380,000 babies born too soon in the U.S.

Posted by Sara

WPD-2015-Report-Card-MapThis year, the United States received a “C” on the March of Dimes 2015 Premature Birth Report Card. Although the overall rate of preterm birth dropped to 9.6% in 2014, 1 in 10 babies in the U.S. is born too soon. And despite the decline, the U.S. preterm birth rate continues to rank among the worst of high-income countries.

Four states received an “A” on the report card—Oregon, Washington, Idaho, and Vermont. All of these states had a preterm birth rate of 8.1% or less. Louisiana, Alabama, Mississippi, and Puerto Rico all received an “F.” Their preterm birth rates were 11.5% or greater.

For the first time this year, in addition to grading states, the report card graded cities and counties around the nation. This additional analysis showed persistent racial, ethnic, and geographic disparities. According to the report card, Portland, Oregon has the best preterm birth rate at 7.2%, earning that city an “A” on the report card. However, Shreveport, Louisiana has the worst preterm birth rate and received an “F” for its 18.8% rate.

Check out the grade for your state and the top 100 cities with the most births nationwide.

The March of Dimes has set a new goal to lower the national preterm birth rate to 8.1% by 2020 and to 5.5% by 2030. Reaching the 2020 goal of 8.1% will mean that 210,000 fewer babies will be born preterm and achieving the 2030 goal will mean 1.3 million fewer babies will be born preterm saving about $70 billion.

“This aggressive goal can be achieved by increasing best practices in preconception and pregnancy care, wider use of proven interventions such as progesterone and birth spacing, and funding discovery research through our research centers,” says Dr. Jennifer L. Howse, president of the March of Dimes.

Continued research to identify new medical advances to prevent preterm birth is necessary in order to reach the new goal. The March of Dimes supports a nationwide network of five cutting-edge, team-based research centers seeking to find the unknown causes of preterm birth and ways to prevent it.

November is Prematurity Awareness Month and World Prematurity Day (WPD) will be observed on November 17 by the March of Dimes and partner organizations worldwide. Activities in honor of WPD are expected in about 100 countries. Join us for Twitter chats throughout the month and the 24-hour #worldprematurityday Buzzday on November 17th.

Caring for yourself as you care for your preemie

Posted by Barbara

Mom holding babyGetting through a pregnancy, having a baby in the NICU, and caring for a baby with special needs at home can take a physical and emotional toll on a woman’s health. This month is a good time to remember to take care of yourself, so that you are in top form to take care of your family. Not only is November Prematurity Awareness Month, it is also National Caregivers Month.

By nature, moms tend to be wired to care for their babies. The daily routine (which goes well into the night) seems to blend into the next day and week. The 24/7 job of being a mom can often feel like a blur. Have you ever asked yourself what day it was only to be surprised when you learned that it was only Tuesday? Weekends, in the sense that most people think of them – free time, sleeping late, etc. – don’t exist. In fact, a Saturday feels much like a Tuesday in the new-mom world. It consists of the same routine: feedings, diaper changes, and caring for the special needs of your preemie.

It is not surprising then, that many moms experience exhaustion and burnout. Who wouldn’t? Every human being needs rest. Constant stress coupled with loss of sleep is a recipe for a downward spiral.

Just as moms care for others, they must learn to care for themselves. Unless you were really good at doing this before your baby was born, it may take a bit of practice. Carving out bits of time to care for yourself should be top on your list. I like to call it using “snippets of time.” Here are some examples:

  • Got five minutes? Give your best friend a call. Just hearing her voice for a few minutes will give you a lift.
  • Ten minutes may not seem like a long time to you, but that is how long it takes to take a shower and feel refreshed. You don’t need to plan a long chunk of time to do that – seize it whenever you have someone you trust watching your baby.
  • Got 30 minutes alone? A walk or yoga video will help to create the energy you didn’t know you had. (Yes, exercise creates energy.)
  • Too tired to walk? Try a quick nap (best done when your baby is also sleeping). Even 15 minutes will feel like you have been turbo charged.
  • Schedule time with your spouse. Somehow, if it isn’t scheduled, it isn’t as likely to happen. If it is on the calendar, it is much more apt to become a reality. After all, if you went through the trouble to make sure someone you trust is watching your baby, then you will probably be sure you spend time together. But, again, it doesn’t have to be for hours. Even one hour out together will help to break up the 24/7 routine and give you a fresh perspective.

