Looking Forward , Sarah Verbiest, founder of Every Woman Southeast, reflects on the new year and what it holds.
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Oral health is KEY to overall health and the well-being of pregnant women and their babies. It is also a time when 3women are particularly vulnerable to poor oral health outcomes. It has long been known that hormonal changes commonly are associated with gingivitis (Löe, 1965). If left untreated, gingivitis may progress to periodontitis, which in turn may be associated with tooth loss (Russell, 2008), poor glucose control (Xiong, 1999) and preterm birth (Walia, 2015). Mothers with high rates of caries are also more likely to have children with high caries rates (Boggess, 2006) that may lead to pain and impact nutrition, speech development and permanent teeth eruption patterns.More Link

sarahphoto3Mother’s Day gives us the chance to reflect on our mother, the women who have been our mentors, and the mothers around us.  Motherhood is a messy, crazy, amazing, life-altering, life-long journey.  It is not for the faint hearted! Before my first child was born I couldn’t have imagined that within seconds of holding her in my arms I would willingly give my life to protect hers.

The decision to enter into this journey is certainly not one to be taken lightly. More Link

During my teenage years, my girlfriends always provided good advice. From who to date and what outfit to wear to school, to what colleges to apply to and how to bargain shop. They did not have a say, however, in my figuring out when to have children. Planning for my reproductive future was always a tricky subject. Between talks with my dad about the consequences of being a teen mom, and the dirty looks given to my fellow students who got pregnant as teenagers, it was a distant goal and definitely not something I intended at a young age. However, there is far more talk today about reproductive life planning, especially among young adults.

RLP-Infographic-WebReproductive life planning is a readiness tool to help women and men of reproductive age develop and work towards their personal goals for having or not having children. Almost half of all pregnancies are unplanned – in North Carolina that is more than 50,000 pregnancies each year. A baby’s vital organs and tissues develop very early in pregnancy, often times even before a woman knows that she is pregnant. The healthier a woman is before pregnancy, the more likely she and her baby are to be healthy during and after pregnancy.

Research has shown that nearly 50% of all medical conditions that complicate pregnancies and negatively impact birth outcomes can be traced back to the preconception period. Since women are likely to go to their friends for advice (like me), experts have determined that providers and consumers should become knowledgeable about reproductive life planning. For instance, providers are now encouraged to ask one key question during each patient encounter, “Are you planning to become pregnant in the next year?” And there are more programs than ever before like the North Carolina Preconception Health Campaign, which educates consumers and providers on counseling strategies that can be used to start the reproductive life planning dialogue.

Planning how many children you want (if any at all), or when you intend to have them, may seem far-fetched. In reality though, there is so much planning that happens day to day, why not consider your reproductive future? You may feel that these decisions are beyond your immediate reach or that you have little control over this aspect of your life. Trust me, time passes quickly and before you know it, if you are a sexually active individual, you could become a parent. So why not plan for it (or plan to delay it) until you and your partner are ready? Your plan could help you consider what form of birth control to use or whether to wait until marriage before having sex. Think of it as your overall guidepost to help you spell out your life goals. It could help you answer questions like what are your plans for school or career, and your plan for finding a life partner. And, how would having children fit into those plans?

Of course, we all know that plans can change. Your reproductive life plan can change too, however it is never too late to start planning or to modify the plan you have. Even if you have children already, your plan can help you think about any other future children you might want. You can also speak with your health provider about how early you can start to try to get pregnant again. Research has shown that waiting 18-23 months is the safest interval between births. Given the high numbers of unintentional pregnancies and the related complications during pregnancy and beyond, health providers are now having more of these conversations with their patients.

Had someone given me a reproductive life planning guide when I was younger, or even asked me about my life plans, I would have paid attention. If nothing else, I definitely would have passed it along to my girlfriends so that I could finally be the one to offer up some sound advice!

Re-Posted Blog from Every Woman North Carolina.

