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Member states were asked the following question: 

What are some of your state’s current or planned activities related to inter-conception health?

Delaware

By Mawuna Gardesey
Public Health Administrator, Delaware Deptartment of Health & Human Services, Division of Public Health, Center for Family Health Research & Epidemiology

The interconception period presents a unique opportunity to improve the health of future pregnancies, especially for women whose previous pregnancy had a poor outcome, such as preterm, low birth weight, fetal or infant death. Interconception care is an important part of our Healthy Woman Healthy Babies model because a previous poor outcome is the highest risk factor for another adverse outcome.

Our interconception care package or "bundle" is designed to address any known risk factors, such us chronic diseases or unhealthy behaviors present in the previous pregnancy and ensure closer clinical monitoring of subsequent pregnancies. For women whose previous outcome was a preterm birth, for example, our providers review their cases for their suitability for alphahydroxy progesterone treatment. The standard interconception care package includes contraceptive education and counseling to promote healthy birth spacing, access to a broad range of contraceptive methods, reproductive health services, pregnancy diagnosis and counseling, testing and treatment for STDs and HIV/AIDS, and oral health education and referrals. Additional services, such as psychosocial care and nutritional services, are available when indicated.

The significant impact of social factors on maternal health requires that we pay more attention to the social context in which people, live, work and play. We are looking at a set of interventions to address the social determinants of health. We expect this effort to be challenging but we believe there is no other way to significantly reduce our infant mortality rate and the racial disparity while sustaining that reduction.