Category Archives: Pregnancy
Every baby should have a chance to celebrate a healthy, happy first birthday. Unfortunately, that is not always the case. And that risk disproportionately affects people with lower income and people of color. This Infant Mortality Awareness Month, we can celebrate some progress in helping more babies reach that first milestone, according to health officials who shared successes at the Association of State and Territorial Health Officials (ASTHO) Annual Meeting in Orlando, Fla., this week.
>>Follow our ASTHO Annual Meeting coverage throughout the week.
“We are collectively moving forward in improving birth outcomes across the nation,” said David Lakey, MD, Commissioner of the Texas Department of State Health Services and former ASTHO president, who took on healthier babies as his President’s Challenge during his tenure. Lakey set out a goal of an 8 percent reduction in premature births by 2014.
“There is a high human cost of prematurity,” said Lakey, and that cost includes low birth weight, increased morbidity and mortality, and an impact on standardized test scores and other outcomes later in life for those who do survive. “Those who are born early have a much lower chance of having a healthy, happy first birthday.”
There is also an economic and societal cost of premature birth, the cost of which is largely paid for by Medicaid. Lakey said that 57 percent of all Texas births are paid for by Medicaid. Extreme preterm birth costs an average of $71,000—while a full-term birth costs an average of $420.
Each year, the March of Dimes National Communications Advisory Council, which includes journalists from many websites and magazines that cover pregnancy and early childhood, holds a reporters’ luncheon to share information that can lead to healthier births, babies and mothers. This year’s luncheon, being held tomorrow, focuses on treating mental health conditions in mothers during and after pregnancy. The issue is important for many reasons, in particular because many women have been taking prescription medications for depression, anxiety, panic attacks, ADHD, and other mental health issues since adolescence and may need to change or stop the medicines in order to have a healthy baby, yet run the risk of a relapse or worsening of their health condition.
NewPublicHealth recently spoke with, Siobhan Dolan, MD, a consultant to the March of Dimes and an obstetrician gynecologist and clinical geneticist at Montefiore Medical Center/Albert Einstein College of Medicine about communicating information about treating mental health during pregnancy to both mothers and health care professionals.
NPH: For the upcoming luncheon, the March of Dimes has singled out mental health medications. Why that area of health?
Dr. Dolan: There is a huge overlap between women of reproductive age who are dealing with becoming pregnant and having families and caring for families and women who have mental health issues and may be entering their reproductive years already on medication.
And we know that bonding and creating a family and getting your family life off to a good start in the early postpartum period is much, much better when a woman is in a balanced mental health state. So if there’s either a preexisting depression or a postpartum depression, we need to pay attention to that.
A study released this fall in the American Journal of Public Health looks at a critical evidence-based teen pregnancy prevention program led by the United Way of Greater Milwaukee. The United Way catalyzed critical partnerships between schools, community organizations and the Milwaukee Health Department to focus on the goal of reducing teen pregnancies.
In 2008, United Way of Greater Milwaukee, together with its partners, made a public commitment to reduce teen births among 15- to 17-year-olds by 46 percent by 2015. In October 2011, the City of Milwaukee and United Way announced the fourth consecutive yearly drop in the teen birth rate, by 13.5 percent, to its lowest level in decades. The current trend indicates that the partners are on track to reach their goal of 30 births per 1,000 (a 46 percent drop) by 2015.
Initiatives to support these goals include:
- Significant investments in programs through the Healthy Girls project that helps young people understand the consequences of teen pregnancy while also teaching them the skills needed to cope with social pressure to engage in sexual activity.
- A collaboration with the Medical College of Wisconsin and Children's Hospital of Wisconsin residents to develop content for a youth-focused, website, Baby Can Wait, with medically accurate and age-appropriate content on preventing pregnancy and promoting healthy relationships.
- United Way worked with Milwaukee Public Schools and other community leaders to revise human growth and development curriculum. Community members were given an opportunity to review the materials and make suggestions about content, and teachers received training in the new curriculum.
NewPublicHealth caught up with Nicole Angresano, Vice President at United Way of Greater Milwaukee, to get her take on the program’s successes and what other communities can learn from them.
NewPublicHealth: What is different about this effort to focus on teen pregnancy for your community?
Healthy Babies Minnesota is an umbrella of activities aimed at using prenatal and first-year initiatives to make Minnesotans healthier throughout their lives. NewPublicHealth spoke with Edward Ehlinger, MD, the state’s commissioner of health, about the program.
Today marks the start of the regional Infant Mortality Summit, kicking off a collaborative, multi-State initiative to improve infant health outcomes. NewPublicHealth will feature some innovative programs and initiatives to support healthy babies this week.
NewPublicHealth: What are key initiatives that make up Healthy Babies Minnesota?
Dr. Ehlinger: We have a lot of activities related to pregnancy, prenatal care, preconception care and early childhood care; and so we’re collaborating on all of those. We also have a Children’s Cabinet that’s focusing on early childhood growth and development. We’re also really focusing on adverse childhood experiences. We’re collecting information across the state on what’s happening to babies in the first year of life, adverse childhood experiences, to make sure that we prevent those or can intervene quickly. And we’re also really focusing on preconception care. Trying to make sure that women who are anticipating becoming pregnant will focus on all of the important issues—make sure their weight is normal, their blood sugars are under control, if necessary, that they’re not smoking, they’re not drinking.
