Feature Article
Preconception Care: Planning for the Future

https://doi.org/10.1016/j.nurpra.2014.09.011Get rights and content

Highlights

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    Routine preconception care can have a positive impact on maternal-fetal outcomes.

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    Nurse practitioners can play a pivotal role in providing preconception care at every visit.

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    Any visit should include preconception evaluation, intervention, and counseling.

Abstract

In the United States, rates of maternal mortality, unplanned pregnancies, low birthweight infants, and preterm infants continue to rise, making the need for preconception care a priority in the delivery of care. Traditionally, women have viewed preconception care as a single visit made before attempting pregnancy; however, the maximum benefits are obtained when the woman and her partner receive care throughout the reproductive years, whether pregnancy is immediately planned or not. The primary care nurse practitioner has a pivotal role in the identification of risk factors and encouragement of healthy behaviors that have the potential to improve maternal and perinatal outcomes.

Section snippets

Background of PCC

The benefits of prenatal care have long been recognized with advocacy for prenatal care being first introduced to the United states in the early 1900s and it becoming commonplace in the 1980s.4 In recent years, there have been efforts to emphasize PCC in an attempt to promote healthy lifestyles in both men and women before pregnancy is considered. Additionally, PCC can have positive effects on the rates of preterm birth, low birthweight infants, and unplanned pregnancies. Evidence suggests that

The NP’s Role in PCC

It is imperative that NPs take 3 preconception goals into consideration in the care of both women and men; these goals include the identification of possible risks to the mother and fetus as well as the pregnancy, the education of the future parents or mother regarding their risk factors, and the initiation of interventions.10 The history and physical examination should be geared toward the patient’s chief complaint, and then the provider can incorporate the appropriate aspects of PCC.

Barriers to Preconception Care

In today’s already strained medical system, adding another item to a visit that is already compressed can seem overwhelming to most NPs. In addition to time constraints and the requirement to see as many patients as possible in a day, other barriers also exist such as access to care, fragmented care, lack of treatment services for high-risk behaviors, inadequate reimbursement to providers for health promotion/prevention, inadequate impact of health promotion messages to the public, limited data

Conclusion

Reproductive planning should be a consideration at every office visit. The primary care NP is in the prime position to intervene and have a significant impact on maternal and perinatal outcomes through the implementation of PCC practices for both men and women. Every visit provides the opportunity for evaluation, intervention, and counseling regarding reproductive life choices, health issues, and behaviors that could have a significant impact on pregnancy outcomes. A combination of policy

All authors are affiliated with the University of Louisiana at Lafayette in Lafayette, LA. Helen M. Hurst, DNP, APRN-CNM, is an assistant professor and graduate coordinator and can be reached at [email protected].

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    All authors are affiliated with the University of Louisiana at Lafayette in Lafayette, LA. Helen M. Hurst, DNP, APRN-CNM, is an assistant professor and graduate coordinator and can be reached at [email protected].

    Denise M. Linton, DNS, FNP-BC, is an assistant professor and NP coordinator.

    In compliance with national ethical guidelines, the authors report no relationships with business or industry that would pose a conflict of interest.

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