Turtles look cute but are dangerous to pregnant women and young children

27
Jan
Posted by Barbara

boy w pet turtleIf you’re pregnant or have children under the age of 5, you should remove any reptile or amphibian you may have in your home. That’s because they can carry salmonella, a bacteria that can make you and your children very sick – it can even be life threatening.

The salmonella bacteria is commonly carried by reptiles, such as lizards, snakes and turtles, and amphibians, such as frogs, salamanders and newts. Chickens, ducks and geese can also carry salmonella.

Pregnant women, infants, young children and anyone with a weakened immune system are at a higher risk of getting the infection.

The risk of salmonella is so serious that the sale of turtles less than 4 inches in size has been banned in the United States since 1975. These little creatures may look cute but they have the potential to cause serious disease. The CDC warns: “Don’t be fooled Just because you can’t see the bacteria doesn’t mean they aren’t there.”

According to the FDA, the death of a 4-week-old baby in Florida in 2007 “was linked to Salmonella from a small turtle. The DNA of the Salmonella from the turtle matched that from the infant.”

Scary stuff.

How can you get infected with Salmonella?

You can get infected by eating foods that are contaminated with Salmonella, such as poultry, meat and eggs, or by touching an infected animal.

Even if a pet reptile has a negative test for salmonella, it doesn’t mean the animal is not infected. It may mean that the animal was just not “shedding salmonella” on the day it was tested. Salmonella can be found in feces (poop), soil, water (including fish tank water), and the food and bedding of infected animals. Salmonella germs can spread easily to an animal’s fur, feathers and scales.

Symptoms of salmonellosis

Signs of salmonellosis usually start a half day to three days after contact and symptoms last from four to seven days. Call your health care provider right away if you have any of these symptoms:

  • Belly pain
  • Blood in your stool (poop) or dark or amber-colored urine (pee)
  • Dehydration (not enough water or fluids in your body)
  • Fever or chills
  • Headache
  • Muscle pains
  • Nausea, diarrhea or vomiting (throwing up)

To check for salmonellosis, your health care provider will take a stool sample and send it to a lab for testing.

Is Salmonella dangerous during pregnancy?

Yes. It can lead to health complications during pregnancy, including:

  • Dehydration
  • Bacteremia (bacteria in the blood), which can lead to problems, like meningitis, a serious infection that causes swelling in the brain and spinal cord.
  • Reactive arthritis (also called Reiter’s syndrome), which can cause swelling or pain in your joints.

Salmonellosis can be passed to your baby during pregnancy. If your baby is born with salmonellosis, she may have diarrhea and fever after birth. She also may develop meningitis.

Bottom line

Don’t have turtles and other reptiles or amphibians in your home. If you touch them at a petting zoo or other place, be sure to thoroughly wash your hands immediately after coming into contact with them.

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

 

Don’t forget about Zika

25
Jan
Posted by Sara

woman window 2Just because it is winter in many parts of the U.S. does not mean that Zika has gone away. You still need to take appropriate precautions and be prepared. Zika infection during pregnancy can cause microcephaly and other brain problems in your baby. It also may be linked to other birth defects and pregnancy loss. Pregnant women and their partners need to take special care to protect themselves from Zika infection.

Travel

If you are pregnant or trying to get pregnant, it is best for you and your partner to avoid travel to a Zika-affected area. So if you are planning travel to any tropical climates this winter, make sure you check the CDC website to see if your destination is affected with Zika.

Currently, Zika-affected areas include:

  • The United States, including Puerto Rico. Zika had been spreading by mosquitoes in parts of Miami-Dade County, Florida, but there have been no new cases of people infected by mosquitoes there recently. The CDC says pregnant women and their partners who are worried about being exposed to Zika may want to postpone travel to all parts of Miami-Dade County unless travel is absolutely necessary. The CDC also says that pregnant women may want to postpone travel to Brownville, Texas, because several cases of Zika have been reported in this area.
  • Africa
  • North, Central and South America
  • Pacific Islands

Zika can be sexually transmitted so it is important to use a barrier method of birth control (like condoms) if your partner has recently traveled to a Zika-affected area.

