Spotlight on Camille Winbush

Camille Winbush is a talented young actress and entrepreneur with many television and film credits to her name. She has a recurring role as Lauren on the ABC Family show The Secret Life of the American Teenager and grew up on screen in her role of Nessa, the oldest of three children on The Bernie Mack Show. Among her many roles is her volunteer celebrity ambassador position with the March of Dimes.
  
Camille joined the March of Dimes as a volunteer in the California Chapter, Los Angeles Division and rose up to become a March of Dimes Team Youth Ambassador. She attributes her commitment to the March of Dimes to her family's own personal experience with premature birth. With her cousins' survival of premature births in mind, Camille participates in March for Babies walks and special events in Los Angeles. She also has spoken at March of Dimes national volunteer leadership conferences and gatherings of national service partners. Camille shared her personal story and led a fundraiser at the Future Business Leaders of America (FBLA) national conference in Anaheim, California.

Most common questions

Does the March of Dimes provide information about birth defects?

Yes. The March of Dimes produces fact sheets on several birth defects, including autism, chromosomal abnormalities, cleft lip, congenital heart defects and Down syndrome. Simply type the name of the birth defect into the search box.

How can I soothe my baby if she has colic?

About 1 in 5 babies develops colic - usually between 1 and 4 months of age. They cry constantly, often extending or pulling up their legs or passing gas. Sometimes their tummies are enlarged with air and gas from crying. There's no one cause of colic, but there are many different ways to ease your baby's discomfort. One way is to walk her in a soft-sided baby carrier that you strap to the front of your body. You can also try laying her tummy-down across your knees and gently rubbing her back. The pressure against her tummy may relieve her discomfort. Breastfeeding moms can ask their baby's health care providers about a change in food choices or eliminating specific foods that may cause your baby's colic. Keep in mind that colic usually disappears by 4 months of age, no matter what treatments you try.


What are some reasons to have a c-section?

You may need a c-section if there are medical problems that put you or your baby in danger. For example, you may need a c-section if your baby is too big to pass through the birth canal, or if the baby is in a breech position (feet first) or a transverse position (shoulder first). The best position for your baby is head first. You may need a c-section if your labor is really slow or if the baby's heart rate slows during labor. Other reasons for a c-section include having problems with the placenta or with the umbilical cord, having an infection that you can pass to your baby during birth, and being pregnant with twins or more. If you've had a c-section in a previous pregnancy, you may need to have one in your next pregnancy. If your pregnancy is healthy and there's no medical reason to have a c-section, it's best to plan for a vaginal birth and wait for labor to start on its own. Ask your provider if there are reasons why you may need to have a c-section.

How early can a baby be born and live?

There is no set timeline for survival for babies born early. Babies born earlier than 23 weeks have a much smaller chance of survival than babies born after 23 weeks.


About 9 out of 10 babies born at 28 weeks survive. But many have serious health problems. Any baby born before 37 completed weeks of pregnancy is considered premature. Premature babies have less time to develop in the womb than babies who arrive on time. This puts them at greater risk of medical and developmental problems. Every extra day in the womb helps the baby develop and mature and probably improve his or her health and development later in life. Between 23 and 26 weeks, every extra day in the womb increases a baby's chance of survival by 2 to 4 percent.

What federal agencies are involved in premature birth research?

Multiple federal agencies support prematurity-related research but among the most engaged are the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health and Maternal and Infant Health Research within the Centers for Disease Control and Prevention.

Why did the March of Dimes support health care reform?

Since our founding, the March of Dimes has worked to shape public policy that affects maternal and child health. Health reform offered an unparalleled opportunity to improve the health of and address the needs of women, infants and children. Specifically:

  • Expanding and improving coverage for maternity and pediatric care
  • Strengthening Medicaid (which covers more than 40% of all births)
  • Increasing the number of currently uninsured women of childbearing age and children who will be covered in 2014

By law and longstanding tradition, the March of Dimes is strictly nonpartisan and remained nonpartisan throughout the debate. Initially, we worked with members with many different views and party affiliations, but as the debate went on, we focused our energies on ensuring that legislation likely to be approved contained the strongest provisions possible to address the unique health needs of children and pregnant women.

How can I learn what conditions newborns are screened for in my state?

Two key resources are the National Newborn Screening and Genetics Resource Center and the March of Dimes. You can easily compare state programs on our Peristats website.

Actavis

Actavis, Inc., one of the largest pharmaceutical companies in the world, joined in partnership with the March of Dimes in 2011. Together, their goal is to raise awareness about the risk factors for preterm birth. In 2013, Actavis is once again a national sponsor of March for Babies. 

 

Agnes Higgins award, maternal-fetal nutrition

Established in 1980, the March of Dimes Agnes Higgins Award honors the late Agnes Higgins of the Montreal Diet Dispensary for her innovation and years of service to the cause of improved maternal nutrition. A pioneer in devising methods of nutritional assessment and counseling, Mrs. Higgins greatly advanced the understanding of eating healthy as a crucial factor in healthy pregnancy and prevention of low birthweight. The Agnes Higgins Award is presented in recognition of distinguished achievement in research, education or clinical services in the field of maternal-fetal nutrition.

Call for nominations

Nominations of candidates are being solicited for the 2011 and 2012 March of Dimes Agnes Higgins award. Please make your recommendations on or before March 30, 2011. The nomination form includes eligibility criteria, submission instructions and contact information.

Nomination criteria

Candidates for the Agnes Higgins Award must have:

  • Been widely involved in maternal-fetal nutrition through teaching, research and/or clinical practice for at least five years
  • Shown a demonstrable effect in raising the quality of maternal-fetal nutritional care through scholarly pursuits, research, education and/or practice
  • Demonstrated ability to apply maternal-fetal nutritional standards of practice and/or facilitate their implementation by others

Recipients

Each statement below was written at the time the award was announced.

2010: David Barker, MD, PhD, FRS
Dr. Barker is Professor of Clinical Epidemiology, University of Southampton, UK, and Professor, Department of Cardiovascular Medicine, Oregon Health and Science University. David Barker trained as a physician at Guy’s Hospital, London, and thereafter at the Queen Elizabeth Centre, Birmingham. After 3 years in Uganda, he moved to the University of Southampton in 1972. Until 2003 he was Director of the Medical Research Council Environmental Epidemiology Unit and a Consultant Physician at Southampton University Hospitals. Dr. Barker’s research focuses on how a baby’s nutrition and growth in the womb determines its health in adult life. Studies by his MRC Unit showed that people who had a low birth weight or were stunted at birth are at increased risk of coronary heart disease and related disorders, such as hypertension, diabetes and stroke. This led to the ‘fetal origins hypothesis’ which proposes that coronary heart disease originates through responses to under nutrition during fetal life and infancy, which permanently change the body’s structure, physiology and metabolism. The hypothesis is strongly supported by studies in animals. The discovery that coronary heart disease originates in utero points to the importance of protecting the nutrition and health of women, before and during pregnancy, and protecting young children as part of the strategy to prevent chronic disease in later life.

2009: Gail G. Harrison, PhD, MNS
Dr. Harrison is Professor, University of California, Los Angeles (UCLA), School of Public Health. She is also Director, UCLA Center for Global and Immigrant Health, and Senior Research Scientist, UCLA Center for Health Policy Research. Dr. Harrison is an internationally known scholar whose research, much of it in developing countries in Africa, the Middle East, and Latin America, and in vulnerable populations in the United States, has led to several important advances in maternal-fetal health. In the late 1970s and early 1980s, her work proved that maternal obesity affects fetal growth. In 1983, Dr. Harrison was the lead investigator of a study in Egypt that demonstrated how healthy a pregnant woman eats influences the development and health of her baby and the nutrient composition of her breast milk. More recently, as a member of an Institute of Medicine (IOM) committee, Dr. Harrison conducted research that showed low-income pregnant women are more likely to eat fresh fruits and vegetables if they receive specific food subsidies. That led to the committee’s recommendation that fresh fruit and vegetable vouchers be distributed as part of the U.S. government’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program, which provides federal grants to states for food, health care referrals, and nutrition education. In addition to her work with the IOM, Dr. Harrison has served as the president of the Society for International Nutrition Research and has consulted with the World Health Organization.

2008: Susan E. Carlson, PhD
Dr. Carlson is the A. J. Rice Professor of Nutrition and Professor of Pediatrics at the University of Kansas Medical Center. She is also Clinical Professor of Obstetrics and Gynecology at the University of Missouri-Kansas City. Dr. Carlson has devoted her career to understanding and promoting maternal and infant nutrition. She is internationally recognized for her work in maternal-fetal nutrition and specifically for her research on DHA, an omega-3 fatty acid. Dr. Carlson was the first to recognize and note the implications that human milk-fed infants had higher amounts of circulating DHA than formula-fed infants. In 2002, she was awarded honorary membership in the American Dietetic Association for her pioneering work leading to the recognition that DHA was a conditionally essential nutrient for infants. Since 2002, Dr. Carlson has taken an active role in the education of U.S. pediatricians, obstetricians, nurses and dietitians about the role of DHA in maternal and infant health. She has been involved nationally and internationally in evaluating the quality of evidence and establishing best-practice guidelines for intake of DHA by infants and pregnant women.

2007: Anna Maria Siega-Riz, PhD, RD
Dr. Siega-Riz is Associate Professor of Epidemiology at the University of North Carolina, School of Public Health. She has a joint appointment in the Department of Nutrition and is a fellow of the Carolina Population Center. She serves as the Director of the Nutrition Epidemiology Division and the Nutrition Epidemiology Core of the Clinical Nutrition Research Center. Dr. Siega-Riz's research interests include maternal nutritional status and its relationship to birth outcomes, gestational weight gain and obesity development, eating methodology, reproductive epidemiology, child and adolescent eating behaviors, and trends in eating among minority populations. She is a co-investigator on the Pregnancy, Infection, and Nutrition (PIN) Study, a large prospective epidemiological study examining the role of infection, stress, physical activity, and nutrition on preterm births among women receiving prenatal care from public institutions. Dr. Siega-Riz is recognized as an outstanding researcher, teacher and mentor in maternal-fetal nutrition. She is known for her passion about the health of mothers and children.

2006: William W. Hay, Jr., MD
Dr. Hay is Professor of Pediatrics at the University of Colorado School of Medicine and Vice-President/President-Elect of the American Pediatric Society. He is widely recognized as one of the country's most distinguished academic pediatricians and a strong mentor of young scientists. Dr. Hay's career in nutrition research has spanned 34 years. His scientific interests include fetal and neonatal nutrition, intrauterine fetal growth, and fetal growth restriction, all of which have relevance to the fetal origins of adult diseases. Dr. Hay is recognized internationally for his contributions to the understanding of fetal glucose and amino acid deprivation. He is the author of numerous landmark books and papers that are required reading for many pediatricians in training across the United States.

2005: Barbara Luke, ScD, MPH, RD
Dr. Luke is Professor in the Department of Epidemiology and Public Health, with joint appointments in the Department of Obstetrics and Gynecology and the Department of Pediatrics at the University of Miami School of Medicine. Dr. Luke is internationally known for her work on improving outcomes in multiple pregnancies through enhanced prenatal care and patient education, including targeted weight gain recommendations and healthy eating therapy. She is the founder of the University Consortium on Multiple Births, a collaborative group of researchers around the country who pool their maternal and neonatal data to evaluate factors affecting outcomes. She has written or edited 16 books. The latest When You're Expecting Twins, Triplets, Quads, co-authored with Tamara Eberlein and published by HarperCollins, won the Outstanding Book of the Year award in 2000 from the American Society for Journalists and Authors. It is among the top 10 best-selling pregnancy books in the U.S. Dr. Luke's goal is to help every child reach his or her full growth potential at birth through optimal maternal nutrition.

2004: Barbara Abrams, DrPH, RD
Dr. Abrams is Professor of Epidemiology, Public Health Nutrition and Maternal and Child Health at the University of California, Berkeley, School of Public Health where she also currently serves as Associate Dean of Student Affairs. After more than a decade of experience providing nutrition counseling and education directly to expectant mothers in prenatal clinical care settings, she turned her attention to conducting research studies to better understand how maternal weight and weight gain before, during and after pregnancy contribute to health outcomes in newborn infants and their mothers. She is most proud of her work educating future leaders in the field of maternal nutrition and public health.

2003: Lois Jovanovic, MD
Dr. Jovanovic is Director and Chief Scientific Officer at Sansum Medical Research Institute in Santa Barbara, CA and Clinical Professor of Medicine, University of Southern California, Los Angeles. Dr. Jovanovic is an internationally recognized expert in the nutritional management of gestational diabetes. She has made significant contributions in medical nutrition therapy of gestational diabetes, specifically in high-risk Hispanic-American women. Her goals are to provide pregnant women and clinicians with tools and methods for successful management of gestational diabetes and to reduce the numbers of macrosomic and malformed newborns born to diabetic women.

2002: Theresa O. Scholl, PhD, MPH
Dr. Scholl is Professor in the Department of Obstetrics and Gynecology at the University of Medicine and Dentistry of New Jersey School of Medicine. For almost 20 years, Dr. Scholl has studied the relationship between nutrition and health outcomes in adolescent pregnancy. Specifically, her research has focused on effects of continued adolescent maternal growth during pregnancy; the impairment of maternal growth on nutrient transfer between mother and fetus, resulting in increased risk of low birthweight babies; improved pregnancy outcomes following material intake of zinc, folate and multivitamins; the association of pre-pregnancy weight, prenatal weight gain and anemia with growth and preterm deliveries; and the possible adverse effects of oxidative damage to fetal DNA through dietary exposure.

Other recipients

Lynn B. Bailey, PhD
Kathryn G. Dewey, PhD
Mary Frances Picciano, PhD
David M. Paige, MD, MPH
Godfrey P. Oakley, Jr., MD, MPH, and Paul B. Pencharz, MB, ChB, PhD, FRCP(C)
Paul B. Pencharz, MD, ChB, PhD, FRCP(C)
Frederick C. Battaglia, MD
M. Elizabeth Brannon, MS, RD
Judith E. Brown, PhD, MPH, RD
Mary Egan, MS, MPH
Norbert Freinkel, MD
Howard N. Jacobson, MD
Janet C. King, PhD, RD
William McGanity, MD
Charlotte G. Neumann, MD, MPH
Roy M. Pitkin, MD
Pedro Rosso, MD
Reginald C. Tsang, MD
Myron Winick, MD
Bonnie Worthington-Roberts, PhD

Alcohol during pregnancy

Drinking alcohol when you're pregnant can be very harmful to your baby. It can cause your baby to have a range of lifelong health conditions. Drinking alcohol during pregnancy can cause miscarriage, preterm birth and stillbirth.

How does alcohol during pregnancy harm your baby?

When you drink alcohol during pregnancy, so does your baby. The same amount of alcohol that is in your blood is also in your baby's blood. The alcohol in your blood quickly passes through the placenta and to your baby through the umbilical cord.

Although your body is able to manage alcohol in your blood, your baby's little body isn't. Your liver works hard to break down the alcohol in your blood. But your baby's liver is too small to do the same and alcohol can hurt your baby's development. That's why alcohol is much more harmful to your baby than to you during pregnancy.

Alcohol can lead your baby to have serious health conditions, called fetal alcohol spectrum disorders (FASD). The most serious of these is fetal alcohol syndrome (FAS). Fetal alcohol syndrome can seriously harm your baby's development, both mentally and physically.

Alcohol can also cause your baby to:

  • Have birth defects (heart, brain and other organs)
  • Vision or hearing problems
  • Be born too soon (preterm)
  • Be born at low birthweight
  • Have learning disabilities (including intellectual disabilities)
  • Have sleeping and sucking problems
  • Have speech and language delays
  • Have behavioral problems

What can you do?

Drinking alcohol during pregnancy can cause permanent harm to your baby. But the good news is that these harmful conditions can be completely avoided. If you stay away from alcohol during pregnancy, your baby can't have FASDs or any other health conditions caused by alcohol.

If you're pregnant or even thinking about getting pregnant, stop drinking alcohol. Alcohol includes wine, wine coolers, beer and liquor. There is no amount of alcohol that is proven to be safe.

You may know some women who drank regularly during pregnancy and had seemingly healthy babies. You may know some women who had very little alcohol during pregnancy and had babies with serious health conditions. Every pregnancy is different. Drinking alcohol may hurt one baby more than another. The best way to ensure a healthy baby is to stay away from alcohol altogether.

If you had an occasional drink before knowing you were pregnant, chances are it probably won't harm your baby. But it's very important that you stop drinking alcohol as soon as you think you might be pregnant. The sooner you stop drinking, the better off you and baby will be. Also, be sure to get regular prenatal care and tell your health care provider about any concerns you may have.

What can dads do?

Fetal alcohol syndrome and other alcohol-related health illnesses are caused when mom drinks during her pregnancy. Research is still being done to know if alcohol harms dad's sperm before a woman gets pregnant. But that doesn't mean dads can't do their part during pregnancy. Your partner can help you stay away from alcohol by:

  • Encouraging you to keep away from social situations where people may be drinking
  • Teaming up with you by staying away from alcohol, himself

How can you avoid alcohol?

Here are some tips for giving up alcohol:

Avoid situations where you usually drink, like parties or bars.

Ask your partner, family and friends to help you stay away from alcohol.

If you have a problem stopping:

  • Ask your health care provider or employer about alcohol treatment programs.
  • Join an Alcoholics Anonymous support group. Their telephone number is in the white pages or community service pages of your local telephone book.
  • Contact the National Council on Alcoholism and Drug Dependence (NCADD), (800) NCA-CALL (622-2255).
  • For more information and a referral to resources in your area, visit the Substance Abuse Treatment Facility Locator on the Substance Abuse and Mental Health Services Administration’s website or call (800) 662-HELP (662-4357).

Last reviewed July 2012

Alpha Phi Alpha Fraternity Inc

The March of Dimes and Alpha Phi Alpha Fraternity, Inc. began collaboratively implementing Project Alpha in 1980. Designed to provide young men with current and accurate information about teen pregnancy prevention, Project Alpha consists of a series of workshops and informational sessions conducted by Alpha Phi Alpha Fraternity brothers.

The three goals of Project Alpha programs are:

  • Sharing Knowledge by combating ignorance and fear with factual information
  • Changing Attitudes by providing motivation toward positive changes in sexual behavior
  • Providing Skills by creating a sense of empowerment and self-esteem

Alpha Phi Alpha Fraternity, Inc. chapters all across the country worked with their local March of Dimes to implement Project Alpha programs. Project Alpha week is the first week of November. This program reaches more than 25,000 young men every year.

In addition to Project Alpha, March for Babies® serves as an example of the Alpha Phi Alpha Fraternity, Inc. - March of Dimes partnership. In the last 5 years, Alpha Phi Alpha Fraternity brothers have raised over $1 million for the March of Dimes. Learn more at alpha-phi-alpha.com.

Baby and Me: Tobacco Free

Oregon chapter

"Baby & Me: Tobacco Free" is an incentive-based program utilizing the 5'As counseling approach to assist pregnant women in quitting smoking and to help them stay tobacco-free after the birth of their baby. The population served was economically disadvantaged smoking women receiving prenatal and postpartum services through Douglas County Public Health Programs (Prenatal Clinic Care, Family Planning, Maternity Case Management, Babies First, Healthy Start, WIC).

This program involved:

  • Conducting 5'As cessation counseling training for participating public health program staff and local health care providers.
  • Enrolling and collecting baseline data on participants.
  • Providing four or more prenatal cessation counseling sessions for each participant. Participants who test smoke-free at each session receive a $10 gift certificate and are entered into a drawing for a Baby Me gift basket.
  • Using carbon monoxide (CO) testing to determine smoke free status during pregnancy and after delivery.
  • Conducting monthly visits with participants for 6 months following delivery to monitor smoking status, providing support and incentives. Participants who remain smoke-free after the birth of their babies receive a $20 diaper voucher each month for up to 6 months postpartum.
  • Compiling class attendance records, number of vouchers issued/redeemed, quit status during pregnancy and at 3 and 6 months postpartum.

The results included:

  • Nineteen professional staff were trained on the 5'As method.
  • Fifty-three women received services.
  • Seventy-nine percent were smoke-free during pregnancy.
  • One-hundred percent of the women who delivered during the term of the project were smoke-free at the time of delivery.
  • Fifty percent of the women who were smoke-free during pregnancy remained smoke free during the postpartum period.
  • Upon request by program participants, carbon monoxide testing was also provided for husbands/partners of the pregnant women receiving services.
  • Parents of pregnant teens agreed to quit smoking to support their daughters' quit attempt.

Lessons learned:

  • Recruitment of participants was surprisingly difficult. To address this issue, a program flyer was developed and marketing was broadened. Enrollment increased as a result.
  • Increased cost of tobacco products is an incentive to quitting. Having participants determine the amount of money they spend on tobacco products each month is a good exercise.

Bank of America Corporation

As a longtime supporter of March for Babies, raising more than $30 million over the past 13 years, Bank of America fields the largest March for Babies team nationwide – with more than 8,000 employees participating with their family and friends. Creative fundraising activities, strong local volunteer relationships and executive leadership are among just a few of the elements that contribute to the success of Bank of America's campaign.

Beaulieu

Beaulieu of America, a leader in floor covering founded in 1978, is based in Dalton, GA. As the third largest flooring manufacturer and the largest carpet-only maker in the world, Beaulieu is a national partner of the March of Dimes 2013 imbornto® campaign. As a campaign partner, Bliss by Beaulieu Indulgence proudly supports the March of Dimes through consumer purchases at retail. For every square yard purchased in May, June and July 2013, Beaulieu will donate $.50 to March of Dimes.

Big 5 Sporting Goods

Big 5 Sporting Goods continues to play a vital role in driving the competitiveness, fun and ultimately the fundraising in March for Babies for families everywhere. Since 2000, the company has participated in March for Babies by engaging their customers through an annual in-store fundraising promotion, contributing more than $3.8 million. Customers can make a donation or pick up a local March for Babies sponsor form in any Big 5 store in their 12-state footprint. 

Bon-Ton Stores

The Bon-Ton Stores, Inc., with corporate headquarters in York, PA and Milwaukee, WI, operates 272 department stores, including 11 furniture galleries, in 24 states throughout the Northeast, Midwest and upper Great Plains. The Bon-Ton Stores operate under seven nameplates, including Bon-Ton, Bergner’s, Boston Store, Carson’s, Elder-Beerman, Herberger’s and Younkers. The Bon-Ton Stores joined the March of Dimes in 2013 supporting the launch of the imbornto® campaign.  From Mother’s Day through Father’s Day, Bon-Ton is committed to raising funds to ensure that all babies are born strong and healthy. Activation includes in-store and on-line opportunities for customer donations and engagement. 

Builders Club

With 40,000 members worldwide, the Builders Club is the largest service organization for middle/junior high school students. It is a student-led community service organization whose sponsor is another March of Dimes partner, Kiwanis International. Builders Club members from all over the county join the March of Dimes during March for Babies to improve the health of babies. This partnership helps the Builders Club achieve their mission to provide their members with the opportunity to build character, develop leadership skills and perform service activities amongst their communities. Learn more about the Builders Club partnership.

Centering Pregnancy

To address racial disparities in birth outcomes in New Jersey, the chapter funded the introduction of CenteringPregnancy (http://www.centeringhealthcare.org/) to local health care providers and as well as the establishment and on-going support of this model of group prenatal care at several local sites. The women who benefited from this program are pregnant African American women who get their prenatal care at Family Health Centers and clinics.

This program involved:

  • Holding a showcase of program best practices which included CenteringPregnancy®.
  • Establishing programs at Newark Community Health Center (NCHC), the University of Medicine and Dentistry of NJ and JFK Family Health Center.

The results included:

  • One site reporting that only one of the 28 women completing the program had a preterm birth.
  • Sixty-six percent of the participants liked receiving their prenatal care in the group.
  • Eighty percent felt that they learned a lot about prenatal care in the group.
  • Eighty percent enjoyed being with other women in the group care.
  • Sixty-six percent felt well prepared for labor and delivery.
  • Eighty-seven percent felt prepared for caring for a new baby.
  • NJ Department of Health and Senior Services, after co-chairing the Social Equity in Birth Outcomes Initiative with the March of Dimes, decided to reprioritize its maternal child health grants to require evidence based programs that reduced racial disparities in birth outcomes.
  • NCHC applied to the state for a Department of Health grant to improve access to prenatal care. NCHC received $300,000 grant to provide prenatal care at two prenatal clinics in the city of Newark that are at the sites of newly closed hospitals. Centering will be implemented at both sites.
  • The University of Medicine and Dentistry of New Jersey’s OB/GYN clinic will provide access to CenteringPregnancy® for over 2,000 pregnant women at five clinics in Essex County. Essex County has the highest preterm birth rate (14.8 percent) in the state.

Cigna

Cigna prides itself on helping all the individuals it serves use their unique strengths to achieve their full potential. Its commitment to helping individuals improve their health and well-being is demonstrated by its 18 consecutive years as national partner of the March of Dimes and national sponsorship of March for Babies. The company and its employees have contributed more than $27 million to improve the health of babies and their families, and foster healthier communities. Additionally, Cigna's dedicated employees serve on local March of Dimes chapter boards and offer energetic support for March of Dimes special events throughout the year. 

Circle K International

Circle K International chapters conduct educational workshops, perform community service and fundraise for the March of Dimes. They can also work in cooperation with local Key Club or Builders Club organizations to participate in March for Babies. Learn more about Circle K International and the partnership.

Citi

The proud tradition that has linked Citi with the March of Dimes through March for Babies demonstrates their responsibility to their franchise, which calls upon Citi employees to take an active role in the communities where they work and live. In all parts of the country, thousands of Citi employees take to the streets, the shores, the mountains and the parks on March for Babies weekends and celebrate the positive effect they have made on their communities and the nation. Since 2000, Citi employees have contributed more than $34 million and have truly saved the lives of thousand of babies.

 

Comenzando Bien

Texas chapter

Comenzando bien® is a prenatal curriculum designed for pregnant women to learn about having a healthy pregnancy in a supportive group setting. It also provides culturally relevant social support/prenatal education for pregnant Hispanic women and demonstrates improved birth outcomes/behavior change. The curriculum is available in both English and Spanish.

This program involves:

  • Revising the Comenzando bien evaluation tools to be user-friendly and to measure desired variables;
  • Creating a statewide database to track information on sites and facilitators;
  • Training facilitators at 32 sites participating in the initiative;
  • Enrolling 3,600 women in the Comenzando bien 6-session series of classes and graduation;
  • Collecting pre/post tests and follow-up postcards from participants. The pre/post tests measured knowledge change and satisfaction. The follow-up postcard measured birth outcomes and behavior changes.

The results included:

  • A total of 2,248 pre-tests, 2,036 post-tests and 922 follow-up postcards were collected.
  • Of the participants reporting birth outcomes, 98.1 percent delivered a full-term baby.
  • Nearly all participants (99.4 percent) reported that Comenzando bien provided them with social support.
  • One-hundred percent of participants reported that they changed their eating or exercise habits because of what they learned in the Comenzando bien classes.
  • On the pre-test, only 10.6 percent of participants stated that babies should always be put to sleep on their backs. However, on the follow-up postcards, 97 percent of participants reported that they put their baby to sleep on its back.
  • One-hundred-sixteen participants reported that they stopped smoking because of what they learned in the Comenzando bien classes.
  • Culturally relevant prenatal education can improve birth outcomes, enhance participants’ social support and create behavior change. Participants gain social support and become mentors to each other.
  • Graduate participants who become mentors create a vested interest in each woman’s well-being.
  • Evaluation tools used through this project are being tested in Kansas (link) and California (link) chapters in 2010 so that results can be compared among three different states.

Lessons learned:

  • Host quarterly workshops for all facilitators in order to maintain continuity of education, share ideas and resources, and ensure evaluation protocols are followed.
  • Use incentives to encourage each Comenzando bien site to utilize all evaluation tools and to increase program participation.

C-section: Medical reasons

Cesarean birth is the birth of a baby by surgery. The doctor makes an incision (cut) in the belly and uterus (womb) and then removes the baby. The surgery is called a cesarean section or c-section. The natural way for a baby to be born is through the mother's vagina (birth canal). But sometimes vaginal birth isn't possible. If you or your baby have certain problems before or during labor, c-section may be safer than vaginal birth.

You and your health care provider may plan your cesarean in advance. Or you may need an emergency (unplanned) c-section because of a complication that arises for you or your baby during pregnancy or labor.

Why might I have a c-section?

  • Your health care provider may suggest that you have a c-section for one or more of these reasons:
  • You've already had a c-section in another pregnancy or other surgeries on your uterus.
  • Your baby is too big to pass safely through the vagina.
  • The baby's buttocks or feet enter the birth canal first, instead of the head. This is called a breech position.
  • The baby's shoulder enters the birth canal first, instead of the head. This is called a transverse position.
  • There are problems with the placenta. This is the organ that nourishes your baby in the womb. Placental problems can cause dangerous bleeding during vaginal birth.
  • Labor is too slow or stops.
  • The baby's umbilical cord slips into the vagina, where it could be squeezed or flattened during vaginal delivery. This is called umbilical cord prolapse.
  • You have an infection like HIV or genital herpes.
  • You're having twins, triplets or more.
  • The baby has problems during labor that show it is under stress, such as a slow heart rate. This is sometimes called "fetal distress."
  • You have a serious medical condition that requires intensive or emergency treatment (such as diabetes or high blood pressure).
  • The baby has a certain type of birth defect.

A woman who has a c-section usually takes longer to recover than a woman who has had a vaginal birth. Women can expect to stay 3 to 4 days in the hospital after a c-section. Full recovery usually takes 4 to 6 weeks. Usually, the hospital stay for vaginal birth is 2 days, with full recovery taking less time than a cesarean. C-section may be more expensive than a vaginal birth.

What about the risks?

When c-sections are done, most women and babies do well. But c-section is a major operation with risks from the surgery itself and from anesthesia.

The National Center for Health Statistics estimates that 1 in 3 babies in the United States are delivered by c-section. Over the past few years, the rate of cesarean birth has increased rapidly. Some health care providers believe that many c-sections are medically unnecessary. When a woman has a cesarean, the benefits of the procedure should outweigh the risks.

The risk of late preterm birth

C-sections may contribute to the growing number of babies who are born "late preterm," between 34 and 36 weeks gestation. While babies born at this time are usually considered healthy, they are more likely to have medical problems than babies born a few weeks later at full term.

A baby's lungs and brain mature late in pregnancy. Compared to a full-term baby, an infant born between 34 and 36 weeks gestation is more likely to have problems with:

  • Breathing
  • Feeding
  • Maintaining his or her temperature
  • Jaundice

It can be hard to pinpoint the date your baby was conceived. Being off by just a week or two can result in a premature birth. This may make a difference in your baby's health. Keep this in mind when scheduling a c-section.

Other risks for the baby

  • Anesthesia: Some babies are affected by the drugs given to the mother for anesthesia during surgery. These medications make the woman numb so she can't feel pain. But they may cause the baby to be inactive or sluggish.
  • Breathing problems: Even if they are full-term, babies born by c-section are more likely to have breathing problems than are babies who are delivered vaginally.

Breastfeeding

Women who have c-sections are less likely to breastfeed than women who have vaginal deliveries. This may be because they are uncomfortable from the surgery or have less time with the baby in the hospital. If you are planning to have a cesarean section and want to breastfeed, talk to your provider about what can be done to help you and your baby start breastfeeding as soon as you can.

Risks for the mother

A few women have one or more of these complications after a c-section:

  • Increased bleeding, which may require a blood transfusion
  • Infection in the incision, in the uterus, or in other nearby organs
  • Reactions to medications, including the drugs used for anesthesia
  • Injuries to the bladder or bowel
  • Blood clots in the legs, pelvic organs or lungs

A very small number of women who have c-sections die. Death is rare, but it is more likely with cesarean than with vaginal delivery.

If a woman who has had a cesarean section becomes pregnant again, she is at increased risk of:

  • Placenta previa: The placenta implants very low in the uterus. It covers all or part of the internal opening of the cervix (the birth canal).
  • Placenta accreta: The placenta implants too deeply and too firmly into the uterine wall.

Both of these conditions can lead to severe bleeding during labor and delivery, endangering mother and baby. The risk increases with the number of pregnancies.

Making decisions

Every pregnancy is different. If you are considering a planned c-section for medical reasons or are interested in asking that your baby be delivered by c-section, talk with the health care provider who will deliver your baby. Carefully consider the risks and benefits for your baby and yourself. These questions may be useful when you speak to your provider.

If your provider recommends delivery before 39 weeks:

  • Is there a problem with my health or the health of my baby that may make me need to have my baby early?
  • Can I wait to have my baby closer to 40 weeks?

About c-section:

  • Why do I need to have a c-section?
  • What problems can a c-section cause for me and my baby?
  • Will I need to have a c-section in future pregnancies?

July 2008

Destination Maternity Corporation

Destination Maternity (incorporating A Pea in the Pod®, Motherhood Maternity® and Destination Maternity® stores) is the largest maternity retailer in the United States, and a national sponsor of the March of Dimes Prematurity Campaign. The company is committed to providing information for their customers to better understand the risk of premature birth and steps women can take to ensure a healthy pregnancy. All their stores conduct an in-store donation campaign in the spring and fall, and many offer multiple year-round giving programs with a portion of the proceeds benefiting the March of Dimes, including the opportunity to purchase a co-branded bracelet.  In addition, first-time customers in Destination Maternity stores receive gift bags with a bilingual March of Dimes Pregnancy & Newborn Health Education Center brochure, providing instructions on how to access information on pregnancy topics.
 

 

Developmental milestones for baby

During the first year of life, your baby will grow and develop at an amazing speed. Her weight will double by 5 to 6 months, and triple by her first birthday. And she is constantly learning. Major achievements—called developmental milestones—include rolling over, sitting up, standing and possibly walking. And your heart will likely melt at the sound of her first “mama” or “dada.”

No two babies are exactly alike. Your baby will develop at her own pace. Most babies reach certain milestones at similar ages. However, it's not unusual for a healthy, “normal” baby to fall behind in some areas or race ahead in others.

The following milestones are only guidelines. Your baby's health care provider will evaluate your baby's development at each well-baby visit. Remember: Always talk to your child's health care professional if you think your baby is lagging behind.

If your baby was born prematurely (before 37 weeks of pregnancy), you need to look at the milestone guidelines a little differently. The age at which your baby is expected to reach various milestones is based on her due date, not her birthday. So if your baby was born two months early, she will most likely achieve milestones two months later than the guidelines below predict.

By the end of their first month, most babies:

  • Make jerky, quivering arm movements
  • Bring hands near face
  • Keep hands in tight fists
  • Move head from side to side while lying on stomach
  • Focus on objects 8 to 12 inches away
  • Prefer human faces over other shapes
  • Prefer black-and-white or high-contrast patterns
  • Hear very well
  • Recognize some sounds, including parents' voices

Watch our video on Developmental Milestones, Age 1 Month.

By the end of their third month, most babies:
  • Raise head and chest when lying on stomach
  • Support upper body with arms when lying on stomach
  • Stretch legs out and kick when lying on stomach or back
  • Push down on legs when feet are placed on a firm surface
  • Open and shut hands
  • Bring hands to mouth
  • Grab and shake hand toys
  • Follow moving object with eyes
  • Watch faces closely
  • Recognize familiar objects and people at a distance
  • Start using hands and eyes in coordination
  • Begin to babble and to imitate some sounds
  • Smile at the sound of parents' voices
  • Enjoy playing with other people
  • May cry when playing stops

Watch our video on Developmental Milestones, Age 3 Months.

