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Preconception Health and Health Care Initiative Fact Sheet

MO-07-0144 PC

 

Rationale

·        Maternal and infant pregnancy outcomes are impacted by the overall health of women over the course of their lives, not just during pregnancy

·        Women who conceive while experiencing chronic conditions (e.g. obese, diabetic, hypertensive, mental illness), in dangerous environments (e.g. neighborhood/partner violence, food insecurity, toxins, trauma) or while engaging in harmful behaviors (e.g. substance abuse, tobacco and alcohol consumption) have a higher risk of pregnancy-related complications that contribute to preterm births, major birth defects, and long-term maternal and infant morbidity

·        Using an equity framework, preconception health is a first step to addressing intergenerational risk factors for health outcomes that reflect historical and ongoing injustice

Goal

·        Improve the capacity of formal systems (e.g. public health, health care, health insurance, social services, education and supporting agencies) to provide health promotion, screening and interventions for women of reproductive age

·        Reduce environmental risk factors that affect her health before, during and after pregnancy

Framework

·        Preconception Health is a women’s’ health initiative rooted in life course theory, the idea that health is shaped by the timing of life events, environmental exposures, and societal status accumulated throughout an individual’s life and across several generations

·        Individual health outcomes reflect systemic impediments to health; interventions focus on systems and environmental change

Current Problems

·        Despite recent decreases in maternal mortality, preterm birth and infant mortality, inequities persist related to race/ethnicity and income/education

·        Women’s health status prior to conception is poor in California: only 32.7% of women consumed folic acid, 11.6% smoked, 15.1% binge drank, and 45% were overweight or obese

·        31.2% of live births in California were unintended pregnancies (mistimed or unwanted), but Black (40.3%) and Latina (38.4%) women were more likely to experience unintended pregnancies than White (23.3%) and Asian/Pacific Islander (21.1%) women

·        Women with unintended pregnancies were much more likely to smoke prior to pregnancy, have Medi-Cal insurance (41.2%) or no insurance (47.3%) compared to private insurance (20%), and were less likely to consume folic acid (19.1%) than women who did not experience unintended pregnancies

Data Source: California Maternal and Infant Health Assessment 2013-2014

History

·        The First National Summit on Preconception Health, organized by the Centers for Disease Control and Prevention (CDC), was held in June 2005

·        CDC convened the Select Panel on Preconception Care which developed a set of 10 recommendations for improving preconception health and health care, published in the MMWR Recommendations and Reports on April 21, 2006

·        Building on the impetus set by CDC, the Preconception Health Council of California (PHCC) was convened in May 2006 with the leadership of the Maternal, Child, and Adolescent Health Program of the California Department of Public Health and the March of Dimes California Chapter as a statewide taskforce on preconception health

·        The PHCC partners with organizations and stakeholders across the state to provide direction for the integration of preconception care into public health and clinical practice and to promote preconception health messaging for women of reproductive age

Program Activities

·        Assessment: The Preconception Health Initiative monitors indicators among California women of reproductive age and encourages the adoption of promising practices within direct service and population-based programs

·        Strategy: The Preconception Health Initiative sets and communicates the goals and objectives for preconception health in consensus with stakeholders and consumers through the Preconception Health Council of California every five years through the Title V Block Grant Needs Assessment

·        Equity: Developing and implementing preventive health strategies tailored to populations with greatest disparities that reflect inequity e.g. Black preterm birth rate, Latino unintended pregnancy rate, American Indian diabetes rate

·        Care Quality: Developing provider education tools, conducting health care provider trainings at meetings and conferences, and establishing protocols for implementing best practices

·        Technical Assistance: Provide support and resources to Local MCAH Programs to conduct educational programs and campaigns about preconception health for women and to providers

·        Communication: The website for the Preconception Health Council of California, www.everywomancalifornia.org, and its associated social media accounts,  feature resources, tools and best practices for professionals and serves as a networking spaces for those interested in preconception health and health care

Current Initiatives

·        Unintended Pregnancy Prevention: Increasing contraception use for women at risk of unintended pregnancy by increasing screening for pregnancy intention and reproductive life planning at all primary care visits and increasing consumer knowledge about preventive services for women

·        Increasing Postpartum visit attendance: Partnership with Medi-Cal, Covered California, Health Plans and Text4Baby to market and schedule postpartum visit appointments

·        Standardizing the content of the postpartum visit: Developing Continuing Medical Education Modules through the National Preconception Health and Health Care Initiative and Publishing the Interconception Care Project of California Guidelines

Collaborations

·        The Association of State and Territorial Health Organizations Increasing Contraception Learning Community 2016-2017

·        Prematurity Leadership Council to reduce preterm birth rate among Black women in California, started in 2015

Who Benefits

·        8.1 million women of reproductive age in California directly benefit from investments in preconception health

Funding and Authority

·        California Health and Safety Code 123225, 123230, 123235. 123255.  (a-d), 131051 (d) (15), 131085.  Give authority to the Deputy Director for Primary Care and Family Health to run a preconception health and health care initiative and to engage in multifaceted activities related to the protection, preservation and advancement of this area of public health, including the allocation of resources

·        Federal Title V Maternal and Child Health Block Grant provides funding for preconception health

·        Preconception health priorities identified by California  in the Federal Title V Needs Assessment for 2016-2020 include decreasing unintended pregnancy, family violence, maternal morbidities and health care quality and access

·        Executive Order B-19-12 executed on May 3, 2012 established that reducing the individual, social, and economic burdens of preventable and chronic conditions and improving the health of Californians is a priority for California and established the Let’s Get Healthy California task force which identified two strategic directions: impacting health across the lifespan and pathways to health, each of which is in alignment with the goals of the preconception health initiative

 

 
 
Last modified on: 11/10/2016 10:04 AM