title: Reviewing the effectiveness of pre-pregnancy counseling protocol on pregnancy and labor indices.
abstract: BACKGROUND
  Pre-pregnancy care is considered as the services assessing and reducing the pregnancy risks through providing medical care and mental support. Therefore, a pre-pregnancy counseling protocol was prepared based on a series of guidelines. This study aimed to determine the effect of the protocol on pregnancy and labor indices.
  
  
  METHODS
  This was a four-phase field study conducted in four randomly selected urban and rural health centers in Shahreza. In the first phase, the information including pregnancy and labor indices was extracted. The participants were all the women who had a delivery in the year before the study (census). In the second and third phases (3 and 6 months after implementing the protocol in the case centers), the process of implementing the protocol was assessed. In the fourth phase (a year later), pregnancy and labor indices were determined in case and control centers (on all the women who had labor in the year before) again and the results were compared in case and control groups as well as before and after implementing the protocol. Data was collected by reviewing documentations and using data collection forms. It was then analyzed by descriptive and analytical statistics using SPSS13.
  
  
  RESULTS
  The obtained results indicated the positive effects of pre-pregnancy cares on cesarean indices, percentage of underlying diseases, pregnancy over the age of 35, and pregnancy intervals of less than 3 years. In addition, the protocol had been implemented correctly in 8.2% of the cases in the second phase, and in 30.2% of the cases in the third phase.
  
  
  CONCLUSIONS
  The positive effects of pre-pregnancy cares on some of the indices raised the necessity of seriously considering and integrating this program in the routine women's health care programs. Considering that less than one-third of the staff members of the case centers had completely conducted the pre-pregnancy cares, monitoring the staff's performance is essential for improving the effectiveness of the care.
authors: Vice Chancellery of Health and Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Shahla
authors: S
authors: Shahidi
authors: Pejman
authors: P
authors: Aghdak
authors: Ziba
authors: Z
authors: Farajzadegan
authors: Minoo
authors: M
authors: Izadi
authors: Manijeh
authors: M
authors: Mohammadi
authors: Mojgan Nikkhah
authors: MN
authors: Fard
keywords: Pre-pregnancy counseling; labor indices; pregnancy indices; reproductive age