Maternal Health and Prenatal Care

Health promotion programs that focus on improving the health and well-being of pregnant women can help to contribute to better outcomes in early childhood. One of the early childhood health promotion frameworks, the Life Course Framework, describes how women's experiences and exposures during pregnancy, and even before, can impact children's health. This framework suggests that the longer an individual is exposed to and applies positive environmental, physical, mental, and behavioral activities to their routine, the better their health. The opposite is also true: the longer a person is exposed to unhealthy or negative behaviors, the poorer their health. The children of Pregnant women who exhibit positive physical, mental, environmental, and behavioral health over their lifecourse show the best birth outcomes and optimal childhood health. Research suggests that childhood obesity and related conditions are traceable to exposure to risk factors in the 1,000 days from conception through their second birthday.

For women of childbearing age, maintaining a healthy weight is a preventive measure that can contribute to childhood health. In 2014, nearly 40% of women over the age of 18 living in the most rural counties of the U.S. self-reported as obese. Maternal obesity increases the risk of adverse pregnancy and birth outcomes, including preeclampsia, gestational diabetes, preterm birth, having a large baby, and stillbirth. Maternal obesity is also the strongest predictor of obesity in children.

Preconception care is preventive care that all women of childbearing years ideally receive prior to becoming pregnant. It provides education and counseling on physical, mental, environmental, and behavioral health that cultivate the healthiest opportunities for mother and baby.

Many pregnancies in the U.S. are unintended, meaning the pregnancy occurred at a time that was not planned or desired, or the pregnancy occurred when no children were wanted. Unintended pregnancies often occur at higher rates in communities with high levels of poverty and lower educational attainment. Unintended pregnancies often result in securing prenatal care later than recommended and premature birth, which can result in health problems, including developmental delays, in children.

Expectant mothers can benefit from regular prenatal visits starting early in pregnancy. Prenatal care involves education on appropriate health behaviors during pregnancy and how to provide the best environment for their baby to grow. These visits provide an opportunity to monitor the health of the baby and the mother to improve birth outcomes.

Aside from emphasizing the importance of healthcare visits and prenatal care, programs may choose to target several other factors that influence children's health, including:

• Reducing or eliminating exposure to toxic substances, such as lead
• Addressing mental health and substance use issues during pregnancy and after a child is born
• Supporting women and families with community resources and services to help with a wide range of health and social needs

For more information, see the Maternal Health Toolkit.

Resources to Learn More

Health Disparities in Rural Women
Document
Describes the various health disparities women in rural communities face, notably poorer obstetric and reproductive health outcomes, as well as the impact of obstetric-gynecologic workforce shortages.
Organization(s): American College of Obstetricians and Gynecologists
Date: 2/2014