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.

It’s not surprising to hear that being healthy before pregnancy can help prevent pregnancy complications. But if you have a heart condition like heart disease or a health problem like high blood pressure (which can lead to heart problems), you might worry about how it could affect your pregnancy. Here are a few things to know:

• High blood pressure can cause preeclampsia and premature birth during pregnancy. But managing your blood pressure can help you have a healthy pregnancy and a healthy baby.
• During pregnancy, your heart has much more work to do than before you got pregnant. It has to beat faster and pump more blood. If you have heart disease, then this extra stress on your heart may be a concern.
• Most women with heart disease have safe pregnancies. But symptoms of heart disease can increase during pregnancy, especially during the second and third trimesters.
• Some medicines carry a risk for birth defects. These include ACE inhibitors and blood thinners. These are a type of medicine that may be used to treat heart and blood pressure conditions. If you take these medicines, ask your health care provider about their safety and about other medicines that may be safer for you and your baby. But don’t stop taking any medicine without your provider’s OK.

Planning your treatment before pregnancy

Planning your pregnancy can help you make informed decisions about what’s best for you and your baby. Heart problems are one of the leading causes of pregnancy related-death. Getting early treatment for conditions that can cause complications during and after pregnancy may help save your life.

If you have a heart condition, talk to your health care team (for example, your cardiologist and obstetrician) before you get pregnant. They can help you understand what risks (if any) you may have during pregnancy. You also can talk to them about any concerns you have, like changing to a safer medicine. You may want to meet with a genetic counselor to review the risks of passing congenital heart problems to your baby. This risk varies depending on the cause of the heart disease.

If you have high blood pressure, talk to your provider about a treatment plan to help keep you and your baby healthy during pregnancy. By managing your health before pregnancy, you and your provider can make sure you’re ready for pregnancy.

Visit marchofdimes.org for more information about having a healthy pregnancy and reducing your risk for complications.

Being a parent in the newborn intensive care unit (also called NICU) can bring a mix of emotions, like fear, loneliness and anxiety. It can leave you with so many questions and a longing for support and understanding. March of Dimes helps moms and families throughout the NICU journey, as well as through every stage of pregnancy. It’s what we do. We invite you to use our digital resources to get information, answers to your questions and useful tools. They also can connect you with women and families who have had similar pregnancy and NICU experiences.

March of Dimes Facebook Mentorship Program for NICU Grad Moms:

If you’ve recently brought your baby home from the NICU, we’ve launched a digital platform to pair you with a fellow NICU grad mom as a mentor. Our Facebook Mentorship Program connects you with a support system to help you balance self-care with taking care of your baby, find support from moms who know what you’re going through and get advice and content from a trusted source like March of Dimes. If you’re interested in participating as a mentee, visit our Facebook Mentorship Program.

March of Dimes My NICU Baby™ App:

My NICU Baby app provides answers, tools and support to help you focus on your baby during the NICU stay. Track your baby’s feedings and learn about NICU staff, policies, equipment and terminology. Designed by experts, the app can help you advocate for the best care for your baby. Available for free on the App Store and Google Play. Visit mynicubaby.org for more information.

Share Your Story®:

Share Your Story is a warm, supportive online community filled with families who have been touched by, inspired by or personally affected by the mission of March of Dimes. These families know what it means to face uncertainty and fear at a time when most people expect excitement and joy. The community is fueled by caring, helpful individuals who “get it” because they have been where you are now. Share Your Story offers understanding, healing, friendship and support. Join Share Your Story.

September is Infant Mortality Awareness Month. It’s a time for us to bring attention to the fact that, sadly, babies die during infancy. And it’s a time to talk about why we must take action to help fix this problem.

Infant mortality is the death of a baby before his first birthday. According to the CDC, in 2016 the infant mortality rate in the United States was 5.9 deaths per 1,000 live births. The rate for Non-Hispanic black was much higher at 11.4 per 1,000 live births.

These facts are alarming. March of Dimes is working hard in advocacy, education and research to level the playing field so all moms and babies are healthy.

What are the leading causes of infant mortality in the U.S.? 

1. Birth defects
2. Premature birth and low birthweight
3. Sudden infant death syndrome (also called SIDS)
4. Pregnancy complications
5. Injuries (such as suffocation)

What can you do?

