Unintended Pregnancies

Did you know unintended pregnancies account for the majority of pregnancies in the United States?  The United States unintended pregnancy rate is higher than many other developing countries. Unintended pregnancies among the South and Southwest and densely populated states are the highest. In Tennessee, 56% of pregnancies are unintended.

An unintended pregnancy refers to a pregnancy that was mistimed or unwanted accounting for roughly 45% of all pregnancies. Mistimed pregnancies account for 27% of all pregnancies. A pregnancy that is considered mistimed is when a woman did not want to become pregnant at the time the pregnancy occurred but did want to become pregnant in the future. Also, 18% of pregnancies are unwanted; unwanted pregnancies are when a woman did not want to become pregnant then or anytime in the future. Most unintended pregnancies are a result of no use or improper or inconsistently use of contraceptives.

Poor and low-income women, women aged 18-24, cohabiting women and minority women have the highest rates of unintended pregnancy compared to women with higher incomes, white women, college graduates, and married women. An unexpected pregnancy does have not only a significant impact on the mother but also the father. A study reported the proportion of births fathers reported as unintended was four in 10 in 2006-2010. However, more than one in 10 men indicated they did not know about the pregnancy until after the child was born; and single men aware of the pregnancy reported three-fourths of the births resulted from an unintended pregnancy.

Unintended pregnancies nationwide were estimated to be $21.0 billion in 2010- $14.6 billion in federal expenditures and $6.4 billion in state expenditures. In 2010, Tennessee publicly funded 73.7% of unplanned births. On average Tennessee paid $416 per woman aged 15-44 in Tennessee compared with $201 per woman nationally. In 2014, publicly funded family planning centers in Tennessee helped prevent 27,100 unintended pregnancies in 2014.

Unintended pregnancies can are preventable. You can avoid an unexpected pregnancy by doing the following:

• Practice abstinence
• Use contraceptives

Women can use the following contraceptives:

• Condoms
• Diaphragm
• Oral Contraceptives
• Depo-Provera
• Implants (Implanon or Norplant)
• IUD’s (Paragard or Mirena)

The only contraceptive available for men is condoms.

Progesterone (17P) and the Benefits

Progesterone is a hormone which plays a vital role during pregnancy.  Early in pregnancy progesterone helps the uterus grow and keeps it from contracting. Later in the pregnancy progesterone helps a woman’s breast produce breast milk and also aid in delivering oxygen to the growing baby. Progesterone comes in two types of treatment vaginal progesterone and progesterone shots. Progesterone treatment is not for women who are pregnant with multiples such as twins or triplets.

Vaginal progesterone can help decrease the risk of premature birth if a woman has a short cervix and pregnant with one baby. Vaginal progesterone comes in a gel, a suppository, or a capsule.  This form of treatment can start as early as 24 weeks of pregnancy and can continue up to 37 weeks. There are no known side effects for the mother or baby.  Research on mothers and babies showed no increase in congenital disabilities or developmental problems in the first four years of life.

Progesterone shots aid in reducing the risk of premature birth if a woman had a premature birth previously and if a woman had a spontaneous premature birth before and were pregnant with one baby. Spontaneous refers to labor beginning on its own without any drugs, other methods, and the sac around the baby broke early.  Progesterone shots can start within 16-24 weeks of pregnancy and be given once a week until 37 weeks of pregnancy.  The injections are offered in two methods a brand drug called Makena and Prepared (also known as compounded) at select pharmacies. Prepared is only provided if a woman has certain health conditions such as an allergy.

Some insurance companies and state Medicaid programs have assistance for paying for the shots. In conclusion, progesterone shots do not always prevent premature birth and do not reduce a woman chance of giving birth early if the previous premature birth was not spontaneous. If interesting in learning more about progesterone treatments such as 17P consultant with a healthcare provider regarding safety, side effects, and to determine if progesterone treatments are right for you.

