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Home , Prenatal care

FEBRUARY 2016

NEW YORK STATE HEALTH INSURANCE PROGRAM (NYSHIP) for Empire Plan enrollees and for their enrolled dependents, COBRA enrollees with their Empire Plan benefits and Young Adult Option enrollees

PRENATAL CARE Every baby deserves a healthy beginning and you can take steps before your baby is even born to help ensure a great start for your infant. That’s why The Empire Plan offers mother and baby the coverage you need. When your primary coverage is The Empire Plan, The Empire Plan Future Moms Program provides you with special services

WHAT’S INSIDE 1-2 Five Important Steps

3 Early 4 Take Action to Be Healthy; Exercise During Pregnancy 5 6 Future Moms Program 7 Your Healthy Diet During Five Important Steps to Having a Healthy Baby Pregnancy 8 Medications and Pregnancy; 1. Call Your Doctor 2. Call The Empire Plan at Skincare Products to Avoid As soon as you think you are pregnant, 1-877-7-NYSHIP (1-877-769-7447) 9 Feeding Your Baby call your doctor. You can do the most for The Empire Plan Hospital Program 10 New Parents your baby during the first three months of provides coverage at hospitals or 11 Choosing Your Baby’s Doctor; pregnancy, so try to start your doctor visits licensed birthing centers. You must call Health Care Spending as soon as possible. for preadmission certification before 12 Extended Care: Medical maternity and other hospital admissions Case Management The Empire Plan covers your maternity care under the Medical/Surgical Program. related to your pregnancy. 13 You may choose a participating or 14 Questions & Answers non-participating provider for your 16 Resources maternity care.

This issue of Reporting On is for information purposes only. Please see your doctor for diagnosis and treatment. Read your plan materials for complete information about coverage. 3. Enroll in the Future Questions may include: Moms Program ▶ Is this your first pregnancy? As soon as you know you are ▶ Have you had problems during previous ? pregnant, call 1-877-7-NYSHIP (1-877-769-7447) and press or say 2 ▶ Do you have diabetes? for the Hospital Program for preadmission ▶ Do you get urinary tract infections? certification and to learn about the Future If you choose to participate in the Future Moms Moms Program. Call early–during the first Program, you will receive the following: month of pregnancy, if possible–and tell the representative you’re calling ▶ A toll-free number you can call for answers to your about your pregnancy. The questions about important topics, such as pregnancy, maternity specialist labor, nursing and postpartum depression. This line is will ask you some staffed by registered nurses, 24 hours a day, seven days questions to a week. determine ▶ A helpful prenatal care book: Mayo Clinic Guide to if there Healthy Pregnancy are any ▶ Educational materials to help you handle any potential unexpected events concerns. ▶ Screening by a registered nurse for common pregnancy risks like premature delivery or depression ▶ Useful tools to help you, your doctor and your Future Moms nurse keep track of your pregnancy and spot possible risks ▶ Free phone consultations with a dietitian, pharmacist, , exercise physiologist or licensed Participating Provider behavioral health clinician, if needed. If you choose a participating provider (obstetrician, For more information on the services offered by the family practice physician or certified nurse-), Future Moms Program, see page 6. there are no copayments for prenatal visits, delivery 4. Be informed or your six-week checkup after delivery. You pay only your Ask your doctor or nurse-midwife, the doctor’s copayment for covered services at participating laboratories. nurse and the maternity specialist questions. To locate an Empire Plan participating provider or laboratory, Community resources and web sites listed on call The Empire Plan toll free at 1-877-7-NYSHIP (1-877-769-7447) the back cover of this publication provide even and press or say 1 for the Medical Program. Or, visit the New more information. Make sure you know how York State Department of Civil Service web site at www.cs.ny.gov. you can have a healthy pregnancy and baby. Select Benefit Programs, then NYSHIP Online. Follow the prompts 5. Enroll your baby for coverage to the NYSHIP Online home page, and click on Find a Provider. Always check with the provider before you receive services to Remember to change from Individual make sure he or she participates in The Empire Plan for New York coverage to Family coverage or add your State government employees. baby to your Family coverage. If you are an active employee, contact Non-Participating Provider your agency Health Benefits Administrator If you choose a non-participating provider (obstetrician, family within 30 days of your baby’s birth. practice physician or certified nurse-midwife), after the annual If you are a retiree, write to the Department deductible is met, The Empire Plan pays 80 percent of the of Civil Service Employee Benefits Division, reasonable and customary charges for maternity care up to Albany, New York 12239, within 30 days of your your coinsurance maximum. You pay the balance, until baby’s birth.* the coinsurance is met. There are separate charges *Retirees of Participating Agencies: Call the Health for services at non-participating laboratories. Benefits Administrator at your former agency. 2 requirements foroptimalhealth. baby get theessentialdaily choices sothatyou andyour incorporate healthy nutritional In themeantime, be sure to they endtheirfirsttrimester. lessen formanywomenas Fortunately, thesesymptoms ▶  ▶  ▶ ▶  ▶ to relieve any sickness: Try following symptom. the this experiencing are you if not concerned be do not so nausea, experiences women and/or estrogen. Not every (hCG) gonadotropin chorionic human hormones of the are factor, acontributing levels levels including rising during pregnancy can at happen any Hormone time. sickness, morning nausea Although often called Nausea nutritionalsupport. optimal for prenatala vitamin to iron take and in protein may Remember help. rich progesterone. foods Eating of hormone the plenty of rest. Fatigue levels related high to the is first in the especially trimester. to get is important It take alot of energy, apregnancy your Supporting will Fatigue EARLY PREGNANCY   Take meal prenatal your evening with your vitamins Try fresh ginger. Ginger found in certain can be smells. have aversions certain to women Some find women Keep Some crackers bedside. at your empties The meals. frequent small Eat or before bed rather than on an empty stomach. empty an on ratherthan stomach. bed before or grating fresh ginger into abeverage. with real made for items ginger. You try can also Make or teas. such sure sodas as beverages, to look trigger situationsIdentify the them. avoid and help. can around moving that eating crackers before getting out of or bed Avoidmeal. spicy, greasy and fried foods. slowly duringpregnancy alarge may and hold not

