PREGNANCY PLANNING AND PRE-CONCEPTION COUNSELING

Objective: To estimate the percentage of women with one or more of fou r potentially modifiable risks who could have availed themselves of pr e-conception counseling. Methods: We defined pre-conception counseling to be consultation that occurs shortly before a couple attempts conce ption. Thus, we assumed that to obtain pre-conception counseling, a wo man must plan her pregnancy. We used data from a population-based surv ey of 12,452 new mothers in four states who delivered babies during 19 88-1990. Mothers were contacted 3-6 months after delivery and asked ab out pre-conception behaviors and the planning status of their pregnanc ies. We estimated the percentage of women who planned their pregnancie s and had an indication for pre-conception counseling related to smoki ng, drinking, being underweight, or delaying initiation of prenatal ca re. Results: State-specific response rates ranged from 68-84%. Sixty p ercent of mothers reported that their pregnancies were planned. In gen eral, mothers with unintended pregnancies were more likely to have an indication for preconception counseling than mothers with planned preg nancies. Thirty-eight percent of all mothers planned their pregnancies and had one or more indications for preconception counseling. An addi tional 30% had one or more indications for counseling but did not have a planned pregnancy. Conclusions: Despite the limited range of indica tions for counseling that we considered, a substantial percentage of w omen potentially could have used counseling. A similar percentage of w omen could have benefited from family planning services.