News Moms Need

April is Sexually Transmitted Infections Awareness Month. In the United States, nearly 20 million new sexually transmitted infections happen each year.

Sexually transmitted infections (also called STI, sexually transmitted diseases or STD) are infections that you can get from having unprotected sex or intimate physical contact with a person who is infected.

Having an STI during pregnancy can cause serious problems for babies, including premature birth, low birthweight, miscarriage, and other problems after birth. Many people with STIs don’t know they’re infected because some STIs have no signs or symptoms. Therefore, the best way to protect your baby from STIs is to protect yourself from STIs.

Here’s what you can do to help protect yourself from STIs:

• If you have sex, have safe sex. Have sex with only one person who doesn’t have other sex partners.
• Use a condom every time you have sex. Condoms are barrier methods of birth control and help prevent pregnancy, as well as STIs.
• Get tested and treated. The sooner you get tested and treated, the less likely you are to have complications from your infection.
• Ask your partner to get tested and treated. Even if you get treated for an STI, if your partner’s infected you can get the infection again.
• Go to all your prenatal care visits, even if you’re feeling fine. If you think you may have an STI, let your health care provider know. That way you can get tested and treated right away.
• Get vaccinated. Some vaccinations can help protect you from some STIs, like hepatitis B and some types of human papillomavirus (HPV).
• Don’t have sex. This is the best way to prevent an STI.

Counseling for sexually transmitted infections is a preventive service 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.

Your immune system is your body’s way of protecting itself from illnesses and diseases. During pregnancy your immune system weakens. This is a normal change, but it also means you need to be extra careful with the foods you eat. Certain foods can get contaminated with different germs and make you sick.

Foodborne illnesses can be especially dangerous during pregnancy. Symptoms such as vomiting, diarrhea and fever, can become life-threatening. If you are infected during pregnancy, foodborne illnesses can cause birth defects, premature birth, miscarriage, or stillbirth.

How can you reduce the risk of becoming ill from contaminated foods?

Hygiene is key

• Wash your hands with soap and warm water for at least 20 seconds before and after handling food.
• Wash all fruits and vegetables under running tap water before eating, and remove surface dirt with a scrub brush, cutting away any damaged sections, which can contain harmful germs.
• Wash utensils and cutting boards with hot soapy water after each use. Don’t use cutting boards made of wood. They can hold more germs than other kinds of cutting boards.
• After preparing food, clean countertops with hot soapy water.

Separate, cook, and chill food properly

• Use one cutting board for raw meat, poultry and seafood. Use a different board for fruits and vegetables.
• Separate raw meat and poultry from cooked or ready-to-eat foods.
• When you’re shopping, keep raw meat, poultry and seafood and their juices separate from other foods.
• Cook foods to their proper temperature.
• Make sure your refrigerator’s temperature is between 32-40 F and the freezer at 0 F or below.
• Refrigerate all leftovers within 2 hours after eating. At room temperature, bacteria in food can double every 20 minutes.
• Chill foods that need to be kept cold. Cold temperatures keep most harmful bacteria from multiplying.
• Thaw meat, poultry and seafood in the refrigerator, not on the counter or in the sink.

Food recalls

Every year many people get sick from eating contaminated foods. Pay special attention to the news to learn about recent recalls and safety alerts. Inspect your pantry and fridge and remove foods that have been recalled.

Contaminated food doesn’t always smell or look bad. Only a very small amount of germs are enough to make you very sick. If you are unsure about any food you have at home, it is best not to eat it. When in doubt, throw it out!

If you think you may have food poisoning, call your health care provider right away. You can read more about foods that you should avoid during pregnancy here.

For the most recent information on food recalls visit:

• United States Department of Agriculture
• foodsafety.gov
• U.S. Food and Drug Administration

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

By Kweli Rashied-Henry, March of Dimes Director of Health Equity

Frederick Douglass once said “If there is no struggle, there is no progress.” As a country, we have made tremendous strides in the health of all populations since this famed abolitionist spoke these words in the mid-19^th century. Overall life expectancy has increased and infant death before the age of one has declined. However, health is still experienced disproportionately in the United States.