uncomfortable, there is nothing to worry about. Invest about. worry to nothing there is uncomfortable, may this be sore. and heavier While swollen, to become pregnancy. can cause breast levels tissue hormone Rising Breast earliest are changes symptoms of very one the in Breast Changes ▶ ▶ ▶ ▶ tips: these try Also to do so. instructed take not any Do unless laxatives managed. canand be dangerous not it is Although uncomfortable, down. pregnancy,During digestive your system may slow Constipation yourself very very yourself may you and about find concerned to be something twinge It is natural that is every worried to be Emotions doctor.constant cramping, your notify please heavy,experience red bright or severe, bleeding However, normal. perfectly be at any if you time by spotting. accompanied spottingbe Again, may pregnancy. crampingdeveloping may occasion, On working with the it and amuscle is is uterus your Remember normal. cramps be can menstrual A small amount of cramping that resembles Cramping/Spotting doctor. your call or fever, urine, in your with urination, must you burning If develop you worrisome. but not bothersome, cavity. pelvic in the up space taking ovaries may be This to grow.starts Initially, to enlarged due be may this also uterus the as conception after week seventh or sixth For symptom this around the begins many women, Frequent Urination supportivein agood bra of discomfort. the tosome ease thoughts on the positives! on the thoughts

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3 REPORTINGOn | Prenatal Care | FEBRUARY 2016 EXERCISE DURING PREGNANCY Moderate exercise for at least 30 minutes on most, if not all, days of your pregnancy is recommended unless there is a medical reason to avoid exercise, according to the American College of Obstetricians and Gynecologists (ACOG). Exercise during pregnancy can benefit both you and your baby by: TAKE ACTION TO ▶ Preventing high and , which sometimes develop during pregnancy BE HEALTHY ▶ Building stamina for labor and delivery f you become pregnant, or are planning on ▶ Easing common discomforts like constipation, Ibecoming pregnant, you will need to adjust your backache, fatigue and varicose veins lifestyle to ensure that you and your baby are as Enhancing well-being and promoting early recovery healthy as possible. ▶ and weight loss after labor and delivery ▶ Get early, regular care. Talk to your doctor about Relieving some emotional strains after your prenatal care, your lifestyle and personal and family ▶ baby’s birth, when some women are affected by . These discussions can help your postpartum depression, or “baby blues” doctor identify possible risk factors and recommend treatment or lifestyle changes specific to your situation. Always be mindful of your safety during exercise and take the following precautions: ▶ Take a prenatal multivitamin. A good prenatal vitamin will have higher levels of folic acid, which ▶ Discuss your plans for exercise with your doctor helps protect against birth defects, premature before you begin. birth, low , and pregnancy ▶ Avoid activities that put you at high risk for injury, complications. Folic acid is also naturally found such as downhill skiing, horseback riding or in orange juice, peanuts, green leafy vegetables, contact sports. beans, broccoli, asparagus, peas, lentils and Keep your rate at a moderate level; a good enriched grain products. ▶ rule of thumb to follow is to make sure you are able ▶ Stop smoking. Smoking during pregnancy can lead to speak comfortably during exercise. If you cannot to , and . say more than a few words without becoming out Babies of mothers who smoked during pregnancy of breath, lower your exercise intensity. are more likely to have poor lung development, After your first trimester, avoid exercise that asthma, respiratory infections or even Sudden Infant ▶ requires you to lay flat on your back for extended Death Syndrome (SIDS). Avoid secondhand smoke; periods of time, which can reduce blood flow to it is just as dangerous. the uterus. ▶ Stop drinking alcohol, using illicit drugs and taking Avoid overheating and stay hydrated before, during prescription and over-the-counter drugs (including ▶ and after exercise. herbal supplements) that are not prescribed by a doctor who knows you are pregnant. ▶ Make sure you do a full cool down and stretch thoroughly after exercise. ▶ Eat a balanced diet. Your baby is nourished by what you eat, so be sure to include healthy food choices Brisk walking, swimming, jogging and dancing are and avoid those with no nutritional value. usually safe and effective forms of exercise during pregnancy. Or, try prenatal yoga or aerobics classes ▶ Gain enough weight, but not too much. Health care designed for pregnant women. providers recommend that a woman of normal weight gain 25 to 35 pounds during the course of Based on information from the March of Dimes pregnancy. Ask your doctor how much weight you and WebMD should gain, based on your weight before pregnancy. 4 P ▶ ▶ ▶ ▶ ▶ ▶ ▶ ▶ ▶ ▶ following: forthe tests includes properly. developing usually is baby care Prenatal also rate growth are and that signs your important heartbeat baby’s your Anormal to follow abdomen your growth. measuring begin will doctor your After 20weeks, about heard –usually to be byenough 12or about 13weeks). developed baby’s is your heart when (beginning visit Your baby’s to listen your at each will doctor heartbeat tests. urine and blood and pressure blood include These pregnant checks women. baby. are all givento prenatal tests developing Some health duringpregnancy healthyour of the and your PRENATAL TESTING Presence ofPresence Group (GBS). Bstreptococcus Your doctor that tolerance test Aglucose Gestational diabetes. tract aurinary can indicate which urine, in your Protein asign of can be diabetes. which urine, Sugar in your an indicate could which urine, in your Bacteria Your a carry you or not type, including whether blood to make count) red sure cell blood (low Anemia are you to show immunity blood in your ofPresence with outpap ruled a is smear. This of . Cancer the Hepatitis sexually B,, HIVother and transmitted performs a cervical test at about the sixth at the about month test of acervical performs condition. this identifies weeks 28 about at usually performed is in it.protein may doctor has suggest urine your additional if tests pressure. blood condition high that includes Your infection or, in pregnancy, later apregnancy-related urine. up in your Your may doctor suggest sugar additional if tests shows baby. your and for you infection both aserious risk that can pose a possible blood problem. from of babies their aseries injections to protect need factor Rh arethe considered negative Rh usually and factor. Rh the called protein Women have do not who delivering soon. baby too your tiredfeel especially possibly and increase of risk your getting Too iron. enough little to cause you iron could pregnancy.during are you if can infected cause birth defects which (chickenpox), (German varicella and measles) rubella to baby. to adeveloping dangerous be that could diseases you are pregnant. They help your doctor monitor are your doctor you help pregnant. They renatal receive are you tests while tests medical

