Be Healthy and Thrive in Forsyth County
Why Babies Die

Contributing Factors

Many different factors can contribute to an infant death, though they may not always be a direct cause of death. For example, if a woman smokes cigarettes while she is pregnant, she is twice as likely to have a baby die compared to a pregnant woman who does not smoke. Yet, not every pregnant smoker has a baby that dies. Smoking is therefore one factor that certainly contributes to babies being born sick but does not necessarily cause their death.

Many of the contributing factors are related to choices people make either on purpose or unintentionally. These choices are often influenced by root causes – broader challenges in a person’s life or in our community that might make choices easier or harder.

Contributing Factors:

Smoking

  • Cigarette smoking is the leading cause of preventable death in the United States.
  • Thousands more women die of lung cancer each year than of breast cancer.
  • Pregnant women who smoke have a higher risk of:
    - having a baby die (both stillbirth and infant death)
    - having a baby die from Sudden Infant Death Syndrome
    - having a baby born low birth weight
  • North Carolina mothers who smoked during pregnancy were 5 times more likely to have a baby die from SIDS than moms who did not smoke.
  • In our community, women who smoke while they are pregnant are nearly twice as likely to have a baby die (includes fetal and infant death).
  • Forsyth County African American women who smoke while they are pregnant are more than 4 times as likely to have a baby die than white women who also smoke.

How to Prevent Smoke Damage to Women and Babies

If you are a smoker:

  • Try to quit! Most people try to quit at least four times before they are able to stay quit for good. Don’t give up.
  • Call 1-800-QUIT-NOW for free help from a Quit Coach.
  • Do not smoke around pregnant women and children.
    - Leave the apartment or home to smoke your cigarettes – stepping outside will make a world of difference for that child and mother-to-be.
    - Do not smoke if children or pregnant women are with you in the car.

For help when you try to quit, go to Quit Now NC.

If you are not a smoker:

  • Ask other people not to smoke around you or your children - in your home, at work, in the car, at restaurants.
  • Tell your family and friends that you are trying to have a healthy baby and ask if they would please smoke outside.
  • Make a smoke-free home pledge and post it where visitors can see it easily. This asks all people not to smoke in your home. Explain to your family why you think this is important and ask for their help for the sake of your baby.

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Unplanned Pregnancy

Facts about Unplanned Pregnancy

  • 85% of women having vaginal sex but using no birth control get pregnant within one year.
  • 2 out of 3 pregnancies in our community are not planned.
  • In our community, 1 out of every 5 pregnancies ends in abortion.
  • The only sure way to prevent pregnancy is to not have sex.

How can getting pregnant when you plan to help you and your future baby?

  • If you plan ahead for a future pregnancy, it will give you time to make changes in your life that can improve your own health and give your baby-to-be a better start.
  • When women can space their births at least two years apart, they have healthier babies because their bodies can recover in between births.
  • Babies have a higher chance of dying if:
    - Their mother has had another child less than two years ago.
    - Their mothers are teenagers or young girls.

How to prevent unplanned pregnancy

  • The only sure way to prevent pregnancy is to not have sex.
  • If you are sexually active, use birth control. Talk with your health care provider to find out which method of birth control is right for you and will best fit into your lifestyle. Remember, many forms of birth control will protect you from pregnancy but not from sexually transmitted diseases.
  • Use Emergency Contraception if you do have unprotected sex. Emergency contraception pills can prevent pregnancy for up to 5 days AFTER sex. Ask your doctor for an advance prescription so you can have the medicine at home just in case you ever need it. Remember, emergency contraception pills are NOT the same as the abortion pill.
  • Be aware that not all women are sexually active by choice. No one has the right to force you to have sex, even if it is your husband. If you live in or near Winston-Salem, you can call the local Sexual Assault Hotline at 722-4457.

More about Emergency Contraception

What is Emergency Contraception? Emergency Contraception is a prescription medicine that has the same hormones found in ordinary birth control pills. These hormones can prevent pregnancy from occurring if you take them within 5 days of having unprotected sex.

When can you use it? Emergency Contraception is most effective if taken within 120 hours (5 days) after having unprotected sex. The sooner you take it, the better!

Is it legal? Yes. Emergency Contraception became legal in the United States in 1984.

Is it the same thing as the abortion pill? No. The abortion pill dislodges a fertilized egg that was already attached to a pregnant woman’s womb.

