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CIGNA HealthCare

Healthy

Babies

®

Program

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© 2005 CIGNA

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What’s Inside

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Guidelines for a Healthy

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Pregnancy and Baby The Importance of Healthy

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CIGNA HealthCare 24-Hour

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Health Information Line

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and Topic Guide

Teeth and Gums Pregnancy and Stress

Pregnancy and Depression

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Congratulations Congratulations on your commitment to your baby’s health. By taking part in the CIGNA HealthCare Healthy Babies® program, you join thousands of other CIGNA HealthCare mothers-to-be who believe that what you do during your pregnancy matters to your baby’s health.

We’re ready to help. Do you have questions about labor? Are you having unusual pains? Or are you just concerned about being a new mother? We can help. Just call the number on your CIGNA HealthCare ID card and follow the prompts to the CIGNA HealthCare 24-Hour Health Information LineSM to talk to an experienced, registered nurse who can answer many of your questions.

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Guidelines for a Healthy Pregnancy and Baby ■

Make and keep regularly scheduled appointments with your doctor and follow his or her advice.

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Take a multi-vitamin that contains 400 micrograms of FOLIC ACID every day. Folic acid helps reduce the risk of having a baby with certain birth defects of the brain and spinal column.

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Be sure to make and keep regularly scheduled appointments with your doctor and follow his or her advice.

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Don’t drink alcohol or take drugs either, except those approved by your doctor. For help to quit smoking or drinking, talk to your doctor or check the resource lists in this package. ■

During pregnancy, your gums and teeth need extra attention due to changes in your body. Make and keep regular appointments with your dentist and brush and floss daily. Good oral health can contribute to a healthy pregnancy and can help prevent premature delivery. For more information about the importance of dental health during pregnancy, see page 3.

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Weight gain is healthy when you’re pregnant. For a healthy baby, a good weight gain range is about 25 to 35 pounds. Your doctor will recommend the best weight gain for you.

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Pregnancy can be stressful. At times during your pregnancy, you may feel sad or scared. While those feelings are normal, prolonged or excessive stress may not be good for your or your baby. Untreated stress is strongly linked to low birth weight and premature delivery. For more information about stress during pregnancy, see page 4. For help with stress, talk to

Eat a healthy diet that includes foods that contain folic acid – like orange juice, peanuts, fortified breakfast cereals and green leafy vegetables. Your need for iron doubles during pregnancy, so eat plenty of iron-rich foods – like meat, whole grains, dried fruits and beans. Find an exercise program you enjoy and participate in it at least three times a week (with your doctor’s approval). Avoid risky sports like waterskiing, diving, snowmobiling, surfing, skating, downhill skiing, gymnastics and horseback riding. Don’t smoke and avoid secondhand smoke. Smoking can harm your unborn baby. Harmful chemicals get into your baby’s blood, and your baby gets less oxygen, which can affect your baby’s weight. Smoking also increases your risk for a miscarriage.

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The Importance of Healthy Teeth and Gums

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your doctor or check the resource lists in this package.

According to the American Dental Association (ADA), most

Learn the signs of premature labor by reading the March of Dimes pamphlet on premature labor in this package. Know when you need to call your doctor.

problems. This conclusion was based on data taken from

Prepare for your baby’s arrival by enrolling in childbirth preparation and infant-care classes. Consider breast feeding. Experts agree, breast milk is best for your baby.

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Always use a three-point seat belt. Learn the proper way to secure your infant safety car seat.

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Avoid high-risk sexual behavior and use condoms to help limit exposure to sexually transmitted diseases.

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Be sure to enroll your new baby in your health benefits plan right away, according to your plan’s instructions.

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Make, and keep, your post-natal appointment with your doctor.

pregnant women don’t visit a dentist, even if they have dental nationwide surveys of women who recently gave birth. Pregnant women who don’t take care of their teeth and gums can be risking their own and their baby’s health. Changes in estrogen and progesterone levels affect the body's response to the bacteria that cause gum infections. And these infections may increase the chance of a premature birth. In fact, pregnant women with chronic gum disease during the second trimester are up to seven times more likely to give birth prematurely.1 Research also shows a potential link between gum disease and other serious health problems, such as heart disease, stroke and diabetes. Preventing gum disease To help prevent gum disease, the ADA suggests: ■

brushing your teeth twice a day with a soft-bristle toothbrush

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flossing daily

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eating a healthy diet and limiting snacks between meals

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seeing your dentist regularly

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American Dental Association

Symptoms of gum disease Gum disease is usually painless, but can also have symptoms, such as: ■

tender, swollen or bleeding gums when you brush your teeth

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dark red or receding gums

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bad breath or a bad taste in your mouth

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loose teeth

Gum disease is treatable CIGNA Dental strongly encourages all women who are pregnant, or thinking of becoming pregnant, to make an appointment for a dental checkup. Be sure to let your dentist know if you’re pregnant. This is especially important because it will affect your dentist’s decision to take dental x-rays. Your dentist can provide you with more information and advice about how to keep your teeth and gums healthy when you are pregnant.