the baby’s growth and development. This test also helps test also baby’s the This development. and growth pregnancy the follow and date doctor the baby helps and waves sound to create uses apicture of the or more offered. be One may also An syndrome. disorders, including Down baby’scertain a for risk determines screening This given of between 16th pregnancy. 18th and the weeks screening ablood for alpha-fetoproteininclude (AFP) partner’s family and medical history.tests can These of pregnancy,course your your and on you depending Your prenatal other the may over doctor tests perform ▶ you receiveyou test. the free toll at 1-877-769-744(1-877-7-NYSHIP)Plan before Empire The call covered, be are will atest unsure whether here, doctor. used with discuss them your terms If you If have you any prenatal questions about or the tests movement. the to relates rate baby’s baby’s how and the womb in the movement heart a fetal nonstress that test measures frequency of the a and/or from fingerlike the ; in projections the asampling sampling of (CVS), baby’s the villus tissue chorionic abnormalities; genetic certain detects that of atest fluid baby the surrounding the , Your may doctor suggest more including tests, of sex baby. the and the placenta ofbaby, around fluid the health location and the of the presence the of moredetermine baby, than one level the Cystic fibrosis Cystic fibrosis that can disease an inherited (CF), severely affect breathing and digestion. birth. during infected becoming treatment baby from the to protect duringlabor a woman’s reproductive system), may you receive of considered and for many part anormal women pregnancy.your present is (common If bacteria the Basic Medical Program.) Certificate NYSHIP General InformationBook received from providers. non-participating (Seeyour Empire Plan BasicMedicalProgram coversservices covered, but maybesubjecttoacopayment.The Additional testing,basedon medicalnecessity, isalso nurse-.practice physiciansorcertified obstetricians/gynecologists,familyPlan participating postnatal visitsandurinalysesreceived from Empire The Empire Plancoversinfullallroutine pre- and EMPIRE PLANCOVERAGE formore informationabout TheEmpire Plan and Empire Plan

5 REPORTINGOn | Prenatal Care | FEBRUARY 2016 FUTURE MOMS PROGRAM regnancy is an exciting and special time, but it can 28 Weeks also be a little overwhelming. P Around the 28th week of pregnancy, your Future Moms As a part of your health plan, you can sign up for the Program nurse will call to check in with you again. Your Future Moms Program – a pregnancy support program nurse will discuss your most recent checkup, confirm designed just for moms-to-be. Whether this is your first that you have had the appropriate tests and screenings pregnancy or your fifth, the Future Moms Program can and answer any questions you have about prenatal tests, help you along the way. delivery options, caring for your baby or any other health As soon as your doctor confirms your pregnancy, call concerns on your mind. The Empire Plan and notify us that you are pregnant. This After this phone call, you will receive another packet call is important. When you call, your pregnancy-related with helpful information about your third trimester and hospital admissions will be precertified, so you will be preparing for labor, with topics including delivery options covered at the highest level when you are admitted. Also, and postpartum depression. you will speak with a maternity specialist who will ask you some basic questions about your pregnancy. The maternity specialist will ask you if you would like to After Delivery participate in the Future Moms Program. Your Future Moms Program nurse will call you two to When you sign up for the Future Moms Program four weeks after your delivery to congratulate you on the you receive: birth of your child and check on how you and the baby are doing. Your nurse can also offer additional support if ▶ Your own coach you have the baby blues or are suffering from postpartum ▶ Access to a registered nurse helpline 24 hours a day, depression. After this call, you will receive a birth kit that seven days a week includes information on infant care and home safety. ▶ Helpful and informative materials throughout your The Future Moms Program provides a valuable element pregnancy on topics including your baby’s development of additional support and guidance during and after and growth, fitness and nutrition, feeding your baby, your pregnancy. choosing the right doctor and infant safety

Initial Assessment At the beginning of the program, a nurse will ask questions to check risk factors. If you are identified CALL AT ANY TIME as high risk for preterm labor, additional support and education are available through the High Risk Pregnancy You can call the Future Moms Program at any Program (see page 12). time for information relating to your pregnancy or delivery or if you have questions about your Shortly after you join the Future Moms Program, you’ll benefits or course of treatment. Nurses are receive a Future Moms Program Welcome Kit in the mail. available 24 hours a day, seven days a week at This packet includes: 1-877-7-NYSHIP (1-877-769-7447). Press or say 2 ▶ A Future Moms welcome letter including a toll-free line for the Hospital Program. Spanish-speaking nurses staffed with representatives who are available 24/7 for are available and, if you speak a language other than help with all your pregnancy-related questions English or Spanish, we have access to a language ▶ The book, Mayo Clinic Guide to Healthy Pregnancy line. If you have trouble speaking or hearing, you ▶ A Maternity Care Diary, which will help you track can use TTY/TTD services. Call 800-257-6494 or milestones during your pregnancy, including your call the relay center at 800-828-1140. baby’s development and how your body may be changing Call your health care provider for a nonemergency medical condition or illness. If you have a medical emergency, call 911 or your local emergency number immediately.

