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Pregnant Women

 A baby born prior to week 37 of gestation is considered premature. 

  •   Late preterm: between 34 and 36 completed weeks of pregnancy 

  •   Moderately preterm: Between 32 and34 weeks of pregnancy

  •   Very preterm: Born less than 32 weeks of pregnancy

  •   Extremely preterm: Before 25 weeks of pregnancy

Info About Risk Factors

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  • ​Delivering a premature baby in the past

  • Being pregnant with multiples (e.g., twins, triplets)

  • Tobacco: For more info -  www.momsquit.com

  • Substance abuse 

  • Short time (less than 18 months) between pregnancies

  • African-American/Black ethnicity        

  • Body size

  • Cocaine use

  • Infection

  • Minimal prenatal care

  • Physical exertion

  • Psychological stress

  • Short cervixes

  • Socioeconomic status

 
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 Unlimited sessions for help in non-judgmental, supportive ways to quit smoking and to remain tobacco-free

Working with a Quit Coach can double your chances of

quitting

 

Free, confidential quit services found in your community or by phone 

 
 

Impact and Complications For Baby

  • Respiratory distress syndrome

  • Brain hemorrhage

  • Jaundice

  • Infections

Short Term

  • Chronic lung disease

  • Symptoms of anxiety and depression

  • Attention, visual memory

  • Planning, problem solving, inhibition

  • Multitasking and mental flexibility

Long Term

 

African American/Black High Risk

  • Health related conditions

  • Racism

  • Stressors

  • Unhealthy behaviors

  • Physical isolation

  • Living in violent neighborhoods

  • Lack of social support

 

Warning Signs

  • Contractions that makes your belly tighten like a fist every 10 minutes or more

  • Change in vaginal discharge (increase amount or leaking fluid or bleeding)

  • Pelvic pressure, like your baby is pushing down

  • Constant low, dull backache

  • Abdominal cramps with or without diarrhea

  • Your water breaks

If You Have Signs, Talk To Provider

  • If you have even one warning sign, talk to provider immediately

  • If you can’t reach your provider, go to the Emergency Department

  • Be sure to give a report of all of your signs and symptoms, including any contractions that you're having, how long they last and how far apart they are.

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Complication/Infant Mortality

High Blood Pressure/Hypertension
Gestational Diabetes
Infections
Preeclampsia
Pregnancy Loss/Miscarriage
Stillbirth
Anemia
Blood Clots
Short Cervix
Placenta Previa
Placential Abruption
Preterm Labor
 

Infant Mortality

Infant mortality is the death of an infant prior to age one.  In 2017, the rate of infant mortality in the United States was 5.8 deaths per 1,000 live births.  In New Jersey, the rate of infant mortality was lower, at a rate of 4.5 deaths per 1,000 live births. 

What Causes Infant Mortality?

The leading causes of infant mortality are:

  • Birth defects

  • Low birth weight

  • Pregnancy complications

  • Sudden infant death syndrome (SIDS)

  • Injuries

There are several factors associated with infant mortality, including socioeconomic status, race, maternal age, nutrition, lack of prenatal care and substance use during pregnancy including alcohol and nicotine. 

Maternal smoking increases the risk for babies to be born premature, have low birth weight and sudden infant death syndrome (SIDS).  Quitting smoking early in a pregnancy is the best thing a mother can do to help reduce these risks.

 

Race is another factor that has shown to impact infant mortality rates.  African American/Black women are at an increased risk compared to non-Hispanic whites.  In fact, African American/Black women have 2.3 times the infant mortality rate as non-Hispanic whites.  In addition, African American/Black infants are 3.8 times as likely to die from complications of low birthweight.

 

How To Get Help From Family And Friends

Currently Pregnant

If you are currently pregnant, now is the time to begin building your support system.

  • Think about which family and friends you currently have that will be helpful during your pregnancy, with labor and delivery, and supporting you after birth.

  • Create a birth plan and share it with your partner, family, friends, and/or doula. Discuss how they can help you advocate for what you want during labor and delivery and who will be available after the birth to help you.

