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Preconception health is defined by the Centers for Disease Control and Prevention (CDC) as interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman’s health or pregnancy outcome through prevention and management. It emphasizes those factors that must be acted on either before conception or early in pregnancy to have the greatest impact. The fundamental elements of preconception care include screening for medical and social risk factors, providing health education, and delivering effective treatment or prevention plans.
There are many women’s health issues that fall under the umbrella of preconception health, including:
- Folic acid supplements
- Rubella vaccinations
- Existing health conditions, including:
- Hepatitis B
- Blood diseases
- Eating disorders
- Medications that can affect the fetus or the mother, such as epilepsy medicine, blood thinners, and some medicines used to treat acne
- Pregnancy history
- Tobacco use
- Alcohol use
- Family planning
- Counseling to promote healthy behaviors such as appropriate weight, nutrition, exercise, and oral health. Counseling can help a woman avoid substance abuse and toxic substances. It can help women and couples understand genetic risks, mental health issues (such as depression), and intimate partner domestic violence.
The good news is that you likely already counsel women about all of these health issues. The idea of preconception health simply encourages providers to counsel women in a thoughtful and explicit way for the express purpose of improving birth outcomes and women’s health.
The CDC has issued 10 recommendations for preconception health that reflect the best of scientific evidence and programmatic experience in the field, and are designed to promote optimal reproductive health outcomes for all women and couples. Five of these Recommendations apply specifically to the clinical health care setting:
- Recommendation 1: Individual responsibility across the life span. Each woman, man, and couple should be encouraged to have a reproductive life plan.
- Recommendation 3: Preventive visits. As a part of primary care visits, provide risk assessment and educational and health promotion counseling to all women of childbearing age to reduce reproductive risk and improve pregnancy outcomes.
- Recommendation 4: Interventions for identified risks. Increase the proportion of women who receive interventions as follow up to preconception risk screening, focusing on high priority interventions (i.e., those with evidence of effectiveness and greatest potential impact).
- Recommendation 5: Interconception care. Use the interconception period to provide additional intensive interventions to women who have had a previous pregnancy that ended in an adverse outcome (e.g., infant death, fetal loss, birth defects, low birthweight or preterm birth).
- Recommendation 6: Pre-pregnancy check-ups. Offer, as a component of maternity care, one pre-pregnancy visit for couples and persons planning pregnancy.
The Campaign is currently focusing on three key areas of preconception health: