Imagine heading out on a high-stakes trek without a plan. You’re dreaming of the destination and know it will take the better part of a year to get there. Excited, you set out with the highest hopes but without physical or mental preparation for any challenges along the way. Unless you thrive on risk, starting a long, life-changing trip without planning ahead is less than ideal.
But that’s often how the path to parenthood, one of life’s most profound journeys, begins: without planning or preparation. In fact, 86% of women are not getting preconception care from their family physician or OB-GYN, which can lead to a range of poor outcomes, from unnecessary fertility treatment to pregnancy complications and preterm births. That’s a problem for aspiring parents, their employers, and society as a whole.
What is preconception care?
Put simply, preconception care is personalized, preventative care that helps women and men increase their chance of having a healthy baby. Unlike prenatal care, which happens during pregnancy, preconception care should begin at least three months prior to conception. It encompasses a wide range of medical, behavioral and social interventions designed to improve the health of aspiring mothers and fathers, and reduce risks to an unborn child.
For example, during preconception care, women of reproductive age receive routine blood pressure checks. If diagnosed with hypertension, they receive guidance on lifestyle changes and medications that are safe to take during pregnancy. Women with a body mass index (BMI) greater than 30 (considered obese) are counseled about the risks during pregnancy and postpartum. Those with diabetes are advised on the importance of glucose control for a healthy pregnancy.
Quitting tobacco use, limiting alcohol consumption, reducing stress, eating a healthy diet, adjusting prescription medicines, staying current with vaccines, and taking a daily folic acid supplement are lifestyle changes and recommendations commonly advised during preconception care to promote healthy pregnancies. When future parents take these steps, their babies are less likely to be born early, have a low birthweight, or be born with birth defects. The Centers for Disease Control and Prevention (CDC) recommends all women and men follow these recommendations, regardless of plans to conceive. Not only does doing so contribute to a healthier life, but it protects babies in the case of unplanned pregnancy, which accounts for 50% of pregnancies in the U.S.
The lack of preconception care contributes to poor outcomes
The alarming gap of preconception care in the U.S. contributes to grim statistics:
- One in every 10 babies in the U.S. is born prematurely.
- The U.S. has the highest maternal mortality rate among developed countries, and 60% of these deaths are preventable.
- Pre-existing chronic diseases, such as hypertension and diabetes, are now responsible for half of all maternal deaths.
- The U.S. has among the highest rates of infant mortality in the developed world, caused primarily by birth defects, preterm birth and low birth weight.
- Birth defects affect one in every 33 babies born in the U.S. each year, which translates to 120,000 babies and hospital costs alone exceeding $2.6 billion.
As the rates of chronic disease, obesity and substance-abuse disorders continue to rise, so too does the need for preconception care.
Preconception care also critical for conception
Preconception care is not only critical for the health of babies, it’s important for fertility and conception in the first place. Health screenings can identify and address conditions or factors that negatively impact fertility, for example. Basic education about menstrual cycles and ovulation can help couples understand the optimal timing to try to conceive.
Without this guidance early in the journey, aspiring parents may experience emotional distress when pregnancy doesn’t happen quickly. Or, they may jump prematurely to costly in vitro fertilization (IVF) treatments, using their fertility benefit without first understanding the basics of conception. Indeed, less than 3% of infertility patients need advanced treatments like IVF. At Maven, 17% of our fertility track members don't end up needing or receiving fertility treatment, either because they were counseled and decided to adopt instead, or because they got pregnant naturally.
Preconception counseling is an important opportunity to learn about different paths to parenthood, as well. “People are typically unaware of the options available to them when they learn their chances of getting pregnant on their own are low,” explained Dr. Brian Levine, Reproductive Endocrinologist and founding partner of leading fertility clinic CCRM. “Through preconception counseling, they can discuss alternative routes to pregnancy, like using the egg from another woman or sperm from another man.”
Barriers to preconception care
Given the importance of preconception care, why are so few women and men receiving it? Experts point to several factors, including the prevalence of unplanned pregnancies, lack of access to primary and specialty care (which has only worsened in the pandemic), time constraints in doctor visits, and a fragmented healthcare system that focuses more on (and reimburses for) reactive rather than preventative care.
How you can help
The good news? Employers can help remove these barriers and ensure aspiring parents in their workforce get the support and care they need on any path to parenthood. As you design your fertility and maternity benefits, look for solutions that provide unbiased support and guidance at the right time — before pregnancy or unnecessary fertility treatments.
Your fertility and maternity healthcare solutions should provide:
- Early and ongoing engagement with aspiring parents
The first step in effective preconception care is engagement, which means you need to reach aspiring parents early — before they conceive or start fertility treatment — and give them a compelling, personalized solution they want to use. A digital-only app for fertility or maternal care won’t suffice. Look for solutions that combine technology, compassion and evidence-based content and clinical support.
- 24/7/365 access to high-quality specialty care
Virtual care can help aspiring parents overcome access to care barriers. Look for solutions that offer round-the-clock access to advocates and high-quality specialty providers, including nutritionists, fertility awareness educators, OB-GYNs, reproductive endocrinologists, mental health providers, adoption coaches, and surrogacy coaches.
- Holistic care and support at all stages of the parenthood journey
Help aspiring parents achieve optimal emotional, mental and physical health as they embark on the journey to parenthood. Care models that integrate mental and physical health are shown to dramatically improve health outcomes and reduce healthcare costs. Also make sure to invest in fertility benefits that offer family planning or preconception care rather than simply reimburse for fertility treatment.
- Education to build health literacy, especially in fertility and pregnancy
Offer aspiring parents a curriculum of information and resources to help them better understand timed intercourse, facts about fertility, all paths to parenthood and other important topics.
Maven is the world's largest virtual clinic for women's and family health. Our unique care model enables employers and health plans to improve maternal health outcomes and lower costs, while empowering parents to grow their families while growing their careers. The Maven platform is global, includes personalized programs across fertility, maternity, and parenting/pediatrics, and offers 24/7 access to Maven's proprietary telemedicine network, the largest in women's health. To find out how Maven can help your organization improve healthcare outcomes for families, request a demo today.
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