Archive for the ‘Pregnancy’ Category

What does it mean to have a short cervix?

Wednesday, November 15th, 2017

A short cervix means the length of your cervix is shorter than normal. To be more specific, a short cervix is one that is shorter than 25 millimeters (about 1 inch) before 24 weeks of pregnancy.

Why is the length important?

If you have a short cervix, you have a 1-in-2 chance (50 percent) of having a premature birth, before 37 weeks of pregnancy. So if you have a short cervix and you’re pregnant with just one baby, your health care provider may recommend these treatments to help you stay pregnant longer:

  • Cerclage
  • Vaginal progesterone. Progesterone is a hormone that helps prepare your body for pregnancy. It may help prevent premature birth if you have a short cervix and you’re pregnant with just one baby. You insert it in your vagina every day starting before or up to 24 weeks of pregnancy, and you stop taking it just before 37 weeks.

If your provider thinks you have a short cervix, she may check you regularly with ultrasound.

How do you know if you have a short cervix?

Checking for a short cervix is not a routine prenatal test. Your provider probably doesn’t check your cervical length unless:

  • She has a reason to think it may be short.
  • You have signs of preterm labor. This is labor that begins too soon, before 37 weeks of pregnancy.
  • You have risk factors for premature birth, like you had a premature birth in the past or you have a family history of premature birth (premature birth runs in your family).

What makes a cervix short?

Many things can affect the length of your cervix, including:

  • Having an overdistended (stretched or enlarged) uterus
  • Problems caused by bleeding during pregnancy or inflammation (irritation) of the uterus
  • Infection
  • Cervical insufficiency

Read about our own Health Education Specialist Juviza’s personal experience being pregnant with a short cervix and her new connection to the March of Dimes’ mission.

Have questions? Text or email us at AskUs@marchofdimes.org.

Managing ADHD during pregnancy

Wednesday, October 25th, 2017

According to the CDC, approximately 11% of children 4-17 years of age (6.4 million) have been diagnosed with attention deficit/hyperactivity disorder (ADHD). Although the condition is usually diagnosed in children, ADHD can continue to affect individuals into adulthood. People with ADHD often have trouble paying attention, controlling impulsive behaviors, or may be overly active.

Non-medical treatments

There are non-medical treatment options for ADHD. Talk to your provider to find out whether they may be helpful for you during pregnancy. Non-medical treatment options can be used in addition to medication or instead of medication. They can include:

  • Cognitive Behavioral Therapy: This type of therapy focuses on how to change unwanted thoughts and behaviors. If you have ADHD ADHD, cognitive-behavioral therapy can help with time management, organization, and planning.
  • Coaching: Coaching focuses on helping people with ADHD overcome common challenges such as planning, time management, goal setting, organization, and problem-solving. A coach can help you to set goals, develop a plan of action to achieve those goals, and to overcome any obstacles that may get in the way. Coaches can be used in addition to medication and cognitive behavioral therapy.

Medications

If you are taking medication to manage your ADHD and are pregnant or planning a pregnancy, it is important to talk to your health care provider. Your provider can tell you if a prescription medicine is safe to take during pregnancy. She may want you to stop taking a medicine or switch to one that’s safer for you and your baby. Together you can weigh the risks and benefits of continuing to use your ADHD medication during pregnancy.

You can also reach out to MotherToBaby for information about specific medications and how they may affect pregnancy and breastfeeding.

Have questions? Text or email us at Askus@marchofdimes.org.

Changes in prescription drug labeling offer new safety information about pregnancy and breastfeeding

Wednesday, October 18th, 2017

Today’s guest post is written by Leyla Sahin, MD, U.S. Food and Drug Administration Division of Pediatric and Maternal Health.

Thank you for inviting me to talk with you about FDA’s new prescription medicine labeling system which provides information on the benefits and risks of using medicines during pregnancy and breastfeeding.  This new system is one way that FDA works to support healthy pregnancies.

Why has the FDA decided to change their system of labeling prescription medications for use during pregnancy and breastfeeding?

FDA wants women and their health care providers to have useful and up-to-date information to help them make decisions about the benefits and risks of using prescription medicines during pregnancy and breastfeeding. The decision to change the labeling was based on several years of careful consideration and listening to healthcare providers, organizations and the general public about the pros and cons of the old system. We learned that the old system was somewhat confusing and not used consistently. The new Pregnancy & Lactation Labeling for prescription medicines will include more helpful information about a medication’s risks to pregnant women, the developing baby, and babies that are breastfed. Over-the-counter (also called, OTC) medicines that you get without a prescription are not affected by the new labeling rules.

