Infections during Pregnancy

February is International Prenatal Infection Prevention Month. No one ever wants to acquire any kind of infection, but pregnant women especially want to avoid infection in order to protect themselves and their babies.

One of the more common infections in pregnancy is Group B Strep. Up to 25% of pregnant women may have it. Pregnant women are tested for it during their routine prenatal care between 35 and 37 weeks gestation. In pregnancies with a positive result, antibiotics are given during labor to prevent spread of the infection. It is important for everyone to be tested for Group B Strep during each pregnancy.

Many people have heard that pregnant women should avoid certain soft cheeses, some deli meats, and other foods. This is due to the risk of listeriosis, another infection that can occur in pregnancy. Foods that are contaminated by the bacteria listeria can cause listeriosis. These foods may include those mentioned above as well as hot dogs, sprouts (bean sprouts, for example), and unrefrigerated melon. For more information on listeriosis prevention and high risk foods, check the CDC website.

Most recently, Zika Virus has been a concern for pregnant women due to its potentially causing many problems during pregnancy and for babies. The best ways to protect oneself from Zika is to avoid areas where it is common (many Central and South American and Caribbean countries), to avoid exposure to mosquitoes, and to practice safe sex with any partner who could have been exposed to Zika.

For more information on Prenatal Infections, click here!

Working Together for Healthy Families and Healthy Babies

By Juanita White, Community Building Manager
Binghampton Development Corporation

I have the honor of belonging to a special group of women of all ages who get together at various times throughout the year. We make up reasons to get together but we really do it because we grew to enjoy each other’s company over the year. We like to get together and do “women things” and talk “women talk.”

One of the women revealed to us about three years ago that she had a miscarriage. She told us months after the incident so that we wouldn’t make a big deal out of it. That would make her sad, she told us, and we respected that. She lost the baby early in her pregnancy but as any woman who has ever been pregnant knows, loss hurts and loss of a baby, your own flesh and blood, hurts worse than anything. So we understood that she and her husband wanted to bear that pain in private, away from questioning, though caring, friends.

We had a luncheon together in late 2014 to celebrate the 50th birthday of one of the women in the group. We were all in high spirits, having a grand old time. Our friend, “Gloria” I’ll call her though that is not her name, joined us. Gloria celebrated with us but she was not her usual self. Oh yes, she laughed at the over-the-hill jokes and the gag gifts but those big, light brown doe eyes seemed a little sad to some of us. Nobody pried; we respect each other’s privacy. We sensed that something was wrong but assumed she was still grieving the loss and maybe getting pregnant was difficult. We didn’t know. We didn’t ask.

One day Gloria’s sister, a friend of mine, told me that Gloria did indeed get pregnant again but lost that child too. I was heartbroken; I know how much she wants to be a mother. Her sisters have children and she, being the youngest, wanted to start a family too. Gloria is young – 32 – so she was in her late 20’s when her body started betraying her, giving her false hopes of motherhood, only to snatch her dreams away.

There was some reason to be hopeful, her sister told me. Gloria and her gynecologist worked together to determine the root cause of the problem. Gloria has a small medical issue that would not keep her from carrying a child to term but they needed to find the right medical interventions to help her carry the baby to term. The doctor did some research, found another doctor to collaborate with her on Gloria’s particular issue, and decided upon a plan. Gloria was generally healthy-she ate right, drank a little, not too much, exercised a bit. (Hey, who can hit the gym five days a week? Well, great for you but….) Anyway, together the three formed a team and determined to see Gloria become a mother one day.

Long story short: Gloria and her husband became parents of a 7 lb. healthy baby boy in early 2016.  We hosted the “bluest” baby shower in Memphis and named ourselves  “The Godmothers.”

The story here is that healthy women have healthy babies. Doctors who work with their patients can help women prepare for a healthy full term birth. Good health care is important. Birth spacing matters.  Being stress-free is a MUST. Having supportive family and friends means everything.   In the end “A Healthy Pregnancy= A Healthy Baby.”

Prematurity Awareness Month

October is coming to a close, and November – Prematurity Awareness Month- is right around the corner. Premature birth is a leading cause of infant death in the United States.

Premature birth is defined as a birth occurring before 37 weeks gestation. Being born preterm can prevent many important fetal growth and developmental milestones for babies. Babies who are born preterm may spend significant amounts of time hospitalized in the NICU (neonatal intensive care unit), and they may face lifelong health and developmental problems.

