It takes more than a village to raise a child. It takes resources and education as well. Maternal and infant mortality rates in the District are on the rise after dipping for some time. Health advocates, hospital administrators, midwives and doulas and policymakers are shining the spotlight on this issue. Ward 6 Councilmember Charles Allen even called for a maternal mortality review panel to investigate these deaths.
There are many things that a woman can do to preserve her life and the life of her baby throughout all the stages of pregnancy.
You have to ask yourself: Are you ready for a baby?
Body
Is your body ready for the challenge of pregnancy? A woman’s health is of the utmost importance to ensure that she can carry the baby to full term and deliver without complications. According to the DC Health’s Perinatal Health Report, in 2016 the preterm birth rates for Wards 7 and 8 were 13.4 percent and 13.8 percent respectively. That is lower than 10 years prior but far from the 6.5 percent targeted rate. Research reveals that preterm births were highest among mothers who had pre-pregnancy diabetes, pre-pregnancy hypertension or were overweight or obese.
In her opening remarks at the inaugural DC Maternal and Infant Health Summit last month, Mayor Muriel Bowser stressed the importance of a woman’s health. “We know that a mother’s health history does not reset when she becomes pregnant. That means that we cannot only focus on women when they become pregnant but we can focus on well women throughout their lives,” said the mayor. Along with other mayors and health professionals, Bowser vowed to focus on a mother’s health before, during and after delivery.
One of the most pressing challenges to an expectant mother’s health is smoking. In the District, 7.1 percent of non-Hispanic black mothers smoked prior to pregnancy and 5 percent of them continued to do so during pregnancy. Not only does smoking lead to increased risk of miscarriage and stillbirth, but it can also affect the baby’s development. According to the Centers for Disease Control, cigarette smoke can deprive babies of oxygen and disrupt the development of the brain center responsible for controlling breathing.
Dr. LaQuandra Nesbitt, director of DC Health, says there is help for expectant mothers who smoke. “We have an initiative that is focused on pregnant women through our 1-800-QUIT-NOW program. We have some special ways we target the QUIT line that specifically target pregnant women. We emphasize the need to stop smoking because of the pre-maturity and preterm births.”
Mind
What’s your plan for prenatal care? Where will you get that care?
Although finding an obstetrician who practices in River East can be challenging, prenatal care, particularly in the first trimester, has been promoted as the best way to ensure a healthy pregnancy. Dr. Nesbitt explains that the time of entry into prenatal care is one of the factors DC Health is examining as a possible cause in the rise in maternal deaths.
“One of the things we are investigating as a contributing factor,” explained Dr. Nesbitt, “is whether or not women are not getting into prenatal care during the first trimester or whether the quality of care during delivery contributed to the mortality rate. What a woman needs the most is prenatal care that occurs for the 40 weeks that she is pregnant, including the early diagnosis of a pregnancy and getting into prenatal care in the first trimester.”
How high is your stress level? Do you live in a safe environment?
A woman’s stress level can be considerably raised by a number of environmental factors such as unemployment, homelessness, family problems, domestic violence, racism and even living in a high-crime neighborhood. The March of Dimes suggests that having a supportive network, cutting back on activities, exercise and eating a nutritious diet are some of the ways to relieve stress during pregnancy. If you struggle with mental health issues, seek help soon so that you can have some strategies and resources in place for dealing with stressors if they come.
Home
When it comes to babies, many mothers will agree that you need space. Additionally, practitioners will advise that you also have furniture specifically for the baby. A bassinet, crib or a pack-and-play is absolutely necessary to keep baby sleeping in a safe environment.
Be open to a home visit or two. Aza Nedhari, executive director and co-founder of Mamatoto Village in Northeast, says home visits help practitioners gain perspective on what mothers have and need. “For me, that home visitation piece is so important to gain a level of insight into the needs of that person. You don’t know what’s going on with someone when they come to your office. You never know what that person’s home life is like, or what are the contributing factors to their health, physical or mental well-being. In their home you can see a broader picture.”
Sleep Safe DC offers home visits to help expectant families prepare a space for their newest addition. It offers education for the whole family on how to prepare the baby for bedtime and explains the importance of placing the baby on its back to reduce the risk of sudden infant death syndrome (SIDS).
What’s the best place to start pregnancy planning? DC Healthy Start is a navigation service provided by the District government. It can help connect women with care, set up health screenings and provide parenting support for expectant fathers. You can also consult with your health insurance company to see what services it offers. Unity Health Care and Community of Hope offer maternity and infant care in River East.
Whatever your plans for your reproductive future, remember to inquire early. Be vigilant about your health and put yourself first.
Candace Y.A. Montague is the health reporter for Capital Community News.
