09Sep

Centering Pregnancy

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There is another way to think about prenatal care, centering pregnancy. In this model of care, women meet in groups to discuss their concerns and celebrate together.  The women take charge of their prenatal care, performing much of the prenatal assessment themselves. The best part, this model seems to work.

What This Means to You

If this is a new concept for you, take some time to explore the website and become familiar with the basic idea. Can you think of other ways prenatal care might be improved?

07Sep

Basics of Prenatal Care

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I thought you might like to see some recommendations for prenatal care.  Grab a cup of tea, these are long documents.

The American Academy of Family Physicians offers these  recommendations for Prenatal Care Counseling.

The Institute for Clinical Systems Improvement offers these guidelines for Routine Prenatal Care.

Rocky Mountain Health Plans offers this printable brochure for Prenatal Care Guidelines.

The State of New York as specific guidelines for what type of prenatal care a practitioner must give to receive Medicaid reimbursement.

The World Health Organization offers these recommendations for prenatal care.

What This Means to You

The recommendations for prenatal care can be extensive. Here in the US increasing the amount of risk surveillance and monitoring recommended during pregnancy is not working to improve outcomes of labor.  Why might this be?

06Sep

Benefits of Prenatal Care

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This week I want to spend some time looking at the various benefits (assumed and proven) of prenatal care.  One thing we know, women who have some form of prenatal care have better outcomes in labor than women who have no prenatal care. Why might this be?

One reason may be the opportunity prenatal care gives for identifying and treating other health problems.  What kind of problems?  Any kinds of problems.  For example, did you know half of babies  living in poverty are being raised by mothers suffering from depression? It is terrible that 70% of the mothers go without treatment because depression puts both the mother and the baby at risk for other health problems.  Good prenatal care can identify issues like chronic high blood pressure or ongoing illness that if left untreated would cause problems for the mother beyond this pregnancy.

Another reason is to identify early any issues that might put mother and baby at risk for an adverse pregnancy outcome. Early identification allows the mother the best chances at prevention and a good outcome. This may be as “simple” as reviewing dietary practices and providing nutritional counseling, or as “complex” as genetic testing.

Good prenatal care also provides educational opportunities for the family, informing them about the changes they are undergoing and helping them anticipate the changes yet to come. This also gives the family and practitioner a chance to discuss the goals for labor and create a plan to work together to meet those goals.

But this is all in theory.  How well the potential benefits transfer to real practice depend on the way the prenatal care is administered.  After all, 70% of those depressed mothers never received treatment.

What This Means to You

Carefully consider what your goals are when you interact with families prenatally.  Do your interactions meet those goals?

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