Fewer premature babies born since Covid-19 lockdown | Hacker News Reader

Fewer premature babies born since Covid-19 lockdown

cbc.ca

204 pointsbreitling175 comments

Let's not ignore the possibility that the reduction in pre-term birth could be due to women receiving less pre-natal screening, leading to conditions that would warrant immediate induction going undetected. In fact, data collected from a hospital in the UK indicates a 4X increase in the incidence of stillbirth.

From: https://www.medscape.com/viewarticle/934056 edit: Non-paywalled: https://outline.com/MZUPk3

> The incidence of stillbirth was significantly higher during the pandemic period (16 of 1,718 births; 9.31 per 1,000 births) than the prepandemic period (four of 1,681 births; 2.38 per 1,000), a difference of 6.93 stillbirths per 1,000 births.

A hypothesis put forth by the authors on why this is:

> they say the uptick in stillbirths may be due to indirect effects such as a reluctance to go to the hospital when needed (such as in the case of reduced fetal movements), fear of contracting COVID-19, or not wanting to further burden the National Health Service. Changes in obstetric services may also have played a role.

Take that paper with a grain of salt.

If you look at their stillbirth rate in the whole of 2017 (rather than an arbitrarily short period immediately before covid), you find their stillbirth rate was 4.21 per 1,000.

They went from 4.21 in 2017, to 2.38 in a few months in 2019, then 9.31 in 2020?

The UK hasn't really been improving in stillbirth rates, so it would be very impressive if they'd halved theirs.

Source, the UK's national perinatal death surveillance report (pdf, page 88): https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/report...

Would 4.21 -> 9.32 still have been significant on that small a sample size?

This is the most reasonable explanation I have heard and I'm surprised it was not discussed in https://www.medrxiv.org/content/10.1101/2020.06.03.20121442v... The increase in stillbirths roughly matches the reduction in pre-term births but the proof would be in the reduction in medically induced births during lockdown for which we don't seem to have the data.

Interesting, is the data there to show COVID infections of stillbirth? Can that account for at least some of them to offset?

Considering only 0.4% of the UK population has gotten covid ( 300,000 cases / 68,000,000 population) I would say it's incredibly tenuous to blame the 400% stillbirths increase on covid infections.

Heart attacks are similarly down 40-60%.

https://www.nytimes.com/2020/04/06/well/live/coronavirus-doc...

And cancer diagnoses are down by half.

https://youtu.be/TWF8KLKy-I0

Of course, no, they aren’t down, it’s just that people that absolutely should be going to the hospital aren’t and they’re endangering their lives trying to avoid COVID-19.

Could something similar be at play here?

I laughed out loud when they suggested that this is a “low stress” time to be pregnant. All indicators show the opposite.

Difference is you can't "hold in" a pre-term birth b/c you're afraid of covid.

Half of premature babies are delivered via c-section and many more are induced, usually because there is some risk to the mother or baby at holding the baby to term.

Such as inducement for preeclampsia, which in prior years accounted for ~15% of premature births in the U.S.: https://www.marchofdimes.org/complications/preeclampsia.aspx

Like with coronary and cardiovascular diseases, I imagine long-term impacts won't be known for several years.

c-sections are money makers, we left our hospital in Boston when we found they had a 50% c-section rate, ha

The pressure to schedule an induction up to a week or so early is also very strong. The sales pitch is "we can schedule at a convenient time for you and ensure that you'll have a bed". Implying that you're being super irresponsible by letting nature decide when the baby's ready. It all just feels like the OB/GYN is worried about their schedule more than the baby's or mother's well-being.

And c-sections are definitely subtly encouraged even if there's not a real need.

That's straight-up cyberpunk horror territory. What the actual fuck

Could many of those C-sections be at the request of the mother? I know quite a few professional women who have scheduled C-sections (or just induced births) so they can "manage" the delivery better. Seems crazy to me, but not my body, child, or career.

Unless there's a medical need it's not ethical to give a c-section as it creates greater risk of complication (including and especially death), more long-term effects, worse effects on the child, and just so happens to make the hospital more money. Of course if there is a medical need then they should be done, but it's not like tonsilectomy.

That also seems horrifying & cyperpunk to me but I doubt a significant chunk of women choose it, let alone independently.

In India, it's something of a fashion and women choose it because its convenient, etc.

India is cheating

Based on time-of-day data, it seems the scheduling is more likely to convenience the doctors.

It could be a ward that specializes in handling risky pregnancies, so a desired result.

I find it doubtful that the people researching this phenomenon didn't think of that, don't you?

I think the surprising truth is that women may, inconsciously or to some extent, influence the time of birth.

If you look at the distribution of birth per calendar days there are unusual spikes and distributions on special days such as valentines day and i'm not sure this could explain by people deciding to have specifically more sex 9 month before considering the "supposed" randomness of the day of birth aound the 9 month mark..

http://thedailyviz.com/2016/09/17/how-common-is-your-birthda...

I could be wrong but I thought that was explained by c section scheduling. Doctors love nothing more than a tight schedule and birth is anything but that.

Had a child due around Christmas in our family, and I think both you and parent are both correct. The mother really didn't want to miss Christmas and the doctor offered to schedule an early induction. They didn't offer to induce on Christmas Day, eve or the day after. The baby came a couple days after Christmas.

That would be kinda sad though

But you can 'hold in' cancer?

It's not about cancer deaths, it's cancer diagnoses. Don't go to the hospital/doctor => no diagnosis

Oh if that's what the commentor I replied to meant, I misunderstood completely. :thumbs-up:

Yeah I was thinking the same.. This is not a low stress time. I've not been so stressed (and depressed) for a long time.

There's lots of evidence from fitness tracker companies that most people (who use fitness trackers at least) are indeed less stressed.

But fitness devices are notoriously bad at tracking stress :) I have stress measurement on both my Galaxy watch active and my phone (S8), and neither reading has any correlation with how stressed I am.

Basically when I've been working out it always thinks I'm stressed because my heartrate is still high, and when I'm all stressed in work it shows the lowest possible :S

I think it's just not possible to measure something as complex as stress using so few metrics. Same with sleep tracking. When I had a sleep study done I was wired up like a borg :D Checked the sleep tracking on my watch later with the graphs I received and it didn't match at all.

