Exploring Periconceptual Health with Oregon WIC Participants

Background: Each year just under half of all pregnant women in the U.S. are enrolled in WIC. By initiating services in the prenatal period and continuing them postpartum WIC has the unique opportunity to interact with women during the periconceptual stage, the critical early weeks of a pregnancy and the time before a subsequent conception. Given that 50% of adult WIC participants are classified as overweight, 20% are anemic and 12% of WIC participants had a pregnancy less than six months after the birth of their last child, understanding women’s perceptions and experiences with periconceptual health is critical.

Methods: 60 in-depth interviews with English speaking WIC participants in 14 local WIC agencies.  The interviews used a phenomenological approach. Interviews were audiotaped, transcribed and major themes identified.

Results: The majority had at least one pregnancy that was unplanned. Most were familiar with multiple contraceptive methods, had access to them, but use was sporadic. Dental care was more difficult to access than prenatal care, and concerns about quality of dental care for those with Medicaid were frequent.  Ideal birth spacing was based on financial and relationship status more than health. Motherhood was highly valued. Feelings of stress and guilt as well as chaotic childhoods were seen as influencing factors. Diet and exercise advice was viewed as somewhat unrealistic. Most were supportive of WIC discussing birth spacing.

Discussion: Periconceptual health education should include the emotional aspects of motherhood, acknowledge the value of parenting, and help WIC participants overcome personal and systems level barriers.