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Congratulations!

Pregnancy can be the most memorable and frightening experience.  It puts out front many hopes and dreams for ourselves and our families.  PPI is here to support those hopes and dreams with worthwhile information, programs, and services.  We send our sincere best wishes and hope to become your partner in a healthy birth.

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Signs or Symptoms Of Preterm Labor

  • Change in your vaginal discharge (watery, mucus or bloody) or more vaginal discharge than usual 

  • Pressure in your pelvis or lower belly, like your baby is pushing down 

  • Constant low, dull backache 

  • Belly cramps with or without diarrhea 

  • Regular or frequent contractions that make your belly tighten like a fist. The contractions may or may not be painful.

  • Your water breaks **

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It is important to have an open dialogue with your provider, giving them a detailed history of all previous pregnancies to determine the best course of treatment for any current or future pregnancies.

 

Prenatal Schedule

One of the first things to do when pregnant is to schedule a visit with your OB/GYN. It will be the first of many visits. All of which are important to monitor the baby's development and your health.  

 

Use our prenatal schedule to plan this journey and build a strong relationship with those who will assist you in delivering a healthy baby. 

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Signs or Symptoms Of Preterm Labor

  • Change in your vaginal discharge (watery, mucus or bloody) or more vaginal discharge than usual 

  • Pressure in your pelvis or lower belly, like your baby is pushing down 

  • Constant low, dull backache 

  • Belly cramps with or without diarrhea 

  • Regular or frequent contractions that make your belly tighten like a fist. The contractions may or may not be painful.

  • Your water breaks **

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It is important to have an open dialogue with your provider, giving them a detailed history of all previous pregnancies to determine the best course of treatment for any current or future pregnancies.

Preterm Labor

If you do go into preterm labor, hospitals can provide additional medications to support you and the baby including antibiotics, steroids, and medications that slow or stop labor contractions temporarily. 

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  • Antibiotics may be used to during pregnancy to treat and prevent infections in the baby and the mother.

  • Steroids can be used to help speed up the baby’s lung growth, which will decrease the chances of breathing problems if the baby is born too soon.  

  • Utilizing medications to slow or stop labor temporarily allows enough time for the steroids to help the baby’s developing lungs.v 

Speak to your provider (ob/gyn, nurse midwife, birth worker) about your concerns and the options available to you.  Your provider (ob/gyn, nurse midwife, birth worker) will be able to help determine the best treatment for you and your baby. 

Signs Of Labor

NOTE FROM STEVE  - IS THERE A HANDOUT OR INFORMATION WE CAN LINK TO HERE, CREATE AS A HANDOUT, OR ADD TO EXPLAIN THE SIGNS OF LABOR - IT FEELS LIKE IT SHOULD GO HERE - IN MY OPINION

Personalize Your Birth Plan

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A birth plan is all about you. It details your preferences for labor and delivery. What you think will make the experience more comfortable – for you.  

 

Must Include 

Who is your support person (s) 

If you are considering interventions 

Your comfort level with I.V.’s/ fluid intake, 

If you want an epidural 

 

Making it Work 

Schedule out blocks of time in your birth plan.  

Everything may not go as planned. Still, it is important to list your preferences 

Discuss your plan with support person(s) 

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

When everyone understands your wishes, they can better advocate for you and your baby. 

 

Remember 

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
 

How To Talk With A Provider

Talking with a doctor can be intimidating. For a new mom or a mom from a culture different than the doctor’s, it can be overwhelming. Here are some tools and ideas to build confidence and skills in speaking with providers.  

Seek early and regular prenatal care.

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

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Bring someone with you for support

Ask if you are at risk for pre-term birth and what prevention options are available to you. 

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Check out PPI’s Virtual Coach. Get weekly messages between appointments and more. Text BabyNJ to 52046 to start.  (learn more here)

Sample Questions To Ask Provider

Pregnancy brings about many questions. PPI has put together a list to help guide the discussion at your next prenatal visit. Click here for a downloadable copy  

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

  2. What are 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 have signs and symptoms of preterm labor? 

  6. Will 17-P or another intervention help lower my risk of preterm birth? 

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

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Student Writing

Write your questions down or bring educational resources to help relay concerns.

 You don’t need fancy terms and medical lingo. Show your provider a brochure, a web page or, a social media post. Ask them to fact check it or let you know if any of the information applies to you. 

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Do not leave until you fully understand what the provider has said. You have a right for your medical treatment and options to be explained in a way that you understand. 