They're good at showing raw stats like footsteps, location and heartrate (and tracking them over time for laps/pace etc) but that's about it. But I don't trust their derived measurements at all. If the other trackers work like my watch, they'll think you're super relaxed if you haven't been working out.

Not arguing your broader point, but heart rate variability is a better tracker of stress than heart rate itself, if you want to track it yourself.

Anecdotally, I can say the opposite. The algorithms seem to work on me to a reasonable extent.

Not many heavily pregnant people will be out doing strenuous exercise!

There isn't much point wearing your fitness tracker if you never leave the house.

I think what you're saying has merit.

No data from me, only a personal anecdote.

I avoided the ER during a severe illness comprising intense bloating, severe pain, and constant vomiting for about five days roughly a month ago.

I ended up in the hospital for about eight days and was discharged just over a week ago. Turns out I'd suffered a severe acute necrotizing pancreatitis attack and just "battled through" with gatorade, water (when I could keep fluids down) and sleep. I even worked from home in between falling over on the couch!

I just really didn't want to visit the hospital. Figured it was a bad stomach bug or bad take out.

No—it turns out I was lucky to avoid the ICU and am going to be dealing with it for the next 6-12 months, if not permanently. I lost about 30 lbs in a couple of weeks because I couldn't really eat.

Even now I'm doing what I can to prevent a premature return to the hospital outside of appointments. The intake procedure is slower and requires more attention than normal from people suffering and in pain.

It's quite stressful. And this is in Canada where I didn't have to worry about a single hospital bill after multiple CT scans, ultrasounds, XRays, medications, regular blood work and blood cultures, and a semi-private hospital bed.

Outside of the stress of health issues, the worst thing I've had to endure is my employer asking me to have an insurance form filled out by my attending doctor in case I have to be re-admitted. It's difficult organizing having forms filled out when most appointments are held over the phone presently.

I can't imagine the burden of trying to navigate grants and massive bills on top of it all.

Yes, reluctance of going to the hospital is definitely the biggest factor for rapid changes in hospital-treated, non emergency health trends.

So what's the advertising campaign going to look like to get people to start going again? "Get that hernia repaired" just doesn't sound that catchy.

It short-sighted to look at those reductions in heart attacks and cancer and claim that they are all the result of people not going to the hospital, I'm sure for some percentage is true but there are dozens more factors likely involved: Less going out means less exposure to smog/contamination, less car accidents, less commute-caused stress, less physical confrontations with coworkers and strangers (eg thieves), more homemade food over street food, less bar fights, less weekend nightlife (eg parties) means less likelihood to get a cold (and pneumonia et al), as well as less promiscuity, you get the point, and I'm sure I'm missing a lot more possible factors on this list.

I'm sure there's some truth in all those other factors but I'm not sure how much any of them have to do with heart attack rate, much less cancer.

People are absolutely putting off going to the doctor or hospital for symptoms and problems that they can at least convince themselves are "nothing" or which will get better on their own.

I did it myself in May for a probable pinched nerve. (I did talk to a doctor friend of mine admittedly and she didn't think it was something that needed urgent medical attention and it has largely subsided on its own for now.) But it was definitely at the point where I would normally have gone to see my doctor.

Suicides were down in Japan due to less stress without the pressures of work. Something like that could also affect heart attack rates, though no idea if it would be significant. Record numbers of people have quit smoking as well, though I don't know if that would affect heart attack risk that fast.

So you're saying people are just pushing through heart attacks then going about their business?

That’s exactly what the NYTimes piece I linked to postulates:

“The most concerning possible explanation is that people stay home and suffer rather than risk coming to the hospital and getting infected with coronavirus. This theory suggests that Covid-19 has instilled fear of face-to-face medical care. As a result, many people with urgent health problems may be opting to remain at home rather than call for help. And when they do finally seek medical attention, it is often only after their condition has worsened. Doctors from Hong Kong reported an increase in patients coming to the hospital late in the course of their heart attack, when treatment is less likely to be lifesaving.”

It is in fact very possible to do this, a fact I found surprising. In Asimov’s biography he described having gone about his affairs for at least several weeks after a major heart attack. He thought it was indigestion I think.

This is, of course, a very bad thing for the health outcome of a patient, and it is far preferable that they get early treatment. But it is certainly quite possible to live after a heart attack.

It’s in fact a common enough phenomenon that Harvard writes articles about it: https://www.health.harvard.edu/heart-attack/when-heart-attac...

I was a bit taken aback at first, too, but then I realised heart attack symptoms fall on a continuous scale, and sometimes people don't even know they had a cardiovascular event. Smaller ones that mainly cause a lot of discomfort but then go away might be ignored now when they shouldn't be. Pure speculation, of course.

That would explain some of the excess mortality from the covid situation. Besides the induced poverty, this is one mechanism whereby the lock down could have longer lasting damage than the virus.

We can’t judge this yet though, as we don’t have a 10 year lens to look back on what is going on. If there is no vaccine developed, then it is more likely true (since the lockdown just delays the inevitable).

> Of course, no, they aren’t down, it’s just that people that absolutely should be going to the hospital aren’t and they’re endangering their lives trying to avoid COVID-19.

Do we have any clear data for this link of causality? Isn't it just one guess among many as to why?

It is unlikely single factor explains the entirety of the changes in these metrics and I actually doubt healthcare usage reluctance will turn out to be the primary factor.

Here in Spain it's almost impossible to see a doctor if you're not dropping dead.

If I try to book an appointment with my GP it tells me I can't, they only do over the phone consultancies unless it's an emergency.

So at least here it's not even reluctance but rather the lack of possibility to see a doctor.

Those differences are so wild!

Here in Germany it was easy for my partner to get an appointment at her GP. She also asked and that particular GP didn’t see a single COVID case. Not every German city is like that, certainly, but that shows what a difference in the lived experience different reaction times, measures and luck played.

>I laughed out loud when they suggested that this is a “low stress” time to be pregnant. All indicators show the opposite.