Prevent mosquito bites

If you or your partner do travel to a Zika-affected area, it is important that you both protect yourselves from mosquito bites. Here’s how:

  • Use an insect repellant that’s registered with the Environmental Protection Agency (EPA). Always follow the instructions on the product label and make sure the product contains one or more of these substances that are safe to use during pregnancy and breastfeeding:
    • DEET (at least 20%),
    • picaridin,
    • oil of lemon eucalyptus,
    • para-menthane-diol,
    • IR3535.
  • Wear a hat, a long-sleeved shirt, long pants, shoes and socks.
  • Stay in places that have air conditioning or screens on windows and doors to keep mosquitoes out.
  • If you’ve been in a Zika-affected area, use bug spray or lotion for 3 weeks after you get back to help prevent Zika from spreading to others.

Getting pregnant

If you or your partner have or may have Zika, when is it OK to get pregnant?

According to the CDC:

  • If you have signs or symptoms of Zika, wait at least 8 weeks from your first sign or symptom before trying to get pregnant.
  • If you think you were exposed to Zika but don’t have signs or symptoms, wait at least 8 weeks from when you think you were exposed before trying to get pregnant.
  • If your partner has signs or symptoms of Zika, wait at least 6 months from his first sign or symptom before trying to get pregnant.
  • If your partner has been exposed to Zika but doesn’t have signs or symptoms, wait at least 6 months from when he thinks he was exposed before trying to get pregnant.

The CDC recommends that you wait at least this long to be sure you and your partner aren’t infected with Zika virus when you try to get pregnant. Zika infection usually stays in your blood for a few days to a week, but it has been found in an infected man’s semen more than 3 months after symptoms started.

Remember, most people who have Zika don’t have signs or symptoms. If you think you or your partner may have Zika but haven’t had signs or symptoms, talk to your provider.

As the spring and summer approach, make sure you continue to check our web article and the CDC website. We cannot predict when or where a Zika-outbreak may occur, so once mosquitoes are biting, make sure you are taking the appropriate precautions and protecting yourself.

Let someone else clean Mr. Whisker’s litter box when you’re pregnant

23
Jan
Posted by Lauren

ToxoplasmosisWe often receive emails from pregnant women concerned about their cat and his litter box. Dirty cat litter might contain a harmful parasite called Toxoplasma gondii, which causes toxoplasmosis.

If you have toxoplasmosis within 6 months of getting pregnant, you may be able to pass it to your baby during pregnancy. Toxoplasmosis can cause pregnancy complications such as preterm birth (birth before 37 weeks) and stillbirth. The earlier in pregnancy you get infected, the more serious the baby’s problems may be after birth. For example, a baby could have a birth defect called microcephaly or vision problems.

Do you need to find Mr. Whiskers a new home?

The good news is that your cat can stay. But, you should have your partner, a friend, or family member change your cat’s litter for you. If you must change it yourself, be sure you wear gloves and wash your hands thoroughly afterward.

Is it just Mr. Whiskers? Or are there other ways to get toxoplasmosis?

You can also come in contact with the parasite that causes toxoplasmosis through:

  • Eating raw or undercooked meat – be sure to cook meat thoroughly and wash your hands after handling raw meat.
  • Eating unwashed fruits and vegetables – peel or thoroughly wash all raw fruits and vegetables before eating.
  • Touching kitchen utensils and cutting boards used to prepare raw or undercooked meat and fruits and vegetables – clean cutting boards, work surfaces and utensils with hot, soapy water after using them.
  • Touching dirt or sand – use work gloves when gardening and be sure to wash your hands afterward. Stay away from children’s sandboxes as well.

Pregnancy is a time of many changes, and it’s also a time to ask for help when you need it. Mr. Whiskers won’t mind that someone else is changing his litter box so that you can protect yourself during pregnancy.

For more information on toxoplasmosis, see our web article. Have questions? Text or email us at AskUS@marchofdimes.org.

When in doubt, wash your hands

20
Jan
Posted by Lauren

washing handsNow that winter has arrived, it seems like the temperatures are decreasing and the spread of germs is increasing. In an effort to stay healthy this season I find myself constantly washing my hands and trying to maintain good hygiene. Hygiene refers to activities, such as hand washing, bathing, and brushing your teeth, that help you stay healthy. Maintaining good hygiene is one of the best ways to help prevent the spread of infections.

