"Wait One Year" Program; A Postpartum Educational Intervention Designed to Reduce Recurrent Preterm Birth

Wait One Year Program: A postpartum educational intervention designed to reduce recurrent preterm birth

Recurrent preterm birth accounts for approximately 10% of all preterm births. We designed an educational program for women having idiopathic preterm birth. Methods: Our educational efforts were delivered by RN educators with the aid of a self-developed 7-minute educational DVD focused on 5 specific areas. These were: delaying conception for 12 months, smoking cessation, stress reduction, folate supplementation and dental hygiene. A MFM specialist also addressed obstetrical and medical interventions in a separate educational session. We tried to deliver the intervention as soon after delivery as practical. Results: In 28 months we approached 150 patients who delivered at gestational ages <=34 weeks gestation and 119 agreed to participate (enrolled). Of those patients 76/119(64%) had either RN and or MD intervention. At initial enrollment 38/55(69%) were using or planned to use contraception, 13/55(24%) smoked; 17/55 (31%) described high levels of stress during pregnancy, 29/55(53%) were using supplemental folic acid; and 29/55(53%) had dental care in the last year. There were 4/76(5 %) pregnancies within one year in patients receiving intervention and 5/43(12%) pregnancies in the patients enrolled but not receiving intervention. Conclusions: Educating patients in the immediate postpartum period was usually well accepted by patients but we identified several logistic, emotional and financial barriers prevented higher educational intervention and follow-up.