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Pregnancy and Stress Whether your pregnancy was planned or unexpected, some stress is a normal part of the process. At times during your pregnancy, you may feel happy, sad or scared. While these feelings are normal, prolonged or excessive stress may not be good for you or your unborn child and can lead to problems. Untreated prenatal stress is strongly linked to low birth weight and/or premature delivery. Negative responses to stress can include use of alcohol, tobacco and drugs — all of which can affect fetal development, delivery and parenting. But the good news is that stress is highly treatable. What contributes to stress during pregnancy? ■

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unplanned life changes resulting from unplanned pregnancy

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uncertainty about the pregnancy and how it will change your daily life

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anxiety over becoming a parent

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your age

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financial stress, unemployment

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how and when to tell your family, friends and coworkers

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changes in your body, relationships, career and finances

worry about how your other children will react

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lack of understanding from family and friends

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Insist on help with regular chores.

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past bouts of depression

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physical stress, such as morning sickness, back pain, urinary tract infections, chronic illnesses

Don’t combine too many activities.

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Avoid alcohol, drugs and nicotine.

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Learn how to say “no.”

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Look at the sources of your stress and see if you can reduce the associated stress.

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Try techniques to reduce your stress, such as massage, relaxation and keeping a journal.

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life events, death of a family member or close friend, previous miscarriage, change of job or home.

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Eat and sleep properly.

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Exercise regularly.

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Boost your support network.

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Allow yourself regular time for leisure.

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Set goals for yourself.

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Pregnancy and Depression Pregnancy is usually a time of excitement and anticipation — but not for everyone. In fact, one in 10 pregnant women experiences depression and may need professional help. How common is depression during pregnancy? While depression can occur at any point during pregnancy, recent information indicates that approximately 7 percent of women experience depression in the first trimester. The rate increases to 12 percent in the second and third trimesters.2

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thoughts of death or suicide

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pain, headaches and stomach problems that do not get better, even after seeing a doctor

What are the symptoms?

What if depression is not treated? Untreated depression can not only keep you from enjoying your pregnancy, it can also interfere with the critical bonding period with your new baby. That can have consequences for you, your baby, your other children, your partner and your extended family. But, most important, untreated depression during pregnancy can also lead to more complicated forms of depression after your baby is born.

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sad, anxious or “empty” mood

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feeling of hopelessness

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feelings of guilt, worthlessness, helplessness

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loss of interest or pleasure in activities you once enjoyed, including sex

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low energy level, feeling “slowed down”

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problems remembering and making decisions

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changes in eating and sleeping habits

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feeling on edge

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British Medical Journal, 2001

Because many of these symptoms are often considered a normal part of pregnancy, it’s important to discuss your thoughts and feelings with your doctor at each visit.

Understand your own emotions; know what to look for and, remember, help is available.

Postpartum Blues ■

What is it? Mild feelings of stress and/or depression, sometimes called the “Baby Blues.”

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Four common myths

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Bonding is automatic.

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Mothers are happy all the time.

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Breast feeding is natural and easy.

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It’s easy to manage your baby by yourself.

How common is it? Temporary shifts in mood may be experienced by 50 to 85 percent of women. Why does it happen? The first two months after giving birth can be very difficult. Everything has changed — your body, your relationships and your daily routine. There are major hormonal changes and new challenges for you and your body. In addition, every day you deal with expectations, myths and anxieties. It can all be overwhelming when you are tired and stressed.

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When does it begin? Usually symptoms occur three to 14 days after delivery.

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What are the symptoms? • mild stress • minimal depression

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How long does it last? Usually from several days to a few weeks, at most.

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Will it go away? Yes, the baby blues generally improve during that time and go away without treatment.

Postpartum Depression ■

What is it? Moderate feelings of stress and/ or depression that may have been experienced in the past.

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How common is it? Eight to 15 percent of women experience postpartum depression.

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Why does it happen? It is thought to be a combination of biological, hormonal, social and psychological factors.