Preconception Health and Preconception Health Care Why it’s Important

What is preconception health? Preconception health is the health of women and men during their reproductive years, which are the years they can have a child. Preconception health focuses on the necessary steps to protect the health of a future baby. Getting and staying healthy is the primary focus of preconception health. Preconception health focuses on taking control of your life and living a life you are excited to live.

For those who plan to become pregnant, women should concentrate on preconception health as it will help decrease any health concerns and or issues when becoming pregnant or during pregnancy. Preconception health can reduce premature births, having a low birth weight, congenital disabilities or other disabling conditions.

Preconception health care is medical care that a woman or man receives from a physician or other health professionals.  It focuses on parts of the health which have been shown to increase their chances of having a healthy baby.  Preconception health care varies on the individual and allows the physician to suggest treatment and follow-up care.

 

Pregnancy and Exercise

Did you know that women who exercise regularly before pregnancy should be able to maintain their exercise routine to a certain degree during pregnancy?  Exercise does not increase the risk of a miscarriage. However, for women who plan to exercise during pregnancy should consult with their healthcare provider to discuss limitations of the types of exercise they should avoid.  Here are 12 exercise guidelines when pregnant:

1. If you are just starting to exercise to improve one’s health during pregnancy, you start slow and don’t over exert yourself.
2. Listen to the signals your body is spending,
3. Never exercise to feel exhausted or shortness of breath.
4. Wear shoes that provide comfort, strong ankle, and arch support.
5. Take frequent breaks and drink plenty of fluids.
6. Avoid exercising in extremely hot weather.
7. Avoid rocky and/or unstable ground when running or cycling.
8. Do not participate in contact sports.
9. Weight training should focus on toning.
10. Avoid exercise that involves lying flat on back during the second and third trimesters.
11. Incorporated relaxation and stretching before and after you exercise.
12. Maintain a healthy diet including fruits, vegetables, and complex carbohydrates.

Birth Spacing

What is birth spacing? Birth spacing is the act of waiting between pregnancies.  Women should wait at least 18 months before getting pregnant again to maintain the best health for her body and children.  The 18 month period is also referred to as birth spacing.  With pregnancies that occur less than 18 months, the body may not be ready to have a heathy baby.

When women do not wait at least 18 months between pregnancies, they increase their risk of a premature birth and low birth weight. Premature birth and low birth weight can increase the health risk for both mother and child. Also, premature birth and low birth weight are associated with infant mortality and short and long term complications.

Birth spacing can be accomplished by utilizing methods such as birth control, practice abstinence during ovulation, and use condoms.

Reference

Delaware Health and Social Services (2011). Birth Spacing.        Retrieved from http://www.dhss.delaware.gov/dhss/dph/files/birthspacingfaq.pdf

 

The Importance of Folic Acid

Folic Acid plays a vital role before and during pregnancy.  Folic acid is a form of folate which is a B vitamin. Everyone needs folic acid. Vitamins and fortified foods (bread, pasta, and cereals) contain folic acid.  Also, folate is found naturally in leafy green vegetables, oranges, and beans.

All women need 400 micrograms of folic acid every day. Pregnant women should intake 400 to 800 micrograms of folic acid. No one should get more than 1,000 micrograms of folic acid a day unless prescribed by a physician.  Obtaining too much folic acid can hide signs of a vitamin B12 deficiency, which can cause nerve damage.

African American and Mexican American women are at a higher risk of not getting enough folic acid each day. Folic acid protects unborn babies against severe congenital disabilities called neural tube defects.  Congenital disabilities usually occur within the first weeks of pregnancy, often before a woman knows she’s pregnant. Folic acid aids in the prevention of other congenital disabilities and miscarriages. Also, not getting enough folic acid can cause a woman to develop anemia also referred to as folate deficiency anemia.

Remember to get at least 400 to 800 micrograms of folic acid daily before, during, and after pregnancy.

