Healthy pregnancies
Madison area offers lots of help
by Diane Walder
The CDC's National Center for Health Statistics reports that the U.S. infant mortality rate rose for the first time in nearly 50 years, and preterm birth rates in Wisconsin have risen by 18 percent in the last decade.
"While the reasons for this are complex, what is primarily important for healthy pregnancy is avoiding tobacco, alcohol and other drugs, and getting early and regular prenatal care-medical and emotional support, nutritious foods and exercise," says Mary Bradley of Madison's Department of Public Health.
"Early prenatal care is essential to identify or prevent problems, but many women delay it or think it's unnecessary because they've birthed before-some of this is access to medical care. We have excellent Medicaid benefits, but a large population of people don't qualify," says Bradley.
"We serve high-risk women-those who use tobacco, alcohol and other drugs, have sexually transmitted and dental infections, and those who have had a preterm or low birth-weight baby. Our major goal is to make sure women receive prenatal care by a midwife or physician. Our public health nurses help access medical care while we focus on teaching about how to have a healthy pregnancy," says Bradley.
In addition, Women, Infant and Children Nutrition Program (WIC) serves limited income families and mothers as soon as they know they're pregnant. "WIC provides food and nutrition information to help pregnant women and their children under age five be healthy," says Janet Daniel of Madison's Department of Public Health.
Ann Rifenberg, Director of the Nursing Midwifery Service for UW Health, advises pregnant women to avoid fish and processed meats, which may contain a harmful bacteria. Eat organic produce or wash it with soap to remove pesticides and herbicides. Take vitamins, and avoid certain cold remedies, St. John's Wort, and blue and black cohosh.
"Staying physically fit is equally crucial," says Rifenberg. "There are discomforts of hauling a baby around for nine months. As long as you can stay active and vigorous, you'll approach birth in a positive way and recover faster."
"We believe that good nutrition can prevent diseases of pregnancy like hypertension," says Aszani Kunkler, certified nurse midwife and founder of the Madison Birth Center, Wisconsin's only free-standing birth center. It provides classes, support groups, midwifery care and family birthing rooms.
"Our focus is continuity of care," says Kunkler. "We use preventive medicine and education upfront so clients know how to stay healthy. We educate women about what to expect and each client develops a uniquely close and trusting relationship with her midwife. We encourage natural childbirth, which facilitates breastfeeding and bonding. Research shows that birth center and home births with qualified midwives are as safe or safer than hospital births for low-risk women, " says Kunkler.
Midwifery care is recommended for normal pregnancy. Historically, pregnancy and birth were the domain of midwives, but as medicine and the business of medicine grew and became a male-dominated industry, the normal process of childbirth became treated as an illness.
"Physicians are important when a pregnant woman becomes ill-their training is geared toward diagnosis and treatment. Midwives enhance or elevate a woman and her family's wellness during the process of pregnancy, childbirth and the postpartum period. Unless there's a problem, our clients, who use Meriter Hospital's maternity unit, never see a physician," says Rifenberg.
A new resource to help parents make informed choices about their pregnancy and birth experience is Happy Bambino. The new center and store on Madison's east side provides free early parenting classes, breastfeeding clinics and support groups. Community-oriented, it offers an extensive variety of low-cost classes and a free directory of Madison's birthing professionals and specialists.
"Our approach is that pregnancy and birth are exciting times in a woman's life, and we want to empower women to participate fully in this process," says Kunkler.
