News Moms Need

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

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

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

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

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

Screening for gestational diabetes is a preventive service covered by most health insurance plans under the Affordable Care Act, at no extra cost to you. Learn more about recommended preventive services that are covered under the Affordable Care Act at Care Women Deserve.

What is gestational diabetes?

Gestational diabetes is a type of diabetes that happens during pregnancy. It means that your body is not using a hormone called insulin the way it should, or your body is not making enough of it. When this happens your blood sugar increases. Having high blood sugar during pregnancy increases the risk of certain complications during pregnancy, including: preeclampsia, having a very large baby (macrosomia), premature birth, and having a c-section.

Here are some things you can do to help you manage and treat your gestational diabetes:

• Prenatal care: Women who have gestational diabetes need to have more prenatal care checkups. This helps your healthcare provider verify that you and your baby are doing ok.
• Monitor blood sugar: You will need to check your blood sugar regularly and keep a log. This can help your provider monitor your treatment. You may need to use a specific device to measure your blood sugar.
• Eat healthy foods: Choosing healthy foods, eating the right portion sizes and having regular meals are key to help you control your blood sugar.
• Being active: Physical activity helps regulate your blood sugar. Ask your provider how much and what type of activity is best for you. It’s ok for most women to do 30 minutes of moderate physical activity (like walking, riding a stationary bike) a day.
• Medication: Your provider may recommend the use of insulin to control your blood sugar. In certain situations, an oral medication might be indicated. Your provider will give you more information according to your specific needs.

Healthy eating for gestational diabetes

The best way to make sure you are eating the right amount and types of food is to visit a registered dietitian nutritionist (also called RDN). A RDN can create an individualized nutritional plan tailored to your likes, dislikes, and your specific needs. Eating well is one of the most important steps in controlling your blood sugar and reducing the risks associated with gestational diabetes. Here are some things you can do:

• Don’t skip meals. The best way to keep your blood sugar level from dropping or spiking is to eat regularly. This means not skipping meals. Make sure you eat breakfast, lunch and dinner every day. You might also need to have 2-3 small snacks a day. The goal is to spread your calories during the day and avoid spending many hours without eating or eating too much in one meal.
• Portion sizes. You will need to eat frequently, but you also need to be careful not to overeat. Learn about how many calories you need to eat every day and make sure you are eating the right portion sizes. For example, one small banana (about 6”) counts as one portion, while a big banana (about 9”) counts as two.
• Learn about carbohydrates. You will need to keep track of the amount of carbohydrates you eat per meal. This is the first step in managing your blood sugar. Foods that contain carbohydrates are: fruits, rice, pasta, potatoes, bread, milk and beans, among many others. Your RDN can make a nutritional plan that specifies the portion sizes you need of each in your meals. Certain foods that contain carbohydrates and are also high in fiber are beans, lentils and oatmeal. These are a good source of carbohydrates for women with gestational diabetes. The fiber content in these foods and the type of carbohydrate takes longer to digest and will help your blood sugar stay within your target range.
• Proteins and fat. Make sure you eat lean proteins like chicken breast, fish low in mercury, legumes, eggs, and low fat dairy products among others. About 20 percent of your calories should come from protein sources. Healthy fats like avocado, olive oil, almonds, and nuts are good choices. Limit the amount of butter, cream, high fat meats or fried foods.
• Vegetables are your best friend. Make sure you eat plenty of vegetables and leafy greens every day. Be adventurous and try new recipes. You might get inspired while you visit the farmers market. Ask about how to cook vegetables you’re not familiar with or ask for recipes. You might get great suggestions. Eat a variety of colors like spinach, cauliflower, yellow squash, pumpkin, beets, etc. This will help you consume a variety of nutrients too.
• It’s ok to use artificial sweeteners. According to the American College of Obstetricians and Gynecologists (ACOG) sugar substitutes such as aspartame, stevia, sucralose and acesulfame potassium are thought to be safe to eat in moderate amounts during pregnancy. Women with a metabolic disorder known as phenylketonuria (PKU) should not have aspartame (sold as NutraSweet^® or Equal^®) because it contains the amino acid (phenylalanine) that their bodies can’t break down.
• Limit or avoid certain foods. Avoid foods that are concentrated on added or simple sugars like sodas, desserts, cookies, candies, fruit juice, dried fruits, syrups, honey, agave syrup, among others. These types of foods have very low or no nutritional value, and will increased your blood sugar. Limit them as much as possible.