Why is washing your hands so important?

Women who are pregnant or thinking about becoming pregnant can increase their chances of having a healthy baby by doing things to prevent the risk of infection. Not all birth defects can be prevented, but by including small, healthy hygiene activities into your daily routine, you can help prevent the spread of infections.

So how often, is often?

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 or wiping runny noses

Besides washing hands, what else can you do?

Don’t put your child’s food, utensils, cups or pacifiers in your mouth. Children’s saliva or urine may contain cytomegalovirus or CMV, a kind of herpesvirus that women can pass to their baby during pregnancy. CMV can cause problems for some babies, including a birth defect called microcephaly. Be sure to wash your hands every time after touching a child’s bodily fluids.

By making small changes to your hygiene routine, you can help prevent the spread of germs and infections. Have questions? Text or email us at AskUs@marchofdimes.org.

 

Parent navigators – a lifeline for NICU moms and dads

17
Jan
Posted by Barbara

Preemie on oxygen.jpg resizedIf you’re the parent of a baby born prematurely, you know the stress and anxiety that is a part of having your baby in the Neonatal Intensive Care unit (NICU).  Even if the entire NICU staff is super supportive and answers your every question, you may still feel like you’re on an ocean in a life raft without oars or directions. The feeling can be overwhelmingly scary.

Then, once your baby is discharged from the NICU, you may begin a whole new journey of medical visits, specialists, therapies, and figuring out the complex world of health insurance. If your baby has special healthcare needs, these next steps may be confusing at best.

Enter Parent Navigation Programs. These are programs designed to assist parents of children with special healthcare needs. The hook is that parents are assisting parents. The parent navigators have been in their shoes, as they have children with special healthcare needs.

One of our NICU Family Support Partner hospitals, Children’s National Health System in Washington D.C., employs parent navigators to provide support to parents of children with complex medical conditions. They help the parents of newly diagnosed babies or young children navigate the complicated healthcare system to get the care their child needs and to access vital community resources. And, perhaps the best part is that these parent navigators provide the emotional support that only another parent of a special needs child can fully understand.

Children’s National started their Parent Navigator Program in 2008, and is now launching a new program aimed specifically towards parents of newborns in the NICU. These babies may be born prematurely (before 37 weeks of pregnancy), with complex medical conditions and/or with birth defects.

“This short-term, peer-to-peer “buddy” program looks to decrease stress, anxiety and depression in mothers of NICU babies during hospitalization” says Michelle Jiggetts, MD, MS, MBA, Program Administrator of the Complex Care Program and the Parent Navigator Program at Children’s National.

The success of this new program will be measured scientifically, by looking at the differences between parents who leave the NICU with a parent navigator, and those who do not. They will measure caregiver stress, anxiety and depression, as well as the amount of healthcare services a baby uses after leaving the NICU. The hope is that the group that had the benefit of a parent navigator for a year following their baby’s hospital discharge, will fare better overall – both parents and baby. You can learn more about this unique program, here.

According to Dr. Jiggetts, the parent navigator’s role is to:

  1. Provide peer-to-peer mentoring and support
  2. Link families to community resources and support groups
  3. Coach parents to be active partners and communicate effectively with health care providers
  4. Suggest useful tools (e.g. care notebooks) to help organize medical information
  5. Help families navigate the healthcare system and insurance issues
  6. Encourage families to focus on self-care

It seems like a no-brainer that a program like this will be incredibly helpful. As we all know, babies don’t come with instruction manuals, and infants with special healthcare needs have their own intense challenges. Having a peer “buddy” available to provide the low-down each step of the way must be a life-line that any parent would appreciate, but especially a parent of a preemie or baby with a health condition.

Even though you’re in a life raft on that ocean, you’ve now been given oars and a compass, and land is in sight.

 

Prevent infections by preventing foodborne illnesses

13
Jan
Posted by Sara

woman eating saladAt one time or another in our lives, we’ve probably all experienced the very unpleasant symptoms of food poisoning. Usually within a day, you bounce back to your normal self. But for pregnant women and babies, foodborne illness can be extremely dangerous. Symptoms such as vomiting, diarrhea and fever, can become life-threatening. If you are infected during pregnancy, foodborne illnesses can cause premature birth, miscarriage, or stillbirth. And some foodborne illnesses, such as listeriosis, can infect your baby even if you don’t have any signs or symptoms of food poisoning.

