Arizona is HOT, especially in the summer. I knew this when I moved to Tucson almost a decade ago. Since then, I have had two pregnancies while living in Arizona. I was lucky not to have to spend the last weeks of pregnancy and first weeks with my newborn in the summer heat.

Of course, Arizona is not the only place experiencing hot weather. 2023 was the planet’s warmest year on record, according to the National Oceanic and Atmospheric Administration. Temperature records have already been broken in 2024, and extreme heat is becoming more commonplace. It is important to understand how extreme heat can affect health in the general population, and for us at MotherToBaby, how high temperatures can specifically affect people who are pregnant. For more insight on this issue, we turned to Dr. Christina Han with our partner, the Society for Maternal-Fetal Medicine.

What is extreme heat?

Extreme heat has been defined as “a period of high heat and humidity with temperatures above 90 degrees for at least two to three days.” (Ready.gov). According to Dr. Han, ”extreme heat can lead to health issues for anyone, including heat rash, sunburn, heat cramps, heat exhaustion or heat stroke. These environmental changes also increase the rates of violence and exposure to pollution.  Some groups of people are more likely to be affected by extreme heat, including people who are pregnant.”

What is hyperthermia?

Hyperthermia is a rise in body temperature that happens when the body absorbs more heat than it releases. One of the most common causes of hyperthermia is heat stroke. Fever, extreme exercise, or use of hot tubs or saunas can also increase the chance of hyperthermia.

Being pregnant during extreme heat can increase the chance of developing heat stroke, heat exhaustion, or other heat-related illness. In extreme heat, the body has to work harder to keep cool for two. When the body is unable to cool itself properly, there can be an increased chance of hyperthermia.

What are the concerns with extreme heat and pregnancy?

Studies have reported a small increased chance for neural tube defects (NTDs) in babies of people who had high fevers lasting 24 hours or longer  before the 6th week of pregnancy.  A few studies have reported a small increased chance for other birth defects when fever or hyperthermia happen in early pregnancy, especially if the fever is untreated. Other studies have not found a higher chance for birth defects when a person experiences hyperthermia early in pregnancy.

People who are pregnant also need to drink more water to avoid dehydration. Chronic dehydration can affect pregnancy outcomes. One study suggests that chronic dehydration can affect newborn weight, length, and head and chest circumference. Some studies have reported associations between high temperatures during pregnancy and a higher chance of preterm birth, low birth weight, and stillbirth.

What are some signs of heat-related illness?

Heat stroke: Body temperature of 103°F or higher; hot, red, dry, or damp skin; headache; confusion, dizziness; nausea; passing out.

Heat exhaustion: Heavy sweating; cold, pale, and clammy skin; nausea/vomiting; dizziness, headache, muscle cramps; tiredness/weakness; passing out.

Heat-related illnesses can sometimes be an emergency. Anyone who thinks they are having a medical emergency should seek care right away. For more information on when to seek medical help, visit the Centers for Disease Control and Prevention (CDC) page here: https://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html.

Dr. Han also shared some general tips for dealing with extreme heat during pregnancy:

• Stay cool as much as possible, both indoors and outdoors
• Avoid peak sun hours if you must be outside
• Avoid or minimize strenuous activities
• Wear appropriate clothing such as hats and loose lightweight clothing
• Avoid alcohol and limit caffeine
• Wear sunscreen
• Use caution when engaging in strenuous activities; be sure to take breaks, drink water, and get plenty of rest.
• Check the local news for heat warnings and health/safety tips

Find more information from CDC on preventing heat-related illness here: https://www.cdc.gov/extreme-heat/prevention/index.html.

Dr. Han’s final tip: Don’t forget to talk with your provider! “Your healthcare provider can help you find resources and ways to protect yourself and your family. Managing exposure to extreme heat is important for everyone’s health, including those who are pregnant.”

MotherToBaby specialists are also available to talk with you about exposures before or during pregnancy. Best of luck staying cool out there!

