Staying safe

• Keep away from things that can hurt you or your baby.
• Smoking and abuse can be harmful during pregnancy.
• Stay safe, seek help and ask your provider any questions.

The needs of a pregnant woman during a disaster are unique. You still need to follow any evacuation and preparation instructions given by your state, but here are some special things to consider.

If you're pregnant or think you may be pregnant and have questions about the health effects of the disaster, talk with a health care provider.

The Gulf oil spill
The U.S. Centers for Disease Control and Prevention (CDC) has posted information about the oil spill for pregnant women. 

Before a disaster
Prepare as much as you can before a disaster strikes. This will help you to stay healthy and safe. Follow these tips:

• Make sure to let your health care provider's office (doctor, midwife or nurse-practitioner) know where you will be.
• Make a list of all prescription medications and prenatal vitamins that you are taking.
• Get a copy of your prenatal records from your health care provider.
• If you have a case manager or participate in a program such as Healthy Start or Nurse-Family Partnership, let your case manager know where you are going. Give him or her a phone number to use to contact you.
• If you have a high-risk pregnancy or you are close to delivery, check with your health care provider to determine the safest option for you.

During a disaster
Below are some guidelines on what to do if you need to evacuate your area because of a disaster emergency..

• Bring any medications you are currently taking, including your prenatal vitamins and your prescriptions.
• Keep a copy of your prenatal medical records with you and contact information for your health care provider in case you need to visit another provider.
• If you are driving, stop to get out and walk every 1 to 2 hours.
• Wear comfortable shoes.
• Pack some snacks. 
• Remember that maternity clothes may not be available if you evacuate. Pack extra clothes for yourself, including undergarments.

After a disaster
Once you've made it through a disaster emergency and are safe, you'll want to take steps to ensure you stay healthy. For example, if your health care provider's office is closed or if you had to evacuate, call a local hospital or health department to get information about prenatal care and local hospitals. Below are some other things to keep in mind.

Eat healthy 
Even in a disaster, it's important to eat healthy and safe. Do not eat spoiled food or any food you think may be spoiled.

• Eat several times throughout the day.
• Do not eat spoiled food or any food you think may be spoiled.
• Try to choose food that is high in protein and low in fat. Carbohydrates like bread and pasta help to give you energy. For more information, read Healthy Eating.
• Visit the U.S. Centers for Disease Control and Prevention (CDC) Web site for more information about food safety.

Find water for drinking, cooking and bathing
Having safe water is very important for staying hydrated, cooking and more.

• Listen to and follow public announcements about the local water supply. Local authorities will tell you if tap water is safe to drink or to use for cooking or bathing.
• If the local water supply is not safe to use, follow local instructions to use bottled water or to boil or disinfect tap water for cooking, cleaning or bathing.
• If tap water is not safe, boiling is the preferred way to kill harmful bacteria and parasites. To kill most organisms, bring water to a rolling boil for 1 minute.
• If you can't boil unsafe tap water, you can treat it with chlorine tablets or iodine tablets. Follow the directions that come with the tablets. Keep treated water out of reach of children and toddlers.
• Drink at least eight glasses (8-ounce servings) of water every day.

Learn about immunizations during pregnancy 
Pregnant women should NOT receive vaccines for varicella (chickenpox) and measles, mumps and rubella (MMR). Getting these shots during pregnancy may harm your baby. However, there are some vaccines that are safe while pregnant and that you may need after surviving a disaster. Learn more about vaccinations during pregnancy.

Watch for signs of labor
Stress is a risk factor for preterm labor (labor that happens before 37 weeks of pregnancy). If you have any of the symptoms below, don't wait for them to just go away. If you're in a shelter, immediately go to the person in charge of your site. Tell him or her you need medical care right away.

Preterm labor signs include:

• Contractions (your abdomen tightens like a fist) every 10 minutes or more often
• Leaking fluid or bleeding from your vagina
• The feeling that your baby is pushing down
• Low, dull backache
• Cramps that feel like your period
• Cramps in your belly with or without diarrhea

If you are not in a shelter and have any of these symptoms, contact a health care provider. If you're full term and have reached 40 weeks of pregnancy, watch for signs of normal labor.

Get some physical relief when you can
No matter what your housing situation, take a little time (10 to 15 minutes) to lie down and put your feet up. Try to do this a few times each day.

To have this time be most effective, try your best to:

• Go to a quiet spot.
• Clear your mind of worries for these few minutes.
• Take deep breaths from your belly, not your chest.
• Avoid getting overheated.

Stress and pregnancy 
Stress can affect your and your baby's health during pregnancy. It's best to try to avoid stress whenever possible.

• Find someone to talk to a few times a day.
• Invite the person to be your "buddy."
• Share with him or her any concerns you may have about being pregnant in these difficult circumstances. The fact that you have someone to talk to is helpful all by itself.

Health care providers can help you cope with stress or refer you to other professionals. You can also get help from:

• A clergy member
• The department of psychology at a local college or university
• The local community mental health center.

If you ever feel like harming yourself or your baby, talk to a health care provider right away.

An emergency situation causes stress for a family. If you are concerned about your relationship and your safety, call the National Domestic Violence Hotline at (800) 799-SAFE (7233).

Potential dangers
Remember that it's important to stay safe during and after a disaster emergency.

Flood Water in streets and buildings
Flood water may contain harmful substances. For instance, the water may contain bacteria that could cause serious disease. It's best if children and pregnant women avoid touching or walking in flood water.

If you do touch the water, use soap and clean water to wash the parts of your body that came in contact with it. Whenever possible, people who must come in contact with the water should wear protective clothing, such as gloves and boots.

If you are pregnant, be especially careful not to swallow any flood water. Try to keep it away from your mouth. If you feel sick in any way, talk to a doctor or nurse right away. Remember to tell them that you are pregnant.

Toxic exposures during pregnancy
If you're worried that you may have been exposed to dangerous chemicals or substances during your pregnancy, talk to a health care provider.

The Organization of Teratology Information Specialists (OTIS) offers free telephone counseling to pregnant women worried about toxic exposures. Call the toll-free number (866) 626-6847.

Returning to your home
Pregnant women may face several possible dangers when returning home, depending on their individual circumstances and the damage to their homes. If you're pregnant and your home has been damaged, it may be best to ask disaster workers, family members and friends to clean up. Possible hazards that could threaten your health and your pregnancy include:

• Pollutants such as bacteria and mold that have contaminated household items
• Hard physical work, such as carrying and lifting heavy items
• Falling while stepping over debris
• Electrical shocks

Your state and local health or environmental departments can tell you about pollutants in your area. For information on environmental hazards and pregnancy, read the March of Dimes fact sheet.

More information and help
U.S. Centers for Disease Control and Prevention American Red Cross
American Association of Poison Control Centers
American Mental Health Counselors Association
American Psychological Association
Center for Mental Health Services, Emergency Services and Disaster Relief Branch
Girls and Boys Town National Hotline
Mental Health America
Salvation Army
United Way

May 2009