Prematurity and Preconception Health
By Phyllis J. Sloyer, RN, PhD, FAHM, FAAP
I generally have a few weeks to prepare remarks for this column that relate to a given topic for Pulse. Obviously, some issues are more likely to be a part of my professional sphere of responsibility while others are not. In fact my sphere of responsibility on some topics can be compared to asking a plumber to conduct complicated surgery. I have also been introduced to a lot of new jargon and acronyms which tend to evoke unsettling responses from me. So, when I received a message to prepare this month’s column, I was pleasantly surprised to understand the topic and in some respects use this to really understand what a lifespan (actually life course) approach means (one of those new terms).
Research tells us that the woman’s health before she becomes pregnant is very important to the outcome of her health and her baby’s health for years to come. This is not a simple task. There are many factors that influence the woman’s health, including biomedical, behavioral and social factors. Additionally, success requires intervention from many walks of life; public health, clinical health, social services, mental health, insurance, etc.
We are making progress in the world of women’s health and look forward to the day when we have the equivalent Bright Futures guidelines that promote the health of all women. Furthermore we know that the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists have classified the main components of preconception care into a specific set of interventions: physical assessment, risk screening, vaccinations, and counseling. They have also identified the important areas of risk screening: reproductive awareness; environmental toxins and teratogens; nutrition and folic acid; genetics; substance use, including tobacco and alcohol; medical conditions and medications; infectious diseases and vaccination; psychosocial concerns (e.g., depression or violence).
So, you can readily see that a one-time visit or episodic attention to the health of a woman simply won’t work. If we continue to perpetuate non-continuous, poor quality and fragmented care, we certainly will witness the other topic of this issue of Pulse: prematurity. We are all too familiar with the life long effects of prematurity. The economic burden on families and societies is too great not to want to address the health of women. I look forward to the day when prematurity is a rare event.
I hope you will enjoy this issue and begin to review your programs from the perspective of successful approaches that will improve the health of all women.