News Moms Need

We are facing a maternal health crisis in the United States. More and more women are dying from complications related to pregnancy and childbirth. This is especially true for women of color. Black women have maternal death rates over three times higher than women of other races. This is simply not acceptable, and we will not stand by as this trend continues. You can take action now to fight for the health of all moms.

What’s the difference between pregnancy-related death and maternal death?

You may have heard these terms in the news lately. Pregnancy-related death is when a woman dies during pregnancy or within one year after the end of pregnancy from problems related to pregnancy. Maternal death is when a woman dies during pregnancy or up to 42 days after the end of pregnancy from health problems related to pregnancy. Regardless of the term or timeframe, the death of a mom is tragic with devastating effects on families.

Who is most at risk?

About 700 women die each year in the United States from complications during or after pregnancy. Black women in the United States are three to four times more likely to die from pregnancy-related causes than white women. This difference may be because of social determinants of health. These are conditions in which you are born, grow, work, live and age that affect your health throughout your life. These conditions may contribute to the increase in pregnancy-related death among black women in this country.

The risk of maternal death also increases with age. For example, women age 35 to 39 are about two times as likely to die from pregnancy-related causes as women age 20 to 24. The risk for women who are 40 and older is even higher.

What you can do

If you’re pregnant, thinking about getting pregnant or sharing this news with someone you love, regular health care before, during and after pregnancy helps women and health care providers find health problems that can put lives at risk. Learning warning signs of complications can help with early treatment and may prevent death.

Always trust your instincts. If you’re worried about your health or the health of someone who is pregnant, pay attention to signs and symptoms of conditions that can cause problems during pregnancy. A health care provider or hospital is your first line of defense.

Take action today

You can help us lead the fight for the health of all moms and babies. Take action now to support legislation that can protect the women you love and prevent maternal death. We need thousands of voices to persuade policymakers to pass laws and regulations that promote the health of women, babies and families. You also can make a donation to level the playing field so that all moms and babies have the same opportunity to be healthy. And learn about the signs and symptoms of health complications after birth that can save lives.

The American College of Obstetricians and Gynecologists (ACOG) recently released new guidelines calling for changes to improve the postpartum care women receive after giving birth. Postpartum care is important because new moms are at risk of serious and sometimes life-threatening health complications in the days and weeks after giving birth. Too many new moms suffer or die from causes that could have been prevented.

How have ACOG’s postpartum care guidelines changed?

In the past, ACOG recommended that most women have a postpartum checkup 4 to 6 weeks after giving birth. A postpartum checkup is a medical checkup you get after having a baby to make sure you’re recovering well from labor and birth. ACOG now says that postpartum care should be an ongoing process, rather than a one-time checkup. Your postpartum care should meet your personal needs so that you get the best medical care and support. Seeing your health care provider sooner and more often can help prevent serious health complications.

ACOG recommends that all women should:

• Have contact with their health care provider within 3 weeks of giving birth
• Get ongoing medical care during the postpartum period, as needed
• Have a complete postpartum checkup no later than 12 weeks after giving birth

How can you get ready for postpartum care?

Make a postpartum care plan with your provider. Don’t wait until after you have your baby — make your plan while you’re pregnant at one of your prenatal care checkups. To make your plan, talk to your provider about:

• Contact info. How do you get in touch if you’re worried or have questions?
• Your reproductive life plan, including birth control. What method is right for you?
• Physical and emotional changes after pregnancy. What should you expect?
• Health conditions or pregnancy complications to follow up on. What’s your treatment plan?
• Looking out for postpartum depression. What are the signs and symptoms?
• Feeding your baby. Are you planning to breastfeed or feed your baby formula?
• Contacting your provider within 3 weeks of giving birth. When should you get a complete checkup?
• Health insurance. Does your plan cover all your visits? 

Learn more about postpartum care at marchofdimes.org.

Vaccinations can help your baby have a healthy start in life. When your baby gets on-time vaccinations, he gets protection from serious diseases. Most babies can follow the vaccination schedule from the Centers for Disease Control and Prevention (also called CDC). Ask your baby’s provider if this schedule is right for your baby. If your baby has a health condition, travels outside the U.S. or has contact with someone who has a disease, she may need a different schedule.