How is the new labeling system different from the older system? What new information will I see on my prescription labels?

The biggest change for the new labeling system is that the letter categories are being phased out. The old system used five-letters (A, B, C, D and X) to categorize what is known about the risks of taking a medicine.  Instead of the letters, the new labeling will have a description of the known risks in sentence format.  The new labeling will also include information about the background risks of having a birth defect or miscarriage. Background risks  are risks that every woman starts out with, even if she does not take any medication.  Information about the risks of the medical condition on the pregnancy will be included, if known. In addition, there will be information on dose adjustments that may be needed in pregnancy.

FDA decided to eliminate the pregnancy letter categories because they were often misinterpreted as a grading system. Medications could have the same letter categories but have very different risks. People sometimes focused so much on the letters and did not focus on what the risk data actually said.

Will the new labels tell me if the medication will affect fertility?

The new labeling format includes a subsection called “Females and Males of Reproductive Potential”. This new section will include recommendations about birth control and pregnancy testing, if it’s a medication that should not be used in pregnancy because of a known or suspected risk. It will also include information about what is known about a medication’s effects on fertility if this information is available.

Some medications are more dangerous at certain times in pregnancy. Will the new labeling provide specific information for each trimester of pregnancy?

If there is information about effects in a specific trimester, it will be included in the labeling. The labeling will also include medical and disease factors that should be considered.

I’m breastfeeding. How can I find out if the medication I’m taking will be found in my breastmilk and if it will affect my baby?

The “Lactation” subsection will provide information, when it is known, about the amount of medication that is transferred into breastmilk and potential effects on the breastfeeding infant.

Will it be clear when a medication should be completely avoided during pregnancy or breastfeeding?

If a medicine should not be used during pregnancy or breastfeeding, this information will be clearly stated in the labeling.  If there are ways to minimize exposure to the breastfed infant, this information will be included as well.

When can I expect to see these changes?

The changes have already started. The new prescription labeling system went into effect on June 30, 2015.  New prescription medications approved on or after that date will immediately have the new format. For products approved on or after 2001, but prior to 2015, the changes will occur over the next several years.  Some products are not required to change to this new format but all prescription medications will be required to remove the pregnancy letter category.

The risk information included in drug labeling often comes from research. How can I participate in research?

The new labeling will include information about pregnancy exposure registries. A pregnancy exposure registry is a study that collects health information from women who take prescription medications or receive vaccines when they are pregnant. There are registries for a number of medications and vaccines. By signing up for a pregnancy exposure registry, you can help other pregnant women and prescribers find out more about the safety of medicines used during pregnancy.

If there is a pregnancy exposure registry available for a medication, you will see contact information in the medication labeling. FDA’s Office of Women’s Health keeps a web listing of registries that you can search by medication name or medical condition. Here’s the link: www.fda.gov/pregnancyregistries

In addition to the research information that will be included in the prescription medication labeling, FDA has information on the participation of women in clinical trials. FDA is also participating in a multi-Agency task force to address the participation of pregnant and lactating women in research.

Can you prevent infections during pregnancy?

Monday, October 16th, 2017

There are some infections that you can get either before or during pregnancy that may cause complications for you and your baby. You can’t always prevent infections, but here are some tips that can help:

Wash your hands: Washing your hands regularly can help to reduce the spread of colds, the flu and other infections, like cytomegalovirus (CMV).

Wash your hands:

  • Before preparing or eating food
  • After handling raw meat, raw eggs or unwashed vegetables
  • After being around pets or animals
  • After changing diapers, wiping runny noses, or picking up toys

Prepare food properly: Handle foods safely whenever you wash, prepare, cook and store them. Wash knives, cutting boards and dishes used to prepare raw meat, fish or poultry before using them for other foods. Foods to avoid during pregnancy include raw meat, fish, and eggs and unpasteurized foods.

Get vaccinated: Vaccinations can help protect you and your baby from certain infections during pregnancy. Some vaccinations are safe to get during pregnancy, but others are not. Talk to your provider to make sure any vaccination you get during pregnancy is safe. Make sure your vaccinations are up to date before you get pregnant.

Protect yourself from Zika: If you get infected with the Zika virus during pregnancy, you can pass it to your baby. It causes a birth defect called microcephaly and other brain problems. Zika virus spreads through mosquito bites and through body fluids, like blood and semen.

