Posts Tagged ‘preconception checkup’

Pregnancy loss: Will it happen again?

Friday, March 9th, 2018

The loss of a pregnancy or a baby is one of the most difficult experiences. Whether you had a miscarriage, stillbirth or your baby died soon after birth, it’s normal to have mixed feelings about a future pregnancy. Some women may want to start trying getting pregnant as soon as possible, while others may prefer to wait. Will it happen again? – is a common question many women ask themselves when thinking about getting pregnant again.

Trying to get pregnant again after a baby’s death may be really stressful for you. Here are few things you can do:

  • Share your feelings with your partner about getting pregnant again. Your partner may feel differently about getting pregnant again, but you and your partner are the only ones who can decide what’s right for you.
  • Try to be hopeful. Remind yourself that every pregnancy and baby are different. Just because you’ve had a baby die doesn’t mean it will happen in your next pregnancy.
  • If you work, talk to your boss about how to reduce the stress at your job.
  • Talk to your provider or a counselor about ways you can reduce stress.
  • Go to your preconception checkup to make sure you’re healthy. Being healthy when you get pregnant can help you have a healthy pregnancy.
  • Eat healthy foods, drink lots of water and do something active every day. Try to get a full night’s sleep.
  • Don’t smoke, drink alcohol or use harmful drugs.

How long to wait before getting pregnant again?

For most women, it’s best to wait at least 18 months (1½ years) from the end of one pregnancy before getting pregnant again. This gives your body enough time to recover before your next pregnancy.

Not all women can wait 18 months between pregnancies. Talk to your provider about how long to wait between pregnancies if:

  • You’re older than 35.
  • You’ve had a miscarriage or stillbirth. Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy. Stillbirth is when a baby dies in the womb after 20 weeks of pregnancy.

When you’re ready to try again

The best thing you can do to help you have a healthy pregnancy next time is to take good care of yourself. Before your next pregnancy:

  • Get a preconception checkup. This is a medical checkup you get before pregnancy to help make sure you’re healthy when you get pregnant.
  • Take a vitamin supplement every day with 400 micrograms of folic acid in it. Folic acid is a vitamin that every cell in your body needs for healthy growth and development. If you take it before pregnancy and during early pregnancy, it can help protect your baby from birth defects of the brain and spine called neural tube defects, birth defects of the mouth called cleft lip and palate and some heart defects.
  • Get to a healthy weight. Eat healthy foods and do something active every day. Talk to your provider about the right weight for you.
  • Don’t smoke, drink alcohol or use harmful drugs. Talk to your provider if you need help to quit.

For more information

  • From hurt to healing (free booklet from the March of Dimes for grieving parents)
  • Share Your Story (March of Dimes online community for families to share experiences with prematurity, birth defects or loss)

Weight gain and pregnancy: what’s right for you

Monday, February 26th, 2018

Gaining the right amount of weight during pregnancy is important. It can help protect your health and the health of your baby.

Why is weight gain during pregnancy important?

If you gain too little weight during pregnancy, you’re more likely than other women to have a premature baby or a baby with low birthweight.

If you gain too much weight during pregnancy, you’re more likely than other women to:

  • Have a premature baby. Premature babies may have health problems at birth and later in life.
  • Have a baby with fetal macrosomia. This is when your baby is born weighing more than 8 pounds, 13 ounces. Having a baby this large can cause complications, like problems during labor and heavy bleeding after birth.
  • Need a c-section.
  • Have trouble losing weight after your baby’s birth. This can increase your risk for health conditions like diabetes and high blood pressure.

How much weight should you gain during pregnancy?

This depends on your health and your body mass index (also called BMI) before you get pregnant. BMI is a measure of body fat based on your height and weight. To find out your BMI, go to www.cdc.gov/bmi. Your provider will use your BMI before pregnancy to determine how much weight you should gain during pregnancy.

In general, if you’re pregnant with one baby:

  • If you were underweight before pregnancy, you want to gain about 28 to 40 pounds during pregnancy.
  • If you were at a healthy weight before pregnancy, you want to gain about 25 to 35 pounds during pregnancy.
  • If you were overweight before pregnancy, you want to gain about 15 to 25 pounds during pregnancy.
  • If you were obese before pregnancy, you want to gain about 11 to 20 pounds during pregnancy.

If you’re overweight or obese and are gaining less than the recommended amounts, talk to your provider. If your baby is still growing well, your weight gain may be fine.