Because vaccines protect against diseases that aren’t common anymore, you may wonder why you need to vaccinate your baby. These diseases aren’t common in this country, but they still exist. For example, many cases of whooping cough and measles have occurred in the United States over the past few years. You can help protect your baby from serious diseases and their complications by making sure your baby gets all the vaccinations he needs.

Follow our vaccination schedule based on the CDC recommendations.

What you need to know:

• Vaccines help protect your baby from harmful diseases and help prevent him from spreading diseases to others.
• In the first 2 years of life, your baby gets several vaccines to protect her from 14 diseases, including whooping cough (also called pertussis) and measles.
• Babies 6 months and older need the flu shot every season. Your baby gets two flu shots in his first year of life. He then gets one shot each year after.
• Vaccines help your baby develop immunity. Immunity is protection from disease.
• Vaccines are very safe. They are carefully tested and checked by scientists and healthcare professionals before anyone can get them.
• Getting more than one shot at a time won’t harm your baby. Even as a newborn, your baby’s immune system can handle many shots at once.
• All babies, including babies who spend time in the newborn intensive care unit (also called NICU), need vaccinations. Most premature and low-birthweight babies follow the same CDC vaccination schedule.

For more information about your baby’s vaccinations, visit marchofdimes.org

When you’re pregnant, there are a few foods you need to avoid or limit. Fish can be a great part of healthy eating during pregnancy, but it’s important to eat the right kinds of fish in the right amounts. Let’s break it down — here are a few things you need to know about eating fish during pregnancy.

What can you do to get the health benefits of fish during pregnancy in a safe way?

You have probably heard that fish has a lot of health benefits. Studies suggest that eating fish during pregnancy may help reduce the risk of premature birth (before 37 weeks of pregnancy). Healthy fats in fish also help your baby’s brain and eyes develop. These healthy fats are called omega- 3 fatty acids.

During pregnancy, eat fish that is low in mercury. Mercury is a metal that can be dangerous. Fish get mercury from the water they swim in and from eating other fish. Fish that are low in mercury include:

• Herring
• Salmon
• Trout
• Shrimp
• Tilapia
• Crab
• Catfish

How much fish is safe to eat each week?

During pregnancy, eat 8 to 12 ounces a week of fish that doesn’t have a lot of mercury. If your portions are small, you can eat fish three times a week, but only two times a week if your portions are bigger. Here are some examples:

Your menu for eating fish three times a week could look like this:

• 4 ounces of salmon
• 4 ounces of light tuna (a small can, drained)
• 2 ounces of shrimp (about seven medium-sized shrimp)

Your menu for eating two times a week could look like this:

• 6 ounces of tilapia
• 3 ounces of crab cake

Practical tip: To measure your portion size, hover your hand on top of the piece of fish. A four-ounce piece of fish should be about the same size as the palm of your hand.

Some types of fish are not as low in mercury as other types. It’s OK to eat up to 6 ounces of these fish each week during pregnancy:

• Albacore (white) tuna
• Halibut
• Snapper
• Mahi-mahi

What type of fish do you need to avoid during pregnancy?

Don’t eat fish that are high in mercury, like shark, swordfish, king mackerel and tilefish. Always check with your local health department before you eat any fish you catch yourself. Avoid undercooked or raw fish, like sushi, raw oyster and tuna tartare.

For more information about eating healthy during pregnancy visit marchofdimes.org

August is National Immunization Awareness Month. This week’s focus is on vaccines for pregnant women.

If you are pregnant, certain vaccines can help protect you and your baby from infections. When you get the recommended vaccines during pregnancy, you pass this protection to your baby.

What vaccines do you need during pregnancy?

The Center for Disease Control and Prevention (CDC) recommends two vaccines during pregnancy:

1. Flu. A flu shot during pregnancy protects you from serious complications and protects your baby for several months after birth. You need a flu shot every season, as the flu strain changes year to year.
2. Whooping cough (or Tdap). You should get Tdap at 27 to 36 weeks of pregnancy. It is best to get it during the earlier part of this time period. You need to get the Tdap vaccine every time you’re pregnant. When you get the Tdap vaccine during your pregnancy, your body makes antibodies and you pass some of them to your baby before birth. These antibodies give your baby some short-term, early protection against whooping cough. This helps keep him safe until he is able to get his own vaccine when he’s 2 months old.