Kweli Rashied-Henry, MPH is the North Carolina March of Dimes State Coordinator for the NC Preconception Health Campaign, and a Leadership Team member for the Every Woman Southeast Coalition.

On June 13, 2014, I had the opportunity to attend Tulane University’s 2nd Biennial Black Women’s Health Conference (BWH) in New Orleans, Louisiana, representing the Every Woman Southeast Coalition (EWSE), and connecting with one of our coalition members in Louisiana. The full conference agenda can be accessed here and click here to view the recorded highlights from the conference sessions.

1As an exhibitor, I had the opportunity to connect and speak with different conference attendees, sharing resources and information about Every Woman Southeast. People truly appreciated our newsletters’ topic areas, which prompted a few attendants to speak about their own health experiences as it related to the newsletter themes. Additionally, it was great to connect with other organizations and agencies that were represented at the conference. Many professionals in the health, social work, and criminal justice fields were very interested in learning more about EWSE, and were appreciative of the fact that we were represented there with useful and informative resources to share. Everyone LOVED the Birth Control after Baby and the Taking Care of You: Your Post-partum Health and Visit Booklets.

As a conference participant, I had the chance to listen to the dynamic keynote speaker, Dorothy Roberts, and had a chance to get her to sign a copy of her latest book, Fatal Invention: How Science, Politics, and Big Business Re-Create Race in the Twenty-first Century. Dorothy Roberts delivered a powerful presentation, illustrating the thread of inhumane historical medical practices (e.g. “the father of gynecology”, J. Marion Sims), the racial stereotypes and racist structural policies that impact black women and their families, and the connections to current poor maternal health outcomes of black women. I was also able to attend a couple of breakout sessions that focused on black infant and maternal health disparities, factors that influence black women’s decisions to pursue counseling, and understanding the historical exploitation of black women’s bodies and its effect on black women’s health.

2Earlier in the week, I attended a week-long training as part of my professional development with the CDC’s Public Health Prevention Service Fellowship. A half-day was dedicated to topics in health disparities, which included keynotes from former CDC Medical Officer Dr. Camara P. Jones MD, MPH, PhD, who presented on levels of racism and health disparities, and from Environmental Justice Officer at the CDC, Dr. LaToria Whitehead, PhD, MPH, who presented on environmental justice and her work with the CDC. One of the points that stood out to me most was how Dr. Jones defined health equity and described “achieving health equity.” She stated:
…Health equity is assurance of the conditions for optimal health for all people. Achieving health equity requires valuing all individuals and populations equally, recognizing and rectifying historical injustices, and providing resources according to need. Health disparities will be eliminated when health equity is achieved…” (Source: Jones CP 2010, adapted from the National Partnership for Action to End Health Disparities).
Another highlight of the training was that I had the opportunity to co-facilitate a discussion during a breakout session for the viewing of the Unnatural Causes Episode Two: When the Bough Breaks documentary.

I mention the above experiences because it ties back into my participation in the roundtable discussions during the BWH Conference roundtables session on racism-based stress and pregnancy outcomes of African-American women. During this session, the presenters also showed a video clip from the Unnatural Causes documentary and led a discussion as well. The most poignant component of both discussions was when audience members shared their personal stories about their pregnancy, experiences with healthcare providers, and spoke about their experience with racism in general. Since we only had a short amount of time for discussion during the breakout session I facilitated, our discussions centered more on people’s reactions to the disparity of poor birth outcomes between college-educated black women and high school drop-out white women, and opportunities for public health professionals wanting to become involved in work that seeks to address these disparities.

On the other hand, the roundtable discussion during the BWH conference centered more so on ways to address the issue of infant mortality experienced 3by African Americans. This led to a very long and dynamic conversation and feedback to the facilitators. Some of the roundtable participants were very shocked at the fact that racism is a huge factor in poor birth outcomes, some believed that this was not new information and that the black community has always been aware of the overall health impact of racism and oppression, and other participants expressed criticism for how the documentary failed to leave room to show examples of how black women have organized historically and in the present-day to address such issues with poor birth outcomes.