Diabetes is a serious health concern, especially when left untreated. About 9 out of 100 women in the U.S. have diabetes – a condition in which your body has too much sugar (called glucose) in the blood. You can develop diabetes at any time in your life.

Seven out of every 100 pregnant women (7 percent) develop diabetes during pregnancy, also called gestational diabetes. Gestational diabetes usually goes away after you give birth. But if you have it in one pregnancy, you’re more likely to have it in your next pregnancy. You’re also more likely to develop diabetes later in life.

Having diabetes or gestational diabetes can cause you to go into preterm labor, before 37 weeks gestation. Babies born this early can face serious health problems including long-term intellectual and developmental disabilities.

Are you at risk?

You may be more likely than other women to develop gestational diabetes if:

• You’re older than 25.
• You’re overweight or you gained a lot of weight during pregnancy.
• You have a family history of diabetes. This means that one or more of your family members has diabetes.
• You’re African-American, Native American, Asian, Hispanic or Pacific Islander. These ethnic groups are more likely to have gestational diabetes than other groups.
• You had gestational diabetes in a previous pregnancy.
• In your last pregnancy, you gave birth to a baby who weighed more than 9 1/2 pounds or was stillborn.

You can develop gestational diabetes even if you don’t have any of these risk factors. This is why your health care provider tests you for gestational diabetes during pregnancy.

How do you know if you have gestational diabetes?

If you’re pregnant, you will get a glucose tolerance test at 24 to 28 weeks of pregnancy, or earlier if your provider thinks you’re likely to develop gestational diabetes. You may have heard of other pregnant women having to drink an 8oz cup of a thick syrupy drink – this is part of the glucose tolerance test, along with measuring your blood glucose levels.

What else can you do?

If you are pregnant or thinking about becoming pregnant, talk to your health care provider. Getting diabetes under control could help prevent preterm labor and premature birth. Being active, eating healthy foods that are low in sugar and losing weight may help reduce your chances of developing diabetes later in life.

Learn more about managing pre-existing diabetes and gestational diabetes.  And, as always, visit your health care provider before and during pregnancy.

From September 15^th through October 15^th we celebrate Hispanic Heritage Month, a time where we recognize Hispanic culture, as well as achievements, and contributions Hispanics and Latinos have made to the United States.

According to the U.S. Census, there are approximately 57.5 million Hispanics in the United States– about 18% of the country’s total population and the largest ethnic or racial minority in the country. Despite this wonderful growth, there is concern over the health status of Hispanics/Latinos and their health outcomes. According to the Centers for Disease Control and Prevention (CDC), our community is at higher risk for diabetes. This is a disease that affects blood sugar. Over time diabetes can cause serious health problems and complications if not treated. Many things can increase the risk of diabetes (known as risk factors). Some factors cannot be controlled, such as family health history. But other factors, such as diet and physical activity, can be controlled. There are several things we can do to reduce the risk of this disease, live a healthy life, and celebrate our culture day by day. For example:

• Having a medical checkup every year is the key to prevention. Talk to your healthcare provider if someone in your family has diabetes (for example, your grandparents, parents, or siblings). Ask your provider about your risk factors and ask them to give you a diabetes test.
• Cook your favorite foods in a healthy way. Use vegetables and herbs to season your food. Peppers, onions, garlic, and cilantro are some of the basic and common ingredients in Latin cuisine. These ingredients provide rich flavor to any meal, and can help you cook with less salt. Instead of desserts or cookies, eat fresh fruit.
• You do not need to have a gym membership to be active. You can do things in your home or community. For example, dancing is an activity that helps you stay physically active. You can organize activities with other people who enjoy dancing, or you can dance at home with your children or with your partner.
• Avoid smoking, and second hand smoke. Do not let people smoke in your car or at home. Be careful about how much alcohol you consume or avoid it all together. All of this can cause serious health problems and cause complications if you already have diabetes.

If you and your partner want to have a baby, these recommendations can be helpful as you plan your pregnancy. Diabetes can make it harder to get pregnant; it can affect the fertility of you and your partner. Additionally, during pregnancy, diabetes can increase your risk of having a premature baby. That is why it is important to think about the health of your future baby before getting pregnant.