In some special cases, other vaccines may be recommended by your provider.

• Vaccines for travel: If you plan to travel outside of the United States during your pregnancy, talk to your health care provider at least 4 to 6 weeks before your trip to discuss any special precautions or vaccines that you may need.
• Hepatitis B: If you are pregnant and have hepatitis B, your baby is at the highest risk for becoming infected during delivery. Talk to your provider about getting tested for hepatitis B and whether or not you should get vaccinated.
• Additional vaccines: Talk to your provider about other vaccines you may need before, during, or after you become pregnant. Not all vaccines are safe to get during pregnancy. There’re cases were some vaccines are recommended. If you have a history of chronic liver disease, your provider may ask you to get vaccinated against hepatitis A. Also, the meningococcal vaccine may be recommended by your provider if you work in a lab.

For more information visit marchofdimes.org

Breast milk is the best food for your baby. Breast milk gives your baby important nutrients that help him grow healthy and strong. Do not feel discouraged if you have some discomforts when you first start breastfeeding. Many new moms have difficulties. However, with the right support and information, you will be able to breastfeed your baby.

Here are some common problems moms may have and what you can do about them:

“My baby won’t latch-on.”

When your baby’s latched on, her mouth is securely attached to your nipple for breastfeeding. To help your baby latch on, first, find a comfortable place to breastfeed your baby. It could be in a chair, on the couch or on your bed. Remove your clothes from the waist up and have your baby wear only his diaper. Lay your baby between your breasts so that your tummies are touching. Skin-to-skin contact is the best way to help your baby get comfortable and ready to latch-on. Here’s how to make sure your baby gets a good latch:

• When your baby opens his mouth, bring him to your breast. Bring him to you — don’t lean into him.
• Hold your baby close. Both his nose and chin should touch your breast. Don’t worry — he can breathe and eat at the same time. Your baby should have a good mouthful of your areola (the area around your nipple).
• When your baby has a good latch, you will feel his tongue pull your breast deep into his mouth. If you feel his tongue at the tip of your nipple, it’s not a good latch.

“My nipples hurt.”

Many women feel nipple pain when they first start breastfeeding. If your nipples are cracked and sore, you may need to change the position you use to breastfeed. If you have nipple pain:

• Make sure your baby is fully latched on. If she’s not latched on, remove her from your breast and try again.
• After feeding, put some fresh breast milk on your nipples. Just like breast milk is good for your baby, it can help you too. Creams also may help. Ask your provider which kind to use.
• Talk to your provider or lactation consultant if the pain doesn’t go away.

“My breast is swollen and feels hard.”

Your breasts swell as they fill up with milk. They may feel tender and sore. Most of the time the discomfort goes away once you start breastfeeding regularly. Here are some ways to help feel better:

• Try not to miss or go a long time between feedings. Don’t skip night feedings.
• Express a small amount of milk with a breast pump or by hand before breastfeeding.
• Take a warm shower or put warm towels on your breasts. If your breasts hurt, put cold packs on them.
• If your breasts stay swollen, tell your provider.

With patience and practice, you and your baby can be great at breastfeeding! Give yourself time to learn this new skill and trust yourself. Don’t be afraid to ask for help. You may just need a little extra support to get started. Your health care provider, a lactation consultant, a breastfeeding peer counselor or a breastfeeding support group can help you. Find out more about how to get help with breastfeeding by visiting marchofdimes.org.

Breastfeeding counseling, breast pumps, and supplies are services covered by most health insurance plans under the Affordable Care Act, at no extra cost to you. Learn more about recommended preventive services that are covered under the Affordable Care Act at Care Women Deserve.

