1. Access a nationally recognized professional practice resource such as AAP, AAFP, AWHONN, March of Dimes, CDC, etc. Review guidelines for pre and interconception care. What information did you find that influenced your awareness of preconception counseling? What information will you utilize when you provide care for a woman who is planning a pregnancy? Remember to cite your source using APA format.
2. Why is it important to be aware of cultural influences regarding pregnancy and prenatal care? What resources are available to you as an advanced practice nurse to guide and support you in providing culturally appropriate healthcare services in the pre and interconception timeframe

Please respond to your peer’s posts, from an FNP perspective. To ensure that your responses are substantive, use at least two of these prompts:

• Do you agree with your peers’ assessment?
• Take an opposing view to a peer and present a logical argument supporting an alternate opinion.
• Share your thoughts on how you support their opinion and explain why.
• Present new references that support your opinions.

Please be sure to validate your opinions and ideas with citations and references in APA format. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.

Antonia’s response:

The AAFP web site defined preconception care as individualized care for men and women that is focused on reducing maternal and fetal morbidity and mortality, increasing the chances of conception when pregnancy is desired, and providing contraceptive counseling to help prevent unintended pregnancies; and inter-conception care as care provided between pregnancies.

Many of the potentially modifiable risk factors that affect future pregnancy outcomes occur prior to pregnancy. Preconception care offers family physicians and their patients an opportunity to discuss these risk factors so they can be minimized. The information that influenced my awareness of preconception counseling was that women of reproductive age should be screened for current, recent past, or childhood physical, sexual, or emotional interpersonal violence and referred to appropriate resources when needed. All the other recommendations are things that I was conversant with except this one.

The information that I would utilize when providing care for a woman planning pregnancy would be her current physical health, her family history, current chronic disease management, and past STI. I believe these aspects are things that could have a physical effect on her ability to get pregnant. Preconception care should also include counseling on immunizations. All women of reproductive age should have their immunization status for tetanus-diphtheria-pertussis (Tdap); measles-mumps-rubella (MMR); and varicella reviewed annually and updated as indicated. In addition, all women should be assessed annually to determine the need for vaccines that are recommended for those who have medical, occupational, or lifestyle risk factors for other infections. (2018)

Reference

Preconception Care (Position Paper). (2018, May 04). Retrieved January 30, 2019, from https://www.aafp.org/about/policies/all/preconcept… for Women

Jodi’s Response:

Review guidelines for pre and interconception care

It is recommended that a woman who is planning to become pregnant should begin planning and implementing changes prior to conception to increase the chances of having a healthy baby. Since half of all pregnancies are unintended it is important to discuss pregnancy planning with all women of childbearing age who are not covered by a form of birth control (Farahi & Zolotor, 2013) Preparing for a baby might mean that the woman needs to make physical changes in her activity and diet changes to prepare her body for pregnancy. For some this can be done over a few months and for other it might take longer. Even if the woman has had a child prior there are steps that she should take to ensure she is having the healthiest pregnancy possible (Planning for Pregnancy, 2018).

Awareness of preconception counseling

Woman of child bearing age who are planning to become pregnant should begin with seeing her PCP or OB/GYN. At this appointment it is important to discuss the health history and any medical problems that the woman has that may affect her pregnancy. The conversation then becomes more specific about conditions that the woman has experienced that my influence her pregnancy, or issues with prior pregnancies. If she takes any medications it is important to review the medications to make sure they are safe, and update her on any vaccinations that she might need. It’s important to talk to her about steps she can take to prevent certain birth defects (Planning for Pregnancy, 2018).

Care for a woman who is planning a pregnancy

Woman who are planning to become pregnant should take folic acid to decrease the chances of neural tube defects (Farahi & Zolotor, 2013). Folic acid has shown to be beneficial to the fetus as well as the mother. Folic acid can help to decrease anemia and peripheral neuropathy in mothers and congenital abnormalities in the infant (Greenberg, Bell, Guan, & Yu, 2011). Taking 400 micrograms of folic acid every can at least one month prior to conception and during pregnancy can help prevent major birth defects of that fetus’ spine and brain (Planning for Pregnancy, 2018) The woman should have if any, medical conditions should be controlled. The woman should quit smoking, not consume alcohol, and stop using any kind of street drugs. It is important to educate our patients about avoiding toxic substances and environmental contaminants. She can come in contact with these substances at work or home. Educate her about synthetic chemicals, fertilizer, cat and rodent feces, metals, and bug sprays. These substances can be harmful to the men and woman’s reproductive system. It is important to make sure that the woman is free from violence, and has a sound mental health. Helping to woman to expose her family history can help to determine any potential complications or defects that might be experienced (Planning for Pregnancy, 2018). One of the most important things that we can do for our patients is to empower them and give them the knowledge to explore and learn more about themselves and their own health promotion.

References

Farahi, N., & Zolotor, A. (2013, October 15). Recommendations for Preconception Counseling and Care. Retrieved from American Family Physician: https://www.aafp.org/afp/2013/1015/p499.html

Greenberg, J. A., Bell, S. J., Guan, Y., & Yu, Y.-h. (2011). Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention. Obstetrics & Gynecology, 52-59.

Planning for Pregnancy. (2018, January 23). Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/preconception/planning.html

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