For most people it isn't, but for some people it is. If you are financially secure, then staying at home with no obligations could very well be relaxing.

I thoroughly enjoyed the lockdown until about a month ago, when I started getting tired of it. I spent every day out in the woods reading.

Psychologically not, but staying home is physically way less stressful which possibly makes the difference.

Air pollution is something to be taken very seriously,

Regarding that (and since we are hackers here), I bought myself one of these last year:

https://m5stack.com/products/pm-2-5-sensor-usb-power-sht20

Pretty affordable and it works really well, readings match another device I have which was much more costly.

Since then I turn it on from time to time, I live in an apartment near a highway, I am impressed by:

How much air quality changes between days, during the day and depending on whether there's traffic or not,

how much it changes due to household activities (cooking, cleaning).

and how it changes when someone is smoking, even outside of my unit.

Thanks to this I have developed a routine of opening/closing windows at certain times that allows me to improve the average air quality inside my place. If I had the time (and some actuators) I could probably automate that, that would be cool yeah :D.

I highly recommend getting one of these or a similar sensor. Also, I'm looking to find something similar but capable of measuring CO and CO2, if anyone knows let me know.

You can also check the quality in your neighbourhood at the luftdaten website. Many people have sensors already wired up! It's originally a German project but now there's many sensors worldwide.

https://deutschland.maps.sensor.community/#2/50.1/49.7

I use this to measure the outside PM2.5 and PM10 which did indeed drop a lot during the lockdown. Inside I have a Xiaomi air purifier which also measures PM2.5. Everything's wired up to home assistant.

I don't see many issues indoor, it never really exceeds 10, even when I'm cooking or vacuuming (though the kitchen is on the other side of the house). I thought it wasn't working right, in fact, but then one time there was a small fire outside in a bin. I just smelled it a bit in the house, there was no visible smoke, but the purifier went right up to 200 (and beyond) in seconds :)

But I can recommend getting a purifier, it does really help. I have bad hayfever and when I have the thing off for a day I really feel it (during the hayfever season of course).

I should dig for it, but I saw a study from the 1960's where the researcher exposed dogs to high levels of pm2.5 uranium oxide dust. It collected in the dogs lungs. But a lot also ended up in associated lymph nodes. Doesn't leave you with a warm feeling about things like diesel exhaust.

> I highly recommend getting one of these or a similar sensor. Also, I'm looking to find something similar but capable of measuring CO and CO2, if anyone knows let me know.

I have some suggestions for bare boards/chips that you can program yourself and run your own self-hosted IoT cloud over WiFi.

CO: $8 [0] + [1] and very very easy. Great place to start, but these sensors have a reputation for being somewhat garbage (see downthread discussion for more detail). I wouldn't use it as an emergency carbon monoxide alarm but it'll do sensitive measurements (10 to 500ppm), even if it's not accurate and I'd guess not particularly repeatable over time. There are more expensive ones available which may be more reputable. Just need an arduino or any other micro controller. I personally like [2] because it has built-in WiFi but still very cheap. I run a basic web server on them that exposes the data to Prometheus/Grafana. See [3].

CO2[4]: $60 here and you'll want a $10-20 ESP32 or ESP8266 to go with it. Arduino libraries are already written for it and the Arduion IDE has good support for ESP32 so I doubt it would be much work at all to test on / port to ESP32 and fix any porting bugs when they pop up. Alternatively if you feel like writing the interface from scratch you can go down the $40 for equivalent parts from Arrow, DigiKey, or Mouser. Honestly - interfacing with these things is generally not complicated at all as long as there aren't hardware bugs or undocumented behavior.

tVOC: $20 here[5] It looks like your PM 2.5 sensor does not also measure total VOC, so this could be handy. For a very scientific breakdown of how a metal-oxide detecting chip can be used to calculate VOC's, see the following[6]. Thankfully, there is free firmware supplied by sparkfun which does all the heavy lifting, but whenever you're using a chip cross-purposes its good to double-check the math and science.

I personally combine these kinds of sensors with the WiFi-enabled ESP8266 or ESP32 microcontrollers, which make for ~$20+ USB-flash drive sized sensors I can litter around the apartment/outside. I like controlling my own cloud, because I can't stand how Nest only provided 7 days of historical data, or reliance on cloud servers for things like itead.cc / EWeLink apps. It's stupidly simple to set up Prometheus and Grafana to self-host your own cloud. See mine here[7]

If anyone decides to go this route and gets stuck anywhere, feel free to ping me. Email in profile.

0: (CO sensor) https://www.sparkfun.com/products/9403

1: (Board for easy soldering/mounting) https://www.sparkfun.com/products/8891

2: (Cheap ESP32) https://www.microcenter.com/product/613822/inland-esp32-wroo...

3: (HTTP server running on $10 microcontroller) http://esp32.rosskoepke.com/

4: (CO2 sensor) https://www.sparkfun.com/products/15112

5: (MOx sensor which is programmed to output tVOC -- I would not trust the CO2 though) https://www.sparkfun.com/products/14193

6: https://amt.copernicus.org/articles/12/1441/2019/amt-12-1441...

7: http://grafana.rosskoepke.com:3000/d/MrL-NKnMz/ross-home-off...

for what it's worth, i wouldn't trust any sensor in the form of the sparkfun CO sensor (link 0 in your comment) -- there was a fellow in denmark who did a ton of research with these sensors to create an electronic nose that exploited their huge lack of sensitivity. most of them are sensitive to a huge range of gases beyond what they are ostensibly labeled for, so he would drive them at different voltages and could basically get fingerprints of various substances: the nose could smell the difference between different types of olive oils or detect different spices. they are also very finicky to changes in temperature / humidity.

Oh, I completely agree. Particularly the ones for various flammable gases. I've tested some of them in a lab and found them lacking for scientific analytic data collection, although I still found use for them as binary "presence" sensors to provide additional leak-point monitoring. I wouldn't recommend using them to meet safety requirements; I only used them to go above and beyond the minimum safety measures. I found they worked well enough to alert humans "hey this fitting might be coming loose" well before a whole-room LEL monitor on the wall noticed anything.