Somehow, your preemie caretaking will not seem so overwhelming when you get little breaks. Here are a few more ideas to help you.

How do you take care of yourself? Please share your tips.

Have questions?  Send them to AskUs@marchofdimes.org.


It’s Prematurity Awareness Month – come chat with us!

Posted by Barbara

preemie and mom

We have lots of great Twitter chats scheduled. Please join us:

  November 4th 11am ET #PreemieChat with @NICHD_NIH

November 9th 2pm ET #ActEarly with @AUCDNews

November 12th  1pm ET #PrematurityChat with @keepemcookin

November 13th 9pm ET #NICUchat with @PeekabooicuRN

November 17 is World Prematurity Day. Join us for the 24-hour #worldprematurityday Buzzday.
Help raise awareness by wearing purple -the color of prematurity and the March of Dimes.

November 18th 1pm ET #NICUPMAD with @postpartumprog & @selenidotorg

November 19th 1pm ET #PreemieChat with @GeneticAlliance

For more information about these chats contact: askus@marchofdimes.org

preemie hand in adult hand

Postpartum depression

Posted by Sara

contemplative woman facePostpartum depression (PPD) is the most common health problem for new mothers. For most women, having a baby brings joy and happiness but about 1 out of every 8 women experience postpartum depression. It is the most common complication for new moms. Recently actresses Hayden Panettierre and Drew Barrymore publicly discussed their struggles with PPD.

Postpartum depression is different than the baby blues. The baby blues are caused by the sudden change in hormones after childbirth. This leaves many women feeling sad or moody and is very common. The baby blues usually peak about 3-5 days after delivery. Postpartum depression is more severe and long-lasting. PPD is strong feelings of sadness that last for a long time. These feelings can sometimes make it difficult for you to care for your baby. PPD can happen any time after childbirth, although it usually starts during the first three months. PPD is not your fault. It is a medical condition and it requires medical treatment.

Causes of postpartum depression

We’re not sure what exactly causes PPD but it can happen to any woman after having a baby. We do know that certain risk factors increase your chances to have PPD:

  • You’re younger than 20.
  • You’ve had PPD, major depression or other mood disorders in the past.
  • You have a family history of depression.
  • You’ve recently had stressful events in your life.

Warning signs

You may have PPD if you have five or more of the signs below and they last longer than 2 weeks.

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’re worried about hurting yourself or your baby, call emergency services at 911 right away.


If you think you may have PPD, call your health care provider. Your provider may suggest certain treatments such as counseling, support groups, and medicines. Medicines to treat PPD include antidepressants and estrogen (estrogen is a hormone. Hormones are chemicals in your body).  If you’re taking medicine for PPD don’t stop without your provider’s OK. It’s important that you take all your medicine for as long as your provider prescribes it.

PPD is not your fault. It is a medical condition that can get better with treatment so it is very important to tell your doctor or another health care provider if you have any signs. The earlier you get treatment, the sooner you can feel better and start to enjoy being a mom.

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

Eating during labor

Posted by Barbara

Woman in laborYou may have heard a news report saying that it is okay for a pregnant woman to eat a light meal during labor. In fact, they even said it may be a good idea for some women, based on new research from Canada (not yet published). But, don’t rush out for a cheeseburger on your way to the hospital; you need to know all the details.