Nearly twenty years ago, April was established as National Minority Health Month to encourage health and health equity partners and stakeholders to work together on initiatives to reduce disparities, advance equity, and strengthen the health and well-being of all Americans. In the U.S., racial and ethnic disparities (or inequities) in preterm birth are worsening. Black women are about 50 percent more likely to give birth prematurely compared to other women and their babies are more than twice as likely to die before their first birthday compared to babies born to white women. This stark reality signals the need for health equity, which means that everyone has a fair and just opportunity to be as healthy as possible. It also signals the need for healthy moms before, during and after pregnancy.

Being healthy across the course of one’s life is essential for having a healthy baby in the future. Most of us recognize the importance of prenatal care during pregnancy. Experts also advise screenings for medical and social risk factors, providing health education, and delivering effective treatment or prevention plans as a set of practices that could improve health prior to conception. Women and men of reproductive age who improve their preconception health can increase their likelihood of having a healthy baby if and when they desire. In short, healthy moms and dads can lead to stronger babies. Yet disparities can be stubborn and may require more than simply changing behavior.

According to the Office of Minority Health, your zip code can be a predictor of your health. In other words, your place of birth, where you work and play, your income and education, and a host of other factors – in addition to the choices you make each day about what to eat, when to work out and whether or not to see a doctor can impact your health. These factors are often referred to as the “social determinants of health,” and they contribute to health disparities among racial and ethnic minorities in America. “Addressing the social determinants is key to ensuring that every baby is born healthy regardless of wealth, race or geography.”

According to the Pew Research Center, rapid growth among minority populations is projected by 2050.  If this trend holds, many of tomorrow’s parents will come from communities that share a disproportionate burden of preterm birth and infant death. Although advances in medicine and technology were likely responsible for much of the improvements in these health outcomes in the U.S. over the years, it is also likely that the collective actions of everyday people has helped us realize that better health is not just for ourselves but for future generations. Looking back on this progress can surely help us look forward to what it will take for our babies to continue to grow and thrive.  National Minority Health Month is a special occasion for us to acknowledge the struggles that continue to evade us and what’s needed to support future generations.

Recently the FDA and CDC issued a notice that some lead tests done by Magellan Diagnostics may be incorrect.

The FDA says “certain lead tests manufactured by Magellan Diagnostics may provide inaccurate results for some children and adults in the United States.”

If you have a child age 6 years old or younger, are pregnant or breastfeeding, speak with your healthcare provider or local health department to determine if retesting is needed.

The dangers of lead

Lead is a metal that comes from the ground, but it can be in air, water and food. You can’t see, smell or taste it. High levels of lead in your body can cause serious health problems for you and your family.

Children younger than 6 years of age can be severely affected by lead. It can cause developmental problems, hearing loss, vomiting, irritability, belly pain and weight loss. Very high levels of lead may even cause death.

Lead poisoning (high levels of lead in your body) can cause serious problems during pregnancy, such as premature birth, miscarriage, and high blood pressure. It can also cause fertility problems, mood disorders, headaches, muscle or joint pain, trouble concentrating, belly pain, anemia and fatigue in adults.

Where is lead?

Most lead comes from paint in older homes. When old paint cracks or peels, it makes dust that has lead in it. The dust may be too small to see. You can breathe in the dust and not know it.

Lead may be found in drinking water, at construction sites, in arts and crafts materials used to make stained glass, lead crystal glassware, and some soil.

For more information on lead poisoning, see our web article and the CDC’s information.

Bottom line

If you have a child age 6 or younger, or you are pregnant or breastfeeding, contact your healthcare provider to determine if a lead test should be repeated.

If you are pregnant, trying to get pregnant, or think you might be pregnant, the best thing to do for your baby is to avoid alcohol. Drinking alcohol at any time during pregnancy can cause serious health problems for your baby. When you drink alcohol during pregnancy, the alcohol in your blood quickly passes through the placenta and the umbilical cord to your baby.  No amount of alcohol has been proven safe at any time during pregnancy.