“I am so overwhelmed with all information available online nowadays about pregnancy and having a baby, I don’t know how to know what is best for me and my pregnancy!” shared Michelle, who was 15 weeks into her first pregnancy. Not only has the first trimester been full of morning sickness, but she has been obsessed with reading all the latest advice regarding healthy pregnancies and newborn care. This led Michelle to reach out to MotherToBaby’s confidential and free text service asking about prenatal vitamins, but she also wanted to know what other resources were available for first time parents.

As a MotherToBaby specialist, I knew the perfect resource to direct Michelle to: Nurse-Family Partnership. Elly Yost, a nurse practitioner with over 35 years of experience explains how this evidence-based, community health program can help first-time moms and their children affected by social and economic inequality.

Moms enrolled in the Nurse-Family Partnership program benefit by getting the care and support they need in order to have a healthy pregnancy. At the same time, families develop a close relationship with the nurse who becomes a trusted resource they can rely on for advice on everything from safely caring for their child to taking steps to provide a stable, secure future for their new family. Find out more about Nurse-Family Partnership here.

Q: What does the relationship look like between an NFP nurse and parent-to-be?

Elly: The relationship between an NFP nurse and a parent-to-be is built on trust and support. We prioritize the client as the expert in their own life, ensuring that their desires and needs guide our approach to supporting a healthy pregnancy. Our role is to meet them where they are and provide the tailored support to navigate this transformative journey effectively.

Q: What health benefits might a person experience from participating in the NFP Program?

Elly: Participating in NFP can yield a range of health benefits for first-time parents. Through regular health assessments conducted by a registered nurse (RN), participants receive personalized health screenings aimed at promoting overall wellness. This holistic approach not only addresses the immediate health needs of the parent but also extends to the well-being of their child. By closely monitoring factors such as blood pressure and weight gain, NFP nurses work with expectant mothers to identify and understand potential danger signs, such as swelling or headaches, that may indicate underlying health concerns.

Recognizing that pregnant women are the experts on their own bodies, NFP empowers them with knowledge and support to recognize and address anything that seems concerning. We learn about each person’s health history to customize care to their needs.

NFP nurses also regularly check on the baby’s growth and development after birth by measuring length, weight, and head circumference, along with developmental milestones using Ages and Stages Questionnaires®. We look at what the parent and child need emotionally and socially, understanding how their health is linked and creating a caring environment for them to bond.

Q: Why does the Nurse-Family Partnership model work?

Elly: The NFP model is proven to work because it prioritizes the needs and desires of the parents it serves. By adhering to client-centered principles, we believe in listening to each first-time mom we work with because we know she’s the one who knows her life best. We’ve seen that even small changes can lead to big, positive results, so we focus on finding solutions together.

One big part of what we do is making sure moms feel heard and supported. We talk with them about how they’re feeling during pregnancy, understanding that it’s normal to have all kinds of emotions during this time. We’re here to offer guidance and reassurance, helping them navigate any worries they might have.

Our team of RNs is crucial to our work. With their education and experience, they provide moms with the best information and support possible. They’re here to make sure every mom gets the care and guidance she deserves on her journey.

Q: How long does the relationship between the NFP and the family last?

Elly: Something unique about the role of an NFP nurse in the partnership with moms is the duration of the relationship. Families have the freedom to stay connected with their NFP nurse until their child turns two. This extended period allows for a deep and meaningful relationship to develop between the nurse and the parents, fostering trust, support, and continuity of care throughout the critical early stages of the child’s development. This extended duration underscores the uniqueness of the bond formed within the NFP partnership, reflecting a commitment to long-term support and empowerment for both the parents and their child.

Q: How does the role of an NFP nurse change after a baby is born?

Elly: After a baby is born, NFP nurses adjust their role to support the special bond between the mother and her newborn. While the basics of care stay the same, the focus now extends to the dyad and family unit. The nurse’s attention is directed towards both the individual needs of the mother, developmental milestones, well-being of the newborn, and the family.

Despite this adjustment, the core role of the nurse as a source of guidance, advocacy, and support for the mother persists, ensuring that she continues to receive personalized care and attention throughout her journey into motherhood.

Q: How do NFP nurses support first time parents’ mental health?

