Pregnancy planning and pre-conception counseling. The PRAMS Working Group.
OBJECTIVE
To estimate the percentage of women with one or more of four potentially modifiable risks who could have availed themselves of pre-conception counseling.


METHODS
We defined pre-conception counseling to be consultation that occurs shortly before a couple attempts conception. Thus, we assumed that to obtain pre-conception counseling, a woman must plan her pregnancy. We used data from a population-based survey of 12,452 new mothers in four states who delivered babies during 1988-1990. Mothers were contacted 3-6 months after delivery and asked about pre-conception behaviors and the planning status of their pregnancies. We estimated the percentage of women who planned their pregnancies and had an indication for pre-conception counseling related to smoking, drinking, being underweight, or delaying initiation of prenatal care.


RESULTS
State-specific response rates ranged from 68-84%. Sixty percent of mothers reported that their pregnancies were planned. In general, mothers with unintended pregnancies were more likely to have an indication for pre-conception counseling than mothers with planned pregnancies. Thirty-eight percent of all mothers planned their pregnancies and had one or more indications for pre-conception counseling. An additional 30% had one or more indications for counseling but did not have a planned pregnancy.


CONCLUSIONS
Despite the limited range of indications for counseling that we considered, a substantial percentage of women potentially could have used counseling. A similar percentage of women could have benefited from family planning services.
Adams
M M
MM
Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
Bruce
F C
FC
Shulman
H B
HB
Kendrick
J S
JS
Brogan
D J
DJ
D000328:Adult; D001519:Behavior; D003376:Counseling; D005193:Family Planning Services; D005260:Female; D006801:Humans; D016015:Logistic Models; D016742:Preconception Care; D011247:Pregnancy / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors