Received 12 June 2008; received in revised form 13 August 2008; accepted 29 August 2008.
Scientific evidence indicates that improving a woman's health before pregnancy will improve pregnancy outcomes. However, for many years, our efforts have focused primarily on prenatal care and on caring for infants after birth. The concept of preconception care has been identified repeatedly as a priority for improving maternal and infant health. Preconception care is not something new that is being added to the already overburdened healthcare provider, but it is a part of routine primary care for women of reproductive age. Many opportunities exist for preconception intervention, and much of preconception care involves merely the provider reframing his or her thinking, counseling, and decisions in light of the reproductive plans and sexual and contraceptive practices of the patient. With existing scientific evidence that improving the health of “W”omen will improve the health of mothers and children, we must focus on improving the health of “W”omen before pregnancy and put the “W” in Maternal and Child Health.
aNational Center on Birth defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
bDepartment of Family Medicine, Boston University School of Medicine, Boston, MA
cDepartment of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA
dDepartment of Pediatrics, Dartmouth Medical School, Lebanon, NH
eDepartment of Obstetrics and Gynecology, Maricopa Medical Center, Phoenix, AZ
fDepartment of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, NC
gDepartment of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, and National March of Dimes, White Plains, NY
hEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
Reprints not available from the authors.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Conflict of Interest: Hani Atrash, MD, MPH; Brian W. Jack, MD; Kay Johnson, MPH, EdM; Merry-K Moos, BSN, FNP, MPH; Phillip G. Stubblefield, MD; Robert Cefalo, MD, PhD; Karla Damus, MSPH, PhD, RN; and Uma M. Reddy, MD, MPH have no conflict of interest including grants, honoraria, advisory board membership, or share holdings. Dean V. Coonrod, MD, MPH is a Grant Recipient from the March of Dimes Arizona Chapter to develop an internatal Care Clinic and has funding from CMS (#1HOCMS030207 101) working on compliance with the 6 week postpartum visit as a strategy to improve preconception care.
ABSTRACT