Elly: NFP nurses play a crucial role in supporting the mental health of first-time parents through a combination of clinical expertise, compassionate care, and advocacy. From a clinical perspective, nurses conduct thorough assessments for depression and anxiety. Additionally, nurses assess the temperament and emotions of mothers, providing tailored support and referrals based on individual needs and preferences.

What sets NFP nurses apart is their dedication to building trusting relationships and providing personalized care. They invest time in getting to know each client, fostering a supportive environment where parents feel comfortable expressing their concerns and emotions. This level of care and observation allows nurses to offer not only clinical support but also emotional reassurance and guidance.

NFP nurses also act as advocates, guiding parents through the healthcare system and connecting them with resources for mental well-being. By addressing both the clinical and emotional aspects of mental health, NFP nurses empower first-time parents to navigate the challenges of parenthood with strength and confidence.

Q: What would you like to see improved about the current state of pregnancy and/or post-birth care?

Elly: I think one area for improvement in current pregnancy and post-birth care is the practice of listening and truly hearing the experiences and concerns of expectant and new parents. For example, the ‘Hear Her’ campaign by CDC highlights the importance of this simple yet profound concept: actively listening to pregnant and postpartum people and believing them.

By taking the time to genuinely hear and understand the needs and perspectives of clients, healthcare providers can foster trust, enhance communication, and deliver more patient-centered care. Empowering women to share their stories and validating their experiences can lead to improved outcomes and a more supportive healthcare environment for all.

Q: What is additional guidance you would give a first-time parent?

Elly: Additional guidance I would offer to first-time parents is simple yet powerful: You’re doing a great job! Love for your child is the cornerstone of effective parenting. Embrace the idea of ‘good enough parenting,’ where you do your best without feeling pressured by unrealistic standards. In a world full of advice and expectations, what matters most to your child is your love and care. Trust your instincts, show them love, and believe in your ability to navigate parenthood’s journey. If you are a first-time mom who is 28 weeks pregnant or less, you can find a free, personal NFP nurse in your area here.

NFP Is Here For You!

After sharing the resources of NFP with Michelle, she texted back the next day saying “Thank you! I read through their website and this is exactly what I need to make me feel confident in my decisions during the rest of my pregnancy and have someone to help me during the early days of parenthood. I already enrolled in the program and hope to get started soon.” It is so lovely to hear that NFP was exactly what Michelle needed, and I hope that she and other first-time parents continue to benefit from this resource for years to come.

Back when Zika swept the western hemisphere, the travel recommendations for women who were pregnant or planning a pregnancy were clear: avoid any areas that had a risk of Zika infection. It was fairly easy to know where those areas were, as governments and public health organizations around the world worked tirelessly to identify and report cases. World maps showing areas of risk provided clear “yes/no” guidance. Was there any doubt about who shouldn’t travel where? Not really. Not back then.

But what about now? The number of reported Zika cases has fallen dramatically in recent years. However, the accuracy of reporting can vary widely from country to country, so the once-clear world map of Zika risk now appears much less well-defined.

One of the most common Zika-related questions we still get at MotherToBaby is, “How likely is it that I’ll get Zika if I travel to Country X?” (Or a variation of the same: “We went to Country X. Do we really need to wait 3 months before we try to get pregnant?”) One resource to help answer that question is the interactive world map maintained by the Centers for Disease Control and Prevention (CDC) to illustrate areas with Zika risk. Visit the map now and you’ll find four colors, each indicating a different level of Zika risk and the corresponding recommendations for pregnant women, their partners, and those who are planning pregnancy.  Let’s take a look at what each color means :

• Red areas have active Zika transmission. Travelers to red areas are at risk of Zika infection.
  • Pregnant women and their partners should avoid all unnecessary travel to red areas.
  • Couples and individuals who travel to red areas should wait at least 2 months (women) or 3 months (men) before trying to get pregnant, and have only protected sex during that wait time.
• Purple areas have had active Zika transmission sometime in the past, and there could still be sporadic cases. Travelers to purple areas might be at risk of Zika infection.