Gaining weight slowly and steadily is best. Don’t worry too much if you don’t gain any weight in the first trimester, or if you gain a little more or a little less than you think you should in any week. You may have some growth spurts—this is when you gain several pounds in a short time and then level off. Don’t ever try to lose weight during pregnancy.

Just thinking about getting pregnant?

If you’re thinking about getting pregnant, remember that it’s best to start your pregnancy at a healthy weight. You can make sure you’re at a healthy weight at your well-woman checkup (which can also be your preconception checkup). Did you know that your well-woman checkup is a preventive service and is covered by most insurance plans with no extra costs to you? Learn more about recommended preventive services that are covered under the Affordable Care Act at Care Women Deserve.

Get vaccinated before you get pregnant

Wednesday, January 17th, 2018

If you are planning a pregnancy, it is very important to make sure that you are up-to-date on all of your vaccinations. Vaccinations help protect you from infection and you pass this protection to your baby during pregnancy. This helps keep your baby safe during the first few months of life until he gets his own vaccinations.

Why do adults need vaccinations?

You probably got vaccinations as a child, but they don’t all protect you your whole life. Over time, some childhood vaccinations stop working, so you may need what’s called a booster shot as an adult. And there may be new vaccinations that weren’t available when you were young. Talk to your provider to make sure you’re fully protected with vaccinations.

What vaccinations do you need before pregnancy?

Before you get pregnant, you should make sure that you are up-to-date on all your routine adult vaccinations, including:

  • 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. If you come down with the flu during pregnancy, you’re more likely than other adults to have serious complications, such as pneumonia.
  • HPV. 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. This vaccine protects you against the measles, mumps and rubella.
  • Varicella. Chickenpox is an infection that causes itchy skin, rash and fever. It’s easily spread and can cause birth defects if you get it during pregnancy. It’s also very dangerous to a baby. If you’re thinking about getting pregnant and you never had the chickenpox or the vaccine, tell your provider.

There are some vaccines that are not safe to get during pregnancy, so make sure you get them before you get pregnant. Once you get these vaccinations, you should wait at least one month before you try to get pregnant.

  • BCG (for tuberculosis)
  • Meningococcal
  • MMR
  • Typhoid
  • Varicella

If you’re thinking about getting pregnant, schedule a preconception checkup, so your health care provider can make sure you are up-to-date with all of your vaccinations.

And if you just had a baby, it’s a good time to get caught up on any vaccinations that you missed before or during pregnancy. This can help protect you from diseases in future pregnancies. If you’re breastfeeding, it’s safe for you to get routine adult vaccines. Ask your health care provider if you have questions.

Thinking about pregnancy after premature birth

Wednesday, November 8th, 2017

Even if you do everything right, you can still have a premature birth. We don’t always know what causes premature birth, but we do know that if you’ve had a premature baby in the past, you’re at increased risk of having a premature birth in another pregnancy. If you have given birth early, here are some ways you may be able to reduce the chances of premature birth in another pregnancy:

Wait 18 months between giving birth and getting pregnant again

Waiting at least 18 months between pregnancies gives your body time to recover from one pregnancy so that is it ready for the next one. Use birth control so you don’t get pregnant again too soon. Talk to your provider about the best birth control option for you.

Schedule a preconception checkup

Being as healthy as possible when you get pregnant can help you have a healthy, full-term pregnancy. At your preconception checkup you and your provider can talk about:

Talk to your provider about progesterone shots

Progesterone is a hormone that helps your uterus grow and keeps it from having contractions. Progesterone shots may help prevent you from giving birth early again if:

  • You’re pregnant with just one baby.
  • You were pregnant before with just one baby and had spontaneous premature birth.

Get treatment for short cervix

Your cervix is the opening to the uterus that sits at the top of the vagina. The cervix opens, shortens and gets thinner and softer so your baby can pass through the birth canal during labor and birth. Having a short cervix increases your risk for giving birth early. Talk to your provider about cerclage and vaginal progesterone.

Take low dose aspirin to help prevent preeclampsia

Preeclampsia is a kind of high blood pressure some women get after the 20th week of pregnancy or after giving birth. If not treated, it can cause serious problems during pregnancy, including premature birth. If you have risk factors for preeclampsia, like you’ve had it before or you have high blood pressure or other health conditions, your provider may want you to take low-dose aspirin during pregnancy.

Quit smoking, drinking alcohol, using street drugs and misusing prescription drugs.

All of these can put your health and your baby’s health at risk and make you more likely to give birth early. Quitting or getting help to quit is the best thing you can do. Talk to your provider about programs that can help.

