Expecting to expect? See your doctor

Are you expecting to be expecting? Saving conception for years down the road?

Either way, you should be in a physician's talking about prenatal and preconception care, doctors and researchers say.

"It teaches them to pay attention to their bodies," said Linda Erb, perinatal services coordinator for the county Department of Public Health.

Prenatal care, which is for the soon-to-be mom, entails health care, education and counseling about how to handle different aspects of pregnancy and identifying risks.

Preconception care helps a women get into the best health before getting pregnant.

The Centers for Disease Control and Prevention gave this focus of care a push into the foreground last year when it recommended that all women of reproductive age, meaning between their first period and menopause, treat their health as if they could be pregnant at any time.

This means taking folic acid supplements, maintaining a healthy weight and lifestyle and keeping chronic conditions like asthma and diabetes in check.

Preconception care could positively impact a baby's health during the first months of pregnancy, when many women don't even know they are pregnant, said Dr. Joel Cohen, chief of service of obstetrics and gynecology at Kaiser Permanente in Bakersfield.

"The first six to eight weeks is a critical time in development," he said. "That's when everything is forming."

But while this may improve the health of mom and baby, the link between prenatal care and preterm birth is negligible, according to a recent report.

A landmark study released last year by the National Academy of Science's Institute of Medicine found there isn't enough evidence that prenatal care prevents a premature birth.

Historically, though, avoiding preterm birth has not been a focus of prenatal programs, the report said. Several local health advocates say that is changing.

Prenatal care often falls along ethnic and economic lines, leaving out the mothers who are most at risk for preterm birth, which could also explain its diminished effect, a recent report from the Central Valley Health Policy Institute at Fresno State found.

Asian/Pacific Islander mothers were 27 percent less likely to receive care than white mothers, the study says. Black mothers were 19 percent less likely and Hispanic mothers were 17 percent less likely.

This somewhat follows the local trends for preterm birth. Black women have the highest rates of preterm birth, though, followed by Asians, Hispanics and then whites.

"In many cultures, pregnancy is considered a healthy, natural state. Why do you go to a doctor for prenatal care?" asked Mary Lou Moore, associate professor in the department of obstetrics and gynecology at North Carolina's Wake Forest University. Moore recently spoke at a perinatal health conference at Children's Hospital Central California. "The idea that we have control over nature is a very Anglo/Northern European way of life."

Prenatal care needs to be stressed regardless of its intended target problem, said Dr. Sudhir Patel, chief of neonatology at Kern Medical Center and director of neonatology at Mercy Southwest Hospital.

"If everyone received prenatal care, we may not change preterm birth," he said. "But the baby's health at birth will be better."

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Source: The Bakersfield Californian, Saturday, Apr 14 2007

Fertility and Conception: Raising Bakersfield

Expecting to expect? See your doctor