I'd love to see that Danish fellow's research to get a sense for how terrible the non-flammable gas sensors are as well.

I might have suggested a more expensive/reputable sensor but as I remarked in another reply -- it's my opinion that any solid-state gas sensor should probably be verified and calibrated against reference gas compositions. Let me know if I'm mistaken though! I just find it difficult to trust any manufacturer's datasheet claims.

I also tried to state in my original post that the CO sensor shouldn't be used in a safety-critical application. But I'll make another note to make sure people read these down-thread discussions so they're not mislead.

I wish any of the affordable NDIR sensors would work below 400 ppm, and also without exposing them to a reference concentration every once in a while.

Considering the effects of even small CO2 level increases on mental abilities, I'm looking forward to an indoor CO2 scrubber to get back below 300 and ideally below 200 ppm in the office/living room.

You've definitely done your research on these so most of this is for other readers while I kind of pretend I'm narrating to you. You may be aware, but the earth is currently at an average of >400ppm right now, so most hobbyists won't need to measure lower than 400ppm.

If you want a "cheaper" sensor that does measure all the way to 0ppm, I could suggest this one [0] for $70 at digikey.

Realistically I think any solid-state gas sensor is generally going to require calibration with reference gases --- and that totally sucks. For CO2 there are some affordable options but some other gases I've looked at are pretty unreasonable for hobbyists. I've decided that I'm personally okay with inaccuracy as long as it has good repeatability. Your needs may be different, but for me it's not so much that I need to know the exact number, but rather that I need to be able to chart trends/cycles over weekly/monthly timelines. I also accept that my sensors will drift up/down over long timelines and I try to account for that possibility in any analysis I do.

It's less than optimal, but as a hobbyist the sacrifices don't completely kill the endeavor.

0: https://rmtplusstoragesenseair.blob.core.windows.net/docs/pu...

Here is entirely anecdotal speculation as to why this is happening (credentials - mom of two). In the late stages of pregnancy the uterus starts preparing for birth by doing Braxton hicks contractions. The uterus flexes its muscles. They get stronger and physically push the baby down like a ping pong ball coming out of a balloon. BH contractions are also like clock ticks to pregnancy, the closer you get to delivery the more frequent and stronger they get. If you get dehydrated, they accelerate. If you get stressed out or exhausted, they accelerate. If you skip a meal, they accelerate. Late stage pregnancy mothers legitimately need less physical strain and more opportunity to take care of their bodies or the baby comes early. Keeping the same active pace of work for a few weeks in the third trimester can cost years of additional effort and suffering as a premature baby may accrue permanent damage. Remote work allows for your body to rest while your brains can work at full speed for longer. It is challenging to make “remote“ work right now, but for my part, I’m constantly prototyping and brainstorming ways to make the experience better. We can do so much more in our lifetimes if reduce the dangerous commutes.

I would think that stress levels are higher now...

Mental stress may be high, but you can also turn off the news. Physiological stress is much lower when you have drinks, food, and bathroom within reach every 20 minutes for most of the day. It also helps not having to strut around an office for 10 hours with a giant ball of water and human resting on your internal organs and sloshing back and forth with every movement, throwing you off balance. During pregnancy your body is a machine taken over by a different process you have zero control over, and any resource shortage hits that process first. Meds you take, foods you eat, lack of sleep or other deprivations. You are really an observer of someone else’s work (evolution) and the months of pregnancy teach you to pay attention to your contractions and body reactions, to the baby’s kicks, and any other data outputs, and how they affect the baby. Your amigdala grows and your empathy remains high for life (it grows equally in men who become primary caregivers too). Empathy in this case is the ability to put yourself in another person’s shoes, foresee deeper into layers of potential consequences and prevent undesirable circumstances.

Depends on how much media you consume. Go outside, walks even, read classics, breathe, write in a journal, get some sunshine.

> Late stage pregnancy mothers legitimately need less physical strain and more opportunity to take care of their bodies or the baby comes early. Keeping the same active pace of work for a few weeks in the third trimester can cost years of additional effort and suffering as a premature baby may accrue permanent damage.

You are rediscovering why in traditional societies woman stop working when getting pregnant. This is not a plot by the so-called patriarchy but something that have been intuitively understood by humanity for millennia: woman need lot of rest before and after the baby is born.

In Denmark, maternity leave usually starts 4 weeks before the expected birth day. This actually seems to be shorter than the EU average, many countries start the leave 8 or more weeks before birth.

Why should women stop working entirely after having a child? Given sufficient maternity leave, they can take care of their bodies when it is required, and then get back to work when they can.

Having a baby is such a crucial and important event in any woman's life that a mandated pre-delivery-full-pay leave seems like a viable mandated right I would whole-heartedly support.

As an employer, why would you choose to hire women who you knew you would have to pay a mandated pre-delivery-full-pay leave to as opposed to a man without that risk?

This has already been solved in multiple countries. For instance here in Norway, the leave goes for both parents. There is something like 12 months that can be shared between the parents, and both have around a month of leave just at the birth.

Even asking about pregnancy/child plans in a interview is illegal.

The pay during maternity leave is covered by the state. I am guessing this holds for all countries but I can only say for sure for my country.

It is somewhat annoying for the employer to "lose" the employee for a year but there is ample notice (eight months or so :) ) so the employer can prepare for the absence.

Exactly, when the state pays the maternity leave, it doesn't create a disincentive for the employers.

Should be obvious, but somehow is not. Even if you make laws like "the employer cannot ask about ...", well, they cannot ask, but they can still make a guess, right? (And then make up an excuse, because guessing is also illegal, of course.) Instead, if the maternity leave is paid by the state, the employer does not bear the cost, the mother doesn't have to worry about the employer going out of business during her pregnancy, etc.

Generally, as a rule of thumb, if the "society wants" something, it should be paid by taxes, not thrown as an additional burden of the employers. That way, employers are incentivized to try to avoid the extra costs by doing things that are socially wrong, and the employees are not dependent of having a good and wealthy employer, and even the unemployed can get the same benefits by the same channels.