Drinking any amount of alcohol at any time during pregnancy can harm your baby’s developing brain and other organs. Drinking alcohol during pregnancy increases your baby’s chances of:

• Premature birth. This is when your baby is born before 37 weeks of pregnancy. Premature babies may have serious health problems at birth and later in life.
• Brain damage and problems with growth and development.
• Birth defects, like heart defects, hearing problems or vision problems.
• Fetal alcohol spectrum disorders (also called FASDs). Children with FASDs may have a range of problems, including intellectual and developmental disabilities. They also may have problems or delays in physical development. FASDs usually last a lifetime.
• Low birthweight (also called LBW). This is when a baby is born weighing less than 5 pounds, 8 ounces. Being low birthweight can cause serious health problems for some babies.
• Miscarriage
• Stillbirth

What can you do?

Alcohol is often part of social activities, like weddings, birthday parties or sports events. You may be used to having a glass of wine with dinner or at the end of a busy day. Giving up alcohol during pregnancy may be hard.

Here are some tips to help you:

• Think about when you usually drink alcohol. Plan to drink other things, like fruit infused water, sparkling water or just plain water. Use a fun straw or put an umbrella in the glass to make it seem more fun.
• If you are having problems with self-control, is best to stay away from situations or places where you usually drink, like parties or bars.
• Get rid of all the alcohol in your home.
• Tell your partner and your friends and family that you’re not drinking alcohol during pregnancy. Ask them to help and support you.
• If you need help to stop drinking, talk to your health care provider. He may help you find resources on how to stop drinking.

For more information on how to have a healthy pregnancy, visit marchofdimes.org.

You know that staying healthy during your pregnancy is important. But did you know that having a healthy baby actually starts before you get pregnant? Preconception health is your health before pregnancy. Being healthy before pregnancy can help improve your chances of getting pregnant  and it can help to reduce the chances of complications during your pregnancy. If you’re thinking about getting pregnant, make sure you start to focus on your health at least 3 months before you start trying to conceive. Here are some things you can do:

Schedule a preconception checkup: This is a medical checkup you get before pregnancy. It helps your health care provider make sure you’re healthy and that your body is ready for pregnancy. Your provider can identify, treat, and sometimes prevent health conditions that may affect your pregnancy.

Take a multivitamin with 400 micrograms of folic acid: Folic acid is a B vitamin that every cell in your body needs for healthy growth and development. If you take it before and during early pregnancy, it can help protect your baby from birth defects of the brain and spine called neural tube defects.

Review your family healthy history: Your family health history is a record of any health conditions that you, your partner and everyone in your families have had. Your family health history can help you and your provider look for health conditions that may run in your family. Use the March of Dimes Family Health History Form to gather information.

Get to a healthy weight: You’re more likely to have health problems during pregnancy if you’re overweight or underweight. Talk to your provider about what is a healthy weight for you.

Don’t smoke, drink alcohol, or use street drugs: All of these can make it harder for you to get pregnant and they’re harmful to your baby when you do get pregnant. Tell your provider if you need help to quit.

Review medications that you take: Some medications are not safe to use when you’re pregnant but there may be other alternatives.  Don’t stop taking any prescription medicine without your provider’s OK. Stopping certain medicines, like medicines for asthma, depression or diabetes, can be more harmful to you or your baby than taking the medicine. Talk to your provider about the medications you take.

Get treatment for health conditions: This includes making sure chronic conditions like diabetes or high blood pressure are under control. Your provider can also check for infections, including sexually transmitted infections (STIs). Some STIs can be passed to your baby during pregnancy or a vaginal birth.

Get vaccinated: Make sure you are caught up on all of your vaccinations before pregnancy. Infections like chickenpox and rubella (also called German measles) can harm you and your baby during pregnancy.

Stay safe from viruses and infections: Wash your hands well (especially after contact with any bodily fluids or raw meats), avoid undercooked meats, let someone else change the litter box, and don’t share food, glasses, or utensils with young children.

It is common to have emotional changes after your baby is born.

You may feel excited, exhausted, overwhelmed, and even sad at times.

Taking care of a baby is a lot to think about and a lot to do.

On top of all that, after the birth of your baby, your hormones are adjusting again.