In 2014, 1 in 10 babies born in the US were born premature. According to the CDC, many factors can contribute to preterm birth, including:

• Previous preterm birth
• Being pregnant with more than one baby (twins, triplets, or more)
• Problems with the uterus or cervix
• Chronic health problems in the mother, such as high blood pressure, diabetes, and clotting disorders
• Certain infections during pregnancy
• Cigarette smoking, alcohol use, or illegal drug use during pregnancy

For moms in Shelby County, there are resources for addressing some of these factors. 17P, a progesterone injection, is available for women who are at risk of preterm birth. The Shelby County Tobacco Prevention program can be helpful for moms who want to quit smoking. Additionally, any primary care physician or OBGYN can help mothers understand and assess their risks associated with preterm delivery and work towards having healthy and full-term pregnancies.

The March of Dimes has information regarding preterm birth and what you can do to help prevent it!

What’s Your Story?

Do you have a story you’d like to share about the importance of prenatal care? Have you been involved in a successful program and want to share your story? Do you belong to an organization in Shelby County that could benefit others to ensure their baby is healthy? We are looking for personal stories for the IMRI blog, and we’d like to feature you as a guest blogger! Send an email to ShelbycountyIMRI@gmail.com and someone from our team will be in contact with you.

Life Story Prenatal Care

Life Story Prenatal Care

By: Meredith Pace, RN, BSN, MA

Christ Community Health Services

While Shelby County may have one of the highest infant mortality rates and preterm delivery rates in the nation, behind every statistic is a unique story.
At Christ Community Health Services we value each of the stories behind the statistics and desire to provide excellent prenatal care to women as they live bravely as the main character in their lives. This is why we currently use the Life Story Prenatal Curriculum, a group prenatal visit model with a Christian perspective.

Through Life Story, pregnant women come together for group prenatal care visits and form a supportive community in this thrilling new chapter of their lives—motherhood. Women like Latasha* and Michelle, who became friends early on in their Life Story group and walked together through the fears related to first time pregnancy. Women like Maya, who looked to her Life Story group as a place for encouragement and belonging as she experienced pregnancy without the help of a partner, or Anna, who was inspired to pursue her nursing degree after acknowledging her hopes in Life Story.

Life Story group prenatal visits consist of 8-12 women with similar due dates. There are 10 total visits during the course of the pregnancy, starting in the 2nd trimester. Groups are led by consistent co-facilitators, at least one of whom is a licensed prenatal provider, and a respectful, open environment is cultivated to make sure every one’s voice is heard.

Life Story operates from the belief that our individual physical health is affected by the choices we make, which are influenced by what we think about ourselves and how we relate to God. This prenatal model seeks to provide care for women’s physical health as well as mental, emotional and spiritual health.
We tend to mental and emotional health as we help women see the unique story of their lives and create a safe space for them to share their story. Personal assessments completed by the women each week specifically address these elements of health and help them evaluate the roles they fill. We introduce pregnant moms to the new story beginning with their expected child and highlight that all of our life stories are a subplot of God’s larger story of love for His children.

Through this understanding of God’s love we provide spiritual care as we process the significance of God’s story, His saving work for all, and the threads of His work in each of our stories/lives. As we discuss our life stories, we point out the ability for all people to change their life story—to work towards their hopes through choices and a relationship with God. Each session also includes a story about a character in the Bible with struggles and hopes to which we all relate. The stories are told in a refreshing, simple way that is both entertaining and engaging.

The actual medical assessments are conducted one-on-one with each patient behind a privacy screen at the beginning of the session while the other mothers eat snacks, visit, and begin the activities. Health and medical information is shared through games and other participatory activities after the individual assessments are completed. For example, we talk about the physical changes experienced by a mom in pregnancy through an altered version of the game “Pictionary”. The women review the signs and symptoms of preterm labor with interactive models. And interesting visual aids are utilized when discussing healthy eating habits. Life Story also connects new moms with resources and community programs designed for their specific needs.

Behind every health statistic in Shelby County is an important story and a valuable life. Through the Life Story Prenatal Care Program, Christ Community Health Services is honoring the stories of the strong, wise, and gifted women throughout the city. We consider it a privilege to journey with them into the new chapter of motherhood and it’s through honoring these individual stories we hope to change the statistics.

*All patient names changed to protect privacy.

