Posts Tagged ‘preconception care’

Collecting your family health history

Wednesday, November 22nd, 2017

While you’re gathered with your family this holiday, remember that Thanksgiving is a great opportunity to record your family’s health history. Your family health history is a record of any health conditions and treatments that you, your partner and everyone in both of your families have had. It can help you find out about medical problems that run in your family that may affect your pregnancy and your baby.

Taking your family health history can help you make important health decisions. It can help you learn about the health of your baby even before he’s born! Knowing about health conditions before or early in pregnancy can help you and your health care provider decide on treatments and care for your baby.

How to collect your family health history

Talk to your family. You can use our family health history form to help you. Print out a few copies and pass them around to your family over Thanksgiving. Have family members add as much information as they can about their health and the health of their parents, grandparents and other family members. Try to get a form from everyone in your family and your partner’s family.

Ask questions. Ask relatives what diseases they have had and when they were diagnosed. Make sure you ask about conditions like diabetes, high blood pressure, intellectual disabilities, cancer, and repeat pregnancy loss. Also, find out about your ethnic background is. Knowing what countries or regions your ancestors came from is important because some diseases, like sickle cell and Tay-Sachs, run in people from certain backgrounds or parts of the world.

Update the information regularly. Keeping track of your health history never stops. Add to it as your family grows and changes. To help make sure that your history is up to date, keep copies of:

How to use your family health history

Once you’ve got it, share it! Show it to:

  • Your provider at your preconception checkup or your first prenatal care appointment. Your provider uses it to see if health conditions run in your family. This can help him figure out if you’re likely to pass a condition to your baby during pregnancy.
  • Your family members. It’s great information for everyone in your family. It’s really helpful for someone who’s pregnant or thinking about getting pregnant.

If you learn that your family has a health condition that gets passed from parent to child, you may want to see a genetic counselor. This is a person who is trained to help you understand about how genes, birth defects and other medical conditions run in families, and how they can affect your health and your baby’s health. Your provider can help you find a genetic counselor, or you can contact the National Society of Genetic Counselors.

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

U.S. study shows fewer babies are dying in their first year of life

Wednesday, March 22nd, 2017

The death of a baby before his or her first birthday is called infant mortality. A new report released by the CDC shows that the infant mortality rate in the U.S. dropped 15% from 2005 to 2014. In kangaroo-care-242005 the rate was 6.86 infant deaths per 1,000 live births. In 2014, the rate dropped to 5.82 deaths per 1,000 live births.

While the study did not look at the underlying causes of the decline, it did report valuable information:

  • Infant mortality rates declined in 33 states and the District of Columbia. The other 17 states saw no significant changes.
  • Declines were seen in some of the leading causes of infant death including birth defects (11% decline), preterm birth and low birthweight (8% decline), and maternal complications (7% decline).
  • The rate of sudden infant death syndrome (SIDS) declined by 29%.
  • Infant mortality rates declined for all races, except American Indian or Alaska Natives.
  • Infants born to non-Hispanic black women continue to have an infant mortality rate more than double that of non-Hispanic white women.

“On the surface, this seems like good news. But it is far from time to celebrate,” said Dr. Paul Jarris, chief medical officer for the March of Dimes. “What is concerning, though, is that the inequities between non-Hispanic blacks and American Indians and the Caucasian population have persisted.” Dr. Jarris adds, “This report highlights the need to strengthen programs that serve low income and at-risk communities, especially those with the highest infant mortality rates.”

The infant mortality rate is one of the indicators that is often used to measure the health and well-being of a nation, because factors affecting the health of entire populations can also impact the mortality rate of infants.

What can you do?

Having a healthy pregnancy may increase the chance of having a healthy baby. Here are some things you can do before and during pregnancy:

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

New year – healthy you

Tuesday, January 3rd, 2017

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.

Your developing baby

Friday, March 18th, 2016

There are specific times during a baby’s development when a certain body part is especially vulnerable to damage from harmful substances and exposures. These substances can include alcohol, medications, and cigarette smoking. The chart below shows these critical periods. If something interferes or disrupts development during these times, the result may be a birth defect.

developing baby

*Image courtesy of NOFAS.

Birth defects

The dark blue segments on the picture above show when certain body parts are most at risk for major birth defects. Major birth defects cause significant medical problems and may require surgery or other treatment. Some examples of major birth defects include heart defects and spina bifida.