Emergency contraception works like the birth control pill or Depo-Provera to prevent pregnancy by delaying or inhibiting ovulation, inhibiting fertilization or inhibiting implantation of a fertilized egg, depending on when during the menstrual cycle a woman initiates the method.

How do I get it? Go ahead and ask your doctor or health care provider for a prescription today just in case you ever need it. That way, if you ever need emergency contraception, you won’t have to make a special doctor’s appointment immediately.

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Infections

Recent research shows that a wide variety of infections may be linked to premature birth. It seems that the chemicals a pregnant woman’s body makes to fight an infection might be similar to the hormones that tell her body to start labor. Common vaginal infections, sexually transmitted diseases, and even cavities or other infections in the mouth have been linked to premature birth.

Infections to watch out for if you are pregnant or planning to become pregnant.

Cavities and Gum Disease
Infections in the mouth will trigger a chemical response that travels throughout your whole body. Brush and floss your at least once a day to try to keep your gums healthy. See a dentist to address any problems as well as for preventive check ups when your mouth is trouble-free.

Reproductive Tract Infections
A variety of reproductive tract infections are very common in women and are fairly easy to treat. These include infections such as urinary tract infections and Bacterial Vaginosis (BV). Bacterial Vaginosis often causes an abnormal discharge and an unpleasant odor.

Sexually Transmitted Diseases (STDs)
There are two main types of STDs. Those passed through sexual fluids include HIV, gonorrhea, chlamydia, and trichomoniasis. Other STDs such as herpes, syphilis, chancroid, and human papillomavirus (HPV) are primarily transmitted through contact with infected skin.

All of these sexually transmitted diseases may impact a pregnancy. Harmful effects on the baby may include stillbirth, low birth weight, eye infection, pneumonia, infection in the blood stream, brain damage or motor disorders, blindness, deafness, other organ damage, acute hepatitis, meningitis, chronic liver disease, and cirrhosis. Many of these side effects might not show up for months or even years after birth.

How to Prevent Infections Before Pregnancy

  • See your doctor or health care provider for a yearly check up. Get tested for vaginal infections and sexually transmitted diseases. Remember that many diseases have almost no symptoms so ask to be tested even if you feel fine.
  • Be picky about your partner. When you have sex with someone, you are really are exposing yourself to all of the people your partner has ever slept with. Ask your partner to get tested and tell him that you’ll get tested, too. If your partner ever threatens you or forces you to have sex, call 911 for help as soon as you can.
  • Use condoms or don’t have sex. Abstinence is the safest way to protect yourself from all sexually transmitted infections. Using a condom every time you have sex will significantly reduce your risk of catching a disease but condoms are never 100% effective.
  • Pay attention to your body. You are probably the only one who will notice if you develop a Reproductive Tract Infection. Pay attention to your bodily smells and vaginal secretions. Go to the doctor if you notice anything very different or unusual.

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Drugs & Alcohol

Most drugs have serious negative consequences for all women and men. Any drugs a woman takes while she is pregnant are shared with the baby growing inside her. This includes alcohol, tobacco, cocaine, and all other illegal, prescription and over-the-counter drugs. Many drugs can have serious effects on the developing child as well as the mother.

Alcohol

  • Drinking alcohol while you are pregnant can cause Fetal Alcohol Syndrome, the leading cause of birth defects among babies in this country. Birth defects are the second leading cause of infant death.
  • Drinking while you are pregnant has very serious harmful consequences on the fetus even as early as your first month or two.
  • Fetal Alcohol Syndrome (FAS) can include abnormal facial features, growth restriction, small head, problems with joints, heart defects, and central nervous system problems. Children with FAS may have physical disabilities and problems with learning, memory, attention, problem solving, and social/behavioral problems.
  • Drinking alcohol during pregnancy increases a woman’s risk to have a miscarriage or a stillborn baby.

Cocaine

  • Women who use any form of cocaine while they are pregnant are more likely to have a miscarriage.
  • Their babies more often born too small (low birthweight), may have problems with learning and behavior, and may be withdrawn.
  • Cocaine use while you are pregnant may also trigger premature labor or can cause the placenta to pull away from the uterus, a condition that can be fatal for the mother and baby if not treated.

