disease Control and Prevention’s latest vaccine safety report, published March 1, says over 30,000 vaccinated women have reported pregnancies.
According to the CDC, pregnant vaccinated women have not reported different or more severe side effects compared to non-pregnant women who received a COVID-19 vaccine. What’s more, the agency said there has not been an uptick in pregnancy-related complications, like stillbirth and miscarriage – the rate remains the same for all pregnant women, whether they got a vaccine or not.
Governmental organizations have so far avoided taking a strong stance in either direction, though experts say the way the vaccine is made suggests it’s safe in that population.
Ashley McFarland, a 34-year-old registered nurse in Boise, Idaho, says she doesn’t know how to help other women make the decision – one she, as a healthcare worker who’s trying to get pregnant, will soon have to make herself.
“Even as an educated medical professional, I don’t know how the vaccine effects pregnant women and their fetuses,” she told Insider. “Hopefully this critical and pertinent information becomes more understood as more research is completed.”
Many organizations encourage women and their providers to make individual decisions
Many organizations encourage women and their providers to make individual decisions the Pfizer, Moderna, and Johnson & Johnson vaccines, now authorized for emergency use in the US, weren’t tested on pregnant people because researchers first want to know how vaccines behave in healthy, non-pregnant people. Only then can they make recommendations about whether certain vaccines should be trialed among expectant parents.
Both say that while discussing the pros and cons with a provider can be helpful, it shouldn’t be required.
The World Health Organization previously recommended against using COVID-19 vaccines during pregnancy, but has shifted its guidance after some backlash. Now, the organization says pregnant people with a high risk of exposure to COVID-19 or who have health conditions that increase their risk of severe disease may be vaccinated.
Pros and cons of getting the vaccine if you’re pregnant
Getting the vaccine means being almost entirely protected from contracting COVID-19. If infected, pregnant people have a higher risk of intensive-care unit admission, ventilation, life support, and death than patients who aren’t pregnant, though the overall risk is still low, a November report from the CDC found. They’re also more likely to deliver prematurely.
Pregnant women of color are particularly at risk for contracting the disease and experiencing related complications.
But getting the vaccine also means taking a bit of a gamble. Researchers don’t have good data on the risks to pregnant people, though healthcare and public health professionals expect that they’re low.
“Based on how the COVID vaccine works, there should be very little risk to a developing baby,” Dr. Jessica Madden, a pediatrician and neonatologist who serves as medical director of Aeroflow Breastpumps, told Insider. That’s because, like the flu vaccine, the coronavirus vaccines are do not contain live virus.
“The mRNA in the vaccine acts locally, in the muscle cells surrounding the injection site,” she said. “It cannot enter into cells’ nucleus, thus it has no effect on DNA.”Plus, limited data from animal studies haven’t revealed any harms during pregnancy.
But the vaccine could possibly lead to a fever as a side effect, which can be problematic to the developing fetus early in pregnancy. However, ACOG says it can be treated with Tylenol, which is safe in pregnancy and doesn’t seem to affect how the vaccines work.
Risk of exposure, pregnancy complications and community transmission rates all matter
Anita Kashyup, a clinical pharmacy specialist in Wauwatosa, Wisconsin, who’s trying to get pregnant, decided to get vaccinated after weighing the pros and cons.
“For me, the potential benefits (being protected against getting covid and hopefully then preventing passing it on to others) felt more strongly supported than the potential (unknown) risk with pregnancy,” she said, adding that the few women who did get pregnant while enrolled in the vaccines’ clinical trials reported no complications.
But other healthcare workers have decided against it, Dr. Zaher Merhi, an OB-GYN, reproductive endocrinology and infertility specialist, and the founder of Rejuvenating Fertility Center, told Insider.
The pregnant people he’s offered the vaccine to have by and large turned him down. “For them, it’s like, ‘I’ve been fine since March or I got COVID and it’s fine. Why do I need to take something that to me, right now, I don’t know the risks?'”
“But on the other hand,” he added, “they’re not seeing pregnant women who are dying from the disease, so it’s a battle.”
ACOG says the decision should be informed by transmission rates in the community, as well as the individual’s risk of severe disease from COVID-19. A pregnant person’s occupation and pregnancy complications matter too, Madden said.
It makes more sense, for example, for a pregnant bus driver in a city with high coronavirus rates to get the vaccine than someone who works from home in a small town where transmission is low. Likewise, a pregnant person with gestational diabetes would benefit from the vaccine more than one with a low-risk pregnancy.
For now, these scenarios are theoretical, as most people aren’t eligible for the vaccine. But in certain states, pregnancy will soon be a qualifying condition.
Some states include pregnant people in Phase 1b of vaccine rollout
Some states list pregnancy as a high-risk condition that qualifies people to receive COVID-19 vaccines.
In New York, pregnant people were included in Phase 1b of vaccine rollout, which began February 15. Illinois has also opened up its eligibility criteria to include pregnant people on February 25, and other states, such as Mississippi, listed pregnancy as a qualifying condition Phase 1b in early February.
For those pregnant people who do have the option to get vaccinated, Madden said it’s important to consult with a doctor or midwife, but not feel forced into a choice.
“You should feel like your decision is respected,” she said, “and please know that if you choose not to get the vaccine right now, or in the future, that it is OK.”
And for those who don’t yet qualify, more information is on the way to help them decide what to do.
“For women who are pregnant now, but not in prioritized groups, by the time the vaccine is available to them, most will no longer be pregnant,” Madden said. “There should be a lot more information available about the safety of the vaccine in pregnancy by the time most of them are eligible to receive it.”
Founder and former Theranos CEO Elizabeth Holmes is pregnant, according to new court documents.
Holmes expects to give birth in July, and is requesting a delay to her federal trial, according to newly filed court documents. Both Holmes’ lawyers and the prosecution requested the trial’s delay. If approved, she’ll face trial for multiple federal charges of fraud starting on August 31.
Holmes, who was the focus of an HBO documentary about Theranos, is alleged to have defrauded the company’s investors out of millions of dollars with the promise of a new type of blood test. That test was purported to perform a multitude of blood tests, able to detect everything from high cholesterol to cancer, with a simple pin prick.
The company raised over $700 million from investors on the promise of such a test. By August 2015, the FDA began investigating Theranos and found “major inaccuracies” in its tests.
Holmes, alongside former Theranos president Sunny Balwani, was charged with nine counts of wire fraud and two counts of conspiracy to commit wire fraud by the US Department of Justice in 2018. She subsequently stepped down from her role as CEO.
If convicted, Holmes is facing upwards of 20 years in federal prison.
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