perinal


"Each man, woman, and couple should be encouraged to have a reproductive life plan."
-Centers for Disease Control and Prevention (CDC)

Pre-pregnancy health: Becoming a Parent
- The Challenges

The importance of pre-pregnancy and interconception health and reproductive life planning cannot be underestimated.

Pre-pregnancy health, also known as preconception care is an important component of health care for men and women in their reproductive years. It is an anticipatory process, often facilitated by a care provider, which encourages individuals and couples to seriously consider their decision to become parents. Preconception care also provides an opportunity for women, men, and couples to evaluate their current health status and potential risk factors and learn how they can make healthy choices.

Interconception care, a subset of preconception care, offers healthy mothers the opportunity for wellness promotion, while providing high-risk mothers strategies for risk reduction before their next pregnancy.

These processes help people examine their desire and readiness for parenthood. Individuals consider their health, age, emotions, support network, finances, and career goals as they decide to become parents, to delay parenthood, or not to become parents.

Reproductive capacity spans almost four decades for most women. Optimizing women’s health before and between pregnancies is an ongoing process that requires access to and the full participation of all segments of the health care system.

Because preconception health visits are not always covered by insurance or always offered by health care systems, providers face challenges in delivering preconception health. Providers can take advantage of every opportunity to incorporate the three components of pre- and interconception care into their existing care models:

  • Health Promotion– includes information and counseling about contraception, immunizations (hepatitis B, rubella, varicella, Tdap, HPV, and influenza), smoking cessation, alcohol and other drug use, nutrition and weight management, home and workplace hazards, social and emotional support, financial resources, and access to care. It also includes additional education to promote a healthy pregnancy.
  • Risk Assessment– includes a complete health history, a physical examination, and selected laboratory tests. The health history reflects a broad definition of health and includes family, medical (including medication use and chronic conditions), reproductive, and psychosocial (major psychological stressors and screening for depression/anxiety and domestic violence) components.
  • Treatment/Intervention– includes folic acid/vitamin therapy, alternative medication regimens, contraceptive or infertility treatment, identification of the best medications to minimize fetal risk, and referrals to others for specialty care, such as genetic testing.

 

References:
WAPC Position Statement: Pre- and Interconception Care and Reproductive Life Planning (2012)

Lu, M.C., Kotelchuck, M., Culhane, J.F., Hobel, C.J., Klerman, L.V., Thorp, J.M. (2006). Preconception care between pregnancies: the content of internatal care. Maternal and Child Health Journal, 10(5 Suppl), S107-S122.

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