Teratogens and Zika | indiebirthmidwiferyschool.org

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Teratogens and Zika

April 24, 2021

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A guest post by IBMS student Maíra Dias Botelho de Magalhães who you can find over at www.birthinghearts.com/

Teratogens are substances that cause malformation on the developing fetus in utero. It can be a substance, an organism or a process. Critical periods for optimal fetal development occur between weeks 3 and 8 of embryo life, especially. In this essay, we will be examining the effects of the Zika virus as a teratogen in pregnancy and newborn babies.

After a sudden rise in the number of babies born with microcephaly (a neurological condition in newborn babies where the head is much smaller than other babies with the same age) in the Northeast of Brazil in 2015, studies conducted by the Instituto Oswaldo Cruz (IOC/Fiocruz) found a link between this phenomenon and the Zika virus spread around the same time in that region.

This hypothesis was reinforced when the virus genome was detected in the amniotic fluid of pregnant women who had been infected with the virus in early pregnancy and whose babies were diagnosed with microcephaly by ultrasound. In other words, it was found that when women who had found themselves with symptoms of the Zika disease during the first and early second trimester of pregnancy, they would gestate and give birth to babies with smaller brains than normally observed. Mental retardation and failure of other vital organs are associated with this condition.

Zika symptoms include light or absence of fever; pain on the joints, usually on the extremities which can become swollen; red eyes and aversion to light; red spots with intense itchiness; numbness on the extremities; difficulty to walk; neurological alterations and compromise. For pregnant women in early pregnancy (during the critical period of cellular differentiation), Zika infection has a high chance of debilitating the embryo resulting in neurological damage, including microcephaly.  The most up-to-date research on this flavivirus comes from the IOC in Brazil. 

When a midwife or birth attendant is working with a client who has had symptoms of Zika, it’s important to investigate at what point during gestation the embryo/fetus was exposed to the disease, so that it can be explained to the mother how this exposure can affect the development of her baby. As this is a very delicate subject, compassion and the ability to have crucial conversations with other human beings in a non-violent communication manner is extremely valuable on the part of the caregiver. If the mother chooses to investigate further, referring her to an ultrasound friendly doctor to confirm this suspicion, as well as a sample of the amniotic fluid, may be advisable. Emotional support for her during this intensely emotional time will be adamant, no matter what happens. 

This virus has the mosquito Aedes aegypti as a host, as does dengue and chikungunya viruses. Therefore, tropical climate countries like Brazil and Malaysia, for example, are at greater risk for its spread. This South East Asia country, however, unlike Brazil, had been exposed to this virus decades prior to the outbreak in Brazil, and hence did not have an epidemic of Zika in 2015 although its population of this specific mosquito is large. 

As a personal anecdote, I’d like to share that my family and I moved to Malaysia (from Brazil) in 2014. My teenage daughter and I caught dengue in its capital, Kuala Lumpur, during our first month of arrival. We had never had dengue before. It was painful and terrible. Then, soon after that, there was the outbreak of Zika and the microcephaly cases rose in Brazil. There was a certain commotion within the expatriate community already living in Malaysia or about to live there for the first time because of the potential dangers of contamination with Zika. However, for the reason briefly explained above, there was not a single outbreak of the disease there. 

I was a prenatal yoga teacher and doula at the time, and most of my clients were foreigners. One of them had recently moved to KL and was pregnant. She was a nurse herself in the USA and had been advised by her Department of State of her country not to travel to Malaysia due to the outbreak of Zika in Brazil. She told me this recommendation didn’t make sense to her because she thought of all the pregnant women who currently lived there and thought to herself: why would I be more at risk than the local pregnant women? So, despite those medical recommendations, she traveled to Malaysia, and everything was fine, of course!

I understand that the Zika situation was a matter of public health in warm countries where the mosquito Aedes aegypti proliferates. And that this may not ever be the case here in the USA. However, I can’t help but compare it with the current situation in the world, the coronavirus, and the age of fear and mass control. To this date, no evidence was found that having covid-19 can cause damage to the developing embryo or fetus. The stress that pregnant women have been put through because of this virus, however, is ridiculously disproportionate. I hope this world situation normalizes soon. 


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Meet the duo behind the Indie Birth Midwifery School

We are mamas and birth workers who decided to do birth differently– and bring others along with us. We are kind, fun to work with, and great at (lovingly) calling people on their bullshit when necessary. With 12 children and 18 years of midwifery between us, we’ve learned a thing or two along the way, and Indie Birth Midwifery School is our space to share it all with you.

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