Current medical guidelines say that a woman should not eat solid food once she is in labor. The reason is to protect her from aspirating (breathing) food into her lungs. If a woman eats and then needs an emergency C-section, she could be at risk of aspirating during the surgery. Aspiration may lead to pneumonia, too. So, not eating any solid foods during labor is a guideline to protect the mother. (It is also the rule for scheduled C-sections and other surgeries.)

Labor is physically demanding, even grueling. A particularly long labor can leave a woman totally exhausted and lacking in energy, especially for when she needs to push. A little bit of food may go a long way in boosting her energy level. And, this study found that due to medical advances in anesthesia, eating a little bit of light food would probably not have a bad effect on a woman in labor.

The Canadian review looked at 385 prior studies and concluded that anesthesiologists and obstetrical doctors (OB/GYN) should work together to identify women for whom a light meal may be beneficial. They emphasized that doctors must identify women at low risk for aspiration – this is extremely important. And, each woman needs to be assessed individually.

But what does ACOG say?

As of the writing of this blog post, the American College of Obstetrics and Gynecologists (ACOG) has not changed their position on eating during labor. Their position remains that “solid foods should be avoided in laboring patients.”

How about liquids?

ACOG says “Although there is some disagreement, most experts agree that oral intake of clear liquids during labor does not increase maternal complications…modest amounts of clear liquids may be allowed for patients with uncomplicated labor.” So, if you can’t eat solid foods, clear liquids (such as broth) may help increase your energy level. But whether it is safe for you to drink anything at all is something you should discuss with your prenatal health care provider.

What’s the bottom line?

Remember, this study has not been published yet, and ACOG has not changed its guidelines.

As with all medical procedures, talk with your health care team to determine what is best for you.


RDS and BPD – breathing problems in preemies

Posted by Barbara

NICU sign 1If your baby was born prematurely, you are probably concerned about his lungs. A baby’s lungs are not considered to be fully functional until around 35 weeks of pregnancy. If your baby was born before that, it is possible that he may struggle with breathing.



A serious breathing problem called respiratory distress syndrome (RDS) is the most common illness in the NICU. But, the good news is that due to medical advances, babies with RDS have a 99% survival rate.

Babies with RDS struggle to breathe because their immature lungs do not produce enough surfactant, a protein that keeps small air sacs in the lungs from collapsing. March of Dimes grantees helped develop surfactant therapy, which was introduced in 1990. Since then, deaths from RDS have been reduced by half.

Babies with RDS also may receive a treatment called C-PAP (continuous positive airway pressure). The air may be delivered through small tubes in the baby’s nose, or through a tube that has been inserted into his windpipe. As with surfactant treatment, C-PAP helps keep small air sacs from collapsing. C-PAP helps your baby breathe, but does not breathe for him. The sickest babies may temporarily need the help of a mechanical ventilator to breathe for them while their lungs recover. Learn more about the differences between C-PAP and a ventilator, as well as causes, symptoms and treatment of RDS.


BPD (bronchopulmonary dysplasia) is a chronic lung disease common in preemies who have been treated for RDS. These babies may develop fluid in the lungs, scarring and lung damage. Medications can help make breathing easier for them. Usually babies with BPD improve by age 2 but others may develop a chronic lung condition similar to asthma. Learn about asthma, including questions to ask your child’s health care provider and how to help your child understand his breathing problems.

Even though the outlook for babies born prematurely has improved greatly, many babies still face serious complications and lasting disabilities. Many March of Dimes grantees seek new ways to improve the care of these tiny babies, while others strive to prevent premature delivery.

Have questions?  Email or text AskUs@marchofdimes.org. We are here to help.


Considering using a midwife? Here is info to help you choose a maternity care provider.

Posted by Barbara

pregnant-woman-on-weight-scale-shrunkSpecial thanks to our guest, Ginger Breedlove, PhD, CNM, FACNM, for providing this post.

A Certified Nurse-Midwife (CNM) and Certified Midwife (CM) are trained health professionals who have completed a graduate education program. They can provide you with a full range of services before and during pregnancy, labor and birth, and postpartum. CNMs and CMs are experts in the care of women who have a healthy pregnancy.

