March of Dimes Interconception Outreach Grant: Empowering Women to Prevent Prematurity

Despite advancements in medical expertise, technology and regionalized care, poor perinatal outcomes persist in the Midlands at rates that are much too high.  Preterm delivery is the most common precursor of fetal / infant morbidity and mortality.
Karla Damus, RN, MSPH, PhD from the National March of Dimes addressed SC perinatal experts in June 2006.  She implied that “preterm birth is to be viewed as a common complex medical disorder.”  It occurs too frequently and has various, interrelated etiologies.  Causes can be iatrogenic, psychosocial, medical, biologic, genetic, obstetric, behavioral, etc.  Often, providers only approach these issues as they arise in pregnancy or as a woman decides to plan a pregnancy. 
Bernard Guyer, MD, a public health expert from Johns Hopkins University advocates for a life span approach … detecting, treating, modifying behaviors / health conditions / risk factors that can lead to adverse perinatal outcomes … from childhood to menopause.  This approach takes advantage of every opportunity to repetitively reinforce to women ways to actively, continuously reduce modifiable risks to promote healthy perinatal outcomes (whenever pregnancy should occur in her life). 
Perhaps society could make an impact on perinatal outcomes if all caregivers took more of a role in primary prevention.   Unfortunately, this is not always practical or possible due to provider time constraints, reimbursement issues and lack of client motivation.   Providers outside of OB often tend to think that perinatal health promotion should be left to OB and Family Planning.  Windows of opportunity are being missed whenever women access the healthcare system and providers don’t spend time with them on prevention.
This program views the postpartum period as a window of opportunity for interconception education about risks and health promotion.  It takes into account that some poor perinatal outcomes can be due to modifiable risks.  It  challenges women to take more responsibility for their health and future outcomes and it will challenge providers to practice as efficiently as possible, taking every opportunity to educate / support woman.  
Our March of Dimes Interconception / Prematurity Risk Reduction Grant (IPRR) emphasizes the importance of entering / navigating pregnancy in the healthiest state possible to promote optimal birth outcomes.  It offers individualized interconception counseling to postpartum women who have had a poor outcome (preterm birth, loss, anomaly) ... empowering them to decrease modifiable risks to achieve healthier future perinatal outcomes.   IPRR developed several practical tools for women and providers: 1) risk reduction education / resources, 2) a portable patient record that the woman takes with her for personal reference and to share with other MD’s she goes to for care (including an individualized risk assessment, risk reduction goals and special instructions for future pregnancies, and 3) a template for a reproductive life plan (ie. self assessment questions to help women plan, contracept, be in control of their futures).  IPRR also provides outreach to health care professionals / paraprofessionals and the public on planning through one's entire lifespan to have a healthy pregnancy.