The light blue sections of the chart show periods when fetal development is susceptible to minor birth defects and functional defects. Minor birth defects do not cause significant problems and usually do not require medical intervention, such as treatment or surgery. Minor birth defects include things like the shape of the ears or certain facial features. Functional defects affect how a part of the body works. For example, hearing loss can be a functional defect.

Timing of exposures

According to MotherToBaby, “Harmful exposures during the first trimester have the greatest risk of causing major birth defects. This is because of the many, important developmental changes that take place during this time. The major structures of the body form in the first trimester. These include the spine, head, arms and legs.  The baby’s organs also begin to develop. Some examples of these organs are the heart, intestines and lungs.”

While exposures during the first trimester do pose the greatest risk of birth defects, exposures during the second and third trimester can cause problems with growth as well as minor birth defects. Factors that affect growth can put babies at risk for other health problems.

The brain continues to develop throughout pregnancy, after the baby is born, and into young adulthood. Harmful substances and exposures during the second and third trimester can cause developmental delays and learning disabilities.

Planning for pregnancy is important

Looking at the chart above, it is easy to see why preconception care is so important. Crucial fetal development happens very early in pregnancy– in many cases, before a woman even knows that she is pregnant. Seeing your health care provider BEFORE pregnancy and discussing any medications you are taking and underlying medical conditions, like diabetes or high blood pressure, can help you be better prepared for pregnancy and to reduce your risk of birth defects.

*We would like to thank the National Organization on Fetal Alcohol Syndrome (NOFAS) for allowing us to use their fetal development chart. Please visit their website for more important information about fetal alcohol spectrum disorders.

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

 

Preconception health for dads

Friday, February 12th, 2016

becoming a dadWe talk a lot about getting a woman’s body ready for pregnancy. But what about men? Dad’s health before pregnancy is important too. Here are a few things men can do if they are thinking about having a baby in the future.

Avoid toxic substances in your workplace and at home

If you and your partner are trying to get pregnant, it may be more difficult if you are exposed to the following substances:

  • Metals (like mercury or lead)
  • Products that contain lots of chemicals (like certain cleaning solutions, pesticides or gases)
  • Radioactive waste, radiation or other dangerous substances (like drugs to treat cancer or X-rays)

Read more about how to protect yourself at work and at home here.

Get to a healthy weight

Obesity is associated with male infertility. And people who are overweight have a higher risk for conditions such as heart disease, type 2 diabetes, and possibly some cancers.

Prevent STDs

A sexually transmitted disease (also called STD) is an infection that you can get from having sex with someone who is infected. You can get an STD from vaginal, anal or oral sex.

Many people with STDs don’t know they’re infected because some STDs have no symptoms. About 19 million people get an STD each year in the United States.

It is important to continue to protect yourself and your partner from STDs during pregnancy. STDs can be harmful to pregnant women and their babies and cause problems, such as premature birth, birth defects, miscarriage, and stillbirth.

Stop smoking, using street drugs, and drinking excessive amounts of alcohol

All of these behaviors are harmful to your health. Being around people who smoke is dangerous for pregnant women and babies. Being exposed to secondhand smoke during pregnancy can cause your baby to be born with low birthweight.

Secondhand smoke is dangerous to your baby after birth. Babies who are around secondhand smoke are more likely than babies who aren’t to have health problems, like pneumonia, ear infections, asthma, and bronchitis. They’re also more likely to die of SIDS.

Drinking excessive amounts of alcohol and using street drugs can negatively affect a man’s fertility.

Know your family’s health history

Your family health history is a record of any health conditions and treatments that you, your partner and everyone in both of your families have had. It can help you find out about medical problems that run in your family that may affect your baby. Taking your family health history can help you make important health decisions. Knowing about health conditions before or early in pregnancy can help you and your health care provider decide on treatments and care for your baby.

Be supportive of your partner

Help your partner. If she is trying to quit smoking, make sure you support her efforts—and join her if you need to quit too! If she has a medical condition, encourage her to see her doctor.

Even before pregnancy, dads play an important role in their baby’s lives, so make sure you are planning for the future too.

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

What you need to know about birth defects

Monday, January 18th, 2016

snugglingEvery 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.

Thinking about becoming pregnant? Are you worried about your diabetes?