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Know how to contact your provider after your appointment.  Be clear on what actions should you take if you experience signs of preterm labor?  

 

Write the answers to your questions down and keep them in a safe place along with your next appointment date.   

 
 

Questions To Ask Your Doctor

Describe your communication approach with patients? 

How much weight should I expect to gain during pregnancy? 

What are safe exercises I can do during pregnancy?  

What vaccinations, if any, should I get now that I am pregnant? 

How long can I work during pregnancy? 

If things do not go as outlined in my birth plan, what can I expect? 

Which over the counter (OTC) medications are safe for me to use?  

What prescription medicines should I stop taking during pregnancy? 

What foods should I stop eating during pregnancy? 

Is there anything I should change now about my lifestyle or daily routine? 

Can my work environment harm my pregnancy? 

How often will I have appointments? Do the number of visits change with each trimester? 

Will you deliver my baby? What should I expect during labor and delivery? 

Might I will need a C-section? 

What breastfeeding support do you recommend?  

What pregnancy symptoms are normal, and which are an emergency? 

Who should I call for a medical emergency? Would this change depending on how far along I am in my pregnancy? 

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African American Women

African American women have risk factors that impact their pregnancies in different ways.  Knowing your risks and talking to your provider is critical to having a successful, healthy pregnancy.  Please use the list of suggested questions below to guide your next prenatal visit. Click here for a downloadable copy of the questions.   

  • Please share how you communicate, understand, and work effectively with people of my race/ethnic group.  

  • What training have had on recognizing implicit bias? How did this influence your decisions on patient care?  

  • How has the hospital train its medical team on implicit bias? Does this hospital/health care system have a policy on implicit bias?  

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  • African American women have high related risks and factors that can complicate pregnancy. Do I have an increased risk of any specific complications or conditions during pregnancy or delivery? How will you manage those risks in my pregnancy?  

  • What screenings do you recommend for me to help ensure a healthy pregnancy?  

  • Which over the counter medications are safe for me? Are there any prescription medicines I should stop taking during my pregnancy?  

  • African American women have risk factors that impact their pregnancies in different ways.  Knowing your risks and talking to your provider is critical to having a successful, healthy pregnancy.  Please use the list of suggested questions below to guide your next prenatal visit. Click here for a downloadable copy of the questions.   

  • Please share how you communicate, understand, and work effectively with people of my race/ethnic group.  

  • What training have had on recognizing implicit bias? How did this influence your decisions on patient care?  

  • How has the hospital train its medical team on implicit bias? Does this hospital/health care system have a policy on implicit bias?  

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  • African American women have high related risks and factors that can complicate pregnancy. Do I have an increased risk of any specific complications or conditions during pregnancy or delivery? How will you manage those risks in my pregnancy?  

  • What screenings do you recommend for me to help ensure a healthy pregnancy?  

  • Which over the counter medications are safe for me? Are there any prescription medicines I should stop taking during my pregnancy?  

  • I want to discuss my birth plan. If things do not go as planned, what can I expect during labor and delivery?  

  • I have a support person. What has been your experience in working with support persons in the delivery room?  

  • Who will be on my birth team (obstetrician, nurse, midwife)?  

  • Will you deliver my baby?   

  • Describe your communication approach with patients. If I have any complications during birth, how will you share this with me and my support person?  

  • What are the pros and cons of having a vaginal birth? What are the pros and cons of having a C- section? How likely am I to need a C-section?  

  • What is your position on inventions such as inductions, C-sections, epidurals and other pain medications, and IVs? Are all interventions available to me if needed?  What are my options?  

  • Please describe normal pregnancy symptoms and those that are considered an emergency. 

  • Who should I call for a medical emergency? Will this change throughout my pregnancy?  

  • What type of support do you recommend if I want to breastfeed?   

  • AA women and health Disparities  

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Preventing Preterm Labor

Because medical experts are not able to identify what causes preterm labor, there are many signs you should be aware of and discuss with your physician, midwife, or birth worker as soon as possible:

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Seek early and regular prenatal care.

Seek early and regular prenatal care

 Prenatal visits can help your health care provider monitor your health and your baby's health. Seeking early and regular prenatal care allows you to discuss any signs or symptoms that concern you.  

Eat a balanced and healthy diet

Good nutrition is an important part of a healthy pregnancy. Some research suggests that a diet high in polyunsaturated fatty acids (PUFAs) is associated with a lower risk of premature birth. PUFAs are found in nuts, seeds, fish and seed oils. 