By the end of their seventh month, most babies:
  • Roll over both ways (stomach to back and back to stomach)
  • Sit up
  • Reach for object with hand
  • Transfer objects from one hand to the other
  • Support whole weight on legs when held upright
  • Develop full-color vision and mature distance vision
  • Use voice to express joy and displeasure
  • Respond to own name
  • Babble chains of consonants (ba-ba-ba-ba)
  • Distinguish emotions by tone of voice
  • Explore objects with hands and mouth
  • Struggle to get objects that are out of reach
  • Enjoy playing peek-a-boo
  • Show an interest in mirror images

Watch our video on Developmental Milestones, Age 7 Months.

By their first birthday, most babies:
  • Sit without assistance
  • Get into hands-and-knees position
  • Crawl
  • Pull self up to stand
  • Walk holding onto furniture, and possibly a few steps without support
  • Use pincer grasp (thumb and forefinger)
  • Say “dada” and “mama”
  • Use exclamations, such as “oh-oh!”
  • Try to imitate words
  • Respond to “no” and simple verbal requests
  • Use simple gestures, such as shaking head “no” and waving bye-bye
  • Explore objects in many ways (shaking, banging, throwing, dropping)
  • Begin to use objects correctly (drinking from cup, brushing hair)
  • Find hidden objects easily
  • Look at correct picture when an image is named

Watch our video on Developmental Milestones, Age 1 Year.

By their second birthday, most children:
  • Walk alone
  • Pull toys behind them while walking
  • Carry large toy or several toys while walking
  • Begin to run
  • Kick a ball
  • Climb on and off furniture without help
  • Walk up and down stairs while holding on to support
  • Scribble with crayon
  • Build tower of four blocks or more
  • Recognize names of familiar people, objects and body parts
  • Say several single words (by 15 to 18 months)
  • Use simple phrases (by 18 to 24 months)
  • Use two- to four-word sentences (“want snack”)
  • Follow simple instructions
  • Begin to sort objects by shapes and colors
  • Begin to play make-believe
  • Imitate behavior of others
  • Show growing independence

Last reviewed June 2012

Duchesnay USA

The March of Dimes and Duchesnay USA are working together to education women about NVP – nausea and vomiting of pregnancy.  Also known as morning sickness, VP is the most common pregnancy symptom, affecting 70 to 85 percent of pregnant women.  To provide access to information on NVP that can help women manage their symptoms, Duchesnay USA launched www.MorningsicknessUSA.com - a comprehensive NVP resource that includes recipes, lifestyle management ideas and articles by experts. 

 

Due in a Few

Even before the baby bump becomes apparent, soon-to-be moms can announce their upcoming bundle of joy by wearing Due in a Few’s Pregnancy Pins (available in pink, blue and white).  New to the retail environment, Due in a Few founders designed the ribbon pin, which they expect to become a universal symbol of pregnancy, not only a business opportunity, but also as a way to support March of Dimes.  Sold online currently, a portion of proceeds from sale of the pins will benefit March of Dimes.

Eating healthy during pregnancy

It's important to eat smart and make healthy food choices to support your baby's growth during pregnancy. Try to eat foods from each of the five food groups every day. They provide important nutrients that you and your baby need.

In general, most women need around 300 extra calories per day during pregnancy. (One extra healthy snack, such as four fig bars and a glass of skim milk, will provide these calories.) However, the exact amount of extra calories you need depends on your weight before pregnancy. Talk to your health provider to learn more about a healthy eating plan that’s right for you. Be sure to watch your serving sizes; you may be eating more than you need to.

Remember: Fatty foods (like doughnuts and chips) and sweets (like sodas, cookies and candy) don't give your baby enough of what he needs to grow.

Follow these guidelines:

Choosing healthy foods

Take folic acid

Folic acid is a B vitamin that helps prevent birth defects of the brain and spinal cord (called neural tube defects). All women of childbearing age should take a multivitamin with 400 micrograms of folic acid every day before pregnancy and during early pregnancy, as part of a healthy eating plan. Your healthy eating plan should include foods that are good sources of folic acid and folate (the form of folic acid that occurs naturally in food). Examples are:

  • Fortified breakfast cereals
  • Enriched grain products
  • Beans
  • Leafy green vegetables
  • Orange juice
  • Healthy eating hints

Healthy eating hints

Meals: Eat four to six smaller meals a day instead of three bigger ones to help relieve the heartburn and discomfort you feel as your baby grows bigger.

Snacks: Cheese, yogurt, fruit and vegetables are good, healthy snacks. Peanut butter and nuts are also good, if you aren't allergic to them.

Liquids: Drink at least six to eight glasses of water, juice or milk every day.

Vitamins: Take a multivitamin or prenatal vitamin every day. Ask your health care provider if you need to take an iron or calcium supplement, too.

Caffeine: Limit the caffeine you get each day to 200 milligrams. That's about the amount in one 12-ounce cup of coffee. Caffeine amounts in coffee depend on the brand you drink and how it's made. So check the label on the package, or ask at your coffee shop. Instead of drinking regular coffee, try coffee that's decaffeinated (has a smaller amount of caffeine). Caffeine is also found in tea, chocolate, soda and some over-the-counter medicine. Read labels on food, drinks and medicine to know how much caffeine you're getting.

Foods to avoid

Some foods can make you and your baby sick. Avoid these foods that can cause food poisoning or contain harmful chemicals:

  • Raw fish, especially shellfish
  • Soft-scrambled eggs and foods made with raw or lightly cooked eggs
  • Unpasteurized juices
  • Raw sprouts, especially alfalfa sprouts
  • Unpasteurized soft cheeses, such as brie, feta, Camembert, Roquefort, queso blanco, queso fresco and Panela
  • Unpasteurized milk and any foods made from it
  • Herbal supplements and teas
  • Fish that can be high in mercury, like shark, swordfish, king mackerel and tilefish. It's OK for pregnant women to eat a limited amount of fish that have small amounts of mercury. You can eat up to 12 ounces of these fish a week. The 12 ounces can include shrimp, salmon, pollock, catfish and canned light tuna. Don't eat more than 6 ounces of Albacore (white tuna) in one week. Always check with your local health department before you eat any fish you catch yourself.
  • Raw or undercooked meat, poultry, seafood and hot dogs. Deli meats (such as ham and bologna) can cause food poisoning. Avoid them or reheat them before eating.
  • Refrigerated pates, meat spreads or smoked seafood. Canned and shelf-stable versions are safe.

For more information, read Food-borne risks in pregnancy and Food safety.

Nonfoods

Never eat nonfood items like clay, starch, paraffin or coffee grounds. Eating these things can cause problems for you and your baby.

For more information

Visit the food pyramid for pregnancy from the U.S. Department of Agriculture.

Food serving chart

Education and development for health professionals

The March of Dimes offers a range of educational opportunities for health professionals, some of which include continuing education credits. Our resources include online materials, nursing modules, grand rounds, conferences and seminars.

Prematurity Prevention Symposium

The Prematurity Prevention Symposium enhances prematurity prevention efforts in the United States through the sharing of information about the design, implementation and evaluation of interventions, programs, policies and other activities undertaken to help prevent preterm births. It also brings together a coalition of individuals and organizations dedicated to promoting prematurity prevention.

The Prematurity Prevention Symposium is organized by the March of Dimes in collaboration with the American College of Obstetricians and Gynecologists, American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Nurse-Midwives (ACNM) and Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN).

Visit the Prematurity Prevention Resource Center (PPRC) or email us for more information.

Nursing education

For more than 30 years, the March of Dimes has offered continuing education to perinatal nurses. Developed by top experts in the field, our print and online materials can be used for individual or group study. We also support future nursing leaders by awarding scholarships to students who are pursuing graduate degrees in perinatal nursing.

Genetics education

 Genetics & Your Practice educates health care professionals who serve women before and during pregnancy, infants and children, adolescents and adults. The program provides information and resources to help busy professionals integrate genetics into their practices.

See also: The STABLE program

Environmental risks and pregnancy

Having a healthy pregnancy is more than just eating healthy and getting good prenatal care. It’s also important to keep your environment (where you live and work) safe from things that can harm you and your baby like radiation, chemicals and some metals.
Harmful substances can get into your body through your skin or when you breathe, eat or drink. Some can be immediately dangerous to you and your baby. With other substances, you have to come in contact with large amounts for a long time for them to cause harm.

Some jobs, like farming and working in dry cleaning stores or factories, may force you to be around or in contact with harmful substances. If you work in these kinds of jobs, talk to your health care provider and your employer about how you can protect yourself before and during pregnancy. You may need extra protection at work or a change in your job duties to stay safe.

You also can take steps to protect yourself and your baby from harmful substances at home.

Can radiation harm your pregnancy?

Radiation is a kind of energy. It travels as rays or particles in the air. Radiation can attach itself to materials like dust, powder or liquid. These materials can become radioactive, which means that they give off radiation.

You come in contact with small amounts of radiation nearly every day. This radiation comes from natural sources (such as sun rays) and man-made sources (such as microwaves and medical X-rays) that don’t cause harm. However, a nuclear power plant accident or similar emergency could put you in contact with larger, more dangerous amounts of radiation.

2011 nuclear power plant crisis in Japan

Since the Fukushima Daiichi nuclear power plant accident in Japan in 2011, very small amounts of radiation have been found in the United States. The Centers for Disease Control and Prevention (CDC) says that it’s not enough radiation to cause health problems. So you don’t need to take any drugs to treat radiation sickness. These drugs are only given to people who come in close contact with large amounts of radiation. In fact, these drugs can cause health problems in people who don’t need them.

Radiation during pregnancy

During pregnancy, your body works hard to protect your baby from radiation that you come in contact with every day. Most babies born to moms who come in contact with low amounts of radiation during pregnancy aren’t at increased risk for birth defects.

However, some radiation may cause health problems in you and your baby. It depends on the amount of radiation that your body takes in, the kind of radiation and the length of time that you’re in contact with it.

If you’re in contact with large amounts of radioactive material, and this material gets inside your body (you swallow it or breathe it), it may cause harm to your baby during pregnancy.

When radioactive material gets into your bloodstream, it can pass through the umbilical cord to your baby. It also can be dangerous if radioactive material builds up in areas of your body that are close to your uterus (womb), such as your bladder.

If you come in contact with large amounts of radiation early in your pregnancy, your baby may be at risk for birth defects. Exposure to large amounts of radiation, equal to having more than 500 chest X-rays at one time, is not common. But some pregnant women in Japan came in contact with this much radiation after the atomic bombs dropped on Hiroshima and Nagasaki in 1945. If you do come in contact with large amounts of radiation, you may not feel sick, but the radiation may be enough to cause serious problems in your baby. Radiation can slow his growth, cause birth defects, affect brain development or lead to cancer.

Extremely large amounts of radiation later in pregnancy can cause severe health risks for your baby. Exposure to extremely large amounts of radiation, equal to having more than 5,000 chest X-rays at one time, is not common. But some women came in contact with this much radiation from the 1986 Chernobyl nuclear power plant accident in the Ukraine. If you come in contact with extremely large amounts of radiation, you may show signs of radiation sickness. Early symptoms include vomiting, diarrhea and fever. Later signs of radiation sickness range from fatigue to hair loss or bloody stools.

If you’re pregnant, contact your health care provider immediately if you think you’ve been exposed to large amounts of radiation. CDC offers tips to prepare for radiation emergencies and steps you can take to stay safe after being exposed to radiation.

Can lead harm your pregnancy?

Lead is a metal. It was once used in gasoline and house paint but is no longer used in any products. With most lead used in products, you can’t see, smell or taste it. Today the most common sources of lead are house paint (used before 1978) and water that comes from wells or through lead pipes.

Lead can be harmful to everyone, but it’s especially harmful to young children and pregnant women. Contact with lead during pregnancy can put you at risk for miscarriage, and your baby may be at risk for preterm birth, low birthweight and developmental delays. Most women in this country don’t come in contact with high levels of lead. But if you think you have, your health care provider can check your lead levels with a blood test.

Lead paint

If you live in a home built before 1978, you could be in contact with lead. Older homes were once painted with house paint that had lead.

If you live in an older home and the paint isn’t crumbling or peeling, there’s little risk to your health. However, crumbling paint can lead to dust with lead substances, which can be harmful to your health.

If you need to remove lead paint from your home, hire experts to do it. Stay out of your home until the job is done. You can learn more about lead paint and removing lead at the U.S. Environmental Protection Agency (EPA) website.

Lead in water

If you have lead plumbing in your house or if you have well water, lead could get into your drinking water. Boiling your water does not get rid of lead.

If you think you have lead plumbing:

  • Use only cold water for drinking and cooking. Water from the cold water pipe has less lead than water from the hot pipe.
  • Run water for 15 to 30 seconds before drinking it, using it for cooking or making baby formula, especially if you haven’t used water for a few hours. If you use a water filter, get one that is certified by NSF International to remove lead.
  • Contact your local health department or water supplier to find out how to get pipes tested for lead.

If you use well water, contact the EPA Safe Drinking Water Hotline at (800) 426-4791 for information on testing your well water for lead and other substances that can harm your health.

Other sources of lead in the home

Lead can be found in other parts of the home, including:

  • Lead crystal glassware and some ceramic dishes. Don’t use these items. Ceramics you buy in a store are generally safer than those made by craftspeople because stores have to follow certain safety guidelines.
  • Some arts and crafts supplies, including oil paints, ceramic glazes and stained glass materials. Use lead-free art supplies during pregnancy and breastfeeding.
  • Vinyl miniblinds that come from other countries.
  • Old painted toys and some new toys and jewelry. The U.S. Consumer Product Safety Commission website has information on recalls.
  • Make-up, such as lipstick, that has surma or kohl. Check the label on your make-up for a list of ingredients.
  • Canned food from other countries.
  • Candy from Mexico called Chaca Chaca. Lead in this candy may come from ingredients like chili powder and tamarind, or from ink on plastic or paper wrappers.

Lead on the job

If you work in a job that puts you in contact with large amounts of lead, your health could be at risk. These jobs include painting, plumbing, auto repair, battery manufacturing and certain kinds of construction.

To help you stay safe:

  • Change your clothes (including shoes) before coming home.
  • Shower at work to avoid bringing lead into your home.
  • Wash your work clothes at work or wash them at home separately from the rest of the laundry.

Can mercury harm your pregnancy?

Mercury is a metal. There are two kinds of mercury that can be harmful during pregnancy: elemental (pure) mercury and methylmercury.

Elemental mercury

Elemental mercury is used in some dental fillings (used to fill in cavities in teeth), older thermometers and fluorescent light bulbs.

A dental filling that is silver-colored is called an amalgam. Amalgam contains elemental mercury, silver and other metals. Small amounts of mercury from amalgam fillings can get into the air you breathe.

While amalgams are safe in adults and children over age 6, there’s not enough information to know if they’re safe during pregnancy. If you’re concerned about having an amalgam filling, talk with your dentist.

Mercury in older thermometers and fluorescent bulbs is surrounded by glass and doesn’t pose any health risk unless the glass breaks. If the glass breaks, small amounts of mercury can get into the air you breathe.

If you break a thermometer, don’t vacuum the spilled mercury. Instead, use a piece of paper to roll the beads of mercury onto another piece of paper. Seal the paper in a plastic bag. Contact your local health department to ask how to throw the mercury away.

Fluorescent bulbs have much less mercury in them than old thermometers. But you still have to be careful to clean up the mercury if you break an old bulb. The EPA has guidelines for cleaning up fluorescent bulbs.

Methylmercury

Methylmercury is made when mercury in the air gets into the water supply. The mercury comes from natural sources (such as volcanoes) and man-made sources (such as burning coal and other pollution).

You can get methylmercury in your body by eating fish that swim in waters with methylmercury. Methylmercury is mostly found in certain large fish, like swordfish, shark, king mackerel and tilefish. During pregnancy, don’t eat these kinds of fish because the mercury in them can cause harm to your baby.

It’s OK for pregnant women to eat a limited amount of fish that have small amounts of mercury. You can eat up to 12 ounces of these fish a week. The 12 ounces can include shrimp, salmon, pollock, catfish and canned light tuna. If you eat albacore (white) tuna, don’t eat more than 6 ounces a week.

Mercury on the job

If you’re pregnant and work in a dental office or at a job (like electrical, chemical and mining jobs) that uses mercury to make products, talk with your health care provider about how to stay safe.

Can arsenic harm your pregnancy?

Arsenic is a metal. It gets into the environment through natural sources (crumbling rocks and forest fires) and man-made sources (mining and making electronic products).

Small amounts of arsenic normally found in the environment are unlikely to harm your baby during pregnancy. But if you come in contact with higher levels of arsenic, it may be harmful to your pregnancy and cause problems like miscarriage and birth defects.

Arsenic also can be harmful to children. If children are in contact with arsenic for a long period of time, it may lead to lowered IQ.

You may be in contact with harmful levels of arsenic if you:

  • Work or live near metal smelters (where metal is made)
  • Live near harmful waste sites or incinerators (used to burn garbage)
  • Drink well water that has high levels of arsenic. This may be well water found near metal smelters, waste sites or incinerators. Or it may be well water in areas of the country, like parts of New England and the Midwest that have naturally high levels of arsenic in rock.

If you live in areas that may have high arsenic levels, follow these steps to protect yourself:

  • Limit your contact with soil.
  • Get your well water tested for arsenic to make sure it’s safe to drink.
  • Seal decks and outdoor play sets made before 2003. Arsenic was once used in these products. You can use a special stain or sealant to reduce your chances of coming in contact with arsenic.
  • Change out of work clothes and shoes that were in contact with arsenic before you go home.

Can pesticides harm your pregnancy?

Pesticides are chemicals used to kill or keep away insects and rodents. You can use some pesticides in your home. Others are for use only outside or on crops.

Being in contact with large amounts of pesticides may be harmful during pregnancy. It may lead to miscarriage, preterm birth, low birthweight, birth defects and learning problems. If you live or work in an area with crops, you may be exposed to large amounts of pesticides. During pregnancy, stay away from pesticides whenever you can.

If you need pest or rodent control in your home:

  • Try to use traps, like mousetraps or sticky traps, instead of pesticides. Be careful not to set traps in places where children can get to them.
  • Have someone else put the pesticide in your home. Ask them to follow the directions on the product label.
  • Put food, dishes and utensils away before using the pesticide.
  • Have someone open the windows to air out your home and wash off all surfaces where food is made after using the pesticide

If you use pesticides outside your home:

  • Close all the windows and turn off the air conditioning. This helps keep pesticides in the air from coming into the home.
  • Wear rubber gloves when gardening to avoid touching pesticides.

Insect repellants

Insect repellants are products you put on your skin or clothes to help keep insects, like mosquitoes and ticks, away. This helps prevent insect bites. You don’t want any insect bites during pregnancy because some insects carry infections that may be harmful to you and your baby.

Insect repellants are safe to use during pregnancy. Follow directions on the product label. You also can prevent bites by staying indoors in the early morning or late afternoon when mosquitoes are most likely to bite. Wearing long pants and long sleeves when going outdoors helps, too.

Can solvents harm your pregnancy?

Solvents are chemicals that get rid of other substances. Solvents include alcohols, degreasers, paint thinners and stain and varnish removers. Lacquers, silk-screening inks and paints also contain solvents.

If you inhale (breathe in) solvents at any time, you risk liver, kidney and brain damage and even death. During pregnancy, being in contact with solvents, especially if you work with them, can be harmful. It may lead to miscarriage, slow your baby’s growth, or cause premature birth and birth defects.

If you work with solvents or if you do arts and crafts using solvents, here’s how you can stay safe:

  • Air out your work area. Open a window or use a fan.
  • Wear safety clothes, like gloves and a face mask.
  • Don’t eat or drink in your work area.

Can air pollution harm your pregnancy?

Air pollution is a mixture of small substances and gases that are in the air. Most women who live in areas with high levels of air pollution (such as large cities) have healthy babies.

However, research shows that if you come into contact with high levels of certain air pollutants (like car exhaust), you may be slightly more likely than other women to have a premature or small baby. Some research shows that these air pollutants may lower a child’s IQ.

If you live in a large city with high levels of air pollution, limit your outdoor activities, especially exercise, on days when the air in your area is unhealthy.

Can household cleaning products harm your pregnancy?

Household cleaning products are products (like soaps and cleansers) you use to clean your home. When using household cleaning products, read labels carefully. Don’t use products that may be toxic (harmful). Products that are toxic (like some oven cleaners and carpet cleaners) say so on the label. If the label doesn’t have any safety information, don’t use the product. Or contact the product maker to make sure the product is safe to use during pregnancy.

Products that have ammonia or chlorine (bleach) in them probably don’t harm your baby during pregnancy. But their smell may cause nausea. When using these products:

  • Open windows and doors.
  • Wear rubber gloves.
  • Don’t mix products. Mixing ammonia and chlorine can cause dangerous fumes.

Instead of cleaning products, use safer, more natural products. For example, use baking soda to scrub greasy areas, pots and pans, sinks, tubs and ovens. And mix vinegar and water to clean floors and countertops.

Can chemicals in plastics harm your pregnancy?

Plastics are made from certain chemicals. Two of these chemicals are phthalates and bisphenol A (BPA). Phthalates make plastic soft and flexible. They are found in toys, medical equipment (such as tubing), shampoos, cosmetics and food packaging. BPA makes plastics clear and strong. It’s sometimes used in baby bottles, metal cans and water bottles.

Some research shows that being in contact with phthalates and BPA may be harmful during pregnancy. Since 2009, phthalates are no longer used in toys or other children’s products. While there isn’t a ban on BPA, many products are BPA-free.

More research needs to be done to know for certain if chemicals in plastics can harm your pregnancy or baby.

Here’s how to limit your contact with harmful plastics:

  • Don’t use plastic containers with the number 7 or the letters PC (stands for polycarbonate, a kind of chemical) in the triangle found on the bottom.
  • Limit use of canned food.
  • Don’t microwave food in plastic containers or put plastics in the dishwasher.

Here’s how to limit your baby’s contact with harmful plastics:

  • Breastfeed your baby so you don’t have to use baby bottles.
  • Use baby bottles made of glass, polypropylene or polyethylene.
  • Give your baby only plastic toys that are made after February 2009 or that are labeled phthalate-free or BPA-free.
  • Don’t use baby lotions or powders that contain phthalates. Check the product label to make sure.

For more information

Organization of Teratology Information Services
Centers for Disease Control and Prevention (CDC) – Radiation and Pregnancy

Last reviewed October 2011

Exercise during pregnancy

Some women think that pregnancy is a time to sit back and put their feet up. Not so! For most women, it’s important to exercise during pregnancy. In fact, it has many health benefits.

Healthy pregnant women need at least 2½ hours of exercise each week. This is about 30 minutes each day. If this sounds like a lot, don’t worry. You don’t have to do it all at once. Instead, split up your exercise by doing something active for 10 minutes three times each day.

Why is exercise during pregnancy good for you?

For healthy pregnant women, exercise can:

  • Keep your heart, body and mind healthy
  • Help you feel good and find the extra energy you need
  • Help you stay fit and gain the right amount of weight during pregnancy
  • Ease some of the discomforts you might have during pregnancy, like constipation, backaches, trouble sleeping and varicose veins (swollen veins)
  • Prevent health problems like preeclampsia and gestational diabetes
  • Help your body get ready to give birth
  • Reduce stress

Can exercise during pregnancy hurt your baby?

Exercise is safe for most healthy pregnant women. With your health care provider’s OK, exercising during pregnancy is safe for you and your baby. Talk to your health care provider before you start any exercise program. Ask about what kinds of exercise are safe for you to do.

Can all pregnant women exercise?

No. Not every woman should exercise during pregnancy. Don’t exercise if you have:

  • Heart problems that affect blood flow
  • Preterm labor. Preterm labor is labor that happens too early, before 37 completed weeks of pregnancy.
  • An incompetent cervix. This is a cervix that opens too early, before the baby is full term.
  • Lung disease
  • A pregnancy with twins, triplets or more. Being pregnant with multiples increases your chances for having preterm labor.
  • Vaginal bleeding during the second or third trimesters (from 4 months of pregnancy on) that doesn’t go away
  • Ruptured membranes (when your water breaks)
  • Preeclampsia
  • Placenta previa. This is when the placenta sits low in the uterus and covers all or part of the cervix. The placenta supplies the baby with food and oxygen through the umbilical cord. The cervix is the opening to the uterus that sits at the top of the vagina.

Ask your provider if it’s safe for you to exercise if:

  • You have a health problem, like anemia, high blood pressure, diabetes, a thyroid problem or seizures
  • You’re overweight or underweight

What types of exercise are best during pregnancy?

If your provider says it’s safe for you to exercise, pick activities you think you’ll enjoy. Some hospitals and health clubs offer aerobics and yoga classes just for pregnant women. Or try things you can do with your partner or friends, like walking or dancing.

Swimming is especially good for you. The water supports the weight of your growing body, and moving against it keeps your heart rate up.

If you exercised before you were pregnant, it’s usually safe to continue what you were doing. Be sure to check with your provider first. As your pregnancy continues and your belly gets bigger, you may need to change some activities or ease up on your workout.

If you didn’t exercise before you were pregnant, start slowly. Try to build up your fitness little by little.

Are there any types of exercise that aren’t safe during pregnancy?

Be careful and check with your provider when choosing your activities. During pregnancy, avoid:

  • Anything that might hurt you or cause you to fall, like horseback riding, downhill skiing, gymnastics or bike riding
  • Any sport where you might get hit in the belly, like ice hockey, kickboxing, soccer or basketball
  • After the third month of pregnancy, any exercises that make you lie flat on your back. Lying on your back can limit the flow of blood to your baby.
  • Any sport that has a lot of jerky, bouncing movements
  • Scuba diving. This can lead to dangerous gas bubbles in your baby's blood vessels.
  • Exercising at high altitudes (more than 6,000 feet) because it can lower the amount of oxygen that reaches your baby.
  • Exercising outside on hot, humid days because your body can overheat. Also, stay out of saunas, hot tubs and steam rooms.

When you exercise, drink lots of water. Pay attention to your body and how you feel. Stop exercising and call your provider if you have any of these signs:

  • Vaginal bleeding
  • Dizziness
  • Trouble breathing
  • Headache
  • Chest pain
  • Muscle weakness
  • Pain or swelling in your lower legs
  • Contractions
  • Leaking amniotic fluid
  • Your baby stops moving.

Does pregnancy change how your body responds to exercise?

During pregnancy, your body changes in many ways. When you’re exercising, you may notice these changes:

  • Breathing: You need more oxygen when you’re pregnant, especially in your second and third trimesters. Your growing belly puts pressure on your lungs, making them work harder in a smaller space. You may even find yourself feeling short of breath at times.
  • Heart rate: Your heart works harder and beats quicker during pregnancy to get oxygen to your baby. You may have less energy for exercise.
  • Body temperature: You start sweating sooner than you did before pregnancy. To protect yourself and your baby from overheating, your body starts sweating at a lower body temperature.
  • Balance: As your body changes during pregnancy, so does your sense of balance. You may notice that you lose your balance more easily.
  • Joints: Your hormones (chemicals made by the body) are at high levels during pregnancy. This can make the tissues in your body more relaxed. Try to avoid any movements that may strain or hurt your joints.

Can exercise during pregnancy help you after pregnancy?

Yes. Once your baby is born, exercise can help you regain your energy and get back to your prepregnancy weight. It also can help prevent the baby blues. Baby blues are feelings of sadness that some women have in the first few days after having a baby.

 

Once your baby is born, when can you start exercising again?

You may feel ready to exercise again a few days after your baby is born. Or you may want to wait longer. With your health provider's OK, you can start light exercise as soon as you feel up to it.

If you were active during your pregnancy, it’s easier to get back into exercise after your baby is born. Just be sure to start slowly. If you feel pain or have other problems during exercise, stop doing the activity and talk to your provider. If you had a cesarean section, don’t exercise until your provider says it’s OK. A c-section is surgery in which your baby is born through a cut your provider makes in your belly and uterus.

Last reviewed March 2012

See also: Conditions that make exercise dangerous during pregnancy, Sex during pregnancy, Warning signs when to stop exercising and call your provider

Express Scripts

Express Scripts is committed to making the use of prescription drugs safer and more affordable. They manage prescription benefits for tens of millions of Americans on behalf of thousands of clients, including health plans and plan sponsors. For the past eight years, Express Scripts employees have supported March of Dimes through team participation in March for Babies. The Express Scripts Foundation also provides funds for March for Babies sponsorship in their key markets.


 

Family, Career and Community Leaders of America

Family, Career and Community Leaders of America (FCCLA) is a nonprofit national career and technical student organization for young men and women in family and consumer sciences education in public and private school through grade 12. The March of Dimes initiated an educational partnership with FCCLA in 2005 but FCCLA members have been raising thousands of dollars on behalf of the March of Dimes for many years prior to partnership.

Since 1945, FCCLA members have been making a difference in their families, careers and communities by addressing important personal, work and societal issues through family and consumer sciences education. Today over 220,000 members in nearly 7,000 chapters are active in a network of associations in 50 states as well as in the District of Columbia, the Virgin Islands and Puerto Rico. Chapter projects focus on a variety of youth concerns, including teen pregnancy, parenting, family relationships, substance abuse, peer pressure, environment, nutrition and fitness, teen violence and career exploration. Learn more about FCCLA at fcclainc.org.

Famous Footwear

National March for Babies sponsor Famous Footwear is a pacesetter in the specialty retailer category. Their highly successful in-store, customer donation campaigns in the spring and fall (conducted in all Famous Footwear and Naturalizer stores) raise more than $1.25 million each year, with employees behind every dollar raised. Famous also collaborates with Dr. Scholl’s as the “Official Shoe Sponsor of March for Babies,” offering a collection of shoes benefiting March of Dimes that are available exclusively at Famous Footwear stores and online at famous.com.  And, this Mother’s Day through Father’s Day, Famous Footwear, together with Crocs, is supporting the March of Dimes imbornto® campaign via a donation to March of Dimes for every pair of Crocs sold in store or online.  Famous Footwear’s parent company, Brown Shoe Company, engages headquarter’s employees through participation and support of March for Babies, too.  Since 1997, Famous Footwear customers and associates have contributed more than $12 million.

  

Farmers Insurance Group

Farmers congratulates the March of Dimes on 75 years of miracles. The March of Dimes has been a driving force committed to giving all babies a fighting chance for a healthy life, and Farmers has been proud to be a part of that fight for the past 25 years. Farmers employees and agents have worked together to raise nearly $40 million in support of the March of Dimes through March for Babies and Be a Hero for Babies Day. This year, Farmers has joined in support of the March of Dimes imbornto® campaign.

 
At Farmers, their agents were born to help you plan for what s ahead. We know that becoming a parent is a big step, and they’re here to help you get smart about insurance and find a smarter road-map to your family's future. Plus, Farmers imbornto® events allow agents and employees to further fundraise for their communities. As the nation’s third-largest personal lines property and casualty insurance group, Farmers is committed to improving the communities where their customers, agents and employees live and work and to continue to help get babies back where they belong – healthy and strong.

 

FedEx

FedEx promotes a culture that values community service and good corporate citizenship. Since 1979, FedEx has supported the March of Dimes through participation in March for Babies. Each year FedEx employees contribute significant funds toward our common mission of "Deliveries, on Time."  In addition, they provide leadership on chapter boards and event committees. FedEx's generous in-kind donations and use of their #11 NASCAR to promote our brand allows the March of Dimes to reach a wide audience of prospective parents with important health messages. In 2013, FedEx began providing support for the March of Dimes Mom & Baby Mobile Health Centers, an exciting new element to our long standing relationship.

First Response

A brand of Church & Dwight Co., Inc., First Response is the market leader in home pregnancy testing. Their national partnership aims to reach women of childbearing age and promote the importance of early pregnancy detection and prenatal care. Joint messaging, which is woven into tagged advertising, on-pack branding, literature/product displays and in-store promotion, focuses on informing women that the sooner they know they are pregnant, the sooner they can start giving their babies a healthy start.

 

From hurt to healing

The death of a baby is one of the most painful things that can happen to a family. It's so unfair. Babies aren't supposed to die. They are the beginning of life, not the end.
Your baby may have died in your womb, either early or later in your pregnancy. Or your baby may have died at birth or just after birth. You may be overwhelmed by your feelings. Know that you are not alone in your grief. The March of Dimes is sorry for your loss. We hope we can help you come to deal with the death of your baby by reading these articles.

The information here can help you and your family understand your grief and feelings and learn how to ask for help. It gives suggestions for dealing with family and friends while you're grieving and how to help your other children understand your family's loss. And finally, when you are ready, there are suggestions on how you and your family can remember your baby.

We hope this helps you heal… and when you're ready, think about the future.

Order bereavement materials

Order our resources for grieving families, including the booklet From Hurt to Healing.

Future Business Leaders Of America

The March of Dimes has enjoyed a successful partnership with FBLA-PBL since 1970. In this time, FBLA-PBL has raised millions of dollars for the March of Dimes and, in turn, the March of Dimes has reached hundreds of thousands of young people with its health education and mission messages. The March of Dimes is FBLA-PBL's only national charity partner, and attends all national and regional FBLA-PBL conferences. FBLA-PBL generates more than $500,000 annually through March for Babies participation and year-round fundraising.

FBLA-PBL is the premier business education association in the country. The mission of FBLA-PBL is to bring business and education together in a positive working relationship through innovative leadership and career development programs. A national association of middle school, high school, career and technical, community college, college and university students interested in business and business-related careers, FBLA-PBL has nearly 250,000 members and more than 15,000 chartered chapters throughout the United States, Puerto Rico, the Virgin Islands and Europe. Learn more about FBLA-PBL and their March of Dimes partnership.

General Electric

At GE, employees spend time supporting their local communities, because it matters to them. GE and the March of Dimes share a unique history, dating all the way back to the 1940s when GE equipment was modified and provided to the March of Dimes to support polio patients. In the 1950’s the March of Dimes provided polio shots for GE employees in the US to promote the need for healthy lifestyles.Over the past 25 years, GE teams have supported the March of Dimes, walking every April to raise money and awareness.

Getting pregnant

You've thought carefully about having a baby and decided you're ready. You stopped smoking and drinking alcohol. You're eating healthy foods and taking a multivitamin with 400 micrograms of folic acid every day. You've visited your health care provider, and you're putting money in your savings account each month. You're ready to start trying to get pregnant.

How pregnancy happens

A woman's ovaries release an egg every month, about 14 days before the first day of her period. This is called ovulation. When a couple has sexual intercourse (and does not use birth control) around the time of ovulation, a man's sperm swim to meet the woman's egg. When a sperm penetrates the egg, it's called fertilization or conception. The fertilized egg (embryo) then travels to the woman's uterus (womb), where it burrows into the lining of the uterus and begins to grow.

A word about birth control

There are no rules about how long you should wait to start trying to get pregnant after stopping birth control. You can begin trying right away. But if you don't have regular periods, it may be more difficult to determine the right time for conception.

  • If you've been on birth control pills, you may not have regular periods for a month or two after stopping the pills.
  • If you take Depo-Provera, it can take from three months to one year to ovulate regularly after your last injection.
  • If you have an IUD (intrauterine device) or implants, you can start trying to get pregnant as soon as you have the device removed.
  • The barrier methods - such as condoms, diaphragms and spermicides - stop working as soon as you stop using them.

When is your body ready to get pregnant?

 A woman's egg is fertile for only 12 to 24 hours after its release. A man's sperm can live up to 72 hours after intercourse. So the best time to have sex if you're trying to conceive is:

  • A few days before ovulation
  • The day of ovulation

The closer intercourse is to ovulation, the more likely it is you'll get pregnant. And the more often you have sex, the more likely you are to get pregnant.

