Give Your Baby the Best Possible Start
Babies born too early (especially before 32 weeks) have higher rates of death and disability. In 2018, preterm birth and low birth weight accounted for about 17% of infant deaths (deaths before 1 year of age).
The preterm birth rate rose for the fifth straight year in 2019. Additionally, racial and ethnic differences in preterm birth rates remain. For example, in 2019, the rate of preterm birth among African-American women (14.4%) was about 50 percent higher than the rate of preterm birth among white or Hispanic women (9.3% and 10% respectively).
Content Source: CDC Preterm Birth, 2020
Start Smart for Your Baby®
Our program for expecting and new mothers
Here for You and Your Baby – Every Step of the Way
A healthy pregnancy, birth and mom should be the goal of all expecting parents and families. That means information, resources and a true partnership to ensure you and your baby get everything you need to make a smart start on your journey.
Your Health Net health plan may include Start Smart for Your Baby®, a program for women who are pregnant and for moms who have just had a baby. We want to help you take care of yourself and your baby through the whole process.
Find pregnancy support for you and your baby
Go to your doctor as soon as you think you are pregnant. If you need help finding a doctor or making an appointment, call us at 888-893-1569 (TTY: 711).
Meet our care managers
Our care managers are nurses and social workers who can give you customized support, before, during, and after your pregnancy. They can help you find resources and support your doctor's plan for care. If you want to speak with a care manager, call us at the number on the back of your member ID card.
Prenatal care
First things first
It is important to see your doctor as soon as you think you are pregnant. Studies1 show that getting prenatal care early can help you have a healthier baby.
Regular doctor visit
It is important to go to all of your prenatal visits, even if you are feeling well. Your recommended prenatal visits will be:
- Every 4 weeks during the first 32 weeks
- Every 2 to 3 weeks from 32 to 36 weeks
- Every week from 36 weeks
Flu vaccine
Getting the flu when you are pregnant can make you much sicker than other people. It is important to get the flu shot as early as possible during flu season to help protect yourself and your unborn baby.
Covid-19
Pregnant or breastfeeding people may choose to be vaccinated against COVID-19. The American College of Obstetricians and Gynecologists recommends that the COVID-19 vaccine should not be withheld from pregnant or breastfeeding individuals.
Tdap
It is important to get the Tdap vaccine when you are pregnant. Tdap is one vaccine that protects against three diseases: tetanus, diphtheria, and pertussis (whooping cough). The Centers for Disease Control and Prevention and Mayo Clinic suggest that pregnant people get this vaccine between 27 through 36 weeks of pregnancy, even if they have gotten the vaccine in the past.
| Risk Factors | What should I do about the risk factors? |
|---|---|
| Previous preterm delivery | Talk to your doctor about medicines like 17P or other ways to help prevent another preterm infant. |
| Pregnant with multiples | Carrying more than one baby means you will need to get extra rest and see your doctor more often. |
| Certain infections | Make sure you get tested and treated for all of your infections and tell the doctor about any symptoms you may be having. |
| Substance use | Avoid smoking, drinking alcohol and using illegal drugs during pregnancy. |
| Short time period between pregnancies | Wait at least 18 months before getting pregnant after your last delivery. |
| Stress | Serious types of stress caused by things like divorce, a death in the family, losing a job, financial problems, or a lack of social support can lead to preterm delivery. Reach out for help if you are experiencing high levels of stress. |
During pregnancy, your body goes through many changes. These changes are a natural part of pregnancy. Understanding these changes can help you through them. Some of the changes are emotional, some are physical, and some are changes to your routine.
| Trimesters | Description of Symptoms | What can I do about the symptoms? |
|---|---|---|
| First trimester (1–12 weeks) This is a period of fast growth and development for the baby. The baby has developed all of his or her body parts and organs. |
Feeling tired: Most people feel very tired during the first three months of pregnancy. The tired feeling usually goes away by 13 weeks. Morning sickness: Feeling sick to your stomach. Some may vomit or throw up. It can happen any time of the day – not just in the morning. It usually begins in the first month of pregnancy. In most cases, it gradually goes away by the end of the 13th week and it is almost always gone by week 20. |
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| Second trimester (13–27 weeks) The baby continues to grow and develop quickly. By the 22nd week you should be able to feel the baby moving. |
Headaches: Your body experiences a surge of hormones and an increase in blood volume. This can cause more frequent headaches. They should decrease by the middle of the 2nd trimester when your hormones stabilize. Heartburn: Many people have heartburn while pregnant. Your hormone changes during pregnancy can change your whole digestive system. Also, your growing womb pushes on your stomach. |
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| Third trimester (28–birth or 40 weeks) The baby continues to gain weight and develop important organs like the lungs and increase brain size. |
Back pain: You may find you have to lean back to keep your balance as your belly grows. This puts more stress on your back muscles, causing back pain. Swelling: Your ankles, feet, and hands may become swollen in the last few months of pregnancy. |
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As your baby grows, steer clear of things that could harm your baby. Preterm birth, low birth weight, birth defects, miscarriages and stillbirths can all be caused by the things on this list.