  • Ask for help gathering supplies you and the baby will need. Are there people you know who have recently had a baby that can donate their clothes and baby items to you?

  • Identify places in the community and online that can be an additional source of support (centering groups for prenatal care, childbirth and breastfeeding classes, doulas, and parent support groups (either in person or online).

Labor & Delivery

Review your birth plan with your support system prior to going into labor.

  • Choose who to ask to be present at your delivery carefully. Think about who will be able to help you relax and support your birth plan.

  • Speak up about what you are feeling and what would be helpful to you during labor and delivery.

  • What would you like your support person to do? What are things they should avoid saying or doing during labor and delivery? Communicate this to them.

  • Do you have an emergency and back-up plan? Birth can come with many surprises. Include your back up plans in your birth plan. Have everything written down to give to your provider in the event you do not have a support person present.

After Birth & Recovery

Remember you do not need to do everything yourself, you deserve help and rest. It is okay to ask for it.

  • Create boundaries for when others can visit to see you and baby

  • Allow others to help with meals, cleaning your living space, running errands, transportation, caring for pets and additional children or other tasks that could give you more time to care for yourself and baby. Create a list of what you need and allow others to help.

  • Create a “babysitting network” of trusted people you can ask to watch baby when you need rest. Consider having these names, phone numbers, and addresses written down on a list or creating a group chat using a cell phone.
     

If you had complications during birth, experienced a loss, or a preterm birth these suggestions for getting help may look very different for you. Be sure to communicate with others how you are feeling and how they can help you.

If you begin feeling sadness, anxiety, or need someone to talk to, you can call this number 24/7 for help. 1-800-328-3838

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How To Talk With A Provider

Speaking with a medical professional is important, here are some times on how to make it most productive.

Seek early and regular prenatal care.

Doctor with Files

Find a provider you trust, who practices cultural humility, centers and cares about your individual needs - Remember you can always change providers or get a second opinion.

Image by Hian Oliveira

Bring someone with you for support

Ask whether you are at risk for preterm birth and what prevention options or interventions are available to you.

Student Writing

Write your questions down or use educational resources to make your discussion easier. You don’t need to remember fancy terms and medical lingo. Show your provider a brochure, a web page, a social media post, and ask them to fact check it or let you know if any of the information is an option for you.

Image by John Schnobrich

Do not leave without understanding what your provider has discussed with you. You have a right for your medical treatment and options to be explained to you in a way that you understand.

Doctors

Find out how to contact your provider after you leave your appointment.

What do you do if you are experiencing signs of preterm labor?

Who should you call?

 

Write this information down and keep it in a safe place along with your next appointment date.

Utilize the Virtual Coach Tool. Text BabyNJ to 52046 to receive weekly messages in between your appointments. (click to download flyer)

 

Sample Questions To Ask Provider

  1. I delivered a baby unexpectedly before 37 weeks. Could this happen again?

  2. What are some of my risk factors for preterm birth?

  3. How can I reduce my risk and have a better chance for a full-term pregnancy?

  4. What are the signs and symptoms of preterm labor?

  5. What should I do if I experience signs and symptoms of preterm labor?

  6. Is 17-P or another intervention right for me to lower my risk of preterm birth?

  7. If I have a preterm birth will my baby need to stay in the NICU?

 

Seek early and regular prenatal care.

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Print a list of questions and take it with you the next time you visit your provider

Pregnant belly

Learn about what is and is not normal during pregnancy and post-partum

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Interview Providers You are Considering

If African American/Black: How To Talk To Provider

If you're African Amercian/Black you're at higher risk of having a preterm birth. There are certain questions you may want to consider asking your provider. 