Tobacco

  • Smoking is harmful for all men and women. Smoking cigarettes or inhaling second-hand smoke can lead to lung cancer, heart disease, trouble breathing, and more.
  • For pregnant women, if you smoke while you are pregnant you are twice as likely to have a baby die than if you don’t smoke.
  • Even second-hand smoke is harmful to pregnant women and infants.
  • Call 1-800-QUIT-NOW for free help in kicking the habit.

Effects of Other Drugs

  • If you are pregnant, your baby is also taking any drug you take. Illegal drugs can lead to a wide variety of health problems ranging from mild to deadly. Many prescription drugs and over-the-counter pharmacy drugs are also harmful during pregnancy.

How to prevent the negative effects of drugs and alcohol on a baby:
Take these steps to be as drug free as you can BEFORE you become pregnant.

  • Limit your drinking of alcohol. Heavy drinking can take a major toll on your body and on any future baby even during the first couple of weeks after conception.
  • If you are a heavy drinker, try to get help to quit or cut back. Binge drinking is very dangerous for anyone.
  • If you are a smoker, try to quit smoking. Call 1-800-QUIT-NOW for free help.
  • Encourage other people you live with to quit smoking, too.
  • If you use street drugs, try to stop or call for help.
  • If you do not want to get pregnant, use some form of birth control.
  • If you are trying to get pregnant, talk to your doctor or a health care provider about the prescription medicine you take. Also mention any medicine that you take without a prescription. You doctor will help you weight the risk to a future baby against how much the drug helps you now.

If you are pregnant:

Avoid drinking any alcohol at all. Stay away from beer, wine, wine coolers, and hard liquor – either straight or in mixed drinks. No alcoholic drinks are completely safe at any time during your pregnancy. Alcohol can especially have very harmful effects early in your pregnancy when your baby is developing its brain and organs.

Reach out for help overcoming an addiction to any illegal drugs. Many drugs are highly addictive and most people have a very hard time quitting on their own. Reach out to your family or friends for support. If your family or friends are encouraging you to take these drugs, call a doctor or teacher instead. Your life is valuable and you deserve to be free from addiction. Other people who have come through the same situation may be a wonderful support.

Try to quit smoking and ask your friends and family to do the same. Call 1-800-QUIT-NOW for free help.

Make sure to tell your doctor or health care provider about all of the over-the-counter and prescription drugs you take during your very first pre-natal visit. Some of these drugs might have harmful effects on the developing baby.

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Domestic Violence

Domestic violence can have serious harmful effects for a pregnant woman and for the baby she is carrying. In addition to the physical effects of violence and the stress that it adds to a woman’s life, many women who are living in violent situations might try to cope by using cigarettes, drugs, or alcohol in their attempt to make it through the day. All of these actions have serious consequences for both mother and baby.

What is domestic violence and how serious a problem is it?

Domestic violence is a pattern of behavior used to establish power and control over another person through fear and intimidation, often including the threat or use of violence. This kind of violence is most often, but not always, by men against women.

Types of violence include physical abuse, sexual abuse, and emotional abuse.

Domestic Violence gets worse. Relationships rarely start out violent. The violence often begins with behaviors like threats, name calling, violence in a woman’s presence (such as punching a fist through a wall), and/or damage to objects or pets. The violence then often builds up to restraining, pushing, slapping, and/or pinching. The next step may include punching, kicking, biting, sexual assault, tripping, or throwing. Finally, it may become life-threatening with behaviors such as choking, breaking bones, or the use of weapons.

Domestic Violence is a very serious problem in our community and around the county. One national survey estimates that 1 out of every 3 American women will be either abused or sexually assaulted at some point in her lifetime.

How to prevent domestic violence and its effects on a pregnant woman and her baby.

If you feel uncomfortable in a relationship, if your partner threatens you or is controlling or just makes you feel unsafe, ask someone else for help. You can call Family Services at (336) 723-8125. If your partner ever threatens you or forces you to have sex, call 911 for help as soon as you can.

Remember that relationships rarely start out with physical or sexual abuse, but it can build over time. The easiest time to leave someone who makes you feel uncomfortable or to help a friend leave is before the relationship ever gets serious.

Domestic Violence is about control and it does not go away or fix itself. If the person being abused is not ready to get out of the relationship, the abuse will continue even if the abuser says he is going to stop. Reach out for help as soon as you feel uncomfortable.

Look out for your friends. Do you see a partner treating your girlfriend with disrespect? Has he talked down to her or ever hit her in your presence? When you and your girlfriend are alone, tell her you care about her and are concerned. She may brush you off or seem upset, but she might just be looking for a way out and ask for your help.

