Pensacola, Florida
Tuesday December 1st 2015


Prepping for Pregnancy

Escambia County Healthy Start Coalition Strives for Healthy Births
By Jennifer Leigh

In 1991, Floridas Healthy Start program was created by state legislation with the goal of reducing infant death, low birth weights, and improving the health and developmental outcomes for all Florida babies.

Twenty-three years ago when Floridas Healthy Start began, Escambia Countys infant mortality rate was 11.3 per 1000 births. The latest data from 2012, shows the rate has dropped to 7.9, but is still among the highest in the state of Florida. Theres still a lot to be done.

No judgment, just help
Last year of the estimated 3,823 pregnant women in Escambia County, 2,619 received Healthy Start services, said Theresa Chmiel, executive director at Escambia County Healthy Start Coalition, Inc. The average client base is right around 2,000.

Our goal is to help identify women who are at risk for a poor outcome, Chmiel said. Premature births [can occur] if the woman has a chronic illness, if she smokes cigarettes, drinks alcohol or struggles financiallyevery woman is given the opportunity.

It all starts with a prenatal risk screening, which is offered to all pregnant women in Escambia County at their first prenatal appointment with an obstetrician or midwife. The form is only one page and asks questions about the pregnant womens family history, mental health, physical health and financial status.

Some may wonder if a pregnant woman who smokes a pack of cigarettes a day will be honest on a little white form. Chmiel admits it is a possibility.

We do run against a woman not being very upfront, she said. But nobody is judging. We just want to help you have a healthy baby.

The screening not only looks at the womans lifestyle, but biological factors that could cause potential risks. A family history of gestational diabetes or preeclampsia (high blood pressure and excess protein in the urine) doesnt guarantee that youll have the same complications, but it helps to paint a better picture of your health.

The Healthy Start Coalition provides a wide range of free services to mothers partnering with the Florida Department of Health, WIC Nutrition Program for Women, Infants and Children, Childrens Home Society of Florida and Florida KidCare. Whether a woman needs information about breastfeeding, smoking cessation or health insurance for her baby, Healthy Start is the first place she should look. Even the website is chock-full of information for soon-to-be moms or women planning to conceive.

Healthier mom, healthier baby
Dr. Julie DeCesare is an obstetrician at Sacred Heart Womens Hospital, where Healthy Start has an office. When a woman comes in for a prenatal visit, one of the first things DeCesare does is go through the Healthy Start risk screening form.

Its an absolutely huge resource, she said. Our goal is to screen everyone, regardless of socio-economic status. For example, alcohol use in pregnant women crosses all socio-economic boundaries.

Medically speaking, risk factors such as a womens weight, recreational activities and exercise habits, or lack thereof, can greatly affect her infants health.

If a woman is underweight, it affects the babys growth and development, DeCesare explained. Obesity is a growing problem today. Being overweight and pregnant can create a variety of issues such as diabetes and high blood pressure. It also increases the chances of needed a C-section, which is a major surgery.

With more than a decade of experience, DeCesare has seen a significant increase in unhealthy pregnancies.

Escambia County is a very obese county, she said. When I started training 15 years ago, it was very rare to see a pregnant woman with diabetes. Now, its commonplace for women to be coming into a pregnancy unhealthy.

Recreational habits such as smoking and drinking create their own set of issues as well. Thats why Healthy Start and Sacred Heart offer smoking cessation classes to help decrease the number of women smoking while carrying a child.

What I tell my patients is if you smoke, your baby smokes too, DeCesare said. The nicotine and carcinogens enter into the amniotic fluid, which surrounds your baby in the uterus. It actually darkens the fluid, like your lungs.

To demonstrate the affects smoking causes, DeCesare brings out her doll, Smokey Sue Smokes for Two, to show her patients. Its a simple design, with a dolls head smoking a cigarette attached to a jar carrying a plastic fetus. It usually sends an effective message.