Manage chronic conditions

Certain conditions, such as diabetes, high blood pressure and obesity, increase the risk of preterm labor. Work with your health care provider to keep any chronic conditions under control.***

Avoid risky substances

If you smoke, it is important to try to quit as early as possible. Discuss your options with your provider. There are smoking cessation programs available to you that can increase your chances of success. It is also important not to use illicit drugs or alcohol during your pregnancy. 

Consider pregnancy spacing

 Some research suggests a link between pregnancies spaced less than six months apart, or more than 59 months apart, and an increased risk of premature birth. Consider talking to your health care provider about pregnancy spacing. 

Be cautious when using assisted reproductive technology (ART)

If you are planning to use ART to get pregnant, consider how many embryos will be implanted. Implanting more than one embryo increases your chances of a multiple pregnancy, which carries a higher risk of preterm labor. 

 
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Postpartum Period

The period after delivery and up to 42 days is called the postpartum period or the 4th Trimester.  

4th Trimester, What Is it?

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Typically, when pregnancy is discussed, three trimesters are mentioned, along with the symptoms of pregnancy or key developmental milestones of the fetus.  

The 4th trimester is a term some in doctors use to describe the needs of a woman who has recently given birth.  This period may last for the first 3 months after delivery as they transition into parenthood. 

 

The needs and care of the birthing person and the family during the postpartum period are often overlooked.  However, it is just as important for families to plan for the 4th trimester as it is for the planning of the first three trimesters!  

What can you do to care for your health during the 4th trimester?  

Mood and Emotional Well Being 

Pay attention to how you feel mentally and emotionally. Perinatal mood disorders including postpartum depression, anxiety, and psychosis are common for new parents and can negatively impact your mood and desire to parent. If you notice signs of sadness, frustration, overly worrying about your baby, or having thoughts that you might hurt your baby, reach out to a provider, support group, or therapist immediately.  

Infant Care & Feeding 

Breastfeeding has important benefits for you and your baby. Whether you breastfeed or formula feed, there can be a lot of barriers that you are experiencing regarding what baby is eating during this time. Resources are available to support you with feeding including WIC, lactation consultants, and your medical provider who all may be able to give you accurate information regarding infant care & feeding. 

 

Sexuality, Contraception, & Birth Spacing 

Giving birth and parenting a newborn is challenging and causes many changes that can make you feel ill-prepared for sexual activity right away. Providers in NJ typically recommend postponing any type of intercourse or insertion of objects into the vagina for 6 weeks. It is important to ask your provider if this in fact is their recommendation based on your treatment and talk to them about contraception if you want to prevent another pregnancy from happening right away. Using birth spacing to wait at least 18 months before beginning another pregnancy can help reduce your risk for having preterm birth and baby with low birth weight. (Link to our birth spacing section) 

Sleep & Fatigue 

As a new parent, you are likely tired! Lack of sleep can significantly impact your mood, coping, health, and safety. During the first few months after having your baby it is important to identify your support system and ask others for help so you can rest. Trying to sleep when the baby sleeps can be difficult but taking naps and practicing safe sleep habits are important.   

Physical Recovery from Childbirth 

After birth, you may experience pain from tearing or having a c-section. You may also experience new physical ailments such as hemorrhoids, breast tenderness, painful sex, heavy bleeding, backaches, bowel, or urinary problems. It is just as important for you as a new parent to attend your 6 weeks follow up appointment as it is for you to bring your infant to their “well-baby” exams. Be honest about the pain you are feeling and call 911 or your medical provider immediately if you begin experiencing any of the postpartum warning signs.

 

Medications, Substances & Exposures 

Be mindful of the medications you are prescribed, substance use, and exposures during the first few months after pregnancy. Especially if you are breastfeeding. Ask your provider before taking any medications or substances to ensure there will be no harmful effects for you or baby. Also, be mindful of lead prevention and consider having the drinking water or paint in your home tested as high levels of lead can cause lead poisoning in you or your infant. For more information.

 

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?

Holding Hands
  • Depression

  • Anxiety

  • Obsessive Compulsive Disorder

  • Panic Disorder

  • Post-Traumatic Stress Disorder

  • Psychosis

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PMD Risk Factors 

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

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

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Signs of PMD 

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Do you have a non-emergency topic that you'd like more information about?  You can submit a question to our "Ask the Dr.!" team and we'll do our best to include in it our periodic video updates.  If you have an emergency question or concern, please contact your provider.

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