Figuring out the best time to try to get pregnant

If your period is regular (it comes the same number of days apart every month): Use the March of Dimes ovulation calendar to help you figure out when you can get pregnant.

If your periods are irregular (the number of days apart varies from month to month): There are a number of fertility tracking methods that can help you determine when you're ovulating. They are listed below.

It's important to talk to your health care provider to learn more about the most effective way to use them.

  • The temperature method: Use a basal body thermometer to take your temperature every day before you get out of bed. Your temperature will rise by up to 1 degree just as you ovulate. Having intercourse as close as possible to this temperature rise improves your chances of getting pregnant.
  • The cervical mucus method: Pay attention to the mucus in your vagina. It gets thinner, slippery, clearer and more plentiful just before ovulation.
  • Ovulation prediction kit: Ovulation prediction kits test urine for a substance called luteinizing hormone (LH). This hormone increases each month during ovulation and causes the ovaries to release eggs. The kit will tell you if your LH is increasing. You can purchase ovulation prediction kits at pharmacies.

If you use the temperature or cervical mucus methods, begin tracking changes a few months before you want to conceive. If you're using an ovulation predictor kit, begin using it about 10 days after the start of your last period.

Signs of pregnancy

How will you know you're pregnant? Be sure to learn the signs of pregnancy.

When things don't go as planned

If you don't get pregnant right away, don't worry. Nearly 9 out of 10 couples who try to get pregnant do so within 1 year. It may not happen immediately, but the odds are it will happen soon.

If you've been trying to get pregnant for more than a year (or 6 months, if you're over 35 ), talk to your health care provider. You can get tests to find out why you're having problems getting pregnant. Some women have irregular or infrequent ovulation or damage to the tubes that carry the egg to the womb. Some men have low sperm counts or abnormal sperm. Many couples can overcome these problems with medical treatment.

Remember: It takes two to get pregnant!

If you're having trouble getting pregnant, your partner can do things to help his sperm production. He can:

  • Quit smoking.
  • Limit the amount of alcohol he drinks.
  • Give up marijuana and other drugs.
  • Wear boxers and loose pants instead of briefs and tight pants.
  • Ask his provider about his prescription medications. Some medications used to treat high blood pressure, infections and other health conditions can make a man less fertile.

March 2007

Helping out during pregnancy

Finding out that you are going to be a father can be an exciting and confusing time. You may be asking yourself:

  • How will having a baby change my life?
  • How will I pay for all the things our baby will need?
  • How can I be a good dad?
  • What can I do to help during pregnancy?

Questions like these are normal. Here are seven things you can do to help your partner have a healthy pregnancy:

1. Go with your partner to her preconception and prenatal visits. The health care provider will need to know your medical history, too. Get to know the people who will be taking care of your partner and baby during the pregnancy.

Before you and your partner visit her health care provider, write down any questions you have and discuss them with her. And don't be afraid to ask those questions during the visit.

During the prenatal visit at the end of the first trimester (months 1–3 of the pregnancy), you can hear the baby's heartbeat.

During the second trimester (months 4–6), go with your partner if she needs an ultrasound (a test that uses sound waves to take a picture of the baby). You'll be able to see your baby's head, arms, hands, legs and feet. You may even find out the sex of your baby. Your baby will start to seem very real to you.

During a third-trimester (months 7–9) prenatal visit, ask the provider how you can help during labor and delivery.

2. Watch, listen, browse and read. Watch videotapes, listen to audiotapes, check out the Internet, or read books about pregnancy, childbirth and being a parent.

3. Help plan for the baby. Talk to your partner about what you both want for the baby. Decide where the baby will sleep, and make that part of your home colorful and welcoming for the baby. Go shopping for baby things. If you are worried about not having enough money, here are some tips to help you:

  • Ask family members and friends if you can borrow a crib, changing table, toys and baby clothes. Many people are between kids or don't plan to have any more kids and are glad to let you use their baby things.
  • Check out secondhand and thrift shops. They often have baby furniture, toys and clothes at low prices.
  • Put a small amount of money aside each week to help pay for baby things. Even $10 a week can add up to make things easier once the baby comes.

4. Go to childbirth education classes with your partner. You will learn how to help your partner during labor and delivery. Ask the doctor, midwife, nurse or local hospital or clinic about childbirth classes near you.

5. Help your partner stay healthy during pregnancy.

Help her eat lots of different healthy foods. Good choices include whole grain breads, cereal, rice and pasta; skim or low-fat milk, cheese and yogurt; low-fat meat and chicken; and lots of fruits and vegetables. Eating Healthy has helpful information for your partner. And watch what you eat, too! If you eat right, you'll make it easier for her.

Quit smoking. If you smoke, you are blowing out secondhand smoke. This smoke isn't good for your partner or the baby. It can hurt the baby when it's inside your partner's uterus and after birth. Also, pregnant women who smoke are more likely to have babies born too small and too soon. If you both smoke or even if one of you smokes, now is a great time to quit. Get help from your provider or groups such as the American Cancer Society.

Help her stay away from alcohol. It's best for women not to drink any alcohol during pregnancy because it can cause birth defects. Help your partner stay away from beer, wine, wine coolers, liquor and mixed drinks. You can help by giving her healthy juices and water to drink or by making fun nonalcoholic drinks together. If your partner drinks a lot of alcohol and can't stop, get help for her.
Help her stay away from street drugs. Illegal drugs can hurt your baby. Get help for your partner if she uses illegal drugs. If you use illegal drugs, stop now for your baby's sake.

Talk to her about drugs and herbal products. Some prescription drugs and over-the-counter medicines can hurt your baby. Your partner should tell her health care provider about any medicines she is taking. She also should check with her provider before taking any new medicine. The provider can make sure that any prescription or over-the-counter medicine your partner is taking is safe for the baby.

Help your partner stay away from dangerous household products. Keep paint, paint thinner, solvents and pesticides away from your partner. Don't let her empty a cat's litter box.

Encourage her to exercise. Exercise is a great thing you can do together. Walking is easy and cheap, and it can be done almost anywhere. Exercise has more information. Check with your partner's health care provider to find out the safest kinds of exercise you can do together.

Help your partner get rest and lower her stress. Letting your partner rest when she needs to is good for her and the baby. You can help by cleaning up, shopping for groceries and making meals. Take a nap or cuddle together. Talking together about your hopes and plans for the baby can help lower stress.

Understand the changes that are a normal part of pregnancy. Pregnancy causes many changes in a woman's body. You may find that your partner is happy one minute and sad the next. These fast changes in feelings are called mood swings and are common during pregnancy. Your partner also may be tired a lot of the time. That's because it's hard work to carry a new and growing life inside of her body.

6. Have sex if you and your partner want to. Your partner may want to have more sex or less sex than before she was pregnant. Her desire for sex may change as her body changes. Many people find that sex feels different during pregnancy. As her belly gets bigger, try different positions. Find one that's comfortable for both of you. Talk to each other about what feels good. Remember, as long as your health care provider says it's okay, it's safe to have sex during pregnancy. It won't hurt the baby.

To avoid sexually transmitted infections, have sex with only one person who doesn't have any other sexual partners and/or use a condom when having sex. Discuss HIV testing for you and your partner with your health care provider.

7. Support your partner's decision to breastfeed. Breast milk is the best food for your baby. It has everything that your baby needs to grow and be healthy. Find out about breastfeeding together. Talk to your doctor, midwife or nurse about breastfeeding.

August 2009

Hess Corporation

A leading global independent energy company, Hess is committed to meeting the highest standards of corporate citizenship and creating a long-lasting, positive impact on the communities in which they do business. Hess reached a huge milestone in 2010 – the company’s retail locations along the East Coast brought their 10-year fundraising total to more than $1 million. Employees engage customers by purchasing a paper cutout in support of March for Babies.

How to breastfeed

You may have heard people say that breastfeeding is the most natural thing in the world. The truth is that breastfeeding isn’t always easy. It may take time and practice. Be patient and give yourself and your baby time to get comfortable with breastfeeding.

Most women can start breastfeeding within 1 hour after their baby is born. A nurse or lactation consultant can help you get started. A lactation consultant is a person with special training in helping women breastfeed.

How do you breastfeed?

Use these steps to help you get started:

  1. Find a comfortable place to sit with your baby — in a chair, on the couch or on your bed. Sit up or lie back. Lay your baby between your breasts so that your tummies are touching. Skin-to-skin contact helps your baby get comfortable.
  2. Gently guide your baby so that his nose is close to your nipple. With one hand, support his head. With the other hand, hold your breast and tickle his lip with your nipple.
  3. When your baby opens his mouth, bring him to your breast. Bring him to you — don’t lean into him. Your baby should have a good mouthful of your areola (the area around your nipple). This is called latching on. Hold your baby close. Both his nose and chin should touch your breast. Don’t worry — he can breathe and eat at the same time.
  4. When your baby has a good latch, you feel his tongue pull your breast deep into his mouth. If you feel his tongue at the tip of your nipple, it’s not a good latch. Latching on is important for your comfort and to help your baby get enough milk. Remember: it’s called breastfeeding, not nipple feeding!

    When your baby stops feeding, burp him. Sit him on your lap. Support his chest and head with one hand and pat his back with your other hand. After he burps, offer him the other breast. It’s OK if he doesn’t want it.

If you need to stop nursing, don’t try to pull your baby off your breast. Instead, put your pinky finger in the side of his mouth to release the latch.

Breastfeeding shouldn’t hurt. If it does, talk to your provider or lactation consultant. You probably just need a little help getting started. Don’t feel badly about asking for help.

How do you hold your baby when you breastfeed?

There are different ways to hold your baby when you breastfeed. Try them all to find out which one you and your baby like best. You may want to use a pillow to help support your baby.

The cross-cradle hold and the football hold (also called the clutch hold) let you have the best control of your breast and your baby’s head. These are the easiest holds for breastfeeding when you’re just starting out.

Can you breastfeed multiples (twins, triplets or more)?

Yes. If your babies are healthy, you can start breastfeeding them one at a time. This helps each baby learn to latch on. Later you can feed two at once.

Most moms make plenty of milk for all their babies. Talk to your lactation consultant about feeding rotation. This means which baby eats first and from which breast.

How do you know when your baby’s ready to eat?

Look for her feeding cues. Feeding cues are ways that your baby tells you that she’s hungry. Examples are:

  • Rooting (turning her head toward anything that strokes her cheek or mouth)
  • Sucking movements or sounds
  • Putting her hand to her mouth
  • Crying — This is a late feeding cue. Try to breastfeed your baby before she starts to cry.

How often do you breastfeed?

Feed your baby when she’s hungry. For most newborns, this is about eight to 12 times over 24 hours. That’s about once every 2 to 3 hours. But each baby is different. Your baby may want to feed more often or less often. As your baby grows, her feeding patterns may change, and she may go longer between feedings.

To make nighttime feedings easier, put the baby’s crib in your room. Just don’t sleep with the baby in your bed.

How long does each feeding last?

Most babies feed for 15 to 30 minutes at a time at one breast. It’s OK if your baby takes more or less time. When she is finished with one breast, burp her. Then switch her to feed from the other breast. It’s OK if she only wants to nurse from one breast. Just be sure to start her on the other breast at the next feeding. Let your baby end breastfeeding on her own.

How do you know if your baby is getting enough milk?

Lots of new moms ask this question. Your body is pretty amazing. As you breastfeed, your body learns when your baby needs more milk. Your body makes exactly the right amount for your baby. But what if you’re still not sure he’s eating enough? Your baby is probably getting enough milk if he:

  • Is gaining weight
  • Is making six to eight wet diapers a day by the time he’s 5 to 7 days old

When do you start feeding your baby other foods?

Feed your baby only breast milk for at least 6 months. This means no water, formula, other liquids or solid food — just breast milk. At about 6 months, your baby may be ready to start solid food. Solid foods can be soft or mashed, like baby cereal or baby food. Keep feeding her breast milk even when she starts eating solid food. This can help make sure your body keeps making enough milk.

Any amount of breastfeeding is good for your baby’s health and development. Even breastfeeding for a short time is good for your baby.

Do you need special clothes to breastfeed?

No, but nursing bras have flaps that make breastfeeding easier than if you’re wearing your regular bra. You may want to get one or two while you’re pregnant so you have them when your baby is born. Get a nursing bra that is one size larger than your regular bra size so it will fit when your breasts get larger when your breast milk comes in.

You may find it easier to breastfeed in shirts that pull up, rather than shirts that button. Sometimes it’s hard to get buttons undone quickly when you’ve got a hungry baby wanting to eat!

What is weaning?

You can breastfeed your baby for as long as you want. When you stop breastfeeding, it’s called weaning your baby. Some babies begin weaning on their own between 6 and 12 months as they start eating solid food and become more active. Weaning is a slow process that doesn’t happen in a few days. Taking your time can make weaning easier for you and your baby.

If you wean your baby off breast milk before she’s 12 months old, feed her formula. She can stay on formula until she’s ready to drink regular milk after she turns 1.

Last reviewed February 2012

See also: Breastfeeding and medications, prescription drugs, Breastfeeding: What dad can do, Breastfeeding your baby in the NICU, Keeping breastfeeding safe, Using a breast pump, A visit with a breastfeeding support group

In Depth Content 277

In Depth Content 278

Infant health research sample grants

Michael Cappello, MD, Yale University School of Medicine, New Haven, Connecticut, is seeking to develop a vaccine against hookworm infection. This parasitic infection affects up to 40 million pregnant women worldwide each year. Infected women often develop anemia and nutritional deficiencies, which can result in poor fetal growth, premature birth and childhood learning problems.

James E. Crowe, MD, Vanderbilt Medical Center, Nashville, Tennessee, is seeking to develop effective drug treatment for respiratory syncytial virus (RSV), the leading cause of infant hospitalization in the United States. Almost all babies contract RSV in the first 2 years of life, with most developing only mild cold-like symptoms. RSV is more likely to cause serious complications, such as pneumonia, in babies who were born prematurely or with birth defects.

Florence S. Dzierszinski, PhD, McGill University, Canada, is investigating how the body's immune system responds to Toxoplasma gondii, the parasite that cause toxoplasmosis, as a step toward developing a vaccine or drug treatment to prevent transmission of the infection from a pregnant woman to her baby. When contracted by a pregnant woman, toxoplasmosis can result in miscarriage, stillbirth and birth defects.

Paul Hruz, MD, PhD, Washington University School of Medicine, St. Louis, Missouri, is seeking to understand how a gene may contribute to type II (adult-onset) and gestational (pregnancy-related) diabetes, as a basis for developing improved drug treatments. Women with diabetes with onset prior to pregnancy are at increased risk of pregnancy complications and of having a baby with birth defects. Babies of women with gestational diabetes are at increased risk of large size, birth injuries and newborn health problems.

Ho Yi Mak, MD, Stowers Institute for Medical Research, Kansas City, Missouri, is seeking to identify genes that help regulate fat storage, as a basis for developing new ways to prevent obesity and type II diabetes, which is common in obese individuals. An increasing number of pregnant women are obese, which increases the risk of pregnancy complications and of having a baby with birth defects.

Franck Mauvis-Jarvis, MD, PhD, Northwestern University, Feinberg School of Medicine, Chicago, is studying how changes in the functioning of a gene may predispose a woman to develop gestational diabetes, as a basis for developing ways to prevent it. This pregnancy-related form of diabetes occurs in about 5 percent of pregnancies and contributes to newborn health problems, and possibly, to childhood obesity and diabetes.

Alistair McGregor, PhD, University of Minnesota Medical School, Minneapolis, is studying the effectiveness of anti-viral drugs in preventing transmission of cytomegalovirus (CMV) from a pregnant woman to her baby. About 1 percent of babies are born with congenital CMV infection, sometimes resulting in mental retardation, and vision and hearing loss.

Lynda A. Morrison, PhD, Saint Louis School of Medicine in Missouri, is developing a vaccine against the virus that causes genital herpes, in order to prevent dangerous newborn infections. Babies who contract this infection from their mothers during delivery sometimes develop serious infections, lasting disabilities such as mental retardation, and some die.

Joseph W. St. Geme, MD, Duke University Medical Center, Durham, North Carolina, is studying a recently identified form of Haemophilus (a family of bacteria) to learn how it causes severe newborn infections, as a step toward developing an effective drug treatment. This infection poses a high risk of death in infected premature infants.

Virginia D. Winn, MD, PhD, University of Colorado, Denver, is studying a role of a gene in causing preeclampsia, a potentially dangerous pregnancy-related form of high blood pressure, as a basis for developing drug treatments. Preeclampsia occurs in up to 8 percent of pregnancies and contributes to about 15 percent of preterm deliveries.

Inside March of Dimes Global Programs

In 1998, recognizing the need to extend the March of Dimes mission internationally, the Board of Trustees approved the establishment of an international program. This decision was made in response to the clear international policy vacuum that existed at that time with respect to the prevention and treatment of birth defects and preterm birth. In addition, there were few reliable measures of the extent of the problem. Reports from lower and middle income countries were largely anecdotal, whereas evidence from industrialized nations showed a high toll of birth defects and preterm birth.

The first step for Global Programs was to partner with developing country experts to implement evidence-based interventions in-country. Interventions aimed to strengthen capacity for surveillance of birth defects and preterm birth; improve perinatal health care delivery through provider training; and offer opportunities for women and their families to learn about healthy pregnancy. In tandem with these efforts, which continue today, Global Programs has focused on collection, publication and broad dissemination of data that raise the visibility of the problem of birth defects and preterm birth and make the case to policy makers and donor organizations for implementing programs of care and prevention.

How we work

Global Programs carries out its work by partnering with academic medical centers, international organizations and non-government organizations in middle- and lower-income countries that share the goals of the March of Dimes Foundation. Global Programs has no overseas offices; our partners carry out all in-country programs. Global Programs partnerships have four guiding principles: local ownership; cost-sharing; synergy between March of Dimes technical expertise and those of our partners and a focus on short-term, product-intensive projects.

In the decade since its establishment, Global Programs has developed partnerships focused on perinatal health education and training, genetics education, birth defects and perinatal health surveillance, and interventions for specific risk factors –– including fortification of foods with folic acid to prevent neural tube defects and rubella immunization to prevent congenital rubella syndrome. See the interactive map and a description of our partnership projects by region for further details). In addition to mission alliance activities, Global Programs has had a major role in organization and sponsorship of international conferences, including the International Conferences on the Prevention of Birth Defects and Disabilities in the Developing World, which is held every other year. Global Programs has also produced two reports – The March of Dimes Global Report on Birth Defects (2006) and the white paper, The Global and Regional Toll of Preterm Birth. (2009). The reports have had significant impact. They are the first publications ever to present rates of birth defects and preterm birth worldwide, by region and, in the case of the global birth defects report, by country. The global birth defects report findings alone reached more than 800 million households worldwide via radio, TV and print. This media response stirred international action, including passage of a WHO resolution on birth defects.

Current programs

In 2008, March of Dimes Global Programs took the innovative step of building a network of partner institutions with the aim of sharing expertise, project implementation strategies and products across partner sites. Members of the March of Dimes Global Network for Maternal and Infant Health (GNMIH) include Prof. Roberto Giugliani, MD, PhD, Hospital de Clinicas de Porto Alegre, Brazil; Prof. Nanbert Zhong, MD, Department of Medical Genetics, Peking University, China; Prof. Khalid Yunis, American University of Beirut, Lebanon and Prof. Carmencita Padilla, MD, MAHPS, Institute of Human Genetics, National Institutes of Health, Philippines. The network approach has several advantages, including enhanced consistency in definitions, data collection and study methods and strengthened capacity for complementary activities. Currently, cross-cutting activities are focused on improving surveillance of birth defects and preterm births, education of primary care providers on the diagnosis of common birth defects and appropriate referral; and community education on steps couples can take to help ensure a healthy baby, including preconception (pre-pregnancy) care. The GNMIH is also working to develop a global volunteer youth network of students and young professionals.

The March of Dimes Global Network has a number of U.S.-based organizations as technical partners. These include the American Academy of Obstetrics and Gynecology (ACOG), the American Academy of Pediatrics (AAP), the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN), the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the World Health Organization and representation from the European Union.

While developing the Global Network, Global Programs has continued its focus on partnerships with one or more institutions in other countries. Current mission alliances outside of the Global Network include activities in Central America, Central Europe and India.

In Central America, Global Programs is partnering with the Pan American Health Organization (PAHO), the U.S. CDC, the Institute of Nutrition of Central America and Panama (INCAP) and the Ministry of Health of Costa Rica to establish uniform norms and standards for fortification of foods with micronutrients across the countries of Central America. This is a five-year Inter-American Development Bank funded initiative which commenced in 2007. Since 2000, March of Dimes has carried out a number of projects in Latin America, many of which focus on the promotion of fortification of foods with folic acid.

In India, Global Programs is working to reduce maternal and neonatal mortality in partnership with the Jawaharlal Nehru Medical College/KLES Hospital and Medical Research Centre, Belgaum, Karnataka. The program, which began in 2004, is providing training to medical officers and auxiliary nurse midwives in rural areas to improve perinatal health care; facilitating the development of a hospital referral system; and educating the community about healthy pregnancy. Additionally two pilot projects are underway: one to improve prenatal health and newborn care in a peri-urban area of Belgaum City and a second to provide education in health and basic hygiene, as well as primary health care, to adolescent girls in a rural area of Belgaum District.

Global Programs has also carried out a number of partnerships in Central and Eastern Europe. At present, we are working with the Dartmouth Medical School on a project in Kosovo to improve perinatal health surveillance and use of these data to improve care of women and neonates. We are also conducting a pilot study of late stillbirths and early neonatal deaths occurring in a hospital setting. The study, which aims to identify quality of care improvement measures, is being carried out under the auspices of the Kosovo-based Foundation for Healthy Mothers and Babies and in collaboration with the University Clinical Center of Kosovo.

Going forward

Global Programs will continue its engagement with world-class partners in lower-income countries to reduce the toll of adverse pregnancy outcomes, including birth defects and preterm birth. Our program focus is expanding to include the promotion of preconception health and the harmonization of care across the reproductive, maternal, newborn and child health (RMNCH) continuum. We will continue to marshal data for research, intervention and policy by issuing a Global Preterm Birth Report with country estimates in 2011. In addition, Global Programs will continue to support and extend the work of the March of Dimes by maintaining an active, visionary and leadership role in the fight to reduce the harsh global toll of birth defects and preterm birth and ensure a day when all babies everywhere have a healthy start in life.

Johnson & Johnson

Johnson & Johnson is partnering with the March of Dimes in conducting the signature program Healthy Babies are Worth the Wait® Community Program, a demonstration project among the March of Dimes, the University of Medicine and Dentistry of New Jersey, Newark Beth Israel Medical Center, Newark Community Health Centers and the New Jersey Department of Health and Senior Services to reduce the rate of preventable preterm births and racial and ethnic disparities in preterm birth in Newark. Previously, Johnson & Johnson partnered with the March of Dimes in the HBWW pilot initiative in Kentucky, implemented in collaboration with the Kentucky Department for Public Health. Johnson & Johnson was also a founding member of the Prematurity Campaign.

 

Key Club

Key Club organizations across the country have worked to raise money for the March of Dimes since 1978. After decades of strong partnership, Key Club International and the March of Dimes continue to innovate new awareness and fundraising activities which students participate in alongside joining their local March for Babies. Key Club organizations are encouraged to work with March of Dimes as one of three designated charities.

Key Club is the oldest and largest service program for high school students. It is a student-led organization that teaches leadership through serving others. Members of the Kiwanis International family, Key Club members build themselves as they build their schools and communities. Currently, there are more than 215,000 members nationwide on nearly 5,000 high school campuses. Learn more information on the Key Club partnership.

     

Kiwanis International

Early members adapted the name "Kiwanis" from the expression "Nunc Kee wanis" which mean "We make noise." in the Native American Otchipew language. Certainly, Kiwanians have been "making noise" to meet their communities’ needs since the first club’s inception in 1915.

As Kiwanis clubs sprang up around the world, a focus on children developed into a trend – and led to the Kiwanis International - March of Dimes partnership! On the local level, March of Dimes State Chapters and Divisions work closely with their Kiwanis clubs to serve the children of their communities. Kiwanis also helps raise badly needed funds for the March of Dimes by participating in March for Babies or other special events.

Today Kiwanians can be found in more than 70 countries and Kiwanis family members include more than 522,000 individuals at all stages of their lives: college students join Circle K; high school students form Key Clubs; junior and middle schools sponsor Builders Clubs; elementary schools have K-Kids clubs; and disabled adults can join Aktion Clubs. To learn more, visit the Kiwanis International website at kiwanis.org.

Kmart Corporation

The March of Dimes is proud to recognize Kmart as the Foundation’s longest-standing corporate partner and largest contributor to its mission, having raised more than $110 million over the past 30 years. Kmart customer and associate contributions have reached levels yet to be attained by any corporation in our history. 2013 marks the 21st year that Kmart has been the exclusive national mass merchandise retail sponsor of March for Babies. Their partnership is part of Kmart for KidsSM, the umbrella program for Kmart’s philanthropic initiatives, which focuses on improving children’s health and wellness. The strength of the March of Dimes/Kmart partnership, the desire to ensure the health of all babies and the sheer passion and compassion of Kmart customers and associates continues to inspire us all.

 

Later prenatal checkups

It’s important to keep seeing your health care provider during pregnancy. Regular prenatal care can help you have a healthy pregnancy and baby.

What is your prenatal care schedule?
If your pregnancy is healthy, you may be able to follow a schedule like this:



If you have a health problem during pregnancy, your provider may want to see you more often. Make sure you go to all of your prenatal care checkups even if you’re feeling fine.

What happens at your prenatal care checkups?
Your first prenatal care checkup is usually the longest because your provider asks you lots of questions and does several tests. Later prenatal care checkups may be much shorter.

At later prenatal checkups, your provider:

  • Checks your weight.
  • Takes your blood pressure.
  • Measures your belly to see how your baby is growing (second and third trimesters).
  • Checks your hands, feet and face for swelling.
  • Listens for the baby's heartbeat (after the 12th week of pregnancy).
  • Feels your belly to find your baby's position (later in pregnancy).
  • Does tests, such as blood tests or ultrasound.
  • Talks to you about your questions or concerns. It's a good idea to write down your questions and bring them with you so you don't forget what to ask!

During your first prenatal checkup, your provider talked to you about your family health history. As you continue your prenatal checkups, keep learning more about it.

If you find something new, or have a question for your health provider, write it down. You can talk to your health provider at your next visit.

Also, go to all your prenatal checkups, even if you’re feeling fine!

Who else knows about your health information?
Your health care provider may have you answer health questions to find out about your health history and the health of your family members related to you by blood. She may have you answer these questions using a paper form or a computer while you’re in the waiting room.

It can be hard sharing such personal information, like if you had a sexually transmitted infection or if you use drugs. Know that the answers you give help your provider give you and your baby the best care.

All of the health information you share is private and safe. It doesn’t matter if the information comes from your prenatal tests, is written down in a paper form, gets added into a computer or is shared during a talk you have with your provider. Only your health care team knows your health information.

So, don’t be afraid to give honest answers or share your concerns with your provider. She can’t tell anyone else what you say without your permission.

How can you get free or low-cost prenatal care?
If you don't have insurance or can't afford prenatal care, find out about free or low-cost services in your area:

  • Call (800) 311-BABY (800-311-2229). This toll-free number connects you to your local health department.
  • For information in Spanish, call 800-504-7081.

Last reviewed May 2011

See also: First prenatal care checkup, Routine prenatal tests

Life after the NICU

After your experience in the NICU, you have become a NICU graduate parent. Your child is a NICU graduate. Congratulations!

You will look back on the time you spent with your child in the NICU and see how the experience has changed your life. You may find you have strengths and passions you didn't know you had.

  • You may feel that your experience has changed you forever and that you want to help others who will walk this road after you. Consider the following:
    Stay connected with the other families you have met and become friends with in the NICU. Exchange contact information. You and these families may have things in common even after your babies leave the NICU.
  • Keep in touch with your baby's NICU. Send updated photos to the staff. Visit the NICU. Speak to a parent group. Attend NICU family reunions.
  • Find support groups that help you parent your child.
  • Get involved with the March of Dimes. Our mission is to help babies like yours and to support parents like you. Learn about the NICU Family Support project and our Prematurity Campaign. To get involved, find your local March of Dimes chapter. Share your baby's birth story and get support from other NICU families on Share Your Story. Your experience, your story, your passion and love for your child are so vitally important to other families and to babies born too small, too sick or too soon.

Parents have to decide how they will incorporate the NICU experience into their lives and the lives of their children. As time passes, most parents find themselves involved in other aspects of their child's life. Their memories of the NICU fade as they watch their child grow and face new tasks and challenges, such as walking, potty training, preschool and more.

Remember: You and your child are strong. Be proud of all that you have come through together. Look forward to and cherish the celebrations ahead.

August 2009

Low birthweight

Low birthweight is when a baby is born weighing less than 5 pounds, 8 ounces. About 1 in every 12 babies in the United States is born with low birthweight.

Some low birthweight babies are healthy, even though they’re small. But being low birthweight can cause serious health problems for some babies.

What causes a baby to be born with low birthweight?
There are two main reasons why a baby may be born with low birthweight:

  1. Premature birth. This is birth before 37 completed weeks of pregnancy. About 7 of 10 low-birthweight babies are premature. The earlier a baby is born, the lower her birthweight may be. About 1 in 8 babies in the United States is born prematurely. Talk to your health provider about things you can do to help reduce your chances of having a premature baby.
  2. Fetal growth restriction. This means a baby doesn’t gain the weight she should before birth. You may hear the terms “growth-restricted,” “small-for-gestational age” or “small-for-date” to describe these babies. They may have low birthweight simply because their parents are small. Others may have low birthweight because something slowed or stopped their growth in the womb. About 1 in 10 babies (10 percent) are growth-restricted. Your health care provider may think your baby isn’t growing normally if your uterus (womb) isn’t growing. He may use ultrasound and heart rate monitoring to check your baby’s growth. In some cases, a baby’s growth can be improved by treating health conditions in the mother, like high blood pressure.

Can a mother’s health condition lead to premature birth or fetal growth restricition?
Yes. These conditions in the mother may lead to premature birth and/or fetal growth restriction:

Preterm labor
This is labor that starts too soon, before 37 completed weeks of pregnancy.

Chronic health conditions
These are health conditions that last for a long time or that happen again and again over a long period of time. Chronic health conditions need treatment from a health care provider. Conditions that may lead to low birthweight include high blood pressure, diabetes and heart, lung and kidney problems.

Infections
Certain infections, especially infections in the uterus, may increase your chances of having a premature baby.

Problems with the placenta
The placenta grows in your uterus and supplies your baby with food and oxygen through the umbilical cord. Some problems in the placenta can reduce the flow of blood and nutrients to your baby, which can limit your baby’s growth. In some cases, a baby may need to be born early to prevent serious complications for both mom and baby.

Not gaining enough weight during pregnancy
Women who don’t gain enough weight during pregnancy are more likely to have a low-birthweight baby than women who gain the right amount of weight.

Smoking, drinking alcohol and using street drugs
Pregnant women who smoke cigarettes are nearly twice as likely to have a low-birthweight baby than women who don’t smoke. Smoking slows a baby’s growth and increases your chances of having a premature birth. Using alcohol and street drugs during pregnancy can slow your baby’s growth in the womb and can cause birth defects. Some drugs, like cocaine, may increase your chances of having premature birth.

Other conditions
You’re more likely than other women to have a low-birthweight baby if you:

  • Have low income
  • Don’t have a lot of education
  • Are black
  • Are younger than 17 or older than 35

Can a baby’s health condition lead to premature birth or fetal growth restricition?
Yes. These conditions in the baby may lead to premature birth and/or fetal growth restriction:

Birth defects
These are health conditions that are present at birth. Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, how the body develops, or in how the body works. They may limit a baby’s development in the womb, which may lead to low birthweight. Babies with birth defects are more likely than babies without birth defects to be born prematurely.

Infections
Certain infections in the baby can slow growth in the womb and cause birth defects. These include cytomegalovirus, rubella, chickenpox and toxoplasmosis.

What medical problems can low birthweight cause for newborns?
Low-birthweight babies are more likely than babies with normal weight to have health problems as a newborn. Some need special care in a hospital’s newborn intensive care unit (NICU) to treat medical problems like:

  • Respiratory distress syndrome (RDS). This breathing problem is common in babies born before 34 weeks of pregnancy. Babies with RDS don’t have a protein called surfactant that keeps small air sacs in the lungs from collapsing. Treatment with surfactant helps these babies breathe more easily. Babies with RDS also may need oxygen and other breathing help to make their lungs work.
  • Bleeding in the brain (called intraventricular hemorrhage or IVH). Bleeding in the brain can affect low-birthweight premature babies, usually in the first 3 days of life. Brain bleeds usually are diagnosed with an ultrasound. Most brain bleeds are mild and fix themselves with no or few lasting problems. More severe bleeds can cause pressure on the brain that can cause fluid to build up in the brain. This can cause brain damage. To reduce the fluid, your baby may be treated with medicine. In some cases, a surgeon may insert a tube into the baby’s brain to drain the fluid.
  • Patent ductus arteriosus (PDA). PDA is a common heart problem for premature babies. Before birth, a large artery called the ductus arteriosus lets the baby’s blood bypass his lungs. This artery usually closes after birth so that blood can travel to the baby’s lungs and pick up oxygen. When the artery doesn’t close properly, it can lead to heart failure. Providers use tests like ultrasound to check for PDA. Babies with PDA are treated with a drug that helps close the artery. If the drug doesn’t work, a baby may need surgery.
  • Necrotizing enterocolitis (NEC). This is a problem in a baby’s intestines. The intestines are long tubes below the stomach that help digest food. NEC can develop up 2 to 3 weeks after birth. It can be dangerous for a baby. It can lead to feeding problems, swelling in the belly and other complications. Babies with NEC are treated with antibiotics and fed intravenously (through a vein) instead of by mouth while the intestine heals. In some cases, a baby may need surgery to remove damaged parts of intestine.
  • Retinopathy of prematurity (ROP). ROP is condition that affects blood vessels in the eye. It mostly affects babies born before 32 weeks of pregnancy. Most cases heal themselves with little or no vision loss. Some babies need treatment, though, to prevent vision loss.

What medical problems can low birthweight cause later in life?
Babies born with low birthweight may be more likely than babies born at a normal weight to have certain medical conditions later in life. These include high blood pressure, diabetes and heart disease.

Talk to your baby’s health care provider about what you can do to help your baby be healthy. As your child grows, make sure she eats healthy food, stays active and goes to all her health care checkups. Getting regular checkups throughout childhood can help your provider spot health conditions that may cause problems as your baby grows older. These checkups also help make sure that your child gets all the vaccinations she needs to stay protected from certain harmful diseases.

What can you do to reduce your chances of having a low-birthweight baby?
Learn what you can do to get healthy before and during pregnancy to help reduce your risk of having a low-birthweight baby and improve your chances of having a healthy pregnancy and a healthy baby.