For example, if you want to prevent crime, you don't say "the employers should provide police to protect their employees", but instead you pay the police from taxes, and leave the employers out of it. Exactly the same logic applies to health care, parental leave, etc.

Not arguing either way, but there is a natural disincentive for employers to have to plan around their employees being gone for those long periods of time, plus the ramp-up time upon their return, depending on the job.

The hand-wavy hippie arguments are "because it's the right thing to do" but of course the real answer needs to be "because we made the benefit equal for dads to remove just the situation you refer to".

Most developed countries have figured this out. Some set amount of parental leave can be used by the parents of the child with the government paying some percentage of their usual salary instead of the employer. In Sweden the parents get a total of 480 days paid at 80% of their salary.

This is why paid maternal leave is forced on employers in European countries, so that they have no choice but to do so.

Employers factor in that risk in their employee payment budget, build up reserves for it in accounting (same as they do with people falling sick or having regular PTO), in some cases governments step in and subsidize wages and that's it.

Employers as a class in general will not ever hand away such things voluntarily, they had to be fought for violently over a hundred years ago in collective action.

One of the reasons I love my employer is that they offer 6 months full pay to both men and women, with the option to have up to a year off (for women this moves to basic pay, men zero) after the 6 months - if you are having or adopting a child.

This way as someone who interviews people it doesn't matter if they are men or women, you know that some will have children, some won't, but we will cope when they are away. And they will be back again. Far far more of our men and women return to work and stay with the company after having children than the UK average. I haven't personally benefitted from this (I had my kids when at another company with just 2 week paternity leave) but it makes me happy to see colleagues able to use this time to grow close to their child and also return to work rested and happy.

We also have great flexibility in working patterns that has only increased since the pandemic. Happy humans deliver great work.

Because you're aware of the broader picture around employing practices that are sustainable for society at large, and not only focused on your immediate selfish return of investment?

Because you value the diversity in your workforce, not only because it looks good, but because it brings a unique culture to your company (as well as being fair)?

Because ultimately as a company you need workers past the current generation. If women stop making babies due to having to bear a financial and occupational burden, then your company will quickly disappear due to a lack of workers and customers.

This question is exactly why the federal govt has to level the playing field. It should be a tax incentive for companies to have workers on leave for reasons that support the health of society.

Would it be illegal for a newly pregnant woman to go and interview for 10 jobs, each of which she then never sets foot in because she immediately goes on pregnancy leave while still being paid for them all? Asking for a friend...

If I understand correctly, in Germany that works fine and is a lot less profitable than you’re expecting because the maternity pay is based on how much you were earning a year ago.

Caveat: I’m still learning German, and this is a second-hand description from a coworker who is a father but isn’t an employment lawyer

If you work in a place where labour laws allow working 1000 percent, why not?

That should be the option (and a socially acceptable one) in all societies IMO. Working until delivery and dumping a newborn to a daycare at 6 months old is insane IMO.

Aren't most women's rights advocates asking for more maternity leave, not less?

> You are rediscovering why in traditional societies woman stop working when getting pregnant.

Which "traditional" societies? Because you sure as hell didn't stop working in any pre-agrarian, post-agrarian, industrial or ... you know any society on Earth prior to the invention of the white-collar job.

If you lived in a multi-generational household, your share of the household labor absolutely decreased. And neighbors also picked up some of the slack.

I'm talking about early 1900s, based on stories from my grandparents about what life was like.

The plot by patriarchy is not asking women to stop working during the third trimester. The plot is to ignore those needs and punish women who stop working by not paying them maternity leave or holding their pregnancy against them when they come back to the workforce.

I thought the plot by patriarchy was trying to keep women at home instead of in the workforce?

It’s not 1962. It’s not that simplistic. But talk to literally any mother in literally any white collar job. “I’m expecting” or even “we’re thinking of having kids” results in fewer projects, getting turned down for promotions, and if you’re in a technical role, you’re pushed into management ASAP. I get that I’m a stranger on the internet, but you gotta trust me on this. This isn’t random/sometimes — this is CONSTANT. And it’s not even all malicious! It just comes from a place of, I would say, well-intended ignorance.

It's not ignorance, it's common business sense. Suppose you couldn't work full-time because of reason X. It doesn't matter what reason X is, I can not use your work in the same way, if for no other reason than Brooks's law applying.

Unless you're an anti-natalist, you can argue that X=pregnancy is really important to society as a whole, but then the burden should be carried by the whole of society, not just the slice that happens to run a business.

Either way, we have to admit that you can't be a mother and have equal career prospects to someone who stays childless, just like you can't put the same amount of work into two different careers and still get the same result for each as if you had put all the work into just one.

So you are saying that the plot of patriarchy used to be to keep women out of the workspace, but now the plot is the opposite, to keep them out of the home? It sounds like the patriarchs need to get together and make up their minds.

Is it really impossible to imagine that things change?

Or, less succinctly -- that there isn't an actual literal plot, there's just people reacting to incentives, and those incentives change?

The hard thing to imagine is the in-between time. These two plots are so opposite one another that in the middle of switching between the two the patriarchy must’ve had a coup, or had a meeting where the head of the patriarchy laid down the law and everyone tied the line, or there was mass confusion. Did the old patriarchs get replaced by new patriarchs with a new plot? Did they purposefully change their plot and women currently are unwittingly playing their game? Did they just give in to the inevitable and then devise a new plot?

There is no contradiction as "keeping them home" was staying all the time at home with no income and advancement.

And being forced to work here means "being punished for talking about possible pregnancy or needing more rest in the last few weeks or it or in case of health issues".

Whether patriarchy or not, these are not contradictory.

Sorry to hear about these experiences. It reminds me of the prisoners dilemma in game theory. Business leaders may (wrongly, or not) think that putting women on projects that will get delayed by pregnancy will put them at a competitive disadvantage.

The prisoners dilemma can only ever be solved by an entity that sees the whole picture, i.e. the federal govt. They have to mandate everyone play by the same rule, or else those who stick their head out for charity’s sake may endure all the sacrifice that entails (which is not fair).

I think we need to move past the genderization of capitalism (an abstract force) into "patriarchy" -- Capitalism has no interest in gender, age, or pretty much anything relating to human qualities. The trending force for capitalism is to have humans automated away -- let alone be given free money to have a baby.

