In the 1980s, prenatal care entered the public mainstream as a way of improving maternal and infant health outcomes.
Prenatal care intervention now reaches most American women for the duration of their pregnancies. However, nationally, maternal and infant health outcomes haven’t continued to improve, and some problems have worsened for reasons that continue to be preventable.
Because prenatal care usually doesn’t begin until week 11 or 12 of a pregnancy, preconception care as an intervention is gaining attention as a way of continuing to improve maternal and infant outcomes.
Preconception care attempts to identify and modify medical, behavioral and social factors that put a woman’s health and the health of her future pregnancies at risk for negative outcomes.
According to the American College of Obstetricians and Gynecologists (ACOG), preconception care screens for risks and provides health promotion, health education, and interventions to address identified risks to women in their reproductive years.
With preconception care, a woman has the opportunity to change and modify her behaviors or risk factors prior to becoming pregnant, thereby improving the chances for positive outcomes during the first weeks of pregnancy when the fetus is most susceptible to developing certain problems before many women even realize they are pregnant.
Preconception care can be of great benefit to women who are at risk for negative pregnancy outcomes resulting from infectious diseases. For example, ensuring that women are vaccinated for rubella provides protection against the mother transmitting congenital rubella syndrome to her infant.
Providing hepatitis B vaccination prevents transmitting hepatitis B infection to infants and protects the woman from risks that may come with hepatitis B infection, such as liver cancer, liver failure, cirrhosis or death.
Preconception screening and treatment for sexually transmitted diseases (STDs) reduces the risk of having an ectopic pregnancy, infertility, or chronic pelvic pain from sexually transmitted chlamydia and gonorrhea.
Preconception screening and treatment also reduces fetal risk for death or physical or developmental disabilities such as mental retardation and blindness that can occur as a result of fetal exposure to STDs.
Additionally, preconception screening for HIV/AIDS provides an opportunity for prompt treatment and information so that women or couples can make early decisions about pregnancy timing. These interventions have a record showing evidence-based effectiveness in improving pregnancy outcomes.
What does this mean for you? If you are a woman in your reproductive years, talk to your doctor about your reproductive life plan. Your doctor can work with you to evaluate your health risks and provide recommendations and information so that you can make choices to positively affect your health and future pregnancies for years to come!