  1. Are you aware that black infant and maternal mortality is at a state of crisis?

  2. Are you familiar with preeclampsia?

  3. Who will be delivering my baby?

  4. Do you mind my support person being in the room?

  5. How would you handle massive bleeding during pregnancy or delivery?

  6. Are you comfortable working with black people?

  7.  What does culturally competency mean to you?

  8. What is the policy around cultural competency within this health system/clinic?

  9. Have an Advocate/ Support Person During Pregnancy

  10. (Doula’s, your partner family member, friend, etc.)

 

Personalize Your Birth Plan

Who will be your support person?  When everyone understands your plan they can advocate effectively for you and your baby.

Are you considering interventions?

Are you comfortable with I. V’s/ fluid intake, Do you want epidural?

Schedule out blocks of time in your plan. Everything may not go as planned however it is important to list your preferences

Discuss your plan with support person/people.

Share your plan with your provider. (Consider writing this in a letter format)

If Something Feels Wrong, Speak Up

Lean on Family and Friends

Find local groups for African-American/Black Mothers/ Parents

Do Not Avoid Postpartum Check UP’s

You’re Black and Pregnant. What Should Your Birth Plan Actually Look Like?

MCN Journal: Preterm Birth Risk

Resources (note: if these should be links - please provide the proper web urls for each)

MomsRising
Shades of Blue Project
The Blavatnik Family Women's Health Research Institute
Sista Midwife Productions & the Sista Midwife Directory
Black Maternal Health Caucus
MomaGlow
Sese Doula Services
Black Mothers Breastfeeding Association
 

1. Speak Up, Ask Questions

Self-Advocacy

It is important to know that when you are pregnant your voice matters. You have the right to have your voice heard and your questions, needs, wants, and concerns made a priority. If you are currently pregnant, use the tips below to be an advocate for yourself and to gather support around you.

Make a list of questions you have and bring them with you to your next prenatal appointment. Ask your provider to answer the questions you have in a way that you can understand rather than using complicated medical words.

2. Ability To Change Providers Or Get Second Opinion

Many people do not know that you are able to change your provider if they are not making your needs a priority or if you feel they are not listening to you. If you have health insurance call the number on the card and ask for a list of providers that are covered near you. If you do not currently have insurance try calling NJ-211 and ask them to assist you.

3. Identify Your Local Support Team

 Advocating for yourself is great. You also want to make sure you surround yourself with others who will support what you are asking for. Your support team can include a partner, friend, family member, doula, and/or medical provider that you trust and know will advocate on your behalf when you ask them to.

4. Consider Working With A Doula

A doula is a professional support person who can help you navigate pregnancy, birth, and postpartum. Doulas are well informed of your birthing rights and how to translate what you want to medical providers. They can also be an emotional support to you and help you make decisions regarding the birth of your baby.

Link with more support info (needed)
Link with more support info (needed)

5. Know Your Rights

When you are pregnant you have a right to privacy, for your voice to be heard, to make your own decisions regarding your body and your baby among other things. Speak to a doula or someone you know and trust who has given birth before and discuss what your rights are while pregnant and giving birth. You can also ask your medical provider what they feel your rights are to ensure you are all on the same page when it comes to you and baby.

6. Create A Birth Plan

Make a list of how you want your ideal birth to go and also write down what you want to be done in the case of emergency or if your birth doesn’t go as planned. There are templates online you can use to make a birth plan or work with your prenatal provider and/or doula to create one.

7. Use Your Resources

New Jersey has many resources to help you navigate pregnancy and birth. It can become overwhelming to know who to reach out to or what is available. A general resource you can call is NJ-211 and they can help guide you to resources in your local community.

Self-Care In Pregnancy

Pregnancy is a unique time in any women’s life.  There are many unknown changes that occur to your body, your emotions, and the life of your family.  For many women, these changes can be very stressful. What types of stress effects your pregnancy?

Although some stress is normal in pregnancy, too much stress should be avoided.  Often everyday stress can cause headaches, trouble sleeping, eating too much, or too little.  High levels of stress that continue for a long time can result in chronic health problems, such as high blood pressure and heart disease.  When pregnant, high levels of stress can also increase the risk of having a premature baby (born before 37 weeks) and the risk of having a low birthweight baby weighing less than 5 ½ pounds.  Delivering early or having an extremely small baby may not only be scary for the parents but may create additional health problems for the baby.