If you have more questions on this topic, or any others related to preconception health and pregnancy, you can email us at: askus@marchofdimes.org or preguntas@nacersano.org. Our bilingual health educators can help guide you and provide you with a list of questions you can ask your health care provider if you are at risk of getting, or have, diabetes and want to have a baby.

A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus. If your pregnancy is healthy and you don’t have any medical complications, it’s best to have your baby through vaginal birth. However, sometimes your health care provider may suggest that you have a c-section for medical reasons. In these cases, a c-section can help to keep you and your baby safe.

You and your provider may schedule a c-section because of known pregnancy complications, such as:

• You’ve had a c-section in a previous pregnancy or other surgeries on your uterus.
• There are problems with the placenta. Placental problems can cause dangerous bleeding during vaginal birth.
• You have an infection, like HIV or genital herpes.
• You’re having multiples (twins, triplets or more).
• You have a chronic health condition, like diabetes or high blood pressure, that requires treatment.

There are also situations that come up during labor and childbirth that may require you to have an unplanned (emergency) c-section. Here are some possible reasons you may need to have an unplanned c-section:

• Your baby is too big to pass safely through the vagina.
• Your baby is in a breech position (his bottom or feet are facing down) or a transverse position (his shoulder is facing down). The best position for your baby at birth is head down.
• Labor is too slow or stops.
• Your baby’s umbilical cord slips into the vagina where it could be squeezed or flattened during vaginal birth. This is called umbilical cord prolapse.
• Your baby has problems during labor, like a slow heart rate. This is also called fetal distress.
• Your baby has a certain type of birth defect.

Remember, if you’re scheduling your c-section for medical reasons,make sure to talk to your provider about waiting until at least 39 weeks of pregnancy, if possible. This gives your baby the time she needs to grow and develop before birth.

If your pregnancy is healthy and you don’t have any medical reasons to have a c-section, it’s best to have your baby through vaginal birth. But for some women and their babies, a c-section is safer than a vaginal birth. If you have questions or concerns about whether a c-section may be right for you, talk to your health care provider.

Have questions? Send them AskUs@marchofdimes.org.

Getting early and regular prenatal care can help you have a healthy and full-term pregnancy. However, a recent report shows that the preterm birth rate in the US has increased for the second year in a row. This is an alarming indication that the health of pregnant women and babies in our country is getting worse. As Stacey D. Stewart, president of the March of Dimes states, “Every mother needs healthcare throughout her pregnancy to help avoid preterm birth and birth complications, with the goal of every baby being born healthy.”

So, what can you do to have a healthy pregnancy and a healthy baby? You should call your health care provider to schedule your first appointment as soon as you find out you’re pregnant. Make sure you’re ready to talk to your provider about:

• The first day of your last menstrual period (also called LMP). Your provider can use this to help find out your baby’s due date.
• Health conditions. Such as depression, diabetes, high blood pressure, and not being at a healthy weight. Conditions like these can cause problems during pregnancy. Tell your provider about your family health history.
• Medicines. This includes prescription medicine, over-the-counter medicine, supplements and herbal products. Some medicines can hurt your baby if you take them during pregnancy, so you may need to stop taking it or switch to another medicine. Don’t stop or start taking any medicine without talking to your provider first. And tell your provider if you’re allergic to any medicine.
• Your pregnancy history. Tell your provider if you’ve been pregnant before or if you’ve had trouble getting pregnant. Tell her if you’ve had any pregnancy complications or if you’ve had a premature baby (a baby born before 37 weeks of pregnancy), a miscarriage or stillbirth.
• Smoking, drinking alcohol, using street drugs and abusing prescription drugs. All of these can hurt your baby.
• Stress. Stress is worry, strain or pressure that you feel in response to things that happen in your life. Talk to your provide about ways to deal with and reduce your stress. High levels of stress can cause complications during pregnancy.
• Your safety at home and work. Tell your provider about chemicals you use at home or work and about what kind of job you have.

Make sure you go to all of your prenatal care appointments, even if you feel fine. Going to all of your checkups gives your provider the chance to make sure you and your baby are healthy and allows you to ask any questions you may have (write them down before your appointment so you don’t forget).

The March of Dimes work to give every baby a healthy start is more vital than ever. We urge everyone concerned about the health of babies to make their voices heard by going to marchofdimes.org.

