Healthy Pregnancy Class September 20 2012 Presented by

Healthy Pregnancy Class September 20, 2012 Presented by: Women’s Health Education Janet Peirce‐Hollett, Banner Del E. Webb Medical Center Donna Snow, Blue Cross Blue Shield Meredith Moore, Brockhurst & Associates

About our Presenters Janet Pierce-Hollett, IBCLC Banner Del E. Webb Medical Center Phone: 623‐ 524‐ 4464 E‐Mail: Janet. Peirce‐Hollett@bannerhealth. com Donna Snow Blue. Cross Blue. Shield of Arizona Phone: 602‐ 864‐ 4351 E‐Mail: Dsnow@azblue. com Meredith Moore Brockhurst & Associates Phone: 602‐ 263‐ 9265 E‐mail: meredithmoore@brockhurstassociates. com

Agenda 1. Healthy Pregnancy presentation – Janet Peirce‐Hollett 2. BCBS Maternity Benefits – Donna Snow 3. Short Term Disability Benefits – Meredith Moore 4. Dysart Leave Policy – Kimberly Mihelich 5. Question & Answer Session

Planning for a Healthy Pregnancy Dysart Unified School District Janet Peirce-Hollett, IBCLC Banner Del E. Webb Medical Center

Planning for a Healthy Pregnancy Making healthy choices now can impact your future pregnancy.

Planning for a Healthy Pregnancy Planning to take care of yourself now will help you to take care of yourself during a future pregnancy. – How are you doing now with your: • Weight • Diet • Exercise • Stress management • Alcohol use • Tobacco use

Planning for a Healthy Pregnancy You deserve to take the time and effort to take care of yourself so you can better care for and set a good example for your future child! What goals can you set to improve your overall health?

Planning for a Healthy Pregnancy What changes can you make in your lifestyle now that will affect a future pregnancy?

Folic Acid (Folate) 400 mcg • Folic Acid is known to help prevent birth defects • All women of childbearing age should take a multi ‐vitamin with at least 400 mcg Folic Acid daily • It is challenging to get enough Folate from foods

Dental Care • Make a dental appointment before getting pregnant. – Gum disease can show no signs or symptoms – Gum disease can cause red, sore, bleeding gums – Bacteria from gum disease can lead to a small and/or pre‐mature baby

Visit Your HCP For a Pre-Pregnancy Checkup • Current health concerns and lifestyle choices can impact your pregnancy – Diet and Exercise – Weight related health concerns – Alcohol use – Smoking cigarettes – Prescription medication – Street drugs – Immunizations

Pregnancy Risk: Being Overweight • Communicate with your HCP about any health challenges you face and how they may affect a future pregnancy. • Being overweight can increase pregnancy risks like high blood pressure, gestational diabetes, and delivering by cesarean section. • Risks for baby include being born premature, large for gestational age, or even becoming obese in childhood.

Staying Healthy During Pregnancy

I’m Pregnant! Now What? • Select an Obstetrician if you haven’t already. • Make an appointment and keep all prenatal appointments and appointments for tests. • Follow your doctor’s instructions carefully. • Ask questions if you don’t understand!

I’m Pregnant! Now What? Consider signing up for a free on‐line pregnancy support Internet site. http: //www. babycenter. com http: //www. text 4 baby. org http: //www. thebump. com Sites like these email or text you weekly to guide you through your pregnancy.

I’m Pregnant! Now What? • Stay well hydrated! • 10‐ 12 glasses everyday helps: – You meet the physical demands of pregnancy – You have healthy blood cells – Dehydration can trigger contractions – Caffeinated beverages don’t count (Diuretic effect)

Know the Warning Signs That Need Immediate Medical Attention

Warning Signs – Before 37 Weeks • • More than 4 contractions per hour Menstrual or abdominal cramping Low Backache Pelvic Pain or Pressure Fever Headache/vision disturbances Urinary discomfort Vaginal Bleeding/changes in vaginal discharge

Nutritional Balance and Calorie Intake • Am I eating for two? Yes and No! – You need only an extra 300 calories daily • Protein • Iron • Calcium • Spend every calorie wisely – Limit fat intake to less than 30% – Avoid Alcohol, limit Caffeine – Avoid unpasteurized diary and raw eggs – Avoid or cook processed lunch meats – Avoid eating fish that are high in mercury

Exercise During Pregnancy • • • Low‐impact Walking Swimming Prenatal Yoga DVDs tailored for pregnancy. Increase strength, flexibility, and relaxation.