As a result, these changes can have an effect on your emotions and how you feel.

Here are few suggestion that may help you:

• Tell your partner how you feel. Let your partner help take care of the baby.
• Ask your friends and family for help. Tell them exactly what they can do for you, like go grocery shopping or make meals.
• Try to get as much rest as you can. We know it’s easier said than done, but try to sleep when your baby is sleeping.
• Try to make time for yourself. If possible, get out the house every day, even if it’s for a short while.
• Eat healthy foods and be active when you can (with your health care provider’s ok). Eating healthy and getting fit can help you feel better.
• Don’t drink alcohol, smoke or use drugs. All these things are bad for you and can make it hard for you to handle stress.

If you experience changes in your feelings, in your everyday life, and in how you think about yourself or your baby that last longer than 2 weeks, call your health care provider right away. These could be signs of postpartum depression.

How do you know if you have postpartum depression?

Postpartum depression (also called PPD) is different from having emotional changes. PPD happens when the feelings of sadness are strong and last for a long time after the baby is born. These feelings can make it hard for you to take care of your baby. You may have PPD if you have five or more signs of PPD that last longer than 2 weeks. These are the signs to look for:

Changes in your feelings:

• Feeling depressed most of the day every day
• Feeling shame, guilt or like a failure
• Feeling panicky or scared a lot of the time
• Having severe mood swings

Changes in your everyday life:

• Having little interest in things you normally like to do
• Feeling tired all the time
• Eating a lot more or a lot less than is normal for you
• Gaining or losing weight
• Having trouble sleeping or sleeping too much
• Having trouble concentrating or making decisions

Changes in how you think about yourself or your baby:

• Having trouble bonding with your baby
• Thinking about hurting yourself or your baby
• Thinking about killing yourself

If you think you may have PPD, call your health care provider right away. There are things you and your provider can do to help you feel better. If you’re worried about hurting yourself or your baby, call emergency services at 911.

In the United States, 9 out of every 100 women (9 percent) has diabetes. Diabetes is a health condition marked by an increase in blood sugar, also called glucose. People with diabetes need to make sure their blood sugar levels are not too high nor too low.

This is particularly important for women, because preexisting diabetes (type 1 or type2) that’s not under control before pregnancy can lead to serious complications during pregnancy. Some of these complications include preeclampsia, premature birth, and birth defects. So, if you have diabetes, talk to your health care provider about how to best have it under control before trying to get pregnant to help prevent these serious complications.

There is another type of diabetes that only occurs during pregnancy, called gestational diabetes. Gestational diabetes usually develops after 20 weeks of pregnancy and goes away after you have your baby. However, developing gestational diabetes can make your more likely to develop diabetes later in life. The good news is that there’s a way to determine if you may have gestational diabetes. Between weeks 24 and 28 of pregnancy, you get a prenatal test called glucose screening test. If you get a positive result on your glucose screening test, you get another test called glucose tolerance test to see if you have gestational diabetes.

If you have gestational diabetes, here are few things you can do to help you control diabetes during pregnancy:

• Go to all you prenatal care visits, even if you’re feeling fine.
• Learn how to control your blood sugar by eating healthy foods and being active every day.
• If you have to take medicine, take it exactly as your provider tells you to.

Screening for gestational diabetes is a preventive service 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.

In the last weeks of pregnancy, lots of important things happen to your baby. These changes help your baby have a healthy start. If your pregnancy is healthy, it is best to stay pregnant for at least 39 weeks, and wait for labor to begin on its own. If you choose to induce labor, talk to your provider about waiting until you’re at least 39 weeks pregnant. Inducing labor or scheduling a c-section should only be for medical reason.

In the last week of pregnancy:

• Your baby’s brain is still growing and developing. At 35 weeks, your baby’s brain weighs just two-thirds of what it does at 39 weeks.
• Important organs like the lungs and liver need this time to develop and function properly. Babies born too early may have breathing problems and jaundice after birth.
• Your baby is gaining weight. Babies born at a healthy weight have an easier time staying warm than babies born too small.
• Your baby is still learning how to suck and swallow. Learning these skills will help your baby feed better and avoid certain feeding problems.
• Your baby’s eyes and ears are going through important changes. Babies born too early are more likely to have vision and hearing problems.