There are ways to protect yourself

During pregnancy, make sure that you are doing all that you can to prevent infections due to bacteria and viruses that cause foodborne illnesses.

When preparing food:

  • Wash your hands before and after food preparation. You should wash your hands with warm water and soap 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 bacteria.
  • Remove and throw away the outer leaves of leafy green vegetables, like lettuce and spinach.
  • 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.

Make sure food is separated, cooked, and chilled properly before serving:

  • Separate raw meat and poultry from cooked or ready-to-eat foods.
  • Cook foods to their proper temperature. See the Minimum Cooking Temperatures chart for details on cooking meats, poultry, eggs, leftovers, and casseroles.
  • Chill foods that need to be kept cool if you will be outside for long periods. Foods made with mayo, such as pasta or potato salads, need to be kept cold and out of the sun. Or try using a recipe for an olive oil-based dressing. These will keep fresher longer.
  • Never eat cooked food that has been out of the refrigerator longer than two hours. At room temperature, bacteria in food can double every 20 minutes. The more bacteria there are, the greater the chance you could become sick. Cold temperatures keep most harmful bacteria from multiplying.

Avoid these foods during pregnancy to prevent food poisoning:

  • Do not eat raw or undercooked meat (beef, poultry, pork, and fish).
  • Don’t eat raw or runny eggs or any foods made with them–this includes cake batter and raw cookie dough!
  • Raw meat, fish and eggs can contain harmful germs that can give you food poisoning, like salmonella infection. Cooking them fully kills the germs, which helps keep you and your baby from getting sick.
  • Avoid raw sprouts, especially alfafa sprouts.
  • Avoid unpasteurized (raw) milk and cheeses. Many dairy products, like milk, eggs and cheese, are pasteurized. This means they’re heated to kill germs. Avoid unpasteurized juice, milk, or soft cheeses, such as brie, feta, Camembert, Roquefort, queso blanco, queso fresco and Panela. If the product label doesn’t say “pasteurized,” pick a different product. Unpasteurized dairy products can give you food poisoning, like listeriosis.

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.

This may seem like a lot of foods to avoid. But, the truth is that there are many good foods you can eat during pregnancy. Visit our website for menu ideas.

“I just found out I’m pregnant and I haven’t been taking folic acid. What should I do?”

11
Jan
Posted by Lauren

Pregnant couple with providerThis is a question we often receive through AskUs@marchofdimes.org. The good news is that no matter when you find out you are pregnant, you will still benefit from taking a daily prenatal vitamin that contains 600 micrograms (mcg) of folic acid.

Folic acid is B vitamin that every cell in your body needs for normal growth and development. It helps your body make red blood cells that carry oxygen from your lungs to all parts of your body.

Before pregnancy, we recommend taking a daily multivitamin that contains 400 mcg of folic acid to help prevent birth defects of the brain and spine, or neural tube defects. As soon as you find out you are pregnant, begin taking a daily prenatal vitamin with 600 mcg of folic acid. Your health care provider can prescribe prenatal vitamins for you, or you can get them over the counter without a prescription – just be sure to check the label.

Folic acid is important before and during early pregnancy to prevent neural tube defects in your baby. However, a pregnant woman needs extra folic acid throughout her pregnancy to help her produce the additional blood cells her body needs. Folic acid also supports the rapid growth of the placenta and your baby, and is needed to produce new DNA (genetic material) as cells multiply.

If you have not been taking a multivitamin that contains folic acid up until now, perhaps you have been getting folic acid from food sources. Fortunately, in the United States, most grain products are fortified with folic acid (such as cereals, breads, pasta, etc.), so you are likely getting a certain amount of folic acid from your diet. Products that say “enriched” or “fortified” usually contain folic acid, but check product labels to be sure.