For women looking to quit, DeCesare said smoking cessation patches and gum are OK, since they have fewer carcinogens. However they still produce nicotine, as do e-cigarettes. The best bet is to quit cold turkey.

While some pregnancy articles claim that a few glasses of alcohol do not negatively affect the baby, DeCesare advises to just say no.

There is no safe amount of alcohol for a pregnant woman to drink, she said.

Drinking can put babies at risk for such issues like Fetal Alcohol Syndrome, birth defects, low birth weight, preterm birth and vision and hearing problems among others.

Educating the Moms
Just about 50 percent of pregnancies are unplanned, DeCesare said, which in part leads to unhealthy choices.

Some women could be drinking and dont realize theyre pregnant, she explained. Thats why I believe if youre not preventing pregnancy, youre trying. I firmly believe if we can increase the rate of planned pregnancies, we will see a decrease in the effects of physical and emotional stress in pregnant women.

When its too late to plan, education is key to more healthy pregnancies and births.

Once shes pregnant, theres not much we can do, DeCesare said.

Thats where Healthy Start comes in handy to all women who may not be pregnant now, but are planning to start a family. Its never too early to start taking better care of yourself.

You need to be healthy for your baby to be healthy, DeCesare said. A lot of women only go to the doctor when theyre sick. Its the rare patient that comes in and says Doc, Im thinking of getting pregnant.

After the pregnancy and birth, its time for mothers and fathers to take care of their newborns out in the world with a whole new set of precautions.

You see the billboards all over Pensacolaon the interstate and 9th Avenue to name a few. Theyre those gloomy looking signs with a doctor wearing a lab coat saying Never sleep with your baby. It may seem morbid, but its a major issue that Healthy Start sees in Escambia County. The best way to prevent these deaths is through education.

We see a lot of infant deaths in Escambia County from co-sleeping and unsafe sleeping environments, Chmiel said. Blankets, Teddy bearsthey all pose a danger to the baby.

For first-time parents, DeCesare said child care education, including safe sleeping habits, should begin during pregnancy.

Most patients have no idea, she said. And the baby industry doesnt help with all sorts of crib liners and decorations. The safest sleeping arrangement is the baby in his or her own empty crib.

Education doesnt stop with sleeping arrangements. After an 18-year-old pregnant women and her unborn baby died earlier this month in a car accident on Brent Lane, DeCesare made note to stress the importance of seat belts and properly fitted car seats for babies and toddlers.
A Great, Big Baby Shower

Every year at the Healthy Start Baby Shower, the coalition provides information and education to hundreds of pregnant women, new mothers and their families in Escambia County.

Its one of the ways to let the community know were here and available, Chmiel said. Every mom may not qualify for Healthy Start services, but its still important to have the information.

Now in its 18th year, the Healthy Start Baby Shower has grown to include information on topics such as car safety, healthy snacks, health insurance, stress, breastfeeding, HIV/STDs, infant sleep safety, exercise, infant care and bonding with your baby. Students in the AIM project at University of West Florida will also do a fun activity with older siblings.

The whole event is geared toward education, said Tarron Hunsucker, program coordinator at Healthy Start Coalition, Inc.

The free event is not meant to raise funds, but awareness.

Its not really our goal to get more clients, but provide information, Chmiel said. Not every woman is at risk. We just want to share the importance of early and consistent prenatal care for you and your babys health.

WHEN: 10 a.m. to 1 p.m. Saturday, May 3
WHERE: Legion Field Neighborhood Resource Center, 1301 W. Gregory St.
COST: Free


Your health = your babys health
Dr. Julie DeCesares tips for a healthy pregnancy are consistent with what you read and hear everywhere, but it bears repeating.
Maintain a healthy weight.
Stay active.
Exercise cannot only improve sleep, energy levels and mood, but can help build much-needed endurance for the day of labor.
Take your prenatal vitamins and folic acid.
Eat a well-balanced diet (for two).