Family Services is available to help you. Call them in Winston-Salem anytime at one of their hotline numbers: (336) 723-8125 for Domestic Violence or (336) 722-4457 for Sexual Assault.

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Poor Nutrition

Healthy eating and being a healthy weight can give you more energy and help prevent many serious health problems caused by being too heavy. Some health problems that can come from being overweight or obese include high blood pressure, heart disease, diabetes and more.

Good nutrition is especially important for women in the years and months before they become pregnant. The eating habits of women before and during pregnancy have a huge impact on their own health and the long-term health of their babies.

Facts about Nutrition:

Overweight and Obesity

  • 60% of United States women age 15-49 are overweight or obese.
  • Obese women who get pregnant are at higher risk for health problems such as gestational diabetes and dangerously high blood pressure.
  • The babies of obese women are more likely to be born premature, to have birth defects, and to become obese themselves when they grow up.

Underweight

  • Being underweight before getting pregnant or gaining too little weight during pregnancy can also be a problem. Underweight pregnant women or teens are more likely to have a low birth weight baby. These babies are at very serious risk for major health issues and even death.

Living Well, Eating Well

  • Try to follow the food guide pyramid. Remember that “serving size” may be very different from what we think of as one full serving. For example, a full plate of spaghetti would probably count as 3-4 servings of grains.
  • If you get pregnant, the food group requirements will change. Ask your doctor for more information.

View the Food Guide Pyramid for adults at the Food and Nutrition Information Center.

How to prevent the impact of poor nutrition on a pregnant woman and her baby.

Before you become pregnant:

  • Change your eating habits for the better. Are you constantly on a diet? Do you try to lose weight by skipping meals? Do you eat too little so you can fit into those tiny clothes? Finding and keeping a weight that is healthy for you is a process of making choices and it does not happen overnight. Give yourself a few months to ease into a new meal routine, to learn to buy and make healthier food, and to start building simple exercise into your everyday life. Ask your health care provider about healthy food choices.
  • Start taking a multi-vitamin every day to make sure you are getting the vitamins and minerals you need for a healthy body. Multi-vitamins also help prevent many birth defects in a future child. In order for the B vitamin Folic Acid to prevent many of these birth defects, you must take multivitamins every day for at least two months before you get pregnant.

If you are pregnant:

  • Gaining some weight while you are pregnant is good for you and your baby. If you are at a normal weight when you get pregnant, doctors encourage most women to gain and average of 25 to 35 pounds during pregnancy. Weight gain during pregnancy does not mean getting fat. It means gaining the weight your baby needs to grow healthy and strong. When you go for your prenatal visits, ask your health care provider to help you with finding and keeping the weight that is best for you and your baby.
  • Take vitamin and mineral supplements. When you are pregnant, your body will need extra of some vitamins and minerals and limited amounts of others. The B vitamin Folic Acid is very important, especially very early in your pregnancy. You will need lots of extra iron because your body will now be making blood for you and for your baby. You will also need extra calcium for making the baby’s bones strong. Go for all of your prenatal care visits and ask the doctor about vitamin supplements. Even when you are taking pre-natal vitamins, the food you eat throughout your pregnancy is still very important so try to keep eating a balanced diet.

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Single Parenting

Having and raising a child is a challenge for any parents. It is often even more difficult to go through pregnancy and raise a child by yourself. Women who have children when they are unmarried or without a supportive partner are much more likely you face serious financial hardships than are couples who have children.

  • In the United States, one out of every two single mothers who have never been married (and their children) live below the federal poverty level. The number is lower for mothers who were married but are now divorced: one in three divorced moms live in poverty (1998).
  • In our community (Forsyth County), one out of every three women giving birth is not married. That number varies widely by ethnic group = two out of three minority mothers of newborns are unmarried and one out of every four white mothers are. Keep in mind that not every unmarried mother is raising her baby alone. Fathers are often involved in a child’s life or may live with the family even though the parents are not married. Some single mothers also live with other relatives or friends who help raise the child.
  • The earlier a woman starts raising babies alone, the harder her financial situation often is. Having a child before finishing high school often means that the mother never finishes her education, rarely goes on to college, and may not complete any training for a higher-skilled job. This makes getting a good-paying job very difficult for women who started their families young.
  • Childcare can be a very large portion of the working single mother’s budget. The national average cost for childcare for one child is $4,000 to $6,000 each year– the same as one year of college tuition at a public university.
  • A number of women choose to parent alone on purpose. In relationships where there was domestic violence or abuse, it can actually be better for the mother and child to be away from the abuser and try to make do on their own.