I actually find the notion of "patriarchy" incredibly sexist -- were not men the canaries in the coalmine -- the original victims -- for the dehumanization of capitalism?

I happen to support capitalism as a means of production -- but it should be understood as an abstract, inhuman force like an optimization algorithm. "Patriarchy" is a red herring.

Funny thing is, wifes in mining areas did earn own money, for themselves and kids, because males were dying much sooner then women.

> I actually find the notion of "patriarchy" incredibly sexist -- were not men the canaries in the coalmine -- the original victims -- for the dehumanization of capitalism?

Given that women didn’t have a vote when the Industrial Age made coal mining into a primary power source, and given that marriage was seen as making the concept of rape logically impossible until 1992 in the UK [0], I disagree.

Separately, I would argue that while capitalism will exploit such prejudices, I don’t think it is the origin of them.

[0] obvious trigger warning applies: http://www.bailii.org/uk/cases/UKHL/1991/12.html

> Given that women didn’t have a vote when the Industrial Age made coal mining into a primary power source, and given that marriage was seen as making the concept of rape logically impossible until 1992 in the UK [0], I disagree.

I'm not following how this relates to the comment you're replying to. Are you saying that women are the original victims of capitalism? Or that capitalism was created by men? Or something else?

I’m denying the claim “were not men the canaries in the coalmine -- the original victims -- for the dehumanization of capitalism?”

Lots of men had their humanity disregarded, but women were treated worse, and that legacy continued for a very long time.

These issues still exist in some places, based on what I’ve seen reported by trans people who transition so successfully that people who knew them before the transition mistook them for their own opposite gendered siblings and treated them differently in accordance with gender stereotypes rather than by merit.

As an aside, playing the ‘who is the greater victim game’ is a meaningless exercise that doesn’t focus on the simple facts of life: there is suffering, be a friend to those in need.

Those examples don't contradict the claim you're denying. The claim wasn't "men had it worse than women". It was that capitalism originally hurt men (coal miners, specifically). The commenter was arguing that capitalism is not a plot by the patriarchy devised to oppress women. To contradict their claim, you need an example of capitalism originally victimizing women.

I doubt anyone here would disagree that women have suffered more from sexism.

Incidentally, and unrelated to that point, you chose oddly mild examples of bad treatment of women. I'd much rather live in a society where I couldn't vote or charge my spouse with rape than be a coal miner and suffer from black lung and be in significant danger of dying in a workplace accident. You could have gone with the awful treatment of women under the Taliban, to name one example.

Thank you. I'm all for the Simone de Beauvoir flavor of feminism. I understand that women want more power, even if it is in a corrupt system -- but the problem I have with "Lean In" feminism is that it serves as cover for exploitation... it is, in our cultural zeitgeist, somehow "okay" for a black woman like Condoleeza Rice to bomb Iraqis -- does blackness and femininty now serve as the perfect mask and disguise for capital and oppression?... should we not elevate our consciousness towards an overarching view of the system?

Yes, the industrial system was not built for women... it was built to make cheap knick-knacks... which has no relation to having babies. It is indifferent to women, not beneficial by design to men... the scape-goating is counter-productive, and behind the male mask -- falls to deaf ears. That is my point.

Noted, and thanks for keeping it polite. :)

I find your preferences shocking, considering when childbirth anaesthetic was invented, when abortions and woman-centric contraceptives became commonplace, and when the idea of doctors washing their hands between autopsies and the maternity ward became common sense rather than being treated as an insult.

I really couldn’t use the Taliban. They’re (1) modern day and (2) primarily a theocracy.

I think we're just interpreting how the hypothetical choice works differently. You're right, I wouldn't want to live in the 18th or 19th century at all. But I'd prefer to not be able to vote (in isolation of other factors) to being a coal miner (in isolation of other factors).

> I actually find the notion of "patriarchy" incredibly sexist -- were not men the canaries in the coalmine -- the original victims -- for the dehumanization of capitalism?

"Patriarchy" is intertwined with the means of production but is also distinct therefrom. Women in Victorian England were not fully legally recognized as persons and did not have the same property rights as their husbands, and this is in a period during which capitalism obtained in England. This arrangement with men as the "patriarch" of the household, exercising control over subaltern women, predates capitalism by millenia (c.f. Roman "pater familias").

This "patriarchy" doesn't only consist of formal law, but may exist in tradition and social mores. For example adultery may be technically equally penalized for men and women but carry a vastly greater stigma and punishment in practice for women, as in feudal China. As another example, women may technically have recourse to the law if they are subjected to domestic violence but be prevented from doing this by the fear of social opprobrium and further mistreatment by family and community, as was again the case in Victorian England. "Patriarchy" doesn't refer to any concerted effort or plot, but is a description of the outcome of social institutions and cultural attitudes which, AS A SYSTEM, disadvantage women.

> capitalism ... should be understood as an abstract, inhuman force

Capitalism, and patriarchy, are BOTH generally understood as being systemic: i.e. properties of human institutions. The concepts DO NOT inherently place blame on individuals, or even make judgments about the morality of the system.

Whether or not our society exhibits patriarchy is an empirical question, to be answered with reference to data. Arising from but separate from this, there is the ethical question of value-judgment about the society. But there is absolutely no basis to call the notion of patriarchy "sexist".

slaps knee Thank you.

Potential upstream causes:

"One is social distancing, which may have cut down on the amount of general infection from contact with others.

Another is less air pollution, from fewer cars being on the roads."

I'd love to see increased incentive for cities to act hastily on reducing <pm2.5 air pollution. Talk about a covert inequality exacerbator.

It’s possible one of the worst long term pollution problems is from tire wear which is not addressed by cleaner running vehicles, so there’s multiple avenues to address there but most solutions only address the fuel/exhaust, was a hacker news story earlier this year.

The contribution of tire and brake pad wear is really quite low compared to other sources of air pollution.

