Despite
major advances in medical care, poor birth outcomes continue to be a
problem in the United States. Each year, 12% of babies are
born premature, 8% are born with low birth weight, and 3% have major
birth defects. Of women giving birth, 31% suffer pregnancy
complications. Risks associated with poor pregnancy outcomes
remain prevalent among women of reproductive age. For example,
11% of women smoke during pregnancy, and 10% consume alcohol.
Of women who could get pregnant, 69% do not take folic acid
supplements, 31% are obese, and about 3% take prescription or over
the counter drugs that are known teratogens. In addition,
about 4% of women have preexisting medical conditions, such as
diabetes, that can negatively affect pregnancy if unmanaged.
All of these factors pose risk to pregnancies, but could be
addressed with proper health interventions.
Prenatal care, which usually begins at week 11
or 12 of a pregnancy, comes too late to prevent a number of serious
maternal and child health problems in the U.S. The fetus is
most susceptible to developing certain problems in the first 4-10
weeks after conception, before prenatal care is normally initiated.
Because many women are not aware that they are pregnant until after
this critical period of time, they are unable to reduce the risks to
their own and to their baby’s health unless intervention begins
before conception.
Preconception care is critical to improving the
health of the nation. The Healthy People 2000 goals set a
target aiming for 60% of primary care physicians to provide
age-appropriate preconception care, yet only about one in four
providers currently provides preconception care to the majority of
the women they serve. Preconception care could succeed in
improving maternal and child health where the current paradigm is
failing, but most providers don’t provide it, most insurers don’t
pay for it, and most consumers don’t ask for it.
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Date: April 12, 2006
Content source: National Center on Birth Defects and Developmental
Disabilities
