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Women and Men Urged to Seek 'Preconception Care'
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Page: << Prev | 1 | 2 | 3 | Next >> In part, the CDC recommendations encourage every woman, man and couple to have a reproductive plan, even if they do not intend to conceive. About half of all pregnancies in the United States are unintended, the agency noted, underscoring the need for contraception counseling.
In addition, the nation's primary-care providers are urged to take the lead on providing preconception risk assessment services, patient education and health promotion counseling to reduce reproductive risks and improve pregnancy outcomes.
"Full implementation requires substantial support from a number of sectors and will take some time," said Samuel F. Posner, a co-author of the preconception care report and associate director for science in the CDC's Division of Reproductive Health. Part of the challenge, he conceded, is overcoming numerous barriers, including the lack of a mechanism for billing insurers and getting reimbursed.
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Some insurers limit the use of billing codes for preventive services to once a year, Dunlop explained, while others do not pay for these services at all.
What's more, the notion of preconception care doesn't really resonate with many women, she said. Take, for instance, a recently married 23-year-old who wants to hold off a couple of years before starting a family. She may not even consider herself a candidate for preconception care until she's ready to conceive.
All the more reason for doctors to ask patients about their reproductive plan and schedule a follow-up visit if necessary. "Leave them with the message that it's important you plan the pregnancy, not just in general with yourself and your partner, but with me as your health-care provider, because there's things we have to take care of ahead of time," Dunlop said.
When should women seek preconception care? While there are no hard-and-fast recommendations, Dunlop believes most experts would advise healthy women to see their doctor at least three months prior to planning to conceive. Women with chronic conditions, including diabetes, obesity, hypertension and seizure disorders, may need more time to get their disease under optimal control and adjust their medications before trying to conceive.
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Copyright © 2008 ScoutNews, LLC. All rights reserved.
Last updated 7/22/2008
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SOURCES: Anne L. Dunlop, M.D., M.P.H., assistant professor, Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta; Samuel F. Posner, Ph.D., associate director, science, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, U.S. Centers for Disease Control and Prevention, Atlanta; Michael C. Lu, M.D., M.P.H., associate professor, obstetrics and gynecology, University of California, Los Angeles; March of Dimes, White Plains, N.Y.
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