Advocating for Your Unborn Child During Pregnancy and Beyond~ Know how to help protect your baby f rom infection!

1. Advocating for Your Unborn Child During Pregnancy and Beyond~ Know how to help protect your baby from infection! This presentation is for informational purposes only and does not constitute medical advice.

2. Some people think it’s best to keep “scary” thoughts from pregnant women but knowledge can empower you to be your baby’s best advocate!

3. It’s important for pregnant women to know that some germs they may carry can cause their baby to… die during pregnancy (miscarriage/stillbirth) even before their water breaks be born prematurely because germs caused their water to break and/or labor to begin too soon become very sick and even die after being born have permanent handicaps such as blindness, deafness, mental challenges, and cerebral palsy

4. Is there anything I can do to help protect my baby? So how does that knowledge empower me?

5. That knowledge can empower you to become aware of the many ways you can help protect your baby from infection and become a better advocate for your baby’s health!

6. Offer your care providers a checklist early in pregnancy to help protect your baby from infection and be aware that…

7. Bacteria in your urine can mean that you are heavily colonized which can put your baby at a greater risk for infection • Make sure your urine is cultured* for GBS and other bacteria during at least your first prenatal visit. • *This is not the standard urine dipstick test done at most visits! • If significant bacteria is found in your urine, you should receive appropriate treatment…and then ask for a “test of cure.” • Request follow-up urine cultures if your urine has tested positive. • And….

8. If you have a positive urine culture for GBS, consider yourself GBS positive • for the rest of your pregnancyand know that you should receive IV antibiotics • for GBS when labor starts or your water breaks. • Get copies of your lab test results and keep them in your purse/wallet!

9. If you have a vaginal infection, your baby can be infected before and during birth • See your care provider promptly for any symptoms of vaginal infection! • Make sure you are evaluated – not all problems “down there” are • due to a yeast infection even though symptoms may be similar. • Follow through with prescribed treatment and request a “test of cure” • about three weeks afterwards. • You can also….

10. Consult with your provider first before you check your vaginal pH during pregnancy. Routine weekly vaginal pH testing can help detect early symptoms of infection so you can follow up with your provider. • Be aware that bacteria, viruses, and other microorganisms can be passed back and forth between sexual partners. Do not have a new sexual partner during pregnancy.

11. Prenatal testing can help you and your care providers be proactive in your baby’s health • Make sure you have the appropriate testing done including testing for GBS during your 35th-37th week of pregnancy. Talk with your care provider about being tested for STI’s, hepatitis B, and HIV. • Request copies of all test results and keep them with you so they are available when you arrive at the hospitalin case their records are not current. • If you have cultured positive for GBS, make sure that you receive IV antibiotics for GBS as soon as possible once labor starts or your water breaks.

12. Be aware that alternative remedies have not been proven to be • effective against GBS. Some remedies can even be unsafe. • Be aware that GBS can come and go in your body so you may • test negative during pregnancy,but be positive during labor and • delivery. A few hospitals offer rapid, DNA-based tests which can • be performed during labor or any time during pregnancy with results • in less than 2 hours. Because your GBS status can change by the • time you go into labor, culture tests can show a false negative, or your • culture test results may not be available, these rapid tests can help • supplement your routine GBS testing.

13. Invasive procedures can move germs closer to your baby -- even past a mucous plug and through intact membranes • Avoid unnecessary internal exams. Internal exams can tell how far you are dilated, but do not accurately predict when your baby will be born. • Talk to your care provider about the benefits vs. risks of methods of induction. Applying cervical ripening gel and “stripping membranes” can push bacteria closer to your baby. • Be aware that during an internal exam care providers may elect to strip your membranes without any forewarning! Some experts suggest CONSENT be obtained before membrane stripping especially when GBS +.

14. Ask your care provider about the benefits vs. risks of internal fetal monitors as the puncture it causes on your baby’s scalp may be a point of entry for infection. (The IV antibiotics you • receive in labor for GBS generally take 4 hours to be effective.)

15. Know the signs of infection in your baby during pregnancy… • Decreased or no fetal movement after your 20th week of pregnancy – this is why kick counting is so important! • (Be aware that hyperactive or frenetic movement can be a sign of distress. Example: your baby becoming entangled in his/her cord) • You have any unexplained fever. Contact your care provider immediately if you notice any of the above!

16. Babies have underdeveloped immune systems so while you are pregnant… • Wash your hands thoroughly after taking care of young children • who can carry germs such as CMV even without appearing sick. • Avoid kissing young children on or around the mouth as they can carry • CMV and other germs. • Have someone else change your cat’s litter box to avoid toxoplasmosis germs • which can harm your baby. Wear gloves when gardening! • Handle food properly and don’t consume any unpasteurized food products, • soft cheeses, or undercooked poultry or meat to avoid listeria and other germs.

17. and after your baby is born… • Have everyone (including the hospital staff!) wash their hands • before touching your baby. • Be especially cautious so that your baby does not come into contact • with any germs from cold sores (herpes). • BREASTFEEDING IS ESSENTIAL FOR PASSING ANTIBODIES • TO YOUR BABY. (Breast milk is BRAIN and IMMUNITY food!)

18. Your baby’s body and placenta can give important clues to his/her health • Ask about immediate placental examination in the delivery room. Examination of the placenta immediately after delivery may offer clues to help your new baby, you, or your future babies and offer valuable insight as to your baby’s environment before birth. • Ask for pathology testing/autopsy if your baby dies. Testing may reveal clues not only for your own closure, but to help your future babies be born and stay healthy!

19. Be able to recognize symptoms of infection in your baby for immediate medical intervention • High-pitched cry, shrill moaning, whimpering • Marked irritability, inconsolable crying • Constant grunting as if constipated • Projectile vomiting • Feeds poorly or refuses to eat • Sleeping too much, not waking for feedings, difficulty being aroused • High or low or unstable temperature; hands and feet may still feel cold even with a fever • Blotchy, red, or tender skin • Blue, gray, or pale skin due to lack of oxygen • Fast, slow, or difficult breathing • Body stiffening, uncontrollable jerking • Listless, floppy, or not moving an arm or leg • Tense or bulgy spot on top of head • Blank stare • Infection at base of umbilical cord or in puncture on head from internal fetal monitor

20. Knowing how you can help • protect your baby from infection, • making a checklist ✔, and • partnering with your care providers to advocate for your baby’s health...

21. …can help you have a…

22. For more information on Group B Strep and prenatal infection prevention please visit www.groupbstrepinternational.org. Please note: This presentation contains only a partial list of the many ways to help prevent infection in your baby so as always seek advice from your care provider.  This presentation is for informational purposes only and does constitute medical advice.