How can going through pregnancy and infancy without a supportive partner impact a baby’s health?

  • Single mothers and mothers-to-be may face more stress and financial hardships during their pregnancy and the early life of the baby compared to women who have a supportive partner.
  • Studies suggest that very high levels of stress may increase the risk of preterm labor and low birthweight. Pregnant women with high levels of stress have been found to have higher levels of the hormone that might help trigger labor.
  • Women under stress may also try to reduce their stress in unhealthy ways such as using cigarettes, alcohol or other drugs; over eating or skipping meals.

Items to consider before becoming pregnant:

Do you want to be a parent at this point in your life? If you already are a parent, are you ready for another child? What would you do if you did become pregnant? Take time today to think about what your answers might be. If you have a partner, try talking it over with him to see what his thoughts are. Having a serious conversation about these questions might make both of you more careful about using birth control.

Use a birth control method that is right for you and back up your birth control with Emergency Contraception. If you don’t have a doctor, you can make an appointment at the Family Planning clinic in the Health Department or go to Planned Parenthood. No one form of birth control is right for everyone. Talk to your health care provider or staff at the clinic to find out which is best for you and fits within your budget. Remember that if you use a method like the Pill to prevent pregnancy, you still need to use condoms to protect you and your partner from sexually transmitted diseases.

Back up your birth control with Emergency Contraception. Ask your doctor for a prescription so that you can be prepared in case you ever have a birth control emergency.

Take a multi-vitamin every day. Vitamins are great for you and help your body in many ways. The B vitamin Folic Acid is especially important should you happen to get pregnant. If you take it every day for at least two months before pregnancy, it can help prevent birth defects in your newly forming baby.

If you are pregnant and single:

Reach out to people you trust for support. Your family or friends might be a valuable source of emotional and/or financial support while you are pregnant and when you become a mother. Even having a friend to talk to when you are worried can help reduce your stress. Reaching out to others for help doesn’t make you weak – it makes you smart.

Try to maintain a positive relationship with the baby’s father. Children benefit from nurturing relationships with their dads. Make an effort to help the father be involved in your child’s life.

If you ever feel threatened by the child’s father or think your child is in danger, call 911.

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HIV

Any pregnant woman who is HIV positive will face significant medical challenges for both herself and her baby. On average, an HIV positive woman has a 25% to 45% possibility of passing her HIV to her baby if she takes no steps to prevent transmission. However, a woman who takes all the possible steps has can cut that transmission rate down to less than 5%.

What is HIV/AIDS and how could I get it?

  • HIV is the Human Immnuodeficiency Virus. This is the virus that causes AIDS, the Acquired Immune Deficiency Syndrome.
  • Over 20 million men, women, and children have died of AIDS worldwide. There are approximately another 42 million people living with AIDS in the world today.
  • Many people in the United States are living long, productive lives with HIV. There are many drugs available to help keep the virus and disease under control. However, the effectiveness of the drugs can change over time and the many different kinds of drugs are very expensive.
  • HIV is passed in body fluids from an infected person to a non-infected person. This can be:
    - through sexual fluids (vaginal, anal, or oral sex – sex between a man and a woman or between two people who are the same sex)
    - through blood (sharing needles, blood transfusions of untested blood, health workers being accidentally poked with a needle that has HIV infected blood in or on it), or
    - from mother to child during pregnancy, birth, or through breast milk
  • You cannot catch HIV through casual contact like a handshake or a hug, from a mosquito or even from a public toilet seat.

What affect does HIV have on a pregnancy or a newborn baby?

