1. Healthy Before Pregnancy
March of Dimes
NC Preconception Health Campaign
These slides contain notes, speaking points, and other activities to enhance the lesson. Words written in Times are meant to be read aloud. All other notes are for your reference, and may be read aloud if desired.

2. Reproductive life planning: Lesson Plan 5

3. What’s your plan?
The possibility of having a baby is way off in the future
Having sex but not ready for kids?
Already a parent but think more children might fit into your plan?
Never want to be a parent?
Which question or questions fit you best?
Notes:
Students may feel like they fit into multiple categories, at different times in their lives. Some students may think that pregnancy/parenthood can’t happen to them, so it’s something interesting for them to consider.

4. Have you heard of…. Pregnancy intendedness? What could that mean?
Pregnancy intendedness means that a pregnancy was planned for.
About half of all U.S. pregnancies are unintended. For adolescents that number is even higher.
Out of all 50 states, with #1 being the state with the highest number of teen pregnancies, where do you think NC ranks?
Ninth
How many teens do you think become pregnant each year in NC?
More than 19,000 North Carolinians between the ages of 10 and 19 get pregnant each year.
And while our rates have improved over the past two decades, we cannot deny the profound effect that teen pregnancy has on communities, future generations and the teens themselves.
Here is the problem...research shows that most young adults agree that pregnancy should be planned, but they are not taking adequate measures to prevent pregnancy or STIs.

5. Unintended pregnancies: What’s the big deal?
Women are more likely to have:
Babies that are too small
Babies that die before their first birthday

6. Unintended pregnancies: What’s the big deal?
Women are less likely to:
Be taking a daily multivitamin
Seek prenatal care in the first trimester
Be healthy during pregnancy
Breastfeed their babies
Taking a daily multivitamin with folic acid can prevent neural tube defects, birth defects of the brain and spine.

7. What is a Reproductive Life Plan?
Part of an overall LIFE plan
Determining when (and if) having children fits into your life plan
Taking steps to achieve optimal physical health, emotional well-being and financial independence and stability PRIOR to starting a family

8. Your overall LIFE plan What are your personal goals? Education Job
Romantic partnership
Friends
Life experiences
Values

9. If and when… Do you want to become a parent at all?
If yes, at what age?
If yes, what other accomplishments do you want to have achieved first?
If yes, what would you like to have in place first?

10. If and when…
If you want to be a parent at some point how many children would you like to have?
How far apart would you like your children to be spaced ?
Activity:
Ask students to write these answers down and draw a simple timeline. Now ask them to reflect back on the personal goals slide. Ask them to insert these achievements into the same timeline thinking through factors such as financial means, how long it takes to secure a degree and become proficient in a career.
Notes:
Most experts recommend that women should wait at least 18 months after the birth of their child before getting pregnant again. Waiting 18 months gives women’s body the time it needs to fully recover from the last pregnancy. It also helps prevent health risks for future pregnancies, like premature birth or having a low-birthweight baby. Spacing pregnancies too close together also has been associated with sudden infant death syndrome (SIDS). Frequent pregnancies can have an impact on the mother's health.
However, for people planning to have more than one child, it's best to wait no more than five years between pregnancies.

11. Teen mothers have...
Increased risk of premature and low birth weight babies
Higher rates of infant death (babies dying)
Higher rates of smoking
Less access to prenatal care
Higher risk of premature labor, anemia and high blood pressure
Less education and higher rates of poverty
Delaying having kids can give your future family a healthier start.

12. Teen pregnancy in NC
58.6 out of every 1,000 teen girls ages 15 to 19 became pregnant in 2008
Minority teens at higher risk
Hispanic teens at especially high risk
Teens in rural counties are at higher risk than urban
While teen pregnancy rates declined across the board, significant disparities still exist between racial and ethnic groups and between rural and urban residents.
Notes:
Source: NC Department of Health and Human Services
The pregnancy rate among white teens was 47.8 per 1,000 girls, while the corresponding rate for minority teens was The rate for Hispanic teens was North Carolina’s underserved rural counties typically saw higher rates of teen pregnancy. (Source: NCAPPC news release)

13. Don’t be in the “Fog Zone”
Align your plans for pregnancy and family with your sexual choices
What is the Fog Zone?
It’s the foggy place many young adults and adolescents find themselves, where they are not actively intending to become or cause a pregnancy, but they are not doing enough to prevent pregnancy either. In other words, if you are not actively intending to become pregnant, then you should be abstaining from sex or using consistent, reliable contraception (or better yet, dual method contraception).

14. Getting ready: Physical health
Take a multivitamin with 400 micrograms (mcg) of folic acid every day
Get wellness checkups every year and regular dental checkups
Eat healthy food, maintain a healthy weight and get/stay fit
The physical health of the mom and dad before pregnancy affect the health of their future baby. For females, there are specific things you can do to help your baby even before you’re pregnant.

