Category Archives: Informative artikel

Babinden, celebrated every year on January 21st, is one of the most cherished folk holidays in Bulgaria, rooted in ancient traditions, care for women, and respect for medicine. While the holiday has evolved over time, it remains a symbol of affection, recognition, and gratitude toward the women who assist future mothers during the most important moment of their lives—the birth of a child.

HISTORY OF THE HOLIDAY

The origins of Babin Den trace back to ancient times when Bulgarians believed there were special women, called “babi“ (grandmas in English) responsible for childbirth. These women, usually older and experienced, were thought to possess unique knowledge on how to help women during labor. They not only provided physical assistance but also performed rituals and magic to ensure the safety of both the mother and the child. Over time, the holiday began to be associated with medicine, as a way of honoring the professionals working in this field.

THE ESSENCE OF THE HOLIDAY

The main idea behind Babinden is to honor the women who are in any way connected to childbirth—grandmothers, midwives, gynaecologists,and everyone who assists mothers and newborns. On this day, various customs and rituals take place, including expressions of thanks and gifts. Traditionally, a group of women would gather to perform a ritual of “bathing the grandma” or the midwife. She would be poured over with water or a special ceremonial act would take place to show respect for her hard work and efforts. Additionally , small gifts would be given to her – shirts, socks, etc. The grandmother-midwife would also gift similar presents to the children she delivered and tie red and white strings with a silver coin on their wrists. There are many other popular traditions and rituals, however, the most important part is that on this day everyone has lots of fun.

THE ROLE OF THE GRANDMOTHERS

Grandmothers and midwives are central figures of the holiday. They are symbols of female strength, knowledge, and experience that are passed down to younger generations. In the past, these women not only helped birthing mothers but also played a crucial role in the social structure of the community. Often in rural villages, the grandmothers were the only ones who could assist during childbirth, as doctors and hospitals were scarce in remote areas.

THE HOLIDAY IN PRESENT DAY

Today, Babinden is more of a celebration for midwives and doctors rather than the grandmothers in the traditional sense. With the advancement of medicine and healthcare, the role of grandmothers in childbirth has diminished, but the holiday continues to be observed with respect toward healthcare professionals. Although customs and rituals have changed, the essence of the holiday remains the same—to honor the women and medical specialists who help bring new life into the world.

Babin Den is a holiday that not only combines traditions and customs but also highlights the importance of women’s roles in society and healthcare. It is an occasion to express gratitude toward all those who, with care and attention, help new generations enter this world, while simultaneously showing respect for the ancient knowledge and practices that have contributed to the development of modern medicine.

THE FIRST MONTHS WITH OUR BABY – SHORT GUIDE

In Vitro Fertilization (IVF) can be a life-changing experience for women dreaming of having a child, but it is often an emotional challenge as well. In addition to the physical aspects, emotional preparation is equally important for managing expectations, navigating the process, and maintaining mental health. In this article, we offer some advice on how to take care of your mental well-being during IVF.

EDUCATE YOURSELF ABOUT THE IVF PROCESS

Understanding what IVF involves can help manage your emotions. Knowledge reduces anxiety and fear of the unknown, giving a sense of control. Research the stages of IVF, success rates, and potential challenges. Attend consultations with your reproductive specialist, ask questions, and read medical literature or personal stories from people who have undergone IVF. Being well-informed will help you set realistic expectations and prepare for the emotional highs and lows.

SET REALISTIC EXPECTATIONS

Unfortunately, IVF does not guarantee 100% success. Success varies depending on factors such as age, health condition, and previous conception problems. It is important to remain optimistic but realistic. Understand that IVF may require several attempts and that failure is possible. Emotional preparation for this possibility will help you avoid feelings of shock or disappointment if the first attempt does not result in pregnancy.

ACCEPT YOUR EMOTIONS

It is normal to experience a variety of emotions during IVF: hope, excitement, anxiety, fear, disappointment, or even sadness. Do not suppress these feelings. Accept them as part of the process. Be kind and patient with yourself, and understand that it is normal to experience emotional fluctuations. Keeping a journal or practicing meditation can help you process your emotions.