Not all causes of infant mortality can be prevented. But here’s what you can do to help keep your baby healthy and reduce the risk of infant death:

Before pregnancy

• Take a multivitamin with 400 micrograms of folic acid. Taking folic acid before and during early pregnancy can help prevent birth defects of the brain and spine called neural tube defects. Some studies show that it also may help prevent heart defects and cleft lip and palate in your baby.
• Get a preconception checkup. This is a medical checkup you get before pregnancy. At this checkup, your provider looks for health conditions that may affect your pregnancy and the health of your baby. Your provider can help you get treated for these conditions to help your baby be born healthy.
• Get to a healthy weight. Getting to a healthy weight before pregnancy may help prevent complications during pregnancy. Eat healthy foods and do something active every day.

During pregnancy

• Get early and regular prenatal care. Go to all your prenatal care checkups, even if you’re feeling fine. This lets your provider make sure you and your baby are healthy. She also can spot and treat any problems that you may have during pregnancy.
• Don’t smoke, drink alcohol or use harmful drugs. Alcohol, drugs and chemicals from smoke can pass directly through the umbilical cord to your baby. This can cause serious problems during pregnancy, including miscarriage, birth defects and premature birth.

After your baby’s birth

• Make sure your baby sleeps safely. Put your baby to sleep on her back on a flat, firm surface (like a crib mattress). The American Academy of Pediatrics (AAP) recommends that you and your baby sleep in the same room, but not in the same bed, for the first year of your baby’s life, but at least for the first 6 months.
• Wait at least 18 months after having a baby before getting pregnant again. Getting pregnant again before 18 months can increase the chance in your next pregnancy of premature birth and low birthweight. Waiting at least 18 months between pregnancies allows your body time to fully recover from your last pregnancy before it’s ready for your next pregnancy.

Take action today

You can help us lead the fight for the health of all moms and babies. Join March of Dimes’ advocacy network and take action now to support legislation that can help protect moms and babies.

Visit marchofdimes.org and learn more about the steps you can take to be as healthy as possible before and during pregnancy.

If you’re pregnant, trying to get pregnant or think you may be pregnant, don’t drink alcohol. Drinking alcohol at any time during pregnancy can cause serious health problems for your baby. If a woman drinks alcohol during pregnancy, the alcohol in her blood quickly passes through the placenta and the umbilical cord to her baby.

According to the National Organization on Fetal Alcohol Syndrome (also called NOFAS), “When you drink alcohol, so does your developing baby. Any amount of alcohol, even the alcohol in one glass of wine, passes through the placenta from the mother to the growing baby. Developing babies lack the ability to process or metabolize alcohol through the liver or 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. If you don’t drink alcohol, it’s completely preventable.
• Low birthweight (also called LBW). This is when a baby is born weighing less than 5 pounds, 8 ounces. Having low birthweight can cause serious health problems for some babies.
• Miscarriage. This is when a baby dies in the womb before 20 weeks of pregnancy.
• Stillbirth. This is when a baby dies in the womb after 20 weeks of pregnancy.

If you stop drinking alcohol before and during pregnancy, you can help prevent these serious conditions.

What can you do?

Don’t drink alcohol if you’re pregnant or can get pregnant. This may be hard because 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.

Here are some tips to help you avoid alcohol during pregnancy:

• Think about when you usually drink alcohol. Plan to drink other things, like fruit-infused water, sparkling water or plain water. Use a fun straw or put an umbrella in the glass to make it seem more festive.
• 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 can help you find resources to help you stop.

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

Newborn screening tests check for rare but serious and mostly treatable conditions. Babies with these conditions often look healthy at birth. If a health condition is found early with newborn screening, it often can be treated. This may help avoid more serious health problems for your baby. Newborn screening includes blood, hearing and heart tests.

When is newborn screening done?

All babies in the United States get newborn screening before they leave the hospital, usually when they are 1 or 2 days old. If your baby is not born in a hospital, talk to her health care provider about getting newborn screening before she is 7 days old. Some states require that babies have newborn screening again, about 2 weeks later.

How is newborn screening done?

Newborn screening has three parts:

1. Blood test. Your baby’s heel is pricked to get a few drops of blood. The blood is collected on a special paper and sent to a lab for testing. The lab then sends the results back to your baby’s health provider.
2. Hearing screening. The provider places a tiny, soft speaker in your baby’s ear to check how your baby responds to sound.
3. Heart screening. This test is called pulse oximetry. It checks the amount of oxygen in your baby’s blood by using a sensor attached to his finger or foot. This test is used to screen babies for a heart condition called critical congenital heart disease (also called CCHD). CCHD is the most severe heart defects. Babies with CCHD need treatment within the first few hours, days or months of life. Without treatment, CCHD can be deadly.

