Preconception care can play a major role in reducing infant mortality. Dr. Terri Major-Kincade, MD, a neonatologist with the Pediatrix Medical Group in Dallas, explains, “Early prenatal care is often too-late prenatal care.”
She urges fellow providers to use the resources available to help patients improve their chances for a healthy pregnancy. She also speaks to the disparity in birth outcomes, pointing out that some minority groups are two to three times more at risk for preterm birth.
preconception interventions
There is considerable evidence that preconception interventions can significantly reduce the risk of birth defects as well as loss of the pregnancy, low birth weight and preterm delivery. As outlined by the CDC, providers can:
- Collaboratively manage medical conditions such as diabetes, obesity, hypertension, STIs, hypothyroidism, seizure disorders and HIV
- Counsel women to avoid risks such as alcohol consumption, smoking, prescription and OTC drug abuse, under-nutrition and exposure to toxic substances
- Encourage women to engage in healthy behaviors including; take a daily multivitamin with at least 400 mcg of folic acid, exercise at least 30 minutes a day, eat a balanced diet, manage stress and maintain weight within normal BMI parameters
- Inform women about the availability of vaccines to protect their infants from the consequences of infections that affect the mother (including flu, pertussis, rubella, varicella and hepatitis B)
- Counsel men to avoid tobacco use and exposure to toxic substances
- Counsel men to engage in reproductive life planning, proper nutrition and healthy weight maintenance
Healthy Texas Babies offers a variety of resources and planning tools that you can share with your patients during their pregnancies. Together, these documents make up a toolkit to encourage open lines of communication, patient-centered goal setting and can support behavior change over time.
The Life Planning Tool, Preconception Provider Poster and My Health Priorities Patient Worksheet complement each other and send a message to patients that their provider is open to their questions.
From the provider perspective, the tools help optimize patient education during the limited time you have in the clinical encounter. All of these tools are not designed to be implemented in one visit. They initiate an ongoing discussion about patient goals that change with the patient’s circumstances and development. These tools will help providers address:
- Intimate partner violence
- Early entry into prenatal care
- Smoking and alcohol cessation
- Obesity and chronic conditions
The Life Planning Tool asks questions about facets of health that impact reproductive potential and provides anticipatory guidance about those topics. As the patient performs a self-inventory of risk factors and health habits, they are developing a vision of what they want their childbearing years to be like. By the end, they have a better sense of what they will need to achieve their goals and can better visualize their future.
The Life Planning Tool can help providers:
- Recommend more appropriate forms of birth control for patients’ lifestyles
- Identify risk behaviors patients may not have verbally disclosed
- Set goals for care collaboratively with patients and achieve greater buy-in and patient satisfaction
The Preconception Provider Poster can be placed in your waiting room or in exam rooms to prompt open discussion about factors that may impact women’s health. It sends the message to your patients that you care about their reproductive goals, are comfortable with their questions and have the information they seek.
The My Health Priorities Patient Worksheet complements the Preconception Provider Poster and can be used in a single encounter or on recurring visits to cover a variety of topics. While checkboxes next to each topic allow the provider to quickly close in on the patient’s issues, blank lines within each question prompt the patient to tailor questions to their particular concerns.
resources
To learn more about preconception counseling and integrate it into your medical practice, please visit the CDC preconception health care information page.
For your patients who are considering children, you can download copies of our Personalized Life Plan PDF. This helpful tool can assist in fostering a dialogue with your patients about having children and guiding them to make smarter decisions.
The National Preconception / Inter-conception Care Clinical Toolkit gives primary care providers a way to address their patients’ needs based on an important “vital sign” question: “Are you hoping to become pregnant in the next year?”
These Healthy Texas Babies exam room posters help keep your patients informed and spur discussion of important health topics.
The Every Woman California project has developed a wealth of materials to support the clinician who provides pre- and inter-conception care. The Clinical Protocols include preconception algorithms, six-week postpartum checklists and questionnaire and preconception guidelines.
Alcohol and Pregnancy: Myths and Facts explores the common misconceptions about “safe” levels of alcohol consumption during pregnancy and reinforces that drinking alcohol even in small amounts can have lifelong consequences for a child.
This Men’s and Women’s Heath Tips card for Spanish-speaking audiences outlines simple tips for daily wellness.
This Spanish-language poster informs your patients about the wealth of health resources available at AlgunDiaEmpiezaAhora.com.
