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HELENE KENT MPH, RDN, HM KENT CONSULTING, DENVER, COLORADO [email protected] Women’s Health, Interconception Care and WIC

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Page 1: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

HELENE KENT MPH, RDN, HM KENT CONSULTING, DENVER, COLORADO [email protected]

Women’s Health, Interconception Care and WIC

Page 2: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Learner Objectives

• Identify three reasons why an interconception approach will benefit WIC enrolled postpartum women and their children.

• Recognize the vital role of weight and other nutrition topics within in interconception care.

• State how current WIC interventions may be adapted to include an interconception care approach.

• Find resources to assist with this effort.

Page 3: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

PRECONCEPTION AND INTERCONCEPTION HEALTH

Page 4: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Preconception and Interconception Health

• The goal of the care is two-fold: improve the woman’s health and help reduce health risks to her future baby.

• Refers to the state of a woman’s health and the care she receives before and between pregnancies (interconception care).

• Identifies and modifies risks (biomedical, behavioral and social) risks to a woman’s health and/or pregnancy outcome through prevention and management.

Page 5: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Preconception and Interconception Health

• An adjunct to prenatal care. importance as a way to improve women’s and infant’s health.

•• Impacts a woman’s overall wellbeing today and later in life.

• Offspring's health is impacted by woman’s health Health. Generational impact. Nutrition is an important factor affecting fetal genome – life-long consequences.

• Children born to women with this care should be less likely to be premature, low or high birthweight, have a birth defect or other disabling condition.

Presenter
Presentation Notes
Recurrence of some high risk pregnancy conditions is common in subsequent pregnancies Weight retention places women and their fetus at higher risk in subsequent pregnancies
Page 6: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Preconception and Interconception Health

• Address issues that are difficult or impossible to change during pregnancy

• Seeks to positively influences factors associated with poor pregnancy outcomes

• Tailored to the individual woman

• Includes health assessment and maintenance across life

• Includes reproductive life planning

Presenter
Presentation Notes
Is a set of primary prevention interventions to address problems that are difficult or impossible to change during pregnancy e.g. folic acid intake or weight . Seeks to positively influences factors associated with poor pregnancy outcomes, such as interconception length, chronic disease control and unintended conception. Is clinical care tailored to a woman to increase her chances of having a healthy baby. Includes health assessment and maintenance across the life span integrating childbearing and contraceptive considerations with women’s general health concerns. An important component is reproductive life planning that involves activities to help a woman plan, based on her values and resources, how to achieve personal goals about whether or when to have children.
http://www.cdc.gov/preconception/rlptool.html
Page 7: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Resources

• The National Preconception Health and Healthcare Initiative is a leader in promoting preconception health. A public/ private partnership led by CDC.

• Before, Between and Beyond Pregnancy website was established as comprehensive clinical resource.

Page 8: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

INTERCONCEPTION HEALTH AND WIC

Page 9: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

WIC

• Is ideally positioned

• Already does this work – Directly healthy eating and weight– Screening and referral

• It is “repackaging”

Presenter
Presentation Notes
WIC is ideally positioned to support interconception care as the program already addresses most aspects of this care. It is only necessary to review processes and “repackage” them. While WIC cannot provide a complete interconception care visit, staff are able to take the lead in sharing messages regarding healthy eating, choosing foods, weight, postpartum weight loss, folic acid intake • Recommend continued use of folic acid through a daily multivitamin with 400 micrograms of folic acid. and nutrition aspects of chronic health conditions. Staff also play an important role in screening The interconception care the woman receives from referrals will be dependent upon her health care providers’ awareness and practices in this area. WIC staff may share information and resources about preconception/interconception care with providers, especially colleagues housed within the same agency,�as well as referral offices/programs, hospitals, the community and other WIC programs. Many public health partners are involved in preconception efforts and will welcome the involvement of WIC. These partners can serve as resources for referral, training and support.
Page 10: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Interconception Care Topics

• Nutrition and Weight–Weight - especially postpartum –Healthful eating - quality and access–Folic acid intake –Medical nutrition therapy

Page 11: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Obesity and Perinatal Women’s Health