What happens with the tests results?

Most newborn screening results are normal. If your baby’s results are normal, you won’t hear back about them. But you always can ask your baby’s provider for the results.

In rare cases when the screening results aren’t normal, you’ll get a phone call about 2 to 3 weeks after the testing. This call can come from someone at your state’s newborn screening program or from your baby’s health care provider. If you get a call about your baby’s results, don’t panic. Most of the time your baby simply needs more testing.

Your baby’s provider then recommends another kind of test, called a diagnostic test, to see if there is a health problem. If the diagnostic test results are normal, no more testing is needed. If the diagnostic test results are not normal, your provider can guide you about next steps for your baby.

How many health conditions should your baby be screened for?

March of Dimes would like to see all babies in all states screened for at least 34 health conditions. Many of these health conditions can be treated if found early. Each state decides which tests are required. You can find out which conditions your state screens for at babyfirsttest.org.

Learn more about newborn screening at: marchofdimes.org

During pregnancy, the placenta attaches to the wall of the uterus and supplies your baby with food and oxygen through the umbilical cord. Placenta previa is a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. The cervix is the opening to the uterus that sits at the top of the vagina.

How do you know if you have placenta previa?

The most common symptom of placenta previa is painless bleeding from the vagina during the second half of pregnancy. If you have spotting or bleeding during pregnancy, call your health care provider right away. If the bleeding is severe, go to the hospital.

Not all women with placenta previa have vaginal bleeding. A routine ultrasound can identify placenta previa when there’s no bleeding. In some cases a transvaginal ultrasound is needed to find the placenta’s location. Don’t be too worried if this happens. Placenta previa found in the second trimester fixes itself in most cases.

Is there treatment?

Yes. Treatment depends on how far along you are in pregnancy, the seriousness of your bleeding and the health of you and your baby. The goal of treatment is to keep you pregnant as long as possible. But a c-section may be necessary if you have dangerously heavy bleeding or if you or your baby are having problems.

If you have a lot of bleeding, you may be treated with blood transfusions. You also may get medicines called corticosteroids. These medicines help speed up the development of your baby’s lungs and other organs. Your provider may want you to stay in the hospital until you give birth. If the bleeding stops, you may be able to go home.

If you have severe bleeding at about 34 to 36 weeks of pregnancy, your provider may recommend an immediate c-section. If you have bleeding at 36 to 37 weeks, your provider may suggest an amniocentesis. This test checks the amniotic fluid around your baby to see if her lungs are fully developed. If they are, your provider may recommend a c-section to avoid risks of future bleeding.

How can you reduce your risk for placenta previa?

We don’t know how to prevent placenta previa. But you may be able to reduce your risk by not smoking and not using street drugs like cocaine. Another risk for placenta previa is having multiple c-sections. The more c-sections you have, the greater your risk. C-sections should only be for medical reasons. If your pregnancy is healthy, it’s best to let labor begin on its own.

Learn more about placenta previa at: marchofdimes.org

If you’re planning a pregnancy, make sure that you are up-to-date on all of your vaccinations. Vaccinations contain medicine that makes you immune to certain diseases. If you’re immune, you can’t get the disease. You can get vaccinations to prevent certain infections, like chickenpox and rubella (also called German measles), that can harm you and your baby during pregnancy.

Why do adults need vaccinations?

You probably got vaccinations as a child, but they don’t all protect you your whole life. Over time, some vaccinations stop working. So you may need what’s called a booster shot as an adult. And there may be new vaccinations that weren’t available when you were young.

What vaccinations do you need before pregnancy?

If you’re thinking about getting pregnant, get a preconception checkup. This is a medical checkup you get before pregnancy to help make sure you’re healthy when you get pregnant. At your checkup, ask your provider if you need any vaccinations and how long to wait after getting them to try to get pregnant.