SEEK SUPPORT FROM LOVED ONES

Surround yourself with people who can offer emotional support. This may include your partner, close friends, family members, or even online support groups. Infertility treatment can be isolating, but sharing your experience with someone who understands or empathizes can bring relief. If you feel comfortable, join forums or communities where you can talk to others who have gone through or are undergoing IVF. Sometimes, conversations with people with similar experiences can ease the emotional burden.

OPEN COMMUNICATION WITH YOUR PARTNER

If you are going through IVF as a couple, maintaining open and honest communication is essential. IVF can cause stress and strain on the relationship due to uncertainty and the emotional toll. Regularly discuss how you feel, your hopes, and your fears. Be attentive to each other’s emotional needs. Couples counseling, especially with a therapist experienced in the field, can help you stay united and support each other throughout the process.

CONSIDER PROFESSIONAL HELP

Counseling with an appropriate psychotherapist can be an excellent source of emotional support during IVF. Trained counselors understand the unique challenges of assisted reproductive techniques and can offer coping strategies, stress management techniques, and a safe space to express emotions. Do not hesitate to seek professional help if the process becomes too overwhelming.

TAKE CARE OF YOURSELF

During IVF, it is important to prioritize self-care. Engage in activities that help you relax and recover. Whether it is walking in nature, yoga, reading, painting, or spending time with loved ones, find what brings you peace and joy. These small actions can help manage stress and remind you that your identity is not limited to the IVF process.

BE PREPARED FOR UNCERTAINTY

One of the most challenging aspects of IVF is the uncertainty. There is no way to predict the outcome, and waiting for results can increase anxiety. Accepting that not everything is under your control is key to emotional resilience during IVF.

TAKE A BREAK

The IVF process can be physically and emotionally exhausting. Allow yourself the flexibility to take a break if necessary. If you feel emotionally drained, it is perfectly normal to pause and recover mentally and emotionally. Taking care of your mental well-being can prevent emotional burnout.

PLAN FOR THE FUTURE, REGARDLESS OF THE OUTCOME

While you hope for the best, it is important to prepare for all possible outcomes. Discuss with your partner what the next steps will be if IVF does not succeed. This may include trying again, considering adoption, or taking a break from fertility treatments. Having a backup plan can lessen the emotional impact if things do not go as hoped.

The path to becoming a parent may be filled with moments of joy, stress, hope, and sadness. By accepting your emotions, setting realistic expectations, seeking support, and taking are of yourself, you can build emotional resilience to cope with the challenges of IVF.

Link: https://newlifeclinic.bg/en/2022/03/14/emotions-and-stress-during-ivf-treatment/ 

The endometrium, the inner lining of the uterus, plays a crucial role in reproductive health, especially in supporting successful implantation, a key step in achieving pregnancy. This highly specialized tissue undergoes cyclical changes in response to hormonal signals, preparing the uterus to receive and nourish the embryo. The success or failure of implantation largely depends on the quality and receptivity of the endometrium, making it an essential component in early pregnancy.

THE STRUCTURE AND FUNCTION

The endometrium has two distinct layers:

• the functional layer, which undergoes monthly cycles of growth, shedding, and regeneration, and
• the basal layer, which remains constant and serves as the source of regrowth for the functional layer.

During the menstrual cycle, under the influence of estrogen and progesterone, the endometrium goes through three phases: the proliferative phase, the secretory phase, and the menstrual phase. These phases are important for creating the right conditions for implantation.

1. Proliferative Phase – During this phase, which occurs after menstruation, rising estrogen levels cause the functional layer of the endometrium to thicken. The thickening of the endometrium is crucial because it provides a rich environment full of blood vessels and nutrients that will support the embryo. Estrogen also promotes the growth of glands and the vascular network in the endometrium, preparing it for possible implantation.
2. Secretory Phase – After ovulation, progesterone takes over and initiates the secretory phase. During this phase, the endometrial glands begin to produce and secrete substances that create a favorable environment for the embryo. These secretions are rich in nutrients and growth factors, essential for nourishing the embryo in its early stages. The stromal cells also undergo a process called decidualization, where they change structurally and biochemically to support implantation. This phase is known as the „window of implantation,“ typically occurring between days 20 and 24 of a 28-day cycle, when the endometrium is most receptive to embryo implantation.
3. Menstrual Phase – If implantation does not occur, the levels of progesterone and estrogen fall, leading to the shedding of the functional layer of the endometrium during menstruation.

