Maternal health is the health of women during pregnancy, childbirth, and the postpartum period. For many women, motherhood is a rewarding experience. For others it is a time of ill health and sometimes even death. Direct causes of maternal morbidity and mortality include hemorrhage, infection, high blood pressure, unsafe abortion, and obstructed labor. Many of these deaths can be avoided, as medical interventions are well known. Access to medical care before, during, and after childbirth is essential to the health and well being of each mother.
IDPH Releases First Maternal Morbidity and Mortality Report
On October 18, 2018, IDPH released Illinois’ first Maternal Morbidity and Mortality Report. The report identifies statewide trends in maternal deaths and provides recommendations to help prevent maternal mortality. The report is the culmination of more than a year of work done by two IDPH committees, the Maternal Mortality Review Committee (MMRC), established in 2000, and the Maternal Mortality Review Committee for Violent Deaths (MMRC-V), established in 2015. Committee members aimed to gain a better understanding of the causes of maternal mortality, to develop statewide recommendations to prevent future maternal mortalities, and to determine whether the deaths were pregnancy-associated (occurring within one year due to any cause) or pregnancy-related (occurring within one year due to pregnancy).
IDPH remains committed to identifying and reviewing maternal deaths and morbidities and will build upon these findings and recommendations over the coming years. The subcommittees have started reviewing 2016 maternal deaths in an effort to identify changing trends and areas for statewide improvement with the ultimate goal of preventing maternal mortality.
IDPH Announces the Launch of PrEP4Illinois, the Illinois Pre-Exposure Prophylaxis (PrEP) Assistance Program
The Department is excited to announce the launch of a new PrEP Medication Assitance Program. Please go to www.prep4illinois.com or call the hotline at (800) 825-3518.
Exciting advances in HIV treatment and prevention make pregnancy a safe possibility for women living with HIV. There are ways you and your partner can prevent passing HIV to one another or to your baby. You can take important steps for you and your partner’s health, regardless of your pregnancy wishes.
Oral Health During Pregnancy
Due to hormone fluctuations during pregnancy, Oral health during pregnancy is important! Here are some key facts to know:
Did you know that the flu can be more severe in pregnant women than for women who are not pregnant?
- Changes in the immune system, heart, and lungs during pregnancy make pregnant women (and women up to two weeks postpartum) more prone to severe illness from flu, which could result in hospitalization.
- The flu may also be harmful for a pregnant woman’s developing baby.
- A common flu symptom is fever, which may be associated with neural tube defects and other adverse outcomes for a developing baby.
The flu shot has been shown to protect pregnant women from flu illness. Additionally a flu shot given during pregnancy has been shown to lower risk of flu illness and flu-related hospitalizations in their infants for the first several months of life. The Centers for Disease Prevention and Control (CDC), the American College of Obstetricians and Gynecologists (ACOG), the American College of Nurse Midwives (ACNM), and the American Academy of Family Physicians (AAFP) recommend flu shots for all women who are or will be pregnant during the flu season, as it has been shown to help protect both the mother and the baby for several months from the flu.
Every day actions you can take to prevent the flu include:
- Covering your cough
- Avoid close contact with those who are sick
- Stay home when you are sick
- Proper hand washing
- Avoid touching your eyes, nose or mouth—after you have touched objects that could possibly be contaminated
- Clean/disinfect frequently touched surfaces—at home, school or work, especially when someone is ill
- Manage your stress
- Eat nutritious foods and drink plenty of fluids
If you do get sick with flu symptoms, call your doctor immediately, as early treatment is important!
To learn more about Education on a variety of health topics including immunization that are delivered through text messaging and an app based on the due date or baby's birthday, visit the Text4Baby site: https://partners.text4baby.org/index.php. Appointment reminders and an immunization tracker can be used to support a woman in getting the vaccines she needs for herself during pregnancy and for her new baby.
Is it safe to get a flu vaccination during pregnancy?
Yes! The flu shot is not only safe, it could help to reduce pregnancy problems that can arise from having the flu.
- Millions of flu vaccines have been given for decades, including to pregnant women, with a good safety record.
- Multiple studies have shown that women who receive the flu shot during pregnancy do not have an increased risk for miscarriage.
While a recent study found an increased risk of miscarriage in the 28 days after vaccination for women vaccinated early in pregnancy with a specific flu vaccine two years in a row, the study has been criticized for including a very small sample size.
- This study does not measure the overall risk of miscarriage and does not prove that flu vaccine was the cause of the miscarriage.
- Earlier studies have not found a link between flu vaccination and miscarriage.
