Journey to Parenthood

DECEMBER 2018 | FUTUREOFPERSONALHEALTH.COM

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An Independent Supplement by Mediaplanet to USA Today

Journey to Parenthood Country singer and actress Jana Kramer shares the emotional story of her path to motherhood

DISCOVER the steps being made to reverse the maternalhealth crisis in the United States

LEARN what needs to be done to improve prenatal care for mothers and their babies

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in this issue

Learn about the striking disparities in the health of mothers and babies of different racial backgrounds.

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Check out the top five pregnancy trends that are a source of empowerment for expecting mothers.

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Read all about the eight essential items you should have ready when taking home your newborn.

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Why We Need to Improve Prenatal Care for Mothers in the United States In an ideal world, every pregnancy would be full-term and result in a healthy child. Unfortunately, this is not the reality for all moms and babies in the United States.

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Lisa F. Waddell, M.D., M.P.H. Senior Vice President, Deputy Medical Officer, March of Dimes

others and babies in the United States face higher rates of premature birth and death due to pregnancy and childbirth than other countries with similar resources. The preterm-birth rate is on the rise nationwide and in many states.

of care needed by all women of childbearing age. This requires a commitment to high-quality health care and enhanced quality and safety initiatives in hospitals, particularly those that address disparities and structural barriers to care experienced by women and babies of color.

Daunting numbers Approximately 50,000 women face life-threatening complications from labor and delivery, and 700 women die each year in the United States due to pregnancy-related causes. Racial and ethnic disparities in preterm birth and maternal death are persistent and unacceptable.

As a physician, I know that many of these problems can be traced back to disparities in our health care systems, including unequal access to care and unequal quality of care. Other inequalities stem from factors in our homes, our workplaces and our communities.

Identifying and treating medical conditions before, during and after pregnancy is essential to preventing deaths and injuries among moms and babies as part of the continuum

Educating mothers An exciting and proven approach to preventing premature birth and improving care for moms-to-be is group prenatal care — a model of care that brings pregnant women with similar due dates together for prenatal care and education with their obstetric provider in a group setting. The March of Dimes has developed a cost-effective model of group prenatal care — called supportive pregnancy care (SPC) — that health systems and care providers can customize to fit their local needs and resources. SPC promotes skill-building for pregnant women and empowers them to take an involved approach in their health care. We believe SPC can improve both the mother’s and the baby’s health, improve health equity and increase provider satisfaction with prenatal care. n

Publisher Lauren Powers Business Developer Jessica Berman Managing Director Luciana Olson Designers Chris Espino, Tiffany Pryor, Marie Coons Copy Editor Lauren Hogan Director of Sales Shannon Ruggiero Director of Business Development Jourdan Snyder Director of Product Faye Godfrey Production Manager Josh Rosman Production & Social Media Coordinator Bria Mastroianni Lead Editor Mina Fanous Cover Photo Matt Sayles All photos are credited to Getty Images unless otherwise credited. This section was created by Mediaplanet and did not involve USA Today.

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Ayesha Curry’s Third Pregnancy Came With an Unexpected Challenge Ayesha Curry, celebrity cook and entrepreneur, spoke with Mediaplanet about the ups and downs of her current pregnancy.

How has hyperemesis gravidarum (HG) affected this journey to parenthood for you? Do you have any advice for other moms-to-be who may be experiencing severe sickness symptoms throughout their pregnancies as well?

What has it been like preparing for baby number three as a family? Are Riley and Ryan ready to both become big sisters?

Oh goodness. This pregnancy threw me for a loop. By far the most difficult in so many ways.

HG is one of those things you can’t understand or rationalize until you’ve been through it firsthand.

As a parent it was difficult because I felt so guilty that I wasn’t able to be present with my girls. It lasted about seven months for me.

My advice to the moms out there experiencing this is to know that the kids will be fine and that our health during this time is so important for both ourselves and the baby. The silver lining is that it does go away, even though in the moment it doesn’t feel that way.

It’s been great. We’ve always said we would love to have three children and it’s actually happening.

The girls have been thrilled and can’t wait. It’s Ryan’s turn to be a big sister now.

When did you and Stephen know the timing was right to further grow your family? As a couple, what are you both most looking forward to with the arrival of your newest little blessing?

How important is it as parents to work as a team?