ENDOMETRIAL RECEPTIVITY AND IMPLANTATION

Endometrial receptivity refers to a specific period when the endometrium is most favorable for embryo implantation. For successful implantation, a synchronized interaction between the embryo and the endometrium is necessary. Various molecular markers, including cytokines, growth factors, and adhesion molecules, are involved in this complex process. One of the most important markers is the expression of integrins—cell adhesion molecules that help the embryo attach to the surface of the endometrium. Additionally, the secretion of factors like leukemia inhibitory factor (LIF) and vascular endothelial growth factor (VEGF) supports the embryo’s attachment and the development of a healthy blood supply.

The process of implantation involves three stages: apposition (initial contact between the blastocyst and the endometrium), adhesion (a stronger attachment between them), and invasion (when the blastocyst embeds itself into the endometrial tissue). If the endometrium is not receptive, the embryo will fail to implant, leading to unsuccessful pregnancy attempts.

TESTS FOR EVALUATING ENDOMETRIAL RECEPTIVITY

To assess whether the endometrium is in its optimal receptive phase for implantation, several tests are used in modern reproductive medicine. One of the most commonly used is the “Endometrial Receptivity Array (ERA)”, which analyzes gene expression and determines the exact timing of the „window of implantation„. Other tests include endometrial biopsy to assess its structure and function, as well as tests to measure the levels of key markers such as progesterone and estradiol. Ultrasound scans can also measure the thickness and type of the endometrium, helping to evaluate its readiness for implantation. These tests are especially useful for couples struggling with conception or undergoing procedures like in vitro fertilization (IVF).

WHAT CAUSES IMPLANTATION FAILURE

Conditions such as thin endometrium, endometriosis, or chronic endometritis can impair the ability to support implantation. Hormonal imbalances, uterine infections, or structural abnormalities can affect the development and function of the endometrial lining. In assisted reproductive technologies (ART) like IVF, evaluating and optimizing endometrial receptivity is critical for enhancing pregnancy success.

The role of the endometrium in successful implantation cannot be underestimated. Its complex and dynamic nature, regulated by hormones and molecular signals, creates the optimal environment for an embryo to implant and develop. Understanding endometrial health and function is key to addressing fertility issues and improving outcomes in reproductive medicine.

Links:

https://newlifeclinic.bg/en/2024/06/24/understanding-the-importance-of-the-implantation-window/

https://newlifeclinic.bg/en/2023/02/16/in-vitro-and-recurrent-implantation-failure-what-do-you-need-to-know/

https://newlifeclinic.bg/en/2017/08/30/pregnancy-and-endometriosis/

https://newlifeclinic.bg/en/2018/03/02/endometriosis/

The implantation of a fertilized embryo into the uterine lining is one of the most critical steps in human reproduction, determining the establishment of a successful pregnancy. While traditionally viewed as a purely physiological process, recent research has uncovered the vital role of the immune system in facilitating and regulating implantation. Far from being a passive barrier, the maternal immune system plays an active and complex role in creating the conditions for successful implantation, recognizing the embryo as semi-foreign tissue, and promoting its acceptance and growth.

THE CHALLENGE OF EMBRYO IMPLANTATION

Implantation presents a unique immunological challenge. The embryo, which is genetically distinct from the mother due to paternal DNA, could potentially be recognized as a foreign entity by the maternal immune system, leading to its rejection. However, for pregnancy to occur, the immune system must strike a delicate balance between protecting the mother from potential infections and allowing the embryo to implant and develop. This balance involves a combination of immune tolerance, modulation, and selective activity of immune cells.

KEY IMMUNE CELLS INVOLVED IN IMPLANTATION

Several immune cells are crucial for the process and they contribute both directly and indirectly to embryo acceptance and growth. Among them, the most prominent are:

– Uterine Natural Killer (uNK) cells. These cells are the most abundant immune cells in the endometrium during early pregnancy. Unlike traditional NK cells that destroy infected or abnormal cells, uNK cells exhibit a modified function. They promote the remodeling of uterine blood vessels and secrete cytokines, which support the establishment of a nurturing environment for the embryo. They are critical for ensuring adequate blood flow to the growing placenta, thereby supporting the embryo’s nourishment.