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When does it begin? Usually within three weeks after delivery, the woman feels sad or overwhelmed, and the symptoms will not go away. After three months, 50 percent of women with earlier symptoms will be affected by postpartum depression, and by six months, 75 percent of those women experience problems.

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What are the symptoms? Moderate stress to severe sense of stress, moderate to severe depression lasting at least two weeks with no relief of symptoms during that period.

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How long does it last? It may last from three to 14 months.

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Will it go away? Yes, most women recover within a year.

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Postpartum Psychosis ■

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• hallucinations (seeing, hearing or tasting things that aren’t there)

What is it? This condition can involve moderate to acute stress and/or depression, but is distinguished by sudden exaggerated symptoms, such as not sleeping, hearing voices and seeing things that aren’t there. This condition is an emergency and requires immediate medical attention. How common is it? This is the most rare, but most severe, pregnancy-related mood disorder. It occurs in about one in every 1,000 women who give birth. Why does it happen? It is thought to be the result of a rare combination of biological, hormonal, social and psychological factors that affect a woman who typically has an underlying, inherited tendency to depression. When does it begin? It often comes on suddenly, usually in the first two to three weeks after delivery. What are the symptoms? Although it has many of the same symptoms as postpartum depression, in postpartum psychosis, there are particularly unique, extreme symptoms that include:

• delusions (thoughts that have no truth in reality)

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Tell others how you feel and seek help if you continue to feel stressed or sad.

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Have people around you who are understanding and can listen to you when problems come up.

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Keep all your medical appointments and discuss your feelings with your doctor.

• severe loss of sleep • extreme feelings of being on edge • thoughts of harming yourself or another person • strange and unfamiliar feelings and behavior

Get Help Early

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How long does it last? Symptoms may last a few days or much longer, if untreated.

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Will it go away? Eighty percent of cases resolve within 12 months with treatment.

It’s important to your well-being and the well-being of your baby to review both your emotional and physical health with your doctor at each visit.

REMEMBER: Postpartum psychosis is an emergency condition and requires immediate medical attention.

What Can I Do? ■

Be informed about your condition and the risk factors for pregnant women.

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Work to keep your relationship with your partner a good one.

In addition, it’s important for you to call your doctor if you have any symptoms between visits. Your doctor can help you with any symptoms or worries that come up during this important time in your life. If appropriate, your doctor can recommend other professionals for any help you may need.

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CIGNA 24-Hour Health Information Line

SM

Call us whenever you need us The CIGNA HealthCare 24-Hour Health Information LineSM is always open. Call any hour of the day or night for helpful answers and reliable information on a wide range of health-related topics. Talk to a Registered Nurse Get answers to your health questions, directions to the nearest medical facility or pharmacy, helpful home care suggestions, or help with accessing emergency or urgent care. Listen to audiotapes on health topics Listen to information on topics ranging from injuries and illnesses, to wellness and fitness. Hundreds of topics are available. On the next page, we’ve listed the ones that may be useful to you during your pregnancy and after your baby is born.

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Just call the toll-free number on your CIGNA HealthCare ID card.

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Follow the prompts to the 24-Hour Health Information Line.

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Select the number(s) of the topic(s) you want to listen to.

The CIGNA HealthCare 24-Hour Health Information Line is just one of the benefits of choosing CIGNA HealthCare. And your covered family members can also use this helpful, convenient resource.

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AUDIO TAPE TITLE

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TOPIC NO

PRENATAL

Fertility Drugs Fetal Alcohol Syndrome Genetic Screening Before or During Pregnancy Getting Ready for Pregnancy Infertility In Vitro Fertilization Pregnancy Tests Teenage Pregnancy

4319 5238 5240 5241 4323/5245/ 4603 4322 5271 4341

PREGNANCY AND CHILDBIRTH

Antidepressant Medicines Breast Feeding Breast Feeding Advantages over Formula Feeding Caffeine In Your Diet Choosing a Health Care Provider for Your Pregnancy Chorionic Villus Sampling (CVS) Danger Signs in Pregnancy Diabetes in Pregnancy Diabetes: Food Management Diet During Pregnancy Diet for a Healthy Mouth Drug, Alcohol and Tobacco During Pregnancy Ectopic Pregnancy Episiotomy Exercise During Pregnancy Feminine Hygiene Food Diary Use Formula Feeding Hemorrhoids Labor and Delivery Miscarriage Morning Sickness Nausea and Vomiting Normal Growth of a Baby During Pregnancy Nutrition for Diabetics: Eating Out Nutrition for Diabetics: Food Labels Nutrition for Diabetics: Protein Nutrition for Diabetics: Use of Alcohol Overcoming Fear of Childbirth Preeclampsia Prenatal Care Prenatal Tests