PHOTOS: SASHA GULISH

We’ve always wanted our children to be close in age so they can grow together. We’ve been blessed enough to be able to make that happen. They’ll get to experience their teen years, 20s and beyond together, which I think is incredibly special. There are three years almost to the day between each of our babies. Not planned, but that’s how God made it happen.

It’s so important for parents to be on the same page. You never want to send mixed messages to your children, and always want to be in alignment. Talk it out.

Talking about your parenting styles is just as important as keeping the communication alive in a marriage. They go hand in hand. ■

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“Mothers of color are up to 50 percent more likely to give birth prematurely.”

How We Can Give All Babies a Healthy Start More mothers are dying from pregnancy and childbirth complications, making our country the most dangerous place in the developed world to give birth.

Striking disparities Black children face the highest early death rate among racial and ethnic groups in our country. In fact, research shows that mothers of color are up to 50 percent more likely to give birth prematurely, and their babies can face a 130 percent higher chance of dying before their first birthday compared to other ethnicities.

But there is something we can do about it. Last month we

launched #blanketchange, a campaign designed to cultivate awareness and drive action for the urgent health crises moms and babies in this country face, including rising rates of maternal mortality and preterm birth. It is imperative that we advocate to ensure that all women have access to quality health care before, during and after pregnancy.

Empowering communities We can empower families and communities with the knowledge and tools they need to get the best possible start in life. We can work to help our partners in the health professions get the training and resources they need to give the best care. We must support research to discover the unknown causes of premature birth, knowing that the answers to this complex problem will involve a combination of factors and interventions.

Now more than ever, we need to come together and take concrete steps to reverse this alarm-

PHOTO: MARCH OF DIMES

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cross our nation, the health care of pregnant women and their babies is going in the wrong direction.

For the third year in a row, a significant number of American babies were born too soon.

It is essential that we raise awareness and support for babies and families affected by premature birth, as well as bring attention to the striking disparities in the health of mothers and babies from different racial and ethnic backgrounds.

ing trend. The most important resource in this country is human potential. That begins with ensuring every baby has the healthiest start in life, regardless of their racial or ethnic background. By expanding proven programs and

innovative solutions, we can make the necessary shift to improve care for moms and lower the preterm birth rate. Birth equity is our goal, and I believe it can be reached.

We must act now — our nation’s mothers and babies cannot wait

any longer. If we come together as a community, we can create solutions that support healthy moms and strong babies all year long. n Stacey D. Stewart, M.B.A., President, March of Dimes

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PHOTO: MERCK FOR MOTHERS

The U.S. Maternal Health Crisis: Partnering to Reverse the Trend

SPONSORED

A woman in America in 1990 had a better chance of surviving childbirth than her own daughter does today. Ranked 46th among nations, the United States is the only high-income country in the world where pregnancy- and childbirthrelated deaths in women are rising.

Reversing the trend requires collaboration and support from all of us: women and their families, doctors, nurses and other health care providers, community health workers, advocates, policymakers and researchers, professional societies, government agencies and the private sector.

Critical efforts are already under way to tackle the leading contributors to maternal mortality and morbidity in the United States: the lack of data; inconsistent obstetric care; an increase in chronic conditions; and limited awareness of the problem. Many are working across sectors to design and test innovations, scale promising solutions and elevate women’s voices in policy and practice to ensure every woman has access to quality care, no matter where she gives birth.

A groundbreaking report Every year in the United States, there are close to 60,000 neardeaths from pregnancy and childbirth-related causes. Roughly two women die every day. In its first-ever multi-state report on maternal deaths, the CDC found that up to 60 percent of them were preventable.

“A decade ago, we didn’t understand the problem, because we did not have the data — most states were not regularly tracking mater-

nal deaths,” says Dr. Etiebet, lead and executive director of Merck for Mothers, a partner in the CDC’s Review to Action. Another partner, the Association for Maternal and Child Health Programs (AMCHP), reviewed maternal death cases in 12 states to identify the root problem and implement solutions.

“Now, we know what to do to save lives and help women thrive.”

The impact of maternal mortality is felt widely, but it does discriminate. In the United States, a Black woman is 3-4 times more likely to die from childbirth-related causes than a White woman.

“We need to investigate why these racial disparities exist and what can we do to fix them,” Dr. Etiebet says.