– Macrophages. These immune cells also play an essential role during the process. They contribute to tissue remodeling by clearing apoptotic cells and debris from the uterine lining. Macrophages produce growth factors, such as vascular endothelial growth factor (VEGF), which are essential for angiogenesis (the formation of new blood vessels) around the implantation site. This angiogenesis is vital for providing oxygen and nutrients to the developing embryo.

– Regulatory T Cells (Tregs). Tregs are responsible for inducing immune tolerance during implantation. They prevent the maternal immune system from attacking the embryo by downregulating the immune response against the paternal antigens present in the fetus. Tregs secrete anti-inflammatory cytokines, such as interleukin-10 (IL-10), that create a localized immune-suppressive environment, which is essential for embryo survival during early pregnancy.

IMMUNE MODULATION AND IMPLANTATION

The immune system undergoes a series of changes during the implantation window, the period during which the endometrium is receptive to the embryo. This is referred to as „immune modulation.“

– Cytokine Networks. Cytokines are small signaling proteins that regulate immune responses. During the process, the uterine environment shifts towards an anti-inflammatory state, primarily orchestrated by cytokines like interleukin-10 (IL-10), transforming growth factor-beta (TGF-β), and leukemia inhibitory factor (LIF). These molecules suppress excessive inflammatory responses that could harm the embryo while promoting tissue remodeling and vascular changes necessary for implantation.

– Balance Between Pro-Inflammatory and Anti-Inflammatory Responses. Successful implantation depends on a finely tuned balance between inflammatory and anti-inflammatory signals. Initially, a mild inflammatory response is required to enable the invasion of the trophoblast (the outer layer of the embryo) into the uterine lining. However, after this initial phase, a shift towards an anti-inflammatory environment is necessary to support continued embryo development and avoid immune rejection.

IMMUNE DYSFUNCTION AND IMPLANTATION FAILURE

Immune dysfunction can significantly contribute to implantation failure, leading to infertility or recurrent pregnancy loss. Inadequate immune tolerance, excessive inflammation, or an insufficient number of regulatory T cells can result in the rejection of the embryo. Conditions such as autoimmune disorders, chronic inflammation, and infections may lead to an overactive immune response, preventing successful implantation.

Additionally, abnormal activity or function of uterine NK cells has been linked to failed implantation. Excessive cytotoxicity or a lack of appropriate cytokine production by these cells can interfere with the establishment of a proper blood supply to the embryo, impairing its development.

THERAPEUTIC APPROACHES TO IMMUNE-RELATED IMPLANTATION ISSUES

Given the critical role of the immune system in implantation, researchers and clinicians are increasingly focusing on immunomodulatory therapies to improve the process outcomes, particularly in women with recurrent implantation failure (RIF) or recurrent pregnancy loss (RPL). Some of the emerging therapies include:

– Immunosuppressive Drugs. Low-dose steroids are sometimes used to reduce excessive immune responses during the early stages of pregnancy.

– Intravenous Immunoglobulin (IVIG).  IVIG therapy may help to modulate abnormal immune responses in women experiencing RIF by promoting a more tolerant immune environment.

– Intralipid Therapy. Intralipid infusions, a mixture of fats and nutrients, have been shown to alter NK cell activity, potentially improving the rates in women with immune-related infertility.

– Treg-Enhancing Strategies.  Research is ongoing to identify treatments that can boost the number and activity of regulatory T cells, helping to induce tolerance to the embryo and supporting successful implantation.

NK CELLS AND FERTILITY

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Especially for the readers of „Doctor“, Dr. Petrova explained the factors for achieving a successful pregnancy.

Dr. Petrova, when should a couple seek help from a reproductive medicine specialist?

When a couple has regular unprotected sex and the woman is young (up to the age of 36), but no spontaneous pregnancy occurs within a year and a half, then the couple should see a specialist in reproductive medicine without further delay. When a woman is over 36 years old with no pregnancies to date or younger than this age with a previous pregnancy in attempts for a second child, and no pregnancy has occurred within these six months, she should also see a specialist in reproductive medicine. I specify that a consultation does not mean in all cases to start an in vitro procedure. First, necessary diagnostic tests will be assigned to the couple, and only then will the chances of spontaneous pregnancy or the need for assisted reproduction be assessed.