Last reviewed September 2012

 

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Macy's

Macy's, the largest retail brand of Macy's, Inc., delivers fashion and affordable luxury to customers at more than 800 locations in 45 states, the District of Columbia, Puerto Rico and Guam. Macy's stores and macys.com offer distinctive assortments including the most desired family of exclusive and fashion brands for him, her and home. Building on a 150-year tradition, Macy's helps strengthen communities by supporting local and national charities that make a difference in the lives of our customers. March of Dimes and Macy’s have a long history, when employees started walking in March for Babies some 15 years ago – a tradition that continues today.  For the two years, the March of Dimes has been selected as the exclusive in-store beneficiary of Macy’s annual Shop For A Cause program resulting in more than $6.2 million raised.  This unique one-day-only shopping event was created by Macy’s to support local and national charities’ fundraising efforts, which has helped raise more than $42 million for charitable organizations across the country since 2006.  March of Dimes will once again be then national recipient of Shop For A Cause 2013 taking place on August 24th.

March of Dimes Editorial Policy

The March of Dimes presence on the Web reflects our long-standing commitment to provide information and education to the general public and to health professionals and researchers. This site is produced by a team that includes Web content producers, writers, editors, multimedia and graphics producers, interactive developers, health educators, nurses and doctors. March of Dimes Office of the Medical Director and\or outside experts review all clinical information presented on the site. All clinical material is based upon scientific research and the collective experience of practicing physicians and other health care providers. The March of Dimes regularly reviews all material to ensure that it is accurate, appropriate, and in accord with the leading relevant health professional organizations.

The information contained on marchofdimes.com is not intended nor is it implied to be a substitute for professional medical advice, nor is it intended to be medical diagnosis or treatment. The service is presented for the sole purpose of disseminating health information. It is not intended and must not be taken to be the provision or practice of medical, nursing or professional health care advice or services in any jurisdiction. Always seek the advice of your physician or other qualified health provider before starting or stopping any treatment or if you have any questions regarding a medical condition.

The information about drugs contained on this site is general in nature and is intended for use as an educational aid. It does not cover all possible uses, actions, precautions, side effects, or interactions of these medicines, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular drug.

March of Dimes Editorial Policy

The March of Dimes presence on the Web reflects our long-standing commitment to provide information and education to the general public and to health professionals and researchers. This site is produced by a team that includes Web content producers, writers, editors, multimedia and graphics producers, interactive developers, health educators, nurses and doctors. March of Dimes Office of the Medical Director and\or outside experts review all clinical information presented on the site. All clinical material is based upon scientific research and the collective experience of practicing physicians and other health care providers. The March of Dimes regularly reviews all material to ensure that it is accurate, appropriate, and in accord with the leading relevant health professional organizations.

The information contained on marchofdimes.com is not intended nor is it implied to be a substitute for professional medical advice, nor is it intended to be medical diagnosis or treatment. The service is presented for the sole purpose of disseminating health information. It is not intended and must not be taken to be the provision or practice of medical, nursing or professional health care advice or services in any jurisdiction. Always seek the advice of your physician or other qualified health provider before starting or stopping any treatment or if you have any questions regarding a medical condition.

The information about drugs contained on this site is general in nature and is intended for use as an educational aid. It does not cover all possible uses, actions, precautions, side effects, or interactions of these medicines, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular drug.


March of Dimes Website Link Policy

Thank you for your interest in linking to the March of Dimes Foundation websites.

The mission of the March of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality. Our websites provide information and resources for individuals and health care professionals to help women have healthy pregnancies and healthy babies.

Links to our websites

We encourage links to our websites for non-commercial, informational and educational purposes by volunteers, event participants, sponsors, grant recipients and non-profit, health and community organizations.

By linking to any of our websites you agree that:

  • You will not use the link to promote the sale of goods, services or causes, to suggest endorsement by the March of Dimes of any goods, services or causes, or otherwise to misrepresent your relationship with the March of Dimes.
  • Your link will be in text only in the form, www.marchofdimes.com or www.marchforbabies.org , etc., directing the user to the website homepage. You are also free to use the widgets, badges or banners that we have created for use in promoting our campaigns, but you may not otherwise use a March of Dimes logo unless you have a written agreement with us.
  • You will not mirror the homepage (or any other pages) of the March of Dimes websites or frame the content of any our website pages on your website.
    •You will not present the content appearing on any March of Dimes website as your own.
  • You will not provide a link to a March of Dimes website in any context containing content that may be interpreted as libelous, obscene, harassing or criminal or which may infringe or is in violation of the rights of any third party.
  • You will indemnify and hold the March of Dimes, its officers, directors, employees, volunteers, affiliates and licensors, harmless from any and all claims, damages or costs arising out of or related to your link to our websites.
  • The March of Dimes will not be liable for any damages or claims arising as a result of your link to any of its websites.
  • The March of Dimes reserves the right to terminate any links to its websites at any time in its sole discretion and you agree to remove your link upon the request of the March of Dimes.
  • You agree to, and will comply with, the provisions of our Terms of Use which are incorporated into this Link Agreement.

If you have any questions regarding our Link Policy please email us at webmaster@marchofdimes.com

Links from our websites

The March of Dimes does not provide links from its websites to third party websites except in certain limited circumstances in which we have a relationship with a partner or sponsor or we have selected a website as of special interest to our website visitors.

Links on our websites to third party websites do not constitute an endorsement of those websites or the products, services or content found on them. The March of Dimes has no control over the websites to which it may link, does not assume any responsibility for materials or content appearing on them and makes no representation as to the quality or accuracy of that content. These external websites are governed by their own terms of use and privacy policies to which you are directed.

March of Dimes Website Link Policy

Thank you for your interest in linking to the March of Dimes Foundation websites. 

The mission of the March of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality. Our websites provide information and resources for individuals and health care professionals to help women have healthy pregnancies and healthy babies.

Links to our websites
We encourage links to our websites for non-commercial, informational and educational purposes by volunteers, event participants, sponsors, grant recipients and non-profit, health and community organizations.

By linking to any of our websites you agree that:

  • You will not use the link to promote the sale of goods, services or causes, to suggest endorsement by the March of Dimes of any goods, services or causes, or otherwise  to misrepresent your relationship with the March of Dimes.
  • Your link will be in text only in the form, www.marchofdimes.com or www.marchforbabies.org , etc., directing the user to the website homepage.  You are also free to use the widgets,  badges  or banners that we have created for use  in promoting our campaigns,  but you may not otherwise use a March of Dimes logo unless you have a written agreement with us.
  • You will not mirror the homepage (or any other pages) of the March of Dimes websites or frame the content of any our website pages on your website.
  • You will not present the content appearing on any March of Dimes website as your own.
  • You will not provide a link to a March of Dimes website in any context containing content that may be interpreted as libelous, obscene, harassing or criminal or which may infringe or is in violation of the rights of any third party.
  • You will indemnify and hold the March of Dimes, its officers, directors, employees, volunteers, affiliates and licensors, harmless from any and all claims, damages or costs arising out of or related to your link to our websites.
  • The March of Dimes will not be liable for any damages or claims arising as a result of your link to any of its websites.
  • The March of Dimes reserves the right to terminate any links to its websites at any time in its sole discretion and you agree to remove your link upon the request of the March of Dimes.
  • You agree to, and will comply with, the provisions of our Terms  of Use which are incorporated into this Link Agreement.
    If you have any questions regarding our Link Policy please email us at webmaster@marchofdimes.com

Links from our websites
The March of Dimes does not provide links from its websites to third party websites except in certain limited circumstances in which we have a relationship with a partner or sponsor or we have selected a website as of special interest to our website visitors.

Links on our websites to third party websites do not constitute an endorsement of those websites or the  products, services or content found on them. The March of Dimes has no control over the websites to which it may link, does not assume any responsibility for materials or content appearing on them and makes no representation as to the quality or accuracy of that content.  These external websites are governed by their own terms of use and privacy policies to which you are directed.


Martha Stewart Living Omnimedia

Martha Stewart Living Omnimedia’s media offerings include award-winning magazines, innovative websites, digital apps, radio and books, all helmed or inspired by Martha Stewart. Just as March of Dimes inspires and supports families, MSLO’s portfolio of properties elevates the meaningful moments of life, love and family. In 2013, MSLO brings this inspiration to the March of Dimes imbornto® campaign as its lead media partner. MSLO has committed through a custom digital program to support the March of Dimes with a $1,000,000 donation.

Mission Pharmacal

This 60-year-old privately held pharmaceutical company partners with the March of Dimes to help raise awareness among women about the importance of folic acid intake prior to and during early pregnancy. Mission is the maker of the CitraNatal prenatal vitamin family of products. As a national sponsor of March for Babies, Mission Pharmacal is raising awareness through co-branded online advertising and on packaging, through literature/product displays in OB/GYN offices nationwide, and other promotional activities including the company’s Dr. Smith’s Diaper Ointment brand. The company’s headquarters employees and more than 180 sales representatives passionately support the March of Dimes through March for Babies participation.

Mission: Healthy Baby

Pregnancy has its ups and downs for every woman. But high levels of stress can be a very real problem for moms-to-be who serve in the military or have a partner who does. Stress is associated with many health complications and may lead to premature birth or low birthweight in full-term babies. Mission: Healthy Baby® can help.

Mission: Healthy Baby, a partnership of the March of Dimes and the VFW, offers military families information and education on topics ranging from relieving stress to learning how to stay healthy during pregnancy to understanding the costs involved with having a new baby.

The program also treats military moms to the baby shower they might not otherwise have, offers dads ways to get involved and provides comfort to families with a baby in newborn intensive care. These services help make pregnancy and the birth of a new baby a positive and joyful experience for our military families.

FINAL: 5/31/11

Mud Pie

Since 1988, Mud Pie has designed thoughtful giftware and distributed it through independent and premier department stores. The company, based in Stone Mountain, Ga., continues to be a leader in the gift, baby, and women’s accessories sectors of the giftware and home accents market. Mud Pie and the March of Dimes stand strong in the effort to ensure healthy first steps for all babies. As a partner of the imbornto® campaign in 2013, Mud Pie is proud to support the March of Dimes with a 10¢ donation from every pair of socks sold, and a minimum contribution of $100,000.

Newborn care in the delivery room

After months of waiting, your baby is born and you are eager to hold him in your arms for the first time. Before meeting your newborn, you can expect to see doctors and nurses caring for your baby in the minutes after birth to make certain that he is healthy and stable.

Baby’s first cry

Hearing your baby cry in the delivery room is a good sign. Crying helps him get rid of any excess fluid that may still be in his lungs, nose or mouth. Doctors will often encourage a baby to cry for this reason. If necessary, the health care provider will resuscitate a baby that is having trouble breathing.

Connection to mom

While in the womb, your baby received her nutrition and oxygen through the umbilical cord that connected you both. Now that she is born and breathing on her own, her blood supply is redirected to her lungs, allowing the medical staff to cut and clamp the umbilical cord.

Keeping baby warm

When a baby is born, he is wet from the fluid in the womb and can easily become cold. Nurses will dry his skin, wrap him in a blanket, place a knitted hat on his head and may even use heat lamps to help him stay warm. Holding your baby close to you so that your skin touches his also helps keep him warm.

Apgar score

The Apgar score is designed to check your baby’s condition at 1 minute and 5 minutes after birth. Your baby will be checked for five things:

A – Activity; muscle tone

P – Pulse rate

G – Grimace; reflex (measured by placing a bulb syringe in the baby’s nose and seeing his response)

A – Appearance; skin color

R – Respiration

Each category is given a score ranging from 0-2. The numbers are then added up for a final score. Babies who receive an Apgar score of 7 or more probably have come through delivery with flying colors and are in good condition. Those with lower scores may need extra watching or special care, though most will do fine.

Vitamin K shot

 

Your baby will receive a shot of vitamin K immediately after she is born. For a few days after birth, newborns are unable to make vitamin K, which is needed for blood clotting. The vitamin K shot protects your baby from developing a rare, serious bleeding problem that can affect newborns.

Eye drops

Your baby’s eyes will be treated with medicated drops or ointment. This protects her eyes from bacterial infections that can be contracted during delivery.

Newborn screening tests

Your baby’s heel will be pricked to obtain a few drops of blood. This blood sample will be used to screen for genetic and biochemical disorders. These birth defects may not be obvious at first in a baby. But, unless detected and treated early, they can cause physical problems, intellectual disabilities and, in some cases, death. Most babies receive a clean bill of health.

A newborn may also receive a hearing test. The test measures how the baby responds to sounds. A tiny soft earphone or a microphone is placed in the baby's ear. Without testing, hearing loss often is not diagnosed until a child is about 2 to 3 years old. By that time, the child has often developed speech and language problems. Early treatment helps to prevent these problems.

Currently each state or region operates its own newborn screening program. State programs vary widely in the number and types of conditions for which they test. The March of Dimes recommends that all babies be screened for at least 29 disorders, including hearing loss.

Most likely, your baby will be found in good health after her tests. But for the few babies who have different test results, early diagnosis and proper treatment can make the difference between healthy development and lifelong problems.

Other newborn attention

Measurement: Your baby will be measured for weight, length and the size of his head to ensure that he is at a healthy range for the number of weeks of pregnancy.
Bath: Once your baby’s body temperature is stable, she will be given her first bath.

Footprints and medical bracelets: As part of your baby’s first medical record, his footprints will be taken and added to the record. Babies are usually given two identity bracelets (one on his foot, the other on his arm). You, too, will be given a matching bracelet.

Special care

Some babies may face challenges after birth. Babies that need special care may be placed in the neonatal intensive care unit (NICU). This is a part of the hospital where babies are cared for using advanced technology and specially trained health care professionals.

Having a baby in a NICU can leave many parents feeling stressed and sad. While you may be separated from your baby for a period of time, take comfort in knowing that you will still be able to build a bond with her. Rest assured that scientific advances in this field are helping more babies become healthy and go home sooner.

May 2008 (8-08)

NICU reference guide

ABO incompatibility: Blood incompatibility between the mother and fetus that can result in destruction of fetal red blood cells, jaundice, and anemia.

Anemia: Fewer red blood cells than normal levels.

Apnea: Interruption in breathing that lasts 15 seconds or more.

Apnea monitor: Machine that detects interruptions in breathing.

Arteries: Blood vessels that carry oxygen to all parts of the body.

Asphyxia: Lack of oxygen.

Bililights: Blue fluorescent lights used to treat jaundice.

Bilirubin: A yellowish waste product formed when red blood cells break down.

Birth defect: Abnormality of structure, function or body metabolism (inborn error of body chemistry) present at birth that results in physical and/or mental disability, or is fatal.

Blood gases: Levels of oxygen and carbon dioxide in the blood.

Bradycardia: Slow heart rate.

Brainstem auditory evoked response test: Hearing test for newborns.

Bronchopulmonary dysplasia (BPD): Lung damage and scarring that occurs in some babies who were treated with oxygen and mechanical ventilation for a prolonged period.

Cardiopulmonary monitor: Machine that tracks heart and breathing rates.

Catheter: A small, thin plastic tube through which fluids are given or removed from the body.

Central line: A small plastic tube that is placed in a large blood vessel near the heart, to deliver intravenous feedings and medications. A central line can avoid many needle sticks for a baby, when long-term care is needed.

Cerebral palsy: A group of conditions that affect control of movement and posture, often leading to problems with muscle strength, flexibility or movement.

Chickenpox (varicella): Common childhood illness characterized by an itchy rash and fever. When contracted by a pregnant woman, it can occasionally cause birth defects or severe newborn illness.

Computed tomography (CT or CAT scan): Imaging technique that produces precise pictures of tissue using a narrow beam of radiation and computers.

Congenital diaphragmatic hernia: Birth defect involving an opening in the diaphragm, the large muscle that separates the chest and abdomen. Abdominal organs, such as the stomach and intestines, can move through the opening into the chest, where they can crowd the lungs and interfere with their development.

C-PAP (continuous positive airway pressure): Air is delivered to a baby's lungs through either small tubes in the baby's nose or through a tube that has been inserted into her windpipe. The tubes are attached to a mechanical ventilator, which helps the baby breathe, but does not breathe for her.

Cryotherapy: Freezing of abnormal tissue to halt its growth. This form of treatment can be used in severe cases of retinopathy of prematurity.

Cyanosis: A blue or gray discoloration of the skin caused by insufficient oxygen.

Cytomegalovirus: A viral infection that, when contracted by a pregnant woman, can result in severe newborn illness, and sometimes lead to chronic disabilities such as intellectual disabilities, vision and hearing loss.

Echocardiogram: A specialized form of ultrasound examination that is used to study the heart.

Endotracheal tube: Small plastic tube that is inserted through a baby's nose or mouth down into the trachea (windpipe), usually connected to a mechanical ventilator.

Exchange transfusion: Special type of blood transfusion in which some of the baby's blood is removed and replaced with blood from a donor; sometimes used to treat severe jaundice.

Gastroschisis: Birth defect involving an opening in the abdominal wall, through which the abdominal organs bulge out.

Gastrostomy: Surgically created opening in the stomach, through which a baby can be fed.

Gavage feeding: Feeding through a flexible tube placed through the nose or mouth to the stomach or intestines.

Group B streptococcus: Bacterial infection that a baby can contract as he passes through an infected birth canal, sometimes resulting in further illness. Many cases can be prevented by screening and/or treating infected women with antibiotics during labor and delivery.

Heart failure: When the heart cannot pump enough blood to meet the body's needs.

Herpes simplex: Virus that can be transmitted sexually, sometimes causing genital sores in infected adults. A baby may become infected passing through an infected birth canal, sometimes resulting in severe newborn illness or future medical problems.

High-frequency ventilation: Special form of mechanical ventilation, designed to help reduce complications to delicate lungs.

Hyperglycemia: High blood sugar levels.

Hypoglycemia: Low blood sugar levels.

Incubator: Babies are placed in this clear plastic box which keeps them warm and protects them from germs and noise.

Intrauterine growth restriction (IUGR): Term for babies who are smaller than they should be at their gestational age.

Intravenous: Through a vein.

Intraventricular hemorrhage (IVH): Bleeding in the brain, which occurs mainly in premature babies.

Jaundice: Yellowing of the skin and eyes due to accumulation of a waste product called bilirubin in the blood.

Kangaroo care: Holding a baby with skin-to-skin contact.

Magnetic resonance imaging (MRI): Imaging technique that uses powerful magnets and computers to produce a detailed picture of tissue.

Mechanical ventilation: Using a mechanical ventilator to breathe for a very sick baby while her lungs recover.

Meconium aspiration syndrome: Breathing problems that occur when the fetus inhales meconium (fetal stool) during labor and delivery. The stool usually is released shortly before or after birth.

Nasal cannula: Soft plastic tubing that goes around a baby's head and under his nose, where there are openings (prongs) to deliver oxygen.

Nasal prongs: Small plastic tubes that fit into or under a baby's nose to deliver oxygen.

Necrotizing enterocolitis (NEC): Serious intestinal infection that most commonly affects premature babies.

Neonatologist: A pediatrician with advanced training in the care of sick newborns.

NICU: Neonatal (or newborn) intensive care unit.

Nitric oxide: A gas naturally produced by the body that can be given to help expand blood vessels; sometimes used to treat babies with PPHN.

Ophthalmologist: Eye doctor.

Oxygen hood: Clear plastic box that fits over a baby's head and supplies oxygen.

Patent ductus arteriosus (PDA): Heart problem that is seen most commonly in premature babies.

Persistent pulmonary hypertension of the newborn (PPHN): High blood pressure in the lungs, leading to breathing problems, and reduced levels of oxygen in the blood.

Phototherapy: Treatment for jaundice, involving placing the baby under blue fluorescent lights, sometimes called bililights.

Pneumothorax: When air from the baby's lungs leaks out into the space between the baby's lungs and chest wall. While small leaks may cause no problems and require no treatment, larger leaks may cause serious complications such as lung collapse and may need surgical repair.

Premature baby: Baby born before 37 completed weeks of pregnancy.

Pulse oximeter: Small device that uses a light sensor to help determine blood oxygen levels.

Radiant warmer: Open bed with overhead heating source to warm the baby.

Respiratory distress syndrome (RDS): Serious breathing problem affecting mainly premature babies.

Respiratory syncytial virus (RSV): A virus that causes a mild, cold-like illness in adults. In premature babies or full-term babies with lung problems, it can cause serious illness, such as pneumonia.

Retina: Lining at the rear of the eye that relays messages to the brain.

Retinopathy of prematurity (ROP): Eye disorder seen mainly in very premature babies, which can lead to vision loss or blindness.

Rh disease: Blood incompatibility between the mother and fetus that causes destruction of fetal red blood cells.

Sepsis: Widespread infection of the blood.

Spina bifida: Birth defect involving the spinal cord, resulting in varying degrees of paralysis, bladder and bowel problems. Affected babies may require surgery during the newborn period to close the back and prevent further nerve damage and infection; however, surgery cannot reverse nerve damage that already has occurred.

Step-down nursery: Intermediate level of care for babies who have graduated from the NICU.

Surfactant: Detergent-like substance that keeps small air sacs in the lungs from collapsing.

Syndrome: A combination of signs and symptoms that, when present together, are associated with a specific medical condition.

Tachycardia: Rapid heart rate.

Toxoplasmosis: A parasitic infection that, when contracted by a pregnant woman, can result in serious newborn illness and chronic disabilities, such as intellectual disabilities, cerebral palsy, seizures, or vision and hearing loss.

Ultrasound: Imaging technique that uses sound waves to make a picture of tissue.

Umbilical catheter: Thin tube inserted into the belly button; used to draw blood or give fluids, medication, nutrients or blood.

Vein: A blood vessel leading toward the heart.

Ventilator, mechanical: Mechanical breathing machine.

August 2009

Financial and in-kind support provided by...

Our privacy policy and your privacy rights

•Privacy Policy Highlights
•Introduction
•The Information We Collect and How We Use It
•Information from Cookies
•Automatic Data Collection and Advertising
•Sharing Your Information with Third Parties
•Disclosing Personal Information in Special Circumstances
•Your Personal Profile
•Ask Our Experts
•E-mail a Friend
•Credit Card Transactions
•March of Dimes Shop to Help and Product Promotions
•Our Data Security Practices
•Children’s Privacy
•Your Privacy Rights Under California Law
•Contact Us/Opt Out
•Changes to Our Privacy Policy
•Privacy Policies for Our Special Sites
•The Online Fundraising Sites: - March for Babies®, Bikers for Babies®, Jail and Bail
•Share Your Story
•Online Product Catalog
•Banding Together®
•Team Youth®
•Genetics and Your Practice®
•Perinatal Nursing Education
•Perinatal Quality Improvement Portal
Introduction

The mission of the March of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality. The March of Dimes websites provide information and resources for individuals and health care professionals to help women have healthy pregnancies and healthy babies. We also offer opportunities to become involved in our mission and fundraising events and to network and share experiences.

We recognize the importance of protecting your privacy. The purpose of this notice is to explain what information we collect from you when you visit our websites, the way we use this information, the practices and procedures we have put in place to protect your personal information, and the choices you can make regarding our use of your personal information.

This Privacy Policy applies to all of our websites and mobile applications. In addition, specific information pertaining to our Online Fundraising Sites, March for Babies, Bikers for Babies and Jail and Bail, and the Share Your Story, Online Product Catalog, Banding Together, Team Youth, Genetics & Your Practice, Perinatal Nursing Education sites and our Perinatal Quality Improvement Portal is described in detail in separate sections within this policy below.

Please also read our Terms of Use. Your use of the March of Dimes websites constitutes your agreement to the Terms of Use and our Privacy Policies.

Information we collect and how we use it

If you choose to communicate with us online -- create a Personal Profile, register to use any of our educational or information services, participate in any of our online activities, join in our campaign events, make a donation online, request a newsletter, or ask a question of our experts -- we will ask you for certain personal information. The information we collect may include your name, age, gender, postal address, e-mail address, phone number and credit card details.

The March of Dimes also collects personal information we receive offline when you volunteer, donate or take part in any of our events. Information, such as your name, address, telephone number, e-mail address or age, is collected through offline registration forms, telemarketing appeals and postal appeals.

We may obtain additional information, and also update information we have concerning you, as a result of your subsequent involvement with the March of Dimes as a donor, volunteer, participant in our events or other engagement in our mission.

We may also collect personal information online and offline when you enter one of our contests or sweepstakes.

The March of Dimes also receives names and addresses of potential donors from other companies and organizations.

The March of Dimes uses the information you provide us to register you for various events and continuing education programs, to respond to specific questions you may have, to honor requests for brochures or newsletters and to process payments and donations made online.

This information also is used to contact you about new materials, activities, events and opportunities to volunteer and contribute to local and national programs and research initiatives.

Information from cookies

The March of Dimes uses cookies — small text files that a website can place in a visitor’s browser cache — and similar technology (such as Java Script and Web beacons or transparent gifs) to collect data that include your Internet protocol (IP) address, the type of browser and operating system you use, the date and time of your visit, and the amount of any donation you make. We also collect your sign-up information, including the user name that you create when you register for events. We do not save passwords in the cookies.

We use cookies to allow you to stay logged on to our websites, to permit us to recognize repeat visitors, to facilitate your use of the site and to track access to and use of our sites. If you set your browser to reject all cookies, you may not be able to use all the functionality at our websites.

By using cookies, we are able to deliver content that is more relevant to you in light of your interests and location and obtain information that helps us improve the design and functionality of our websites.

Automatic data collection and advertising

We use third parties to provide us data about the use of certain of our websites and mobile applications, including Google Analytics and Adobe, and to serve ads on our behalf across the Internet. These third parties may collect information about your visits to certain of our website pages and may use technology such as cookies and Web beacons. The data collected is reported back to us, and we may link this information to personal information we have concerning you.

This information allows us to track which other websites have linked visitors to our site, and what pages of our site are used by and are of interest to those visitors so that we may better advertise our mission, programs and events.

If you would like more information about this practice and to opt out of having information collected by our web analytics companies, please link to Google Analytics and Adobe. You may also link to our ad server, Atlas here.

Sharing your personal information with third parties

The March of Dimes may rent to or exchange with third parties the names and postal addresses of donors or volunteers (e.g., Mothers March participants) who have provided us with their name and address offline, as a way of raising funds to support important functions and services. These third parties may include March of Dimes event sponsors and other nonprofit and commercial companies. Such parties are carefully screened and must comply with use policies established by the March of Dimes. If you wish to opt out of our list rental and exchange program, you may email us at Contact us.

The March of Dimes also may provide certain personal information obtained offline, such as a donor’s name, address and giving history, to companies and cooperatives that use that information to help the March of Dimes improve its fundraising efforts. These companies and cooperatives may use this personal information to advise other third parties in their marketing and fundraising campaigns and may share your name and address, but no associated personal information, with those third parties.

Except in limited circumstances (for example, when a March for Babies team captain may have access to certain information you have provided at our Online Fundraising Sites or one of your March for Babies or Bikers for Babies sponsors receives your address to send you her donation), and as described in this Privacy Policy the March of Dimes does not share with third parties the personal information that you have only provided online at our websites, or your e-mail address, without your consent.

Personal information that is maintained in our national database is available to our state chapters.

Please be aware that personal information that you may disclose on message boards, in chat forums and at our other social networking sites may be visible to anyone visiting those sites and may be collected and used by third parties.

Disclosing personal information in special circumstances

The March of Dimes, when required, may disclose personal information in response to subpoenas, court orders or other legal process, to law enforcement agencies for the purpose of investigating any activities that we believe, in good faith, to be unlawful, to service providers who work on our behalf and adhere to our privacy policies, and to any successor in interest as a result of a merger or re-organization or by operation of law.

Your personal profile

You may sign up at marchofdimes.com and create a Personal Profile by providing your name, e-mail address, a user name and your ZIP code. We also will ask you to let us know what interests you. We save this information, together with other connections that you may have made with the March of Dimes in the past – such as a donation you may have given -- and any involvement you may have with us in the future.

The March of Dimes will store the password you create for the purpose of responding to you should you forget your password. Only those employees with the responsibility of responding to your request will have access to your password.

When you have set up your Personal Profile, you will be able to use certain applications and services, such as our ovulation indicator. The information you provide to use these services will be deleted at the end of your session unless you specifically request us to save that information for you.

We also use cookies on our sign-up page to collect your IP address and other information that lets us know the date and time of your visit, in what state you are located, how you reached our web page and what pages of our site you have visited.

The information we collect allows us to provide you with content on our websites that is most relevant to you and your interests and to contact you with information about events in your area and opportunities to volunteer, donate or otherwise become engaged in our mission.

Except as described in this Privacy Policy, the information you provide us online when you create your Personal Profile is not shared with a third party without your consent.

Ask our experts

Our service, "Ask our experts," allows you to ask questions, including questions that may involve health issues. To submit a question, we ask for your name and e-mail address.

Personal health-related information included in specific questions submitted to “Ask our experts” is used solely to enable March of Dimes professionals to best answer your questions. This information is never shared with any third party.

Records regarding the nature of individual inquiries are used to create aggregate reports for internal use, are accessed only by March of Dimes employees on a "need-to-know" basis, and are purged after one calendar year from the date of inquiry.

Personal information, such as your name and e-mail address (but no health-related information) that you may provide is maintained in our national database. This personal information may be used to contact you about new materials, activities, events and opportunities to donate to our programs and research initiatives.

E-mail a friend

In order to further our mission and inform you about what you can do to prevent birth defects and have a healthy pregnancy, we offer a feature on our websites that allows you to e-mail the article you are viewing to a friend. This feature requires that you enter your name and e-mail address and the name and e-mail address of the recipient. The March of Dimes stores this information for the sole purpose of sending this one-time e-mail.

Credit card transactions

Payment information, such as credit card number and expiration date, is submitted to us online when you make a donation, register for our Bikers for Babies event, sponsor a participant in any of our events, purchase materials from our Online Product Catalog or pay for continuing nursing education modules.

The March of Dimes uses PayPal® and Verisign® as third-party intermediaries to process your online donations and payments. Your credit card information is transmitted over a secure connection between your computer and our server using Secure Socket Layer (SSL) encryption and is encrypted when submitted to the credit card processor.

This credit card information is never shared with third parties other than the processor, a consultant employed by the March of Dimes to help identify illegal credit card activity at our websites, and, in the case of the Online Product Catalog, the March of Dimes fulfillment center that is responsible for processing your order. Your credit card information may be stored for verification purposes, for processing recurring donations that you have authorized and for processing returns or back orders.

For information about credit card transactions made through Shop to Help, please see below. You may link here to information about credit card transactions at our Online Product Catalog website.

March of Dimes Shop to Help and product promotions

The March of Dimes Shop to Help promotions are operated on external sites owned by third parties. When you click on a link to purchase products from the March of Dimes Shop to Help, you are leaving marchofdimes.com and entering the site of a third party. Please click on the “Privacy Policy” link at the bottom of the store website to view the privacy policy followed by our third-party providers.

The March of Dimes may receive product sales reports that contain your personal information such as name, quantity ordered, e-mail address and postal address. This information is used for internal reporting and monitoring purposes; it is not distributed outside of the March of Dimes to any other parties. The March of Dimes never receives credit card numbers from third-party sites.

Please follow this link for information concerning privacy at our Online Product Catalog.

Our data security practices

The March of Dimes implements physical, electronic and managerial procedures to ensure that your personal information is protected at all times, including encryption, firewalls and password protection. Our servers are housed in an off-site secured co-location facility. All employees are reminded of the importance of protecting the privacy of our donors, website and mobile application users and of adhering to our Privacy Policy.

Children’s privacy

We may collect personal information such as your child’s name, e-mail address and postal address in order to register him or her in March of Dimes activities such as our annual March for Babies event. Your child’s personal information is subject to all of the terms of this Privacy Policy. Please also see the section of this policy which describes the information we collect at our Team Youth site.

If you do not wish your child to participate in March of Dimes activities, please contact donorservice@marchofdimes.com.

Your privacy rights under California law

California’s "Shine the Light" law regulates the sharing of personal information by a company for direct marketing purposes by requiring a company to notify a consumer of its sharing practices or by providing the consumer the opportunity to opt out of having his or her personal information shared with a third party free of charge. If you wish to opt out of having your information shared with third parties, please email us at contact us.

Contact us/Opt out

If you have any questions concerning our Privacy Policy or you wish to correct your personal information you may contact us at:

March of Dimes Foundation
Attn: Privacy Manager
1275 Mamaroneck Avenue
White Plains, NY 10605
E-mail: donorservice@marchofdimes.com
Telephone: 1-888-MODIMES.

If you prefer not to participate in our list rental and exchange program or receive e-mail communications, postal mail or telephone calls from the March of Dimes, please send us an email at Contact us to opt out of participation.

If you have subscribed to any March of Dimes newsletters, you may unsubscribe by following the instructions in the e-mail containing the newsletter.

If you would like to learn more about the web analytics services we use and to opt out, please link to Adobe and Google Analytics.

If you would like to opt out of having information collected by our ad server, please access the Atlas privacy policy.

The March of Dimes also uses the Direct Marketing Association Preference Service to restrict the flow of unwanted communications to individuals. You can add your name to this file and opt out of certain solicitations by visiting the DMA website located at http://www.dmachoice.org.

Changes to our privacy policy

The March of Dimes reserves the right to change its privacy policies at any time. To better serve you and your concerns about your privacy, we will notify you of any changes to our main privacy policy or to any of the privacy policies associated with any of our other websites by posting a notice prominently on the home page of the respective websites indicating that there has been a change or update to the Privacy Policy.

Effective Date: This privacy policy is effective: June 12, 2012

© 2012 March of Dimes Foundation

Privacy policies for our special sites

Online Fundraising Sites privacy policy

March for Babies®, Bikers for Babies®, Jail and Bail

The March of Dimes uses our Online Fundraising Sites - March for Babies, Bikers for Babies, and Jail and Bail websites to help participants maximize their fundraising efforts.

Information we collect and how we use it

If you are a participant or team captain, you will be asked to register by providing your first and last name, postal address, e-mail address, telephone number, the name of your fundraising group (if any), and a user name. We store this registration information to allow you to use the tool effectively -- for example, to log on at different times to contact potential sponsors and to keep them informed of the event -- and to allow you and us to keep track of the sponsorships you receive.

If you sponsor someone and make a donation at this site, we will ask you to provide your name, address, telephone number and e-mail address.

We use the information users provide to advise them of new online materials, activities and events and to offer users the opportunity to contribute to local and national programs and research initiatives.

The March of Dimes does not contact those people whose names and postal and e-mail addresses may be stored on a participant’s page as potential sponsors unless they register as volunteers or donate to the March of Dimes.

The March of Dimes will store the password you create for the purpose of responding to you should you forget your password. Only those employees with the responsibility of responding to your request will have access to your password.

Sharing your information with third parties

If you join a team, your name and the total amount you have raised will be available to the team captain. Your postal address will be made available to those of your sponsors who choose to make their donation by check so that they can send the check to you.

If you make a donation to a team, your name, address and e-mail address will be available to the team captain.

The information you provide when you register or make a donation is maintained in the March of Dimes national database and available to the state chapters.

Except as described in this and our main Privacy Policy, the personal information you provide on the March for Babies, Bikers for Babies, and Jail and Bail websites will not be sold to or exchanged with any third party without your permission.

Disclosing personal information in special circumstances

Information from cookies

Automatic data collection and advertising

Credit card security

If you register as a biker in the Bikers for Babies event online or if you sponsor a participant in any of our events, you may be asked to provide credit card information. Information about credit card transactions can be found at this link.

Contact us/Opt out

You may contact us by email to correct your personal information and to opt out of receiving communications from the March of Dimes or having information collected by our web analytics companies and ad server.

Your Privacy Rights Under California Law

Changes to Our Privacy Policy

Effective date: The Online Fundraising Site Privacy Policy is effective: June 12, 2012.

 

Share Your Story privacy policy

Information we collect and how we use it

In order to participate on the Share Your Story website, you will need to create an account by submitting a valid e-mail address and creating a password. Except as described in this privacy policy, the March of Dimes does not share your e-mail address with third parties without your consent.

