Nursing 209

N209: Reproductive Health Study Guide

Chapter Two: Preconception Period

2.1 Preconception Preconception care as defined by the CDC is “a set of interventions aimed at identifying and modifying biomedical, behavioral, and social risks to a woman’s health or pregnancy outcome through prevention and management.” The goal is to ensure that the woman is as healthy as possible before conception to promote her health and the health of her unborn child. Preconception care is an important part of primary care for women who are in their reproductive years. It does not consist of one well visit for pregnancy counseling, but should be incorporated into every medical decision and treatment plan recommended during the reproductive years. For this reason, a woman’s primary care physician plays an important role in reproductive planning and preparation. Preconception Assessment Preconception planning begins with a thorough health history, including the following: • Age at onset of menses; cycle pattern • Family medical history • General medical history including any acute or chronic conditions, medication, toxic habits, obesity, age, stress, and socioeconomic factors • Sexual history: Includes use of contraception, risk behaviors, and sexual dysfunction • Sexual health history (STDs) • Pregnancy history: Birth history (vaginal vs. C-section), miscarriages, abortions, term vs. preterm, complications with pregnancy and/or delivery, and infertility • Contraception and pregnancy plans: o Contraception for pregnancy prevention o What age they plan to begin having children o Number of years planned between children o Health goals prior to pregnancy (weight loss, smoking cessation, chronic illness control) o Partner’s health history Preconception Health Education Education should be related to risks associated with the patient’s lifestyle and current health status: • Encourage smoking cessation: Smoking makes it harder to get pregnant and increases the risk for miscarriage. It interferes with placental circulation and can lead to placental abruption, preterm delivery, and low birth weight. Smoking during and after pregnancy increases the risk for SIDS (Sudden Infant Death Syndrome).

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