Monday, November 9th, 2015

Diabetes and pregnancyDiabetes can cause problems during pregnancy, such as premature birth, birth defects and miscarriage. But don’t panic; with some planning ahead, you can become as healthy as possible before you become pregnant.

When you eat, your body breaks down sugar and starches from food into glucose to use for energy. Your pancreas (an organ behind your stomach) makes a hormone called insulin that helps your body keep the right amount of glucose in your blood.  When you have diabetes, your body doesn’t make enough insulin or can’t use insulin well, so you end up with too much sugar in your blood.

Too much sugar can cause serious health problems, like heart disease, kidney failure and blindness. High blood sugar can be harmful to your baby during the first few weeks of pregnancy when his brain, heart, kidneys and lungs begin to form. It’s really important to get treatment for diabetes to help prevent problems like these.

If you are thinking about becoming pregnant and have diabetes, here are a few tips:

  • Manage your diabetes to get your blood glucose levels in to your target range. Try to get it under control 3-6 months before you start trying to become pregnant.
  • Take a multivitamin that contains at least 400 micrograms of folic acid every day.
  • Talk to your provider about any medications you are taking to make sure that they are OK to continue taking when you do get pregnant. He or she may want to change some medications now, before you get pregnant.
  • Eat healthy foods and keep moving.
  • Get support and guidance. Talk with your provider, a diabetes educator or a dietician about how to manage your diabetes.

Not sure if you are at increased risk of developing diabetes? Read our post to find out.

Remember: If you are thinking about becoming pregnant, now is the time to talk to your doctor about getting as healthy as you can before you conceive. Take small steps now toward a healthy pregnancy and a healthy baby.

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

Epilepsy and pregnancy

Thursday, May 21st, 2015

speak to your health care providerEvery year in the US, approximately 20,000 women with a seizure disorder give birth. Most of these pregnancies are healthy. But there are a few additional concerns that women who have epilepsy must consider when thinking about getting pregnant.

What is epilepsy?

Epilepsy is a brain disorder in which a person has repeated seizures over time. Seizures are episodes of disturbed brain activity that cause changes in attention or behavior. Epilepsy is a specific type of seizure disorder.

People with epilepsy are usually prescribed medication to help to control seizures. These are known as antiepileptic drugs (AEDs). There are a number of different types of AEDs and they are prescribed depending on age, the type of seizure, and the side effects of the medications. Some individuals with epilepsy may need more than one AED to control their seizures.

Can epilepsy cause problems during pregnancy?

If you have epilepsy and are thinking about getting pregnant, there are a few important things that you need to consider.

  • Women who have epilepsy have an increased chance to have a baby with a birth defect compared to women who do not have epilepsy. This may be the result of the epilepsy or the AEDs used to control seizures. Some AEDs have been associated with an increased risk of cleft lip and palate, neural tube defects, and heart defects.
  • Pregnancy can cause a change in the number of seizures. Most women with epilepsy will have no change in the number of seizures they experience or they will have fewer seizures during pregnancy. A few women will experience more seizures.

Controlling seizures during pregnancy is very important. Having a seizure during pregnancy can cause problems for you and your baby. Seizures during pregnancy can cause:

  • Decreased oxygen to the baby and fetal heart rate deceleration during the seizure.
  • Injury to the baby as a result of any falls or trauma experienced during the seizure. This can include premature separation of the placenta from the uterus (placental abruption) or miscarriage.
  • Preterm labor
  • Premature birth

Should you continue to take anti-seizure medications during pregnancy?

Many women with epilepsy are concerned about taking their AEDs during pregnancy. But according to ACOG, “Because there are serious risks associated with having a seizure during pregnancy and because the potential risk of harm to your baby from taking AEDs is small, experts recommend that seizures be controlled with AEDs, if necessary, during pregnancy. However, the type, amount, or number of AEDs that you take may need to change.”

Will you need any special care during your pregnancy?

One of the most important things that any woman can do to have a healthy pregnancy is to schedule a preconception checkup. If you have epilepsy, it is important to talk to your prenatal care provider as well as your neurologist prior to getting pregnant. Here are some other things to consider:

Before pregnancy:

  •  Review your seizure medications with both your prenatal provider and your neurologist. If changes need to be made, it is better to do this prior to getting pregnant.
  • Take a prenatal vitamin with folic acid. Talk to your health care team about how much folic acid is right for you.
  • Eat a healthy diet, get enough sleep, and avoid cigarettes, alcohol.