6 I baby enough of what he or she needs to grow. needs or she he of baby what enough candy) and cookies sodas, don’tsweets (like give your chips) and remember fatty doughnuts (like and foods that’s and sizes sure Be for to watch you. serving right more to learn ahealthyprovider about eating plan before pregnancy.weight Talk health care to your on your amount of depends extra need you calories day duringpregnancy. per calories However, exact the around 300extra need In most women general, baby need. your and that you nutrients day.important provide every groups They pregnancy. Try from eachof five the to eat food foods DURING PREGNANCY YOUR HEALTHY DIET choices to baby’s support your choices during growth t’s to eat smart make and important healthy food

found intea,chocolate,sodaandsomeover-the- isalso Caffeine has asmalleramountofcaffeine. shop.Tryat yourcoffee which coffee, decaffeinated it’s made,socheckthelabelonpackage,orask dependsonthebrandyoudrinkandhowin coffee Caffeine(the amountinone12-ouncecupofcoffee). Caffeine: need totakeaniron orcalciumsupplement. every day. Askyourhealthcare provider ifyoualso Vitamins: juice ormilkeveryday. Liquids: are alsogood,ifyouaren’t allergic tothem. satisfying, healthysnacks.Peanutbutterandnuts Snacks: youfeelasyourbabygrowsand discomfort bigger. of three biggeronestohelprelieve theheartburn Meals: Healthy EatingHints ▶ ▶ ▶ ▶ ▶ ▶ ▶ ▶ ▶ ▶ Foods toAvoid you’recaffeine getting. counter medicine,soread labelstolearnhowmuch  are safe. seafood. Cannedandshelf-stable versions them before eating. can causefoodpoisoning. Avoid themorheat hot dogs.Delimeats(suchashamandbologna) tuna. (Eatonly6ouncesofalbacore tuna.) shrimp, salmon,pollock,catfishandcannedlight amounts ofmercury. These12ouncescaninclude to 12ouncesaweekoffishcontainingsmall king mackerel andtilefish.It’s okaytoeatup andquesoblanco Roquefort Camembert, with raworlightlycookedeggs Refrigerated pâtés,meatspreads orsmoked Raw orundercooked meat,poultry, seafoodand Fish highinmercury, includingshark,swordfish, Herbal supplementsandsomeherbalteas Unpasteurized softcheeses,suchasbrie,feta, Unpasteurized milkandanyfoodsmadefrom it Raw sprouts, especiallyalfalfasprouts Unpasteurized juicessuchasapplecider Soft-scrambled orrunnyeggsandfoodsmade Raw fish,especiallyrawshellfish Eat fourtosixsmallermealsadayinstead Drinkatleastsixtoeightglassesofwater, Cheese, yogurt, fruitandvegetablesare Cheese,yogurt, Take amultivitaminorprenatal vitamin Limit your caffeine to200milligramsdailyLimit yourcaffeine

7 REPORTINGOn | Prenatal Care | FEBRUARY 2016 MEDICATIONS AND PREGNANCY FDA Pregnancy ▶ Category X – There is documented You also may use cough drops and evidence of fetal abnormalities. salt water gargles. Categories Risks completely outweigh the Most often, the best remedy is he Food and Drug benefits of these medications and fluids, rest and time, but if you TAdministration categorizes they will never be prescribed. develop a fever or your symptoms medications based on possible risks What should I take if I have a cold last longer than 7 to 10 days with no to the . or allergies? improvement, call your obstetrician. ▶ Category A – Human studies have ▶ For a headache, you may take What should I take if I have shown no risk to the fetus. These acetaminophen (Tylenol), a heartburn? medications are considered safe. Category B drug. Extra-strength ▶ Maalox – This is a category B drug ▶ Category B – Animal studies have is acceptable. for occasional heartburn. not shown any risk to the fetus or, ▶ For a runny nose or allergies ▶ ranitidine (Zantac) – This is a if they have, human studies have you may take diphenhydramine category B drug for persistent shown no risk. These medications (Benadryl) or loratadine (Claritin). heartburn. are generally safe. Both are Category B. Note: Avoid ▶ TUMS – This is a category C drug. ▶ Category C – Animal studies have allergy medications found behind Try the first two medications first. shown an adverse effect on the the pharmacy counter (including fetus but no human studies have Claritin D). The best way to avoid heartburn is been done. However, potential ▶ For a cough, first try increasing to eat small, frequent meals. Drink benefits of the medication may fluids, using a humidifier and plenty of fluids and avoid spicy or outweigh the possible risk. elevating your pillows. Guaifenesin fried foods. ▶ Category D – There is documented (Robitussin), a category C drug, risk to the fetus based on data from can be used if the cough is severe. human experiences. Category D will rarely be prescribed.