Learn the signs of preterm labor

Learning the signs and symptoms of preterm labor doesn’t reduce your risk of premature birth. But if you know them and know what to do if you have them, you can get treatment quickly that may help stop your labor. If you have any signs or symptoms of preterm labor, call your provider right away or go to the hospital.

Prenatal health and nutrition start before pregnancy

Friday, September 22nd, 2017

Today’s guest post is written by Donna Dell of Mission Pharmacal on the findings of a survey, conducted in part by March of Dimes, on the importance of taking folic acid before and during pregnancy.

Did you know that taking multivitamins or vitamins containing folic acid is an important component for a healthy mom and baby?

A recent survey conducted by the March of Dimes, in partnership with Mission Pharmacal, showed that only 34 percent of women ages 18-45 started taking a prenatal vitamin or multivitamin before they knew they were pregnant, and the number drops to 27 percent for Hispanic women and to 10 percent for African-American/black women.

Taking a multivitamin containing folic acid every day before and during pregnancy can help prevent serious birth defects of the brain and spine, also called neural tube defects. More than 120,000 babies — or three percent of all births — will be born with birth defects in the U.S. this year.

Here are some other key findings from the survey:

  • While, 97% of women reported taking prenatal vitamins or multivitamins during their last or current pregnancy, 36% of women of childbearing age said they are currently not taking any vitamin or mineral supplements at all.
  • 77% of all women worry that there may be changes to the healthcare system that may negatively impact access to prenatal care.
  • 43% of women who have been or are currently pregnant reported that cost affected when and whether they sought prenatal care for their pregnancy.
  • 84% of women who reported being familiar with folic acid either didn’t know (59%) or weren’t sure of the recommended amount of the nutrient is needed, in order to help have a healthy baby or pregnancy.

So, what are some steps you can take to support a healthy pregnancy and a healthy baby?

  • Take a multivitamin or prenatal vitamin containing at least 400 micro-grams (mcg) of folic acid every day before pregnancy to help prevent serious birth defects.
  • If you’re thinking of having a baby, see your health care provider for a preconception checkup and talk about prescription or over-the-counter vitamins.
  • Once you are pregnant, keep getting your folic acid by taking a prenatal vitamin every day containing 600 mcg.
  • Iron, calcium, vitamin D, DHA and iodine have also been found to play a key role in a baby’s growth and development during pregnancy.
  • Folic acid comes in different forms other than vitamins. Look for the words “fortified” or “enriched” on the package label of foods such as bread, breakfast cereal, flour, pasta, and products made from corn masa, and white rice.
  • Don’t smoke or drink alcohol, and stay up-to-date on vaccines.

Please visit marchofdimes.org for the latest health information, resources and tools for moms and babies.

What vaccines do you need before, during, and after pregnancy?

Wednesday, August 16th, 2017

If you are pregnant or planning a pregnancy, it is very important to make sure that you are up-to-date on all of your vaccinations. Vaccines help protect you from infection and you pass this protection to your baby during pregnancy. This helps keep your baby safe during the first few months of life until he gets his own vaccinations.

Before pregnancy

These vaccines are recommended before you get pregnant:

  • 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. If you come down with the flu during pregnancy, you’re more likely than other adults to have serious complications, such as pneumonia.
  • HPV. 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. This vaccine protects you against the measles, mumps and rubella.
  • Varicella. Chickenpox is an infection that causes itchy skin, rash and fever. It’s easily spread and can cause birth defects if you get it during pregnancy. It’s also very dangerous to a baby. If you’re thinking about getting pregnant and you never had the chickenpox or the vaccine, tell your provider.

If you’re thinking about getting pregnant, schedule a preconception checkup, so your provider can make sure you are up-to-date with all of your vaccinations.

During pregnancy

The Centers for Disease Control and Prevention (CDC) recommends two vaccinations during pregnancy:

  1. Flu shot if you didn’t get one before pregnancy. The flu mist isn’t safe to use during pregnancy.
  2. Tdap vaccine during each pregnancy at 27 to 36 weeks. The Tdap vaccine prevents pertussis (also called whooping cough). Pertussis is easily spread and very dangerous for a baby.

Not all vaccinations are safe to get during pregnancy. Talk to your health care provider to make sure any vaccination you get is safe.

After pregnancy

If you haven’t caught up on vaccinations before or during pregnancy, do it after your baby’s born.

