CDC Releases Recommendations

Healthy Start Works to Improve Health of Women, Families Before Pregnancy

The importance of efforts by Baltimore City Healthy Start, Inc.(BCHSI) to improve the health of women and families before pregnancy was reinforced with the recent release of national recommendations by the Centers for Disease Control and Prevention (CDC).

The recommendations on preconception health and health care are designed to encourage women to take steps toward good health before becoming pregnant. Developed by the CDC in collaboration with more than 35 federal, public and private partners, the recommendations identify more than a dozen risk factors and conditions that require interventions before pregnancy to be effective. The United States ranks 26th in the developed world in infant mortality. If implemented, the recommendations can help improve the health of babies and moms.

"Preconception health is critical and women of child bearing age should have a custom plan that fits their needs and lifestyle" said Alma Roberts, CEO of Baltimore City Healthy Start. Prior to pregnancy, women of childbearing age should see their doctor about managing existing medical conditions. "One way to help prevent neural tube defects is to get enough folic acid, believe it or not this can be done by eating about one tablespoon of peanut butter a day" said Roberts. "It is also important to refrain from smoking and drinking alcohol."

In Sandtown Winchester/Harlem Park, Rosemont, and the Historical Middle East communities of Baltimore City, the Healthy Start Program is already working on many of the strategies recommended by the CDC.

The Baltimore City Healthy Start Program has since it inception in 1992 recognized the importance of a strong Life Planning component which includes the promotion of family economic self-sufficiency offering education, career identification, employability and life skills classes for community residents.

In 2003, with funds from the Kellogg m BCHSI hired an OB/GYN nurse practitioner to provide center and home based family planning education and counseling including the administration and prescribing of contraceptives. In addition, a family practice nurse practitioner (working for BCHS six hours per month) offered complete women's health services to women in the communities without insurance.

Home visitors provide community residents with the following messages for women:

"Preconception health is important for every woman capable of having a baby, and should be tailored to each individual," said Dr. José Cordero, director of CDC's National Center on Birth Defects and Developmental Disabilities and Assistant Surgeon General. "And all couples, whether or not they are planning pregnancies, should have a reproductive life plan."

These recommendations will also give physicians and other health care professionals the knowledge, messages and tools to act on the scientific evidence that exists about how and when to intervene for preconception care. The federal Healthy Start program encourages local projects, like BCHSI to provide services during and between pregnancies to at-risk families.

The recommendations are the result of two-years of collaborative effort with a number of partner groups including The Academy of Obstetricians and Gynecologists, The National March of Dimes Birth Defects Foundation, The Association of Maternal and Child Health programs, The National Healthy Start Association, The American College of Nurse Midwives, The American Academy of Pediatrics, National Association of County and City Health Officials, Association of State and Territorial Health Officials, and The American Academy of Family Physicians.

The full recommendations on preconception care are available at www.cdc.gov/mmwr .

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