Diabetes is a serious health concern. About 9 out of 100 people (9 percent) in the U.S. have diabetes – a condition in which your body has too much sugar (called glucose) in the blood. Glucose is your body’s main source of fuel for energy. Insulin is a hormone that helps the glucose get into your cells to give them energy. If your body does not produce insulin or cannot use it efficiently, then over time, high blood sugar can lead to serious problems with your heart, eyes, kidneys, and nerve cells. You can develop diabetes at any time in your life, including during pregnancy.

There are three different types of diabetes:

• Type 1 diabetes happens most often in children and young adults but it can develop at any age. With type 1 diabetes, your body does not make insulin.
• Type 2 diabetes is the most common type of diabetes. In this case, your body does not make insulin or can’t use it normally. You are at an increased risk for type 2 diabetes if you are older, overweight, have a family history of diabetes, or do not exercise.
• Gestational diabetes occurs during pregnancy. Seven out of every 100 pregnant women (7 percent) develop gestational diabetes. Gestational diabetes is tested for at 24-28 weeks of pregnancy. It usually goes away after you give birth. However, if you have it in one pregnancy, you’re more likely to have it in your next pregnancy. You’re also more likely to develop diabetes later in life.

Managing your diabetes during pregnancy

If you have diabetes, it is very important that you control your blood sugar. High blood sugar can be harmful to your baby, especially during the first few weeks of pregnancy when the brain, heart, kidneys and lungs begin to form.

Your blood sugar is affected by pregnancy, by what you eat and drink, and how much physical activity you get. If you have preexisting diabetes (diabetes BEFORE pregnancy), what worked to control your blood sugar before you became pregnant, may not work as well during pregnancy.
Here are some things that you can do to have a healthy pregnancy:

• Go to all your prenatal care visits, even if you’re feeling fine.
• Follow your provider’s directions about how often to check your blood sugar. Call your provider if your blood sugar is too high or too low.
• Tell your provider about any medicine you take, even medicine that’s not related to your diabetes. Some medicines can be harmful during pregnancy, so your provider may need to change them to ones that are safer for you and your baby.
• If you don’t already have a registered dietician (RD), your provider can recommend one for you. An RD is a person specially trained in nutrition. An RD can help you learn what, how much and how often to eat to best control your diabetes.  She can help you make meal plans and help you know the right amount of weight to gain during pregnancy. Check to see if your health insurance covers treatment from an RD.
• Do something active every day. With your health provider’s OK, being active every day can help you manage your diabetes.

Diabetes can be a challenge, especially when you are pregnant. But it is possible to manage it and have a healthy pregnancy.

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

Diabetes is a serious health concern, especially when left untreated or undiagnosed. Today is Diabetes Alert Day. It is designed to teach the public about the seriousness of diabetes. If you develop diabetes during pregnancy, it can cause problems for your baby.

About 9 out of 100 people in the U.S. have diabetes – a condition in which your body has too much sugar (called glucose) in the blood. Glucose is your body’s main source of fuel for energy. Insulin is a hormone that helps the glucose get into your cells to give them energy. If your body does not produce insulin or cannot use it efficiently, then over time, high blood sugar can lead to serious problems with your heart, eyes, kidneys, and nerve cells. You can develop diabetes at any time in your life, including during pregnancy.

There are three different types of diabetes:

• Type 1 diabetes happens most often in children and young adults but it can develop at any age. With type 1 diabetes, your body does not make insulin.
• Type 2 diabetes is the most common type of diabetes. In this case, your body does not make insulin or can’t use it normally. You are at an increased risk for type 2 diabetes if you are older, overweight, have a family history of diabetes, or do not exercise.
• Gestational diabetes occurs during pregnancy. Seven out of every 100 pregnant women (7 percent) develop gestational diabetes. Gestational diabetes usually goes away after you give birth. However, if you have it in one pregnancy, you’re more likely to have it in your next pregnancy. You’re also more likely to develop diabetes later in life.

Your health care provider tests for gestational diabetes at 24-28 weeks with a glucose screening test. During this test, your drink a liquid that contains glucose. An hour after you drink the solution, your blood will be drawn to check your glucose levels. If your blood glucose is too high, you will need to come back for a glucose tolerance test.

Most of the time, gestational diabetes can be controlled. But if left untreated, gestational diabetes can result in complications such as premature birth. For this reason, if you do have gestational diabetes, it is important to follow your provider’s recommendations.

