<p>David Miranda:<br />Welcome back to VNA Today. I am your host David Miranda, and this week, we are focusing on pregnancy care and how to keep that mom and the baby healthy as well. I had the privilege to speak to VNA's nurse practitioner, Cristina Messina, and she gave us a lot of advice.<br /><br />Cristina Messina:<br />Getting early prenatal care is probably the biggest, biggest, important step I'm starting off with. So, the doctor or nurse practitioner will confirm the pregnancy. They will also screen out other chronic conditions like diabetes or high blood pressure. Then they will see you throughout the pregnancy, and then immediately afterwards.<br /><br />David Miranda:<br />So, if you have an at-home test, do you still have to go visit a doctor?<br /><br />Cristina Messina:<br />Yes. It's a good step to have the doctor or nurse practitioner confirm the pregnancy, and it's needed for a lot of health insurance plans. So, a lot of uninsured women are eligible for Medicaid, but that's only when the pregnancy is confirmed.<br /><br />David Miranda:<br />So once a mom finds out she is pregnant, walk us through the first, second step. What do they do?<br /><br />Cristina Messina:<br />So the first step would be, make an appointment with their doctor or nurse practitioner. They do an exam, a physical exam. They also do routine blood tests. And, they send you for an ultrasound to date the pregnancy.<br /><br />David Miranda:<br />So with prenatal care, is there something, before you even plan to get pregnant? What are the steps? Guide us through that.<br /><br />Cristina Messina:<br />Yes. So it's essential to start a prenatal vitamin, even before you try to conceive. So usually, we recommend that people start three months, even before they start to get pregnant. It has folic acid in it, which can help prevent spinal defects in the baby.<br /><br />David Miranda:<br />So what other top tips would you give pregnant women?<br /><br />Cristina Messina:<br />So, eliminate alcohol. If you were drinking prior to the pregnancy, it's a good idea to avoid that. Also, limit your caffeine intake.<br /><br />David Miranda:<br />Good thing you mentioned that, because I have heard that, when they're pregnant, women are pregnant, they can have a little bit of red wine. Is that true?<br /><br />Cristina Messina:<br />No. Unfortunately, that's not true. After the baby's born, they can, but not during the pregnancy.<br /><br />David Miranda:<br />A pregnancy is a beautiful thing, because I even see a glow on women when they're pregnant. They change.<br /><br />Cristina Messina:<br />Yes. Yes. There's a lot of pregnancy hormonal changes that can happen in a pregnancy. So yes, that can happen.<br /><br />David Miranda:<br />Many, many changes, mood swings and cravings as well, right?<br /><br />Cristina Messina:<br />Yes. Yes. So yes, some women do crave unusual things. For my pregnancy, I actually craved a lot of spicy foods. So, for everyone, it can be a little bit different.<br /><br />David Miranda:<br />What about moving? Exercise?<br /><br />Cristina Messina:<br />So, exercise is important. A lot of women, unfortunately, don't get enough exercise, so we recommend at least five days a week, 30 minutes each time. Walking is probably the most important thing to do and the easiest for a lot of women. So, you can do that. That can help with a lot of pregnancy discomforts.<br /><br />David Miranda:<br />I was talking to my producer, and she says that some women should be visiting their dentist during pregnancy.<br /><br />Cristina Messina:<br />Yes. Yes. It's very important. A lot of women don't know that, that it's very, very essential, important during pregnancy. There's a lot of hormonal changes that can happen. There's a lot of more gum inflammation that can lead to swollen and bleeding gums. So, it's very, very essential to start getting those regular dental visits during the pregnancy.<br /><br />David Miranda:<br />Cristina, thank you so much. Any last tips before we head out?<br /><br />Cristina Messina:<br />Just for the pregnancy, just try, like I said, to avoid certain things that are harmful in the pregnancy. Once you do find out you're pregnant, like I said, it's very, very important to start prenatal care early.<br /><br />David Miranda:<br />Now that we know how to keep mom and baby healthy, next is the birth plan. But before that, I want to give a special thank you to the Dunham Foundation for their grant and support for the VNA's Benefit Assistance Program. There's a free program that helps people in the community enroll in health insurance, including Medicaid, Medicare or the ACA Marketplace. Women who have a medically-verified pregnancy may qualify for Medicaid. VNA can help with the process, when a woman comes into the office and does a free test to confirm her pregnancy. Here are some tips from VNA's midwife, Stephanie Waggoner.<br /><br />Stephanie Waggoner:<br />My name is Stephanie Waggoner. I've been working at the VNA for about six and a half years. Recently, I started to work as a midwife. Previously, I was a women's health nurse practitioner.<br /><br />Stephanie Waggoner:<br />A midwife is someone who helps deliver low risk and uncomplicated deliveries. We manage pregnancies and we also manage women throughout the lifespan, so we do pap smears and routine visits, birth control visits, things like that.<br /><br />Stephanie Waggoner:<br />Although birth plans are not 100% required, we do recommend having a list of things that you would want during your delivery. And you can find helpful resources online, so different type of templates and things like that. But really, it's important to just list the types of things that are important to you in your birth plan.<br /><br />Stephanie Waggoner:<br />My first tip would be to attend a prenatal class, just so you can have an idea of things to expect during birth, different types of things that you want to include in your birth plan. As a mom is, who's going to join you on this journey to motherhood. Something that you want to include in your birth plan is who you absolutely want at your birth. So, whether it's a partner or your husband, or someone that you want to include in your delivery. And then also, if there's anyone that you absolutely don't want in the delivery room at the time of delivery is very important.<br /><br />Stephanie Waggoner:<br />So something else to include in a birth plan is your relevant medical history, so things like allergies, medications you're taking, any significant medical problems you may have. We do try to send all of the prenatal records over to the hospital, but just in case something doesn't go according to plan, we do recommend having that included in your birth plan.<br /><br />Stephanie Waggoner:<br />A big topic that people want to discuss in their birth plan is definitely pain control. So, you know your pain tolerance as a mom, and I think, knowing what you are planning to do for pain control is very important. So, whether it's an epidural, whether it's IV pain medication, whether it's using the shower to kind of help with pain, even getting in the tub, water therapy, things like that, those are all things that you can include in your birth plan.<br /><br />Stephanie Waggoner:<br />Things don't always go according to plan, so it's really important to also know that you may need a C-section, you may need an episiotomy, but it's really important to trust your provider in those moments, and kind of understand that they have your best interest at heart.<br /><br />Stephanie Waggoner:<br />As providers, we're here to support you, so we want you to have as much control over the situation as possible, which is why we want you to include all of these details in your birth plan, just so that we can help you and empower you to make the decisions that you want to make as a mom..<br /><br />Ana Mendez:<br />[foreign language 00:06:52].<br /><br />David Miranda:<br />[foreign language 00:10:21] David Miranda.</p>