The March of Dimes uses this information to register you to use this site and may also use it to contact you about new materials, activities, events and opportunities to volunteer and contribute to our mission.

The March of Dimes advises users that personal information posted on Share Your Story is accessible to the public and visible to anyone who visits the site. By posting information on this site, you may receive unsolicited messages from third parties unrelated to the March of Dimes. The March of Dimes monitors its websites, but it remains the responsibility of the site visitor to use his/her best judgment in choosing the information he/she will post.

Any messages or stories shared on this site may be used in other March of Dimes marketing activities. Please also see our Terms of Use regarding the information you share on this website.

For general information as to how the March of Dimes collects and uses personal information, please consult our main Privacy Policy.

Disclosing personal information in special circumstances

Information from cookies

Contact Us

You may contact us by email to correct your personal information and to opt out of receiving communications from the March of Dimes.

Your Privacy Rights Under California Law

Changes to Our Privacy Policy

Effective date: The Share Your Story Privacy Policy is effective: June 12, 2012.

 

Online Product Catalog privacy policy

Information we collect and how we use it

When you use our Online Product Catalog to purchase our publications and professional education materials, you will be asked to provide your first and last name, your personal and/or business address, your company/organization name, if applicable, your telephone number, your e-mail address and your credit card information . This information is used to allow us and our distributor to process and deliver your purchases and to communicate with you concerning your orders.

We will retain your personal contact information, including your credit card information, to allow us to process back orders, returns and refunds and to allow you to place future orders more easily. We will use your e-mail address to send you information about new products, promotions or discounts. You may contact us at any time if you want to opt out of receiving such e-mails.

For general information as to how the March of Dimes collects and uses your information, please consult our main Privacy policy above.

Except as provided in this and our main privacy policy, we will not share your personal information with any third party without your consent.

Sharing your personal information with third parties

Disclosing personal information in special circumstances

Information from cookies

Credit card transactions

Contact us

You may contact us by email to correct your personal information and to opt out of receiving communications from the March of Dimes.

Your Privacy Rights Under California Law

Changes to Our Privacy Policy

Effective date: The Online Product Catalog Privacy Policy is effective: June 12, 2012.

 

Banding Together® privacy policy

Information we collect and how we use it

When you create a bracelet to memorialize or honor a child, you will be required to submit your first and last name, the child’s first name and the child’s gender. You also may submit the child’s last name, date of birth, city and state and whether the child was full term or born prematurely. The information you provide will be public and accessible to visitors to the site.

When you donate on behalf of a particular child, the March of Dimes receives your name, postal address, e-mail address and credit card information. Your credit card information is securely processed by Verisign® and handled by the March of Dimes in accordance with our credit card practices. Your name may appear as a donor in association with a particular bracelet if you choose to make that information public by checking the appropriate field in the donation form.

For general information as to how the March of Dimes collects and uses personal information, please consult our main Privacy Policy.

Except as described in this and our main privacy policy, the March of Dimes will not sell to or exchange with any third party the personal information you provide on Banding Together.

Sharing your personal information with third parties

Disclosing personal information in special circumstances

Information from cookies

Contact us

If you have any questions concerning the Banding Together website, you may contact us at webmaster@marchofdimes.com.

You may contact us by email to correct your personal information and to opt out of receiving communications from the March of Dimes.

Your Privacy Rights Under California Law

Changes to Our Privacy Policy

Effective date: The Banding Together Privacy Policy is effective: June 12, 2012

 

Team Youth® privacy policy

Information we collect and how we use it

Our Team Youth site is designed to connect teens to the March of Dimes and its mission. Teens signing up to receive the Youth Times online newsletter must provide a first and last name, e-mail address and postal code. In addition to providing the newsletter, we also may use the e-mail address to provide information about March of Dimes programs and events.

The site also features a message board where young adults can exchange information about their experiences with the March of Dimes. A participant is required to provide the March of Dimes with a first and last name and e-mail address and may provide information about his or her involvement in other March of Dimes activities, class year, city, state and postal code.

For general information as to how the March of Dimes collects and uses personal information, please consult our main Privacy Policy.

Except as described in this and our main privacy policy, the March of Dimes does not share the personal information you provide at the Team Youth site or your e-mail address with any third party.

Sharing your personal information with third parties

Disclosing personal information in special circumstances

Information from cookies

Contact us

You may contact us by email to correct your personal information and to opt out of receiving communications from the March of Dimes.

Your Privacy Rights Under California Law

Changes to Our Privacy Policy

Effective date: The Team Youth Privacy Policy is effective: June 12, 2012.

 

Genetics & Your Practice® privacy policy

The Genetics & Your Practice site is designed for professionals working in the primary care setting and has separate custom modules for professionals working with preconception/prenatal patients, infants and children, and adolescents and adults. This site allows you to register for courses for which you can receive continuing education credits.

Information we collect and how we use it

When you register, we will ask you to provide your first and last name, e-mail address and information about your occupation. You also will be required to provide a user name and password in order to create your own personal account and log in and out on the Genetics & Your Practice site.

We use this information to register you at the site, to deliver the course materials, to administer the tests and to provide you with credit for the courses and, if you request it, further information about the March of Dimes and our various services, events and materials.

For general information as to how the March of Dimes collects and uses personal information, please consult our main Privacy Policy.

Sharing your personal information with third parties

The information you provide on this site will not be shared with any third party without your permission unless you are applying for professional continuing education credit and except as described in this privacy policy.

By providing your personal information for continuing education credit, you are granting us permission to forward it to the provider, Swedish Medical Center, and any other accrediting organizations that require it. Your personal information will be used to generate your certificate of completion and for aggregate reporting. Information forwarded to the professional education provider or other accrediting authority will be subject to their individual privacy policies.

Disclosing personal information in special circumstances

Information from cookies

We use cookies to allow you to personalize the site according to your specifications, to track and record your course progress, and to measure the effectiveness of the content by recording your responses to questions and interactions throughout the site.

In addition, our web server recognizes consumer e-mail addresses and domain names for the purpose of analyzing website access and improving the content of the site. Such information is collected and analyzed in the aggregate for internal use and will not be submitted to third parties without your permission.

Please click on this link for further information about cookies and how the March of Dimes uses cookies at its sites.

Site evaluations

If you are seeking Continuing Medical Education (CME) credit, you will be required to complete a pre-test and post-test to gauge your knowledge pre- and post- participation in the case study. You must also complete the case study, a CME evaluation survey and a CME registration form. You do not need to complete these items if you are not seeking to obtain CME credits.

The pre- and post-tests we administer will be evaluated without reference to any personally identifiable information. This information is analyzed for the purpose of compiling aggregate statistics only.

You will not be contacted by us unless you opt to participate in the follow-up evaluation. Results from the evaluations may be published in peer-reviewed journals.

Contact us

You may correct your personal information in the “My Account” section of the Genetics & Your Practice site.

When you register, you will be asked whether you would like to hear from the March of Dimes regarding issues relevant to Genetics & Your Practice and for news alerts, progress reports and promotions to benefit the March of Dimes. You may opt out of these communications at any time by clicking on “My Account” on the main page of the Genetics & Your Practice site. To communicate with us for any other reason, please contact us at this link.

Your Privacy Rights Under California Law

Changes to Our Privacy Policy

Effective date: The Genetics & Your Practice Privacy Policy is effective: June 12, 2012.

 

Perinatal Nursing Education privacy policy

The Perinatal Nursing Education site is designed to provide continuing education for perinatal nurses. This site allows you to register for materials for which you can receive continuing education credits.

Information we collect and how we use it

When you register, we will ask you to provide your first and last name, postal address, e-mail address and information about your occupation. You also will be required to provide a user name and password in order to create your own personal account and log in and out on the Perinatal Nursing Education site.

We use this information to register you at the site, to deliver the course materials, to administer the tests, to generate your certificate of completion and for aggregate reporting. If you request it, we will send you further information about the March of Dimes and our various services, events and materials.

For general information as to how the March of Dimes collects and uses personal information, please consult our main Privacy Policy.

Sharing your personal information with third parties

If you use a token code purchased by someone else, that person will have access to the following information: whether you used the code, your e-mail address, and whether you passed or failed the continuing education test. Otherwise, except as described in this and our main privacy policy, your personal information will not be shared with any third party without your permission.

Disclosing personal information in special circumstances

Site evaluations

You may choose to opt in or opt out of the evaluation of the Perinatal Nursing Education site pre-tests and post-tests. Pre-test and post-tests gauge your knowledge prior to and after participation in the module. The March of Dimes does not link information obtained from the pre- and post-tests to personal information, and this information is analyzed for the purpose of compiling aggregate statistics only.

Information from cookies

We use cookies to allow you to personalize the site according to your specifications, to track and record your course progress, and to measure the effectiveness of the content by recording your responses to questions and interactions throughout the site.

In addition, our Web server recognizes consumer e-mail addresses and domain names for the purpose of analyzing website access and improving the content of the site. Such information is collected and analyzed in the aggregate for internal use and will not be submitted to third parties without your permission.

Please click on this link for further information about cookies and how the March of Dimes uses cookies at its sites.

Credit card transactions

We use Secure Socket Layer technology for online payments, and your account information is encrypted when submitted for processing and verification. We will collect credit card account information for one-time use only. For questions about this policy, please contact profedu@marchofdimes.com. For further information as to how the March of Dimes processes credit card transactions, please click here.

Contact us

You may correct your personal information in the “My Account” section of the Perinatal Nursing Education site.

When you register, you will be asked whether you would like to hear from the March of Dimes regarding issues relevant to Perinatal Nursing Education and for news alerts, progress reports and promotions to benefit the March of Dimes. You may opt out of these communications at any time by clicking on “My Account” on the main page of the Perinatal Nursing Education site.

If you would like to communicate with us for any other reason, please contact us at this link.

Your Privacy Rights Under California Law

Changes to Our Privacy Policy

Effective date: The Perinatal Nursing Education Privacy Policy is effective: June 12, 2012

 

Perinatal Quality Improvement Portal (“PQIP”) privacy policy

The March of Dimes Perinatal Quality Improvement Portal (“PQIP”) provides access to materials and tools to support quality improvement initiatives and programs -- such as the 39+ Weeks Quality Improvement Initiative -- to hospitals working collaboratively with the March of Dimes to improve maternal and infant health.

Hospitals participating in any quality improvement initiative provide the March of Dimes with the names of the various team members at the hospital who will have access to the PQIP. Each team member must then register independently with the March of Dimes. This privacy policy covers the registration information submitted by team members.

Information we collect and how we use it

As a team member, you may choose to be approved for access to the PQIP in one of two ways:

•By registering at the PQIP landing page and providing a first and last name, a user name, an email address and a password.
•By using a user name and password that you provided to the March of Dimes when you created a Personal Profile at www.marchofdimes.com or registered for one of our fundraising events, such as March for Babies, Bikers for Babies or Jail and Bail.
As a team member, your personal contact information will be used to contact you to provide or request information concerning the initiative or program.

The March of Dimes will store the password you create at the PQIP for the purpose of responding to you should you forget your password. Only those employees with the responsibility of responding to your request will have access to your password.

Once you have registered at the PQIP website, you may use the same username and password to sign in and create a Personal Profile at www.marchofdimes.com or register for one of our fundraising events. Our Privacy Policy at Your Personal Profile and Online Fundraising Sites explains what personal information we collect and how we use that information when you visit and log on to these sites.

For general information as to how the March of Dimes collects and uses personal information, please consult our Privacy Policy.

Sharing your personal information with third parties

When we communicate with you, your personal contact information, such as your email address, may be shared with other team members at hospitals participating in the same initiative or program. Except as provided in this privacy policy, we will not share your personal information with any third party without your consent.

Disclosing personal information in special circumstances

Information from cookies

The PQIP Blog

If you contribute to the blog which is set up for your initiative or program at the PQIP, the information you provide, together with your name, username and email address, will be visible to anyone who has access to that blog.

Contact us

You may contact us by email to correct your personal information and to opt out of receiving communications from the March of Dimes.

Effective Date: The Perinatal Quality Improvement Portal Privacy Policy is effective June 12, 2012.

© 2012 March of Dimes Foundation

Our privacy policy and your privacy rights

Privacy Policy Highlights

Introduction

The mission of the March of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality. The March of Dimes websites provide information and resources for individuals and health care professionals to help women have healthy pregnancies and healthy babies. We also offer opportunities to become involved in our mission and fundraising events and to network and share experiences.

We recognize the importance of protecting your privacy. The purpose of this notice is to explain what information we collect from you when you visit our websites, the way we use this information, the practices and procedures we have put in place to protect your personal information, and the choices you can make regarding our use of your personal information.

This Privacy Policy applies to all of our websites and mobile applications. In addition, specific information pertaining to our Online Fundraising Sites, March for Babies, Bikers for Babies and Jail and Bail, and the Share Your Story, Online Product Catalog, Banding Together, Team Youth, Genetics & Your Practice, Perinatal Nursing Education sites and our Perinatal Quality Improvement Portal is described in detail in separate sections within this policy below.

Please also read our Terms of Use. Your use of the March of Dimes websites constitutes your agreement to the Terms of Use and our Privacy Policies.

Information we collect and how we use it

If you choose to communicate with us online -- create a Personal Profile, register to use any of our educational or information services, participate in any of our online activities, join in our campaign events, make a donation online, request a newsletter, or ask a question of our experts -- we will ask you for certain personal information. The information we collect may include your name, age, gender, postal address, e-mail address, phone number and credit card details.

The March of Dimes also collects personal information we receive offline when you volunteer, donate or take part in any of our events. Information, such as your name, address, telephone number, e-mail address or age, is collected through offline registration forms, telemarketing appeals and postal appeals.

We may obtain additional information, and also update information we have concerning you, as a result of your subsequent involvement with the March of Dimes as a donor, volunteer, participant in our events or other engagement in our mission.

We may also collect personal information online and offline when you enter one of our contests or sweepstakes.

The March of Dimes also receives names and addresses of potential donors from other companies and organizations.

The March of Dimes uses the information you provide us to register you for various events and continuing education programs, to respond to specific questions you may have, to honor requests for brochures or newsletters and to process payments and donations made online.

This information also is used to contact you about new materials, activities, events and opportunities to volunteer and contribute to local and national programs and research initiatives.

Information from cookies

The March of Dimes uses cookies — small text files that a website can place in a visitor’s browser cache — and similar technology (such as Java Script and Web beacons or transparent gifs) to collect data that include your Internet protocol (IP) address, the type of browser and operating system you use, the date and time of your visit, and the amount of any donation you make. We also collect your sign-up information, including the user name that you create when you register for events. We do not save passwords in the cookies.

We use cookies to allow you to stay logged on to our websites, to permit us to recognize repeat visitors, to facilitate your use of the site and to track access to and use of our sites. If you set your browser to reject all cookies, you may not be able to use all the functionality at our websites.

By using cookies, we are able to deliver content that is more relevant to you in light of your interests and location and obtain information that helps us improve the design and functionality of our websites.

Automatic data collection and advertising

We use third parties to provide us data about the use of certain of our websites and mobile applications, including Google Analytics and Adobe, and to serve ads on our behalf across the Internet. These third parties may collect information about your visits to certain of our website pages and may use technology such as cookies and Web beacons. The data collected is reported back to us, and we may link this information to personal information we have concerning you.

This information allows us to track which other websites have linked visitors to our site, and what pages of our site are used by and are of interest to those visitors so that we may better advertise our mission, programs and events.

If you would like more information about this practice and to opt out of having information collected by our web analytics companies, please link to Google Analytics and Adobe. You may also link to our ad server, Atlas here.

Sharing your personal information with third parties

The March of Dimes may rent to or exchange with third parties the names and postal addresses of donors or volunteers (e.g., Mothers March participants) who have provided us with their name and address offline, as a way of raising funds to support important functions and services. These third parties may include March of Dimes event sponsors and other nonprofit and commercial companies. Such parties are carefully screened and must comply with use policies established by the March of Dimes. If you wish to opt out of our list rental and exchange program, you may email us at Contact us.

The March of Dimes also may provide certain personal information obtained offline, such as a donor’s name, address and giving history, to companies and cooperatives that use that information to help the March of Dimes improve its fundraising efforts. These companies and cooperatives may use this personal information to advise other third parties in their marketing and fundraising campaigns and may share your name and address, but no associated personal information, with those third parties.

Except in limited circumstances (for example, when a March for Babies team captain may have access to certain information you have provided at our Online Fundraising Sites or one of your March for Babies or Bikers for Babies sponsors receives your address to send you her donation), and as described in this Privacy Policy the March of Dimes does not share with third parties the personal information that you have only provided online at our websites, or your e-mail address, without your consent.

Personal information that is maintained in our national database is available to our state chapters.

Please be aware that personal information that you may disclose on message boards, in chat forums and at our other social networking sites may be visible to anyone visiting those sites and may be collected and used by third parties.

Disclosing personal information in special circumstances

The March of Dimes, when required, may disclose personal information in response to subpoenas, court orders or other legal process, to law enforcement agencies for the purpose of investigating any activities that we believe, in good faith, to be unlawful, to service providers who work on our behalf and adhere to our privacy policies, and to any successor in interest as a result of a merger or re-organization or by operation of law.

Your personal profile

You may sign up at marchofdimes.com and create a Personal Profile by providing your name, e-mail address, a user name and your ZIP code. We also will ask you to let us know what interests you. We save this information, together with other connections that you may have made with the March of Dimes in the past – such as a donation you may have given -- and any involvement you may have with us in the future.

The March of Dimes will store the password you create for the purpose of responding to you should you forget your password. Only those employees with the responsibility of responding to your request will have access to your password.

When you have set up your Personal Profile, you will be able to use certain applications and services, such as our ovulation indicator. The information you provide to use these services will be deleted at the end of your session unless you specifically request us to save that information for you.

We also use cookies on our sign-up page to collect your IP address and other information that lets us know the date and time of your visit, in what state you are located, how you reached our web page and what pages of our site you have visited.

The information we collect allows us to provide you with content on our websites that is most relevant to you and your interests and to contact you with information about events in your area and opportunities to volunteer, donate or otherwise become engaged in our mission.

Except as described in this Privacy Policy, the information you provide us online when you create your Personal Profile is not shared with a third party without your consent.

Ask our experts

Our service, "Ask our experts," allows you to ask questions, including questions that may involve health issues. To submit a question, we ask for your name and e-mail address.

Personal health-related information included in specific questions submitted to “Ask our experts” is used solely to enable March of Dimes professionals to best answer your questions. This information is never shared with any third party.

Records regarding the nature of individual inquiries are used to create aggregate reports for internal use, are accessed only by March of Dimes employees on a "need-to-know" basis, and are purged after one calendar year from the date of inquiry.

Personal information, such as your name and e-mail address (but no health-related information) that you may provide is maintained in our national database. This personal information may be used to contact you about new materials, activities, events and opportunities to donate to our programs and research initiatives.

E-mail a friend

In order to further our mission and inform you about what you can do to prevent birth defects and have a healthy pregnancy, we offer a feature on our websites that allows you to e-mail the article you are viewing to a friend. This feature requires that you enter your name and e-mail address and the name and e-mail address of the recipient. The March of Dimes stores this information for the sole purpose of sending this one-time e-mail.

Credit card transactions

Payment information, such as credit card number and expiration date, is submitted to us online when you make a donation, register for our Bikers for Babies event, sponsor a participant in any of our events, purchase materials from our Online Product Catalog or pay for continuing nursing education modules.

The March of Dimes uses PayPal® and Verisign® as third-party intermediaries to process your online donations and payments. Your credit card information is transmitted over a secure connection between your computer and our server using Secure Socket Layer (SSL) encryption and is encrypted when submitted to the credit card processor.

This credit card information is never shared with third parties other than the processor, a consultant employed by the March of Dimes to help identify illegal credit card activity at our websites, and, in the case of the Online Product Catalog, the March of Dimes fulfillment center that is responsible for processing your order. Your credit card information may be stored for verification purposes, for processing recurring donations that you have authorized and for processing returns or back orders.

For information about credit card transactions made through Shop to Help, please see below. You may link here to information about credit card transactions at our Online Product Catalog website.

March of Dimes Shop to Help and product promotions

The March of Dimes Shop to Help promotions are operated on external sites owned by third parties. When you click on a link to purchase products from the March of Dimes Shop to Help, you are leaving marchofdimes.com and entering the site of a third party. Please click on the “Privacy Policy” link at the bottom of the store website to view the privacy policy followed by our third-party providers.

The March of Dimes may receive product sales reports that contain your personal information such as name, quantity ordered, e-mail address and postal address. This information is used for internal reporting and monitoring purposes; it is not distributed outside of the March of Dimes to any other parties. The March of Dimes never receives credit card numbers from third-party sites.

Please follow this link for information concerning privacy at our Online Product Catalog.

Our data security practices

The March of Dimes implements physical, electronic and managerial procedures to ensure that your personal information is protected at all times, including encryption, firewalls and password protection. Our servers are housed in an off-site secured co-location facility. All employees are reminded of the importance of protecting the privacy of our donors, website and mobile application users and of adhering to our Privacy Policy.

Children’s privacy

We may collect personal information such as your child’s name, e-mail address and postal address in order to register him or her in March of Dimes activities such as our annual March for Babies event. Your child’s personal information is subject to all of the terms of this Privacy Policy. Please also see the section of this policy which describes the information we collect at our Team Youth site.

If you do not wish your child to participate in March of Dimes activities, please contact donorservice@marchofdimes.com.

Your privacy rights under California law

California’s "Shine the Light" law regulates the sharing of personal information by a company for direct marketing purposes by requiring a company to notify a consumer of its sharing practices or by providing the consumer the opportunity to opt out of having his or her personal information shared with a third party free of charge. If you wish to opt out of having your information shared with third parties, please email us at contact us.

Contact us/Opt out

If you have any questions concerning our Privacy Policy or you wish to correct your personal information you may contact us at:

March of Dimes Foundation
Attn: Privacy Manager
1275 Mamaroneck Avenue
White Plains, NY 10605
E-mail: donorservice@marchofdimes.com
Telephone: 1-888-MODIMES.

If you prefer not to participate in our list rental and exchange program or receive e-mail communications, postal mail or telephone calls from the March of Dimes, please send us an email at Contact us to opt out of participation.

If you have subscribed to any March of Dimes newsletters, you may unsubscribe by following the instructions in the e-mail containing the newsletter.

If you would like to learn more about the web analytics services we use and to opt out, please link to Adobe and Google Analytics.

If you would like to opt out of having information collected by our ad server, please access the Atlas privacy policy.

The March of Dimes also uses the Direct Marketing Association Preference Service to restrict the flow of unwanted communications to individuals. You can add your name to this file and opt out of certain solicitations by visiting the DMA website located at http://www.dmachoice.org.

Changes to our privacy policy

The March of Dimes reserves the right to change its privacy policies at any time. To better serve you and your concerns about your privacy, we will notify you of any changes to our main privacy policy or to any of the privacy policies associated with any of our other websites by posting a notice prominently on the home page of the respective websites indicating that there has been a change or update to the Privacy Policy.

Effective Date: This privacy policy is effective: June 12, 2012

© 2012 March of Dimes Foundation



Privacy policies for our special sites

Online Fundraising Sites privacy policy

March for Babies®, Bikers for Babies®, Jail and Bail

The March of Dimes uses our Online Fundraising Sites - March for Babies, Bikers for Babies, and Jail and Bail websites to help participants maximize their fundraising efforts.

Information we collect and how we use it

If you are a participant or team captain, you will be asked to register by providing your first and last name, postal address, e-mail address, telephone number, the name of your fundraising group (if any), and a user name. We store this registration information to allow you to use the tool effectively -- for example, to log on at different times to contact potential sponsors and to keep them informed of the event -- and to allow you and us to keep track of the sponsorships you receive.

If you sponsor someone and make a donation at this site, we will ask you to provide your name, address, telephone number and e-mail address.

We use the information users provide to advise them of new online materials, activities and events and to offer users the opportunity to contribute to local and national programs and research initiatives.

The March of Dimes does not contact those people whose names and postal and e-mail addresses may be stored on a participant’s page as potential sponsors unless they register as volunteers or donate to the March of Dimes.

The March of Dimes will store the password you create for the purpose of responding to you should you forget your password. Only those employees with the responsibility of responding to your request will have access to your password.

Sharing your information with third parties

If you join a team, your name and the total amount you have raised will be available to the team captain. Your postal address will be made available to those of your sponsors who choose to make their donation by check so that they can send the check to you.

If you make a donation to a team, your name, address and e-mail address will be available to the team captain.

The information you provide when you register or make a donation is maintained in the March of Dimes national database and available to the state chapters.

Except as described in this and our main Privacy Policy, the personal information you provide on the March for Babies, Bikers for Babies, and Jail and Bail websites will not be sold to or exchanged with any third party without your permission.

Disclosing personal information in special circumstances

Information from cookies

Automatic data collection and advertising

Credit card security

If you register as a biker in the Bikers for Babies event online or if you sponsor a participant in any of our events, you may be asked to provide credit card information. Information about credit card transactions can be found at this link.

Contact us/Opt out

You may contact us by email to correct your personal information and to opt out of receiving communications from the March of Dimes or having information collected by our web analytics companies and ad server.

Your Privacy Rights Under California Law

Changes to Our Privacy Policy

Effective date: The Online Fundraising Site Privacy Policy is effective: June 12, 2012.


Share Your Story privacy policy

Information we collect and how we use it

In order to participate on the Share Your Story website, you will need to create an account by submitting a valid e-mail address and creating a password. Except as described in this privacy policy, the March of Dimes does not share your e-mail address with third parties without your consent.

The March of Dimes uses this information to register you to use this site and may also use it to contact you about new materials, activities, events and opportunities to volunteer and contribute to our mission.

The March of Dimes advises users that personal information posted on Share Your Story is accessible to the public and visible to anyone who visits the site. By posting information on this site, you may receive unsolicited messages from third parties unrelated to the March of Dimes. The March of Dimes monitors its websites, but it remains the responsibility of the site visitor to use his/her best judgment in choosing the information he/she will post.

Any messages or stories shared on this site may be used in other March of Dimes marketing activities. Please also see our Terms of Use regarding the information you share on this website.

For general information as to how the March of Dimes collects and uses personal information, please consult our main Privacy Policy.

Disclosing personal information in special circumstances

Information from cookies

Contact Us

You may contact us by email to correct your personal information and to opt out of receiving communications from the March of Dimes.

Your Privacy Rights Under California Law

Changes to Our Privacy Policy

Effective date: The Share Your Story Privacy Policy is effective: June 12, 2012.


Online Product Catalog privacy policy

Information we collect and how we use it

When you use our Online Product Catalog to purchase our publications and professional education materials, you will be asked to provide your first and last name, your personal and/or business address, your company/organization name, if applicable, your telephone number, your e-mail address and your credit card information . This information is used to allow us and our distributor to process and deliver your purchases and to communicate with you concerning your orders.

We will retain your personal contact information, including your credit card information, to allow us to process back orders, returns and refunds and to allow you to place future orders more easily. We will use your e-mail address to send you information about new products, promotions or discounts. You may contact us at any time if you want to opt out of receiving such e-mails.

For general information as to how the March of Dimes collects and uses your information, please consult our main Privacy policy above.

Except as provided in this and our main privacy policy, we will not share your personal information with any third party without your consent.

Sharing your personal information with third parties

Disclosing personal information in special circumstances

Information from cookies

Credit card transactions

Contact us

You may contact us by email to correct your personal information and to opt out of receiving communications from the March of Dimes.

Your Privacy Rights Under California Law

Changes to Our Privacy Policy

Effective date: The Online Product Catalog Privacy Policy is effective: June 12, 2012.


Banding Together® privacy policy

Information we collect and how we use it

When you create a bracelet to memorialize or honor a child, you will be required to submit your first and last name, the child’s first name and the child’s gender. You also may submit the child’s last name, date of birth, city and state and whether the child was full term or born prematurely. The information you provide will be public and accessible to visitors to the site.

When you donate on behalf of a particular child, the March of Dimes receives your name, postal address, e-mail address and credit card information. Your credit card information is securely processed by Verisign® and handled by the March of Dimes in accordance with our credit card practices. Your name may appear as a donor in association with a particular bracelet if you choose to make that information public by checking the appropriate field in the donation form.

For general information as to how the March of Dimes collects and uses personal information, please consult our main Privacy Policy.

Except as described in this and our main privacy policy, the March of Dimes will not sell to or exchange with any third party the personal information you provide on Banding Together.

Sharing your personal information with third parties

Disclosing personal information in special circumstances

Information from cookies

Contact us

If you have any questions concerning the Banding Together website, you may contact us at webmaster@marchofdimes.com.

You may contact us by email to correct your personal information and to opt out of receiving communications from the March of Dimes.

Your Privacy Rights Under California Law

Changes to Our Privacy Policy

Effective date: The Banding Together Privacy Policy is effective: June 12, 2012


Team Youth® privacy policy

Information we collect and how we use it

Our Team Youth site is designed to connect teens to the March of Dimes and its mission. Teens signing up to receive the Youth Times online newsletter must provide a first and last name, e-mail address and postal code. In addition to providing the newsletter, we also may use the e-mail address to provide information about March of Dimes programs and events.

The site also features a message board where young adults can exchange information about their experiences with the March of Dimes. A participant is required to provide the March of Dimes with a first and last name and e-mail address and may provide information about his or her involvement in other March of Dimes activities, class year, city, state and postal code.

For general information as to how the March of Dimes collects and uses personal information, please consult our main Privacy Policy.

Except as described in this and our main privacy policy, the March of Dimes does not share the personal information you provide at the Team Youth site or your e-mail address with any third party.

Sharing your personal information with third parties

Disclosing personal information in special circumstances

Information from cookies

Contact us

You may contact us by email to correct your personal information and to opt out of receiving communications from the March of Dimes.

Your Privacy Rights Under California Law

Changes to Our Privacy Policy

Effective date: The Team Youth Privacy Policy is effective: June 12, 2012.


Genetics & Your Practice® privacy policy

The Genetics & Your Practice site is designed for professionals working in the primary care setting and has separate custom modules for professionals working with preconception/prenatal patients, infants and children, and adolescents and adults. This site allows you to register for courses for which you can receive continuing education credits.

Information we collect and how we use it

When you register, we will ask you to provide your first and last name, e-mail address and information about your occupation. You also will be required to provide a user name and password in order to create your own personal account and log in and out on the Genetics & Your Practice site.

We use this information to register you at the site, to deliver the course materials, to administer the tests and to provide you with credit for the courses and, if you request it, further information about the March of Dimes and our various services, events and materials.

For general information as to how the March of Dimes collects and uses personal information, please consult our main Privacy Policy.

Sharing your personal information with third parties

The information you provide on this site will not be shared with any third party without your permission unless you are applying for professional continuing education credit and except as described in this privacy policy.

By providing your personal information for continuing education credit, you are granting us permission to forward it to the provider, Swedish Medical Center, and any other accrediting organizations that require it. Your personal information will be used to generate your certificate of completion and for aggregate reporting. Information forwarded to the professional education provider or other accrediting authority will be subject to their individual privacy policies.

Disclosing personal information in special circumstances

Information from cookies

We use cookies to allow you to personalize the site according to your specifications, to track and record your course progress, and to measure the effectiveness of the content by recording your responses to questions and interactions throughout the site.

In addition, our web server recognizes consumer e-mail addresses and domain names for the purpose of analyzing website access and improving the content of the site. Such information is collected and analyzed in the aggregate for internal use and will not be submitted to third parties without your permission.

Please click on this link for further information about cookies and how the March of Dimes uses cookies at its sites.

Site evaluations

If you are seeking Continuing Medical Education (CME) credit, you will be required to complete a pre-test and post-test to gauge your knowledge pre- and post- participation in the case study. You must also complete the case study, a CME evaluation survey and a CME registration form. You do not need to complete these items if you are not seeking to obtain CME credits.

The pre- and post-tests we administer will be evaluated without reference to any personally identifiable information. This information is analyzed for the purpose of compiling aggregate statistics only.

You will not be contacted by us unless you opt to participate in the follow-up evaluation. Results from the evaluations may be published in peer-reviewed journals.

Contact us

You may correct your personal information in the “My Account” section of the Genetics & Your Practice site.

When you register, you will be asked whether you would like to hear from the March of Dimes regarding issues relevant to Genetics & Your Practice and for news alerts, progress reports and promotions to benefit the March of Dimes. You may opt out of these communications at any time by clicking on “My Account” on the main page of the Genetics & Your Practice site. To communicate with us for any other reason, please contact us at this link.

Your Privacy Rights Under California Law

Changes to Our Privacy Policy

Effective date: The Genetics & Your Practice Privacy Policy is effective: June 12, 2012.


Perinatal Nursing Education privacy policy

The Perinatal Nursing Education site is designed to provide continuing education for perinatal nurses. This site allows you to register for materials for which you can receive continuing education credits.

Information we collect and how we use it

When you register, we will ask you to provide your first and last name, postal address, e-mail address and information about your occupation. You also will be required to provide a user name and password in order to create your own personal account and log in and out on the Perinatal Nursing Education site.

We use this information to register you at the site, to deliver the course materials, to administer the tests, to generate your certificate of completion and for aggregate reporting. If you request it, we will send you further information about the March of Dimes and our various services, events and materials.

For general information as to how the March of Dimes collects and uses personal information, please consult our main Privacy Policy.

Sharing your personal information with third parties

If you use a token code purchased by someone else, that person will have access to the following information: whether you used the code, your e-mail address, and whether you passed or failed the continuing education test. Otherwise, except as described in this and our main privacy policy, your personal information will not be shared with any third party without your permission.

Disclosing personal information in special circumstances

Site evaluations

You may choose to opt in or opt out of the evaluation of the Perinatal Nursing Education site pre-tests and post-tests. Pre-test and post-tests gauge your knowledge prior to and after participation in the module. The March of Dimes does not link information obtained from the pre- and post-tests to personal information, and this information is analyzed for the purpose of compiling aggregate statistics only.

Information from cookies

We use cookies to allow you to personalize the site according to your specifications, to track and record your course progress, and to measure the effectiveness of the content by recording your responses to questions and interactions throughout the site.

In addition, our Web server recognizes consumer e-mail addresses and domain names for the purpose of analyzing website access and improving the content of the site. Such information is collected and analyzed in the aggregate for internal use and will not be submitted to third parties without your permission.

Please click on this link for further information about cookies and how the March of Dimes uses cookies at its sites.

Credit card transactions

We use Secure Socket Layer technology for online payments, and your account information is encrypted when submitted for processing and verification. We will collect credit card account information for one-time use only. For questions about this policy, please contact profedu@marchofdimes.com. For further information as to how the March of Dimes processes credit card transactions, please click here.

Contact us

You may correct your personal information in the “My Account” section of the Perinatal Nursing Education site.

When you register, you will be asked whether you would like to hear from the March of Dimes regarding issues relevant to Perinatal Nursing Education and for news alerts, progress reports and promotions to benefit the March of Dimes. You may opt out of these communications at any time by clicking on “My Account” on the main page of the Perinatal Nursing Education site.

If you would like to communicate with us for any other reason, please contact us at this link.

Your Privacy Rights Under California Law

Changes to Our Privacy Policy

Effective date: The Perinatal Nursing Education Privacy Policy is effective: June 12, 2012


Perinatal Quality Improvement Portal (“PQIP”) privacy policy

The March of Dimes Perinatal Quality Improvement Portal (“PQIP”) provides access to materials and tools to support quality improvement initiatives and programs -- such as the 39+ Weeks Quality Improvement Initiative -- to hospitals working collaboratively with the March of Dimes to improve maternal and infant health.