• Influences fertility• Increased risk of:

– Hypertension, – Pre-eclapsia,– Gestational diabetes, – Assisted delivery, – Depression during and after pregnancy, – Birth defects,– Birth weight (high, low and preterm)

Page 12: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Postpartum Weight Retention

• 75% of women have higher weights at 12 months postpartum than before pregnancy– 47% retain 10 lb or more– 24% retain 20lb or more

• Largely seen among women with prepregnancy obesity rather than those with excessive gain

– Up to 13% of women will move from prepregnancy normal weight to postpartum overweight status

• Weight retention at 6 months postpartum associated with higher weight status and larger waist circumferences at 7yr and 15yr postpartum

Endres et al. Obstet Gynecol 2015;125:144. Kirkgaard et al. Am J Clin Nutr. 2014;99:312

Page 13: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Interconception Care Topics

• Chronic Disease – Receiving needed care– Medical nutrition therapy needs as appropriate

• Family Planning– Address short interconception period– Reproductive life planning– Referral

Page 14: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Interconception Care Topics

• Screening and Referral– Medication Use– Substance Use– Previous Pregnancy Outcomes– Mental Health – Interpersonal Violence

Page 15: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

HOW TO INCORPORATE AN INTERCONCEPTION HEALTH APPROACH IN WIC

Page 16: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Project Background

• Funded by MCHB

• Developed by University of Minnesota, School of Public Health

• Steered by a committee of WIC and MCH practitioners

• Adopted by Association of State Public Health Nutritionists (ASPHN)

• Companion to ASPHN’s The Role of Nutrition in Infant Mortality

Page 17: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Steering Committee

• Jamie Stang, PhD, MPH, RD, LN, Associate Professor, School of Public Health, University of Minnesota

• Denise Sofka, RD, MPH, Project Officer, HRSA, MCHB • Stephanie Bess, RD, MS, LDN, Director WIC Program, Illinois Department of Human

Services• Robin Colbert, MS, RD, LDN, CLC Regional WIC Nutritionist, Illinois Department of

Human Services• Jodi Klement, RD, CD, CLE WIC Nutrition & Breastfeeding Coordinator, Milwaukee

County, Wisconsin Division of Public Health• Patricia Faulkner, MS WIC Nutrition Unit Supervisor, Minnesota WIC/CSFP

Program, Minnesota Department of Health • Sandy Perkins, RD, MS Consultant, Association of State Public Health Nutritionists• Brittany Stotmeister, RD, CD, Graduate Student, School of Public Health, University

of Minnesota• Brittany Ulrich, Graduate Student, School of Public Health, University of

Minnesota• Helene Kent, MPH, RDN Project Manager

Page 18: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Association of State Public Health Nutritionists ASPHN.org Resources

• The Role of Nutrition in Infant Mortality: A Public Health Perspective, MCH Council, Winter 2013

• Preconception Care: The Role of Nutrition, MCH Nutrition Council, Winter 2015 – 16

• Implementing the Recommendations

• Communicating about Weight

Page 19: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Preconception Health: The Role of Nutrition

• Introduction • Preconception health and health care • Organizing frameworks supporting a preconception

health approach• Nutrition and preconception care and health care

– Dietary adequacy– Achieve and maintain a healthy weight– Existing health conditions

• What PHN can do to support preconception care• How to adapt WIC Activities to support PCC

Page 20: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Content

• WIC based activities to support this care

• Interconception care implementation tips– External environment– WIC clinic processes– WIC clinic visit

Page 21: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

What Can You Do?

• Learn more about this topic see suggested resources

• Consider how to adjust your services to include this approach

• Support preconception care services within your community, agency and program

• Encourage women to participate in this care

• Address health equity and use culturally competent interventions

Page 22: Women’s Health, Interconception Care and WIChealth approach • Nutrition and preconception care and health care – Dietary adequacy – Achieve and maintain a healthy weight –

Thank You!Helene Kent - [email protected] Stang - [email protected]

This project was supported in part by the Health Resources and Services Administration, Maternal and Child Health Bureau (contract # T79MC00007)


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