Christ Community Health Services is currently enrolling new mothers for the Life Story Prenatal Care program in multiple locations.

Please contact Meredith Pace, Program Coordinator  at meredith.pace@christchs.org or (901) 260-8511 if you would like more information.

What’s Your Story?

Do you have a story you’d like to share about the importance of prenatal care? Have you been involved in a successful program and want to share your story? Do you belong to an organization in Shelby County that could benefit others to ensure their baby is healthy? We are looking for personal stories for the IMRI blog, and we’d like to feature you as a guest blogger! Send an email to ShelbycountyIMRI@gmail.com and someone from our team will be in contact with you.

Decrease Your Risk of Preterm Birth

Decrease Your Risk of Preterm Birth

By

Rachel Heitman

Director of Injury Prevention, Infant Mortality Reduction and Death Review

Tennessee Department of Health

Did you know that 1 in 10 babies are born too early in Tennessee? In Memphis, 13.7% of all babies are born prematurely or before 37 weeks gestation. Preterm birth is one of the leading causes of infant mortality. When a baby is born prematurely, he/she might need special care in the hospital. The baby is also at risk for life long disabilities or death. Some steps that you can take to reduce your risk and improve your overall health when pregnant include:

1. Avoid alcohol and illicit drug use.

There is no safe level of alcohol use during pregnancy. Alcohol can affect the fetus throughout pregnancy. It is best not to drink at all while you are pregnant. If you did drink alcohol before you knew you were pregnant, you can reduce the risk of further harm to the baby by stopping drinking.
Illicit drug use includes use of any illegal drugs in addition to the use of prescription drugs for a nonmedical reason. Drug use can interfere with the growth of the fetus and cause preterm birth and fetal death.

2. If you smoke, STOP.

Cigarette smoke contains more than 4,000 chemicals. When you smoke during pregnancy, those chemicals build up in your blood stream, which is the source of oxygen and nutrients for your baby. If you need help with quitting, call the quit line at 1-800-QUIT-NOW (1-800-784-8669).

3. Get early prenatal care and attend all of your scheduled appointments.

Some of the largest risk factors for premature birth include high blood pressure, infections, abnormal uterus or cervix, and stress. By going to your provider early and often, these types of conditions can be tracked and monitored and possibly lead to preventing a preterm birth.
4. Learn the signs and symptoms of preterm labor.

The signs of preterm labor include pain in the belly, painful urination, decreased movement from the baby, backache, contractions, cramping, leaking fluid, increased abdominal pressure, increased vaginal discharge, vaginal bleeding, and fever. If you experience any of these symptoms, be sure to check in with your provider.

5. Ask your provider if you are a candidate for 17P.

If you have already had a preterm birth, you might be eligible for a medication called 17P. This medication is a weekly injection starting around the 16th week of pregnancy and continuing until 37 weeks pregnant. There are no known side effects for the baby. This medication has shown to lower the risk of delivering a preterm baby by as much as 33% for women that have had a previous preterm birth. If you would like more information about 17P, please talk to your OB provider.

6. Wait at least 18 months between pregnancies.

Take your time between pregnancies. Another high-risk factor for preterm birth is having less than 18 months between pregnancies. Infants conceived less than 6 months after giving birth have a 40% chance of being born premature. A longer time between pregnancies is important to help your body heal. To prevent pregnancy for at least 18 months, talk with your provider or local health department about birth control options. If you do become pregnant within this period, be sure to get early care from your provider.

7. Manage stress.

Increased stress puts you and your baby at risk for a preterm birth. Figure out what’s making you stressed and talk to your partner, a friend, family member or your health care provider about it.

8. Lead a healthy lifestyle before becoming pregnant.

If you are considering becoming pregnant, start your healthy lifestyle now. This includes exercising, eating healthy, taking a multivitamin, seeing your physician for a check-up, and getting any illnesses or chronic diseases under control
The following links provide more information on prematurity.

http://kidcentraltn.com/article/premature-babies

http://www.marchofdimes.org/premature-babies.aspx

http://www.acog.org/Womens-Health/Preterm-Premature-Labor-and-Birth

Zika Virus & Pregnancy

Zika Virus & Pregnancy

by

Ture Carlson and Tyler Zerwekh, DrPH

Shelby County Health Dept., Environmental Health Services Bureau

There has been a lot of news coverage on Zika virus the past couple months. Most of this media coverage has been based on a potential link between Zika virus and a congenital condition or birth defect called microcephaly.