  • If you’re pregnant or trying to get pregnant, don’t visit a Zika-affected area unless absolutely necessary.
  • Protect yourself from mosquito bites.
  • If your male or female partner may be infected with Zika, use a barrier method (like a condom) every time you have sex or don’t have sex at all.
  • If you’re pregnant and think you may have been exposed to Zika virus, see your health care provider right away.

Ask someone else to clean your cat’s litter box: If you have to do it yourself, wear gloves. Wash your hands thoroughly when you’re done emptying the litter. Dirty cat litter may contain toxoplasmosis, an infection caused by a parasite. Toxoplasmosis can cause health problems for your baby during pregnancy.

Get tested for sexually transmitted infections (STIs): STIs are infections you can get from having unprotected sex with someone who’s infected. If you’re pregnant and have an STI, it can cause serious problems for your baby, including premature birth and birth defects. Testing for STIs is a part of prenatal care. If you have an STI, getting treatment early can help protect your baby.

Talk to your health care provider: Talk to your provider about how to prevent infections, making sure that you’re up-to-date on your vaccinations before pregnancy, and what vaccinations you need during pregnancy.

Have questions? Text or email us at Askus@marchofdimes.org.

New study: don’t skip your Tdap vaccine

Wednesday, October 4th, 2017

The March of Dimes recommends pregnant women receive the Tdap vaccine at 27 to 36 weeks of pregnancy. This vaccine protects against pertussis (also called whooping cough). Pertussis spreads quickly and is dangerous for your baby.

In a new study, researchers from the Centers for Disease Control and Prevention (CDC) found that receiving the Tdap vaccine in the third trimester of pregnancy prevented more than 78% of cases of whooping cough in babies younger than two months. The CDC has recommended pregnant women receive the Tdap vaccine since 2012, but these findings confirm that the vaccine is not only beneficial, but incredibly important in order to protect your baby after birth.

The study looked at babies younger than two months old from six states from 2011 through 2014. They learned that the mothers of babies who had whooping cough were less likely to have received the Tdap vaccine during their pregnancy.

Although these findings show how effective getting Tdap during pregnancy can be, researchers also found that only 49% of pregnant woman who had a baby between fall 2015 and spring 2016 received the vaccine.

Why are these results so important?

So far in 2017 there have been more than 11,000 cases of whooping cough in the U.S. Whooping cough is a serious disease that causes uncontrollable, violent coughing that can make it hard to breathe. Babies younger than one year of age are at the highest risk for severe complications, hospitalization or death.

Babies don’t receive their own whooping cough vaccine until two months of age. But if a pregnant woman gets vaccinated during the third trimester of pregnancy (between 27 and 36 weeks) she can pass her antibodies on to her baby and provide protection during these first two months. This study confirms that vaccination with the Tdap vaccine during pregnancy can prevent whooping cough in babies before they are able to receive their own vaccine.

If you’re pregnant, make sure you ask your prenatal care provider about when to schedule your Tdap vaccine so that you can protect your baby.

To see when it’s time for your baby’s whooping cough vaccine (and other immunizations), see our vaccination schedule.

Have questions? Text or email us at AskUs@marchofdimes.org.

It’s time to schedule your flu shot

Friday, September 29th, 2017

The flu is more than just a runny nose and sore throat. It’s a serious disease that can make you very sick. The flu can be especially harmful if you get it during pregnancy or right after you’ve had your baby. Although it is only September, flu season is fast approaching. So now is the time to schedule flu shots for you and your whole family.

Who should get the flu vaccine?

Everyone 6 months and older should get an annual flu shot. It takes about two weeks after vaccination for your body to develop full protection against the flu. Getting the flu vaccine is especially important for children over 6 months, children with special needs, pregnant women and other high-risk groups.

Do you need to get a flu shot every year?

Yes! Flu viruses change every year, so just because you got a flu shot last year, doesn’t mean that you are protected this year. The flu shot is designed to protect against the flu viruses that are predicted to be the most common during the flu season. Also, immunity from vaccination decreases after a year. For these reasons, everyone needs a flu vaccine every year.

Are flu shots safe for pregnant women?

YES! All women who are pregnant should get a flu shot. It is safe to get the flu shot during pregnancy and it will protect you and your baby from serious health problems during and after pregnancy. However, remember that if you’re pregnant, the flu mist is not safe to use during pregnancy.

Why is the flu so harmful during pregnancy?

