Preconception Care and Reproductive Life Planning: Engaging Primary Care Providers

Purpose: In the United States, about 51% of pregnancies are unplanned (Guttmacher Institute, 2015). Preconception care (PCC) provides patients with the resources and knowledge to prepare for pregnancy and improve birth outcomes. By utilizing PCC, physicians can advise patients on numerous behavioral and lifestyle changes to help prevent complications from occurring. The usage of preconception care is a strong candidate to decrease the amount of unplanned pregnancies for women in their child bearing years. The objective of this project is to identify primary care providers educational and behavioral needs in preconception care screening practice. Materials and Methods: Participants were recruited from NorTex members “by-invitation only” recruitment. The preconception care surveys were administered on-line via email to clinicians, including primary care providers, pediatricians, OB-GYNs, nurse practitioners, and physician assistants to assess the essential role of clinicians in reproductive life planning. The survey contains approximately 12 questions and takes approximately 10 minutes to complete. The on-line responses were exported in a database and analyzed using Excel. Results: Of the 500 expected surveys, 149 have been completed of by family practice physicians (28%), OB/GYNs (10%), pediatricians (2%), physician assistants (5%), nurse practitioners (22%), and nurses (33%). Survey results revealed providers’ obstacles to providing reproductive life planning in their practice included factors such as lack of time with patients (37%) and inadequate/ insufficient information (brochures, posters, flyers, etc.) to provide to the patient (31%). Additionally, providers indicated the need of educational materials on Reproductive Life Planning (57%) and believed inclusion of Reproductive Life Planning questions into the EMR (47%) would help implement Reproductive Life Planning in their practice. Of the participating providers, 83% were unaware of the Texas Department of State Health Services “Someday Starts Now” public awareness campaign. Conclusions: Integrating preconception health into routine primary care encounters with patients of reproductive age should be a significant driver in the reduction of infant mortality rates and increase in healthy families. Future studies should investigate PCC’s integration into providers’ care with the most effect tool, educational material or inclusion of Reproductive Life Planning questions into the EMR.