| Things to avoid | What it does to your body and your baby |
|---|---|
| Alcohol | It can cause serious mental and physical defects in your baby. There is no safe amount of beer, wine or booze during pregnancy.3 |
| Street drugs | They can cause birth defects and problems with your placenta. Infections such as hepatitis C and HIV can also be passed on to your baby.4
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| Smoking and second-hand smoke | Smoke can cause very serious health problems for your unborn child. It is also associated with SIDS (sudden infant death syndrome). If you want to stop smoking, ask your doctor or us for help. If you can’t quit, cut back as much as possible.5
|
| Stress | A little stress is OK, but too much stress has been associated with preterm and low birth weight births. Reach out for help if you are under a lot of stress.6 |
| Prescription Opioids | These are strong drugs used for pain, like codeine and oxycodone. One problem with using these drugs during pregnancy is neonatal abstinence syndrome (NAS). Babies with NAS have drug withdrawal after birth. Breathing, feeding problems, and seizures can occur. Try not to take these drugs during pregnancy. If needed, take them exactly as prescribed. If you have been taking opioids for a long time, talk to your doctor. Do not stop them suddenly. Treatment such as methadone or buprenorphine can help you quit opioids safely.7 |
| Certain foods and drinks | Raw meat or eggs, deli meat, raw or smoked fish, unpasteurized milk and soft cheeses can carry germs that will cause infections in your baby. Deli meats and smoked fish are OK to eat if they are heated. Fish with large amounts of mercury such as shark, swordfish, king mackerel and tilefish should be avoided during pregnancy. Babies exposed to mercury can have brain damage, hearing, and vision problems. Limit canned tuna to two cans per week. Too much caffeine during pregnancy may be associated with preterm birth, low birth weight, and miscarriage.8 For more information about caffeine use during pregnancy, go to March of Dimes. |
Once you get closer to your delivery date, your body will start preparing for your baby's arrival.
False labor
Before true labor begins, you may feel your womb tighten up. This squeezing is called Braxton Hicks, also known as practice contractions or false labor pains. Your contractions are probably just practice contractions if they:
- Are not painful.
- Do not have a regular rhythm.
- Are more than 10 minutes apart.
- Go away after drinking two glasses of water or after a short walk. Practice contractions are OK late in pregnancy.
Signs of true labor
There are several signs that you are in true labor. Call your doctor immediately when you notice these signs:
Water breaks
This means that the bag of water around your baby has broken. You may feel fluid coming from your vagina. If you think your water has broken, don't use a tampon, get in the tub, or have intercourse. Call your doctor.
True contractions
Unlike practice contractions, true contractions will get stronger and more frequent over time. You will feel your entire womb squeezing. Some women say they feel like a belt is getting tighter and tighter around them. If your contractions are less than 10 minutes apart, this may mean that true labor has begun.
Back labor
You may feel pain in your lower back that is associated with the womb contracting (squeezing). This is labor occurring in your back. This pain may spread to your lower belly and could even spread to your legs.
"Every pregnancy is different whether it is your first, last, or somewhere in the middle. Start Smart for Baby is an opportunity for you to get customized support throughout your pregnancy and into the postpartum period. Many times pregnant people have questions that need answers! We are here to help with our one on one support."
– Michelle Estrada, RN BSN CCM, Manager, Care Management, Health Net
This benefit is included in most Health Net Plans.
If you haven't already started getting supplies for your baby-to-be, now's the time to start! Use this checklist to help you find the things you need. Ask friends and family members for help getting these items.