I guess it’s not just the woman who goes to this examination?

Yes, it’s good to have both. But given the commitment of people, often the ladies arrive alone for the consultation. Of course, they carry all the medical documentation from the preliminary examinations and tests, including the man’s spermograms. In most cases, however, both of them arrive because they are both going to make a baby. There are also people who at this stage do not want a child, but wish to be responsible and know the status of their childbearing possibilities. In these cases, we recommend that the woman, on the third day of her period, have sex, thyroid hormones, and the most important – anti-Müllerian hormone, which are used to determine the ovarian reserve. The first recommendation for the man is to have a spermogram. The requirements before the examination itself are 3 to 5 days of sexual abstinence, no alcohol intake during these days and no antibiotic intake in the last month. These primary studies can give us direction in most cases why pregnancy does not occur.

Do you advise couples to change something in their lifestyle that prevents pregnancy?

In a conversation with the couple, it is established which are the lifestyle factors that prevent pregnancy. It strikes me that after sexual contact very often young women immediately go to the bathroom to wash themselves. And in fact, they have to lie down for a certain period of time. Fertility is also adversely affected by the excessive consumption of carbohydrates and the associated obesity. In reality, a very large percentage of young Bulgarians have this problem. Other factors in this category are the use of alcohol, smoking and drugs.

Do the drastic diets that most women undergo prevent pregnancy?

In Bulgaria, it is always fashionable to follow a diet, but not to learn to eat properly. It is very important that we, the doctors, explain to the woman that it is not good to starve for two weeks before the summer vacation in order to look good in a swimsuit. And he must learn to eat wholesomely. The most important meal is breakfast, because in the morning everyone’s insulin rises, which leads to brain hypoglycemia. However, the Bulgarian woman is used to starving or eating only salads in order to lose weight. With such a diet, the stomach is filled with water and minerals, but the brain is starved. Eating should be varied and balanced enough so that the brain does not make large margins between hyperglycemia and hypoglycemia, but maintains a glycemic plateau that will also regulate appetite during the day. If women learn to eat often, but little, for example four times a day, this guarantees good health and a nice figure. Do you research vitamin and mineral deficiencies in couples? Mandatory. In one consultation, in addition to sex hormone tests, a spermogram and a picture of the fallopian tubes, the levels of vitamin D3 and vitamin B12 are examined. They are extremely important vitamins not only for getting pregnant, but also for the proper development of the fetus during the first three months. In my clinical practice, I have found that women suffer massively from deficiencies of beneficial micronutrients because they do not eat well. There are foods that can be used to maintain normal levels of vitamins and minerals without taking supplements. But if they only eat patties and bosa or are starving, they feel full but haven’t had a full meal. It would be very good for them to learn to eat a slow carbohydrate in the morning. There is nothing wrong, in the tradition of Bulgarian culture, to eat stuffed peppers or sarmi, which contain rice, i.e. carbohydrates, for lunch. For an afternoon snack, it is good to eat a fruit or a few raw almonds. And for dinner, focus on light protein – fish or some meat with a salad. If you eat only salad, there is nothing wrong with adding two boiled eggs and olives. They will ensure completeness and balance of the dinner. It strikes me that in our country people do not drink the necessary amount of water.

When should you start assisted reproduction?

If a woman has bilateral tubal obstruction, her only way to get pregnant is through an in vitro procedure. If everything is fine with the woman – tubal patency, hormonal status, as well as the man’s spermogram is good, and both are young people, then insemination begins. By protocol, up to four are made. If even then pregnancy is not achieved, the case of sterility is treated with an unexplained factor and an in vitro procedure is carried out. The third option is when everything is fine in the woman, while in the man two of the four parameters of the spermogram are reduced. In this case, we have a male factor for sterility, and then we go back to the in vitro procedure.

What is an in vitro procedure nowadays?

