Term of Award

Spring 1992

Degree Name

Master of Science in Rural Community Clinical Nurse Specialist

Document Type and Release Option

Thesis (restricted to Georgia Southern)

Committee Chair

M. Christine Talmadge

Committee Member 1

ElDonna Hilde

Abstract

Maternal and infant health in the United States is a serious problem as the United States' infant mortality rates have gradually risen over the years while other industrialized nations are reducing mortality rates. Numerous programs have focused on prenatal health education in an effort to improve pregnancy outcome, however, because many women are not aware of their pregnancy until missing more than one period, the critical period of organogenesis is taking place before the pregnancy is realized and confirmed. Recent evidence suggests that the incidence of congenital defects is increasing. Because the attainment of a healthy pregnancy has been linked to the timing, quantity, and quality of prenatal care, efforts can be directed to encourage women to improve their health prior to conception by reducing their risk factors and obtaining early intervention.

This preconceptional program assumes that by improving maternal health prior to conception, a reduction will be seen in adverse medical conditions during pregnancy, promote early prenatal care, and thereby improve fetal outcomes. Literature searches reveal few preconception programs in the Southeast. With this study, preconceptional screening identifies potential obstetrical risk factors, increases awareness of those risk factors, facilitates medical interventions and behavioral changes in order to reduce those risk factors. The study is a descriptive design utilized to identify potential preconceptional risk factors and interventions aimed at risk reduction. A convenience sampling of ten female students from rural counties in Georgia presenting at the university health clinic health center were asked to participate in the study.

Findings included 119 potential obstetrical risk factors. Each individual student had an average of 13.2 risk factors. The risk factors were distributed throughout all categories in the following order: environmental (29%), hereditary (22%), medical (19%), nutritional (15%), and infectious diseases (14%).

The concept of preconception care is applicable to obstetrically undeserved rural communities. As rural communities await obstetrical solutions, they can begin nurturing a low risk population through preconception care. The health of our children, our families, our communities and our nation begins in the preconception period.

Maternal and infant health in the United States is a serious problem as the United States' infant mortality rates have gradually risen over the years while other industrialized nations are reducing mortality rates. In 1987, the United States placed last among twenty industrialized nations when infant mortality rates were compared (General Accounting Office, 1987). Since early and continuing prenatal care is a major determinant of infant mortality, it is interesting to note that the U.S. differs from other nations by failing to have uniform national standards for prenatal care, and by failing to achieve universal prenatal health coverage for its population. Consequently, the U.S. Public Health Service Expert Panel on the Content of Prenatal Care (1989) charges that the birth of a healthy baby to a healthy woman is a most important goal for our nation. Before the nation can make strides in reducing the infant mortality rates, the nation must attend to the promotion of healthy women as a precedent to the health of infants. All women who can become pregnant are candidates for preconception care and all health care providers who care for these women are candidates for providing preconception care. A preconceptional health promotion program promotes the concept of preconception care, preconception obstetrical risk screening and intervention, and, finally, enables the potential childbearing woman to take responsibility for her own health before conception.

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