If you didn’t get the Tdap vaccine during pregnancy, make sure to get it right after you give birth. Getting the Tdap vaccine soon after giving birth prevents you from getting pertussis and passing it on to your baby. Your baby should get his first pertussis vaccine at 2 months old.

Until your baby gets his first pertussis shot, the best way to protect him is to get the vaccine yourself and keep him away from people who may have the illness. Caregivers, close friends and relatives who spend time with your baby should also get a Tdap vaccine at least 2 weeks before meeting your baby. Babies may not be fully protected until they’ve had three doses of the Tdap vaccine.

If you’re breastfeeding, it’s safe to get routine adult vaccines, but ask your provider if you have concerns.

Have questions? Send them AskUs@marchofdimes.org.

What are cleft lip and cleft palate?

Friday, July 7th, 2017

cleft lipCleft lip and cleft palate occur when a baby’s lip or mouth do not form completely during pregnancy. A cleft lip is an opening in a baby’s upper lip. Cleft palate occurs when a baby’s palate (the roof of the mouth) has an opening in it. About 2,650 babies are born with a cleft palate and 4,440 babies are born with a cleft lip with or without a cleft palate each year in the United States.

What causes cleft lip and cleft palate?

Cleft lip and palate happen very early in pregnancy. Your baby’s lips form between 4 and 7 weeks of pregnancy, and the palate forms between 6 and 9 weeks of pregnancy. Oral clefts don’t have to happen together—a baby can have one without the other.

We’re not sure what causes cleft lip and cleft palate. They may be caused by a combination of factors, like genes and things in your environment, such as medicines you may take. Some risk factors include:

  • Smoking.
  • Diabetes. If you have diabetes before pregnancy, you have an increased risk of having a baby with a cleft lip with or without cleft palate, compared to women who do not have diabetes.
  • Taking certain medicines. If you have epilepsy and take anti-seizure medicines (like topiramate or valproic acid) during the first trimester, you’re more likely to have a baby with cleft lip (with or without cleft palate) than women who don’t take these medicines.

How are cleft lip and cleft palate treated?

In most cases, surgery is needed. Each baby is unique, but surgery to repair cleft lip usually is done at 10 to 12 weeks of age. Surgery for cleft palate is done between 9 and 18 months of age. Children who have a cleft lip or palate may need services such as speech therapy and special dental care as they get older.

Can cleft lip and cleft palate be prevented?

These conditions cannot always be prevented. But here are some things you can do to reduce the chance of your baby having a cleft:

  • Take folic acid. Before pregnancy, take a multivitamin with 400 micrograms of folic acid in it every day. During pregnancy, take a prenatal vitamin with 600 micrograms of folic acid in it every day.
  • Don’t smoke or drink alcohol.
  • Get a preconception checkup.
  • Get to a healthy weight before pregnancy and talk to your provider about gaining a healthy amount of weight during pregnancy.
  • Talk to your provider to make sure any medicine you take is safe during pregnancy. Don’t stop taking any medicine without talking to your provider first.
  • Get early and regular prenatal care.
  • Protect yourself from infections. Make sure all your vaccinations are up to date, especially for rubella. Wash your hands often.

You can learn more about cleft lip and cleft palate on our website.

Knowing your family health history may help your baby

Wednesday, November 18th, 2015

Family at Thanksgiving dinnerRecently I had an appointment with a new healthcare provider and had to complete a health history form at my first visit. It was 3 pages long and took me about 20 minutes to do while in the waiting room. As I was sitting there, I realized that I didn’t know the answers to some of the questions, especially about my relatives.

Was this really that important?

In one word? Yes.

A family health history (FHH) form is a record of health conditions and treatments that you, your sisters, brothers, parents, aunts, uncles, grandparents and great grandparents have had. It can help you figure out the medical problems that run in your family. Knowing your FHH may just save your life. It may also have a direct effect on your baby’s health.

How can a FHH form help your baby?

The FHH form will help your provider see if any of the conditions or diseases that run in your family will affect your baby. For example, premature birth can run in families. And, certain conditions such as diabetes or high blood pressure put you at a higher risk to have a premature baby.

If you and your partner complete a FHH form and share it with your prenatal provider, you may learn about the health of your baby before she is born. The earlier in your pregnancy that your provider is aware of health conditions, the sooner your provider can decide on treatments for you.

It would be even better if you could complete and share this information with your provider before pregnancy, at a preconception checkup. This way, your provider can help you become as healthy as possible before pregnancy.