Causes of Stress During Pregnancy

  • Discomfort from your changing body, such as nausea, constipation, back aches and tiredness

  • Hormonal changes that causes mood swings and heightened emotions, making dealing with stress more difficult

  • Concern about the unknown, from what to expect during labor, to worrying about taking care of your newborn

  • For women who work, concern about managing job responsibilities, preparing for a leave of absence and time away from the job, and balancing work and family responsibilities 

  • For women who have had a previous pregnancy with an unexpected or negative outcome, fear about what might happen with the current pregnancy

Causes of Stress During Pregnancy

In order to reduce and cope with stress in a less harmful way, pregnant women may be faced with making significant changes to their lifestyle, such as giving up tobacco, alcohol, or other substances.  Because stress does not go away in pregnancy and often increases, it is important to find other healthier ways of dealing with it.  Therefore, pregnancy can become an excellent opportunity to make lifestyle changes that will benefit not only your pregnancy but the future life of you and your family. 

Try to find out what is making you stressed and talk to someone about it - your partner, a friend, family member or your health care provider.

Remember that the discomforts of pregnancy are temporary and will eventually disappear.  Talk to your health care provider for tips to manage discomforts.

Try to stay healthy and fit by eating healthy foods, getting plenty of sleep, and approval, exercising every day, with your health care provider’s permission – consider walking, dancing, taking an exercise or Zumba class.

If you’re feeling overwhelmed, cut back on activities that aren’t really necessary.  Take time to rest when you are feeling tired.

Don’t hesitate to ask for help when you need it, from your partner, family, or friends.  It is important to build a support network of people you trust, and accept your help when they offer.  Consider asking for help with cleaning the house, shopping, running errands or going to your prenatal visits with you.  Talk to your health care provider about resources in the community that can provide help and support to you.

Think about what helps you relax- taking a bath, listening to music, doing deep breathing exercises, try meditation or yoga, even if you never have done it before.  Practice breathing to help you through labor.

Try to learn more about your pregnancy and what to expect when your baby arrives. Don’t be afraid or embarrassed to ask questions.  Be sure to ask your health care provider where to find accurate sources of information as many internet sites are NOT reliable sources of information.  

Remember that many pregnant women feel like you do. You are not alone and it’s okay to ask for help.

If you continue to feel depressed, extremely anxious or overwhelmed, talk to healthcare provider about getting help to deal with your emotions.  

If you are working, plan ahead to help you and your employer prepare for your time away from work.

 
 

Prevention

There are many factors, unique to each of us, making the decision to do what's best for you and your baby can be difficult. There are many resources to help.  Here are some tips and resources.

  • Ask Your Provider: Chronic conditions such as diabetes, high blood pressure, and depression can have a negative impact on your pregnancy. Ask your provider about ways to treat conditions to improve your health and pregnancy.

  • Healthy Weight: Talk to your provider and discuss expectations for the right amount of weight before and throughout your pregnancy.

  •  Prenatal Care: It is very important to seek prenatal care as soon as you think you may be pregnant. Prenatal care during your pregnancy will help your provider to make sure you and your baby are healthy.

  • Alcohol and Drug Use: To ensure a healthy pregnancy refrain from use of street drugs, prescription drugs abuse, smoking and drinking alcohol. Ask your provider about programs that can help you quit. 

Resources (note: if these should be links - please provide the proper web urls for each)

Mental Health Resources

Mental Health Resources Services Provided By County

Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, and Salem Counties 

Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, and Salem Counties 

MCN Journal: Preterm Birth Risk

If Something Feels Wrong, Speak Up

Lean on Family and Friends

Find local groups for African-American/Black Mothers/ Parents

Do Not Avoid Postpartum Check UP’s

Prevention

There are many factors, unique to each of us, making the decision to do what's best for you and your baby can be difficult. There are many resources to help.  Here are some tips and resources.