SKINCARE PRODUCTS TO AVOID While most products are On the label: Differin (adapalene), On the label: Salicylic acid, completely safe, a handful of Retin-A, Renova (tretinoin), Retinoic Beta hydroxy acid (BHA). skincare ingredients are best acid, Retinol, Retinyl linoleate, avoided while pregnant or Retinyl palmitate, Tazorac and Soy: Although generally breastfeeding. Avage (tazarotene). considered safe, soy has estrogenic effects, which can Retinoids: Retinoids are a type Salicylic acid: This mild acid worsen the “mask of pregnancy” of vitamin A praised for reducing is used to treat certain skin (dark splotches on facial skin, also wrinkles and improving skin tone. disorders, including acne. BHA, known as or chloasma). However, studies have shown that or beta hydroxy acid, is a form high doses of vitamin A during of salicylic acid. High doses On the label: Lethicin, pregnancy can be harmful to of salicylic acid have shown to Phosphatidylcholine, soy, an unborn child. Oral retinoids, cause birth defects and various textured vegetable protein (TVP). such as isotretinoin (Accutane, pregnancy complications. an acne treatment), are known Note: Alpha hydroxy acids, to cause birth defects. sometimes listed as AHAs, glycolic acid, or lactic acid, are safe. 8 T postpartum depression. from may protect feel calm relaxed, help and which mothers help can that by hormones releasing delivery after bleeding of uterine risk reduce the help also can in life. Breastfeeding later diseases certain of developing risk the and delivery after anemia of developing chance pregnancy gainedduring moreweight easily, have less Breastfeedingmother, the benefit may who can also lose almost alwaysis available free. and jaw,the breast speakingabilities. and And, teeth milk of development correct promotes Breastfeeding also ear types infections of other and infections. diarrhea, fed breast may of milk have vomiting, alower incidence reduce Studies show gas that discomfort. and babies Breast usually is easily milk digested by ababy, may and child’s needs. changing infant breast the as grows, to the to adapt changes milk And, for healthy development. and growth baby needs a that nourishment additional and hormones factors, sugar, ofamounts protein, fat, growth most vitamins, It ababy from naturallyprotect illness. ideal provides help that substances other and antibodies development, Breast fatty contains milk brain to promote acids of BreastBenefits Milk baby’sthe first year. of ababy’s life, breastfeeding to and continue throughout first for the formula ormonths food) nonhuman milk, six feeding ababy breast exclusively milk (no water, juice, Academy American The of Pediatrics recommends baby’s doctor. own your and pediatrician with your decision this always Discuss option. best the However, breastfeeding when not there cases is can be duplicated. extra be has and that cannot ingredients babies form ofBreast nutrition acomplete is for almost milk all Breast Milk development. emotional and social intellectual, baby to and stimulate your nourish as well as with, bond opportunity awonderful to is feeding time choose, you normally,Whichever develop offersadvantages. each and fedBabies either breast or formula can grow and milk born. before baby is your baby’s your both doctor own your and pediatrician with of decision pros cons and discuss this eachand the Consider or bottle abig decision. baby is feed your FEEDING YOURBABY a healthy start in life. Deciding whether to breasta healthy whether in life. start Deciding most can precious give baby is you your he gift

health and development. and health baby’s are vital to the These minerals. and all vitamins easy-to-digest ahealthy of and protein and calories level Your iron, with calcium, fortified be also formula should healthy development. brain eye support and nutrients ARA; and these DHA provides choose you sure be one baby to formula, the feed your If decide you take advantageof formula offeeding. benefits the caregivers to other and mother the enables and breast milk babynutrients present unique the by providing in benefits which feeding, formula and breast milk combine mothers Some breast to similar milk. are very formulas Certain of babies. needs dietary and digestive for the differentcompositions and nourishment variety of are formulas available eachoffers and essential Formula asafe healthy and is alternative to breast A milk. Formula formula is best as your child grows and changes. and grows child your as best formula is which about for arecommendation pediatrician your Ask * no costduringpregnancy period. and/orthepostpartum comprehensive breastfeeding andcounselingat support hospital where youplantodeliver. You are covered for Check toseeifalactationconsultantisavailableatthe ▶ ▶ ▶ ▶ supplier.participating Current breast pumpsuppliersare: for purchase atnocosttoyouwhenuseanHCAP breast Breast pumpfollowingbirth. pumpsare available are covered forthepurchase ofonedoubleelectric If youmakethedecisiontobreastfeed yourbaby, you Your Empire PlanBenefits* Breastfeeding and EBD ifyouare ofyour group uncertain coverage. only. ContactyourHealthBenefits Administratoror Patient Protection andAffordable Care Act(PPACA) Applies tonongrandfathered groups subjecttothe

www.byramhealthcare.com Medline: 1-800-633-5463orwww.medline.com McKesson: 1-844-727-6667orwww.mckesson.com Edgepark: 1-888-394-5375orwww.edgepark.com Byram Healthcare: 1-877-902-9726or

9 REPORTINGOn | Prenatal Care | FEBRUARY 2016 toys and/or blankets. Overloading these items increases the risk of SIDs or suffocation. ▶ Childproof the nursery, bathroom, kitchen, fireplace – any area of your house that poses a threat to your baby – and check the safety of any baby furniture or gadgets (cribs, high chairs, strollers, swings, play yards) that you purchase or are given secondhand. There are a number of web sites with baby product recalls and reviews, including www.safekids.org, www.cpsc.gov and www.jpma.org. Note: It is not recommended to use a secondhand car seat. ▶ Introduce new foods into your baby’s diet as your doctor advises you. Be aware of food allergies in your family that your baby may NEW PARENTS have inherited. Many new parents may have never ▶ Hold, cuddle and play with your ▶ Dress your baby appropriately for cared for a baby until their own is baby. This helps both you and the weather. Make sure your baby’s born. A baby can be exciting and your baby thrive and form a room is the right temperature unfamiliar at the same time, and strong bond. (65˚F is ideal). it’s normal to be nervous about ▶ Smile, talk and laugh with your ▶ Take your baby out for walks or . You have a vital role in the baby. Studies show that a baby can activities. Babies love the sights health and well-being of your baby. hear your voice while in the womb and sounds of the outdoors and The following are helpful tips to get and can recognize parents within benefit from new experiences you off to the right start: the first week of life. and stimuli. ▶ Share the tasks of feeding, changing ▶ Remember to keep your baby’s and caring for your baby so that crib, bassinet, stroller (or any place both parents can get rest. your baby may sleep) free of stuffed

Dependent Care Advantage Account (DCAAccount) A Dependent Care Advantage Account, or DCAAccount, is available to eligible employees of the New York State Executive Branch who are Management/Confidential, employed by the Unified Court System or represented by Council 82, CSEA, DC-37, Legislature, NYSCOPBA, PBA, PEF or UUP.

Will you need for your baby? The DCAAcount could help save you money by allowing you to pay for your child’s care with pre-tax dollars. Under this program, you may set aside up to $5,000 in pre-tax salary for eligible child care. See your Health Benefits Administrator for details or visit www.flexspend.ny.gov.