Zika virus is not new. It was first discovered in 1947 in the Zika Forest, located near Entebbe, Uganda. In the following year, mosquitoes in the Zika Forest were found to be infected with the virus, and that was when it was thought to be a mosquito-transmitted virus. Research several years later confirmed this assumption.

In May of 2015 health authorities in Brazil reported cases of Zika in which the patients had no international travel history, indicating the virus was being locally transmitted. Local transmission means mosquitoes in that area are infected with Zika virus and are spreading it to people. In November of 2015, about six months after Zika was first detected, Brazilian authorities began to notice an increase of babies being born with below normal head sizes.

Microcephaly is a condition in which the head size remains small because the brain does not develop properly. Microcephaly has been associated with other infections like cytomegalovirus, chicken pox, and rubella if the mother has contracted them during pregnancy. Zika is just another potential infection an expecting mother may contract during pregnancy (in areas where there is risk of viral transmission).

It is important to note, current research demonstrates Zika virus has not been clinically proven to cause microcephaly. However, some evidence has led to concern for pregnant women living in or traveling to areas where Zika virus is actively circulating:

1. Increase in microcephaly where Zika is being detected
2. Increase in microcephaly started showing up about six months after Zika started being detected
3. Zika has been found in the amniotic fluid
4. Zika has also been found in the brain tissue of newborns with diagnosed microcephaly

Pregnant women planning to travel outside the U.S.A. should visit the U.S. Centers for Disease Control and Prevention’s website at http://wwwnc.cdc.gov/travel/notices to find out current health issues for their specific destination. Also any pregnant women returning from international travel should inform their physician about their travel history.

Currently, there is no available vaccine for Zika virus so it is important to take precautions and avoid contact with mosquitoes.

• Wear loose fitting long-sleeved shirts and long pants.
• Use EPA-registered insect repellents containing DEET, IR3535, picaridin, or oil of lemon eucalyptus. The U.S. Environmental Protection Agency does not recommend any additional precautions for repellent use by pregnant or nursing women. Use insect repellents as directed.
• Sleep and stay in air-conditioned and/or screened-in rooms.

Currently all of the cases of Zika virus being reported in the United States have been found in travelers returning from foreign countries. There is the potential for a traveler to return to Shelby County and infect the local mosquito population with Zika. In Shelby County there is one mosquito species out of the 48 different species currently known to be able to spread Zika to people, and that is the Asian Tiger mosquito.

Although the Asian Tiger mosquito can be found throughout Shelby County, it is more common in urban areas. It is a black mosquito with very visible white-sliver stripes on the legs and body. This mosquito has a couple of important behaviors.

1. It is active during the day. The Asian Tiger mosquito is one of the few mosquitoes that will try to bite people and animals during the day. Most mosquitoes will only be active at dusk and dawn.
2. Containers, Containers, Containers!!! The Asian Tiger mosquito will only lay eggs and grow in containers that can hold water. This includes but is not limited to tires, cans, buckets, gutters, bottle caps, and sometimes small ornamental ponds that are not working properly. The Asian Tiger mosquito will not lay its eggs or grow in large areas of standing water like swimming pools, flood plains, or ditches.
3. The Asian Tiger mosquito is active late April/ early May until late October. It will not be found during the winter months no matter how warm it may get.
4. The Asian Tiger mosquito does not fly far from where it developed. Odds are if it is biting you in your yard it came from your yard. It is very important, especially after a rain, to check your yard for anything holding water. Encourage your neighbors to do the same.

Healthy Eating Before, During and After Pregnancy

Healthy Eating Before, During and After Pregnancy

by Betty Marrero

Public Heath Coordinator- Chronic Disease

Shelby County Health Department

Maintaining a healthy lifestyle throughout pregnancy, as well as before and after, is key for both baby and mother. A healthy pregnancy actually begins before you become pregnant. It’s important to know how health conditions and risk factors can affect you or your unborn baby if you become pregnant. For example, some foods, habits, and medicines can harm your baby — even before he or she is conceived. Some health problems, such as diabetes, also can affect pregnancy. The five most important things you can do for preconception health are:

1. Take 400 to 800 micrograms (400 to 800 mcg or 0.4 to 0.8 mg) of folic acid every day if you are planning or capable of pregnancy to lower your risk of some birth defects of the brain and spine, including spina bifida.
2. Stop smoking and drinking alcohol.
3. If you have a medical condition, make sure it is under control. Some conditions that can affect pregnancy or be affected by it include asthma, diabetes, oral health, obesity, or epilepsy.
4. Talk to your doctor about any over-the-counter and prescription medicines you are using. These include dietary or herbal supplements.
5. Avoid contact with toxic substances or materials that could cause infection at work and at home. Stay away from chemicals and cat or rodent feces.

