Background. Prenatal care provides an opportunity for counseling regarding behaviors and experiences that increase the likelihood of adverse maternal and fetal outcomes. The objectives of this study are to document: 1) prevalence of preventive health counseling during prenatal care; 2) prevalence of women in higher need of counseling regarding specific health concerns; and, 3) whether women in higher need for counseling were more likely than women in lower need to have received counseling.
Methods. Analysis of the Pregnancy Risk Assessment Monitoring System (PRAMS), a state-specific, population-based, random sample of post-partum women, was performed using data from 14 states, for births during 1997 or 1998 for a total of 24,620 participants. Outcome measures included report of preventive health counseling during prenatal visits by specific topic, and behaviors and experiences regarding cigarette use, alcohol use, breast feeding, partner violence, and preterm labor.
Results. The percent of women reporting preventive counseling during prenatal care is relatively high (> 75%) for 9 out of 13 topics. However, the percent of women reporting counseling is lower (<75%) for partner violence, seat belt use, illegal drug use and HIV risk. Except for counseling regarding cigarette and alcohol use, women in higher, compared to lower, need for 3 other health topics were not significantly more likely to receive counseling.
Conclusions. Preventive health counseling for partner violence, seat belt use, illegal drug use, and risk of HIV could be increased across prenatal settings. Counseling should involve assessment of risks, with focused counseling related to those risks.
Learning Objectives: 1) Describe the prevalance of preventive health counseling during prenatal care for 13 specific topics. 2) Assess whether women at high risk for five health concerns are more or less likely than women in lower need of counseling to have received counseling for those issues during prenatal care. 3) Suggest ways to improve the quality of preventive health counseling during prenatal care.
Keywords: Primary Prevention, Prenatal Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: CDC: PRAMS data
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.