Midwives work in collaboration with physicians for consultation and referral if complications should arise. CNMs and CMs primarily deliver babies in the hospital (97%) with 3-4 % attending at home or in birthing centers.

What can a CNM/CM midwife provide?

  • Gynecological exams
  • Preconception planning
  • Labor and delivery support
  • A more natural childbirth experience
  • Assistance and support with breastfeeding and newborn care

Is there anything a CNM/CM cannot do?

Midwives are trained and licensed to provide comprehensive maternity care services, and work with physician’s to provide medical assistance when necessary. CNMs and CMs provide care to women desiring a non-medicated birth, as well as women that choose epidural anesthesia for birth. Should you need a medical intervention, they work with the collaborating physician and medical team for special care such as Cesarean section. If you have a high-risk pregnancy or a condition such as high blood pressure or Type 2 diabetes, or develop a medical complication, your midwife will refer you to an obstetrician for care.

There are different training credentials for midwives, including some (CPMs) that do not have nursing or graduate degree education.

Here is helpful information about the variety of midwife credentials in the U.S.:

  • Certified Nurse-Midwives (CNM)  are registered nurses who have graduated from a nurse-midwifery education program, passed a national exam and are certified through the American Midwifery Certification Board. CNMs can practice in all 50 states and the District of Columbia.
  • Certified Midwives (CM) are midwives who have completed a midwifery accredited education program and have passed the same national exam as CNMs. CMs can practice in 5 states: Delaware, Missouri, New York, New Jersey, and Rhode Island. Certified Midwives are also certified through the American Midwifery Certification Board.
  • Certified Professional Midwives (CPM) have training and clinical experience in childbirth and have passed a national exam. CPMs are certified through the North American Registry of Midwives. The majority of CPMs work in private homes and a few in birthing centers.

How do you find or learn more about a midwife?

The American College of Nurse-Midwives can help you find a midwife in your area.
The National Association of Certified Professional Midwives also provides information on midwives.

Dr.Ginger BreedloveGinger Breedlove, PhD, CNM, FACNM is the current President of the American College of Nurse Midwives and full-time professor at Shenandoah University in Winchester, VA. She currently sits on the March of Dimes National Nurse Advisory Council, and is engaged in numerous working groups to improve the health of mothers and babies during the childbearing years. As a midwife for over 35 years, Dr. Breedlove has cared for women in hospitals as well as birthing center settings.

Is VBAC the right choice for you?

Posted by Sara

doctor with pregnant womanVaginal birth after cesarean (or VBAC) is safe for many women and their babies. There may be some risks and not everyone is appropriate for a VBAC, so it is important to discuss your personal medical history with your health care provider.

Benefits of VBAC

The majority (60-80%) of women who attempt a VBAC are successful. The benefits of a VBAC include:

  • No need for surgery
  • Shorter recovery time than after a c-section
  • Lower risk of infection, blood, loss, or other complications related to a c-section.

Can I have a VBAC?

You may be able to have a VBAC if:

  • You had at least one vaginal birth prior to your c-section.
  • Your c-section was performed for a reason that is not a concern in the current pregnancy (for example, the baby was breech).
  • You had a low transverse incision. This means the cut was made from side-to-side on your lower abdomen. This is the most common kind of c-section incision.
  • You and your baby are healthy.
  • Your labor starts on its own, before your due date.

Who should not have a VBAC?

A VBAC may not be a safe choice if:

  • Your c-section was not done by a low transverse incision. Other types of c-section incisions aren’t safe for VBAC.
  • There are any problems with the placenta, such as placenta previa.
  • You have certain health conditions, such as diabetes, high blood pressure, heart disease, or genital herpes.
  • You are pregnant with multiples (twins or more).
  • You have had two or more c-sections but have never had a vaginal birth.
  • Your labor is induced.
  • You are past your due date.
  • Your baby is very large.