Support at Banner Del E. Webb • Banner Parents‐to‐Be Book – Your guide to labor and birth, newborn care, and postpartum care – FREE to patients delivering at Banner Del E. Webb. • Pickles and Ice Cream Tour – Video/walking tour of the private birthing suites, couplet care suites and special‐care nurseries.

Support at Banner Del E. Webb • Childbirth preparation classes – Labor and Birth – Breastfeeding – Basic Infant Care – AHA CPR & First Aid – Welcome New Sibling Registration Line: 602 -230 -CARE (2273)

Support at Banner Del E. Webb • Triage Department 2 nd floor Tower C – Preterm Labor or other pregnancy health issues: assessment and treatment. – Skilled RN staff communicating with your doctor. – NST – (Non‐Stress Testing). – Evaluation of amniotic fluid levels.

Nesting Place Doctors OB/GYN doctors with offices in: North Peoria North Glendale Surprise Sun City West Extended and early hours offered at most locations.

Banner Del E. Webb Medical Center Wishing you all the best in your Healthy Pregnancy!

Blue Cross Blue Shield of Arizona Healthy Pregnancy Benefits

BCBS AZ Maternity Benefits • Preconception program with education, counseling and free pregnancy kit. • 24/7 maternity nurse toll‐free telephone support line at 855‐ 466‐ 2229. • Members can access robust information online on the Healthy. Blue wellness portal. Login as a member at azblue. com and click on Healthy. Blue Beginnings. • A comprehensive book to guide you through pregnancy.

BCBS AZ Maternity Benefits • Dedicated maternity nurse to assist with high risk maternity care. • Support line available until your baby is six weeks old. • $100 Babies “R” Us gift card provided by Alere with enrollment by 16 th week of pregnancy and completion of the program by taking the final outcomes assessment.

BCBS AZ Maternity Benefits § Healthy. Blue Beginnings is available to eligible participants. § The program is designed to supplement the care and education you receive from your doctor. § Participants under age 18 must obtain parental consent prior to using the services. § Services and treatment options presented may not be covered under your health insurance plan. § Please review your benefits prior to receiving non‐emergent services. Healthy. Blue Beginnings services are provided by an independent third party contracted with BCBSAZ. Alere is an independent contractor of BCBSAZ, providing health improvement programs and certain Healthy. Blue services to BCBSAZ members. § A gift card, if offered, may be taxable under federal income tax. Members should consult with their tax advisor with any tax questions.

BCBS AZ Maternity Benefits The plan will consider the following for maternity care: ü ü ü ü ü Complete blood count (CBC) & urinalysis; Folic acid supplementation prescribed for females; Behavioral intervention to promote breast‐feeding for women; Routine screening for iron deficiency anemia for asymptomatic pregnant women; Tobacco cessation counseling and augmented pregnancy counseling for members who use tobacco; Alcohol misuse screening and behavioral counseling interventions for pregnant women; Screening for asymptomatic bacteriuria for pregnant women at 12‐ 16 weeks gestation or at first prenatal visit, If later than 16 weeks, screening for Hepatitis B virus infection for pregnant women at their first prenatal visit; Screening for Rh(D) incompatibility through blood typing and antibody testing for pregnant women at their first prenatal visit; Repeated antibody testing for unsensitized Rh(D)‐negative pregnant women at 24‐ 28 weeks gestation, unless the biological father is known to be Rh(D) negative

Short Term Disability Benefits Products Underwritten by Union Security Insurance Company

Short Term Disability Benefits If you were disabled due to: • Accident, Illness, Pregnancy Would you still need a paycheck? How would you pay the expenses that continue? (Rent, groceries, insurance, car payments) Sign up when you are first a new hire or during annual open enrollment (the time to sign up to make sure you have disability coverage for your leave is BEFORE you are pregnant. If you sign up while pregnant you will “not” receive disability benefits during your leave). Assurant Employee Benefits help protect your most valuable asset – your paycheck!