Hospitals participating in any quality improvement initiative provide the March of Dimes with the names of the various team members at the hospital who will have access to the PQIP. Each team member must then register independently with the March of Dimes. This privacy policy covers the registration information submitted by team members.

Information we collect and how we use it

As a team member, you may choose to be approved for access to the PQIP in one of two ways:

  • By registering at the PQIP landing page and providing a first and last name, a user name, an email address and a password.
  • By using a user name and password that you provided to the March of Dimes when you created a Personal Profile at www.marchofdimes.com or registered for one of our fundraising events, such as March for Babies, Bikers for Babies or Jail and Bail.

As a team member, your personal contact information will be used to contact you to provide or request information concerning the initiative or program.

The March of Dimes will store the password you create at the PQIP for the purpose of responding to you should you forget your password. Only those employees with the responsibility of responding to your request will have access to your password.

Once you have registered at the PQIP website, you may use the same username and password to sign in and create a Personal Profile at www.marchofdimes.com or register for one of our fundraising events. Our Privacy Policy at Your Personal Profile and Online Fundraising Sites explains what personal information we collect and how we use that information when you visit and log on to these sites.

For general information as to how the March of Dimes collects and uses personal information, please consult our Privacy Policy.

Sharing your personal information with third parties

When we communicate with you, your personal contact information, such as your email address, may be shared with other team members at hospitals participating in the same initiative or program. Except as provided in this privacy policy, we will not share your personal information with any third party without your consent.

Disclosing personal information in special circumstances

Information from cookies

The PQIP Blog

If you contribute to the blog which is set up for your initiative or program at the PQIP, the information you provide, together with your name, username and email address, will be visible to anyone who has access to that blog.

Contact us

You may contact us by email to correct your personal information and to opt out of receiving communications from the March of Dimes.

Effective Date: The Perinatal Quality Improvement Portal Privacy Policy is effective June 12, 2012.

© 2012 March of Dimes Foundation

Outdoor Advertising Group

With state-of-the-art planning and activation, OAG allows clients to expand their marketing footprint through the strategic deployment of advertising across multiple Out-of-Home  formats. For more than 10 years, the company has generously provided the March of Dimes with excellent media placements nationally, allowing billions of people to see the March for Babies and Prematurity Campaign messages.

Phi Beta Sigma Fraternity, Inc.

Phi Beta Sigma Fraternity, Inc. and the March of Dimes have been working together throughout the country since the 1980s. In the past, Phi Beta Sigma Fraternity, Inc. and March of Dimes chapters conducted project SATAP, Sigmas Against Teen-Age Pregnancy. In 2001, the relationship was revamped and today all fraternity chapters across the country are requested to implement the revised program called Building Strong Fathers Program at least once a year.

With a motto of "Culture for Service and Service for Humanity," Phi Beta Sigma Fraternity, Inc. helps the March of Dimes achieve its mission to improve birth outcomes, and reduce racial and ethnic disparities.

Phi Beta Sigma Fraternity, Inc. was founded in 1914 at Howard University on the principles of brotherhood, scholarship and service. Over 110,000 members comprise 650 chapters throughout the continental United States, Switzerland and Africa. Predominantly African American, Phi Beta Sigma Fraternity, Inc. boasts a membership dedicated to enhancing and promoting systematic fellowship, African American freedom, justice, equal rights and service. Unlike any other Greek organization, Phi Beta Sigma Fraternity, Inc. is constitutionally bound to a sister organization, Zeta Phi Beta Sorority, Inc., which is also a March of Dimes partner. Learn more about Phi Beta Sigma Fraternity, Inc. at pbs1914.org. Or learn more about our partnership.

 

Philips

Philips and March of Dimes are working together to support families whose babies are admitted to a Newborn intensive care units (NICU). The Power of Touch campaign, which is supported by Philips Mother & Child Care and the Philips Cares organization, will complement the services provided to NICU families through the March of Dimes NICU Family Support program. In addition, Philips employees will make a meaningful difference in their communities by volunteering for the March of Dimes at Power of Touch events as well as local March of Dimes events.

Preconception health care

Preconception health care is care a woman of childbearing age receives before pregnancy or between pregnancies. This type of care looks at biomedical, behavioral and social risk factors that may affect a woman’s health. The goal is to provide information and treatment before pregnancy that can improve a woman’s health and help reduce risks to her future baby.

All women of childbearing age can take steps before they get pregnant to improve their chances of having a healthy, full-term baby. More and more babies are born prematurely (before 37 completed weeks of pregnancy), which increases the risk for serious health problems. By getting preconception health care, a woman can learn what steps she can take before pregnancy to protect her health and give her baby the best chance to be healthy.

Why is a preconception checkup important?

A preconception checkup can help assure that a woman is as healthy as possible before she conceives. Her provider can identify and often treat health conditions that can pose a risk in pregnancy, such as high blood pressure, diabetes or certain infections. The provider can give her information on things like nutrition, weight, smoking, drinking alcohol and occupational exposures that can pose pregnancy risks. The provider also can make sure a woman’s vaccinations are up to date and that any medications she takes are safe during pregnancy.

The provider can ask a woman about her health history, as well as that of her partner and her family. If the woman or her partner has a history of birth defects or prematurity, or if either has a high risk for a genetic disorder based on family history, ethnic background or age, the provider may suggest seeing a genetic counselor.

What does a genetic counselor do?

A genetic counselor discusses the risks for a genetic disease in a couple’s future children. The counselor can arrange blood tests (called carrier tests) that can identify carriers of many genetic diseases. If both parents are carriers of a disease, each child has a 25 percent chance of inheriting the disease. Carrier tests are given for a variety of conditions, including:

  • Cystic fibrosis (CF), a disease of the lungs and digestive system that is most common in Caucasians, but can affect children from many backgrounds
  • Tay-Sachs disease, which causes fatal brain damage and is more common in people of Eastern European Jewish ancestry and in some non-Jewish individuals of French-Canadian and Cajun ancestry
  • Sickle cell disease, a blood disorder that mainly affects African-Americans
  • Thalassemia, a blood disorder that mainly affects those of Mediterranean, African and South Asian descent

Genetic screening and counseling before pregnancy may reassure a couple that their children are not at increased risk for a specific inherited disease. Genetic counseling also allows carriers the opportunity to understand their risk and discuss options. Women who can benefit from genetic counseling include:

  • Women over age 35
  • Women who have certain genetic disorders, such as phenylketonuria (PKU)
  • Women who have had a child with a neural tube defect (NTD), a birth defect of the brain and spinal cord

Why should women of childbearing age take folic acid?

Folic acid is a B vitamin that can help prevent birth defects, particularly NTDs. Studies show that if all women consumed the recommended amount of folic acid before and during early pregnancy, up to 70 percent of all NTDs could be prevented (1, 2). Studies also suggest that folic acid may help prevent some other birth defects, including cleft lip and palate and some birth defects involving the heart (1). A recent study also suggests that women who take folic acid for a least 1 year before becoming pregnant may reduce their risk of having a premature baby (4).

To prevent NTDs, the March of Dimes recommends that all women who could become pregnant take a multivitamin containing 400 micrograms of folic acid every day starting before pregnancy, along with eating healthy foods. This advice, based on recommendations from the Institute of Medicine (IOM) (3), assures that a woman gets all the folic acid and other vitamins she needs.

A woman also can get folic acid by eating a serving of folic acid-enriched cereal every day that contains 100 percent of the daily value (DV) of folic acid (400 micrograms). Healthy food choices include foods that are fortified with folic acid and foods that contain folate, the natural form of folic acid found in foods. Many grain products, including flour, rice, pasta, bread and cereals, are fortified with folic acid. Folate-rich foods include green leafy vegetables, dried beans, legumes, oranges and orange juice.

A woman who has had a pregnancy affected by an NTD should take a higher dose of folic acid. Taking a higher dose of folic acid daily (4,000 micrograms or 4 milligrams), beginning at least 1 month before pregnancy and in the first trimester of pregnancy, reduces by about 70 percent the risk of having another affected pregnancy (5). Women with diabetes or epilepsy and women who are obese are at increased risk of having a baby with an NTD (1). Women with these conditions should consult their providers before pregnancy about taking a larger dose of folic acid.

What vaccines might a woman need before pregnancy?

At a preconception visit, the health care provider may do a blood test to see if a woman is immune to rubella (German measles) and chickenpox. Both of these diseases can cause birth defects and other complications if a woman gets them during pregnancy.

If a woman is not immune, she should be vaccinated before pregnancy. She should then wait 1 month after vaccination before attempting to get pregnant.

Women who are at high risk for hepatitis B (such as health care workers) and have not been vaccinated for it should consider getting the hepatitis B vaccine before or during pregnancy. This disease can be passed on to the baby during delivery. A provider also may recommend other vaccines, such as the flu shot.

What maternal illnesses should be treated before pregnancy?

  • Diabetes: Women with poorly controlled diabetes that started before pregnancy are about 3 times more likely than women without diabetes to have a baby with a serious birth defect (6). They also are at increased risk for miscarriage and stillbirth and for having a baby that is very large. Controlling blood sugar before pregnancy and during the first few months of pregnancy can help prevent birth defects.
  • High blood pressure: Chronic high blood pressure can increase the risk of pregnancy complications, including placental problems, poor fetal growth and preeclampsia (a pregnancy-related disorder characterized by high blood pressure and protein in the urine).
  • Systemic lupus erythematosus (SLE): This autoimmune disorder can cause arthritis-like symptoms, kidney disease, skin rashes and other problems. Affected pregnant women are at increased risk for miscarriage, poor fetal growth, preterm labor and stillbirth (7). However, if symptoms are well controlled before pregnancy, the risk of these complications is reduced.
  • Seizures: Some seizure control medications increase the risk of birth defects. During a preconception visit, a provider may adjust a woman’s dose or switch her to a drug that is safer for the fetus. A woman should not stop taking seizure medication without asking her provider, as seizures themselves might harm a fetus.
    PKU: Women with this inherited condition cannot process certain proteins. They must eat a special meal plan and be carefully monitored before and during pregnancy to prevent intellectual disabilities and birth defects in their offspring (6).
  • Kidney disease: Some women with severe kidney disease may suffer additional kidney damage during pregnancy, and their babies may be at increased risk for death, premature delivery or poor growth (7).

How long should a woman wait between pregnancies?

For most women, it’s best to wait at least 18 months before getting pregnant again. This gives a woman’s body enough time to get ready physically for another pregnancy. It also gives her time to adjust to life as a mom. Shorter time intervals between pregnancies may increase the risk of premature birth (8). However, not all women can wait 18 months because of their age or other reasons. A woman should talk to her health care provider to determine the right amount of time for her.

How can preconception care help prevent problems that occurred in past pregnancies?

Even if a woman has not had problems in a previous pregnancy, preconception care can help prevent birth defects or pregnancy complications in a future pregnancy. For example, taking folic acid can help prevent NTDs, and treatment of certain health conditions, such as high blood pressure, can help prevent premature delivery. A 2006 report from the Centers for Disease Control and Prevention (CDC) recommends that all women who have had a previous pregnancy that ended in an adverse outcome receive evaluation and treatment between pregnancies to reduce the risk in future pregnancies (6).

Preconception care is important for women who have had a miscarriage, stillbirth or premature delivery. The health care provider can review a woman’s medical record and may recommend tests to help determine the cause of an adverse outcome. The tests may include blood tests and imaging tests, such as ultrasound. If tests show that a health problem in the woman may have contributed to the outcome, treatment between pregnancies often can reduce the risk of the problem recurring in another pregnancy. If a woman had a previous premature delivery, the provider may recommend lifestyle changes, such as quitting smoking, and discuss the possibility of treatment with the hormone progesterone during her next pregnancy to help reduce the risk of another premature delivery.

What can a woman do to help stay healthy before pregnancy?

A woman should:

  • Avoid alcohol. Drinking alcohol during pregnancy can cause physical and mental birth defects called fetal alcohol syndrome (FAS). Because no amount of alcohol has been proven safe in pregnancy, pregnant women and women considering becoming pregnant should avoid it entirely.
  • Quit smoking. Smoking during pregnancy nearly doubles the risk for having a low-birthweight baby. It also increases the risk for premature delivery, other pregnancy complications and sudden infant death syndrome (SIDS) (9). Smoking also may make it more difficult to conceive (9).
  • Stay away from cocaine and other illicit drugs and prescription drugs not prescribed for her. These drugs pose many risks, including premature delivery, low birthweight, birth defects, learning or behavioral problems, and withdrawal symptoms.
  • Fully cook all meat and don’t change a cat’s litter box. Undercooked meat and cat feces can contain a parasite that causes an infection called toxoplasmosis, which can cause birth defects. Another way to avoid cat feces is to wear gloves when working in the yard or garden.
  • Avoid contact with all rodents, including pet hamsters, mice and guinea pigs. These animals can carry a virus that can harm your baby (10).
  • Avoid sitting in hot tubs and saunas. These may elevate body temperature and, possibly, increase the risk for NTDs (1).
  • Avoid hazardous chemicals, such as solvents (substances that dissolve other substances, like paint thinner).Working with solvents may increase a woman’s risk for miscarriage or having a baby with birth defects (11).
  • Avoid eating fish that can be high in mercury. Mercury is a metal that can harm an unborn baby; it often is found in fish. Pregnant women and women considering pregnancy should not eat fish that are high in mercury, like shark, swordfish, king mackerel and tilefish (12). These women can eat up to 12 ounces per week of fish that are low in mercury, including shrimp, salmon, pollock, catfish and canned light tuna. They should eat no more than 6 ounces of albacore (white) tuna per week. Women should always check with their local health department before eating any fish they catch themselves (12).

Why should a woman try to achieve a healthy weight before pregnancy?

Women who begin pregnancy overweight or obese may be at increased risk of having high blood pressure and diabetes, having a baby with certain birth defects, having labor and delivery complications, and having a stillborn baby (6, 7). They also may have more difficulties becoming pregnant (13). Women who are underweight may be at increased risk of having a premature or low-birthweight baby (7). A woman can help reduce her risk for these complications by attaining a healthy weight before pregnancy.

For more information

References

  1. Centers for Disease Control and Prevention (CDC). Folic Acid: Frequently Asked Questions. Updated 1/30/08.
  2. Berry, R.J., et al. Prevention of Neural Tube Defects with Folic Acid in China. New England Journal of Medicine, volume 341, number 20, November 11, 1999, pages 1485-1490.
  3. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes: Folate, Other B Vitamins, and Choline. Washington, D.C., National Academy Press, April 7, 1998.
  4. Bukowski, R., et al. Preconception Folate Prevents Preterm Delivery (abstract). American Journal of Obstetrics and Gynecology, Special Supplement, Society for Maternal and Fetal Medicine 28th Annual Meeting, volume 197, number 6, December 2007.
  5. Centers for Disease Control and Prevention (CDC). Folic Acid: PHS Recommendations. Updated 7/26/05.
  6. Centers for Disease Control and Prevention (CDC)/Agency for Toxic Substances and Disease Registry (ATSDR). Preconception Care Work Group and the Select Panel on Preconception Care. Recommendations to Improve Preconception Health and Health Care – United States. Morbidity and Mortality Weekly Reports, volume 55, no. RR-6, April 21, 2006.
  7. American College of Obstetricians and Gynecologists (ACOG). Your Pregnancy and Birth, 4th edition. ACOG, Washington, DC, 2005.
  8. Conde-Agudelo, A., et al. Birth Spacing and Risk of Adverse Perinatal Outcomes. Journal of the American Medical Association, volume 295, number 15, April 19, 2006, pages 1809-1823.
  9. U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General – 2004. Office on Smoking and Health, Atlanta, GA.
  10. Centers for Disease Control and Prevention (CDC). Lymphocytic Choriomeningitis Virus (LCMV) and Pregnancy: Facts and Prevention. Updated 9/20/06.
  11. Khattak, S., et al. Pregnancy Outcome Following Gestational Exposure to Organic Solvents. Journal of the American Medical Association, March 24/31 1999, volume 281, number 12, pages 1106-1109.
  12. U.S. Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA). What You Need to Know About Mercury in Fish and Shellfish. Accessed 5/4/06.
  13. American Society for Reproductive Medicine. Patient’s Fact Sheet: Weight and Fertility. Revised 8/01, accessed 5/8/06.

July 2008

Premature birth

Most pregnancies last around 40 weeks. Babies born between 37 and 42 completed weeks of pregnancy are called full term. Babies born before 37 completed weeks of pregnancy are called premature. In the United States, about 12.8 percent of babies (more than half a million a year) are born prematurely (1). The rate of premature birth has increased by 36 percent since the early 1980s (1).
Premature birth is a serious health problem. Premature babies are at increased risk for newborn health complications, such as breathing problems, and even death. Most premature babies require care in a newborn intensive care unit (NICU), which has specialized medical staff and equipment that can deal with the multiple problems faced by premature infants.

Premature babies also face an increased risk of lasting disabilities, such as intellectual disabilities, learning and behavioral problems, cerebral palsy, lung problems and vision and hearing loss. Two recent studies suggest that premature babies may be at increased risk of symptoms associated with autism (social, behavioral and speech problems) (2, 3). Studies also suggest that babies born very prematurely may be at increased risk of certain adult health problems, such as diabetes, high blood pressure and heart disease (4).

When are most premature babies born?
More than 70 percent of premature babies are born between 34 and 36 weeks gestation (1). These are called late-preterm births. Late-preterm babies account for most of the increase in the premature birth rate in this country. A 2008 study found that cesarean sections (c-sections) account for nearly all of the increase in U.S. singleton premature births, and this group had the largest increase in c-section deliveries (5).

About 12 percent of premature babies are born between 32 and 33 weeks gestation, about 10 percent between 28 and 31 weeks, and about 6 percent at less than 28 weeks gestation (1).

All premature babies are at risk for health problems, but the earlier a baby is born, the greater the risk for serious complications. Babies born before about 32 weeks gestation usually are very small, and their organs are less developed than those of babies born later. Fortunately, advances in obstetrics and neonatology (the branch of pediatrics that deals with newborns) have improved the chances of survival for even the smallest babies.

What causes premature birth?
Most premature births are caused by spontaneous preterm labor, either by itself or following spontaneous premature rupture of the membranes (PROM). With PROM, the sac inside the uterus that holds the baby breaks too soon. Preterm labor is labor that begins before 37 completed weeks of pregnancy. The causes of preterm labor and PROM are not fully understood.

The latest research suggests that many cases are triggered by the body’s natural response to certain infections, including those involving amniotic fluid and fetal membranes. However, in about half of all cases of premature birth, providers cannot determine why a woman delivered prematurely.

About 25 percent of premature births are caused by early induction of labor or c-section due to pregnancy complications or health problems in the mother or the fetus (6). In many of these cases, early delivery is probably the safest approach for mother and baby.

However, the March of Dimes is concerned that some early deliveries may occur without good medical justification or may be done at the request of the mother. In some cases, this can lead to late-preterm birth, with potential risks to the baby. Women should wait until at least 39 weeks to schedule an induced labor or a c-section, unless there are medical problems that make it necessary to deliver earlier (7, 8).

Which women are at increased risk for premature birth?
Any woman can give birth prematurely, but some women are at greater risk than others. Researchers have identified some risk factors, but providers still can't predict which women will deliver prematurely.

Three groups of women are at greatest risk for premature birth:

Women who have had a previous premature birth
Women who are pregnant with twins, triplets or more
Women with certain uterine or cervical abnormalities
Certain lifestyle factors may put a woman at greater risk for preterm labor. These include:

Late or no prenatal care
Smoking
Drinking alcohol
Using illegal drugs
Exposure to the medication DES
Domestic violence (including physical, sexual or emotional abuse)
Lack of social support
Extremely high levels of stress
Long working hours with long periods of standing
Exposure to certain environmental pollutants
Certain medical conditions during pregnancy also may increase the likelihood that a woman will have preterm labor. These include:

Infections (including urinary tract, vaginal, sexually transmitted and other infections)
High blood pressure and preeclampsia
Diabetes
Clotting disorders (thrombophilia)
Being underweight before pregnancy
Obesity
Short time period between pregnancies [One study found that an interval of less than 18 months between birth and the beginning of the next pregnancy increased the risk of preterm labor, though the greatest risk was with intervals shorter than 6 months (9). A woman should discuss with her provider the best pregnancy spacing for her.]
Being pregnant with a single fetus that is the result of in vitro fertilization
Birth defects in the baby (10)
Bleeding from the vagina
Certain demographic factors also increase the risk:

Non-Hispanic black race
Younger than age 17, or older than age 35
Low socioeconomic status
Even if a woman has one or more of these risk factors, it does not mean that she will have preterm labor. However, all women should learn the signs of preterm labor and what to do if they have any of them.

What medical complications are common in premature babies?
There are a number of complications that are more likely in premature than full-term babies:

Respiratory distress syndrome (RDS): About 23,000 babies a year (most of whom were born before the 34th week of pregnancy) suffer from this breathing problem (11). Babies with RDS lack a protein called surfactant that keeps small air sacs in the lungs from collapsing.

Treatment with surfactant helps affected babies breathe more easily. Since treatment with surfactant was introduced in 1990, deaths from RDS have been reduced by about half (12).

A provider may suspect a baby has RDS if she is struggling to breathe. A lung X-ray and blood tests often confirm the diagnosis.

Along with surfactant treatment, babies with RDS may need additional oxygen and mechanical breathing assistance to keep their lungs expanded. They may need the support of a ventilator or they may receive treatment called continuous positive airway pressure (CPAP). CPAP delivers pressurized air to the baby’s lungs through small tubes in the baby's nose or through a tube that has been inserted into his windpipe. CPAP helps a baby breathe, but it does not breathe for him. The sickest babies may need the help of a ventilator to breathe for them while their lungs mature.

Apnea: Premature babies sometimes stop breathing for 20 seconds or more. This interruption in breathing is called apnea, and it may be accompanied by a slow heart rate. Premature babies are constantly monitored for apnea. If the baby stops breathing, a nurse stimulates the baby to start breathing by patting him or touching the soles of his feet.

Intraventricular hemorrhage (IVH): Bleeding in the brain occurs in some premature babies. Those born before about 32 weeks of pregnancy are at highest risk. The bleeds usually occur in the first 3 days of life and generally are diagnosed with an ultrasound.

Most brain bleeds are mild and resolve themselves with no or few lasting problems. More severe bleeds can affect the substance of the brain or cause the fluid-filled structures (ventricles) in the brain to expand rapidly. These severe bleeds can cause pressure on the brain that can lead to brain damage (such as cerebral palsy and learning and behavioral problems). When fluid persists in the ventricles, neurosurgeons may insert a tube into the brain to drain the fluid and reduce the risk of brain damage.

Patent ductus arteriosus (PDA): PDA is a heart problem that is common in premature babies. Before birth, a large artery called the ductus arteriosus lets blood bypass the lungs because the fetus gets its oxygen through the placenta. The ductus arteriosus normally closes soon after birth so that blood can travel to the lungs and pick up oxygen.

When the ductus arteriosus does not close properly, it can lead to heart failure. PDA can be diagnosed with a specialized form of ultrasound (echocardiography) or other imaging tests. Babies with PDA are treated with a drug that helps close the ductus arteriosus, although surgery may be necessary if the drug does not work.

Necrotizing enterocolitis (NEC): Some premature babies develop this potentially dangerous intestinal problem 2 to 3 weeks after birth. It can lead to feeding difficulties, abdominal swelling and other complications. NEC can be diagnosed with blood tests and imaging tests, such as X-rays. Affected babies are treated with antibiotics and fed intravenously (through a vein) while the intestine heals. In some cases, surgery is necessary to remove damaged sections of the intestine.

Retinopathy of prematurity (ROP): ROP is an abnormal growth of blood vessels in the eye that can lead to vision loss. It occurs mainly in babies born before 32 weeks of pregnancy. ROP is diagnosed during an examination by an ophthalmologist (eye doctor) several weeks after birth.

Most cases are mild and heal themselves with little or no vision loss. In more severe cases, the ophthalmologist may treat the abnormal vessels with a laser or with cryotherapy (freezing) to protect the retina and preserve vision.

Jaundice: Premature babies are more likely than full-term babies to develop jaundice because their livers are too immature to remove a waste product called bilirubin from the blood. Babies with jaundice have a yellowish color to their skin and eyes. Jaundice often is mild and usually is not harmful. However, if the bilirubin level gets too high, it can cause brain damage.

Blood tests show when bilirubin levels are too high, so providers can treat the baby with special lights (phototherapy) that help the body eliminate bilirubin, thus preventing brain damage. Occasionally, if bilirubin levels rise very high, a baby may need a special type of blood transfusion.

Anemia: Premature infants often are anemic, which means they do not have enough red blood cells. Normally, the baby stores iron during the later months of pregnancy and uses it late in pregnancy and after birth to make red blood cells. Infants born too soon may not have had enough time to store iron.

Babies with anemia tend to develop feeding problems and grow more slowly. Anemia also can worsen any heart or breathing problems. Anemic infants may be treated with iron supplements (drugs that increase red blood cell production), or they may require blood transfusion.

Chronic lung disease (also called bronchopulmonary dysplasia or BPD): Chronic lung disease most commonly affects premature infants who require ongoing treatment with supplemental oxygen. The risk of BPD is increased in babies who still need oxygen when they reach 36 weeks after conception (weeks of pregnancy plus weeks after birth adding up to 36 or more weeks). These babies develop fluid in the lungs, scarring and lung damage, which can be seen on an X-ray.

Affected babies are treated with oxygen and medications that make breathing easier. Sometimes they require support from a ventilator and are weaned slowly from the device. Their lungs usually improve over the first 2 years of life. However, many children with BPD develop chronic lung disease resembling asthma.

Infections: Premature babies have immature immune systems that are inefficient at fighting off bacteria, viruses and other organisms that can cause infection. Serious infections commonly seen in premature babies include pneumonia (lung infection), sepsis (blood infection) and meningitis (infection of the membranes surrounding the brain and spinal cord). Babies can contract these infections at birth from their mother, or they may become infected after birth. Infections are treated with antibiotics or antiviral drugs.

What happens when babies are born at less than 28 weeks?
Fewer than 1 percent of babies in this country are born this early, but they have the most complications (1). Most of these babies are born at extremely low birthweight (less than 2 pounds, 3 ounces). Almost all require treatment with oxygen, surfactant and mechanical assistance to help them breathe.

These babies are too immature to suck, swallow and breathe at the same time, so they must be fed through a vein (intravenously) until they develop these skills. They often cannot cry (or you cannot hear them due to the tube in their throat) and they sleep most of the day. These tiny babies have little muscle tone, and most move very little.

Babies born this early look very different than full-term babies. Their skin is wrinkled and reddish-purple in color and is so thin that the blood vessels underneath can be seen. Their face and body are covered in soft hair called lanugo. Because these babies have not had time to put on fat, they appear very thin. Most likely, their eyes are closed, and they have no eyelashes.

These babies are at high risk for one or more of the complications discussed above. However, most babies born after about 26 weeks gestation do survive (about 80 percent at 26 weeks), although they may face an extended stay in the newborn intensive care unit (NICU) (13).

Survival rates can vary greatly depending on factors other than gestational age. Factors that can improve survival rates include higher birthweight, female sex, history of prenatal treatment with corticosteroids (drugs that speed lung development) and singleton birth (not part of a twin or other multiple birth) (14). Unfortunately, about 25 percent of these very premature babies develop serious lasting disabilities, and up to half may have milder problems, such as learning and behavioral problems (15).

What about babies born at 28 to 31 weeks gestation?
These babies look quite similar to babies born earlier, although they are larger (usually between 2 and 4 pounds) and even more likely to survive (about 96 percent) (13). Many require treatment with oxygen, surfactant and assistance to help them breathe. Some of these babies can be fed breast milk or formula through a tube placed through their nose or mouth into the stomach, although others need to be fed intravenously.

Some of these babies can cry. They can move, although their movements may be jerky. A baby born at this time can grasp a person’s finger. These babies can open their eyes, and they begin to stay awake and alert for short periods.

Babies born at 28 to 31 weeks are at risk for the complications discussed above. When complications occur, however, they may not be as severe as in babies born earlier. Babies born with very low birthweight (less than 3 pounds, 4 ounces) remain at risk for serious disabilities.

What about babies born at 32 to 33 weeks gestation?
About 98 percent of babies born at this time survive (13). Most weigh between 3 and 5 pounds and appear thinner than full-term babies. Many need supplemental oxygen to help them breathe, although some can breathe on their own. Some can breast- or bottle-feed, but those who have breathing difficulties probably need tube-feeding. Babies born at this time are less likely than babies born earlier to develop serious disabilities caused by premature birth, though they remain at increased risk for learning and behavioral problems.

Are babies born at 34 to 36 weeks gestation (late preterm) at risk for medical problems?
Late preterm infants are usually healthier than babies born earlier. More than 99 percent of these babies survive, though they are (16):

6 times more likely than full-term infants to die in the first week of life (2.8 per 1,000 vs. 0.5 per 1,000)
3 times more likely to die in the first year of life (7.9 per 1,000 vs. 2.4 per 1,000)
Late preterm babies often weigh between 4½ and 6 pounds, and they may appear thinner than full-term babies. These babies remain at higher risk than full-term babies for newborn health problems, including breathing and feeding problems, difficulties regulating body temperature, and jaundice (17). These problems are usually mild. Most of these babies can breast- or bottle-feed, although some (especially those with mild breathing problems) may need tube-feeding for a brief time.

A baby's brain at 35 weeks weighs only two-thirds of what it will weigh at 40 weeks (17). Because their brain development is not complete, these babies may be at increased risk for learning and behavioral problems (17). Most do not develop serious disabilities resulting from premature birth.

A recent study, however, found that late preterm infants are more than 3 times as likely to develop cerebral palsy and are slightly more likely to have developmental delays than babies born full term (18). Another study found that adults who were born at 34 to 36 weeks gestation may be more likely than those born full-term to have mild disabilities and to earn lower long-term wages (19).

How can a woman reduce her risk for premature birth?
A woman may be able to reduce her risk for premature birth by visiting her health care provider before pregnancy and, once pregnant, seeking early and regular prenatal care. A preconception visit is especially crucial for women with chronic health disorders, such as diabetes and high blood pressure, which sometimes can contribute to premature birth. When a woman receives adequate preconception and prenatal care, providers often can identify and treat pregnancy problems early, helping to reduce the risk for premature birth.

All women of childbearing age should take a multivitamin containing 400 micrograms of folic acid every day starting before pregnancy. A recent study suggests that taking folic acid for at least 1 year before pregnancy may cut the risk of having a premature baby by half (20). Taking folic acid before and during the early weeks of pregnancy also reduces the risk of certain serious birth defects of the brain and spinal cord.

A woman should avoid smoking, drinking alcohol and taking illicit drugs before and during pregnancy. She should try to reach a healthy weight before pregnancy because women who are overweight or underweight are at increased risk for premature birth. She also should gain the recommended amount of weight during pregnancy.

Recommended weight gain during pregnancy is generally 25 to 35 pounds for women who begin pregnancy at a normal weight, 15 to 25 pounds for women who start out overweight, and about 15 pounds for women who are obese. Women who are underweight before pregnancy should gain 28 to 40 pounds.

Treatment with the hormone progesterone may help prevent another premature birth in women who have already had a premature baby. The American College of Obstetricians and Gynecologists (ACOG) recommends that this treatment be offered only to women with a previous spontaneous (not induced) premature birth who are currently pregnant with one fetus (21). Studies show that weekly injections of a form of progesterone (called 17P) reduces the risk for preterm birth by about one-third in these women (22).

Another study found that treatment with vaginal progesterone suppositories greatly reduces the rate of premature birth in women with a short cervix (most of whom had no history of premature birth) (23). A vaginal ultrasound can determine whether a woman has a short cervix. ACOG recommends that providers consider progesterone treatment for these women, but does not recommend screening all women for a short cervix (21).

Studies have not found progesterone treatment helpful in preventing premature birth in twin pregnancies (21). More studies are needed to clarify which high-risk women may benefit from progesterone treatment and which form of progesterone is most effective.

Can medical problems in premature babies be prevented?
When a health care provider suspects that a woman may deliver prematurely, he may suggest treatment with corticosteroid drugs. Corticosteroids speed maturation of fetal lungs and significantly reduce the risk of RDS, IVH and infant death (12). The provider gives the pregnant woman two or more shots containing these drugs. Treatment is most effective when administered at least 24 hours before delivery.

The provider also may suggest treatment with medications (called tocolytics) that may postpone labor (often for only a couple of days). Even this short delay can give the provider time to treat the pregnant woman with corticosteroids and arrange for birth in a hospital with a NICU that can give appropriate care to a premature infant, which could make a lifesaving difference for the baby.

A recent study found that treatment with a tocolytic called magnesium sulfate may significantly reduce the risk for cerebral palsy in premature infants (24). More studies are needed to confirm the effectiveness of this treatment.

Does the March of Dimes support research into the causes of premature birth?
The March of Dimes supports many grants aimed at improving understanding of the causes of preterm labor, with the goal of learning how to prevent it. For example, grantees are studying the role genes and heredity play in premature births and how the rate of fetal lung development, infection and other factors may trigger labor. Grantees also are seeking to improve treatment for premature babies, including those with RDS, NEC and ROP.

References

Martin, J.A., et al. Births: Final Data for 2006. National Vital Statistics Reports, volume 57, number 7, January 7, 2008.
Limperopoulos, C., et al. Positive Screening for Autism in Ex-Preterm Infants: Prevalence and Risk Factors. Pediatrics, volume 212, number 4, April 2008, pages 758-765.
Schendel, D., and Bhasin, T.K. Birth Weight and Gestational Age Characteristics of Children with Autism, Including a Comparison with Other Developmental Disabilities. Pediatrics, volume 121, number 6, June 2008, pages 1155-1164.
Hovi, P., et al. Glucose Regulation in Young Adults with Very Low Birthweight. New England Journal of Medicine, volume 356, number 20, May 17, 2007, pages 2053-2063.
Bettegowda, V.R., et al. The Relationship Between Cesarean Delivery and Gestational Age Among U.S. Singleton Births. Clinics in Perinatology, volume 35, 2008, pages 309-323.
Iams, J.D. The Epidemiology of Preterm Birth. Clinics in Perinatology, volume 30, 2003, pages 651-654.
American College of Obstetricians and Gynecologists (ACOG). Cesarean Delivery on Maternal Request. ACOG Committee Opinion, number 394, December 2007.
American College of Obstetricians and Gynecologists (ACOG). Induction of Labor. ACOG Practice Bulletin, number 10, November 1999.
Conde-Agudelo, A., et al. Birth Spacing and Risk of Adverse Perinatal Outcomes. Journal of the American Medical Association, volume 295, number 15, April 19, 2006, pages 1809-1823.
Honein, M.A., et al. The Association Between Major Birth Defects and Preterm Birth. Maternal and Child Health Journal, published online 5/17/08.
Martin, J.A., et al. Births: Final Data for 2003. National Vital Statistics Reports, volume 54, number 2, September 8, 2005.
Engle, W.A., and the Committee on Fetus and Newborn. Surfactant-Replacement Therapy for Respiratory Distress in the Preterm and Term Neonate. Pediatrics, volume 121, number 2, February 2008, pages 419-428.
National Center for Health Statistics. 2004 Period Linked Birth/Infant Death Data. Prepared by the March of Dimes Perinatal Data Center, 2008.
Tyson, J.E., et al. Intensive Care for Extreme Prematurity–Moving Beyond Gestational Age. New England Journal of Medicine, volume 358, number 16, April 17, 2008, pages 1672-1681.
American College of Obstetricians and Gynecologists (ACOG). Perinatal Care at the Threshold of Viability. ACOG Practice Bulletin, number 38, September 2002 (reaffirmed 2008).
Tomashek, K., et al. Differences in Mortality Between Late-Preterm and Term Singleton Infants in the United States. Journal of Pediatrics, volume 15, November 2007, pages 450-456.
Engle, W.A., et al, and the Committee on Fetus and Newborn. “Late-Preterm” Infants: A Population at Risk. Pediatrics, volume 120, number 6, December 2007, pages 1390-1401.
Petrini, J., et al. Increased Risk of Adverse Neurological Development for Late Preterm Infants. Journal of Pediatrics online, December 11, 2008.
Moster, D., et al. Long-term Medical and Social Consequences of Preterm Birth. New England Journal of Medicine, volume 395, number 3, July 17, 2008, pages 262-273.
Bukowski, R., et al. Preconceptional Folate Prevents Preterm Delivery (abstract). American Journal of Obstetrics and Gynecology, volume 197, number 6, December 2007, S3.
American College of Obstetricians and Gynecologists (ACOG). Use of Progesterone to Reduce Preterm Birth. ACOG Committee Opinion, number 419, October 2008.
Meis, P.J., et al. Prevention of Recurrent Preterm Delivery by 17 Alpha-Hydroxyprogesterone Caproate. New England Journal of Medicine, 2003, volume 348, pages 2379-2385.
Fonseca, E.B., et al. Progesterone and the Risk of Preterm Birth Among Women with a Short Cervix. New England Journal of Medicine, volume 375, number 5, August 2, 2007, pages 462-469.
Rouse, D.J., et al. A Randomized, Controlled Trial of Magnesium Sulfate for the Prevention of Cerebral Palsy. New England Journal of Medicine, volume 359, number 9, August 28, 2008, pages 895-905.
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January 2009/April 2010

Preterm labor and birth: A serious pregnancy complication

Preterm birth is any birth that occurs before the 37th week of pregnancy. It is the cause of many infant deaths and lingering infant illnesses in the United States. Every pregnant woman needs to know about preterm labor and birth—why it happens and what she can do to help prevent it.