NPH: And what is the next set of ideas for 2012?
Idea Gallery is a recurring editorial series on NewPublicHealth in which guest authors provide their perspective on issues affecting public health. Today, Jennifer L. Howse, PhD, president of the March of Dimes, comments on efforts to give more babies a healthier start in life. This week, a regional Infant Mortality Summit will kick off a collaborative, multi-State initiative to improve infant health outcomes. NewPublicHealth will feature some of the innovative programs and initiatives to support healthy babies.
A baby born in the United States today faces a one out of eight chance of being born too soon. Prematurity is a common, costly, serious and a largely silent health epidemic. The good news is that national, state and local health officials are addressing this problem with historic public health initiatives to give more babies a healthy start in life.
On Nov. 1, the United States received a grade of “C” on the March of Dimes 2011 Premature Birth Report Card. Preterm birth is the leading cause of newborn death. Babies who survive an early birth face an increased risk of serious life-long health challenges, such as breathing problems, cerebral palsy, or learning disabilities. Even babies born just a few weeks early have higher rates of hospitalization and illness than “full-term” infants (39-40 weeks of pregnancy). We’ve developed an educational campaign and a hospital-based toolkit to help parents and professionals better understand the critical importance of those last weeks of pregnancy to a baby’s health.
Although the U.S. preterm birth rate has improved slightly in recent years, nearly half a million infants still are born too soon. Each early birth places a terrible emotional toll on families and a financial burden on the health system. In fact, the first year health and medical costs of one preterm birth are nearly ten times more than a full term birth.
But, the problem hasn’t gone unheeded.
For the last few years, each annual meeting of the Association of State and Territorial Health Officials has kicked off a yearlong President’s Challenge that focuses on a particular health issue impacting all states. Judith Monroe, MD, now the director of the Office for State, Tribal, Local and Territorial Support at the Centers for Disease Control and Prevention used her Presidential Challenge in 2008 to highlight the need to “walk the talk” by promoting wellness in health department worksites.
In 2010 Paul Halverson, director of the Arkansas Department of Health, devoted his President’s Challenge to injury prevention, a topic prominent at this year’s ASTHO annual meeting as well. And last year John Auerbach, state health commissioner in Massachusetts and ASTHO’s outgoing president, made health equity his cornerstone initiative. The focus on these health issues has extended well beyond the challenge year and health officials continue to make them a priority.
For the 2011-2012 President’s Challenge, incoming president David Lakey, MD, commissioner of the Texas Department of Health, is focusing on healthy babies because too many are born too soon, often resulting in developmental and health issues that impact their entire lives.
NewPublicHealth spoke with Lakey about his President’s Challenge, why preventing preterm birth is such a critical issue and key partners across the country to help accomplish his goal to reduce prematurity in United States by 8 percent by 2014.
NPH: How did you come to focus on healthy babies for your President’s Challenge this year?
Lakey: About a year and a half ago when we were discussing the challenges that all of us were facing in the southern part of the United States, Regions 4 and 6, all of us brought up the challenge that we have with prematurity and infant mortality.
I guess the other part of my interest is my background. I’m an infectious disease physician but I did pediatric training and spent time helping to care for premature babies and the consequences that come with that, whether it was intellectual disability or problems with the lungs or other abnormalities.
So we saw this as an issue that we needed to put some focus on. It is also an area that has significant ethnic disparities. If you look at the rates in the African American community, they’re about twice as high as in other populations. And we also started to understand not only the human aspect but also the economic aspect that prematurity is a driver of our Medicaid budgets in our states. We can not only improve health outcomes and improve people’s lives but also do it in a way that saves money for the states and helps us drive our health costs in our system down.
NPH: What are some of the proven strategies for improving these health outcomes?
Just in time for World Breastfeeding Week, the American Academy of Pediatrics is launching their revised guide to breastfeeding, the first time the book has been updated in ten years. New information in the revised edition includes:
- New research on ways breastfeeding can help prevent childhood allergies and obesity
- New information on proper nutrition for nursing mothers, including vitamin, mineral, and supplement recommendations
- Q&A sidebars throughout the book to help moms, including how to adjust to breastfeeding at work
- How to establish a nursing routine
The editor of the revised edition, Joan Younger Meek, M.D., F.A.A.P., who is a pediatrician, registered dietician, and lactation consultant, is also a previous board member and past president of the Academy of Breastfeeding Medicine and chair of the U.S. Breastfeeding Committee (2008-2010.)
Heading into a very special Mother's Day weekend, NewPublicHealth pulled together some links and resources that celebrate Moms for everything they do to keep us healthy, wealthy and wise.
- National Women’s Health Week kicks off on Mother’s Day. The site offers save the date e-cards; free events throughout the country, including free gym passes; a resource list on health issues that most concern women; and a printable chart (PDF) with concise information on how frequently women need specific screening tests and vaccinations.
- Send free Mother’s Day e-cards from the Centers for Disease Control and Prevention that offer healthy behavior reminders.
- Check out these safe teen driving kits including a video and a pledge that teens can share with moms—and dads.
- Send mom this link to http://www.healthfinder.gov. The site, hosted by the Department of Health and Human Services, includes a podcast series on managing work and home life; online checkups; fitness logs and planners; and cool health widgets.
- Health-based phone apps makes great gifts.