Interpregnancy care

Abstract

The aim of interconception care is to provide women who have had a prior adverse pregnancy outcome with optimal care in order to reduce risks that may affect the woman׳s health and any future birth she may choose to have. National recommendations call for action, and evidence supports specific clinical interventions. The need for interconception care is documented in national and state survey and surveillance data. Chronic diseases and behavioral risks affect the health of millions of U.S. women of childbearing age. Interconception care demonstration projects have used a "disease management" approach that includes medical care and case management. The increasing use of postpartum visits, as a gateway to interconception interventions, is essential. The Affordable Care Act emphasis on preventive services and expanded health coverage for women offers new opportunities to finance interconception care. Improved and enhanced clinical practices, along with the engagement of women, in interconception care have the potential to improve birth outcomes and reduce disparities.

Factors associated with maternal mortality at advanced maternal age: a population‐based case–control study

“…Many of these problems are associated with an increased risk of complications in subsequent pregnancies; for example, previous histories of pre‐eclampsia and postpartum haemorrhage have been shown to be associated with future morbidity 20, 29, 30. It has been suggested that inter‐pregnancy care targeted at the management of hypertension and diabetes could improve future pregnancy outcomes 31. However, research evaluating the impact on future outcome is lacking.…”

Facilitators and Barriers for Successful Implementation of Interconception Care in Preventive Child Health Care Services in the Netherlands

“…There is growing evidence that preconceptionally delivered biomedical, psychosocial, and behavioral interventions are effective [1, 11, 18]. Furthermore, recent studies have shown a high prevalence of risk factors in the preconception and interconception period both in the Netherlands [21], as well as in the U.S. [12]. Despite consensus on the importance of preconception and interconception care, this care is still rarely delivered.…”

“…This possibility is especially relevant to interconception care. Interconception care covers the period between pregnancies and is particularly valuable for women who have experienced an adverse pregnancy outcome [12]. Most women who give birth receive some form of perinatal care, postpartum care, and pediatric care for their newborn child.…”

“…Most women who give birth receive some form of perinatal care, postpartum care, and pediatric care for their newborn child. These visits therefore provide a meaningful gateway to interconception care, but they are generally not optimally utilized [3, 12]. …”

Postpartum care and contraception provided to women with gestational and preconception diabetes in California's Medicaid program

“…Postpartum care is recommended to assess women's recovery from pregnancy, need for contraception, success with lactation, risk of postpartum depression, and ongoing need for care of medical conditions identified during pregnancy, such as gestational diabetes [1]. Postpartum care and postpartum contraception play a critical role in ensuring mothers have adequate time to recover from delivery before conceiving a subsequent pregnancy.…”