Preterm birth occurs in about 12 percent of all pregnancies in the United States, often for reasons we just don't understand. A normal pregnancy should last about 40 weeks. That amount of time gives the baby the best chance to be healthy. A pregnancy that ends between 20 weeks and 37 weeks is considered preterm, and all preterm babies are at significant risk for health problems. The earlier the birth, the greater the risk.

You might have read in the newspapers about babies who are born really early and do very well. But it's important for you to know that those babies are the exceptions. Babies who are born very preterm are at a very high risk for brain problems, breathing problems, digestive problems, and death in the first few days of life. Unfortunately, they also are at risk for problems later in their lives in the form of delayed development and learning problems in school. The effects of premature birth can be devastating throughout the child's life. The earlier in pregnancy a baby is born, the more health problems it is likely to have.

Why Does preterm labor occur?

There are no easy answers. Stress might play a part for some women, personal health history or infection for others, or smoking or drug use for others. With funding from the March of Dimes and others, researchers are studying how various factors contribute to the complex problem of premature labor and birth.

Who is at risk for preterm labor?

Preterm labor and delivery can happen to any pregnant woman. But they happen more often to some women than to others. Researchers continue to study preterm labor and birth. They have identified some risk factors, but still cannot generally predict which women will give birth too early. Having a risk factor does not mean a woman will have preterm labor or preterm birth. It just means that she is at greater risk than other women.

Three groups of women are at greatest risk of preterm labor and birth:

  1. Women who have had a previous preterm birth
  2. Women who are pregnant with twins, triplets or more
  3. Women with certain uterine or cervical abnormalities

If you have any of these three risk factors, it's especially important for you to know the signs and symptoms of preterm labor and what to do if they occur.

Lifestyle and environmental risks

Some studies have found that certain lifestyle and environmental factors may put a woman at greater risk of preterm labor. These factors include:

  • Late or no prenatal care
  • Smoking
  • Drinking alcohol
  • Using illegal drugs
  • Exposure to the medication DES
  • Domestic violence, including physical, sexual or emotional abuse
  • Lack of social support
  • Stress
  • Long working hours with long periods of standing
  • Exposure to certain environmental pollutants

Medical risks

Certain medical conditions during pregnancy may increase the likelihood that a woman will have preterm labor. These conditions include:

  • Urinary tract infections, vaginal infections, sexually transmitted infections and possibly other infections
  • Diabetes
  • High blood pressure and preeclampsia
  • Clotting disorders (thrombophilia)
  • Bleeding from the vagina
  • Certain birth defects in the baby
  • Being pregnant with a single fetus that is the result of in vitro fertilization (IVF)
  • Being underweight before pregnancy
  • Obesity
  • Short time period between pregnancies (less than 6-9 months between birth and the beginning of the next pregnancy)

Groups at increased risk

Researchers have also identified certain groups that are at increased risk of having a premature baby. These groups include:

  • African-American women
  • Women younger than 17 and older than 35
  • Women who have a low income

Preventing preterm labor and birth

You can help prevent preterm birth by learning the symptoms of preterm labor and following some simple instructions. The first thing to do is to get medical care both before and during pregnancy. If you do have preterm labor, get medical help quickly. This will improve the chances that you and your baby will do well.

Medications sometimes slow or stop labor if they are given early enough. Drugs called corticosteroids, if given 24 hours before birth, can help the baby's lungs and brain mature. This can prevent some of the worst health problems a preterm baby has. Only if a woman receives medical care quickly can drugs be helpful. Knowing what to look for is essential.

Treatment with a form of the hormone progesterone may help prevent premature birth in some women who have already had a premature baby.

Symptoms of preterm labor

Remember, preterm labor is any labor that occurs between 20 weeks and 37 weeks of pregnancy. Here are the symptoms:

  • Contractions (your abdomen tightens like a fist) every 10 minutes or more often
  • Change in vaginal discharge (leaking fluid or bleeding from your vagina)
  • Pelvic pressure—the feeling that your baby is pushing down
  • Low, dull backache
  • Cramps that feel like your period
  • Abdominal cramps with or without diarrhea

If you start to have any of these symptoms between 20 weeks and 37 weeks of pregnancy, follow the instructions in the section below "What to do if you have symptoms of preterm labor."

Don't let anyone tell you that these symptoms are "normal discomforts of pregnancy"! If any of them (you don't need to have all of them) happen before your 37th week of pregnancy, you need to do something about it.

What to do if you have symptoms of preterm labor?

Call your health care provider or go to the hospital right away if you think you are having preterm labor. Your provider may tell you to:

  • Come to the office or go to the hospital for evaluation.
  • Stop what you are doing and rest on your left side for one hour.
  • Drink 2–3 glasses of water or juice (not coffee or soda).

If the symptoms get worse, or don't go away after one hour, call your health care provider again or go to the hospital. If the symptoms go away, take it easy for the rest of the day. If the symptoms stop but come back, call your health care provider again or go to the hospital.

When you call your provider, be sure to tell the person on the phone that you are concerned about the possibility of preterm labor. The only way your provider can know if preterm labor is starting is by doing an internal examination of your cervix (the bottom of your uterus). If your cervix is opening up (dilating), preterm labor could be beginning.

You and your health care provider are a team, working together to have a healthy pregnancy and healthy baby. Your team works best when both of you participate fully, so your knowledge about preterm labor can be essential in helping to prevent a preterm birth. Talk to your health care provider about all of this, and be sure to keep all of your prenatal care appointments. Preterm birth is one of the complications of pregnancy that health care providers are working hard to eliminate. Your participation in this effort is just as important as theirs!

April 2008/April 2010

Procter & Gamble

Procter & Gamble's Pampers brand, the leading diaper brand in the world, supports the March of Dimes through the online “Gifts to Grow” program. Pampers Childbirth Education curriculum includes information from the March of Dimes on having a healthy, full-term pregnancy. Childbirth educators throughout the United States use the Pampers curriculum in their childbirth classes, reaching women in approximately their 6th month of pregnancy. 

 

Provide Commerce

Provide Commerce joined the March of Dimes family in 2008, with specific activation around the ProFlowers brand.  ProFlowers is a leading e-commerce flower retailer in the United States.  As part of the imbornto® program in 2012 and 2013, ProFlowers makes a donation to the March of Dimes for every bouquet ordered through a designated URL.  ProFlowers has contributed over $200,000 over the course of their relationship to help fund the March of Dimes mission.

Publix Super Markets, Inc.

This regional supermarket chain has raised more than $35 million since the beginning of its partnership with the March of Dimes in 1995. Publix employees and customers have come together to accomplish this – through participation in March for Babies teams as well as donations at check-out – all to support the March of Dimes mission to improve the health of babies. 

Sample birth defects research grants

Asim Beg, PhD, University of Michigan at Ann Arbor, is studying the causes of a form of cerebral palsy called hemiplegic cerebral palsy, which affects movement more severely on one side of the body than the other. The ultimate goal is to develop a drug treatment to prevent or treat hemiplegic cerebral palsy.

Paul Ryland Brakeman, MD, PhD, University of California at San Francisco, is examining the role of a gene in the development of the urinary tract, for insight into the causes of urinary tract defects. Urinary tract defects affect more than 1 in 100 children and are a leading cause of kidney failure in children.

Ricardo Feldman, PhD, University of Maryland School of Medicine in Baltimore, is seeking to develop a novel drug treatment that can prevent brain damage in forms of Gaucher disease that affect the brain. Gaucher disease is an inherited disorder of body chemistry that leads to a build-up of fatty substances in various organs, sometimes including the brain. Currently available enzyme replacement treatment does not reach the brain.

Daniel Richard Foltz, PhD, University of Virginia in Charlottesville, is studying the development of the centromere, the region of a chromosome that directs the orderly pairing and separation of chromosomes during cell division. Malfunctioning of the centromere can result in egg or sperm cells with too many or too few chromosomes, resulting in a baby with Down syndrome or other chromosomal birth defects.

Lisa V. Goodrich, PhD, Harvard Medical School in Cambridge, Mass., is studying the role of a gene in regulating the development of specific nerve cells in the inner ear, which are often abnormal in children with congenital hearing impairment. This could lead to improved treatment of hearing impairment, which affects about 3 in 1,000 children.

Brian Harfe, PhD, University of Florida College of Medicine in Gainesville, is studying the role of specific genes in normal and abnormal limb development. Limb defects are common birth defects, but their causes are poorly understood. Understanding the causes of limb defects would be an important step toward learning to prevent them.

Robert Ho, PhD, University of Chicago, is seeking to determine the role of a gene in guiding the migration of immature nerve cells to their proper locations in a region of the brain called the cerebellum, for insight into how abnormalities in this gene may contribute to autism spectrum disorders (ASDs). ASDs are a group of disorders affecting speech, social skills and behavior that affect about 1 in 150 children.

Soo-Kyung Lee, PhD, Baylor College of Medicine in Houston, Texas, is seeking to determine the role of a gene in development of the central nervous system, for insight into how abnormalities of this gene may contribute to neural tube defects, such as spina bifida (open spine) and anencephaly (a fatal brain defect).

Melissa M. Rolls, PhD, Pennsylvania State University in University Park, is studying nerve cell structures called dendrites, which may be abnormal in most forms of mental retardation, including fragile X and Down syndromes. This research could be a step toward developing a treatment for an underlying cause of mental retardation, which affects 1 to 3 percent of the population.

Stephanie M. Ware, MD, PhD, Cincinnati Children’s Hospital, is seeking to identify novel genes that cause or increase susceptibility to congenital heart defects, in order to improve their diagnosis and treatment. Heart defects are among the most common birth defects, occurring in almost 1 percent of babies, and in most cases, the cause is unknown.

Sample prematurity research grants

Richard Lambert Auten, MD, Duke University Medical Center in Durham, North Carolina, is seeking to devise better ways to deliver nitric oxide (NO) to the lungs of premature infants who are at high risk of bronchopulmonary dysplasia (BPD). This chronic lung disease is common in premature babies who have been treated for breathing difficulties. Inhaled NO treatment helps prevent inflammation, which contributes to BPD, but has not yet proven successful in preventing BPD.

Iain L. Buxton, PharmD, University of Nevada School of Medicine in Reno, is studying variant versions of a protein structure in uterine muscle cells to see if any of these variants are linked with preterm labor. These structures appear to help keep the uterus relaxed during pregnancy. This study could improve identification of women at high risk of premature delivery and, ultimately, allow early treatment to prevent it.

Erika Chiong Claud, MD, University of Chicago, is investigating whether use of certain antibiotics in premature infants may alter gut bacteria and increase susceptibility to necrotizing enterocolitis (NEC), a life-threatening intestinal complication that is most common in babies born very prematurely. This study could possibly lead to changes in the care of premature babies to help prevent NEC.

Kip Connor, PhD, Children’s Hospital, Boston, is studying the role of omega-3 fatty acids (nutrients found in certain fatty fish) in preventing abnormal growth of blood vessels in the eye that can lead to retinopathy of prematurity (ROP). ROP is a common complication of very premature birth and can lead to blindness. This study could possibly lead to nutritional treatments that could help prevent ROP.

Stephen Lye, PhD, Mount Sinai Hospital, University of Toronto, Canada, is investigating how inflammatory proteins (cytokines) produced by the uterus may contribute to the chain of events that results in term or preterm labor. Because these events occur early in labor, they may be targets for new drugs to prevent preterm labor.

Sam Mesiano, PhD, Case Western Reserve University in Cleveland, Ohio, is seeking to identify genes and other factors that help trigger labor, at term or prematurely. A better understanding of biological events that normally start labor may lead to development of novel drugs to prevent premature delivery.

Deborah McColl Money, MD, University of British Columbia, Canada, is using new genetic technologies to detect and analyze vaginal microbes that contribute to preterm premature rupture of the membranes (PPROM), a leading cause of spontaneous premature delivery. This could lead to more accurate identification of women at risk of PPROM, as well as new treatments to prevent it.

Anne M. Moon, MD, PhD, University of Utah in Salt Lake City, is studying how a protein regulates the development of the alveoli, the tiny air sacs in the lungs where gas exchange occurs. Babies born prematurely may have fewer and less mature alveoli than babies born at term, often contributing to a breathing problem called respiratory distress syndrome (RDS). This study could improve treatment for premature babies with RDS and for babies with lung underdevelopment due to other causes.

Jeffrey Murray, MD, University of Iowa, Iowa City, is conducting a comprehensive search of the entire human genome for gene variants that contribute to spontaneous preterm delivery. He also is seeking to identify environmental factors that may interact with such variants to cause prematurity. Identifying the complex causes of spontaneous prematurity is essential to learning how to predict it reliably and prevent it.

Kristina M. Adams Waldorf, MD, University of Washington in Seattle, is studying how uterine stretching may trigger preterm labor, as a step toward developing drug treatments to prevent stretch-induced labor. Uterine stretching appears to be an important stimulus of preterm labor in pregnancies with twins and other multiples and in pregnancies with excess amniotic fluid.

Sanofi Pasteur

We are very excited to welcome actress Sarah Michelle Gellar to the Sounds of Pertussis® Campaign. Like so many moms in our community, Sarah’s top priority is her children’s health.
 
The Sounds of Pertussis Campaign is a national education campaign from March of Dimes and Sanofi Pasteur to help raise awareness about the potential dangers of pertussis, also known as whooping cough, and the importance of adult tetanus, diphtheria and acellular pertussis (Tdap) vaccination. Started in 2009, the Campaign continues to help educate parents, grandparents, caregivers and others in close contact with infants about the importance of getting vaccinated with an adult Tdap vaccine to help protect themselves and to help stop the spread of the disease to infants.
 
Pertussis is a highly contagious and often serious disease, especially in young children.1,2  In adolescents and adults it is usually presented as a severe cough that may last for weeks and even months.1, 2  The best way to help prevent pertussis is timely vaccination with the recommended pertussis vaccines.3
 
Babies start pertussis vaccinations at two months of age, but they may not be fully protected against the disease until they’ve had at least three doses of an infant DTaP (diphtheria, tetanus and acellular pertussis) vaccine.4,5
 
Researchers found that when it could be determined how an infant caught pertussis, family members were responsible for spreading the disease to the baby in up to 80 percent of cases. 5,6 More specifically, parents were responsible up to 50 percent of the time.5,6 That is why the primary goal is to educate parents, grandparents and caregivers on the importance of adult Tdap vaccination.
 
To learn more about pertussis and the Sounds of Pertussis Campaign, please visit SoundsOfPertussis.com. On the website, you’ll find information, resources and educational tools, including the Campaign’s new Facebook application – the Breathing Room – that allows parents to send a brief message to family and friends in their Facebook network asking them to make the pledge to be vaccinated against pertussis. The Breathing Room is intended to help parents track which members of their child’s circle of care have been vaccinated against pertussis. Once family and friends in their Facebook network confirm their vaccination through the application, their Facebook profile picture is populated in to the parent’s virtual baby nursery. The goal is for adult caregivers to commit to being vaccinated and build their own Breathing Rooms to help stop the spread of the disease to the infants in their lives. Visit SoundsOfPertussis.com/BreathingRoom to start building your Breathing Room.

###

References:
 
1. Centers for Disease Control and Prevention (CDC). Disease Information: Pertussis: Causes & Transmission. http://www.cdc.gov/pertussis/about/causes-transmission.html. Accessed March 21, 2013.
 
2. Centers for Disease Control and Prevention (CDC). Disease Information: Pertussis: Signs & Symptoms. http://www.cdc.gov/pertussis/about/signs-symptoms.html. Accessed March 21, 2013.
 
3. Kretsinger K, Broder KR, Cortese MM et al. Preventing tetanus, diphtheria, and pertussis among adults: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine recommendations of the Advisory Committee on Immunization Practices (ACIP) and recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for use of Tdap among health-care personnel. Morb Mortal Wkly Rep 2006; 55(RR-17):1-37. http://www.cdc.gov/MMWR/preview/mmwrhtml/rr5517a1.htm.  Accessed March 21, 2013.
 
4. Centers for Disease Control and Prevention (CDC). Disease Information: Pertussis: Prevention. http://www.cdc.gov/pertussis/about/prevention.html. Accessed March 21, 2013.
 
5. Wendelboe AM, Njamkempo E, Bourillon A et al. Transmission of Bordetella pertussis to young infants. Pediatr Infect Dis J. 2007;26(4):293-9.
 
6. Bisgard KM, Pascual FB, Ehresmann KR et al. Infant pertussis: who was the source? Pediatr Infect Dis J. 2004;23(11):985-9.
 
7. Centers for Disease Control and Prevention (CDC). Disease Information: Pertussis: Prevention. http://www.cdc.gov/pertussis/about/prevention.html. Accessed March 21, 2013.

Sigma Gamma Rho

Sigma Gamma Rho Sorority is a leading national service organization that is comprised of women from a variety of professions. Promoting their members and society to pursue higher education is one of their fundamental beliefs and has been since their founding in 1922 on the campus of Butler University in Indiana. With a recently renewed partnership with the March of Dimes, the focus will be on H3 Healthy Generations, which falls under Sigma Gamma Rho Sorority’s primary service project, Project Reassurance. Sigma Gamma Rho also became a national March for Babies team to help support all babies.

Sigma Gamma Rho Sorority’s primary mission is to better the quality of life in the community in a variety of ways. This enhancement of society is done through public service, leadership development and education. Civic, economic and educational concerns are all addressed. Learn more about Sigma Gamma Rho at www.sgrho1922.org.

 

Stages of labor

Recognizing the signs of labor can help you know when it's time to call your health provider and head to the hospital. Learning about the stages of labor can help you know what to expect during labor and delivery.

Labor occurs in three stages. When regular contractions begin, the baby moves down into the pelvis as the cervix both effaces (thins) and dilates (opens). How long labor lasts and how it progresses is different for every woman. But each stage features some milestones that are true for every woman.

Stage 1: Early labor and active labor

The first stage of labor takes place in two phases: early labor and active labor.

During early labor:

  • Your cervix will start to dilate.
  • You may feel strong and regular contractions that last 30-60 seconds and come every 5 to 20 minutes.
  • You may notice a bloody show.
  • You may be in early labor for a few hours or days, especially for first-time moms.
  • You may want to spend this phase at home or wherever you are most comfortable.

During active labor:

  • Your contractions will become stronger, longer and more painful.
  • There may be very little time to relax in between contractions.
  • You may feel pressure in your lower back.
  • Your provider may tell you to get ready and head to the hospital.
  • Your cervix will dilate fully to 10 centimeters so the baby can be born.

What you can do:

  • Rest and relax.
  • Take a shower or bath (so long as your water hasn't broken).
  • Watch TV or listen to music.
  • Change positions.
  • Take a walk around the house or room.
  • With your provider's okay, drink or eat healthy snacks during the early part of labor.
  • Place ice packs on your lower back.
  • Place a cold washcloth on your forehead.
  • Have your partner rub your lower back.
  • Suck on ice chips.
  • Go to the bathroom often to empty your bladder.

Stage 2: Baby is born

During the second stage of labor, your cervix is fully dilated and ready for childbirth. Your health provider will want you to begin pushing to allow your baby to be born.

During stage 2 of labor:

  • It can last as short as 20 minutes or as long as several hours (especially for first-time moms).
  • You may feel pressure on your rectum from your baby's head moving down the birth canal.
  • You may feel the urge to push.
  • Your provider may give you an episiotomy, a small cut to enlarge the vaginal opening. (Most women don't need an episiotomy.)
  • Your baby's head begins to crown (show).
  • Your provider will guide the baby out of the birth canal.
  • Your provider may use special tools to help you in delivery.
  • Your baby is born and the umbilical cord, which connected mother and baby, is cut.

What you can do:

  • Find a position that is most comfortable for you to push.
  • Push when you feel the urge or when your health provider tells you.
  • If you're uncomfortable or pushing has stopped, try a new position.
  • Rest in between contractions.

Stage 3: Delivery of placenta

During the third stage of labor, the placenta, which gave your baby food and oxygen through the umbilical cord, is delivered. While you are bonding with your new baby during the first minutes of her life, your provider will get you ready for this final stage.

During stage 3 of labor:

  • Contractions will begin 5 to 10 minutes after birth.
  • You may have chills or shakiness.
  • It may take 5 to 30 minutes to deliver the placenta.

What you can do:

  • Relax.
  • Push when your health provider tells you.
  • If you'd like, ask to see the placenta.
  • Begin breastfeeding to provide your baby with important nutrients to help her stay health and grow.

Once you're done, give yourself a big pat on the back for all your hard work. You've made it through childbirth! Now, enjoy these first special moments with your new baby as you and your partner welcome him to the world.

Coping with labor pain

Some women prefer to deal with the pain of childbirth naturally, using breathing and relaxation techniques learned in childbirth education classes. Other women decide to use pain medication to help manage labor pain.

You may want to have a natural childbirth. But during labor, you may decide to use some pain medication, such as epidural or a spinal, to cope with the pain. It's okay to change your mind. Don't feel like you gave up or let your baby down. Only you know how strong the pain feels. It's okay to talk with your provider and do what you think is best.

September 2009

Strategic partnerships, promotions and sponsorships

National March of Dimes partnerships and most multi-market partnerships have a minimum investment of $100,000. The exact donation amount will be determined based upon the nature of the promotion, reach, benefits and expectations of both partners and other factors. Event sponsorships or partnerships have a different pricing structure.

We sometimes find that a proposal is better suited for a local program or constitutes a small fundraiser rather than a strategic partnership. The March of Dimes has 51 chapters and more than 200 offices throughout the United States and Puerto Rico. If your proposal is considered to be more appropriate for a local partnership, we will refer it to the chapter nearest you for consideration, and you will be contacted by a local representative. Any promotion that covers more than one of our chapters or is web based is considered a national partnership.

Requirements

Any company seeking a partnership with the March of Dimes must have been in business for a minimum of a year.

All companies are required to sign a contract that governs all programs, promotions, sponsorships and other strategic partnerships. Contracts protect both parties and clarify expectations.

Promotions

A minimum contribution of 10 percent of the retail price for a product or service is necessary for a program or promotion that features the March of Dimes name or other licensed marks. Additionally, a minimum guaranteed donation of at least $100,000 is required.

If your proposal involves a product, you must provide a sample. If your product is still in development, you also may provide drawings or photos.
We will not approach current partners for distribution or sale of products or services.

Education and awareness

One of the primary objectives with all marketing and cause-related marketing programs is to ensure that consumers are provided with the best maternal and infant health information and a way to contact the March of Dimes for more information. You must agree to include the March of Dimes website (marchofdimes.com) and additional agreed-upon messaging on all promotion, event and program materials to educate the public and raise awareness of our mission.

Public service announcements

If the partnership includes plans for a public service announcement (PSA), the PSA may be distributed only during a mutually agreed-upon time frame, usually from June 15 to February 15. Television PSAs must include the March of Dimes logo and verbal mention of the March of Dimes.

Spokesperson

If the partnership includes plans for an official spokesperson, the March of Dimes will need to review the plans and provide input on the selection. This is to ensure that messaging and information is accurate and consistently communicated with our guidelines.

Endorsements

The March of Dimes does not endorse specific products or brands. This must be disclosed on all packaging, advertising and promotional materials.

Guidelines

The March of Dimes operates under the Better Business Bureau guidelines for charitable giving. These guidelines require full disclosure to the consumer. In compliance with these guidelines and with applicable state laws, we require full disclosure regarding the benefit to the organization when funds are raised through a consumer purchase or promotion (e.g. $10 from the sale of each item) on all packaging, advertising and promotional materials in clear and unambiguous terms. Exact wording will be included in the contract.

Legal registration

A company that conducts a national or multi-location program or promotion with the March of Dimes may be required to register in certain states as a “commercial co-venturer.” A commercial co-venture is a relationship where a company (you) promotes a product or service and represents to the public that a portion of the proceeds will benefit a cause. If the product or service is being promoted in a state that requires commercial co-venture registration, you must file certain documents with the state’s Attorney General’s office (or other state-designated entity). The documents that must be filed vary from state to state, but will generally include registration statement and copy of the executed contract.
The March of Dimes cannot give legal advice to companies that conduct programs or promotions with us; we do advise them to seek legal counsel to ensure that they comply with these registration requirements. We also may request a proof of registration.

A healthy idea

The March of Dimes can help you establish a maternal and infant health education program for your employees. Or we can help complement your existing worksite wellness program. Our no-charge, dynamic program, Healthy Babies Healthy Business can be customized to any setting.

See also: Become a partnerPartnership Questionnaire (PDF, 301kb)

Stress and pregnancy

Pregnancy is a time of many changes. Your body, your emotions and the life of your family are changing. You may welcome these changes, but they can add new stresses to your life.
Feeling stressed is common during pregnancy. But too much stress can make you uncomfortable. Stress can make you have trouble sleeping, have headaches, lose your appetite or overeat.

High levels of stress that continue for a long time may cause health problems, like high blood pressure and heart disease. When you’re pregnant, this type of stress can increase the chances of having a premature baby (born before 37 completed weeks of pregnancy) or a low-birthweight baby (weighing less than 5½ pounds). Babies born too soon or too small are at increased risk for health problems.

What causes stress during pregnancy?

The causes of stress are different for every woman, but here are some common causes during pregnancy:

  • You may be dealing with the discomforts of pregnancy, like nausea, constipation, being tired or having a backache.
  • Your hormones are changing, which can cause your mood to change. Mood swings can make it harder to handle stress.
  • You may be worried about what to expect during labor and birth or how to take care of your baby.
  • If you work, you may have to manage job responsibilities and prepare your employer for time away from your job.
  • Life is busy and it sometimes takes unexpected turns. That doesn’t stop just because you’re pregnant.

What types of stress can cause pregnancy problems?

Stress is not all bad. When you handle it right, a little stress can help you take on new challenges. Regular stress during pregnancy, such as work deadlines and sitting in traffic, probably don’t add to pregnancy problems.

However, serious types of stress during pregnancy may increase your chances of certain problems, like premature birth. Most women who have serious stress during pregnancy can have healthy babies. But be careful if you experience serious kinds of stress, like:

  • Negative life events. These are things like divorce, serious illness or death in the family, or losing a job or home.
  • Catastrophic events. These are things like earthquakes, hurricanes or terrorist attacks.
  • Long-lasting stress. This type of stress can be caused by having financial problems, being abused, having serious health problems or being depressed. Depression is medical condition where strong feelings of sadness last for long periods of time and prevent a person from leading a normal life.
  • Racism. Some women may face stress from racism during their lives. This may help explain why African-American women in the United States are more likely to have premature and low-birthweight babies than women from other racial or ethnic groups.
  • Pregnancy-related stress. Some women may feel serious stress about pregnancy. They may be worried about miscarriage, the health of their baby or about how they’ll cope with labor and birth or becoming a parent. If you feel this way, talk to your health care provider.

Does post-traumatic stress disorder affect pregnancy?

Post-traumatic stress disorder (PTSD) is when you have problems after seeing or experiencing a terrible event, such as rape, abuse, a natural disaster, a terrorist attack or the death of a loved one. People with PTSD may have:

  • Serious anxiety
  • Flashbacks of the event
  • Nightmares
  • Physical responses (like a racing heartbeat or sweating) when reminded of the event

As many as 8 in 100 women (8 percent) may have PTSD during pregnancy. Women who have PTSD may be more likely than women without it to have a premature or low-birthweight baby. They also are more likely than other women to have risky health behaviors, such as smoking cigarettes, drinking alcohol or taking street drugs. Doing these things can increase the chances of having pregnancy problems. If you think you may have PTSD, talk to your provider or a mental health professional.

How does stress cause pregnancy problems?

We don’t completely understand the effects of stress on pregnancy. But certain stress-related hormones may play a role in causing certain pregnancy complications. Serious or long-lasting stress may affect your immune system, which protects you from infection. This can increase the chances of getting an infection of the uterus. This type of infection can cause premature birth.

Stress also may affect how you respond to certain situations. Some women deal with stress by smoking cigarettes, drinking alcohol or taking street drugs, which can lead to pregnancy problems.

Can high levels of stress in pregnancy hurt your baby later in life?

Some studies show that high levels of stress in pregnancy may cause certain problems during childhood, like having trouble paying attention or being afraid. It’s possible that stress may also affect your baby’s brain development or immune system.

How can you reduce stress during pregnancy?

Here are some ways to reduce stress:

  • Figure out what’s making you stressed and talk to your partner, a friend or your health care provider about it.
  • Know that the discomforts of pregnancy are only temporary. Ask your provider how to handle these discomforts.
  • Stay healthy and fit. Eat healthy foods, get plenty of sleep and exercise (with your provider’s OK).
  • Exercise can help reduce stress and also helps prevent common pregnancy discomforts.
  • Cut back on activities you don’t need to do.
  • Have a good support network, including your partner, family and friends. Ask your provider about resources in the community that may be able to help.
  • Ask for help from people you trust. Accept help when they offer. For example, you may need help cleaning the house, or you may want someone to go with you to your prenatal visits.
  • Try relaxation activities, like prenatal yoga or meditation.
  • Take a childbirth education class so you know what to expect during pregnancy and when your baby arrives. Practice the breathing and relaxation techniques you learn in your class.
  • If you’re working, plan ahead to help you and your employer get ready for your time away from work.
  • If you think you may be depressed, talk to your provider right away. There are many ways to deal with depression. Getting treatment and counseling early may help.

Last reviewed January 2012

Sudden infant death syndrome

Sudden infant death syndrome (SIDS) is the unexplained death of a baby under 1 year of age while sleeping. SIDS can happen without warning to a baby who seems healthy.

SIDS is the leading cause of death in babies between 1 month and 1 year old. Most SIDS cases happen in babies between 2 and 4 months old.

SIDS is sometimes called crib death. Cribs don’t cause SIDS, but other sleep issues can increase your baby’s risk for SIDS.

What causes SIDS?

We don’t know what causes SIDS. But some things can put babies at higher risk of SIDS than others, including:

Sleeping

  • Sleeping on his tummy or on his side
  • Sleeping on pillows, soft surfaces or soft bedding
  • Wearing too many clothes to sleep or sleeping in a room that is too hot. These things can cause your baby
    to overheat.
  • Co-sleeping. This means that your baby sleeps with you in your bed. Half of all babies who die of SIDS are babies who share a bed, sofa or sofa chair with another person.

Individual characteristics

  • Being a boy. SIDS happens in boys more often than in girls.
  • Being black or Native American. These babies are more likely to die of SIDS than other babies.
  • Being born prematurely or with low birthweight
  • Having parents who smoke, drink alcohol or use street drugs

Can you lower your baby’s risk of SIDS and other sleep-related dangers?

Yes. Use these tips to help keep your baby safe during sleep.

Are there any products that can lower your baby’s risk of SIDS?

No. The American Academy of Pediatrics (AAP) doesn’t recommend using products, like special mattresses or wedges, aimed at reducing the risk of SIDS. There is no evidence that these products reduce the risk of SIDS or suffocation.

For more information

Last reviewed March 2012

See also: Co-sleeping, Putting your baby to sleep, Safe sleep for your baby, From hurt to healing

Sutter Health

Sutter Health’s mission is to enhance the well-being of people in the communities they serve through a not-for-profit commitment to compassion and excellence in health care services. With a goal of healthier individuals, healthier families and healthier communities throughout Northern California, Sutter Health and its employees continue to show the strength of their commitment to the March of Dimes mission through its presenting sponsorship of March for Babies. During Sutter Health’s 15-year partnership with the March of Dimes, the organization has raised more than $5.3 million, allowing us to continue making a positive, healthy difference in the lives of moms and babies.

 

Take folic acid before you're pregnant

Folic acid is B vitamin that every cell in your body needs for normal growth and development. If women of childbearing age take 400 micrograms of folic acid every day before and during early pregnancy, it may help reduce their baby’s risk for birth defects of the brain and spin called neural tube defects (NTDs). The neural tube is the part of a developing baby that becomes the brain and spinal cord. An NTD can happen when the neural tube doesn’t close completely.

About 3,000 pregnancies are affected by NTDs each year in the United States. If all women take 400 micrograms of folic acid every day before getting pregnant and during early pregnancy, it may help reduce the number of pregnancies affected by NTDs by up to 70 percent. Some studies show that folic acid also may help prevent heart defects in a baby and birth defects in a baby’s mouth called cleft lip and palate.

Who should take folic acid?
All women, even if they’re not trying to get pregnant, should take folic acid.

Folic acid helps prevent NTDs only if taken before pregnancy and during the first few weeks of pregnancy, often before a woman may even know she’s pregnant. Because nearly half of all pregnancies in the United States are unplanned, it's important that all women take folic acid every day.

How can you get folic acid?
Before pregnancy, take a multivitamin that has 400 micrograms of folic acid in it every day. Most multivitamins have this amount, but check the label to be sure.

During pregnancy, take a prenatal vitamin each day that has 600 micrograms of folic acid in it. Your health care provider can prescribe a prenatal vitamin for you. You can also get prenatal vitamins over the counter without a prescription.

Most women don’t need more than 1,000 micrograms of folic acid each day. But some women, like those who’ve had a pregnancy affected by NTDs or women with sickle cell disease, may need more. Talk to your provider to make sure you get the right amount.

Can you get folic acid from food?
Yes. Some flour, breads, cereals and pasta have folic acid added to them. Look for “fortified” or “enriched” on the package to know if the product has folic acid in it. Even if you eat fortified or enriched foods, be sure to keep taking your multivitamin or prenatal vitamin with folic acid.