4253 3707 3708 4700 5217 5218 5221 5223 3902/4704 5225 4655 5227 5228 5232 5234 5237 4730 3725 4023 5247 5252 5254 5065 5257 4715 4716 4717 4718 5260 5270 5274 5275

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AUDIO TAPE TITLE

TOPIC NO

AUDIO TAPE TITLE

Ruptured Membranes Sex During Pregnancy Skin Conditions During Pregnancy Smoking and Drug Interaction Smoking During Pregnancy Travel When You are Pregnant Very Small Premature Baby Working During Pregnancy

5277 5278 5281 4272 5282 5287 3784 5296

GENERAL

DAD / PARTNER

Fathering an Infant Infertility Routine Health Care for Men

3722 4603 4672/4609

Alcohol and Health Alcohol Dependence Alcoholism: Information and Resources Anger Management for Parents Anxiety Child Spacing Depression Drug Abuse and Addiction Drug Abuse Resources Drug Interactions Exercise and Weight Control Exercise Reduces Stress Exercise to Stay Healthy

POSTPARTUM

Exercise After Delivery Losing Weight Postpartum Care Postpartum Complications Postpartum Depression Preventing Separation Anxiety Weight-loss Diets

5233 4714 5267 5268 5269 4329 4733

EARLY INFANCY

Cerebral Palsy Childproofing Your Home Circumcision Crying Baby Dental Care for Infants Diaper Rash Eating Basics for Children Fever Management Finding and Choosing Child Care Home First Aid Supplies Immunization Schedule: Children Mothering an Infant New Baby Creates Jealousy Newborn Screening Tests Normal Development 2 weeks to 2 months Normal Development 2 to 4 months Normal Development 4 to 6 months Safety Seats for Children Sleep Patterns in Newborns Speech Development in Newborns to 2 years Spitting Up Sudden Infant Death Syndrome Undescended Testicle

4305 4653 3712 3715 3853 3718 4706 4412 4320 4925 4663 3736 3739 3740 3746 3745 3749 4674 3765 3769 3770 3771 3783

Hazards of Smoking Home Safety Tips Medicines to Have on Hand Medicines: Using Them Safely Obesity Over-the-counter Medicines Parenting Roles Periodontal Disease Personal Fitness Plan Personal Health Management Physical Exam Before Exercise Prescription Drug Abuse Routine Health Care for Women Secondhand Smoke Single Parenting Smokeless Tobacco Smoking: Ways to Quit Stress Stress and Its Effects on the Body Stress Management Stress Management: Deep Breathing Stress Management: Mental Imaging Stress Management: Progressive Muscle Relaxation Talking With Your Health Care Provider The Healthy Diet The Stress of Chronic Illness Twelve-step Programs Vitamins

TOPIC NO

4400 3304 3305 4301 3310 4307 3321 3323 3324 4263 4117 4411 4118/4708/ 4657 3332 4661 4273 4268 4719/4667 4270 4328 3857 4112 4659 4140 3351 4673 4423 4335 3361 3362 4425 4675 4426 4427 4428 4429 4430 4728 4433 3366 4732

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Any reference in this material to other organizations or companies, including their Internet websites, is not an endorsement or warranty of services, information or products provided by those organizations or companies. This information has been provided to you as part of the CIGNA HealthCare Healthy Babies® program. Nothing in this information should be construed as a specific recommendation for medical care or treatment. Always consult your doctor for proper diagnosis and treatment. “CIGNA” or “CIGNA HealthCare” refers to various operating subsidiaries of CIGNA Corporation. Products and services are provided by these subsidiaries and not by CIGNA Corporation. These subsidiaries include Connecticut General Life Insurance Company, Tel-Drug, Inc. and its affiliates, CIGNA Behavioral Health, Inc., Intracorp, and HMO or service company subsidiaries of CIGNA Health Corporation and CIGNA Dental Health, Inc. In Arizona, HMO plans are offered by CIGNA HealthCare of Arizona, Inc. In California, HMO plans are offered by CIGNA HealthCare of California, Inc. In Virginia, HMO plans are offered by CIGNA HealthCare of Virginia, Inc. and CIGNA HealthCare Mid-Atlantic, Inc. In North Carolina, HMO plans are offered by CIGNA HealthCare of North Carolina, Inc. All other medical plans in these states are insured or administered by Connecticut General Life Insurance Company. 594841 03/05

© 2005 CIGNA