During pregnancy:

  • Plan for additional visits to your health care providers. Medication levels will need to be monitored to make sure they stay consistent.
  • Talk to a genetic counselor about prenatal testing.
  • Most women with a seizure disorder can have a vaginal birth.
  • Women with epilepsy are encouraged to breastfeed. Talk to your health care team.

If you have epilepsy, planning and working with your health care team can help to ensure that you have the healthiest pregnancy possible.

Questions?  Send them to AskUs@marchofdimes.org.

 

Schedule your well-woman checkup today

Monday, May 11th, 2015

nwhw-banner-toolsNational Women’s Health Week (NWHW) is as a time to help women understand what it means to be healthy and well.The goal is to get women to make their own health a top priority.

Today is National Women’s Checkup Day. It’s a day when women are encouraged to schedule their annual well-woman visit. If you are thinking about getting pregnant, it is a great time to schedule your preconception checkup.

What is a preconception checkup and why is it important?

A preconception checkup is a time to see your health care provider to help assure that you are as healthy as possible before you conceive. During this visit you and your provider can:
• Discuss your family history, family planning, and lifestyle habits, such as alcohol and tobacco use.
• Get or schedule necessary tests, such as screenings for blood pressure and diabetes.
• Set health goals, such as being active and maintaining a healthy weight.

It is important to schedule a checkup every year. Even if you’ve already had a baby, it is a good idea to see your provider if you are thinking about getting pregnant again. Thanks to the Affordable Care Act, it’s considered a preventive service and must be covered by most health plans at no cost to you.

So schedule your checkup today! For more information on National Women’s Health Week and to learn about other ways that you can get involved, visit their website.

Pregnancy in women with congenital heart disease

Monday, February 9th, 2015

heart and stethoscopeMost women who have congenital heart disease and decide to get pregnant will have a safe pregnancy with minimal risks. However, there are many factors that may need to be considered. During pregnancy, your heart has much more work to do. It has to beat faster and pump more blood to both the mother and the baby. If you are a woman who has congenital heart disease, then this extra stress on your heart may be a concern. Considering these issues before pregnancy and being prepared for potential complications can help you feel more confident and more in control throughout your pregnancy.

Preconception planning
The most important thing you can do if you are a woman with congenital heart disease is to talk to both your cardiologist and obstetrician before you get pregnant. This will allow you to understand what risks (if any) are involved for your pregnancy. You can also determine if there are any concerns with your heart that need to be fixed prior to pregnancy—for instance, do you need to alter any medications or have any surgical repairs? Doing all of this before pregnancy will allow you to make sure your heart and your overall health is ready for pregnancy.

Some medications carry a risk for birth defects. These include ACE inhibitors and blood thinners. Therefore, if you are taking these medications and want to have a baby, it is important to talk to your doctor about their safety and potential alternatives that may work for you. However, you should never stop taking any medications without your doctor’s approval.

You may also want to meet with a genetic counselor to review the risks of passing congenital heart disease on to your baby. This risk will vary depending on the cause of the heart disease.

Pregnancy
During pregnancy you and your doctors will want to minimize any risks for both you and your baby. You will need to have regular follow-ups with both your obstetrician and cardiologist. It is important that your doctors work together and coordinate your care. Some women will need to be followed by a maternal-fetal medicine specialist (an obstetrician who manages high-risk pregnancies).

Although most women with congenital heart disease have safe pregnancies, symptoms of heart disease can increase, especially during the second and third trimesters when the heart is working much harder. This may mean additional visits to both your cardiologist and obstetrician.

Typically if you have a personal or a family history of congenital heart disease, your obstetrician will offer you a fetal echocardiogram at around 18-20 weeks of pregnancy. This is a specialized ultrasound that allows your doctor to check out the anatomy of your baby’s heart and look for major structural changes. Not all heart defects can be identified through fetal echo though.

Delivery
It may surprise you to learn that most women with congenital heart disease can have a normal vaginal delivery. You and your doctor will want to discuss pain management options and have a plan in place. You may need additional monitoring both during and after delivery. This can include oxygen monitoring as well as EKGs (electrocardiogram—a test that checks for problems with the electrical activity of your heart).

If you have congenital heart disease work with both your obstetrician and cardiologist so that you can have the best outcome possible. As with most chronic medical conditions, planning for your pregnancy will allow you to make informed decisions about what is best for you and your baby.