  • It is very important for an HIV positive woman to use a condom anytime she has sex.
  • The drugs an HIV positive woman takes to try to keep her virus under control can cause major damage to a newly developing baby.
  • If you are HIV positive and want to get pregnant, talk with your doctor about changing medication BEFORE you go off of birth control. Your doctor will probably change your medication for the first three months of your pregnancy while the baby is forming inside you.
  • HIV does not change how the pregnancy proceeds and does not affect the development of the baby. A pregnant HIV positive woman can be just as healthy as a non-pregnant HIV positive woman.
  • A mother’s blood or body fluids can transmit HIV to her baby in these ways:
    - Before birth
    - During labor and birth
    - After birth through breastfeeding

How to Reduce the Danger of HIV

If you do not have HIV disease:

  • Use a condom every time you have sex. If you have been with your partner for a long time and know that he or she has tested negative for HIV, birth control is still important. Remember that people can have HIV for many weeks before it will show up on the test. (If you get tested one day after you are exposed to HIV, for example, you most likely will not have enough of the virus in your blood to show up on the test).
  • If you are pregnant, keep using condoms with any new sexual partner or a former partner that has not been tested recently.
  • Condoms are not 100% effective in preventing the spread of HIV but, other than not having sex at all (abstaining), they are the most effective method we have. Your life is worth the effort of insisting your partner use one.

If you are pregnant and HIV positive:

  • As soon as you decided to try to get pregnant or realize that you are pregnant, talk to your doctor immediately about changing your HIV medication. The common Anti-retroviral drugs HIV positive women take can cause major damage to a developing baby in the first three months of pregnancy.
  • To prevent mother-to-child transmission, talk to your doctor about these options:
    - Taking anti-retroviral drugs during the 4th to 9th months of your pregnancy
    - Taking anti-retroviral drugs during labor and delivery
    - Choosing a cesarean section instead of vaginal delivery. This can protect the baby from direct contact with the mother’s blood and genital tract secretions and fluids.
    - Feeding your baby with formula instead of breastfeeding. If you have access to formula or clean water to mix powdered formula, feeding your baby formula can reduce your risk of infecting the baby between 10% and 15%. In countries where there is no clean water, you can actually do more damage to your child by giving powdered formula mixed with contaminated water than breastfeeding.

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Teen Pregnancy

Pregnant teenagers are more likely to give birth to low birthweight babies than are older women. These under-weight babies are at higher risk for significant medical problems and even death.

Information for parents of teenagers:

  • In our community, we have much higher rates of teen pregnancy than the other cities in NC and higher than the North Carolina average.
  • Almost 1/3 of the teen pregnancies in Forsyth County end in abortions.
  • Parents matter. Teens say that parents influence their sexual decisions more than any other source. Talk with your children about sex and abstinence from an early age. Let them know what you think is OK or not and why.
  • Get help. Having these conversations are not easy but are critical for your child. Go to the Talk With Your Kids Initiative for ideas on how to reach out to your child or teen.

Information for teens:

Waiting to have sex

  • Nearly 2/3 of teens who have had sex wish they had waited. There are a lot of good reasons to say “No, not yet.”
  • Just because you think “everyone is doing it” doesn’t mean they are. Some are, some aren’t – and some are lying.
  • 8 out of 10 teens say they feel pressure to have sex. Don’t let anyone pressure you.
  • Not ready to be someone’s father yet? Simple - don’t have sex. If you do, use protection every time.

Being sexually active

  • 1 out of every 3 teen girls in the US become pregnant at least one time during their teen years.
  • Nearly all teen pregnancies are unintended. Thinking “it won’t happen to me” is not smart. Sex is serious. Make a plan.
  • Carrying a condom is just being smart. It doesn’t mean you’re pushy or easy.

How you can prevent unplanned pregnancy:

  • Try to be as healthy as you can – you’re worth it! These tips are good for you now and for any future baby you might have down the road.
    - If you are a smoker, quit smoking. Ask your friends or family members to quit, too. You can all help each other kick the habit.
    - If you drink alcohol often or heavily, cut back or quit.
    - If you use any illegal drugs, ask someone to help you overcome your addiction.
    - If you feel uncomfortable in a relationship, if your boyfriend or girlfriend threatens you or is controlling or just makes you feel unsafe, ask an adult for help. Abusive boyfriends often start with harsh words before they move on to using their fists. If your partner ever threatens you or forces you to have sex, call 911 for help as soon as you can.
  • Wait to have sex. Are you ready to take care of a baby? Then you might not be ready for sex, either. If someone is pushing you to have sex before you’re ready, tell them you want to wait. You can always say “no” even if you have said “yes” before.
  • If you have sex, use a condom or other form of birth control. Abstinence is the safest way to protect yourself from all sexually transmitted infections and from unwanted pregnancy. Using a condom every time you have sex will significantly reduce your risk of catching a disease or becoming pregnant. *Remember that condoms are never 100% effective.*
  • Back up your birth control with Emergency Contraception. Ask your doctor for a prescription so that you can be prepared in case you ever have a birth control emergency.
  • Be picky about your partner. Before you sleep with anyone, think, “Would I want this person to be the father of my child if I get pregnant?” Remember that sex won’t make him yours and a baby certainly won’t make him stay.

