103.9 Childbearing Years and Pregnancy

Healthy before pregnancy

Preconception health means caring for your body before a pregnancy begins.

• Folic acid daily: Anyone who could become pregnant should take 400 micrograms of folic acid every day to help prevent birth defects.
• Manage health conditions: Get high blood pressure, diabetes and other conditions under care before pregnancy.
• Avoid harmful substances: No alcohol, tobacco, vaping or cannabis. Ask a provider before stopping any prescribed medicine.
• Plan and space: A checkup before pregnancy helps people plan. Spacing pregnancies gives the body time to recover.

Routine prenatal care schedule

Common changes vs urgent warning signs

Often normal, still share with provider

• Missed period, tender breasts
• Morning sickness in early pregnancy
• Tiredness and needing to pee more
• Mild swelling of feet late in pregnancy
• Mild backache

Urgent: get care right away

• Headache that will not go away or gets worse
• Vision changes, dizziness or fainting
• Trouble breathing, chest pain or fast heartbeat
• Bleeding, leaking fluid, or baby moving less
• Thoughts of harming self or baby

When you hear a warning sign

Hear Her means we listen and act. Never wait to see if it passes.

• Listen and believe her: Take every concern seriously. She knows her body.
• Call 911 if severe: Trouble breathing, chest pain, seizure, heavy bleeding, or thoughts of harm.
• Otherwise, get care now: Help her call her provider or go to labor and delivery right away.
• Tell your RN supervisor: Report it at once, following the program protocol.
• Follow up: Check that she got care and document what happened.

Preeclampsia: blood pressure in pregnancy

• 20 wks Preeclampsia usually appears after 20 weeks or after birth
• 140/90 High blood pressure in pregnancy; tell the provider
• 160/110 Severe range: urgent care now, tell the RN at once

Source: CDC; MedlinePlus

Why mothers and babies are at risk

• What we see: Keisha, 27, in East Cleveland, missed three prenatal visits. Her blood pressure was high at her last one.
• Why it happens (upstream): Long bus rides to the clinic, an hourly job with no paid leave, stress from racism, and a history of not being believed by providers.
• What we can build on (assets): Doulas and community birth workers, home visiting nurses, her church, her mother and sister, WIC, and Medicaid rides.

Labor and the fourth trimester

• Signs of labor: Contractions that come regularly and get closer, stronger and longer, or the water breaking.
• When to go: Follow the provider's plan. Go now for bleeding, water breaking, or baby moving less.
• Postpartum recovery: Rest, help at home, and a postpartum visit. Warning signs still matter for a full year.
• Mood after birth: Baby blues fade in about two weeks. Sadness, worry or numbness that lasts or grows needs care.

Situation: the headache at a home visit

Situation: You visit Ms. Ana Torres in Clark-Fulton, two weeks after she gave birth. She says she has had a bad headache for two days and her vision is blurry. She thinks she is just tired.

What do you say and do?

• Tell her these are warning signs that need care right away
• Help her call her provider or go to labor and delivery now
• Call 911 if she has a seizure, chest pain or trouble breathing
• Tell your RN supervisor at once and document it

Talk it over

• Why might a mother not be believed when she says something feels wrong?
• What community assets support new mothers in your neighborhood?
• How can we help partners and families notice warning signs?