Taking care of your gums and teeth during pregnancy can help you and your baby be healthy. One way to maintain good dental health is to visit your dentist regularly. Some women may think it’s not safe to visit the dentist when they’re pregnant. This is a myth. It is safe, and also a good idea to visit your dentist during pregnancy. During your checkup, tell your dentist and hygienist that you’re pregnant and about any changes you may be having with your teeth and gums. Your dental professionals will help you keep a sparkly healthy smile during your pregnancy.

Common dental problems during pregnancy

• Bleeding gums. High levels of progesterone can make your gums swollen, red and sore. This inflammation is called gingivitis. Without treatment, gingivitis can become a serious gum disease called periodontitis.
• Tooth decay. It is common to have more acid in your mouth during pregnancy. This extra acid can break down your tooth coating, called enamel. This makes you more likely to get cavities.
• Lumps on swollen gums. These are tumors that form between teeth, but they are not cancer. These tumors may be caused by having too much plaque (sticky bacteria that forms on teeth). Pregnancy tumors usually go away on their own.
• This is a serious gum disease, and it needs treatment to avoid complications for you and your baby. Some studies have linked periodontitis to premature birth(birth before 37 weeks of pregnancy) and low birthweight (less than 5 pounds, 8 ounces).

What can you do?

• Brush your teeth regularly. Brush for 2 minutes, using a toothbrush with soft bristles, twice a day. Make sure you use a fluoride toothpaste.
• Floss every day.  Floss at least once a day to clean in between your teeth. Regular brushing and flossing around the gum line are key to removing plaque and helping prevent periodontitis and tooth decay.
• Rinse your mouth if you throw up. If you throw up, rinse your mouth with water to wash away the acid. If morning sickness makes you feel too sick to brush your teeth you can rinse your mouth with water or mouthwash.
• Visit your dentist regularly. Have a dental checkup that includes an oral exam and professional teeth cleaning every 6 months. You also need a checkup during pregnancy, especially if you have any discomforts in your mouth.
• Eat healthy foods. Eating foods packed with nutrients will help you and your growing baby get enough calcium, protein and vitamins. These nutrients will also help ensure your baby’s teeth grow healthy.
• Limit sweets. Having too many sweet foods or drinks can lead to tooth decay. Instead of sweets, drink water and pick healthy foods like fruits, vegetables and dairy products.

Visit marchofdimes.org for more information about how to have a healthy pregnancy and baby.

Crest & Oral-B proudly support March of Dimes in the fight for the health of all moms and babies. Oral health matters, especially during pregnancy. To learn more, click HERE or visit marchofdimes.org/partners.

March of Dimes does not endorse specific brands of products.

During your last trimester of pregnancy, you get a test for group B strep (also called GBS). GBS is a common type of bacteria that can cause infection. Usually, GBS is not serious for adults, but it can hurt newborns. It’s important to get this test and know the results so you can protect your baby.

Many people carry GBS — in fact about 1 in 4 (25 percent) pregnant women are carriers. Being a carrier does not mean you have an infection, it means you have this bacteria in your body. GBS bacteria naturally live in the intestines and the urinary and genital tracts. You can’t get it from food, water or things you touch. You can’t catch it from another person, and you can’t get it from having sex. GBS in adults usually doesn’t have any symptoms. But sometimes it can cause minor infections, like a bladder or urinary tract infection (UTI).

If you’re pregnant and have a GBS infection, it can pass to your baby during labor and birth and can make your baby very sick.

Testing and treatment for GBS

You prenatal care provider tests you for GBS at 35 to 37 weeks of pregnancy. The test is a simple swab of your vagina and rectum. If you have GBS, your provider gives you antibiotics during labor and birth to help prevent your baby from getting infected.  Your provider gives you the antibiotics through an IV.

Penicillin is the best antibiotic for most women. If you’re allergic to penicillin, you can get a different medicine. It’s not helpful to your baby if you get treatment for GBS early in your pregnancy. The bacteria can return quickly, so you could have it again by the time you go into labor.

If you have GBS, remind your providers at the hospital when you go to have your baby. This way you can be treated quickly. Treatment works best when it begins at least 4 hours before childbirth. If you have GBS and you’re having a scheduled c-section before labor starts and before your water breaks, you probably don’t need antibiotics.

What are the chances you can pass GBS to your baby?