The flu can be dangerous during pregnancy because:

  • Pregnancy affects your immune system. During pregnancy your immune system doesn’t respond as effectively to viruses and illnesses. This means you are more likely to catch the flu.
  • You are more likely to have serious complications. Health complications from the flu, such as pneumonia and bronchitis, can be very serious and even deadly.
  • Pregnant women who get the flu are more likely to have preterm labor and premature birth (before 37 weeks).

Will getting a flu shot protect your baby?

Getting the flu shot during pregnancy helps to protect your baby from the flu after he’s born. If you get the flu shot during pregnancy, you pass on your immunity to your baby. Some studies have shown that vaccinating a pregnant woman can give her baby antibodies to protect against flu for several months after birth. You baby should get his own flu vaccine at 6 months.

Where can you get a flu shot?

You can get the vaccine from your health care provider. Many pharmacies and work places also offer it each fall. You can use the HealthMap Vaccine Finder to find where the flu vaccine is available in your area.

The flu shot is the best way to protect you and your baby from the flu. You can learn more at flu.gov.

Have any questions? Email or text us at AskUs@marchofdimes.org.

Anemia and pregnancy

Monday, September 25th, 2017

Anemia occurs when your blood doesn’t have enough healthy red blood cells to carry oxygen to the rest of your body. Without the right amount of oxygen, your body can’t work as well as it should, and you feel tired and run down. Your body needs iron to make red blood cells. During pregnancy, you must produce about 50% more blood to meet the oxygen needs of your growing baby. If you do not get enough iron during pregnancy, you can become anemic (have anemia). If you have anemia during pregnancy, it can deprive both you and your baby of oxygen.

Iron deficiency during pregnancy has been linked to an increased risk of premature birth and low birthweight.

Getting the right amount of iron

Before getting pregnant, women should get about 18 milligrams (mg) of iron per day. During pregnancy, the amount of iron you need jumps to 27 mg per day. Most pregnant women get the right amount of iron by taking prenatal vitamins and eating foods that contain iron.

You can help to lower your risk of anemia by eating iron-rich foods throughout your pregnancy. Foods high in iron include:

  • Poultry
  • Dried fruits and beans
  • Eggs
  • Iron-fortified cereals, breads and pastas
  • Organ meats (liver, giblets)
  • Red meat
  • Seafood (clams, oysters, sardines)
  • Spinach and other dark leafy greens

Foods containing vitamin C can increase the amount of iron your body absorbs. So it’s a good idea to eat foods like orange juice, tomatoes, strawberries and grapefruit every day.

Calcium (in dairy products like milk) and coffee, tea, egg yolks, fiber and soybeans can block your body from absorbing iron. Try to avoid these when eating iron-rich foods.

Signs of anemia

Anemia develops over time. As it progresses, you may have these signs and symptoms:

  • Fatigue (very common)
  • Dizziness
  • Headache
  • Cold hands and feet
  • Pale skin
  • Irregular heartbeat
  • Chest pain

Your health care provider uses a simple blood test to check for anemia several times during pregnancy. Make sure you let your provider know if you have any of the signs or symptoms. If you are anemic, your provider may prescribe an iron supplement.

Have questions? Email us at AskUs@marchofdimes.org.

September is Infant Mortality Awareness month

Monday, September 18th, 2017

Infant mortality is the death of a baby before his or her first birthday. According to the CDC, in 2015 the infant mortality rate in the United States was 5.9 deaths per 1,000 live births. That means that in 2015 over 23,000 infants died before their first birthday.

Causes of infant mortality

In the US, the leading causes of infant mortality are:

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

What can you do?

Not all causes of infant mortality can be prevented. But there are some steps that you can take to reduce the risks of certain birth defects, premature birth, some pregnancy complications, and SIDS.

Take a multivitamin with 400mcg of folic acid. While there are many different types of birth defects, taking folic acid before and during early pregnancy can help prevent birth defects of the brain and spine called neural tube defects (NTDs). Some studies show that it also may help prevent heart defects and cleft lip and palate.

Get a preconception checkup before pregnancy. Being healthy before pregnancy can help prevent pregnancy complications when you do get pregnant. Your provider can also identify any risk factors and make sure they are treated before you get pregnant.

Get early and regular prenatal care. This lets your provider make sure you and your baby are healthy. She can also identify and treat any problems that may arise during your pregnancy.

Stay at a healthy weight and be active. Getting to a healthy weight before pregnancy may help you to avoid some complications during pregnancy.