You also can get folic acid from some fruits and vegetables. When folic acid is naturally in a food, it’s called folate. Foods that are good sources of folate are:

  • Beans, like lentils, pinto beans and black beans
  • Leafy green vegetables, like spinach and Romaine lettuce
  • Asparagus
  • Broccoli
  • Peanuts (But don’t eat them if you have a peanut allergy)
  • Citrus fruits, like oranges and grapefruit
  • Orange juice (From concentrate is best)

What other benefits does folic acid have?
Folic acid plays an important role in helping your body make red blood cells. Red blood cells are important because they carry oxygen from your lungs to all parts of your body. Some studies show that folic acid may help protect you from heart disease. Scientists are still learning about all the benefits of folic acid.

Last reviewed September 2012

See also: Eating healthy during pregnancy

The Coming of the Blessing

A March of Dimes initiative called The Coming of the Blessing is addressing high rates of infant death and premature birth among American Indian and Alaska Native babies. The initiative was created by the March of Dimes American Indian/Alaska Native (AI/AN) Women’s Committee. This group of women, representing 10 different tribes, developed health education resources that embrace the cultural and spiritual beliefs related to pregnancy and childbirth shared by many Native people. By emphasizing the strong family and community bonds; the deep and profound respect for nature, life, ancestors, women and children; we can help babies have a fighting chance.

Women from more than 30 tribes, Nations and pueblos have benefited from The Coming of the Blessing. According to a survey of women who participated, 90 percent changed a behavior to be healthier during pregnancy. Mothers made specific changes related to nutrition, stress reduction and the decision to breast feed. Although American Indian and Alaska Native mothers have the highest rate of inadequate prenatal care (23.8 percent) of all racial/ethnic groups, 88 percent of the moms who received prenatal education through The Coming of the Blessing kept all of their prenatal appointments. The preterm birth rate among American Indians and Alaska Natives is more than 14 percent. For women participating in The Coming of the Blessing, the rate was reduced to 7 percent. As a result of these findings, the program is designated as a “promising practice” by Indian Health Service.

Top Ladies of Distinction Inc

In 1995, the March of Dimes revitalized our partnership with TLOD-TTA through a collaborative project called "Healthy choices: Your future and you!" Each TTA chapter conducts an educational conference or other activity with the theme of healthy decision making, utilizing the March of Dimes teen2teen health education series. Each TLOD and TTA chapter also forms a team to participate in their local community’s March for Babies.

Top Ladies of Distinction, Inc. (TLOD) is a national nonprofit educational humanitarian organization composed of women interested in the well-being of individuals and the preservation of values significant to wholesome living. Their main focus includes mentoring youth through their Top Teens of America chapters, enhancing the status of women, enriching the lives of senior citizens and community beautification.

TLOD has 100 chapters with approximately 3,000 volunteers. Each TLOD chapter mentors a Top Teen of America (TTA) chapter. Learn more about TLOD at tlodinc.org.

 

United Airlines

For the past seven years, United Airlines has been a proud national sponsor of March for Babies and the official sponsor of the March of Dimes National Ambassador Program - an annual campaign, which started in 1946 that puts a face on the March of Dimes mission. United and its employees are committed to making the communities they serve a priority. With an employee base of 85,000 strong, United is helping the March of Dimes reach hundreds of thousands of families with important information about having full-term pregnancies and healthy babies. Also part of United Airlines’ sponsorship are in-kind services, advertising and promotion, engagement of their customers through in-flight and online media, and messaging to MileagePlus members.

 

United Auto Workers

Since the introduction of March for Babies (formally known as WalkAmerica), the UAW and labor have supported the March of Dimes. Several UAW presidents have taken active roles in March for Babies – Walter Reuther, Steve Yokich and Ron Gettelfinger. The men and women of the UAW have raised more than $1 million for the March of Dimes through March for Babies and other events.

The International Union, United Automobile, Aerospace and Agricultural Implement Workers of America (UAW) is one of the largest and most diverse unions in North America, with members in virtually every sector of the economy. UAW-represented workplaces range from multinational corporations, small manufacturers and state and local governments to colleges and universities, hospitals and private nonprofit organizations. The UAW has more than 390,000 active members and more than 600,000 retired members in the United States, Canada and Puerto Rico. There are more than 750 local unions in the UAW. The UAW currently has 2,500 contracts with some 1,700 employers in the United States, Canada and Puerto Rico. Learn more about their involvement in March for Babies at uaw.org.

United Auto Workers (UAW)

Since 2005, the UAW, one of the largest and most diverse unions in North America, has partnered with the Big Three Automakers — Ford Motor Company, Chrysler, and GM — in a coordinated fundraising effort to support March for Babies. Endorsed by UAW President Bob King, along with top management from the automakers, this partnership has resulted in millions raised for America's babies. Union liaisons, along with representatives from management, hold key positions on March of Dimes committees and boards across the country. In addition, campaign leaders seek ways to expand their team by engaging auto dealerships and industry vendors.


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When you Submit any User Materials, you represent that such User Materials are unique to you or are used with permission of the copyright holder. You retain the copyright and other ownership rights in the User Materials. However, by submitting the User Materials to the MOD Websites you hereby grant to March of Dimes a non-exclusive, perpetual, royalty-free, worldwide, transferable license to copy, transmit, modify, display and otherwise use the User Materials in any and all media in the sole discretion of the March of Dimes in support of its mission and its fundraising efforts.

Registration data and other personal information you provide are subject to the March of Dimes Privacy Policy.

User Materials submitted by users to the MOD Websites are the sole responsibility of the person who posts them and any opinions or views expressed are those of the individual users. You understand that you may be exposed to User Materials that may be offensive, indecent or objectionable.

The March of Dimes does not control any User Materials, is not responsible for their accuracy, and is not liable in any way for such User Materials. However, March of Dimes reserves the right in its sole discretion to (i) edit or delete any User Materials submitted to or appearing on the MOD Websites, and (ii) refuse access to the MOD Websites to any user.

Digital Millenium Copyright Act (DMCA)

March of Dimes respects the intellectual property rights of others. If you believe that any material appearing on the MOD Websites has been copied in a way that constitutes copyright infringement, please contact the March of Dimes Agent for Notice of copyright claims as follows:

Anne Chehebar
Legal Department
March of Dimes Foundation
1275 Mamaroneck Avenue
White Plains, N.Y. 10605
Tel: 914-997-4626
Fax: 914-997-4532
Email: legalip@marchofdimes.com

This information is for the purpose of contacting the Agent for Notice of copyright claims only. To contact the March of Dimes for any other reason, please go to our Contact Us page.

Disclaimer

THE MOD WEBSITES AND ANY CONTENT, MATERIALS, USER MATERIALS, FEATURES OR PRODUCTS AVAILABLE OR SOLD ON OR THROUGH THE MOD WEBSITES ARE PROVIDED ON AN “AS IS” AND “AS AVAILABLE” BASIS, WITHOUT ANY WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED, INCLUDING WARRANTIES OF TITLE OR IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A SPECIFIC PURPOSE. MARCH OF DIMES DOES NOT WARRANT THAT THE SERVICE ON THE MARCH OF DIMES WEBSITES WILL BE UNINTERRUPTED, ERROR FREE OR FREE OF VIRUSES, WORMS, “TROJAN HORSES” OR OTHER SIMILAR FEATURES. MARCH OF DIMES DOES NOT MAKE ANY WARRANTIES AS TO THE RESULTS THAT MAY BE OBTAINED FROM USE OF THE MOD WEBSITES OR ENDORSE, RECOMMEND, OR MAKE ANY WARRANTIES AS TO THE ACCURACY, RELIABILITY OF ANY CONTENT, INFORMATION, MATERIALS, USER MATERIALS, FEATURES, SERVICES, PRODUCTS, OR STATEMENTS AVAILABLE ON OR THROUGH THE MARCH OF DIMES WEBSITES OR THROUGH LINKS ON THE MARCH OF DIMES WEBSITES. THE USE OF THE MARCH OF DIMES WEBSITES IS ENTIRELY AT YOUR OWN RISK.

Limitation of Liability

IN NO EVENT WILL MARCH OF DIMES, ITS DIRECTORS, OFFICERS, OR EMPLOYEES BE LIABLE FOR ANY INDIRECT, CONSEQUENTIAL, SPECIAL, INCIDENTAL OR PUNITIVE DAMAGES, WHETHER OR NOT MARCH OF DIMES HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES, ARISING OUT OF OR RELATING TO (A) THE USE OR INABILITY TO USE THE MARCH OF DIMES WEBSITES; (B) ANY CONTENT OR PRODUCTS AVAILABLE OR SOLD ON OR THROUGH THE MOD WEBSITES; OR (C) ANY THIRD PARTY CONTENT OR MATERIALS (INCLUDING USER MATERIALS) OR THE DEFAMATORY, INFRINGING, OFFENSIVE OR ILLEGAL CONDUCT OF ANY THIRD PARTY.

Governing Law

These Terms of Use shall be governed by the laws of the State of New York applicable to contracts made and performed there, without regard to its conflict of laws principles, and where applicable, the laws of the United States. You agree to submit to the exclusive jurisdiction of the state and federal courts in the State of New York, County of Westchester, and waive any jurisdictional, venue or inconvenient forum objections to such courts.

Attorney General Mandated State Disclosure

You may obtain a copy of the March of Dimes annual financial report by writing to March of Dimes Foundation, Box 2000, White Plains, NY 10602 (914) 428-7100.In FLORIDA, A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING 1-800-435-7352, TOLL-FREE WITHIN THE STATE. Our Florida registration number is: CH 569. In Georgia, a full and fair description of the programs and activities of the March of Dimes and its financial statement are available at www.marchofdimes.com. In Maryland, copies of documents and information submitted by March of Dimes are available for the cost of copies and postage from the Secretary of State, Statehouse, Annapolis, MD21401, 1410-974-5534. In Mississippi, the official registration and financial information of March of Dimes may be obtained from the Mississippi Secretary of State’s office by calling 1-888-236-6167. In New Jersey, INFORMATION FILED WITH THE ATTORNEY GENERAL CONCERNING THIS CHARITABLE SOLICITATION AND THE PERCENTAGE OF CONTRIBUTIONS RECEIVED BY THE CHARITY DURING THE LAST REPORTING PERIOD THAT WERE DEDICATED TO THE CHARITABLE PURPOSE MAY BE OBTAINED FROM THE ATTORNEY GENERAL OF THE STATE OF NEW JERSEY BY CALLING (973) 504-6215 AND IS AVAILABLE ON THE INTERNET AT www.njconsumeraffairs.gov/ocp/charities.htm. New York residents may obtain a copy of March of Dimes’ annual report by writing to the Office of the Attorney General, Department of Law, Charities Bureau, 120 Broadway, New York, NY 10271. In North Carolina, financial information about March of Dimes and a copy of its license are available from the State Solicitation Licensing Branch at (888) 830-4989. In Pennsylvania, the official registration and financial information of March of Dimes may be obtained from the Pennsylvania Department of State by calling toll-free, within Pennsylvania, 1-800-732-0999. In Virginia, a financial statement for the most recent fiscal year is available upon request from the State Division of Consumer Affairs, P.O. Box 1163, Richmond, VA 23209, 1-804-786-1343. In Washington, you may obtain additional financial disclosure information by contacting the Secretary of State at 1-800-332-GIVE. West Virginia residents may obtain a summary of the registration and financial documents from the Secretary of State, State Capitol, Charleston, WV 25305. REGISTRATION WITH THE AGENCIES DESCRIBED ABOVE DOES NOT IMPLY ENDORSEMENT.

These Terms of Use are subject to change without notice and become effective upon posting. Please check the site periodically for updates.

Effective Date: as of January 7, 2011

©2011 March of Dimes Foundation. All rights reserved. The March of Dimes Foundation is a not-for-profit organization recognized as tax-exempt under Internal Revenue code Section 501(c)(3). Our mission is to improve the health of babies by preventing birth defects, premature birth and infant mortality.

Welcome to the March of Dimes Websites

These Terms of Use, our Privacy Policy and our Link Policy (“MOD Policies”) govern the use of the MOD Websites and the information, services, products, messages, and other content and materials (“Materials”) provided to our visitors. Your use of the MOD Websites constitutes your agreement to these Terms of Use and the MOD Policies.

Use of MOD website materials
The Materials contained on the MOD Websites are provided for educational and informational purposes only. The March of Dimes is not engaged in rendering medical advice or recommendations. The Materials are not a substitute for professional medical advice and treatment or your consultation with qualified physicians and other health care professionals regarding your individual health needs.

We encourage you to take note of the signature date provided at the end of the text of documents contained on the MOD Websites. Ongoing advancements in scientific, medical, health care, technology and other related fields may outdate or alter the overall usefulness and accuracy of the Materials we have made available to you. As you view those MOD Website documents, please take their signature dates into consideration.

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Individual documents provided on the MOD Websites for downloading are copyrighted by the March of Dimes and may be downloaded for personal, non-commercial use only. Permission to otherwise reprint, copy, electronically reproduce, or use any document on the MOD Websites, in part or in whole, is expressly prohibited unless prior written consent is obtained from the March of Dimes or access to the document is accompanied by a statement specifically granting permission to the use the document. In order to obtain consent please contact the March of Dimes Foundation, 1275 Mamaroneck Avenue, White Plains, New York 10605, (914) 997-4488. To send your request by e-mail, go to Contact Us.

The MOD Websites and the contents of the MOD Websites, including text, illustrations, graphic material, designs, photographs, video or audio clips, product listings and descriptions, and the organization of the database are protected by copyright and are owned by or licensed to the March of Dimes and may not be reprinted, electronically reproduced or otherwise exploited.

Text, graphics, illustrations, photographs, videos, images and other content that have been posted, uploaded or otherwise submitted by users of the MOD Websites are owned by the user and licensed to March of Dimes and may not be reproduced, displayed, modified or distributed in any way.

We encourage you to use the widgets, badges and other tools available on our site. You agree that in using these tools, you will not modify their content, that you will include all copyright notices, without modification, that you will not use them in a manner that would imply endorsement by the March of Dimes of your or any third party’s website, products or services or any causes other than those of the March of Dimes, and that you will not use them in any way that is illegal or harmful to any third party or would demean, defame, embarrass, diminish or cause any harm to the March of Dimes.

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March of Dimes® and other March of Dimes event and program names and logos (“MOD Marks”) are trademarks or service marks of the March of Dimes Foundation and may not be used without the prior written consent of the March of Dimes, except that you shall have the right and obligation to maintain the name of the March of Dimes appearing in the copyright notice on any Materials.

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When you sign up to take part in events, submit photographs or video, participate in online discussions or message boards, or purchase products you will be asked to create an account and provide a password. You are responsible for maintaining the confidentiality of your account and password and agree to accept responsibility for all activities that occur under your account or password.

When you communicate with March of Dimes in any way, you may not use a false e-mail address, impersonate any person or mislead as to the origin of your communication. March of Dimes takes no responsibility and assumes no liability for any content represented by you or any third party.

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When you create an account, purchase products or contact us by email, you are communicating with us electronically and you consent to receive communications from us electronically and agree that such communications satisfy any legal requirement that these communications be in writing.

Online Product Catalog
March of Dimes attempts to be as accurate as possible when describing its products. However, March of Dimes does not warrant that the product descriptions or other content is accurate complete, reliable, current, or error-free.
If you are under 18, you may use the March of Dimes Online Product Catalog only with the involvement of a parent or guardian. March of Dimes reserves the right to refuse service, terminate accounts, or cancel orders in its sole discretion.

Links to March of Dimes websites
The March of Dimes encourages you to appropriately link to our websites, subject to our Link Policy. You may not frame the content of the MOD Websites or use metatags or other “hidden text” that incorporates the March of Dimes name or any MOD Marks without our prior written consent.

Links to third party sites
The MOD Websites contain links to other websites that we think may be of interest to you. The linking to such websites does not constitute endorsement of those websites. The March of Dimes has no control over those websites, makes no representation as to the quality, content or accuracy of those websites, and assumes no liability with respect to them. These websites are governed by their own terms of use and privacy policies to which you are directed.

Social networking, blogs, message boards and fundraising sites: User materials
At certain of the MOD Websites, you may post, upload, transmit (“Submit”) comments, messages, text, photographs, videos or other content and materials (“User Materials”). By submitting such User Materials, you agree to abide by the following rules:

(1) you may not Submit User Materials that are libelous, defamatory, obscene, fraudulent, harmful, threatening, abusive or hateful, that infringe the property rights of others (including, without limitation, another person’s copyright or trademark), violate the privacy or publicity right of others, or that are in violation of any law;

(2) you may not Submit User Materials that contain software viruses or other code, files or programs designed to interfere with the functionality of the site or the ability of other visitors to use the site as intended, or interfere in any other way with the use and enjoyment of other visitors to the MOD Websites;

(3) you may not use the MOD Websites to conduct any activity that is illegal or that violates the rights of others;

(4) you may not use the MOD Websites to advertise or sell products or services to others; and

(5) you may not use the MOD Websites to send “Spam.” For the purposes of this site, Spam is defined as messages to recipients with whom the user does not have an existing business or personal relationship.

When you Submit any User Materials, you represent that such User Materials are unique to you or are used with permission of the copyright holder. You retain the copyright and other ownership rights in the User Materials. However, by submitting the User Materials to the MOD Websites you hereby grant to March of Dimes a non-exclusive, perpetual, royalty-free, worldwide, transferable license to copy, transmit, modify, display and otherwise use the User Materials in any and all media in the sole discretion of the March of Dimes in support of its mission and its fundraising efforts.

Registration data and other personal information you provide are subject to the March of Dimes Privacy Policy.

User Materials submitted by users to the MOD Websites are the sole responsibility of the person who posts them and any opinions or views expressed are those of the individual users. You understand that you may be exposed to User Materials that may be offensive, indecent or objectionable.

The March of Dimes does not control any User Materials, is not responsible for their accuracy, and is not liable in any way for such User Materials. However, March of Dimes reserves the right in its sole discretion to (i) edit or delete any User Materials submitted to or appearing on the MOD Websites, and (ii) refuse access to the MOD Websites to any user.

Digital Millenium Copyright Act (DMCA)

March of Dimes respects the intellectual property rights of others. If you believe that any material appearing on the MOD Websites has been copied in a way that constitutes copyright infringement, please contact the March of Dimes Agent for Notice of copyright claims as follows:

Anne Chehebar
Legal Department
March of Dimes Foundation
1275 Mamaroneck Avenue
White Plains, N.Y. 10605
Tel: 914-997-4626
Fax: 914-997-4532
Email: legalip@marchofdimes.com

This information is for the purpose of contacting the Agent for Notice of copyright claims only. To contact the March of Dimes for any other reason, please go to our Contact Us page.

Disclaimer

THE MOD WEBSITES AND ANY CONTENT, MATERIALS, USER MATERIALS, FEATURES OR PRODUCTS AVAILABLE OR SOLD ON OR THROUGH THE MOD WEBSITES ARE PROVIDED ON AN “AS IS” AND “AS AVAILABLE” BASIS, WITHOUT ANY WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED, INCLUDING WARRANTIES OF TITLE OR IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A SPECIFIC PURPOSE. MARCH OF DIMES DOES NOT WARRANT THAT THE SERVICE ON THE MARCH OF DIMES WEBSITES WILL BE UNINTERRUPTED, ERROR FREE OR FREE OF VIRUSES, WORMS, “TROJAN HORSES” OR OTHER SIMILAR FEATURES. MARCH OF DIMES DOES NOT MAKE ANY WARRANTIES AS TO THE RESULTS THAT MAY BE OBTAINED FROM USE OF THE MOD WEBSITES OR ENDORSE, RECOMMEND, OR MAKE ANY WARRANTIES AS TO THE ACCURACY, RELIABILITY OF ANY CONTENT, INFORMATION, MATERIALS, USER MATERIALS, FEATURES, SERVICES, PRODUCTS, OR STATEMENTS AVAILABLE ON OR THROUGH THE MARCH OF DIMES WEBSITES OR THROUGH LINKS ON THE MARCH OF DIMES WEBSITES. THE USE OF THE MARCH OF DIMES WEBSITES IS ENTIRELY AT YOUR OWN RISK.

Limitation of Liability

IN NO EVENT WILL MARCH OF DIMES, ITS DIRECTORS, OFFICERS, OR EMPLOYEES BE LIABLE FOR ANY INDIRECT, CONSEQUENTIAL, SPECIAL, INCIDENTAL OR PUNITIVE DAMAGES, WHETHER OR NOT MARCH OF DIMES HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES, ARISING OUT OF OR RELATING TO (A) THE USE OR INABILITY TO USE THE MARCH OF DIMES WEBSITES; (B) ANY CONTENT OR PRODUCTS AVAILABLE OR SOLD ON OR THROUGH THE MOD WEBSITES; OR (C) ANY THIRD PARTY CONTENT OR MATERIALS (INCLUDING USER MATERIALS) OR THE DEFAMATORY, INFRINGING, OFFENSIVE OR ILLEGAL CONDUCT OF ANY THIRD PARTY.

Governing Law

These Terms of Use shall be governed by the laws of the State of New York applicable to contracts made and performed there, without regard to its conflict of laws principles, and where applicable, the laws of the United States. You agree to submit to the exclusive jurisdiction of the state and federal courts in the State of New York, County of Westchester, and waive any jurisdictional, venue or inconvenient forum objections to such courts.

Attorney General Mandated State Disclosure

You may obtain a copy of the March of Dimes annual financial report by writing to March of Dimes Foundation, Box 2000, White Plains, NY 10602 (914) 428-7100.In FLORIDA, A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING 1-800-435-7352, TOLL-FREE WITHIN THE STATE. Our Florida registration number is: CH 569. In Georgia, a full and fair description of the programs and activities of the March of Dimes and its financial statement are available at www.marchofdimes.com. In Maryland, copies of documents and information submitted by March of Dimes are available for the cost of copies and postage from the Secretary of State, Statehouse, Annapolis, MD21401, 1410-974-5534. In Mississippi, the official registration and financial information of March of Dimes may be obtained from the Mississippi Secretary of State’s office by calling 1-888-236-6167. In New Jersey, INFORMATION FILED WITH THE ATTORNEY GENERAL CONCERNING THIS CHARITABLE SOLICITATION AND THE PERCENTAGE OF CONTRIBUTIONS RECEIVED BY THE CHARITY DURING THE LAST REPORTING PERIOD THAT WERE DEDICATED TO THE CHARITABLE PURPOSE MAY BE OBTAINED FROM THE ATTORNEY GENERAL OF THE STATE OF NEW JERSEY BY CALLING (973) 504-6215 AND IS AVAILABLE ON THE INTERNET AT www.njconsumeraffairs.gov/ocp/charities.htm. New York residents may obtain a copy of March of Dimes’ annual report by writing to the Office of the Attorney General, Department of Law, Charities Bureau, 120 Broadway, New York, NY 10271. In North Carolina, financial information about March of Dimes and a copy of its license are available from the State Solicitation Licensing Branch at (888) 830-4989. In Pennsylvania, the official registration and financial information of March of Dimes may be obtained from the Pennsylvania Department of State by calling toll-free, within Pennsylvania, 1-800-732-0999. In Virginia, a financial statement for the most recent fiscal year is available upon request from the State Division of Consumer Affairs, P.O. Box 1163, Richmond, VA 23209, 1-804-786-1343. In Washington, you may obtain additional financial disclosure information by contacting the Secretary of State at 1-800-332-GIVE. West Virginia residents may obtain a summary of the registration and financial documents from the Secretary of State, State Capitol, Charleston, WV 25305. REGISTRATION WITH THE AGENCIES DESCRIBED ABOVE DOES NOT IMPLY ENDORSEMENT.

These Terms of Use are subject to change without notice and become effective upon posting. Please check the site periodically for updates.

Effective Date: as of January 7, 2011

©2011 March of Dimes Foundation. All rights reserved. The March of Dimes Foundation is a not-for-profit organization recognized as tax-exempt under Internal Revenue code Section 501(c)(3). Our mission is to improve the health of babies by preventing birth defects, premature birth and infant mortality

WellPoint Foundation

Pregnant women in 14 states will receive prenatal services and education from the March of Dimes, thanks to a generous grant from the WellPoint Foundation. The funding supports two major March of Dimes programs: CenteringPregnancy® and Quality Improvement Initiatives Related to 39 Weeks of Pregnancy. The WellPoint Foundation is a private, nonprofit organization wholly funded by WellPoint, Inc. The Foundation focuses on strategic initiatives that address and provide innovative solutions to health care challenges, as well as promoting the Healthy Generations Program, a multi-generational initiative that targets specific disease states and medical conditions. The WellPoint Foundation is also a sponsor of the Missouri Broadcasters for Babies event.

 

 

Wells Fargo & Company

Wells Fargo participates in March for Babies in every state they do business in – with more than 2,500 employees walking each year. Over the past 11 years, employees have raised more than $18 million for the March of Dimes, consistently earning them a spot among our teams nationwide. This kind of dedication and hard work is at the core of the commitment to the communities they serve.

What we know about prematurity

One in 9 babies is born prematurely in the United States each year. Many will be too small and too sick to go home. Instead, they face weeks or even months in the newborn intensive care unit (NICU). These babies face an increased risk of serious medical complications and death; however, most, eventually, will go home.
But what does the future hold for these babies? Many survivors grow up healthy; others aren't so lucky. Even the best of care cannot always spare a premature baby from lasting disabilities such as cerebral palsy; intellectual disabilities and learning problems; chronic lung disease; and vision and hearing problems. Half of all neurological disabilities in children are related to premature birth.

Although providers have made tremendous advances in caring for babies born too small and too soon, we need to find out how to prevent preterm birth from happening in the first place. Despite decades of research, scientists have not yet developed effective ways to help prevent premature birth.

In fact, the rate of premature birth increased by more than 20 percent between 1990 and 2006. This trend and the dynamics underlying it underscore the critical importance and timeliness of the March of Dimes Prematurity Campaign. The rate fell to 12.3 percent in 2008 from 12.7 in 2007, a small but statistically significant decrease.

Why do women give birth early?

In nearly 40 percent of premature births, the cause is unknown. However, researchers have made some progress in learning the causes of prematurity. Studies suggest that there may be four main routes leading to spontaneous premature labor.

  1. Infections/Inflammation. Studies suggest that premature labor is often triggered by the body's natural immune response to certain bacterial infections, such as those involving the genital and urinary tracts and fetal membranes. Even infections far away from the reproductive organs, such as periodontal disease, may contribute to premature delivery.
  2. Maternal or fetal stress. Chronic psychosocial stress in the mother or physical stress (such as insufficient blood flow from the placenta) in the fetus appears to result in production of a stress-related hormone called corticotropin-releasing hormone (CRH). CRH may stimulate production of a cascade of other hormones that trigger uterine contractions and premature birth.
  3. Bleeding. The uterus may bleed because of problems such as placental abruption (the placenta peels away, partially or almost completely, from the uterine wall before delivery). Bleeding triggers the release of various proteins involved in blood clotting, which also appear to stimulate uterine contractions.
  4. Stretching. The uterus may become overstretched by the presence of two or more babies, excessive amounts of amniotic fluid, or uterine or placental abnormalities, leading to the release of chemicals that stimulate uterine contractions.

These four routes are not the only things to consider. Other factors, such as multiple pregnancy, inductions and cesarean sections, can also play a role. But knowledge about these four routes may help scientists develop more effective interventions that can halt the various chemical cascades that lead to premature birth.

Who will give birth early?

 

It is very difficult to predict which women will deliver prematurely. Currently, tests are not considered helpful in identifying low-risk women. However, there are two tests that are useful in determining which high-risk women or women having contractions are unlikely to deliver within the next two weeks. These tests can relieve worries and spare women unnecessary treatments.

  1. Cervical length. The length of a woman's cervix is measured using vaginal ultrasound. Women with a shorter-than-average cervix and those whose cervix shortens on subsequent exams are at increased risk of premature birth. This test is fairly accurate in determining which women are at lower risk of premature birth. A woman can ask her provider about having an ultrasound to check for short cervix.
  2. Fetal fibronectin. Fibronectin is a biological glue that helps attach the fetal sac to the uterine lining. It is normally seen in vaginal secretions up to 22 weeks of pregnancy, then not until 1 to 3 weeks before delivery. A swab is used to take a sample of vaginal secretions between 22 and 34 weeks of pregnancy. If fibronectin is seen, a woman appears to be at increased risk of premature labor. This test shows moderate success in predicting who will not give birth prematurely. In some cases, this test may be combined with a measurement of cervical length to increase accuracy.

Researchers continue to develop new tests for identifying women who will give birth prematurely. Many of the new tests measure biological markers associated with the various routes that lead to premature birth, such as the stress-related hormone CRH or various immune and clotting factors. To date, tests that measure only one of these biological markers have not proven successful, but tests that measure a number of markers are showing some promise.

Medical experts are also looking for variant forms of genes that may increase the risk of preterm labor. This research may lead to improved screening tests.

Who is at increased risk?

Preterm labor and birth can happen to any pregnant woman. But it happens more often to some women than to others. Researchers continue to study preterm labor and birth. They have identified some risk factors, but still cannot predict which women will give birth too early. Having a risk factor does not mean a woman will have preterm labor or preterm birth. Three groups of women are at greatest risk of preterm labor and birth:

  • Women who have had a previous preterm birth
  • Women who are pregnant with twins, triplets or more
  • Women with certain uterine or cervical abnormalities

If a woman has any of these three risk factors, it's especially important for her to know the signs and symptoms of preterm labor and what to do if they occur.

Some studies have found that certain lifestyle factors may put a woman at greater risk of preterm labor. These factors include:

  • Late or no prenatal care
  • Smoking
  • Drinking alcohol
  • Using illegal drugs
  • Exposure to the medication DES
  • Domestic violence, including physical, sexual or emotional abuse
  • Lack of social support
  • Extremely high levels of stress
  • Long working hours with long periods of standing
  • Exposure to certain environmental pollutants

Certain medical conditions during pregnancy may increase the likelihood that a woman will have preterm labor. These conditions include:

  • Diabetes
  • Infections (urinary, vaginal, sexually transmitted; possibly others)
  • High blood pressure and preeclampsia
  • Clotting disorders (thrombophilia)
  • Bleeding from the vagina
  • Certain birth defects in the baby
  • Being pregnant with a single fetus after in vitro fertilization (IVF)
  • Being underweight before pregnancy
  • Obesity
  • Short time period between pregnancies (less than 6 to 9 months between birth and the beginning of the next pregnancy)

Medical researchers also have identified certain groups of women who are at increased risk of having a premature baby. These groups include:

  • African-American women
  • Women younger than 17 and older than 35
  • Women who have a low income

Experts do not fully understand why and how these factors increase the risk that a woman will have preterm labor or birth.

Can treatment prevent premature birth?

Over the years, providers have tried various strategies to help prevent premature birth, including bedrest, intensive prenatal care for high-risk women and drug therapy to stop uterine contractions. None of these are routinely effective, though they may help some individuals.

However, in 2003, two encouraging studies found that treatment with the hormone progesterone reduced the incidence of premature birth in women who had already had a preterm birth. This group is at especially high risk of having another early birth.

The American College of Obstetricians and Gynecologists (ACOG) recommends that progesterone (sometimes called 17P) may be given to a woman if both of these requirements describe her:

    1.    She's had a spontaneous preterm birth before, when she was pregnant with just one baby. Spontaneous preterm birth means labor began on its own, without drugs or other methods. Or the sac around the baby broke early, causing labor.

        AND

    2.    She is currently pregnant with just one baby.

Medical experts agree that progesterone shots can help prevent preterm birth, but only for women who meet both requirements listed above.*

ACOG says that progesterone also may be given to women who have a short cervix.

A number of studies have looked at the effectiveness of antibiotic treatment in reducing the risk of preterm birth. Antibiotic treatment appears to help prolong pregnancy in women with premature rupture of the membranes (the bag of waters breaks before 37 weeks). This condition (also called PROM) often results in preterm birth.

Antibiotics have been given to women with vaginal infections, such as bacterial vaginosis (BV) and trichomoniasis. These women may have an increased risk of premature birth. But most studies have failed to show that antibiotics reduce the risk of early birth in most women with these genital infections.

Some studies suggest that a procedure called cerclage (the doctor puts a stitch in the cervix to help keep it closed) may help reduce the risk of preterm birth in some women who have had a previous preterm birth and who also have certain cervical abnormalities. The doctor removes the stitch at around 37 weeks of pregnancy.

Today women who develop preterm labor before about 34 weeks of pregnancy are often treated with one of several drugs (called tocolytics). These drugs often delay delivery for about 48 hours — buying some extra time to treat the pregnant woman with corticosteroid drugs. Corticosteroids speed maturation of fetal lungs and other organs, reducing the risk of infant deaths and serious complications of prematurity, including respiratory distress syndrome (breathing problems) and bleeding in the brain. Doctors recommend corticosteroids if a woman is likely to deliver before 34 weeks.

Are there complications in the newborn?

Some premature babies face serious complications, including:

  • Respiratory distress syndrome, which is a serious breathing problem that affects mainly babies born before 34 weeks of pregnancy.
  • Bleeding in the brain, called intraventricular hemorrhage (IVH), which is most common in babies born before 32 weeks of pregnancy. It can cause pressure in the brain and brain damage.
  • Patent ductus arteriosus, which is a heart problem that is common in premature babies. Untreated, it can lead to heart failure.
  • Necrotizing enterocolitis (NEC), which is a potentially dangerous intestinal problem.
  • Retinopathy of prematurity (ROP), which is an eye problem that occurs mainly in babies born before 32 weeks of pregnancy. In severe cases, treatment is needed to help prevent vision loss.

We have made progress in learning about the routes that lead to preterm birth. But we have a long way to go in developing treatments to prevent it. Researchers agree that we need to develop better screening tests to identify women destined to give birth early, and treatments that can be used early on to interrupt the cascade of events leading to prematurity.

*American College of Obstetricians and Gynecologists (ACOG) Committee Opinion #419: Use of progesterone to reduce preterm birth, October, 2008.

Last reviewed April 2012

Zeta Phi Beta Sorority, Inc.

Zeta Phi Beta Sorority, Inc., a nonprofit community-base organization, is one of the largest Greek-lettered international sororities. Zeta Phi Beta Sorority was organized over 75 years ago and its members are primarily African American.

The sorority has made significant contributions to more than 600 communities in the United States, West Africa, Germany and the Caribbean through volunteer work and outreach services. More specifically, the members are involved in the granting of scholarships, youth development projects, child care development centers, as well as women's health issues.

The March of Dimes and Zeta Phi Beta have a cooperative program called Stork's Nest®. The program was launched nationally in 1972. This program has both service and educational components. The service is the establishment of a distribution site, the "Nest," where expectant mothers, referred by cooperating hospitals, clinics, and health centers, can get necessary items such as maternity clothes, layettes and furniture at minimal or no cost. The educational component consists of seven sessions covering prenatal care, nutrition, drugs, alcohol and smoking, genetics, infant care and parenting.

Stork's Nest program objectives are to:

  • Provide incentives for expectant mothers to obtain early and regular prenatal care
  • Provide clothing and nursery items for pregnant women who use community health services.
  • Provide educational opportunities for pregnant women to help them make informed choices and decisions relating to parenting, nutrition, and health.
  • Provide information and referral to community resources to enhance the physical and emotional well-being of mothers and their families.

Learn more about Zeta Phi Beta Sorority, Inc.at zphib1920.org.

©2013 March of Dimes Foundation. The March of Dimes is a non-profit organization recognized as tax-exempt under Internal Revenue Code section 501(c)(3).