You also can get folic acid from some fruits and vegetables. When folic acid is naturally found in a food, it’s called folate. Foods that are good sources of folate are:

    • Beans, like lentils, pinto beans and black beans
    • Leafy green vegetables, like spinach and Romaine lettuce
    • Asparagus
    • Broccoli
    • Peanuts (But don’t eat them if you have a peanut allergy)
    • Citrus fruits, like oranges and grapefruit
    • Orange juice (From concentrate is best)

Folic acid is very important throughout your pregnancy, so even if you have been eating the foods listed, you should still take a prenatal vitamin with the recommended amount of folic acid.

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

Update! New guidelines on how to prevent peanut allergies in your baby

09
Jan
Posted by Lauren

peanut butterPeanut allergies have become a hot topic and for good reason. These allergies can be severe and lifelong.

I remember when I was in school, before my math class we would have to dispose of all peanut products before stepping into the room because a student had a peanut allergy. Even when all products were thrown in the garbage, if the food got in the air, it caused her to have a reaction and she needed to leave class immediately. For those people with a peanut allergy, it can seriously affect their everyday lives.

But good news has just arrived. New clinical guidelines have been issued to help prevent the development of a peanut allergy in children.

Why was there a change in the recommendations?

A new study involving more than 600 babies ages 4-11 months found that those infants who avoided peanut products had a higher rate of peanut allergy than those who ate peanut-products.

Babies and children (up to age 5)  who regularly ate peanut products were less likely to develop a peanut allergy. Specifically, high risk infants (babies who had severe eczema or inflammation of the skin and/or an egg allergy) had an 81% reduction in the development of a peanut allergy.

What are the new guidelines?

  1. Infants who are at high risk of developing a peanut allergy and already have severe eczema, egg allergy or both, should have peanut-containing foods introduced into their diet as early as 4-6 months of age to reduce the risk of developing the allergy. But be sure to speak with your baby’s provider before beginning this process.
  2. Infants with mild to moderate eczema should have peanut-containing foods introduced into their diets around 6 months of age to reduce the risk of peanut allergy.
  3. Infants without eczema or any food allergy can have peanut-containing foods introduced into their diets at any time after solids have successfully been introduced.

Important:  In all cases, your baby should start other solid foods before introducing peanut-containing foods. Never give whole peanuts or peanut pieces to children under the age of four. Be sure to speak with your baby’s health care provider before making any changes to your baby’s diet. For more information about peanut allergies, see this article from the American Academy of Pediatrics.

Have questions about these new guidelines? Text or email us at AskUs@marchofdimes.org.

Prevent to protect: talk to your health care provider

06
Jan
Posted by Sara

Pregnant woman talking with doctorJanuary is Birth Defects Prevention month. In the United States, a baby is born with a birth defect every 4 ½ minutes. Some infections before and during pregnancy can have serious consequences, including causing certain birth defects. Talking to your health care provider is an important way that you can help prevent infections and protect you and your baby.

During your preconception checkup or your first prenatal visit, talk to your health care provider about:

How to prevent infections

  • Maintain good hygiene. Wash your hands often with soap and water, especially when preparing food or caring for young children.
  • Take precautions to protect yourself from animals known to carry diseases and insects that may carry infections, such as Zika.
  • Stay away from wild or pet rodents, live poultry, lizards, and turtles.
  • Do not clean a cat litter box during pregnancy.
  • Avoid travel to Zika-affected areas. Be sure to discuss any travel plans with your provider.
  • When mosquitoes are active, prevent mosquito bites using an EPA-registered bug spray containing one of these ingredients: DEET, picaridin, oil of lemon eucalyptus, para-menthane-diol or IR3535. Wear appropriate clothing (hat, long-sleeved shirt, pants, shoes, & socks).
  • Don’t have sex with a male or female partner who may be infected with Zika virus or who has recently travelled to a Zika-affected area.

Vaccinations before pregnancy

It’s best to be up to date on all your routine adult vaccinations before you get pregnant. These vaccinations are recommended before pregnancy:

  • Flu. 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.
  • HPV (human papillomavirus). This vaccine protects against the infection that causes genital warts. The infection also may lead to cervical cancer. The CDC recommends that women up to age 26 get the HPV vaccine.
  • MMR (measles, mumps and rubella). This vaccine protects you against measles, mumps and rubella (also called German measles). Measles during pregnancy can cause miscarriage. Rubella can cause serious problems during pregnancy, such as miscarriage, stillbirth, and birth defects.
  • Varicella. This vaccine protects you from chickenpox, an infection that spreads easily and causes itchy skin, rash and fever. During pregnancy, it can be dangerous for a baby and cause birth defects. If you’re thinking about getting pregnant and haven’t had chickenpox or been vaccinated for it, tell your provider.

