Interconception Care for Mothers During Well-Child Visits With Family Physicians: An IMPLICIT Network Study

Stephanie E. Rosener; Wendy B. Barr; Daniel J. Frayne; Joshua H. Barash; Megan E. Gross; Ian M. Bennett

doi:10.1370/afm.1933

Published eLetters

If you would like to comment on this article, click on Submit a Response to This article, below. We welcome your input.

Submit a Response to This Article

Compose eLetter

Title *

Author Information

Contributors
First Name and Middle Initial * First or given name, e.g. 'Peter'. Last Name * Your last, or family, name, e.g. 'MacMoody'. Email Address * Your email address, e.g. higgs-boson@gmail.com Occupation * Your role and/or occupation, e.g. 'Orthopedic Surgeon'. Affiliation * Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.

Statement of Competing Interests

Competing interests? *

Yes

Please describe the competing interests

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

What code is in the image? *

Enter the characters shown in the image.

Vertical Tabs

Jump to comment:

Transforming how this pediatrician does well child care
Cliff M O'Callahan

Published on: 29 December 2016
Screening as a strategy to improve health of mothers and infants
Lorraine O. Walker

Published on: 21 July 2016
Promising Practice
Jennifer C. Morin

Published on: 14 July 2016
Opportunities for Mom Care at the Well-child Visit
Janis L Biermann

Published on: 12 July 2016

Published on: (29 December 2016)
Page navigation anchor for Transforming how this pediatrician does well child care
Transforming how this pediatrician does well child care
Cliff M O'Callahan, Pediatric faculty
I am a pediatric faculty within one of the sites where this was conducted and it has really transformed how I perform my well child visits in a profoundly positive way. Families understand, once I've explained to them, why their pediatrician is asking about depression and when they are planning to have their next child - and, thus, whether they are smoking, taking vitamins, using a decent form of contraception. These ques...
Show More

I am a pediatric faculty within one of the sites where this was conducted and it has really transformed how I perform my well child visits in a profoundly positive way. Families understand, once I've explained to them, why their pediatrician is asking about depression and when they are planning to have their next child - and, thus, whether they are smoking, taking vitamins, using a decent form of contraception. These questions have often opened up further critical issues pertinent to the child's environment at home - relationship issues and stresses, non- decision about contraception because they have not agreed on whether to have more children (and in the meantime are vulnerable to becoming pregnant). I have realized that parents do like it when I explain that I am already thinking about their next child and helping them to insure it is the healthiest it can be and conceived when they decide. As a pediatrician who is convinced that obesity prevention starts prior to conception, maternal BMI and wellness is the next area to add to the interconceptual discussion. My thanks to the authors for opening my eyes and improving how I work on behalf of families.
Competing interests: A colleague with one of the authors
Show Less

Competing Interests: None declared.
Published on: (21 July 2016)
Page navigation anchor for Screening as a strategy to improve health of mothers and infants
Screening as a strategy to improve health of mothers and infants
Lorraine O. Walker, Professsor
Research from various sources is demonstrating that after pregnancy women may not, for various reasons, receive continuing healthcare.(1) This study exemplifies strategies that can contribute to preventive healthcare of mothers and infants. A particular strength of this study is the focus on family practice settings, which showed the potential benefit of mother- child shared health homes. While screenings may also occur in...
Show More

Research from various sources is demonstrating that after pregnancy women may not, for various reasons, receive continuing healthcare.(1) This study exemplifies strategies that can contribute to preventive healthcare of mothers and infants. A particular strength of this study is the focus on family practice settings, which showed the potential benefit of mother- child shared health homes. While screenings may also occur in strictly pediatric practices, the barriers to referrals across systems can reduce the likelihood of follow-up care of mothers. From an interconception-care perspective, expanding screening to include also queries about pregnancy- related conditions, such as gestational diabetes, and whether mothers have a current source of healthcare would add yet further value and continuity to women's healthcare after pregnancy.(2) Although interconception care is important for perinatal benefits, it also has the potential to contribute women's health across the lifespan, for example, in reducing smoking and future related morbidities, such a lung cancer and heart disease.
1. Bennett WL, Chang HY, Levine DM, et al. Utilization of primary and obstetric care after medically complicated pregnancies: An analysis of medical claims data. Journal of General Internal Medicine. 2014;29(4):636- 645. 2. Walker LO, Murphey CL, Nichols F. The broken thread of health promotion and disease prevention for women during the postpartum period. Journal of Perinatal Education. 2015;24(2):81-92
Competing interests: None declared
Show Less

Competing Interests: None declared.
Published on: (14 July 2016)
Page navigation anchor for Promising Practice
Promising Practice
Jennifer C. Morin, Epidemiologist
From my perspective as a maternal and child health epidemiologist, this is a fantastic example of an approach implemented at the patient level that has the potential to impact population health over time. The IMPLICIT model complements other state and national efforts to address preconception and interconception health as a means for improving birth outcomes. Achieving optimal health across the life course is important,...
Show More

From my perspective as a maternal and child health epidemiologist, this is a fantastic example of an approach implemented at the patient level that has the potential to impact population health over time. The IMPLICIT model complements other state and national efforts to address preconception and interconception health as a means for improving birth outcomes. Achieving optimal health across the life course is important, regardless of one's desire to become pregnant. Assessing women's health in a diverse range of settings increases the likelihood that problems are identified and treated. The approach of addressing maternal health in the context of well-child visits provides a wonderful opportunity to help women who otherwise may have little or no contact with the health care system during the postpartum period and beyond. This study lays a solid foundation for future research of the delivery of interconception care in family medicine settings. There would be value added in future research of the IMPLICIT model in additional sites and patient populations to further explore its impact.
Competing interests: None declared
Show Less

Competing Interests: None declared.
Published on: (12 July 2016)
Page navigation anchor for Opportunities for Mom Care at the Well-child Visit
Opportunities for Mom Care at the Well-child Visit
Janis L Biermann, Senior Vice President
The March of Dimes is very proud to have supported IMPLICIT since its inception; we believe in the model and in the leaders who have worked tirelessly to test the model, collect the data and improve the system within their institutions. Our organization has a strong and long-term commitment to improving the rate of preterm birth in the US. One of the clinical interventions we promote is birth spacing and a toolkit to h...
Show More

The March of Dimes is very proud to have supported IMPLICIT since its inception; we believe in the model and in the leaders who have worked tirelessly to test the model, collect the data and improve the system within their institutions. Our organization has a strong and long-term commitment to improving the rate of preterm birth in the US. One of the clinical interventions we promote is birth spacing and a toolkit to help physicians address family planning as a strategy for birth spacing using the IMPLICIT model will soon be available. The opportunities for providing better interconception care at well-child visits as detailed in this paper will hopefully inspire and encourage other family physicians to assess their opportunity to do the same. We look forward to knowing that more women with risk factors will be identified and treated before pregnancy, as a way to improve her health and reduce adverse pregnancy outcomes.
Competing interests: I have authorized funding for IMPLICIT
Show Less

Competing Interests: None declared.