To wear:
- Booties or socks
- Hats
- Onesies
- Sweaters
- Stretch suits with feet
- Sleepwear, one-piece pajamas, or nightgowns
For bathing:
- Baby bathtub
- Baby lotion for after the bath
- Baby shampoo
- Baby washcloths
- Hooded bath towels
- Liquid baby soap
For sleeping:
- Bassinet or cradle
- Crib and mattress
- Tight fitting crib sheets
- Small, light receiving blankets
- Waterproof pads
For eating:
- Bibs
- Bottles and nipples for breast milk or formula
- Bottle and nipple brushes
- Burp cloths or cloth diapers for spit-ups
For breastfeeding:
- Breast pump (your health plan provides one for no cost)
- Lanolin cream to soothe sore nipples (you might be able to get this at no cost with a prescription from your doctor)
- Nursing pads to wear in your bra (you might be able to get this at no cost with a prescription from your doctor)
For changing diapers:
- Diapers
- Diaper pail
- Baby wet wipes
- Diaper rash cream
- Changing pad and table
- Diaper bag and changing pad to go in your diaper bag
For laundry:
- Fragrance-free soap. These are much less likely to bother your baby's skin
For healthcare:
- Cool mist humidifier to ease baby's breathing when the air is dry
- Medicine dropper to measure medicine
- Nasal suction bulb
- Thermometer
For travel:
- Blankets to cover your baby while you are outside
- Front pack or backpack to carry your baby in for the first six months
- Infant car seat
- Stroller
Other useful supplies:
- Playpen
- Rocking chair
- Safe toys
- Safe baby swing (avoid the kind that hangs from a doorway)
- Pacifiers, if you decide to use them
Your body after delivery9
It is important to see your doctor about 4–6 weeks10 after giving birth. This visit is called a postpartum visit and is important to make sure your body is healing after delivery.
| Symptom | What you can expect and what you can do | When to call the doctor |
|---|---|---|
| Feeling tired |
|
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| Cramps |
|
Severe cramping that is not resolved with pain medication. |
| Sore and swollen breasts |
|
You have a sore, red, painful breast with chills, fever, and flulike symptoms. You may have an infection called mastitis. |
| Sore bottom, painful piles (hemorrhoids) |
|
You are having severe pain or are having a lot of trouble peeing or having a bowel movement. |
| Bleeding and discharge from your vagina | This is normal for the first few weeks after delivery. | You pass blood clots larger than a golf ball or have severe vaginal bleeding that gets heavier. |
| Soreness, numbness, or itching around your cesarean incision |
|
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* You may be able to get these items at no cost with a prescription from your doctor.
Heading home
You are likely to go home 1–2 days after vaginal delivery or 2–4 days following a C-section.
Breastfeeding11
Almost all mothers can breastfeed. Do not worry if your breasts are small or if you are thin. All shapes and sizes can make the milk your baby needs.
Breastfeeding for the first time
If possible, nurse your baby for the first time with skin-to-skin contact within one to two hours after you give birth. This contact has many positive effects for your baby:
- Helps maintain regulated body temperature after birth.
- Helps maintain heart rate, respiratory rate, and blood pressure after birth.
- Your baby is more likely to latch on faster during breastfeeding.
- Your baby is more likely to breastfeed exclusively and for a longer time.
How often do you feed your baby?
Babies typically feed 8–12 times per day and average 1.5–3 oz per feeding for the first week or two. Feed your baby any time he or she seems hungry. Babies may smack their lips, stick out their tongue, move their head side to side, or put their hands in their mouth as a sign that they are getting hungry. If you wait until they are crying, it is often harder to calm them down for the feeding.
Breast milk is great for your baby
Doctors and health organizations agree that breastfeeding is best. You may already know that breast milk is packed with the perfect mix of nutrients your baby needs. Breast milk has special ingredients, like antibodies, that only you can provide.
Using formula
Sometimes, it does not work out to breastfeed. This can happen for many different reasons. If this is the case, formula feeding is another great option. Remember, however your baby gets the nutrition they need, is great!
Breast feeding is good for you too!
- Breastfeeding can help you recover from childbirth.
- Breastfeeding helps create a special bond between parent and baby.
- It protects your health. It can also lower your chance of getting breast cancer, ovarian cancer, and diabetes.
- Breastfeeding can help you get back to your pre-pregnancy weight.
What is skin-to-skin contact?