Important steps to a healthy pregnancy include eating a balanced diet; gaining the right amount of weight; enjoying regular physical activity; taking a vitamin and mineral supplement if recommended by a physician; and avoiding alcohol, tobacco and other harmful substances.

When you’re pregnant, what you eat and drink is the main source of nourishment for your baby. Eating well during pregnancy is more than simply increasing how much you eat. You must also consider what you eat.

A healthy diet includes proteins, carbohydrates, fats, vitamins, minerals, and plenty of water. The U.S. government publishes dietary guidelines that can help you determine how many servings of each kind of food to eat every day.

Scientists know that your diet can affect your baby’s health — even before you become pregnant. For example, recent research shows that folic acid helps prevent neural tube defects (including spina bifida) from occurring during the earliest stages of fetal development — so it’s important to consume plenty of it before you become pregnant and during the early weeks of your pregnancy.

Even though many foods, particularly breakfast cereals, are fortified with folic acid, doctors now encourage women to take folic acid supplements before and throughout pregnancy (especially for the first 28 days).

Calcium is another important nutrient. Because your growing baby’s calcium demands are high, you should increase your calcium consumption to prevent a loss of calcium from your own bones. Your best food sources of calcium are milk and other dairy products. However, if you have lactose intolerance or dislike milk and milk products, ask your doctor about a calcium supplement.

No level of alcohol consumption is considered safe during pregnancy. And although many doctors feel that one or two 6- to 8-ounce cups per day of coffee, tea, or soda with caffeine won’t harm your baby, it’s probably wise to avoid caffeine altogether if you can. High caffeine consumption has been linked to an increased risk of miscarriage and other problems, so limit your intake or switch to decaffeinated products.

Fish and shellfish can be a healthy part of your pregnancy diet because they contain beneficial omega-3 fatty acids and are high in protein and low in saturated fat. Some types of fish contain high levels of mercury, which can cause damage to the developing nervous system of a fetus. Almost all fish and shellfish contain small amounts of mercury, but you can safely eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury, such as salmon, shrimp, clams, Pollock, catfish, and tilapia.

As a new mom, or even if this is your second or third child, you’ll need plenty of energy to take care of baby. Choosing the right foods — fruits, vegetables, whole grains, lean protein and dairy — is especially important if you are breast-feeding. To ensure adequate milk supply, you’ll need to meet your energy needs and include essential nutrients in your diet. For most post-partum women, calorie intake should be in the 1,800 to 2,200 range with an extra 300 to 400 calories more per day while lactating, depending on how much milk the mother is producing.

6 Tips for Mom’s Healthy Meal Plan

• Don’t skip meals.
• Drink at least 6 to 8 glasses of water. If breast-feeding, get into the habit of filling a tall glass of water to keep with you all day.
• You need 1,000 milligrams of calcium daily. You can get this easily by consuming three servings of low-fat or fat-free dairy throughout the day.
• Consume at least 2 cups of fruits and 2½ cups of vegetables.
• Include protein at each meal.

For more information, follow these links:

http://www.familydoctor.org

http://www.womenshealth.gov

http://www.usda.gov

http://www.medplus.com

Merry Christmas Baby Community Baby Shower

On Saturday, December 12, 2015, Tennessee State Rep. G.A. Hardaway Sr. will host the Merry Christmas Baby Community Baby Show from 10am to 2pm at Orange Mound Community Center. Part of the fight against infant mortality, this event celebrates our youngest citizens. We expect 150-200 expectant and new mothers and fathers to come out. The registration site for parents and parents-to-be is https://mxb-community-baby-shower.eventbrite.com. The email address for registration is merryxmasbaby901@gmail.com.

Merry Christmas Baby Community Baby Shower
Saturday, December 12, 2015 – 10:00 a.m.-2:00 p.m.
Orange Mound Community Center
2572 Park Avenue, Memphis, TN 38114