Your due date may not be correct

It’s hard to know exactly how many weeks of pregnancy you are. An ultrasound can help estimate your due date, but it can still be off by as much as 2 weeks. This means you may not be as far along in your pregnancy as you might have thought. This is why, if your pregnancy is healthy, it’s best if your baby is born at least at 39 weeks. This gives your baby the time he needs to grow.

However, in some instances, you may not have a choice about when to have your baby. If there are problems with your pregnancy or your baby’s health, you may need to have your baby early. If this happens, here are some questions you can you ask your provider about scheduling your baby’s birth before 39 weeks?

• Is there a problem with my health or the health of my baby that may make me need to have my baby early?
• Can I wait to have my baby until I’m closer to 39 weeks?

About inducing you labor:

• Why do you need to induce labor?
• How will you induce my labor?
• Will inducing labor increase the chance that I’ll need to have a c-section?

About c-section:

• Why do I need to have a c-section?
• Can a c-section cause any problems for me and my baby?
• Can I have a vaginal birth in future pregnancies?

What is Down syndrome?

Down syndrome is a chromosomal condition caused by extra genetic material. Typically, our cells contain 23 pairs of chromosomes. In the case of Down syndrome, a person has an extra full or partial copy of chromosome 21. This extra genetic material changes how the body and brain develop. People with Down syndrome have a few common physical traits, but each individual is unique and can lead a healthy active life.

We don’t know for sure why Down syndrome happens. Even though it’s a genetic condition, the majority of the cases are not passed on from the parents or family to the baby. Most cases happen because in the early stages of the baby’s development, there is a problem when the cells are dividing. However, there are some factors that may increase the risk of having a baby with Down syndrome, such as:

• Mother’s age. The risk of Down syndrome increases with the mom’s age. Even though the risk is greater as your age increases, about 80 percent of babies with Down syndrome are born to women age 35 or less. This is because younger women have more babies than older women.
• Having had a baby with Down syndrome. Up to age 40, for each pregnancy your chances of having another baby with Down syndrome is about 1 in 100 (1 percent). After age 40, the risk is based on your age. Talk to a genetic counselor to understand your risk of having another baby with Down syndrome.
• Being a carrier of a genetic translocation. Both, men and women, can pass a genetic translocation to their baby. These cases are not very common. If you had a baby with Down syndrome before or if you or your partner have a family history of Down syndrome, it’s best to talk to a genetic counselor.

During pregnancy your health care provider will offer screening tests to see if your baby is more likely to have Down syndrome. These tests are offered to all pregnant women as part of regular prenatal care. However, a screening test won’t tell you for sure if your baby has Down syndrome. It only tells you if there is a higher risk. To know for sure you will need a diagnostic test.

How do you know if your baby has Down syndrome?

If you get an abnormal screening test result, your provider will recommend a diagnostic test. A diagnostic test will confirm if a baby has Down syndrome. There are few diagnostic tests:

• Amniocentesis (also called amnio). This test checks the amniotic fluid surrounding your baby in the uterus to check for Down syndrome. You can get an amnio at 15 to 20 weeks of pregnancy.
• Chorionic villus sampling (also called CVS). This test checks the tissue from the placenta to see if a baby has Down syndrome. You can get a CVS at 10 to 13 weeks of pregnancy.
• Cordocentesis (also called percutaneous umbilical cord sampling or PUBS). For this test your provider inserts a thin needle into an umbilical cord vein to take a small sample of your baby’s blood to check for chromosome defects. You can get this test between 18 and 22 weeks of pregnancy. There’s a much greater risk of miscarriage with cordocentesis than with an amnio or a CVS. So you only get this test if other tests are unclear and your provider can’t confirm if your baby has Down syndrome any other way.

Down syndrome is also identified at birth by physical traits like: almond-shaped eyes that slant up, low muscle tone, a single line across the center of the palm of the hand, and a flattened face. But these traits won’t tell you for sure if your baby has Down syndrome, a chromosomal test call karyotype is needed to confirm this diagnosis.