August 2010 - Amended for Bahamas article link 
Preconception Health and Health Care Update
For some reason the link to the Bahamas Tribune article was broken.  This is a supplement to this month's enews to respond to the many requests for this article.
The PCHHC Update 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.
Preconception Care: Focusing Messages 

Health and public health leaders across the country have been promotingn preconception health and health care.  One challenge is to consisely describe the purpose of preconception care, the importance of preconception health, and what woman should do to improve her preconception health.


Click here or read below to find a very concise and accurate newspaper article that appeared in the Bahamas Tribun Autust 31, 2010.  This is an excellent model for communications and media work related to preconception health and health care.  Thanks to the Maternal and Child Health Secretariat of the Bahamian Department of Health for this contribution to the field. With Dr. Baldwin W. Carey, an OB-GYN trained in public health who has worked in California at King Drew Medical Center and elsewhere, at the head of their Department of Health, as well as strong MCH program leadership, they are making preconception health a priority. 

The Tribune, Bahamas
Published On:Tuesday, August 31, 2010
"Women between the age of 18 and 35 are at the prime of their reproductive years. Whilst many women may face reproductive challenges such as infertility, most will become pregnant at some point, once sexually active. The outcome of pregnancy is determined long before the point of conception. Therefore the health of women in this age range is a priority concern for health care providers in the Maternal and Child Health Services of the Bahamas. In this article, Gina Dean SNO, and Coordinator of the Maternal and Child Health Programme share on the importance of Preconception Health in the population.)
What is Preconception Health (PCH)?
Preconception health refers to the health of women of reproductive (or childbearing) age when they are in a non-pregnant state. This includes adolescents and women, before they become pregnant for the first time, as well as women who are between pregnancies.
Why is there a need to focus on PCH?
We need to focus on PCH because of the strong and important link between the health status of a woman before she becomes pregnant, and her health status and that of her baby, during pregnancy, during childbirth and during the (postpartum) period just after she had her baby. The better a woman's health is before she becomes pregnant, the healthier she and her baby are likely to be after she gives birth.
What is PCH care and what is the main goal of PCH care?
Preconception health care is the educational, promotional and preventive health services provided to women before conception (that is, before becoming pregnant). The main goal is to improve a woman's health before conception (before a first or subsequent pregnancy). The objective of PCH care is to identify factors (diseases, infection, 'risky' health behaviours) associated with negative pregnancy outcomes (deformity, miscarriages, low birth weight etc) so that they can be modified through clinical interventions (treatment) and behavioural changes.
Who are the target groups for the promotion of PCH?
The target group for PCH is all women of reproductive age. That is, females from menarche to menopause, who are capable of having children, even if they do not intend to get pregnant (11 - 50 years). Although females are our primary focus, PCH services also target males; recognising that men are partners and key contributors in reproduction.
What are some of the risk factors for poor pregnancy outcomes among women and infants?
Risk factors for poor pregnancy outcomes include:
* Medical conditions such as diabetes, hypertension, obesity, sickle cell disease (partners who are both carriers of the sickle cell trait should seek counseling before conception), sexually transmitted infections, vitamin and mineral deficiencies (folic acid deficiency is especially important), periodontal disease
* Poor pregnancy history such as repeated premature labour and spontaneous abortions, previous miscarriages, death of baby soon after birth or before the age of two and previous low birth weight infants.
* Lifestyle behaviours such as smoking/illicit drugs, over use of alcohol, and poor nutritional intake
* Psychosocial risks such as abusive relationships (physical, sexual or mental), and poor housing conditions
* Environmental exposures such as exposure to passive tobacco smoke, chemicals, lead, and radiation
* Social, economic and physical risks associated with adolescent pregnancy
* Age related factors such as the increased risk of chromosomal problems for older women. Advancing age also increases risk of hypertension and diabetes in pregnancy.
What can women do to improve their PCH?
* Take a proactive approach to your reproductive health. Have a plan; decide whether you want to have children, when you want to have children, and whether you are physically, mentally and economically prepared for children. Make the necessary changes in your life that is needed based on your answers to these questions so that your reproductive health will go in the direction you would like.
* Be aware of your health status and the risk factors that might be present or contribute to poor pregnancy outcomes and make the necessary changes early.
* Begin or continue to have regular preventive health visits with your doctor
* Have a pre-pregnancy check-up once deciding to get pregnant.
What should women expect during a PCH visit?
Preventive visits should be a part of your routine yearly check-up or primary care visit. This visit should include disease screening, and should seek to address the majority of your personal health care needs as well as address any existing health problems. It will also include risk assessment, reproductive history tracking, medication being taken, nutritional pattern, monitoring of folic acid intake, weight management, substance use, vaccinations, family planning methods, and all social and mental health concerns, including support networks, domestic violence and housing. These are all important to a healthy reproductive life.
Where can women go to access PCH services?
PCH services can be accessed wherever individuals receive their primary health care services. This includes all community health clinics on New Providence and the Family Islands, as well as private primary health centres. Most health care facilities do not generally include the term pre-pregnancy or preconception health in their list of services but all of the components of PCH are available at most of these facilities. Ask for the service at your next visit.

For more information on preconception care and other topics on women and family health contact the Maternal and Child Health Secretariat of the Department of Public Health..."
Seizing Opportunities in National Infant Mortality Awareness Monthafrican american couple and babie
September is National Infant Mortality Awareness Month. From Alaska to Florida, public health and medical leaders are seizing the opportunity to promotion awareness about infant mortality.  Communities are hosting public forums, community health centers are holding parent awarness events, and baseball teams are holding fundraising events.  Experts are maximizng "free media" by writing columns about their state or local infant mortality statistics and what task forces, policy makers, and health professionals can do to respond. Prevention strategies and shameful statistics are being advanced to make the case for change. 
The National Healthy Start Association (NHSA) is launching a new campaign Celebrate Day 366...Every Baby Deserves a Chance.  NHSA has created a toolkit that contains fundraising activities, advocay suggestions, useful statistics, and tips on how to implement the campaign. To downloade the toolkit, visit the NHSA website
The Office of Minority Health of the U.S. Department of Health and Human Services continues its focus on infant mortality prevention. For 2010, the campaign message is A Healthy Baby Begins with Two! Minority Fathers Fight Infant Mortality.  For more on this campaign and to view videos or download materials, visit
Issue: 17 - Amended 

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In This Issue
Concise Messaging
Infant Mortality Awareness Month
Women's Health Chartbook

The Women's Health and Mortality Chartbook is a state-by-state statistical resource on women's health available from the Office on Women's Health at the Department of Health and Human Services.  it contains an easy-to-use collection of current data on critical women's issues.  Key issues related to women's health being measured regularly at the state level are highlighted, with 27 different health indicators featured.  
Click here to access the Chartbook online.
Preconception Health and Health Care Initiative