From Evangeliou et al. (2020), Atmospheric transport is a major pathway of microplastics to remote regions, page 3:

"Surface concentrations of tire wear particles (TWPs) range between a few ng.m−3 and 20 ng.m−3 for PM2.5 and up to 50 ng.m−3 for PM10 (Supplementary Movie 1). Brake wear particle (BWP) surface concentrations reach 50 ng.m−3 at maximum (Supplementary Movie 1). The highest concentrations were calculated for eastern USA, Europe and South-eastern Asia. All concentrations (TWPs 0.4 μg.m−3 for PM2.5, 1.8 μg.m−3 for PM10; BWPs 0.8 μg.m−3 for PM2.5, 1.4 μg.m−3 for PM10) were far below air quality limits for PM (annual mean 10 μg.m−3 for PM2.5, double for PM10) and lower than typical black carbon (BC) concentrations in remote regions."

https://www.nature.com/articles/s41467-020-17201-9

You are correct but the particles from tires make a signficant contribution to pollution in the ocean! I neglected to separate that out from the GP's air pollution discussion. https://www.latimes.com/environment/story/2019-10-02/califor...

But the type of pollution does matter. An important question is does it have a greater impact. And given the studies linking health to distance from the freeway, I think that question needs further investigation.

Electrics have less brake wear and probably more tire wear due to weight increases.

Don't forget about break pads:

https://www.eurekalert.org/pub_releases/2020-01/urai-bda0107...

Regenerative breaking with the right EV could make a huge difference here. I use my breaks way way less now than with a traditional car.

Road wear scales n^4 with vehicle weight [1]. If tire wear is anything similar, it makes an additional strong argument that we should be using fewer (mass transit) and lighter (bicycles) vehicles.

[1] https://www.fhwa.dot.gov/reports/tswstudy/Vol3-Chapter5.pdf

Why should we be using mass transit? Wouldn't a bus be heavier than a car? And n^4 with weight would mean the increase in weight would likely be much worse than the gain from the n reduction in number of cars.

Electric (both fully and hybrid) vehicles have the advantage over fuel cell, LNG/CNG and conventional ICE engines in that they can massively reduce brake pad wear/dust by regenerative braking, so only tire wear remains as an issue.

Here's a study from Denmark showing a 90% drop in the rate of extremely premature births (gestational age below 28 weeks - the HN article talks about 32 weeks, so the drops cannot be directly compared):

https://www.medrxiv.org/content/10.1101/2020.05.22.20109793v...

My guesses (in order of likelihood):

1) More sleep, and easier to respect their circadian rhythm

2) Reduced un-conscious stress levels related to: the comfort of being at home in a safe place...the comfort of knowing they won't go into labor early while far from home and around non-family members...the comfort of knowing they're eliminating unforeseen risks that come with venturing out into the world

3) Significant reduction of non-natural movements/processes such as: getting in/out of car, sitting in stiff desk chair all day, work-schedule dependent restroom use, commuting related stress

4.) Reduced air pollution

> "By staying home, a pregnant woman may have less stress from commuting and from work, and that might have helped them," Alshaikh said.

Ah yes, I'm sure my 7-months-pregnant wife would agree that this has been a lovely, low-stress time. Wouldn't have it any other way.

Came here to say this.

The past few months have been some of the most emotionally stressful in recent memory. Even work-wise -- less of a commute, sure, but unless you already had a job that was compatible with working from home, the transition by itself has been anything but easy and relaxing. Not to mention the incredibly sharp rise in unemployment, the lack of physical social interaction, the fear (or reality) that your parents/grandparents contact the virus, etc etc.

And as for physical stress, exercise is generally good, not bad for one's health, including during pregnancy. Unless your job involves doing physically taxing work, which you continue to do even while pregnant, it's a little hard to imagine how being forced to stay indoors would be particularly good for your overall physical health.

From a purely personal perspective I have genuinely been less stressed recently and like the current situation. Obviously I know this pandemic is an awful event for many people and you were (I think?) being sarcastic. But I would be surprised if there wasn't at least some portion of mothers feeling similarly. Is it enough to account for the changes we're seeing? I suspect it's more than one factor.

Believe me, I get it. I kind of have preferred this myself. But for pregnancy, which is already a terrifying ordeal, consider:

- Can't go to the hospital for ultrasound or other routine procedures; the hospital is too dangerous. Gotta fly pretty much blind.

- Haven't met any other first-time parents, haven't been able to do PEP classes. We feel pretty alone.

- Going to need to take parental leave... indefinitely? Early childcare doesn't look like an option. But can we risk our jobs by taking a lot of leave? Maybe we have to.

- We can't see her parents since they work in the healthcare industry. She has a great relationship with her mom, so this is really tough while pregnant.

- Nobody really knows how bad CoVID is for a newborn, or what its effect on gestation is. It's easy to get sucked into spirals of terror about this. While we'd (probably) be fine if we caught it, the effects on the baby, even from asymptomatic infection, are unknown, and there are hints of brain damage which are _really_ scary.

So, it's pretty damn stressful, at least for us.

I hope this comes across as helpful and not one-upmanship: it is natural to think that having a child is like many of the other things you're used to in life where you can control the outcome.

That can lead to you worrying about and optimising for lots of things that won't matter too much in the grand scheme of things.

I can tell you from first hand experience that you are not in control. You will know you are in a truly stressful situation when you've forgetten about all of the items you've listed above because you're standing there watching, not sure what is going on, just hoping that everything is going to be ok.

I hope you never get to that point and in the meantime try enjoy the ride. I wish you and your family all the best!

You seem to be dunking on them for making a qualitative judgement, but they made a comparative one.

I think spenczar5's reaction is fairly understandable in the context. Live in close quarters with somebody in their 7th month of pregnancy and 5th month of lockdown and we'll see if your goto reflex is to explain further.

There's a need for a lot of sensitivity in this conversation. It's easy for us to armchair-expert this to death... that isn't necessarily a good thing.

It's maybe also possible that some people find it more stressful than their normal routine, and some find it less.

I mean, "armchair quarterback" doesn't really apply to posing a hypothesis, does it?

I didn't say quarterback, did I? For all that HN loves to rip on studies with small sample sets or sketchy statistics, or worse, deriding people sharing their experiences as anecdotal, this community is sure fond of positing alternative hypotheses with zero evidence.