Employees of Participating Employers and employees of Participating Agencies: Ask your Health Benefits Administrator if a similar benefit is available to you.

10 ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  ___  your baby’s doctor: Follow thischecklistofquestionswhenchoosing BABY’S DOCTOR CHOOSING YOUR and engagingforyouyourchild? medicine, circumcision andco-sleeping)? breastfeeding, singleparenthood, alternative sensitive topicsandparenting issues(suchas appointment inthisoffice? a day, includingweekends? routine questions? medical needs? have asubspecialtyifyourchildhasspecial Is heorsheboard Doesthedoctor certified? board certified? withthesamehospitals?Areaffiliated they unavailable? provider? How friendly and helpful is the office staff? How friendlyandhelpfulistheoffice Are waitingrooms and examrooms clean Do youandthedoctorhavesimilarviewson How longdoesittaketogetanonemergency Is emergency coverageavailable 24hours When isthebesttimetocallwith What are hours? theoffice What isthephysician’s pediatricbackground? Are thedoctorswhocoverfordoctor Who coversforthedoctorifheorsheis Are thesehospitalsinTheEmpire Plannetwork? At whathospitalsdoesthedoctoradmitpatients? Is thedoctoranEmpire Planparticipating the doctor and staff who workatyour pediatrician’sthe doctor andstaff andalso office request atour. recommendations. Talk toparents inyour neighborhoodorgetreferrals from yourowndoctor. Request tomeet lookingisaboutsixorseven monthsintoyourpregnancy.A goodtimeto start Askrelatives andfriendsfor child asheorshegrows anddevelops. ofplanningforanewbaby. part Choosing apediatricianis an important Thisis the doctorwhowillcare foryour YOUR PEDIATRICIAN

T have an opportunity duringthe eachfall to enroll You hearing. and vision prescription dental, drug, laboratory, hospital, medical, for deductibles) reimbursed (such expenses and copayments as un- with includes tax-free This expenses dollars. HEALTH CARESPENDING Administrator if a similar benefit is available to you. you. Administratoris to available asimilar benefit if of Health your Participating Ask Agencies: Benefits of Employees Employers Participating employees and information. additional Administrator for eligibility Health your see requirements Benefits apply; employee of UnifiedAdditional the Court System. you areif Management/Confidential or non-judicial a 37,PBA, PIA, are UUP you or if Council designated District are PEF, represented by 82, CSEA, Council NYSCOPBA, You you if in aHCSAccount to enroll may eligible be annual election. amount of HCSAccount your change cannot the you event, aqualifying experience Unless you it contributed. year was plan in which the incurred for must used expenses during be HCSAccount Under federal law, put into that any your you money year $100to $2,500per in ancan HCSAccount. setaside You how much to contribute. determine you can help from previous years expenses your Reviewing be. might expenses carefully eligible should your what consider program, you HCSAccount in the Before participating period. enrollment open HCSAccount helps State employees pay for health-related pay employees forhealth-related State helps Health he Care (HCSAccount) Account Spending 11

REPORTINGOn | Prenatal Care | FEBRUARY 2016 regional health care resources will contact you. The nurse will meet with you and your family to discuss the patient’s medical situation. Your acceptance of this service is voluntary. With your written consent, the nurse and your attending physician will identify treatment options covered under The Empire Plan so that you and your family have the information available to make the best medical decisions possible. The nurse will also identify any community resources that may be available. When you accept medical case management, inpatient services will be coordinated by the EXTENDED CARE: Empire Plan Hospital Program and outpatient services will be MEDICAL CASE MANAGEMENT coordinated by the Medical/ Surgical Program. edical case management treatment plans and facilities. The Mis a voluntary program Benefits Management Program can Even if you do not elect to to help identify and coordinate provide information that may help participate in the Medical Case covered services you or your baby you make the best possible choice Management Program, always call may need once your baby is born. based on the patient’s situation. The Empire Plan and choose the Hospital Program within 48 hours Call The Empire Plan toll free at Preadmission certification and or as soon as reasonably possible 1-877-7-NYSHIP (1-877-769-7447) concurrent review help the Benefits if you are admitted to the hospital. and press or say 1 for the Medical Management Program determine Anyone can make the call, but you Program to voluntarily enroll for if medical case management would are responsible for ensuring that this service. be appropriate. If the Benefits The Empire Plan is notified. You Some serious conditions, such as Management Program decides that will pay a higher share of the cost neonatal (newborn) complications this service could help you, your if you do not follow the Empire may require extended care. If your baby or any covered family member. Plan Benefits Management baby needs this type of care, you may A nurse coordinator who is familiar Program procedures. be faced with many decisions about with Plan benefits and local and

HIGH RISK PREGNANCY PROGRAM The High Risk Pregnancy Program is a component of the Future Moms Program that is designed specifically for women who have been identified as high risk. Like other elements of the Future Moms Program, participation is voluntary.

If you are identified as high risk and elect to participate in the High Risk Pregnancy Program, you will be contacted at least once a month by your Future Moms Program nurse for ongoing assessments.

This additional support is tailored to your individual needs. The timing of these calls will be based on severity of the issue(s) and control of symptoms and/or risk factors.