Short Term Disability Benefits Plan Features Maximum Monthly Benefit (% of Salary) Maximum Monthly Issue Amount 66 2/3% Guarantee Issue amount $5, 000 Elimination Period 5 days for injury & sickness Benefit Duration 6 months for injury & sickness Pre-existing condition exclusion 12/12 $7, 500

Short Term Disability Benefits Plan Features – Pregnancy Benefits • Pregnancy benefits are payable to a normal 6 or 8 week recovery period. • Once delivery occurs, a lump sum payment is made to the normal recovery period. • If you are unable to work prior to delivery, or if the recovery extends beyond the expected time frame, medical information is needed to support your inability to work.

Short Term Disability Benefits Plan Features – Evidence of Insurability Rules If you apply for coverage within 30 days of your eligibility date, no evidence of insurability will be required for benefit amounts up to and including the guarantee issue amount. You can increase your coverage amount by one benefit level increment at each policy anniversary date without evidence of insurability as long as the increased amount does not exceed the maximum issue amount or 66 2/3% of your monthly salary. Increases or additional coverage will be subject to the pre-existing condition limitation. Evidence of insurability will be required if you: (a) apply for coverage more then 30 days after your eligibility date; (b) apply for benefit amounts in excess of the guarantee issue amount of $5, 000; (c) increase your coverage amount; or (d) voluntarily cancel coverage and then reapply.

Short Term Disability Benefits Exclusions The plan does not cover any disabilities caused by, contributed to by, or resulting from: a) Participation in or attempting to commit a felony or working at an illegal occupation; b) Intentionally self‐inflicted injuries; c) Committing or attempting to commit suicide, regardless of mental capacity; d) Being legally intoxicated, under the influence of any narcotic, unless the narcotic is taken under the direction of and as directed by a doctor; e) Active participation in a riot; f) Pre‐existing condition, as defined; g) Commission of a crime for which you have been convicted under federal or state law; h) Elective surgery; i) Participation in or contracting with the armed forces (including Coast Guard) of any country or international authority; j) Tiding in or driving any motor‐driven vehicle in a race, stunt show, or speed test; or while testing any vehicle on any racecourse or speedway; k) Participating in any sporting event for pay or prize money; l) Operating, learning to operate, serving as a crew member on, or jumping from or falling from any aircraft, including those which are not motor‐driven; or m) Occupational sickness or injury.

Dysart Leave Policy Family Medical Leave Act (FMLA) ü Any eligible employee of the District may take up to twelve (12) weeks of leave (FMLA leave) measured backward for each employee from the first time such employee uses leave under FMLA without pay, for the birth of a child of the employee and in order to take care of child. ü An eligible employee is one who has been employed by the District at least twelve (12) months and who has completed at least one thousand two hundred and fifty (1, 250) hours of service immediately prior to the time the FMLA leave is to commence.

Dysart Leave Policy Special conditions applicable to Family Medical Leave Act (FMLA) ü Entitlement to leave for the birth of a child ends at the expiration of a twelve (12)‐month period, beginning on the date of the event. ü A husband wife working for the District may be limited to a total of twelve (12) weeks of leave during each applicable twelve (12)‐ month period for leave for the birth of a child. ü The District shall not require and employee to substitute accrued sick leave for FMLA leave used for reason of birth. An employee shall substitute accrued vacation or personal leave for FMLA leave used for reason of birth.

Dysart Leave Policy Notice: ü An employee must provide at least thirty (30) days notice before the FMLA leave is it begin if the need for leave is foreseeable based on an expected birth. If thirty (30) days notice is not practicable, notice must be give as soon as practicable. ü Notice shall be in the form of a request for leave of absence. ü District may deny FMLA leave to any eligible employee until such time as the employee has provided the required notice.