In the United States, January is National Birth Defects Prevention Month and the Centers for Disease Control and Prevention (CDC) has a robust collection of resources and materials available to the public (and childbirth educators) that raise awareness around this issue.  Childbirth educators can share information about preventing birth defects with every class they teach, but this month is a good time to brush up on effective messaging. Birth defects affect one in every 33 babies (about 3% of all babies) born in the United States each year (CDC, 2008).  Birth defects are the leading cause of infant deaths, accounting for 20% of all infant deaths (Mathews, MacDorman & Thomas, 2015).  The CDC does provide data that indicate specific birth defect occurrences by race and ethnicity which can be very useful if you work with specific homogenous populations.

Every 4 ½ minutes, a baby is born with a birth defect in the United States. That means approximately 120,000 babies are affected by birth defects each year. The CDC states that "Birth defects are structural changes present at birth that can affect almost any part or parts of the body (e.g., heart, brain, foot). They may affect how the body looks, works, or both. Birth defects can vary from mild to severe. The well-being of each child affected with a birth defect depends mostly on which organ or body part is involved and how much it is affected. Depending on the severity of the defect and what body part is affected, the expected lifespan of a person with a birth defect may or may not be affected."  Many birth defects are detected before the baby is born, and almost all are identified by the time a baby turns one year old.  Most defects occur in the first trimester but others can arise during the second or third trimester.

While most childbirth educators are probably meeting their students in the late second or early third trimester, it is still important to discuss birth defect prevention as many families may go on to have other children and the prevention information is important.  Some of the prevention best practices are directly applicable to pregnant people who are in the third trimester.  Here are the top six things educators can and should be sharing with families.

1. Encourage pregnant people to get 400 micrograms of folic acid every day.  Folic acid is in most prenatal and multivitamins, and people who are considering getting pregnant should ideally consume 400 mcg at least one month prior to conception. Adequate folic acid can help prevent neural tube defects.

2. Pregnant people should initiate prenatal care as soon as they know they are pregnant and continue to see their doctor or midwife regularly throughout their pregnancy.  Planning a preconception meeting with a care provider is also helpful if the person is planning to conceive. Advising the doctor or midwife of all the medications that they take both regularly and occasionally should be discussed to determine the safety for the fetus and a conversation about alternatives if necessary should occur.

3. Avoid alcohol, smoking and marijuana and other drugs before becoming pregnant and certainly throughout the pregnancy.  If these items are part of a pregnant person's lifestyle, support them in seeking out resources to help them eliminate these things at least during their pregnancy.  

4  Avoid infections and exposure to potential infections.  Continue to observe good handwashing procedures with soap and water frequently.  Consult a care provider when traveling to locations where the pregnant person may have increased exposure to certain infections.  Practice safe sex if there is a possibility of becoming infected with a sexually transmitted infection. 

5. Pregnant people should remain current on all vaccinations and receive both the flu shot and Tdap vaccine during each pregnancy.

6. People who are pregnant should maintain a healthy weight throughout pregnancy and use a healthy diet and exercise to do support this goal.  A healthy diet and regular exercise can reduce the risk of gestational diabetes.

If a family shares with you that their baby has been impacted by a birth defect, by all means, do what you can to find support for them through peer to peer online and in-person groups, as they navigate the emotions and concerns of expecting a baby with a birth defect.  The March of Dimes is a great place to start.  Families dealing with an infant with a major health issue is more likely to be affected by a postpartum mood or anxiety disorder.  Sharing resources to the entire class is also a good practice as some families may not share with you what they are facing.

Talking about birth defect prevention is a good idea even when folks are at the end of their pregnancies and in your childbirth education classes.  It is an important topic that impacts many families a year worldwide, and the information you share may be helpful to those in your classes for this or future pregnancies.  There is a short but valuable quiz that you and the families that you work with can take to test the general knowledge on the topic of birth defects. Access that quiz here and see how you do.  The CDC has a very robust website with lots of information and this information is also available in Spanish for those who prefer that.  From this website you can access infographics and multimedia materials for use with your classes and in your communications with the public.

References

Centers for Disease Control and Prevention (CDC. (2008). Update on overall prevalence of major birth defects--Atlanta, Georgia, 1978-2005. MMWR. Morbidity and mortality weekly report, 57(1), 1.

Mathews, T. J., MacDorman, M. F., & Thoma, M. E. (2015). Infant mortality statistics from the 2013 period linked birth/infant death data set.

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