Reference:

Office of Women’s Health, U.S Department of Health and Human Services (2017). Folic Acid. Retrieved from https://www.womenshealth.gov/a-z-topics/folic-acid

 

BECOMING A TEEN PARENT

Being a parent changes a teens’ life forever. About 750,000 teens become parents every year. Ninety percent of these are unplanned. Many teens are not ready  financially, mentally or physically. This may be because they’re still growing up themselves. Teenagers may be unsure where to get help or feel confident in discussing sudden changes in their lives.  As a teen parent , you face special challenges.  These may center around:  (1) Dealing with family and friends reactions. (2) Will they support you, be angry or disappointed. (3) Consider how you will raise a child (4) Will the mother and father share equal responsibilities. (4) You will need to be unselfish and prepare for another life. (5) Financial  problems may become a burden. A teenager can learn ways to deal with these challenges.   A responsible  teen parent can be successful. Success starts with  good prenatal care and eating healthy. Avoid harmful habits i.e. Smoking, using drugs or alcohol.  The expectant father can help by encouraging prenatal care and avoiding the same harmful habits as mom. Once the baby is born, keep your baby safe and healthy. Use approved Car seat safety and a safety strap. Breast feeding is recommended for the healthiest outcome of a newborn. Skin to Skin contact is essential. It’s important to bond, talk to and hold your baby.                            Teen pregnancy can bring on lots of stress. Find someone you trust to watch your baby –“Take a break!” Attend  to your emotional needs. Teen parents may have had goals for their lives. Once baby’s caregiving needs are secured. These goals can be attained.  Some may include completing their education, marriage and obtaining  gainful employment .      Parenthood may be the biggest change in life you will ever make.  Face the responsibilities– and enjoy the Rewards!

A “Loving Moment” to Engage Dads

I wonder how much do you know about the characteristics of first time dads/fathers. How does age factor into equation? Take short quiz to see how much you know about first-time dads/fathers. Write down your answers. You can find the correct answers at the end of this post

1. What is the average age for first-time dads? a.                                                            a. 25.3
   b. 26.0
   c. 26.7
   d. 27.8
   e. 28.2

 

2. The average age of first-time dads has risen steadily, while the average age for first-time moms has fallen recently.                                                                                  a. True                                                                                                                                              b. False

 

3. Compared to men who are married when they become first-time dads, how much younger (rounded to the nearest whole number) are men who are single when they become first-time dads?                                                                                      a. 5
   b. 6
   c. 8
   d. 9
   e. 10

 

4. Compared to men who have at least a bachelor’s degree when they become first-time dads, how much younger (rounded to the nearest whole number) are men who never graduated high school when they become first-time dads?        a. 4
   b. 5
   c. 6
   d. 7
   e. 8

 

I asked you to take that quiz to focus your attention on the “Golden Moment” to engage dads/fathers—the time before and immediately after a child’s birth. Dads and moms, including those, who are not married, are most highly motivated for the dad to be involved in their children’s lives during the prenatal and immediate postnatal period.

Countering resistance to dad’s involvement—whether on the part of dad or mom—is like pushing a boulder up a hill. In some cases, it can be impossible to overcome. In other cases, it can be overcome, but not without a lot of work and help from others to reach the other side of the hill.

Resistance is lowest during the Golden Moment. In some cases, it’s nonexistent because couples open their hearts as they anticipate and welcome their newborn. That’s why the use of tactics to reach dads during this time—such as through OB/GYNs, pediatricians, hospitals, birthing and pregnancy centers, and home visiting programs for new parents—prove so effective in the short and long term. Indeed, the long-term impact expands our understanding of why this moment is golden. When you connect a dad during this time, you increase the chance he’ll stay involved for the long haul.

To effectively reach dads during this time, arm yourself with research-based and evidence-informed tools that increase pro-fathering knowledge, attitudes, and skills.

