241177 Why Do Women Decline Preconception Health Care? Findings from the 2007 Los Angeles Mommy and Baby (LAMB) Project

Tuesday, November 1, 2011

Shin Margaret Chao, PhD, MPH , Maternal, Child, & Adolescent Health, Los Angeles County-Department of Health Services, Los Angeles, CA
Chandra Higgins, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Marian Eldahaby , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Nirvi Shah, MPH , Maternal Child & Adolescent Health, Los Angeles County, Palos Verdes Pensinsula, CA
Fathima Wakeel, PhD, MPH , UCLA Center for Healthier Children, Families and Communities, Los Angeles, CA
Luwam Semere, MD , Robert Wood Johnson Foundation Clinical Scholars Program, Department of Medicine and Obstetrics and Gynecology, University of California Los Angeles School of Medicine, Los Angeles, CA
Cynthia Harding, MPH , Maternal, Child and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
BACKGROUND While the benefits of preconception counseling (PCC) are well documented, little is known about who doesn't receive PCC in Los Angeles County (LAC) and , and why not. METHODS We analyzed data from the 2007 LAMB Survey (n=6,264), which asked women in the 6 months pre pregnancy Did you talk to a health professional about how to prepare for a healthy pregnancy? If no, we asked why she didn't go. LAMB is a population-based mail survey of LAC women who recently gave birth to a live-born infant. All calculations were performed using data weighted to 2007 LAC population data. RESULTS Our analyses show that 70% of women didn't receive PCC in the 6 months pre-pregnancy. Compared to women who received PCC, these women were: younger (28 vs. 30 years, p<0.05), having <12 years of education (33.4% vs. 23.2%, p<0.005), being unmarried (38.6% vs. 21.5%, p<0.005), and having no pre-pregnancy health insurance (37.6% vs.16.9%, p<0.005). Latina and African American women were less likely to receive PCC (25%, 27%, respectively ), compared to Asian/Pacific Islander and white women (36%, 58%, respectively). The most common reasons for not receiving PCC were: unexpected pregnancy and knowing how to prepare for pregnancy (59% and 37%, respectively).

DISCUSSION Unexpected pregnancy was the major reason for not receiving PCC. Efforts to promote PCC should target women of reproductive age who are capable of becoming pregnant, especially Latinas, African American women, and indigent women. Social policy changes impacting funding and access to PCC are also needed.

Learning Areas:
Administer health education strategies, interventions and programs
Public health or related public policy
Public health or related research

Learning Objectives:
Identify characteristics of women who decline preconception health counseling. Identify reasons women decline preconception health counseling. Identify strategies in promoting preconception health counseling.

Keywords: Maternal and Child Health, Prenatal Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.