Preconception care focuses on risk prevention, health promotion Kimballwomen's health specialist stresses 'process of care' to address needs throughout reproductive life At Kimball Medical Center, obstetricians and gynecologists are dedicated to promoting optimal health throughout a woman's lifespan. For women of childbearing years, Kimball obstetrician/gynecologist E. David Morgan, M.D., stresses that promoting preconception health is a process of care and interventions designed to address the needs of women during the different stages of reproductive life. Dr.Morgan points to a broad definition of preconception care that is used by obstetricians, including ongoing preconception interventions, the addition of a prepregnancy visit,multiple postpartum visits, and the currently recommended prenatal care visits. "Preconception care offers health services that allow women to maintain optimal health for themselves, choose the number and spacing of their pregnancies and,when desired, prepare for a healthy baby,"he says. Dr.Morgan notes that as with other types of preventive care services, preconception care can be integrated into a limited number of model visits to focus on specific issues at different visits, as is done for well-child care. "The purpose of preconception care is to deliver risk screening, health promotion, and effective interventions as a part of routine health care,"he says."In the United States, this approach is the standard used to achieve prevention of vaccine-preventable disease, heart disease, diabetes, and other chronic conditions." This approach is similar to wellchild care,prenatal care, and adult wellness care in which studies have demonstrated effectiveness, according to Dr.Morgan. "Preconception care should be tailored to meet the needs of the individual woman,"he says."Because preconception care needs to be provided across the lifespan and not during only one visit, certain recommendations will be more relevant to women at different life stages and with varying levels of risk.Health promotion, risk screening, and interventions are different for a young woman who has never experienced pregnancy than for a woman 35 or older who has had three children. "Women with chronic diseases, previous pregnancy complications, or behavioral risk factors might need more intensive interventions,"he adds. The need for preconception health promotion and care was recently identified as a critical public health topic by the Centers for Disease Control and Prevention (CDC). In a recent report, the CDC outlined steps to increase access to and use of preconception care with recommendations that emphasize individual behavior and responsibility for improving preconception health and behaviors across the lifespan. "Staying healthy is a concern for any woman contemplating pregnancy," Dr.Morgan says."It becomes particularly important if she suffers from a chronic condition such as diabetes or high blood pressure or if she develops a problem when she is pregnant. But with proper preconception and prenatal care and testing, these women usually experience few problems during pregnancy if their condition remains under control." For a referral to a Kimball Medical Center ob/gyn, call (888) SBHS-123 (888-724-7123).