Use our FHH form

Here is a form that you can print out and complete.  Print one copy for yourself and one for your partner/spouse. We suggest you take it with you to family gatherings (Thanksgiving anyone?) and ask your relatives to help you fill in the blanks. You may very well find out information about diseases and conditions that run in your family and put you at risk. Early detection is often key in successfully managing a disease.

Here are tips on how to gather information from relatives.

Knowing your risk for certain conditions and that your provider is on top of treatment options, should put your mind at rest. And, knowing you are doing your best to take care of your baby’s health should make you feel even better.

So, when you sit down to apple pie, start a conversation, and fill in your FHH form. The information you share with your family may make a positive difference in everyone’s lives.

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

How can we prevent birth defects?

Friday, January 30th, 2015

speak to your health care providerBirth defects are common, costly, and critical.
Common: Every 4 ½ minutes in the United States, a baby is born with a birth defect.
Costly: Hospital costs for children and adults with birth defects exceeds $2.6 billion. That does not include outpatient expenses.
Critical: Birth defects cause 1 in every 5 deaths during the first year of life. They can result in lifelong challenges and disabilities.

As Birth Defects Prevention Month draws to a close, let’s recap what we know and look at steps that can be taken to prevent them.

Preconception and pregnancy planning
We know that it essential for a woman to take an active role in planning her pregnancy.  If you are thinking of having a baby or if you may want to have children sometime in the future, it is important to make a PACT: plan ahead, avoid harmful substances, choose a healthy lifestyle, and talk to your doctor. You can read more here.

Changing a few behaviors now can make a big difference when you are ready to have a baby. It is best to get any preexisting medical conditions, such as diabetes and high blood pressure, under control before pregnancy. Some medications, such as opioid-based prescription pain medications, are not safe to use when you are pregnant. All of these concerns can be discussed with your doctor during a preconception checkup.

Folic acid fortification
It is well known that taking 400 micrograms of folic acid every day can help to reduce the risk of neural tube defects or NTDs (disorders of the brain and spine). Since the US mandated folic acid fortification of enriched cereal grain products in 1998, the rates of NTDs have decreased by 35%.  That means that there are 1,300 fewer NTDs each year as a result of fortification. And that translates into an annual cost savings of approximately $508 million.

Surveillance
State surveillance systems record the number of babies born with a birth defect each year. The information gained from these surveillance systems furthers research on the causes of birth defects. The data also helps researchers to better understand which populations are at highest risk for specific birth defects. This information can then be used by public health professionals, policymakers, and health care providers to implement prevention strategies.

Research
The March of Dimes is funding research to understand the causes of birth defects and to develop new ways to prevent and treat them. Some March of Dimes grantees are studying basic biological processes of development. A more advanced look at the process of development will help reveal what can go wrong along the way. Others researchers are conducting clinical studies aimed at finding ways to prevent or treat specific birth defects.

Birth Defects Prevention Month may be coming to an end, but there is still a lot of work to do. Go to the National Birth Defects Prevention Network to learn more.

Are you ready to have another baby?

Friday, December 12th, 2014

pregnant woman and toddlerEveryone has a different opinion about how far apart in age their children should be. Some people like to have their babies very close together, while others like a little more time between each child. But there may be more to consider than just personal preference. A recent study found that women who wait less than 18 months between pregnancies are more likely to give birth before 39 weeks.

The study found that mothers who had less time between pregnancies were more likely to give birth before 39 weeks when compared to women whose pregnancies were 18 months apart or more. Women with pregnancy intervals of less than 12 months were more than twice as likely to give birth prematurely (before 37 weeks) when compared to women whose pregnancies were at least 18 months apart.

“Short interpregnancy interval is a known risk factor for preterm birth, however, this new research shows that inadequate birth spacing is associated with shorter overall pregnancy duration” states  Emily DeFranco, Assistant Professor of Maternal-Fetal Medicine at the University of Cincinnati College of Medicine in Ohio and the Center for Prevention of Preterm Birth at Cincinnati Children’s Hospital Medical Center, and co-author of the study. She adds: “This study has potential clinical impact on reducing the overall rate of preterm birth across the world through counselling women on the importance of adequate birth spacing, especially focusing on women known to be at inherently high risk for preterm birth.”

So if you are thinking about having another baby, make sure you schedule a preconception checkup with your health care provider.  The two of you can discuss any health concerns you may have as well as the time between your pregnancies.  Also, if you have had a premature baby in the past, make sure you discuss ways to reduce your risk of having another premature birth.