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Learning Objective 1: Describe two reasons why interconception care is important after a preterm delivery.
Learning Objective 2: Identify women’s preferred time to receive interconception care.
After a preterm delivery, when women would be most receptive to preconception counseling is unknown. Health care providers should counsel women who have had a preterm birth about risks associated with future pregnancies, and improving chances of good outcomes. The objective of this study is to pinpoint optimal timing of interpregnancy preconception care after a preterm birth.
Up to 50% of pregnancies in the United States today remain unplanned (Finer & Henshaw, 2006). One of the greatest risk factors for preterm birth is prior preterm birth (Stubblefied, et al, 208). After a preterm birth, health care providers should counsel their patient about pregnancy spacing (Conde-Agudelo, 2005; Smith, Pell, & Dobbie, 2003), progesterone use (Jack, et al, 2008), and ways to reduce risks of other poor outcomes (Freda, 2006). It is not known when women would be most receptive to such a discussion.
Mothers of preterm infants in the Neonatal Intensive Care Unit were surveyed regarding when they would like to receive counseling and information regarding another pregnancy, and with whom they wanted to speak.
Twenty surveys were returned. Demographics include 60% Caucasian and 30% African American, with 80% having some level of college education, and 31 weeks mean gestation at delivery. 76% desired another pregnancy, but <20% had received any guidance from their obstetrician at the time they responded. More than 50% wanted to receive information beginning at the 4-6 week postpartum visit, and 80% wanted it from their primary obstetric provider. Limitations of the study include the small sample size.
Preconception counseling may be highly effective in reducing pregnancy risks (Moos, et al, 2008). After a preterm birth, women considering another pregnancy are very receptive to preconception counseling beginning at the 4-6 week postpartum visit. Future research should seek a larger, more diverse group of women.