Correct answers to the quiz: 1. (d) 2. (a) 3. (c) 4. (d)

 

Promoting A Healthy Pregnancy

Plan Ahead

Living healthy now means a better chance of a healthy pregnancy and baby later on. Pregnancy can happen even when precautions are practiced. You may be pregnant for weeks whether you planned for it. During that time, your choices can affect your baby’s health and development.

Set Personal Goals for Having /Not Having Kids

• Discuss goals w/ partner
• Next, talk with your health care provider

• Take steps to avoid an unplanned pregnancy
• At least 24 months between each pregnancy may be healthier for you
• Begin preparing for a healthy pregnancy 3 months before getting pregnant
• Eat right and Exercise Regularly
• In general at least 150 minutes of physical activity each week.
• Talk w/ your health care provider before starting an exercise regimen
• Folic acid and folate in your diet (whole grains, leafy greens, beans and citrus fruit
• These suggestions recommended before, during and after pregnancy.
• This practice can help prevent birth defects Stress, Anxiety and Depression all have negative effect on a pregnancy
• Stress can cause headaches and trouble sleeping
• Emotional Health

• High Stress may cause premature birth or low birth weight
• Depression before and after pregnancy can make self-care difficult for mom
• Symptoms vary -Loss of interest in daily routine, hopelessness, sadness and irritability.
• Depression can be treated successfully even during pregnancy
• Anxiety

• Anxiety disorders can worsen during and after pregnancy.
• High levels of anxiety can lead to premature birth and bonding issues.
• Inability to control your worry should be shared w/ health care provider
• Treatment or therapy can help

Hazards to Avoid

• Pregnant women can give lead poisoning to their babies If you suspect lead in your home, have paint, water and soil tested.

 

• • Avoid contact w/ paint, harsh cleaners, pesticides and solvents
  • Consult w/ health care provider for advice and reducing risks with radiation

• Cat Feces are harmful to unborn baby

 

• Avoid alcohol, tobacco, and other drugs which restrict oxygen and nourishment to your baby during and after pregnancy
• Get Help If You Need It

If you need help in stop using tobacco, alcohol or other drugs, consult your health care provider or Center for Substance Abuse Treatment’s Referral Service @ 1-800-662-HELP (1-800-662-4357).

HUGS? Have you Had YOUR ((HUG)) today?

Have you had your HUG today?

As we know there are many different kinds of hugs ranging from the polite hug to the never-ending rocking side to side embrace hug. And just as there are so many ways to hug there are endless reasons why hugs are wanted and needed. Today I want to share HUGS with you!

What is HUGS?

HUGS is                an Acronym which stands for Help Us Grow Successfully. HUGS is a home-based care coordination program developed by the Tennessee Department of Health. Home visitation provides a way to help to decrease infant mortality. The Shelby County Health Department HUGS program provides assessment of family needs, assistance to seek solutions for these needs, and also includes client centered education.

In an effort to reduce the infant mortality rate one of the specific focus areas for the HUGS program is educating families on the risk of Sudden Infant Death Syndrome (SIDS) by providing a safe sleep environment for infants.

Who qualifies for these services?

• Families living in Memphis and Shelby county
• Prenatal/postpartum women
• children through 5 years of age
• Parent/guardian of the client referred to the program.
• Families who have experienced the loss of a child less than 2 years old (due SIDS, prematurity, ETC) – grief counseling is provided…

How does the HUGS program help a family?

A health care professional is assigned to each family. These services are provided at no cost to the families. The care coordinator encourages a healthy pregnancy to promote positive birth outcomes. Families are assisted in accessing health care and other social and educational services. Attention is placed on enhancing family strengths. Education is provided regarding pregnancy, growth, development, and parenting education. Emphasis is placed on SIDS counseling and ways to decrease the risk of SIDS.

Who can I contact if I am interested in the program or to make a referral to HUGS?

Linda Busby, RN

HUGS Supervisor

Phone: 901-222-9703

Fax:  901-222-7976

Email- linda.busby@shelbycountytn.gov