Gestational diabetes usually goes away after you have your baby; but if you have it, you’re more likely to develop diabetes later in life. To help reduce your risk of developing type 2 diabetes after pregnancy:

• Breastfeed. Breastfeeding can help you lose weight after pregnancy. Being overweight makes you more likely to develop type 2 diabetes.
• Get tested for diabetes 6 to 12 weeks after your baby is born. If the test is normal, get tested again every 3 years. If the test shows you have prediabetes, get tested once a year. Prediabetes means your blood sugar levels are slightly higher than they should be but not high enough to have diabetes.
• Get to and stay at a healthy weight and stay active.

If you have any concerns about your family health history, or you think you may be at risk for developing gestational diabetes or diabetes, speak with your health care provider.

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

Every 4 ½ minutes in the US, a baby is born with a birth defect. That means that nearly 120,000 (or 1 in every 33) babies are affected by birth defects each year. They are a leading cause of death in the first year of life, causing one in every five infant deaths and they lead to $2.6 billion per year in hospital costs alone in the United States.

What are birth defects?

Birth defects are health conditions that are present at birth. They change the shape or function of one or more parts of the body and can affect any part of the body (such as the heart, brain, foot, etc). They may affect how the body looks, works, or both.

There are thousands of different birth defects and they can be very mild or very severe. Some do not require any treatment, while others may require surgery or lifelong medical interventions.

What causes birth defects?

We know what causes certain birth defects. For instance, drinking alcohol while you are pregnant can cause your baby to be born with  physical birth defects and mental impairment. And genetic conditions, such as cystic fibrosis or sickle cell disease, are the result of inheriting a mutation (change) in a single gene. However, we do not know what causes the majority of birth defects. In most cases, it is a number of complex factors. The interaction of multiple genes, personal behaviors, and our environment all may all play a role.

Can we prevent birth defects?

Most birth defects cannot be prevented. But there are some things that a woman can do before and during pregnancy to increase her chance of having a healthy baby:

• See your healthcare provider before pregnancy and start prenatal care as soon as you think you’re pregnant.
• Get 400 micrograms (mcg) of folic acid every day. Folic acid reduces the chance of having a baby with a neural tube defect.
• Avoid alcohol, cigarettes, and “street” drugs.
• Talk to your provider about any medications you are taking, including prescription and over-the-counter medications and any dietary or herbal supplements. Talk to your provider before you start or stop taking any type of medications.
• Prevent infections during pregnancy. Wash your hands and make sure your vaccinations are up to date.
• Make sure chronic medical conditions are under control, before pregnancy. Some conditions, like diabetes and obesity, may increase the risk for birth defects.
• Learn about your family health history.

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

You may know that having had a premature baby increases your risk to give birth early in your next pregnancy. No one knows for sure what causes a woman to have a premature baby. However, it is important to understand what factors may make you more likely to give birth early and understand how you may be able to reduce your risk.

When you are ready to think about having another baby after you have had a preemie, here are some things to consider:

When to get pregnant again

Getting pregnant too soon after having a baby increases your chance of giving birth early. If possible, wait at least 18 months between giving birth and getting pregnant again. This gives your body time to recover.

Manage preexisting health conditions

Having diabetes or high blood pressure puts you at a higher risk to have a premature baby. Talk to your health care provider about how to best manage these conditions before you get pregnant again. And weighing too much or too little can also be a risk factor. Try to get to a healthy weight before you get pregnant again.

Prevent infections

Having an infection during pregnancy may increase your chance of giving birth early. Always wash your hands thoroughly and practice good hygiene. This won’t prevent all infections, but it can help. Also, get tested for STDs before you become pregnant.

Treatments for preterm labor

Some women may be able to receive progesterone treatment or cerclage in their next pregnancy to reduce their chances of giving birth early again. Talk to your provider to see if these treatments may be right for you.

In the video below, Dr. Siobhan Dolan discusses who may be a good candidate for progesterone treatment:

If you are planning on getting pregnant again, make sure you talk to your health care provider about what you may be able to do to reduce your risk of premature birth. Together, the two of you can make a plan so that hopefully your next pregnancy can be closer to 40 weeks. You can also go to our online community Share Your Story to talk to other women who gave birth early and are planning a pregnancy or are pregnant again.

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