PITTSBURGH — Women veterans aren’t routinely being queried about their intentions related to pregnancy, making it more difficult to optimize family planning care.

That’s according to a new study in the Maternal & Child Health Journal, which noted, “Routine assessment of pregnancy preferences in primary care could identify individuals to whom counseling about health optimization prior to pregnancy can be offered to promote patient-centered family planning care.”1

VA Pittsburgh Healthcare System-led researchers sought to determine the prevalence of women veterans reporting that they had received counseling about health optimization prior to pregnancy. Researchers also focused on which topics were most frequently discussed and factors associated with receipt of the care.

Data from a nationally representative, cross-sectional telephone survey of 2,302 women veterans, ages 18-45 who used VA for primary care in the previous year was analyzed. The sample included women who were (1) currently pregnant or trying to become pregnant, (2) not currently trying but planning for pregnancy in the future, or (3) unsure of pregnancy intention.

Results indicated that, among 512 women who were considering or unsure about pregnancy, fewer than half (49%) reported receiving any pre-pregnancy counseling from a VA provider in the past year. For those who did, the most frequently discussed topics included healthy weight (29%), medication safety (27%), smoking (27%) and folic acid use before pregnancy (27%).

The authors determined that factors positively associated with receipt of prepregnancy counseling included history of mental health conditions (aOR = 1.96, 95% CI: 1.28, 3.00) and receipt of primary care within a dedicated women’s health clinic (aOR = 2.07, 95% CI: 1.35, 3.18). Negatively associated were factors including far-future and unsure pregnancy intentions (aOR = 0.35, 95% CI: 0.17, 0.71 and aOR = 0.33, 95% CI: 0.16, 0.70, respectively).

“Routine assessment of pregnancy preferences in primary care could identify individuals to whom counseling about health optimization prior to pregnancy can be offered to promote patient-centered family planning care,” the authors concluded.

 

  1. Quinn DA, Edmonds SW, Zhao X, Borrero S, Ryan GL, Zephyrin LC, Callegari LS. Veteran-Reported Receipt of Prepregnancy Care: Data from the Examining Contraceptive Use and Unmet Need (ECUUN) Study. Matern Child Health J. 2021 Apr 30. doi: 10.1007/s10995-021-03131-5. Epub ahead of print. PMID: 33929654.