The woman goes through hormonal stimulation with injections for about 12 days. These are hormones normal to the human body that the body produces anyway. After that, a puncture of the follicles is performed under complete venous anesthesia and ultrasound control. It is good to remove more than four eggs during the puncture. Follicular fluid is given to embryologists, where they look for cumulus complexes. The male secretes material into a cup, which is processed by embryologists. The most viable spermatozoa are selected and the egg cells are fertilized under a microscope, under high optical magnification. The injected eggs are placed in an incubator for several days. Between the third and fifth day after the puncture, the successfully fertilized and dividing egg (embryo) is placed in the woman’s uterine cavity. This is what we call embryo transfer, which is a painless manipulation. The last and most difficult stage is the 12-14 day wait for a blood test and, accordingly, whether pregnancy has been achieved. People need to understand that the human body is a whole and that every system and function is important in achieving pregnancy. It is important whether or not there is a vitamin deficiency, the genetics of the woman and the man, the gynecological status. Also the immunological status, how the metabolism works, what is the amount of fat in the body. With all this in mind and proper preparation done, we can expect success from the in vitro procedure. The procedure itself will not solve the problem if the future parents have not prepared their bodies. The human organism is a wonderful machine that works without fail and as long as we have been told when we have taken care of its health.

The concept of the „implantation window“ is pivotal in reproductive biology and fertility treatments. This period refers to the optimal time frame within a menstrual cycle when the endometrium (the lining of the uterus) is receptive to an embryo, enabling successful implantation and subsequent pregnancy. Understanding this window is essential for individuals and couples trying to conceive, as well as for medical professionals assisting in fertility treatments.

THE TIMING OF THE IMPLANTATION WINDOW

The implantation window typically occurs between days 19 and 21 of a regular 28-day menstrual cycle. This period is contingent on the precise synchronization between the embryo’s development and the endometrium’s readiness. Ovulation usually occurs around day 14, and the fertilized egg (now a blastocyst) travels through the fallopian tube to the uterus over the next 5 to 6 days. For implantation to be successful, the endometrium must be in a receptive state when the blastocyst arrives.

BIOLOGICAL MECHANISMS

The transformation of the endometrium into a receptive state is orchestrated by hormonal signals, primarily estrogen and progesterone. After ovulation, the corpus luteum (the remnant of the ovarian follicle) secretes progesterone, which induces a series of changes in the endometrial lining. These changes include increased blood flow, secretion of nutrients, and modifications in cellular structure, collectively referred to as endometrial receptivity. Specific biomarkers, such as the expression of proteins like integrins and mucins, signal that the endometrium is prepared to interact with the embryo.

CLINICAL SIGNIFICANCE

The concept of the implantation window has profound implications for fertility treatments such as in vitro fertilization (IVF). In IVF procedures, the timing of embryo transfer is meticulously planned to coincide with the recipient’s implantation window. Advances in reproductive medicine have led to the development of tests that assess endometrial receptivity, such as the Endometrial Receptivity Array (ERA). This test analyzes gene expression in the endometrium to pinpoint the exact timing of the implantation window, enhancing the chances of successful implantation and pregnancy.

FACTORS AFFECTING THE IMPLANTATION WINDOW

Several factors can influence the timing and quality of the implantation window. Hormonal imbalances, such as those seen in polycystic ovary syndrome (PCOS) or luteal phase defects, can disrupt the endometrial receptivity. Additionally, conditions like endometriosis or uterine fibroids can alter the uterine environment, making implantation more challenging. Lifestyle factors, including stress, diet, and exposure to toxins, also play a role in endometrial health and receptivity.

The implantation window is a critical phase in the journey to conception, representing a brief period when the endometrium is optimally prepared to receive an embryo. A thorough understanding of this window, coupled with advances in medical technology, can significantly improve the outcomes of fertility treatments. As research continues to uncover the intricate details of endometrial receptivity, the prospects for individuals and couples seeking to conceive will undoubtedly become brighter.

IN VITRO AND RECURRENT IMPLANTATION FAILURE: WHAT DO YOU NEED TO KNOW

Vaccination is one of the most significant medical advances in human history, responsible for eradicating or greatly reducing the spread of many infectious diseases.

The decision to vaccinate a child is key not only to their own health, but also to that of their loved ones and the community. Although there are arguments on both sides, the evidence overwhelmingly supports vaccination as a safe and important public health practice.