12 F the preceding year.the stressful during other or events partner her or mother of the unemployment problems, relationship disorders, of depression mood or familyhistory or personal a include These depression. postpartum for developing risk at mother the place that delivery to unrelated factors are In there addition, problem. may to the contribute also a “difficult baby,” support emotional stress of lack and delivery, and labor during Complications havinginvolved. such estrogen, as progesteronedelivery thyroid and are after hormones in changes that suggests Evidence Most result agree the that it is experts of many factors. depression?What causespostpartum occur.can rarelybaby this (though happens) thoughts suicidal and In moreinsomnia. extreme fear cases, of the harming inconcentrating, eating habits changes and fatigue, difficultyfeelings and/or worthlessness, of hopelessness guilt, are ofcommon which extreme crying, sadness, any of number can experience symptoms, most the Womenyear of . with postpartum depression of depression that at may any within develop time a moreis a subside. do and not serious form This intense However, feelings are these mothers, more new for some areand within gone two of birth. the weeks typically days only last few a changes, hormonal delivery attributedirritability to after- sometimes fatigue, and delivery.depression, anxiety, feelings moodiness, of These blues” first duringthe after week depression, “baby or the of symptoms postpartum experience mothers of new POSTPARTUM DEPRESSION and happiness. At the same time, 50 to 80 percent happiness. 50toand 80percent At time, same the of atime joy birth of is the achild or most women,

try to exercise every day, to exercise every try from ask and for others help Finally, get take plenty care of of well, rest, Eat yourself. or arelative partner your how you’re or friend feeling. may that you getRemember valuable support by telling group, medication or acombination approaches. of these depression support postpartum a in involvement from physician health professional, the or amental formmay of counseling This treatment include for you. best the determine you can help or she he problem, the therefore sufferneedlessly. is awareyour doctor Once of treatment and seek or symptoms the acknowledge never withproblem who many this of 50percent as women Unfortunately, experiencing. been of may one as you be First, don’t you’ve know afraid doctor what your be to let depression? you are from suffering postpartum What shouldyoudoifthink Depression, then choosing Postpartum choosing Depression. then Depression, selecting and Mental Health the to Center going Condition resources by other questionnaires, and self-help articles www.achievesolutions.net/empireplan. You can find Health Substance and Abuse Program web site at Mental Empire Plan customized depression the on postpartum about information helpful is There More depression aboutpostpartum with friends. time spend and Substance AbuseProgram. or say3fortheMental Health (1-877-769-7447) andpress toll free at1-877-7-NYSHIP questions, callTheEmpire Plan depression, orifyouhave fromis suffering postpartum If youthinkoralovedone

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REPORTINGOn | Prenatal Care | FEBRUARY 2016 QUESTIONS & ANSWERS Is it safe for me to use household king mackerel or tilefish, which can If a woman is HIV positive, will her cleaning products while I’m pregnant? contain high levels of mercury. It’s baby be born HIV positive too? Some cleaning agents may cause okay to eat up to 12 ounces a week of New drugs can reduce the risk birth defects after prolonged direct fish that contains a small amount of of HIV-positive mothers passing contact with your skin. Be careful not mercury. The 12 ounces can include the virus onto their babies to to use cleaners with strong fumes, shrimp, salmon, pollock, catfish and two percent or less, compared like oven cleaners. Wear gloves canned light tuna (six ounces for to about 25 percent for untreated and facial protection and work in a albacore tuna). mothers. It is important for a woman well-ventilated area. Read labels or Is touching raw meat or cleaning my considering pregnancy or who is contact the manufacturer to find out cat’s litter box safe during pregnancy? already pregnant to have an HIV more about a product’s safety. You A parasite that causes toxoplasmosis blood test. The New York State AIDS can also call your doctor to check is found in raw meat and cat feces; Hotline provides information about if the substance is dangerous for it can cause severe brain damage free anonymous testing. Call toll pregnant women. in the fetus. Pregnant women free 1-800-541-2437; for a Spanish- Will my dental work pose a risk to should practice good hygiene when speaking representative, call toll my unborn baby? handling raw meat, avoid contact free 1-800-233-7432. Routine dental work should continue with sandboxes and litter boxes and It is better to be tested for HIV throughout your pregnancy and wear gloves when gardening. during pregnancy than to wait should not cause concern. In fact, I’m 36 years old. Is pregnancy safe until delivery. If a woman without delaying needed dental work could after age 35? prenatal HIV test results declines HIV testing during delivery, hospitals are be risky. Badly decayed teeth or While advances in medical care impacted wisdom teeth can cause required to conduct expedited HIV can help women over age 35 have testing on her newborn. Treatments infection that could spread and safer pregnancies than in the past, endanger both you and your baby. for mom during or shortly after there is a higher risk of pregnancy delivery can reduce transmission When your body is fighting to stay complications. healthy, byproducts and chemicals from mother to baby by up to two- are produced and travel through These include high blood pressure, thirds. If you are HIV positive, do not your bloodstream. If these chemicals gestational diabetes, placental breastfeed your baby. The HIV virus reach your uterus, they may cause problems, miscarriage or stillbirth, can be carried in breast milk. premature labor. Research suggests or having a baby with a genetic I am a victim of domestic violence. that women who have gum disease disorder like . Where can I go for help? or periodontitis may be seven times Good prenatal care is especially Call the New York State Domestic more likely to have a baby born too important in order to minimize risks Violence hotline toll free at early and too small. and improve 1-800-942-6906 for the hotline Be sure to tell your dentist or your chances number of your local domestic hygienist you are pregnant so for a healthy violence program. And, talk with necessary precautions are taken. pregnancy your doctor. Your baby’s health is Avoid X-rays unless they are and child. at stake. absolutely necessary. Is there any reason to limit fish intake during my pregnancy? Yes. Certain types of fish may be contaminated with high levels of mercury or industrial pollutants that are harmful to your unborn baby. Avoid eating swordfish, shark,