The American College of Obstetricians and Gynecologists (ACOG) says that providers should offer VBAC to all women with healthy pregnancies who are good candidates for VBAC and who don’t have any of the complications listed above.

But ACOG also says that providers should do VBACs only in hospitals and facilities that have certain emergency care services. These services may not be available everywhere, so some providers and hospitals may not offer VBAC.

If you think you may be a good candidate for a VBAC, make sure you talk to your health care provider. Together you can decide what the best choice is for you and your baby.

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

Prematurity, learning disabilities, and ADHD

Posted by Barbara

birth announcementPremature birth is a leading cause of lasting childhood disabilities. October is Learning Disabilities and ADHD Awareness Month – a good time to become familiar with the effect prematurity can have on learning and behavior.

Of course, many babies who are born prematurely do very well. We hear stories of preemies who had a rough start in life, spent days, weeks or even months in the NICU and years later have no serious issues to report. But, some preemies will have long-term challenges with learning or behavior.


Learning disabilities (LDs) are persistent difficulties in reading, writing and/or math skills. They are not the same as learning differences. In order to help your child with learning struggles, it is important to first understand what LDs are and are not.

Kids with LD see the world in a slightly different way. Check out this post which describes a great resource from Understood.org to give you insight into your child’s world.

Children with attention deficit hyperactivity disorder (ADHD) may have trouble paying attention, controlling impulsive behaviors or be overly active.

What are the numbers?

  • Globally, 5 million babies are born too soon every year.
  • Babies born prematurely are more likely than babies born full term to have learning and behavior problems throughout childhood. About 1 in 3 children born prematurely need special school services at some point during their school years. Learning problems may not appear until elementary or even middle school.
  • According to the U.S. Department of Education, 1 in 5 children in the U.S. has learning and attention issues. “Approximately 2.5 million students in the U.S. are identified as having a specific learning disability—such as dyslexia, dysgraphia, and dyscalculia—and as many as 6 million students are identified as having attention deficit hyperactivity disorder (ADHD).”
  • The CDC reports that in 2012 more than 5 million children aged 3–17 had ADHD (10%). Boys (14%) were almost three times as likely as girls (5%) to have ADHD.

Resources to explore

If your child struggles with learning or behavior, where should you go for reliable information?

  •  The American Academy of Pediatrics (AAP) offers articles for parents to better understand ADHD.
  • Parent Training and Resource Centers, available in every state, offer information and support to families. Find your center.
  • The Center for Parent Information and Resources (CPIR) has hundreds of easy-to-read articles on disabilities, special education and the law – including how to obtain school services for your child.
  • The Understood website provides a wealth of information and support to individuals and parents of children with learning and attention issues.
  • The State of Learning Disabilities, 3rd Edition, 2014, is a downloadable review of LD. It is available on the National Center for Learning Disabilities website where along with the statistics on LD, it describes public attitudes towards people with LD, characteristics of kids with LD, employment issues, and lots of other information.

Students with LD and/or ADHD may face challenges, but they also have strengths and may possess outstanding abilities in certain areas. Understanding your child’s strengths and weaknesses, and focusing on proven educational methods and therapies will help your child be as successful as possible.

Bottom line

Babies born prematurely are more likely than babies born full term to have learning and behavior problems. But help is available. Check out our table of contents for more information.

And if you have any questions, email or text AskUs@marchofdimes.org.


Clean hands stop germs

Posted by Barbara

One of the easiest ways to stay healthy is to…(drumroll please)…wash your hands. It’s quick and easy. Try singing the “Happy Birthday” song to yourself while you lather your hands with soap.

Wash your hands before and after activities surrounding food, toilet use, wound or cut treatment, pet care, garbage and diaper handling and after blowing your nose, coughing or sneezing.This week is International Infection Prevention Week. Hand washing can help you avoid getting sick and prevent the spread of germs to others.

The March of Dimes is now on Vine – check out our fun videos!