Researchers from Averting Maternal Death and Disability (AMDD) at Columbia University are studying the experiences of women from underserved communities to shed light on factors contributing to the disparities, and to inform strategies for promoting respectful maternity

care. “There is a huge opportunity to be more human and aware of how you talk to women,” says AMDD associate director Shanon McNab. “Powerful individual stories bring awareness.”

Building on its first citywide analysis of severe maternal morbidity — the “near misses” — New York City has begun interviewing individual women who survived a life-threatening complication about their interactions with maternity care providers to identify opportunities for systemic change.

Building a better future of care for mothers Hospitals around the country are working to implement evidence-based, standardized approaches, called safety bundles, to improve how care teams manage obstetric emergencies, through programs such as the California Maternal Quality Care Collaborative, the New York State Safe Motherhood Initiative and the national Alliance for Innovation on Maternal Health (AIM). The Institute for

Healthcare Improvement is also complementing efforts by AIM to scale these tools nationally.

Given that most deaths occur in the days and weeks that follow childbirth, the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) has been working to raise awareness of postpartum health risks by developing a checklist of warning signs and training nurses to educate new mothers before they are discharged from the hospital. “We need to start with education of practitioners and providers, and encourage doctors, nurses and even pediatricians to talk to women more about dangerous postpartum signs and symptoms,” says Dr. Trish Suplee, an associate professor at the Rutgers School of Nursing-Camden.

Community-based organizations are pioneering new integrated care models in which community health workers and doulas support high-risk women throughout and after pregnancy. The Camden Coalition, an association of health care providers, community partners and advocates in Camden, NJ, helps connect women with prenatal care, housing, counseling and treatment for addiction if needed. “The women we serve are stigmatized in all kinds of ways,” says Natasha Dravid, director of the agency’s clinical redesign initiatives. “We stand with them to help break some of that stigma.”

To advance the fight to end preventable maternal mortality in the United States, Merck for Mothers is launching Safer Childbirth Cities, a new multi-city initiative to improve outcomes and reduce disparities in maternal health. ■ Kristen Castillo MERCK FOR MOTHERS IS MERCK’S 10-YEAR, $500 MILLION GLOBAL MATERNAL HEALTH INITIATIVE DEDICATED TO CREATING A WORLD WHERE NO WOMAN HAS TO DIE GIVING LIFE.

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Jana Kramer opens up about her journey to motherhood, including her struggles to conceive, miscarriages, morning sickness and her eventual pregnancy.

Jana Kramer and her husband, former NFL player Mike Caussin, were married in 2015 and immediately wanted children. However, they had a tough time conceiving, so they turned to in vitro fertilization (IVF). Two of the three embryos retrieved were implanted, but they resulted in miscarriages, devastating the couple.

K r a m e r, w h o p l a y e d A l e x Dupré on the hit television show “One Tree Hill,” finally found out that she was pregnant with her daughter Jolie Rae, who is now two years old. They were overjoyed by her birth. A few months later, Kramer was pregnant again.

Unfortunately this time, she had a miscarriage.

The couple still wanted another baby, so they tried IVF again with that third embryo, which resulted in another miscarriage. In total, Kramer has had two chemical pregnancies — an early pregnancy loss that happens soon after implantation — and three miscarriages.

Finding a community “When I had my miscarriage last October [2017], I had a really tough time,” Kramer recounts. “I had videos I wanted to do, but I didn’t want to seem like I was trying to get attention or wanting people to feel bad for me. It was more that I didn’t want to feel alone. But instead I deleted the videos, and I just posted a picture.”

Kramer, 34, saved the videos she made during the pregnancy and compiled them into an emotional vlog, which she recently shared on her YouTube channel.

She wants to make the online community aware of the struggles of conception, hoping that it will inspire people to be there for each other.

“People go through this all the time, and they feel like they can’t share because it’s just so sad,” she says. “Selfishly, I wanted to put it out there so that I didn’t feel as alone with the things I was going through. I just wanted to say that it happens to everybody.”

The “I Got the Boy” country singer gave birth in November to a second child, her son Jace, who was conceived naturally. She had bad morning sickness while pregnant and had to take prescription medicine for her symptoms.

PHOTO: MATT SAYLES

Country Singer and Actress Jana Kramer’s Journey to Motherhood

Through her personal experiences and those of friends, Kramer has realized how common miscarriages are.