14 department can recommend experts. experts. recommend can department Your forlead. surfaces health local painted the testing consider home, Before renovating or buying an older to may chew. able that achild be at aheight stairand especially edges, railings such windowsills, surfaces as aware Be children. of painton lead and pregnant to women dangerous that can be levels lead high contain builtbefore 1978mayA home of levels lead? todangerous baby How canIprevent exposing my baby. her to on disease likely to the pass is she treatment, seeks less the a woman areSTDs treated easily. earlier The Most possible. as soon as doctor your sexually transmitted see disease, If thinkdamage. have you you a neurological permanent and infections eye pneumonia, including newborn, your in complications or spontaneous in pregnant may cause women Sexually transmitted diseases to myunborn baby? sexually transmitted (STD) disease Is it possible totransfer for me a Note: and tomakeareservation. and delivery. Contact yourdoctor’s center formore localhospitalorbirthing information office, Taking educationclasscanreduce achildbirth yourstress bypreparing youforpregnancy, labor ▶ ▶ ▶ ▶ ▶ education class.Theseclassesusuallyrunuptoeight weeksandmayinclude: In thesixthorseventhmonthofyourpregnancy, maywanttotakeachildbirth youandapartner CHILDBIRTH EDUCATION CLASSES

A chancetomeetandspend timewithotherexpectingparents cangiveyouduringdelivery yourpartner The bestsupport Relaxation andbreathing techniquestouseduringlaboranddelivery Suggestions ofproper dietandexercise Information aboutwhattoexpectduringpregnancy, laboranddelivery Any charges for theseserviceswillnotbe reimbursed byTheEmpire Plan.

Stay out of the home until the paint Stay the until out of home the off blocking room) the to remove it. safetyfollows precautions (such as hire who an expert found, If is lead between one month and one yearbetween month of one and one cause of leading deaththe in infants yearinfant of is one under age. SIDS of death an unexplained sudden for the Syndrome, diagnosis the Infant Sudden Death is SIDS can Ireduce mybaby’s risk? how it and is What from SIDS. dying I have heard of babies have you if questions. doctor or your health department local your Call infant making and formula. for drinking, water cooking tap cold for more than hours. Use six only used been not has tap the if minutes aminimum –and of two60 seconds –at least cold it until is water tap your running recommends Agency water, Protection Environmental the To of in tap lead levels minimize can touch. baby your those especially condition, aresure good in surfaces painted make Afterwards, completed. is cleanup athorough and gone is

▶  ▶  ▶  ▶  ▶  baby’s risk: there are ways to lower your diefrom SIDS, will babies which way there no is to predictWhile of ages twothe four and months. age. Most between occur deaths SIDS ▶  ▶  during sleep. during sleep. during uncovered baby’s in your toys crib. or put soft pillow-like comforters, awaterbed). (like mattress asoft surface not and doctor),your for naps. even by (unless back otherwise advised smoking cessation resources. 16for page See ofrisk SIDS. with an increased associated been pregnancy has during Smoking baby.allow smoking around your immunizations. routine and checkups well-baby Do not let your baby get warm your too let not Do baby’sKeep your head and face or fluffypillows use not Do baby on afirm your Place or her on his baby to sleep your Put Do not smoke not during pregnancyDo or Take baby for your regular

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REPORTINGOn | Prenatal Care | FEBRUARY 2016 SM The Empire Plan NurseLine and Future Moms Program 1-877-7-NYSHIP (1-877-769-7447) and press or say 5. You can call this number to reach an experienced registered nurse, 24 hours a day, 7 days a week. You can call the same number to reach The Empire Plan’s NurseLine’s Health Information Library. Enter PIN number 335 and a four-digit topic code from The Empire Plan NurseLine brochure. If you do not have your brochure, ask the NurseLine nurse to send you one.

RESOURCES

Alcoholism and Substance Abuse Environmental Health Lead Exposure NYS Addiction Hopeline NYS Department of Health National Lead Information 1-877-846-7369 1-800-458-1158 Center Hotline, U.S. Environmental Protection Agency Cancer Food and Nutrition 1-800-424-LEAD National Cancer Institute Growing Up Healthy Hotline, (1-800-424-5323) 1-800-4-CANCER NYS Department of Health (1-800-422-6237) 1-800-522-5006 Oral Care American Dental Association Diabetes Heart Health 312-440-2500 American Diabetes Association American Heart Association 1-800-DIABETES 1-800-AHA-USA-1 Pregnancy and Birth Defects (1-800-342-2383) (1-800-242-8721) March of Dimes 1-888-MODIMES (1-888-663-4637) Domestic Violence HIV/AIDS NYS Domestic Violence Hotline, NYS AIDS Information Hotline, Smoking Cessation NYS Office for the Prevention NYS Department of Health New York State Smokers’ Quitline of Domestic Violence 1-800-541-2437 1-866-NY-QUITS (1-866-697-8487) 1-800-942-6906 In Spanish: www.nysmokefree.com 1-800-233-7432

This Reporting On is based in part on information from:

▶ American Academy of Pediatrics ▶ Centers for Disease Control ▶ U.S. Food and Drug Administration www.aap.org and Prevention www.fda.gov www.cdc.gov ▶ American Congress of Obstetricians ▶ WebMD and Gynecologists ▶ March of Dimes www.webmd.com www.acog.org www.marchofdimes.com

▶ American Dental Association ▶ National Institutes of Health www.ada.org www.nih.gov

▶ American Medical Association ▶ U.S. Environmental www.ama-assn.org Protection Agency www.epa.gov

New York State Department of Civil Service, Employee Benefits Division, Albany, New York 12239 • www.cs.ny.gov It is the policy of the State of New York Department of Civil Service to provide reasonable accommodation to ensure effective communication of information in benefits publications to individuals with disabilities. These publications are also available on NYSHIP Online at www.cs.ny.gov/employee-benefits. Visit NYSHIP Online for timely information that meets universal accessibility standards adopted by New York State for NYS Agency web sites. If you need an auxiliary aid or service to make benefits information available to you, please contact your Health Benefits Administrator. New York State and Participating Employer Retirees, NYS and PE COBRA Enrollees and Young Adult Option Enrollees: Contact the Employee Benefits Division at (518) 457-5754 or 1-800-833-4344 (U.S., Canada, Puerto Rico, Virgin Islands). This Reporting On was printed using recycled paper and environmentally sensitive inks. RO Prenatal Care/February 2016 AL1356 16