The stories, perspectives, and solutions that were presented by participants of the roundtable discussions at the BWH conference made me reflect back on the points presented during Dr. Jones’ presentation when she pointed out the importance of being willing to talk about and address historical injustices when engaging in health equity work with communities, and the racially-gendered policies that impact black women’s health as presented by Dorothy Roberts. It also prompted me to reflect on the importance of facilitating an emotionally charged topic and having information readily available for participants.

Attending this conference was very meaningful, in terms of sharing the EWSE resources, connecting with other health professionals and organizations, and to get a pulse on how information pertaining to black maternal and infant health disparities is received by the communities most impacted.

For a few examples of black maternal health initiatives spearheaded and/or organized by black women, see below:

Mommy in Chief,” is MadameNoire’s original web series that explores the ups, downs, and everything in between of being a modern mom. The series offers a fun, inspiring, and practical take on parenting for mothers in a variety of life stages and child ages.

Black Women’s Health Imperative’s CEO and President’s Call-to-Action on Black Women’s Maternal Health

Mocha Manuel an online resource where black moms go for information and inspiration for pregnancy, parenting and beyond!

Black Women Birthing Justice is a collective of African-American, African, Caribbean and multiracial women who are committed to transforming birthing experiences for Black women.

Birthing Project USA is the only national African American maternal and child health program in this country.

The Black Maternal Health Project by Women’s eNews on Pinterest is a social media resource page with resources and information from breastfeeding to childbirth culturally geared towards African American women.

Angela D. Aina, MPH is a CDC Public Health Prevention Service (PHPS) Fellow serving her two-year field placement with UNC, Center for Maternal and Infant Health.

**The statements in this blog post  are those of the authors and do not represent the official position of the Centers for Disease Control and Prevention (CDC).**

GetTestedLogo-Pink-High-ResSexually transmitted infections and diseases remain a major public health challenge, especially among women in the southern United States. Young women between the ages of 19 and 24 bear the brunt of these infections, and though many are asymptomatic, the sexual health effects of these can range from physical discomfort to infertility, ectopic pregnancy, Pelvic Inflammatory Disease (PID), cancer, and even death. There are a number of STIs out there, but the ones that occur most commonly in women, based on recent data from the Centers for Disease Control and Prevention (CDC), are chlamydia, gonorrhea, genital herpes, and HIV/AIDS.

What’s more, women of minority races and ethnicities are most greatly affected by STIs of all types, not only in the South, but across the US. For example, Alaska Natives and African Americans are five and eight times more likely to be diagnosed with chlamydia than European Americans, respectively. Socioeconomic, cultural, language and gender barriers tend to limit the ability of some young women of color to receive information about STIs, including HIV, to access culturally appropriate health care, and to reduce sexual risks. A lack of well-funded prevention programs specifically designed to address women of color further limits the capacity of some these young women to protect themselves against sexually transmitted infections. Thus, the burden of protection tends to lie with each individual woman.

Many of us remember from our sex education classes that abstinence from all sex — vaginal, anal, and oral — is the best way to prevent the transmission of STIs. However, there are several alternative means to reduce the risk of contracting an STI during sex:

  • Always use a barrier contraceptive: Use a new condom during every sexual encounter, even during your period. Other forms of contraception, including the pill, patch, ring, diaphragm, sponge, implant, intrauterine device, and rhythm method do not protect against STIs.
  • Get tested and treated: If you suspect or notice any symptoms of an STI, see your doctor immediately so you can be properly diagnosed and treated. Abstain from sex until you have been checked, and if you are diagnosed with an STI ask your partner to be tested and treated as well, to prevent reinfection.
  • Get vaccinated: In the case of HPV, a vaccine exists that can reduce your risk of contracting the strains of the virus that cause cervical cancer. The CDC recommends that all women between the ages of 21 and 65 receive routine screenings needed to protect against HPV.

