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Preconception Health and Health Care Update
Greetings
This is a monthly communication for individuals interested in improving the health of women and infants through preconception health and health care. We welcome your readership and contributions.
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Before and Beyond: Preconception Curriculum Online
 Before, Between and Beyond Pregnancy, the national preconception curriculum and resources guide for clinicians, continues to evolve and expand. Module have been updated recently. The online initiative can be accessed at www.beforeandbeyond.org
Designed to promote evidence-based care, the site provides access to professional education opportunities, key articles, and clinical guidance for specific high risk conditions, practice supports, breaking news, links to state preconception and interconception initiatives and access to patient care resources.
To date three CME modules have been created specifically for the national curriculum and can be accessed only through this site. Two more modules are under development.
- "Preconception Care: What It is and What It Isn't" (1 AMA PRA Category 1 credit)
- "Every Woman, Every time: Integrating Health Promotion into Routine Care" (1.5 AMA PRA Category 1 credit)
- "Maximizing Prevention: Targeted Care for Those with High Risk Conditions" (1.5 AMA PRA Category 1 credit, pending).
Modules are being developed by experts Merry-K. Moos, RN, FNP, MPH, of the University of North Carolina, and Peter Bernstein, MD, MPH of Albert Einstein College of Medicine. CME credits are available to physicians, nurse midwives, nurse practitioners and physicians' assistants. Additional links to other continuing education opportunities are posted on the site. Members of all groups involved in the clinical care of women and men of reproductive age are encouraged to visit the Professional Education section of beforeandbeyond.org to identify resources appropriate to them. The Key Articles and Guidance section of the site provides links to articles about preconception care, including three journal issues that were dedicated to the topic. In addition, clinical options for the care of women with specific conditions is offered. Other features of the site include links to practice supports for the busy clinicians.
This resource could not exist without the volunteer commitment of Montefiore College of Medicine, which is supplying the CME credits, the UNC Center for Maternal-Fetal Health, which provides web space and design, and Ms. Moos and Dr. Bernstein, who have provided or vetted all of the content. The CDC Select Panel on Preconception Care is indebted to them for their efforts to advance evidence-based preconception health and health care. Unfortunately, there is no marketing budget to promote visits to this labor intensive resource. Please do what you can do to promote the site by becoming familiar with the site and by marketing it to the clinicians in your setting, your professional organizations and your state. |
Expecting Prevention -- Heidi Murkoff Promotes Preconception Health 
It doesn't take a brain surgeon...or a cardiologist...or a pediatrician...or even a policy wonk to figure out that a penny's worth of preventive care is worth many dollars of sick care. That the best Rx for American health is also the best Rx for out-of-control health care costs. In a word we all get: prevention.
...Let's leave no child behind when it comes to health care, but let's also remember that health begins before birth -- and that health care should, too....The science of preconception -- and how a couple's health at the time of conception can affect not only the health of a pregnancy and the health of a baby, but the health of a baby much later in life -- is still in its infancy. But what we've learned even in the five years since the CDC first got the preconception party started -- by launching the first preconception initiative ever in 2005 -- is pretty persuasive stuff...That is why preconception planning should be an integral piece of that healthy baby prescription.
Combine comprehensive, across-the-board prenatal care with routine preconception counseling, and the benefits multiply exponentially. Short-term: significantly lowered pregnancy risk and significantly lowered pregnancy cost. Long-term: a physically and fiscally healthier America. In short, it's a health care combination that writes the ultimate prevention prescription. Unarguably life-saving, incalculably cost-saving.
So let's say we give more babies a healthier start in life, right from the beginning. Or maybe...even sooner. |
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Place Matters
In their landmark book Place Matters, authors Peter Dreier, John Mollenkopf, and Todd Swanstrom, described how economic segregation between rich and poor have been shaped by short-sighted government policies. Today, communities are gaining new insights into what strategies to change communities and increase health equity.
Epidemiologist Cynthia Ferre of the Centers for Disease Control and Prevention, and Dr. Thomas Schlenker, director of public health for Madison and Dane County, are leading an investigation into the progress in reducing black infant mortality in one Wisconsin County. Newsweek has reported on this story. While final results are not in, they suspect that state program and policy improvements combined with centers for health care grounded in the community and the cultural context for African American families are central to this success. Other community centers in the U.S. focused on the health of African American women have seen substantial successes, including Washington, D.C.'s Developing Families Birth Center and the Northern Manhattan Perinatal Partnership in Harlem. In 102 communities, federally funded Healthy Start are focusing on interconception health for women and infants, not just prenatal care, for the highest risk families.
Place Matters is also the groundbreaking program of the Joint Center for Political and Economic Studies Health Policy Institute -- a nationwide initiative designed to improve the health outcomes and to address the social factors that determine health in participating communities. The Place Matters initiative aims to address this gap by cultivating new leadership and advancing the Fair Health Movement-one community at a time.
The acclaimed PBS documentary series, Unnatural Causes, broadcast by PBS, is helping to ground the efforts of organizations around the country to tackle the root causes of our alarming socio-economic and racial inequities in health. In the "Place Matters" episode, viewers are reminded how health worsens as social conditions deteriorate in neglected urban neighborhoods and how that can be changed.
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Syndey Australia commits to PLaN Clinics
In Sydney, Australia, health authorities are focused on preconception health care to prevent birth defects and pregnancy complications that can arise from obesity, diabetes and poor lifestyle and nutrition habits. An experienced midwife will run the new state-government-funded PLaN (preconception, lifestyle and nutrition) clinics. "We know that increasing numbers of people are looking to have children and this service aims to help put them on a path to a healthy pregnancy before they conceive," said New South Wales Health Minister Carmel Tebbutt. (From: The Sunday Telegraph , November 21, 2009) | |
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Facts on Medicaid and Women
More than 17.2 million women under age 65 were uninsured in 2008.
Failure to provide Medicaid poor
adults is a major force in this statistic.
Even among those who have children, Medicaid eligibility levels in 12 states were set at less than half of the federal poverty level in 2009. |
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