You should continue skin-to-skin contact for the first few weeks at home. Here are some tips for performing skin-to-skin contact:
- Wash your hands well before starting.
- Have your baby wear only a diaper.
- Sit in a location where you can lean back a bit. Half lying, half sitting is good for your baby's breathing.
- Put your baby against your bare chest. Baby should be facing you, tummy to tummy.
- Enjoy this time with your baby for at least an hour.
Your first few weeks at home
Many people who go home with a baby for the first time can feel overwhelmed. It may be scary thinking about everything you need to do and know about having a new baby. Here are some great tips to help ease your worries about caring for your baby.
Your baby should see the doctor
It is very important to take your baby to see their doctor 3–5 days after birth and again before turning one month. It often helps to make your baby's doctor appointment before you leave the hospital.
If your newborn looks sick, has a fever, is feeding poorly, is sleeping too much, vomiting or changes color, call your doctor right away.
Make sure your baby is safe when sleeping
You should always put your baby on his or her back to sleep (unless the doctor tells you not to) in a crib or bassinet. You and your baby should never sleep in the same bed. However, keep baby's sleep area in the same room where you sleep for the first six months to a year, if possible. Never place your baby on sofas or soft surfaces. Do not keep loose bedding, bumper pads or toys in your baby's sleep area.
Give your baby a bath
Babies should only receive sponge baths until their umbilical cord has fallen off. Never leave your infant unattended in the bath.
- Optimizing Postpartum Care, American College of Obstetricians and Gynecologists, May 2018
- ACOG Postpartum Toolkit, American College of Obstetricians and Gynecologists, 2018
- American Psychological Association
- What to Expect at the Hospital During Childbirth, Babylist, April 19, 2019
- During Pregnancy, Centers for Disease Control & Prevention
- International Lactation Consultant Association
- La Leche League International
- March of Dimes
- Prenatal care: 1st trimester visits, Mayo Clinic, Aug 7, 2020
- Missouri Family Health Council
- What is prenatal care and why is it important?, National Institute of Child Health and Human Development
- What Does A Safe Sleep Environment Look Like?, National Institute of Child Health and Human Development
- Questions to Ask on a Hospital Tour for Birth, VeryWell Family
- Breastfeeding Basics, WIC Breastfeeding Support, USDA
Footnotes
1 Effect of Frequency of Prenatal Care Visits on Perinatal Outcome Among Low-Risk Women – A Randomized Controlled Trial, March 20 1996 https://jamanetwork.com/journals/jama/article-abstract/398623
2 John Hopkins Medicine, Staying Healthy During Pregnancy, www.hopkinsmedicine.org/health/conditions-and-diseases/staying-healthy-during-pregnancy/4-commonpregnancy-complications, accessed April 2, 2021
3 Why Avoid Alcohol During Pregnancy, https://www.marchofdimes.org/it-starts-with-mom/why-avoid-alcohol-during-pregnancy.aspx, accessed May 2021.
4 Street Drugs and Pregnancy, https://www.marchofdimes.org/pregnancy/street-drugs-and-pregnancy.aspx, accessed May, 2021.
5 Smoking During Pregnancy, https://www.marchofdimes.org/pregnancy/smoking-during-pregnancy.aspx, accessed May, 2021.
6 Managing Stress During Pregnancy, https://www.marchofdimes.org/it-starts-with-mom/managing-stress-during-pregnancy.aspx, accessed May, 2021.
7 Prescription Opiods During Pregnancy, https://www.marchofdimes.org/pregnancy/prescription-opioids-during-pregnancy.aspx, accessed May, 2021.
8 Foods to Avoid or Limit During Pregnancy, https://www.marchofdimes.org/pregnancy/foods-to-avoid-or-limit-during-pregnancy.aspx, accessed May, 2021.
9 After the Baby Arrives, https://www.cdc.gov/pregnancy/after.html, accessed May, 2021.
10 Your Postpartum Checkups, https://www.marchofdimes.org/pregnancy/your-postpartum-checkups.aspx, accessed May 2021.
11 Breastfeeding Your Baby, https://www.marchofdimes.org/baby/breastfeeding-your-baby.aspx, accessed May 2021.
12 The American College of Obstetricians and Gynecologists (ACOG) FAQ029, November 2016
This information is not intended as a substitute for professional medical care. Please always follow your health care provider's advice. Programs and services are subject to change.