There are many that will say that pursuing a monogamous relationship with another person is protective against sexually transmitted infections and diseases. However, in addition to factors such as poverty and access to quality STI services, a woman’s ability to negotiate safer sexual practices is what will affect her sexual health. A woman’s relationship status with her male partner, in particular, has been identified as an important predictor of her sexual health. Even a woman who has only one partner may be obliged to practice safer sex, because it may be his behavior rather than her own that increases her risks for STIs.

In all, the greatest thing any woman can do is to know the facts for herself. Know what the symptoms are and speak to a health care professional about any and all concerns. An STI can seriously affect a woman’s sexual, reproductive, and overall health, and can even threaten her life. Taking the necessary precautions to protect yourself can help ensure a safer, healthier future for both yourself and your partner.

Amanda Zabala is a graduate intern at the Center for Maternal and Infant Health. She is currently attending the University of North Carolina at Chapel Hill, Gillings School of Global Public Health, and majoring in Maternal and Child Health.

By Sarah Leff, MPH, Program Associate at the UNC Center for Maternal and Infant Health

In May of last year, I graduated from the UNC Gillings School of Global Public Health with my MPH in Maternal and Child Health (MCH). I have been working at the UNC Center for Maternal and Infant Health, first as an intern and now as a program associate, for a little under two years now. It makes my head spin (in a good way) to think about how much I’ve learned in that short time. Being exposed to so many different aspects of MCH helped me refine what I was really interested in. One of my main interests now is preconception health – even though I had never heard of it before I started graduate school. To me, preconception health is women’s health – making sure that we are healthy and happy throughout our lives. As we say in MCH, ‘from womb to tomb.’ And, since many of us will have children one day, preconception health helps protect their health in the future as well.

Preconception health is an exciting and challenging field to work in, because it is more directly relevant to me as an individual than some of our other projects. Unlike tobacco cessation or postpartum care, preconception health is personal for me – I am a consumer, part of the target audience. I can understand some of the barriers to preconception health, because I’ve experienced them. Beyond tangible barriers like lack of health insurance, there is the mental struggle to value health and prioritize it in my life. Even as someone working in public health, this can be a challenge! It sometimes feels like between leaving our teens and when we become mothers, women drop off the map in terms of health care. We are often busy building our careers, finding time to nurture our personal relationships, figuring out how to make it as independent adults, and laying the foundation for the lives we want to have in the future. Among all of these concrete responsibilities, health can feel somewhat abstract, and healthy behaviors can feel like a luxury. It’s hard to find time to take care of yourself, visit the doctor, cook, and exercise. Unless you don’t have a choice – I’ve found that having a puppy is a great way to make exercise not optional!

So how do we get the message out – to the women we serve AND to ourselves – that our health is important? I’ve been very excited to learn about the new Show Your Love social marketing campaign. This campaign is a partnership between the CDC and the Preconception Health and Health Care Initiative, and the name pretty much says it all – Show Your Love! To yourself, and if you are planning a pregnancy, to your baby. This message resonates because it frames health not as an obligation or another stressful item on your “To Do” list, but as a way to love and care for yourself. This positive message helps remind me that ultimately, health is a prerequisite for everything else I want to enjoy in life, so I need to take care of my health and myself. Show Your Love isn’t a vague concept either – the supporting resources and materials help women with specific steps they can take to protect and promote their health. I’d like to add that preconception health shouldn’t be ‘ladies only’ – it is vitally important to include and engage men in this effort, and encourage them to Show Your Love as well – to themselves, and to the women in their lives.

Love is a word we use a lot in MCH. Maybe because even on the hardest days, we still know we’re lucky to be doing what we love. I hope Show Your Love spreads and catches on across the country – it’s a message we could all use a little more of.

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