No, I'm dunking on them for the comparative judgement, that a reason for fewer preterm births might be less-stressed mothers. I think it's very silly to claim that this is lower stress than your typical year just because you don't have to commute.

Maybe we should all refrain from speaking for all pregnant women without having any facts to support it.

Emotional stress? Yes. Physical stress? Hopefully not?

My wife gave birth just before the lockdown here in the UK.

The stress continues after the baby is born too - regular check-ups, midwife visits, getting vaccinations, emergencies etc all now come with a brand new stress factor of "Am I or my baby going to contract COVID by <doing something that was totally normal in the past> and end up in intendive care? Or maybe will I contract COVID and give it to my spouse/family?" Even having relatives visit their new grandchild/niece/nephew/cousin/etc feels like a risk, but there is a lot of pressure from friends and family to get hands-on baby time.

Babies cannot wear PPE either.

I've certainly got some more grey hairs now!

Interesting, their is also a big difference of % premature births between rich countries up to a factor of 3: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-...

I have some anecdotal experience here which is not in the same trend.

Our baby was born 10 weeks premature on the 4 June, although her being premature seemed to be entirely unrelated to COVID-19. I'm happy to say they've been doing super well and we expect them to come home this week.

Although not related to prematureness, of interest in regards to pregnancy and COVID-19 was that the gynaecologist mentioned during pregnancy that they had anecdotally noticed that during our lockdown here babies in utero were on average noticeably bigger than usual. They supposed that it might be related to moms on average being more relaxed due to not needing to do things like stressful work commutes.

Our baby was quite a bit bigger than average for their maturity which was quite fortunate given how early they arrived.

> By staying home, a pregnant woman may have less stress from commuting and from work

Classically in Psychology the stress of planning a holiday is more than the stress of the death of a loved one.

This might now be considered wrong (?), but you are taught this because stress is not what the average person thinks it is.

That said, shopping and going out is now really stressful, it's an ongoing changing conditions we are not used to, so surely they mean physical stress, but not sure why they did not say that?

Is it because you can't politically say if women rest at home when pregnant it's better for the baby?

Another is less air pollution, from fewer cars being on the roads.

"This might actually help because studies in the past showed that air pollution actually increases the risk for preterm birth," Alshaikh said.

One takeaway that doesn't involve arguing about the so-called Patriarchy and what not: Let's just try to lower pollution rates generally. It's good for everyone, including but not limited to pregnant women.

My son was born 10 weeks (started having issues 14 weeks) too early. One of the primary reasons he was born that early was that my wifes Cervical was expanding too fast. The remedy lay down don't move.

A simple explanation could simply be that by people having stayed at home they are less likely to be physically active and stressed.

I'll bet you that's the primary reason.

A similar thing has been reported in Denmark ("big fall in extremely premature births").

https://www.tvmidtvest.dk/coronavirus/stort-fald-i-ekstremt-...

Hospitals furloughing workers and fewer premature babies are definitely outcomes I did not expect.

Nevermind the 3 causes they are looking at.

I think that this is very likely due to removal/lessening of the impact of doctors on what is a natural process. If doctors are less involved, things take their natural course without problems.

Let's not forget, that the third largest cause of death (higher than covid) is iatrogenic death: https://www.globalresearch.ca/drug-induced-iatrogenic-disord...

There is, in fact, a strong case to be made for closing doctors, hospitals, etc down, in order to increase the populations health!

EDIT - I don't know why my comment is being downvoted. I think I'm making a rational, reasonable argument! If you disagree, no problem! But perhaps state why you think what I'm suggesting is wrong.

'Don't give birth during a plague' is reasonable as a biological imperative.

I theorize its because the "pace of (modern) life" has slowed down.

The stress of non-cummuting may have been offset by the stress of 'OMG there's a pandemic' - a more existential kind of things.

The Scientologists have some very aggressive rules about 'quiet' around baby and birth, rather extremist, but I think there is something to it.

Even in the womb, we are picking up information - imagine all the noise, hormones, moving around etc. we get from pre-birth to age 1.

I wonder if we should head out to the countryside 3 months before and after.

It would be powerful to see more research into this, because the results could be revelatory not just in relation to birth, but in other life activities.

Edit: I'm not suggesting there's any 'Science' in 'Scientology', rather, it's an expansive and odd cult with just a ton on out-of-the-box thinking, a lot of it initiated way back when treatment of mental illness was actually draconian (ie lobotomies, arbitrary detention, brutal treatment) and there are often 'kernels of truth' in some of these things. The 'quiet during and around birthing' always struck me as something actually rational in a way. Not scientific either but Glenn Gould attributed his musical genius to the fact his mother would play softly while he was still the womb (thus he's literally been playing 'before he was born') and I don't think it's unreasonable at all to think 'maybe there is something to it'. Early childhood events have incredible impact on our lives. I think of it like 'the time when the kernel code is established' and things gone wayward at that level cause idiosyncrasies for the rest of one's life.

I am pretty sure most people don't remember whether someone said something during their birth. Generally, people remember very little from their first years. For a child below 5 years, if you talk about something that happened a year ago, from their perspective it never happened (unless you remind them of the thing repeatedly, in which case they actually remember your repetition, not the original event). Also, the babies themselves contribute some of the noise.

The "something is to it" part is probably that you shouldn't play loud metal music in the hospital. Which probably no one does anyway. But being afraid to say a word... that's just superstition.

"whether someone said something during their birth. Generally, people remember very little from their first years"

You're missing the context here. Babies don't understand speech, so it's not like words are going to matter.

And this has nothing to do with 'memories'.

Loud noises, unnatural humming sounds like vehicles, the constancy of it all - is highly unnatural.

The possibility that hormones can alter our development is implied in the article, it's not entirely unreasonable that other stressors can affect us as well.

We were 'designed' to come into a very quiet world (granted, it was a rugged place) but it was audibly very quiet.

Since all of us - adults, children, react in a variety of ways to sound (stressing, soothing etc.) I suggest that audio, in the very earliest phases of one's life can possibly be a stressor.

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