15. Getting ready: Physical health
Understand the risks of certain prescription drugs if you were to become pregnant
Stop smoking and avoid secondhand smoke
Stop drinking alcohol
Don’t use illegal drugs

16. Getting ready: Physical health
Use safe sex practices (ie: condoms) to avoid sexually transmitted infections because some can harm a fetus
Avoid hazardous substances and chemicals
Talk to you health care provider about your family history, genetics and birth defects
Find healthy ways to manage stress
The best way to reduce your risk of getting pregnant or contracting a sexually transmitted infection (STI) is to abstain from all types of sexual activity. If you are sexually active, always use condoms when not intending to become pregnant to protect yourself against STIs that could harm your future baby and even your ability to get pregnant.

17. Getting ready: Emotional well-being
Do you want to have a baby? 
How will a child affect your relationship with your partner? Are you both ready to become parents?
If you’re not in a relationship, are you prepared to raise a child alone? Who will help you?
Being a parent is a full-time job. Before you get pregnant, think about the emotional and lifestyle issues you will face as a parent. It’s important for you and your partner to agree on most of the major issues, or begin discussing your differences, before you become pregnant. Only you can decide if you're emotionally ready for a baby.
Ask yourself:
Are you in a committed, loving, safe relationship that is not abusive?
Do you want to have a baby or is your partner, parent or someone pressuring you?

18. Getting ready: Emotional well-being
How will a baby affect your education or career plans?
Do you and your partner have religious or ethnic differences?
What will you do for child care?
Are you prepared to parent a child who is sick or has special needs?
Do you think your answers to these questions might be different in another 10, 15, or even 20 years?

19. Getting ready: Emotional well-being
Are you ready to give up most of your free time to care for a child?
Do you enjoy spending time with children?
What do you want for your child?
Are you ready to give up sleeping late on weekends? Or find child care when you want to go out without your baby?
Can you see yourself as a parent?
What did you like about your childhood? What didn’t you like?

20. Getting ready: Financial independence
Are you financially independent?
Do you have a steady income and health insurance?
Can you provide the type of home, transportation, food, clothes, diapers, etc. that a baby needs?
What about childcare?
Different people have different ideas about what being financially ready to start a family means. Some people would like to have purchased a home and vehicle, have years of steady employment with health insurance, and savings (retirement, college) in place. Some people like to have a “nest egg” saved, a sum of money set aside. Others are comfortable starting a family living paycheck to paycheck, perhaps even with public assistance. What would work best for you?
Optional points/questions:
Does your employer (present or future) provide maternity/paternity leave?
Check your health insurance. Does it cover medical care for you during pregnancy and for your newborn baby?
Review or purchase long-term disability and life insurance coverage.
Check out special benefits that you may qualify for such as Medicaid and the WIC program.

21. Getting ready: Financial independence
Babies and kids are expensive—Child care, food, clothing and doctor’s appointments add up!
Please raise your hand if you can see yourself becoming a parent at some point in your life? Now give a moment of thought as to what kind of life you would like to be able to give your child or children. Beyond diapers, child care and health insurance costs, research tells us that mature, sound family structures are what children need to thrive.

22. New social norm
Unless you are seeking pregnancy and are committed to the years that it takes to raise children, take active steps to prevent pregnancy now
Magical thinking happens when you don’t think certain things apply to you. Magical thinking can cause unintended pregnancies.
Research tells us that most young adults think that they know a lot about contraceptive choices, but in reality there is a lot of confusion. Educate yourself through resources at school, your community and reputable websites.
Learn about:
the various types of contraception and their varying levels of effectiveness
the difference between long acting and short term methods
how each method works
how to use each one correctly
what to do if a problem arises
what the additional benefits are from various methods
what the risks and possible side effects are from each method
which ones prevent STIs and which ones do not
Bottom line: have a strategy! Magical thinking can lead to unintended pregnancy.

23. New social norm
Young men should take a leadership role in their romantic relationships to prevent pregnancy if a pregnancy is not fully intended at that time
Young men need to learn about human anatomy, reproduction, fertility, sexuality, pregnancy and pregnancy risk, STIs, and contraception just as much as women do. Young men need help learning how to communicate well and advocate for healthy choices within their romantic relationships.
Women are not responsible for everything. Having men take an interest in these topics could change the way contraception and the prevention of STIs is negotiated in relationships. Responsibility for intending pregnancies, preventing pregnancies, and preventing STIs should ideally be shared between partners. Female partners should involve male partners in the planning and decision making process in all these areas.

24. Take care of yourself
The health and lifestyle choices you make today can affect the health of your future family
Revisit your reproductive life plan at least once a year
Advocate for yourself, your body and your life goals
What are health issues you can avoid or lifestyle choices that you make that could help you have a healthier baby in the future?
Answers:
Avoid risky behaviors that lead to STIs
Avoid drugs, alcohol, and smoking—these can be habit forming, and if used while pregnant there can be negative outcomes
Weight—being at a healthy weight now and through young adulthood helps your chances of being at a healthy weight during pregnancy
Abuse—having healthy non-abusive relationships now helps you form the foundation and relationship skills to have a healthy partnership in the future.

25. New social norm
Don’t resign yourself to the idea of “If it happens, it happens”
Take control over your own reproductive lives today, tomorrow and in years to come
Make a plan by answering some of the questions that have been brought up today and revisit your plan from time to time.
Bottom line: take control of your own life and if/when you will become a parent