Your provider may recommend these vaccinations before you get pregnant:

• Flu (also called influenza). Get the flu vaccine once a year before flu season (October through May). There are many different flu viruses, and they’re always changing. Each year a new flu vaccine is made to protect against three or four flu viruses that are likely to make people sick during the upcoming flu season. If you get the flu during pregnancy, you’re more likely than other adults to have serious complications, such as pneumonia.
• HPV (stands for human papillomavirus). This vaccine protects against the infection that causes genital warts and cervical cancer. The Centers for Disease Control and Prevention (also called CDC) recommends that women up to age 26 get the HPV vaccine. You can’t get the HPV vaccine during pregnancy, so if you need it, get it before you get pregnant.
• MMR (stands for measles, mumps and rubella). This vaccine protects you against the measles, mumps and rubella. Wait 4 weeks after you get an MMR vaccination before you get pregnant.
• Varicella (also called chickenpox). Chickenpox is an infection that causes itchy skin, rash and fever. It’s easily spread and can cause birth defects if you get it during pregnancy. If you’re thinking about getting pregnant and you never had the chickenpox or the vaccine, tell your provider. Wait 1 month after you get this vaccination to get pregnant.

Your provider may recommend other vaccinations before pregnancy to protect you against certain diseases, depending on your risk. These include:

• Pneumonia. This is an infection in one or both lungs.
• Meningitis. This is an infection that causes swelling in the brain and spinal cord.
• Hepatitis A and B. These are liver infections caused by the hepatitis A and B viruses.
• Haemophilus Influenzae Type b (also called Hib). This is a serious disease caused by bacteria. It can cause meningitis, pneumonia, other serious infections and death.
• Tdap (stands for tetanus, diphtheria, and pertussis). Pertussis also is called whooping cough. In some cases, providers recommend a Td vaccination, which protects against tetanus and diphtheria but not pertussis. Ask your provider what’s best for you.

Learn more about vaccinations before and during pregnancy at: marchofdimes.org

Now that you’re pregnant, your body is changing to get ready for your baby. Gaining weight is an important part of pregnancy.

If you gain too little or too much weight during pregnancy, you’re more likely than other women to have certain complications, such as a premature birth. This is when your baby’s born too soon, before 37 weeks of pregnancy.

You may be wondering where all the weight goes? If you’re at a healthy weight before pregnancy and gain 30 pounds during pregnancy, here’s where you carry the weight:

• Baby = 7.5 pounds
• Amniotic fluid = 2 pounds. Amniotic fluid surrounds the baby in the womb.
• Blood = 4 pounds
• Body fluids = 4 pounds
• Breasts = 2 pounds
• Fat, protein and other nutrients = 7 pounds
• Placenta = 1.5 pounds. The placenta grows in your uterus (also called womb) and supplies the baby with food and oxygen through the umbilical cord.
• Uterus = 2 pounds. The uterus is the place inside you where your baby grows

Gaining weight slowly and steadily during pregnancy is best. You may not gain any weight in the first trimester. And don’t worry if you gain a little more or a little less than you think you should in any week.  If you’re worried about your weight during pregnancy, tell your health care provider.

To learn more about weight gain during pregnancy, visit: marchofdimes.org

If your baby is in the newborn intensive care unit (NICU) and you have other children, you may wonder about how to get them ready to meet their new brother or sister. The truth is that the NICU can be overwhelming and maybe even a little scary for kids, especially the first time they go. But there are things you and your partner can do to prepare your children for a NICU visit:

• Talk to your children about rules to follow in the NICU. For example, tell them that they’ll need to wash their hands in the NICU and whether or not they can hold the baby.  
• Keep visits short. Some children may get bored while visiting, so try to keep visits to less than 30 minutes. Having another adult there can be helpful in case you want to stay with your baby after your other children leave.
• Describe what they may see. Tell your children what the baby looks like, including how big or small she is. Show your children pictures or videos of the baby, her bed and medical equipment.
• Explain what the NICU equipment does. The machines in the NICU may seem less scary if children know what some of them do.

Before bringing children to the NICU, ask staff about guidelines and policies. Some NICUs may not allow young children inside to help protect the babies from getting an infection. Other NICUs may ask to test children for illnesses before they’re allowed to visit. If your children are not allowed to visit, ask them to make drawings or photo albums to help them feel like they’re helping and loving their little brother or sister.

Visit marchofdimes.org to learn about resources that can help you and your family while your baby’s in the NICU. You can also visit shareyourstory.org, the March of Dimes online community for families to share experiences with prematurity, birth defects or loss.

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.