- The Centers for Disease Prevention and Control (CDC), the American Academy on Immunization Practices (ACIP), and the American College of Obstetricians and Gynecologists (ACOG) have not changed their recommendations and all continue to recommend flu vaccination for pregnant women.
Click here to learn more about flu vaccine safety and pregnancy:
The Centers for Disease Control and Prevention (CDC, 2017) Flu Vaccine Safety and Pregnancy. Retrieved from https://www.cdc.gov/flu/protect/vaccine/qa_vacpregnant.htm
Information for Health Care Professionals:
Health care providers of pregnant women play a vital role in advising patients on how to protect themselves and their developing babies against flu. Women who reported receiving a provider recommendation for and offer of vaccination, are more than twice as likely to be vaccinated compared with women who received only a recommendation but no offer of vaccination, and six times more likely to be vaccinated compared with women who did not receive a recommendation or an offer for vaccination.
Flu vaccination has been shown to protect pregnant women from flu illness. Flu is more likely to cause severe illness in pregnant women than in women who are not pregnant. The Centers for Disease Prevention and Control (CDC), the American College of Obstetricians and Gynecologists, the American College of Nurse Midwives, and the American Academy of Family Physicians have not changed their recommendations and all continue to recommend flu vaccination for pregnant women.
- The Advisory Committee on Immunization Practices (ACIP) offers guidance for vaccine recommendations in pregnant women. See the "Letter to Providers" from the U.S. Department of Health and Human Services supported by several health care professional organizations who endorse these recommendations: https://www.cdc.gov/vaccines/pregnancy/hcp/guidelines.html
- The CDC offers information on how vaccine safety is monitored post-licensure: https://www.cdc.gov/vaccinesafety/ensuringsafety/monitoring/index.html
- The American College of Obstetricians and Gynecologist (ACOG) offers immunization toolkits, vaccine webinars, clinical practice guidelines, email updates, and patient education resources for prenatal care providers: http://immunizationforwomen.org/providers/resources/acog-resources/default.php
- The American College of Nurse Midwives (ACNM) offers resources for midwives, including downloadable patient education materials with colorful visuals and succinct information on the benefits of immunization during pregnancy: http://www.midwife.org/Immunization-Resources-for-Providers
Antiviral treatment should be initiated as early as possible because studies show that treatment initiated early (i.e., within 48 hours of illness onset) is more likely to provide benefit. However, some studies of hospitalized patients with influenza, including an analysis of hospitalized pregnant women, have suggested benefit of antiviral treatment even when treatment was started more than 48 hours after illness onset.
Decisions to start antiviral treatment should not wait for laboratory confirmation of influenza because laboratory testing can delay treatment and because a negative rapid influenza diagnostic test result does not rule out influenza. Pregnant women are considered to be at higher risk of influenza complications by the Advisory Committee on Immunization Practices, and thus, empiric treatment is recommended. Treatment decisions, especially those involving empiric treatments, should be informed by knowledge of influenza activity in the community.
For more information on antivirals for pregnant and postpartum patients, please visit the CDC: https://www.cdc.gov/flu/professionals/antivirals/avrec_ob.htm
Additional CDC Resources for Providers:
- Seasonal Influenza Vaccination Resources for Health Professionals: https://www.cdc.gov/flu/professionals/vaccination/
- Infection Control in Health Care Facilities: https://www.cdc.gov/flu/professionals/infectioncontrol/index.htm
- Clinical Description & Lab Diagnosis of Influenza: https://www.cdc.gov/flu/professionals/diagnosis/index.htm
- Free Flu Materials: https://www.cdc.gov/flu/resource-center/freeresources/index.htm
- Influenza Training: https://www.cdc.gov/flu/professionals/training/index.htm
- References and Resources: https://www.cdc.gov/flu/references.htm
- Flu Activity & Surveillance: https://www.cdc.gov/flu/weekly/fluactivitysurv.htm
- Vaccine Storage & Handling: https://www.cdc.gov/vaccines/hcp/admin/storage/index.html
- Seasonal Flu vaccine information/Vaccine Composition: https://www.cdc.gov/flu/about/qa/flushot.htm
- Materials that can be used to educate patients: https://www.cdc.gov/vaccines/ed/patient-ed.html
Text4baby is a free mobile health information service for pregnant women and new parents with infants under the age of 1 year. Appointment reminders and an immunization tracker can be used to support a woman in getting the vaccines she needs for herself during pregnancy and for her new baby.
- Text4Baby Training Center: https://partners.text4baby.org/index.php/get-involved-pg/partners/training-center