“We’re not supposed to immediately share when we get pregnant because a miscarriage can happen in the first 12 weeks, but I think it’s one of those things that should be celebrated one way or the other because that way you have a community to help you if it doesn’t work out,” she says. “It is so lonely when you don’t share that you’re pregnant and then you do lose the

baby. Then you have no one to be there for you. And that’s the loneliest feeling of all.”

Her advice Kramer went through two rounds of IVF and knows how much time, money and emotion are invested in the process.

“The greatest advice I could give anyone is just to give yourself grace during that time period,” she says, noting that IVF wreaks havoc on hormones. She encourages women to get their partner involved.

“The more you involve your partner, the more he feels involved too,” says Kramer, whose husband knew her ovulation calendar and her medicine schedule. “He doesn’t know what’s going on — you have to be the one to inform him and also encourage him to be a part of it.”

She says infertility and miscarriages will never make sense, b u t u rg e s m o t h e r s t o n eve r give up. n Kristen Castillo

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5 of the Top Pregnancy Trends of 2018

8 Essential Items for the First Months With Your Baby New babies don’t need that much stuff — sleeping, eating and cuddling with you are their main interests.

These baby essentials will get you through the first three months with your new family.

1. A car seat. Whether you choose an infant car seat or a convertible, you can’t leave the hospital without one. Make sure it’s safely installed in your car before you have your baby.

2. A safe spot to sleep. Some parents opt to have their baby sleep in a crib right from the start, while others choose to have their baby share their room in a bassinet for the first few months.

3. Diapers and wipes. Babies go through a lot of diapers — think 8-10 per day. Three jumbo boxes of size-one diapers (for an average size baby) should get you through a couple of months.

And don’t forget the wipes — you’ll be using them for a long time.

4. Baby clothes. To start, plan on seven bodysuits, three swaddles, two hats, four sleepers and five pairs of socks, and keep them the same color so you don’t have to match them. Add more if you don’t have convenient access to laundry.

Expecting mothers are exploring what it means to be pregnant in entirely new ways. Here are some of the most popular pregnancy trends that are empowering women today.

1. The milk bath We have had our fill of flower crowns and underwater maternity photoshoots — milk baths have become the new craze.

Pregnant women are having photoshoots while submerged in milk and flower petals, taking pregnancy glow to a whole new level.

Just make sure to rinse really well afterwards — milk has a lot of sugar, and yeast loves sugar.

2. Gender reveal parties Couples have taken this trend to

a whole new level. Remember the days of the gender reveal at birth? Now parents want earlier gratification, and they want their family in on the fun. From pink or blues cakes to an explosion of colors via baseball bats, expecting parents are having parties with the goal of celebrating the reveal of their baby’s gender.

3. Pregnancy apps and wearable devices New app companies are thriving, and pregnant women are utilizing them. You can now track nutrition, movement and other milestones. You can customize the plan that is right for you and your pregnancy.

4. Education The new-age mom is looking to

be as educated as possible. They are attending classes at their local hospital and birth centers, where they can have a day to find their unique parenting style. Remember, no two families are exactly the same, and learning your unique style will empower you as a mother.

5. Nurseries with reclaimed wood Gone are the days when nurseries were pink, blue, yellow or green.

Couples are now opting to create a space that can grow with the baby, with many couples adding pieces made from reclaimed wood, neutral tones and opting away from the pinks and blues of yesterday. ■ Juliana Geisler, Co-Owner, The Prego Expo, LLC

5. A baby carrier or stroller. A travel system — a stroller you can attach an infant car seat to — should be ready so you can use it right from birth. Meanwhile, a baby carrier or wrap allows you to hold your baby hands free.

6. Diaper bag. Stash diapers and wipes and items like a backup outfit, extra pacifier, bottles or a blanket so you’ll be prepared for (almost) anything when you’re out and about.

7. Feeding tools. Formula-feeding parents will want to stock up on bottles and formula.

If you’re breastfeeding, a breast pump, nursing bra and nipple cream can help make your journey easier.

8. A health kit. Be prepared with a baby thermometer, nail clippers and a nasal aspirator at the very least. You can also buy one of the premade baby first-aid kits on the market.

Rebekah Otto, Editor-in-Chief, Babylist

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