Pregnant women, their partners, and those who are planning pregnancy are encouraged to talk with their healthcare providers to make decisions about travel to purple areas. Careful consideration should be given to the risks and consequences of Zika infection in pregnancy, the nature of their travel, how much potential risk they are willing to accept, how soon they want to get pregnant (if they are not already), and any other factors specific to that individual or couple at that time.

• If pregnant women or their partners decide to travel to purple areas, they should take steps to minimize risk, including using insect repellent and considering the use of condoms for the rest of the pregnancy.
• Women planning pregnancy who travel to purple areas should also take steps to minimize risk, including using insect repellent and considering following recommended wait times before trying to get pregnant (2 months for women, 3 months for men).

There is a sub-category of light purple, which shows higher elevations above 6,500 feet where mosquitoes that can transmit Zika don’t usually live. The chance of getting Zika in light purple areas is very low. However, be sure to consider if your travel plans would take you through dark purple areas on the way to these lighter purple zones.

• Yellow areas have mosquitoes that can transmit Zika, but have not had reported cases of Zika transmission. Travelers to yellow areas are at low risk of Zika infection.
  • All travelers to yellow areas should take precautions to prevent mosquito bites.
• Green areas do not have mosquitoes that can transmit Zika and have not had any reported cases of Zika transmission. Travelers to green areas are not at risk of Zika infection.
  • There are no Zika-related travel recommendations for green areas.

Given that many countries are included in the purple category, how does this map help you know what your risk really is if you travel to a purple area? The answer is that it doesn’t. Purple only tells you there is some level of risk. Here’s why purple—and we at MotherToBaby—can’t be more specific:

• Reliable data for every country around the world simply does not exist.Since Zika virus is no longer considered a public health emergency, many resources that once helped support global data collection have moved on to other, more pressing issues.
• The level of risk within a purple country could change without us knowing right away.The ability of any country to quickly identify and report cases depends on resources, logistics and other factors. This means there could be delays in detecting and announcing any new outbreaks.

The bottom line is that our post-Zika-epidemic world requires that we take the health of current and future pregnancies into consideration when planning travel. Ask ourselves how much potential risk we are willing to accept when we book our vacations and business trips. Does that mean that couples and individuals who want to have children should never go to areas that ever had Zika? Not at all! But if they are currently pregnant, or are not willing or able to effectively prevent pregnancy for at least 3 months after traveling, they might prefer to visit one of the many areas where there is no known risk of Zika. (Think yellow! Think green!)

MotherToBaby is here to answer your questions about Zika or other exposures before or during pregnancy. Happy travels!

I can’t begin to describe how organized I was during the holiday season when I was pregnant with my first child. Since I was pretty far along (5 months), I wanted to make sure each gift was chosen way ahead of time, I knew how long it would take me to get the food trimmings just right and whether I should emphasize red or green in my decorating scheme. All of this had to be done before that “pregnancy brain” I had heard so much about set-in. Little did I know, the most important items on my holiday to-do list weren’t sitting on store shelves or mixed in with the tinsel and mistletoe.

Years later, as a teratogen information specialist for MotherToBaby, I realized some of the best gifts for a healthy pregnancy didn’t come with ribbons and bows, but from awareness and education! For example, did you know the holiday buffet table could include foods that could potentially cause harm to a developing baby? Or, if not careful, decorating could put a pregnant woman in a dangerous situation? Today I encourage pregnant women to master must-know safety tips long before putting together must-have gift lists this season. Here are a few of my tips:

Tip 1. Importance of Getting Vaccinated

It is recommended that pregnant women have a flu vaccine in every pregnancy and be current on Tdap vaccine and Covid 19 vaccines.  Women who are 32-36 weeks pregnant are currently eligible for the RSV vaccine https://mothertobaby.org/fact-sheets/rsv-vaccine/. This vaccine can pass protection to the developing baby, helping lower the chance of severe RSV infection once the baby is born.  

Not only should a pregnant woman be up-to-date on vaccines, but anyone older than 6 months of age who will be around a newborn should be vaccinated.

