Preconception Care

How I Practice Video Series
Peter S. Bernstein, MD, MPH, FACOG

HIP: Preconception Care from ACOG on Vimeo.

Transcript:

Speaking as a maternal-fetal medicine specialist, I’ve found that probably the most important pre-natal visit is the one that actually happens before the pregnancy is conceived. And given that 50 percent of pregnancies in the United States are unplanned, most women aren’t getting appropriate preconception care. It’s something that we need to focus on more and more. And we’re doing this not just to get a healthy newborn, but also to help get a healthy mom at the end of the pregnancy and help her have a healthy family. I’m even thinking about preconception care when I’m doing prenatal care in the current pregnancy. I’m thinking about the future pregnancy that this woman might have. Now physicians give me some push back, they want to know why I am asking them to do something else during their short fifteen minute visit when there’s so many other things that they need to be focusing on. My point is that preconception care is actually what they’re already doing when they’re seeing a patient in the office, I’m just reframing the things that they’re doing in a way that makes them think about the fact that the action they take today may have an impact on a future pregnancy. So I’m thinking about things like alcohol, smoking, and the counseling that we’re providing to women about that. Talking about a future pregnancy may be a motivator to help a woman quit smoking or change her alcohol use behaviors. I’m thinking about domestic violence, addressing problems like obesity and nutrition, and encouraging women to take multivitamins that include folic acid. Now the most important part of preconception care is actually family planning. Unplanned pregnancies are at higher risk of having poor outcomes compared to planned pregnancies, so in my practice we ask all women when they come in for a visit whether they’re planning to become pregnant in the next year. And their answer will be yes, no, or they may be ambivalent or uncertain and their response is going to guide how we address the issues that are going to come up during the course of the visit. And this is how I practice.

   

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