Diana E. Ramos, MD, MPHCo-Chair Preconception Health Council of California

Director, Reproductive Health Los Angeles County Public HealthAssistant Professor, Keck USC School of Medicine

Coauthors: Jeanne Conry, MD,PhD, Navi Sidhu, MD, MPH, Peyton Mason-Marti,MPH

Improving the Healthcare of the Latina New Mother

in California: Interconception Care Project of California

Presenter Disclosures

Diana E. Ramos

No relationships to disclose in relation to the content of this presentation.

California’s Births Comparable to Many

Countries

354,148 Canada

385,963Texas

404,120 Spain

505,757 Italy

550,142California

648,516 Great Britain

679,981 Germany

830,900 France

2005BirthsCountries

354,148 Canada

385,963Texas

404,120 Spain

505,757 Italy

550,142California

648,516 Great Britain

679,981 Germany

830,900 France

2005BirthsCountries

Recommendations for The Post Partum Visit

World Health Organization: –Recommend contact with the health care system

“six hours, six days, six weeks and six months”

post-delivery

–offer comprehensive puerperal care to mothers and newborns

Improved post partum care will not only improve the health and well being of the postpartum woman but will also improve outcomes of

subsequent pregnancies

Recommendations for The Post Partum Visit

ACOG: – Recommend four to six weeks

postpartum– General assessment of physical and

mental well-being

Postpartum Visit Issues

• Compliance

• Patients’ perceived need

• Barriers & Access

Interconception Care Project for California

• Joint March of Dimes/ ACOG Project & Preconception Health Council of California

• Goal: to create guidelines for the postpartum visit that address diagnoses that developed peri-nataly

8

ACOG Interconception CareLogic Model

Review Committee

• Obstetrician /Gynecologists 11• Internal Medicine 1• Nurses 6• MSW 5• PhD 2• Masters Public Health 2• Analyst 1

28 in total

Interconception Care Project for California Focus

• Obesity/nutritional deficiencies

• Bleeding-associated disorders

• Hypertension/cardiovascular disorders

Gestational diabetes

Infections (UTI, STIs, Immunization)

• Mental disorders Intimate partner violence

• Preterm delivery

• Thyroid dysfunction

• Tobacco and other drug dependence

• Neurologic disorders

Interconception Care Project for California Prevailing Messages

• Folic acid

• Contraception

Breastfeeding

Patient Brochures

Material Review

• 200 Health Professionals in California to review algorithms

• 100 patients to review patient brochures in Spanish

• 100 patients to review patient brochures in English

Provider Algorithms

Interconception Care Project for California

Deliverables

• DVD and web-based summary of guidelines

• Patient handouts: Web-based format

• CME web based course

Interconception Care Project for California

•Health Insurers•Patients•Community Based Organizations

Just the Beginning

• Collaboration

• Maximize postpartum visit

• Improve maternal health and the outcomes of subsequent pregnancies

Thank you !