If you have GBS during childbirth and it’s not treated, there’s a 1 to 2 in 100 chance (1 to 2 percent) that your baby will get the infection. The chances are higher if you have any of these risk factors:

• Your baby is premature. This means your baby is born before 37 weeks of pregnancy.
• Your water breaks (also called ruptured membranes) 18 hours or more before you have your baby.
• You have a fever (100.4 F or higher) during labor.
• You’ve already had a baby with a GBS infection.
• You had a UTI during your pregnancy that was caused by GBS.

If you have GBS and you’re treated during labor and birth, your treatment helps protect your baby from the infection.

Visit marchofdimes.org for more information.

Umbilical cord blood (also called cord blood) is the blood in the umbilical cord and placenta. The placenta grows in your uterus (womb) and supplies your baby with food and oxygen through the umbilical cord.

Usually health care providers discard the placenta, umbilical cord and cord blood after a woman gives birth. But some families store the cord blood so it can be used later on to treat diseases. Storing cord blood is also called banking.

If you choose to store your baby’s cord blood, your provider collects it right after your baby is born. It doesn’t matter if you have a vaginal birth or cesarean birth (also called c-section).

How do you know if banking cord blood is right for your family?

If you’re thinking about banking your baby’s cord blood, talk to your health care provider before you give birth. Write your choice in your birth plan and share it with your provider.

You have two main options to store your baby’s cord blood:

1. You can donate cord blood to a public cord blood bank. There is no cost to you to store your baby’s cord blood at a public bank. But the cord blood donation is used for research or to help others who need cord blood. If you or a family member needs cord blood, you can’t use the blood you donated. Not all hospitals allow cord blood donations to public banks. Visit the National Marrow Donor Program to see a list of hospitals that allow donation to public cord blood banks. The American Academy of Pediatrics (also called AAP) recommends donating cord blood to a public cord blood bank.
2. You can store cord blood in a private cord blood bank. Cord blood stored in a private cord blood bank can be used by you, your baby or a member of your family if it’s ever needed. The chances that you or someone in your family may need to use your stored cord blood are very low – about 1 in 2,700. But if someone in your family has a health condition that may need to be treated with a stem cell transplant, storing cord blood may be a good choice. The cost for a private bank is about $2,000, plus a yearly fee of about $125, depending on the bank you use.

Visit marchofdimes.org to learn more about umbilical cord blood.

July is National Minority Mental Health Awareness Month. According to the U.S. Department of Health and Human Services (HHS) Office of Minority Health, people from racial and ethnic minority groups are less likely than people who aren’t minorities to get treatment for mental health conditions, like anxiety and depression.  So what’s causing this difference?

• Social determinants of health. These are conditions in which you’re born, grow, work, live and age that can affect your community, education, income and your relationships with your partner, family and friends.
• Less access to services. According to the Agency for Healthcare Research and Quality (AHRQ), racial and ethnic minority groups in the U.S. are less likely to have access to mental health services than other groups and are more likely to receive lower quality care.
• Ethnic background. Because of cultural beliefs and traditions, some people may They may be afraid to talk to their health care provider or to ask for help.

Mental health awareness is especially important for all women during and after pregnancy. In the United States, about 1 in 10 women (10 percent) has signs or symptoms of depression. About 1 in 7 women (about 15 percent) have depression at some time during pregnancy and the year after pregnancy. Depression before or during pregnancy is different than postpartum depression (also called PPD). PPD is a kind of depression that some women get after pregnancy.

What you need to know:

• Learn the signs and symptoms of depression and postpartum depression.
• If you think you have depression or PPD, tell your health care provider.
• If you’ve had depression before, you’re more likely than other women to have depression during pregnancy.
• If you’re pregnant and taking an antidepressant, tell your provider right away. Don’t stop taking it without talking to your provider first.

Here are some helpful resources:

Treating for two: Safe medication use in pregnancy from the Centers for Disease Control and Prevention (CDC)

Depression during and after pregnancy: A resource for women, their families and friends from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Office of Maternal and Child Health

Mental Health America

National Alliance on Mental Illness, 800-950-NAMI (6264)

National Institute of Mental Health