Reducing poor birth outcomes by improving interconception care for high-risk women

Background: Current research is unveiling serious gaps in the interconception care being provided to mothers of high-risk infants. These women have a heightened need for attention to medical conditions, risk exposures, and health behaviors – for their well-being and that of future children. The Postpartum Plus Prevention Program (P4) was created by the UNC Center for Maternal and Infant Health and the March of Dimes to respond to a CDC call to address interconception service gaps, build knowledge about how to care for this population, and ultimately reduce poor birth outcomes.

Methods: The program offers a package of services aimed at meeting the unique needs of women who deliver prematurely. Services provided by a nurse practitioner after the delivery include evaluation of immediate postpartum health needs, complete health assessment, maximizing the content of the 6-week postpartum visit, and support for the mother's wellness and reproductive health over the course of a year.

Results: With several hundred women served, the program has uncovered and addressed a number of maternal health needs, has begun to understand points of receptivity for health messages, has improved linkages within health care and public health programs for participants, has educated over 1,500 providers about interconception health, and has begun to address policy gaps including advocating for extended Medicaid coverage for this population.

Conclusions: The P4 Program is improving women's health, enhancing continuity of care, and educating health care providers about interconception health practice. This presentation will describe the program in detail and discuss lessons learned from its implementation.