If you do get pregnant

  • Tell someone right away. If your period is even one week late, actions like binge drinking or using drugs or cigarettes can already be hurting the baby growing inside you. Talk to a boyfriend, parent, teacher, pastor or any adult you trust.
  • Remember that you do have choices. Will you keep the baby and try to raise it yourself? With the father? Will you offer it up for adoption? Or will you have an abortion? Get the facts about all of your choices and don’t let anyone force you into one decision. This is your body, your baby and your life.
  • Get into prenatal care. Early prenatal care is very important for any healthy baby.
  • Join the Baby Love program. Baby Love offers lots of extra help from a nurse or social worker all during your pregnancy. Call (336) 727-2890 to see if you are eligible to join.

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Late or No Prenatal Care

In Forsyth County, the overwhelming majority of our pregnant women do start into prenatal care early in their pregnancy. Our prenatal care use rate is actually better that the state and the nation as a whole. Unfortunately, good prenatal care does not solve our infant mortality problem. Late on no prenatal care is simply one of many factors that contributes to infant deaths for a small percentage of our local mothers.

Prenatal care is the series of checkups that women get while they are pregnant. The checkups are a very important part of having a health baby. Going to all of the prenatal care appointments will give a woman’s health care provider a chance to keep an eye out for any problems that might come up during her pregnancy. Prenatal care also gives a mother-to-be the chance to learn all about her new baby and what she can do to stay as healthy as possible.

What does prenatal care involve?

  • Most healthy women have about 15 pregnancy checkups during their 9 months of pregnancy. You may have more if you have serious health problems.
  • 1 visit per month for the first seven months.
  • 1 visit every two weeks during month seven and part of month eight.
  • 1 visit each week from the middle of month eight until you have your baby.
  • During the pregnancy checkups, your doctor, nurse, or midwife will check on you and your baby. They will recommend tests for different kinds of conditions and try to prevent problems from occurring.

What if I can’t afford it?

There are lots of options for pregnant women or for families that are on a tight budget. Many private obstetricians and public clinics will provide care for women who do not have health insurance. Your options for payment may include:

Pregnant Women’s Medicaid – if you are a United States citizen, are pregnant and have a low income, you may qualify for pregnant women’s Medicaid. This is a government program that can pay for much of your care. Go to the Department of Social Services at 741 Highland Avenue to apply. Call them at 703-3803 if you have questions. You will need to take these documents with you: 1) your Social Security Card, 2) a clinical pregnancy test result from a doctor or other health provider (a home pregnancy test will not count), 3) your driver’s license, and 4) proof of your household income– such as paycheck stubs - for the past two months.

Sliding fee scales – a number of local clinics offer payment plans and sliding fees scales for people with no insurance and no Medicaid. Ask to see a financial counselor or ask about payment plans when you go to make a prenatal appointment.

If you have recently become pregnant:

Find a doctor, nurse, or midwife to go to for prenatal care as soon as you think you are pregnant. Go to every appointment even if you feel fine.

Apply for the Baby Love program (also called Maternity Care Coordination)

  • Baby Love nurses and social workers can help you have a healthy baby. They can also teach you about lots of different services available in our community. Call 727-2890 and ask to talk to a Baby Love nurse to see if you qualify for this free program.

Learn the signs of preterm labor

  • If you start going into labor months early, you can go to your doctor or the emergency room where they can try to stop or slow down your labor.
  • Every day your baby stays inside you counts! Even a few days more in your womb can mean the difference between life and death for your baby. Pay attention to your body and call for help if you have any of these signs:
    - Contractions every 10 minutes or more often
    - Fluid (bloody or clear) leaking from your vagina – could be a trickle or a gush
    - Pelvic Pressure (the feeling that your body is pushing down)
    - Low, dull backache
    - Cramps that feel like your period
    - Abdominal cramps (with or without diarrhea)

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Contact Information

The Forsyth County Infant Mortality Reduction Coalition is a community partnership housed within the Forsyth County Department of Public Health.

(336) 703-3260

Did You Know . . .

We could cut our state infant death rate by 10%-20% overnight if all pregnant smokers would quit smoking.