Vaccinations during pregnancy

The CDC recommends two vaccinations during pregnancy:

  • Flu shot if you weren’t vaccinated before pregnancy. You can get a flu shot at any time during pregnancy.
  • Pertussis vaccine (Tdap) at 27 to 36 weeks of pregnancy. Pertussis (also called whooping cough) is an extremely contagious disease that causes violent coughing and is dangerous for a baby. Pregnant women should get a dose of Tdap during every pregnancy, to protect their baby.

Remember, preventing infections before and during pregnancy can help to keep you and your baby safe. Speaking with your healthcare provider can help you become as healthy as possible before and during pregnancy.

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

 

New year – healthy you

03
Jan
Posted by Barbara

Today we welcome guest blogger Sarah Verbiest, DrPH, MSW, MPH, Executive Director, The National Preconception Health and Health Care Initiative.

January brings a time for reflection and a fresh start; a time when many women re-evaluate or set new goals. Health aims such as losing weight, exercising more, eating healthier, sleeping more and stopping smoking are important and often on the top of many women’s lists.

Well woman visitHere’s one that should top yours in 2017:

Go for your annual well woman visit.

Why?

For one, we still have the Affordable Care Act, so preventive services, like an annual well woman visit, should be covered by insurance with no out-of-pocket costs. This means if you have health insurance and the provider is covered under that plan, the visit shouldn’t cost you anything. While this may not yet be true for all health plans, it is likely a benefit you have that you didn’t know was available.

“I’m healthy – so I don’t need to see a doctor. Right?”

Being healthy doesn’t mean you can skip the wellness visit. This annual check-up is more than an overall physical and mental screen – this is a time to talk to your doctor about your questions and get help on those health resolutions. Your doctor can help you stay on track with ways you can set yourself up for success, from the inside out. He or she can also help you take preventative measures if starting a family is not in your plans. And if you hope 2017 will bring the stork your way, this is a critical place to start.

So, is a wellness visit more than just the dreaded pelvic exam?

YES!

A well woman visit has often been thought of as primarily an appointment for a pelvic exam, but it is a much more comprehensive visit than that! In fact, a well visit may not even need to include a pelvic exam anymore. The contents of a well woman’s visit are up to each woman and her provider. Her visit could include nutrition and diet counseling, immunizations, family planning, and screenings for blood pressure, cholesterol, depression, anxiety, and sexually transmitted infections (STIs).

To make the most of a visit, you can create a list of questions and concerns to discuss during your appointment. Be sure to bring up if you would like to become pregnant in the next year. Whether you want to start a family or not- there are vital lifestyle, behavior and contraception topics to discuss to be sure you’re tracking toward your reproductive goals. Especially if you’re planning a trip south, ask about the Zika virus and ways you can protect yourself. January is National Birth Defects Prevention Month, and a trip to the doctor is an essential step to #Prevent2Protect.

Where can you learn more?

The National Preconception Health and Health Care Initiative, a public-private partnership of 70+ national organizations working to advance preconception health, launched Show Your Love, the first national preconception consumer resource and campaign. On this site, you’ll find what you need to know about well visits and preconception health care. Show Your Love website and social media campaign is meant to spark action for consumers to “Show Your Love”—to yourself, your significant other, and your family/future family—by preventing to protect and taking care of your health today.

Sarah Verbiest, DrPH, MSW, MPHSarah Verbiest is Executive Director at UNC Center for Maternal & Infant Health. She serves as Director of the National Preconception Health and Health Care Initiative (PCHHC), a public-private partnership of over 70 organizations focused on improving the health of young women and men and any children they may choose to have. Sarah is also a clinical associate professor at the UNC School of Social Work.  You can follow Sarah on Twitter @S_Verbiest or connect with her on LinkedIn.