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For Release: April 22, 2008
Personal health behaviors and family history have a significant impact on the potential for a healthy pregnancy, yet very few Oklahoma women receive preconception counseling before becoming pregnant, according to a recent study conducted by the Oklahoma State Department of Health (OSDH).
OSDH officials utilized the Pregnancy Risk Assessment Monitoring System (PRAMS), a statewide random survey, to look at the issue of preconception counseling. According to a review of survey data from 2004-2005, 86.5 percent of Oklahoma women of childbearing age did not receive any preconception counseling before becoming pregnant. This finding is not much different from a similar study conducted by the agency on PRAMS survey data collected in 2002-2003 that found 84.5 percent of women of childbearing age did not receive counseling on preparing for a healthy pregnancy.
“Preconception counseling provides great value in helping assure a healthy baby,” said Secretary of Health and State Health Commissioner Dr. Michael Crutcher. “While there are factors that influence the lack of preconception counseling, such as lack of health insurance, clearly more could be done to communicate to health care providers and women of childbearing age the importance of preconception counseling.”
Some highlights of the PRAMS survey on preconception counseling include the following:
• In 2004-2005, only 13.5 percent of new mothers received any type of counseling or advice to prepare for becoming pregnant.
• Those most likely to receive preconception counseling were ages 25-29 with some college education, with health insurance, and who intended to get pregnant and/or were married.
• Women who did not receive any type of preconception counseling were more likely to smoke.
• Women who did not receive any type of preconception counseling were less likely to take a multivitamin in the months prior to pregnancy. However, the study further revealed low levels of pre-pregnancy vitamin consumption, even in maternal groups that knew of the importance of folic acid to help prevent birth defects.
• Tobacco and alcohol use among pre-pregnant women in Oklahoma was high for mothers receiving preconception health care and those who did not receive any care. Almost one-third to one-half of women surveyed consumed one or both before conception. Of those women who received preconception care, this study found that one in five still smoked prior to conception.
“Since taking a multivitamin and abstaining from tobacco and alcohol before becoming pregnant are important for the optimal health of a pregnancy, we need to find ways to get this important message to mothers-to-be,” said Crutcher.
The federal Centers for Disease Control and Prevention (CDC) recommend the following to improve preconception health and health care:
• Individual Responsibility Across the Lifespan. Each woman, man, and couple should be encouraged to have a reproductive life plan.
• Consumer Awareness. Increase public awareness of the importance of pre- pregnancy health behaviors and preconception health care services by using information and tools that are age and culturally appropriate.
• 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 risks and improve pregnancy outcomes.
• Interventions for Identified Risks. Increase the number of women who receive interventions as follow-up to preconception risk screening, focusing on interventions with proven effectiveness and greatest potential to impact the most women.
• Interconception Care (Care Between Pregnancies). Provide additional intensive interventions to women who have had a previous pregnancy that ended in an infant death, fetal loss, birth defects, low birthweight, or preterm birth.
• Pre-pregnancy Checkup. Offer one pre-pregnancy visit for couples and persons planning pregnancy as a component of maternity care.
• Health Insurance Coverage for Women with Low Incomes. Increase public and private health insurance coverage for women with low incomes to improve access to preventive women's health.
• Public Health Programs and Strategies. Integrate components of preconception health into existing local public health and related programs with emphasis on interventions for women with previous pregnancies that ended in an infant death, fetal loss, birth defects, low birthweight, or preterm birth.
• Research. Conduct more research to increase the use of the evidence to improve preconception health.
• Monitoring Improvements. Expand public health surveillance and related research to monitor preconception health and be able to show improvements.
For information about preconception care and planning for a healthy pregnancy, contact Jill Nobles-Botkin at the OSDH at (405) 271-4480. For more information about this PRAMS survey or previous surveys, contact Alicia Lincoln at (405) 271-6761 or visit this Web site: http://www.ok.gov/health/Child_and_Family_Health/Maternal_and_Child_Health_Service/Data_and_Evaluation/index.html.
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