Tip 2. Choose Wisely at the Buffet Table

Drinks like eggnog and spiced cider may contain alcohol https://mothertobaby.org/fact-sheets/alcohol-pregnancy. If you’re not sure what’s s in a beverage, ask the host. Also, avoid soft cheeses made from unpasteurized milk, as they may contain bacteria that can cause a serious illness for a developing baby called Listeria https://mothertobaby.org/fact-sheets/listeriosis-pregnancy, as well as increased risk of miscarriage, uterine infection, or premature labor. Meats like cocktail franks and pâté can also contain bacteria. Meats need to be thoroughly cooked so that bacteria are killed.

Tip 3. CMV (cytomegalovirus) May Be Lurking

CMV is a common virus that often has no symptoms. If a pregnant woman gets CMV https://mothertobaby.org/fact-sheets/cytomegalovirus-cmv-pregnancy, the baby could be at increased risk for hearing loss, developmental delays, or birth defects. To prevent infection, pregnant women should wash hands after changing diapers, feeding children, wiping children’s noses, or handling children’s toys. Also, avoid sharing food, eating utensils, toothbrushes, and pacifiers with children.

Tip 4. Holiday Decoration Safety

Some artificial trees, strings of lights, and ornaments may contain lead. Use gloves or wash hands after handling decorations to reduce exposure. Because of changes in their center of gravity, pregnant women should stay off ladders and let others decorate the hard-to-reach places.

Tip 5. Manage Anxiety and Depression

Having a ‘happy holiday’ can mean lots of stress, especially when pregnant.  Anxiety https://mothertobaby.org/fact-sheets/anxiety-fact to have that perfect holiday is real. Depression https://mothertobaby.org/fact-sheets/depression-pregnancy can be triggered this time of year as well.  Don’t hesitate to ask for help if you are feeling overwhelmed with all the gift giving and holiday activities.  Stay in-touch with your healthcare providers because…. help is available!

I hope these tips are helpful. While my son did end up turning out to be just fine, I think I would have caused myself less stress and worry had I known these tips during my pregnancy. If you have questions, don’t hesitate to reach out to MotherToBaby by phone, text, chat or email.

On behalf of all of us at MotherToBaby, here’s to wishing you a happy and healthy holiday!

Why Donate to MotherToBaby?

MotherToBaby/OTIS specializes in answering questions about the benefits and risks of medications, vaccines, maternal health conditions, and other exposures during pregnancy or breastfeeding. We assist mothers, families, and healthcare professionals by text, chat, phone, and email in both English and Spanish. We can provide these services and our online educational resources because of supporters like you.

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How to Support OTIS and MotherToBaby

Your generosity ensures that we can provide our services at no cost, which especially benefits those families who might otherwise not be able to afford or access care. We have many ways to become involved and support our mission to provide information about exposures in pregnancy and lactation and address disparities in maternal and infant health.

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Ally Program | Raising Awareness for Healthy Babies

MotherToBaby’s overarching goal is to enable informed decision making by effectively communicating accurate, up-to-date, evidence-based information about the effects of exposures during pregnancy or while breastfeeding, leading to a reduction of preventable birth defects and other adverse outcomes. Become an ally for healthy pregnancy and lactation. Read our Ally prospectus and learn more about how you can support MotherToBaby’s important information initiatives.

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1% Campaign | Creating a Legacy. Funding the Future.

Creating your legacy through gift planning with OTIS/MotherToBaby will generate financial resources necessary to sustain research and counseling needed for healthy pregnancies and lactation into the future. We created the 1% Campaign to encourage supporters to include OTIS/MotherToBaby in their estate planning.  Our inaugural member, Al Romeo, explains why it was a good fit for him.

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Give To Our Scholarships | Make a Difference.

Kay Padgett Scholarship: Support OTIS Members in Attending Educational Meetings

Kay Padgett was the administrator of the Reproductive Toxicology Center when it was first conceived in the early 1980s. She was instrumental in getting REPROTOX off the ground and in keeping it running. She was a librarian by training and established search algorithms for REPROTOX that were subsequently adopted by the National Library of Medicine. It was typical of Kay to keep working even after being challenged by the disease that ultimately took her life. When it was clear to her that she would not survive, she helped us design automated systems. Because Kay was so devoted to the teratology information community, we could think of no better memorial than a scholarship to assist OTIS members in attending educational meetings.