Quit smoking and avoid alcohol and street drugs. Alcohol, drugs and harmful 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.

Space pregnancies at least 18 months apart. This allows your body time to fully recover from your last pregnancy before it’s ready for your next pregnancy. Getting pregnant again before 18 months can increase the chance of premature birth, low birthweight, and having a baby that is small for gestational age.

Create a safe sleeping environment for your baby. Put your baby to sleep on his or 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.

The March of Dimes is helping improve babies’ chances of being born healthy and staying healthy by funding research into the causes of birth defects, premature birth and infant mortality.

Have questions? Email us at AskUs@marchofdimes.org.

 

 

 

Food safety for fall

Friday, September 15th, 2017

When preparing food for yourself or your family, it’s important to practice safe food handling to prevent foodborne illnesses. Bacteria can invade areas and surfaces in kitchens and on foods. There are easy steps for you to take to keep your family away from harmful bacteria and enjoy meals together at the same time.

What’s the best way to clean food?

• Wash your hands with soap and warm water for at least 20 seconds before and after handling food.

• Wash all fruits and vegetables. Use a scrub brush. If you can’t get the skin clean, peel it off. This can help remove dirt and chemicals, like pesticides. A pesticide is a chemical used to keep bugs and other pests away from crops. Wash all fruits and vegetables, even if the package says it’s already been washed. Dry everything with a paper towel or clean cloth.

• Cut away damaged sections of fruits and vegetables.

• 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.

What’s the best way to separate food?

• Use one cutting board for raw meat, poultry and seafood. Use a different board for fruits and vegetables.

• When you’re shopping, keep raw meat, poultry, seafood and their juices separate from other foods.

• Store raw meat, poultry and seafood in containers so that their juices don’t get on other foods.

What’s the best way to cook food?

• Use a food thermometer. It can help you cook food—especially meat—to a safe temperature. You may not be able to tell if a food is fully cooked by how it looks, so use these temperature guidelines here.

• When using the microwave, cover the food. Stop cooking to stir the food and rotate the dish to ensure the food’s warm all the way through.

• When reheating sauces, soups and gravies, bring them to a rolling boil.

What’s the best way to chill food?

• Keep the refrigerator at 40 F or below and the freezer at 0 F or below. If you don’t think your temperature is correct, use an appliance thermometer to check it. You can buy this kind of thermometer at hardware or home-supply stores.

• Refrigerate all fruits and vegetables that have been cut or peeled.

• Refrigerate all leftovers within 2 hours after eating. Use shallow containers so that the food cools quickly. When you’re ready to use the leftovers, eat them within 2 hours of taking them out of the refrigerator.

• Thaw meat, poultry and seafood in the refrigerator, not on the counter or in the sink.

• Don’t crowd the refrigerator. This may make it hard to keep food cool and safe.

Fall means school is in session and Halloween is around the corner. Learn important food safety tips for all your fall activities here.

If you have questions, feel free to email us at AskUs@marchofdimes.org.

 

Just had a baby, but pregnant again?

Wednesday, September 13th, 2017

If you’ve already had a baby and are planning for more children, it’s best to wait at least 18 months between birth and getting pregnant again. Getting pregnant before 18 months increases your risk for certain health problems for your baby like premature birth, low birthweight and being small for gestations age (SGA).

We receive many questions through AskUs@marchofdimes.org from women who have become pregnant again in less than 18 months and want to know how to have a healthy pregnancy.

As soon as you learn you are pregnant schedule your first prenatal care appointment with your health care provider. After your first appointment be sure to continue to go to all of your prenatal care visits, even if you are feeling fine. If you have not already, start taking a prenatal vitamin with 600 mcg of folic acid in it every day to help prevent neural tube defects in your baby.

Experts don’t know for sure why getting pregnant again too soon increases your chances of complications like premature birth. So the best thing you can do is be prepared – know the warning signs of preterm labor:

  • Change in your vaginal discharge (watery, mucus or bloody) or more vaginal discharge than usual
  • Pressure in your pelvis or lower belly, like your baby is pushing down
  • Constant low, dull backache
  • Belly cramps with or without diarrhea
  • Regular or frequent contractions that make your belly tighten like a fist. The contractions may or may not be painful.
  • Your water breaks

If you have even one sign or symptom of preterm labor, call your health care provider right away. If you have preterm labor, getting help quickly is the best thing you can do.

Have questions? Text or email us at AskUs@marchofdimes.org.