  • Ask Your Provider: Chronic conditions such as diabetes, high blood pressure, and depression can have a negative impact on your pregnancy. Ask your provider about ways to treat conditions to improve your health and pregnancy.

  • Healthy Weight: Talk to your provider and discuss expectations for the right amount of weight before and throughout your pregnancy.

  •  Prenatal Care: It is very important to seek prenatal care as soon as you think you may be pregnant. Prenatal care during your pregnancy will help your provider to make sure you and your baby are healthy.

  • Alcohol and Drug Use: To ensure a healthy pregnancy refrain from use of street drugs, prescription drugs abuse, smoking and drinking alcohol. Ask your provider about programs that can help you quit. 

Resources (note: if these should be links - please provide the proper web urls for each)

Mental Health Resources

Mental Health Resources Services Provided By County

Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, and Salem Counties 

Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, and Salem Counties 

MCN Journal: Preterm Birth Risk

If Something Feels Wrong, Speak Up

Lean on Family and Friends

Find local groups for African-American/Black Mothers/ Parents

Do Not Avoid Postpartum Check UP’s

Prevention

There are many factors, unique to each of us, making the decision to do what's best for you and your baby can be difficult. There are many resources to help.  Here are some tips and resources.

  • Ask Your Provider: Chronic conditions such as diabetes, high blood pressure, and depression can have a negative impact on your pregnancy. Ask your provider about ways to treat conditions to improve your health and pregnancy.

  • Healthy Weight: Talk to your provider and discuss expectations for the right amount of weight before and throughout your pregnancy.

  •  Prenatal Care: It is very important to seek prenatal care as soon as you think you may be pregnant. Prenatal care during your pregnancy will help your provider to make sure you and your baby are healthy.

  • Alcohol and Drug Use: To ensure a healthy pregnancy refrain from use of street drugs, prescription drugs abuse, smoking and drinking alcohol. Ask your provider about programs that can help you quit. 

Resources (note: if these should be links - please provide the proper web urls for each)

Mental Health Resources

Bergen and Passaic Counties

Mental Health Resources Services Provided By County

Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, and Salem Counties 

Ocean and Monmouth Counties 

 Rutgers Health University Behavioral Health Care

Hunterdon, Mercer, Middlesex, Somerset, Essex, Hudson, Union Counties

 Eva’s Village, Inc
 Zufall Health Center, Inc.

Morris, Sussex and Warren Counties

Medical Conditions

Chronic conditions such as diabetes, thyroid disease, high blood pressure, and depression can have a negative impact on your pregnancy. Ask your provider about ways to treat conditions to improve your health and pregnancy. 

Protect yourself from infections

Talk to your provider about vaccinations that can help protect you from certain infections. Be sure to wash your hands with soap and water after using the bathroom or blowing your nose. Refrain from eating food products with raw meat, fish, or eggs. Have safe sex with contraceptives. 

Stress Reduction

Talk to your provider about how to limit and cope with stress. Here are some great tips to handle stress

  • Eat Healthy Foods 

  • Stay Active 

  • Ask for help from family & friends 

  • Self-care 

MCN Journal: Preterm Birth Risk

If Something Feels Wrong, Speak Up

Lean on Family and Friends

Find local groups for African-American/Black Mothers/ Parents

Do Not Avoid Postpartum Check UP’s

Prevention

There are many factors, unique to each of us, making the decision to do what's best for you and your baby can be difficult. There are many resources to help.  Here are some tips and resources.

  • Ask Your Provider: Chronic conditions such as diabetes, high blood pressure, and depression can have a negative impact on your pregnancy. Ask your provider about ways to treat conditions to improve your health and pregnancy.

  • Healthy Weight: Talk to your provider and discuss expectations for the right amount of weight before and throughout your pregnancy.

  •  Prenatal Care: It is very important to seek prenatal care as soon as you think you may be pregnant. Prenatal care during your pregnancy will help your provider to make sure you and your baby are healthy.

