Experts tout importance of preconception health care

WASHINGTON In collaboration with the Centers for Disease Control and Prevention, experts representing a variety of professional organizations, including the Association of Women's Health, Obstetric and Neonatal Nurses; the American College of Nurse-Midwives; the American Academy of Family Physicians; and the American College of Obstetricians and Gynecologists, summarized the evidence supporting preconception health care in a special supplement to the American Journal of Obstetrics and Gynecology, AWHONN (Association of Women’s Health, etc.) announced last week.

The journal supplement reports on 15 areas, such as infectious disease, immunization, nutrition, environmental exposures and psychosocial stress, in which preconception care can be improved.

The supplement concludes that there is strong evidence to support more screening, health promotion and primary care interventions for women, such as smoking cessation and the intake of folic acid, calcium and other vitamins. “Unfortunately, the current status of preconception care in the United States is far from ideal,” AWHONN stated. “Only one in six obstetrician/gynecologists or family physicians provide preconception care to the majority of the women for whom they provide prenatal or maternity care.”

The CDC defines preconception care as interventions that identify and decrease medical, behavioral and social risks to the health of a woman before conception. For example, women who take medications that may cause birth defects can be counseled to switch to safer medications prior to conception.

"It is critical that every child has a healthy start. Therefore we need fundamental changes in how we provide care to reproductive-aged women," stated Barbara Moran, president of AWHONN. "Nurses are typically the first and most consistent point of contact in the health care setting," she said. "They spend more time with patients—up to 4 times on average—than any other health care provider. Nurses are well situated to provide health promotion, risk assessment and counseling within the primary care setting."

The supplement continues the work of the CDC Expert Panel on the Content of Prenatal Care.