WHY VACCINATE OUR CHILDREN?

In the first place is the protection of personal health. Vaccines protect children from potentially serious and life-threatening diseases such as measles, hepatitis, tuberculosis and many others. These diseases, although rare in countries with high vaccination rates, can cause serious complications, including brain damage and death. Vaccinating children ensures that they are largely protected against these dangers, giving parents peace of mind.

Vaccinating your child also contributes to herd immunity, which occurs when a significant portion of the population is immune to a disease, thereby reducing its spread. This is especially important to protect those who cannot be vaccinated due to public order. reasons, such as infants, pregnant women, or immunocompromised individuals. Herd immunity thus protects the most vulnerable members of society and can prevent epidemics.

Vaccinating children also has significant benefits for the economy. It reduces health care costs by preventing illnesses that would require expensive medical treatments and hospitalizations. It also reduces the burden on parents who would otherwise be away from work to care for sick children.

Avoiding the development of epidemics through vaccination reduces the strain on the health system. We all remember how during the Covid-19 pandemic it was almost impossible to provide hospital treatment for all who needed it.

WHY ARE SOME PARENTS AGAINST VACCINATION?

Arguments against vaccination are largely based on concerns about personal freedom. Some parents believe that they should have the right to make medical decisions for their children without the intervention of health care institutions. Others distrust pharmaceutical companies or government agencies, believing that the benefits of vaccines are overstated and that the potential risks are downplayed.

DEALING WITH VACCINE HESITATION

Despite the enormous benefits, hesitancy about vaccines persists, fueled by misinformation and concerns about the safety of the preparations. Therefore, we advise you to be extremely careful with the selection of your sources of information. There are many online forums and pages that spread „anti-vax“ theories that are not supported by any scientific evidence.

If you have any doubts about a certain vaccine, seek advice from a trusted pediatrician. If necessary, ask for a second or even a third opinion. Each patient is unique, sometimes there really are contraindications to vaccination, but these cases are extremely rare and such a decision should be made only with the approval of a medical specialist who is perfectly familiar with the child’s health condition.

While it is essential to respect individual choices and consider concerns with empathy, the public health consequences of not vaccinating are profound. Refusal to vaccinate not only endangers the child, but also their family and society, undermining collective immunity and potentially leading to outbreaks of preventable diseases.

Iron deficiency anemia is a common condition worldwide, especially among women of childbearing age. When combined with pregnancy, the consequences become even more significant.

Iron plays a key role in the production of hemoglobin, the protein in red blood cells responsible for transporting oxygen throughout the body. During pregnancy, iron needs increase significantly to support fetal growth and development. In addition, blood volume increases during pregnancy, which necessitates the production of more erythrocytes. When iron stores are insufficient, this process is disrupted and this leads to iron deficiency anemia.

CAUSES

Several factors contribute to the development of iron deficiency anemia during pregnancy. These include insufficient dietary iron intake, increased iron requirements due to the growing fetus, and poor absorption of dietary iron. Women who have had heavy menstrual bleeding before pregnancy are at a higher risk of developing anemia.

SYMPTOMS

Symptoms of this condition can range from mild to severe and may include fatigue, weakness, pale skin, shortness of breath, dizziness, and a rapid heart rate. These symptoms often occur in healthy pregnant women. Your doctor’s task is to assess whether you may be anemic in order to prevent possible complications.

Pregnant women with iron-deficiency anemia are at higher risk of complications such as preterm birth (before 37 years), low birth weight, and postpartum hemorrhage.

PREVENTION AND TREATMENT

Prenatal vitamins are routinely prescribed to pregnant women and usually contain enough iron to prevent anemia. However, you should not forget to consume iron-rich foods such as red meat, chicken, fish, beans, lentils, green leafy vegetables and fortified cereals. The absorption of iron from plant sources is higher when combined with foods rich in vitamin C, for example citrus, tomatoes or peppers.

In more severe cases, a balanced diet and vitamins may not be enough. Then additional iron medications can be prescribed in the form of tablets or intravenous infusions.

Not skipping your yearly check-ups, as well as your prenatal appointments help your medical provider diagnose and treat iron deficiency anemia early, which can significantly improve your general health and reduce the risk of complications during pregnancy.