  • Alcohol and Drug Use: To ensure a healthy pregnancy refrain from use of street drugs, prescription drugs abuse, smoking and drinking alcohol. Ask your provider about programs that can help you quit. 

Resources (note: if these should be links - please provide the proper web urls for each)

Ocean and Monmouth Counties 

Mental Health Resources Services Provided By County

Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, and Salem Counties 

Rutgers Health University Behavioral Health Care

Hunterdon, Mercer, Middlesex, Somerset, Essex, Hudson, Union Counties

Bergen and Passaic Counties

Eva’s Village, Inc
Zufall Health Center, Inc.

Morris, Sussex and Warren Counties

Medical Conditions

Chronic conditions such as diabetes, thyroid disease, high blood pressure, and depression can have a negative impact on your pregnancy. Ask your provider about ways to treat conditions to improve your health and pregnancy. 

Protect yourself from infections

Talk to your provider about vaccinations that can help protect you from certain infections. Be sure to wash your hands with soap and water after using the bathroom or blowing your nose. Refrain from eating food products with raw meat, fish, or eggs. Have safe sex with contraceptives. 

Stress Reduction

Talk to your provider about how to limit and cope with stress. Here are some great tips to handle stress

  • Eat Healthy Foods 

  • Stay Active 

  • Ask for help from family & friends 

  • Self-care 

Birth Spacing

Wait at least 18 months between giving birth and getting pregnant again. Birth spacing can reduce outcomes such as low birth weight and premature birth.

Take 400 Micrograms of Folic Acid Every Day

Folic acid is a B vitamin that can help prevent serious birth defects of a baby’s brain and spine. If a woman has enough folic acid in her body at least 1 month before and during pregnancy, it can help prevent negative outcomes.

Learn Your Family History and Risk Factors

  • Risk factors such as being over the age of 35, having a previous preterm can have an impact on your pregnancy and health of you and your baby. Learn more about risk factors here_________.

  • Talk to your provider if you have a family member who has had a genetic disease (sickle cell disease, Tay Sachs disease), developmental disability, birth defect, newborn screening disorder, or other issues during birth, infancy, childhood. 

  • If you were affected by any of the conditions above in a prior pregnancy it is critical to mention this to your provider

  • Alert your provider if you have had a prior premature birth, stillbirth, miscarriage, or a child who died from sudden infant death syndrome (SIDS)

Avoid Toxic Substances and Environmental Contaminants

Avoid harmful chemicals, environmental contaminants, and other toxic substances such as synthetic chemicals, metals, fertilizer, bug spray, and cat or rodent feces around the home and in the workplace. Small amounts of contaminant exposure during pregnancy, infancy, childhood, or puberty can lead to diseases.

 
Woman Baking

Changes To Make Prior To Pregnancy

Preconception Health: Talk to your doctor before you become pregnant. Receiving preconception health care from your provider will focus on the parts of health that have been shown to increase the chance of having a healthy baby. Be sure to discuss your partner’s health as well. 

 

PPD  / Perinatal Mood Disorders

Perinatal mood disorders (PMDs) are common during pregnancy or up to one year postpartum. You may begin feeling mood swings, anxiety, or severe sadness. It is important to know that if you feel this way it is not your fault.

If you or someone you know might have a pregnancy-related mood disorder, you can call this number 24/7 for help.

1-800-328-3838

What Are The Perinatal Mood Disorders?

  • Depression

  • Anxiety

  • Obsessive Compulsive Disorder

  • Panic Disorder

  • Post-Traumatic Stress Disorder

  • Psychosis

Who Is At Risk?

You may be at risk for perinatal mood disorder if:

  • You are currently pregnant 

  • Had a baby within the past year

  • Recently stopped breastfeeding

  • Have had a miscarriage or abortion

Risk Factors 

PMD Risk Factors 

PMDs are never the mom's fault.
Anyone can experience PMDs.
Knowledge is power.
Talk to your healthcare provider.
 
 
 
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Signs of PMD 

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