After five days of a relentless firestorm in Los Angeles County, medical experts warn that smoke levels in the area pose unique risks to pregnant women and their unborn children.
So what should pregnant Los Angeles residents do?
First, doctors say they should follow local emergency guidelines on evacuation, according to Dr. Allison Bryant, a maternal-fetal medicine specialist at Mass General Hospital who chairs the American College of Obstetric Care Practice Committee. OB/GYN (ACOG).
Beyond monitoring evacuation orders, Bryant suggested following Centers for Disease Control and Prevention guidelines that recommend pregnant people stay indoors as much as possible with windows and doors closed, use HVAC systems with filters, or portable air purifiers and wear N95 masks if outdoor exposure is necessary. inevitable. They should maintain their prenatal care schedule as much as possible and update their birth plans if evacuation is necessary.
Emergency preparedness is also crucial. The CDC recommends having a seven to ten day supply of prescription medications and prenatal vitamins on hand. That supply can go in a bag with essential items, including clothing, medical records and insurance information.
CDC advice closely aligns with ACOG's new disaster preparedness guidance released this monthspecifically focused on helping pregnant people navigate emergency situations. While many precautions reflect general public health guidelines, pregnant people face additional considerations about maintaining prenatal care and preparing for childbirth.
“What's different about pregnant people is that we know they're going to need medical care in the not-too-distant future,” Bryant said.
Research suggests that babies are born The damage caused to mothers exposed to wildfires may be less than average, and the effect is potentially stronger late in pregnancy, Bryant said. But the risks go beyond simple exposure to smoke. Pregnancy itself makes people more physically vulnerable, with changes in breathing patterns, heart function and mucous membranes that can intensify the effects of smoke and air pollution.
“During pregnancy, everyone's mucous membranes (the lining of the nose and mouth) are more active and plump,” Bryant said.
This natural increase in congestion means that pregnant people may experience more severe symptoms from smoke exposure than other people in their home.
Although risks don't vary dramatically by trimester, pregnancy itself makes people more vulnerable to respiratory problems, according to Dr. Joseph Ouzounian, professor of obstetrics and gynecology at the Keck School of Medicine of USC.
“Pregnant people will breathe faster than non-pregnant people,” he said. “The heart and cardiovascular system are working harder because, to some extent, they are supporting two lives instead of one.”
Short-term exposure, of a few days, is usually not dangerous if reasonable precautions are taken, such as wearing N95 masks, Ouzounian said. However, longer exposure requires more decisive action. Prolonged exposure to environmental toxins could affect fetal development.
with winds expected to intensify again Sunday and potentially reaching 50 to 60 mph in mountains and hills by Tuesday, relief from poor air quality may not come soon. Following public health guidelines should be enough for most, but Ouzounian said those who are not close to giving birth and cannot maintain adequate air quality at home may want to consider temporary relocation.
“If the exposure is going to last more than a few days, then you need to start thinking about finding a place where the air is better or staying indoors with filters or air purifiers,” he said.
Some of Ouzounian's patients are leaving town, including a woman who lived in a mandatory evacuation zone and temporarily moved to Orange County, where she has already found a new doctor. While most of his patients are staying put, he said if the fires persist or worsen over the next few weeks, he hopes more patients will consider transferring their care.
Dr. Christina Han, a professor of clinical obstetrics and gynecology at the David Geffen School of Medicine at UCLA, also has patients planning to move to Arizona, San Diego and Northern California. This is especially true for those who have lost their homes and know they will not be able to rebuild them within the time frame of their pregnancy.
“Everyone has a different scenario right now, so we have to use shared decision making to make that calculation with them,” Han said.
She emphasizes that patients should consult their OB-GYN before moving, because doctors can help connect patients to care in their new location.
“It's really hard to find an OB at the last minute, so you should try to use your OB-GYN's network,” she said. “Obstetricians and gynecologists have a very tight network, so many of us know where other doctors are across the country and can potentially reach out for help.”
Although research on the effects of wildfire exposure on pregnancy is not definitive, Han emphasized that pregnant people who follow simple precautions will be fine. Your most important advice?
“Exhausting [an N95] “The mask is really important,” Han said, “probably more important than taking prenatal vitamins right now.”
