Infant Mortality Linked to Lack of Preconception and Interconception Care

August 15, 2016|3:45 p.m.| Eighmey Zeeck

Infant mortality is still a critical issue in the United States, known for having the highest rate among developed nations. Infant mortality rates have been linked to a lack of preconception and interconception care, or a lack of access to such care by women of reproductive age. ASTHO, in partnership with both the Alliance for Innovation in Maternal Health (AIM) program and The Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality, is working to help states create solutions to improve pre- and interconception care in order to reduce both infant and maternal mortality rates

Pre- and interconception care necessary to reduce unintended pregnancies

Receiving inadequate or no pre- and interconception care also increases the number of unintended pregnancies and maternal mortality rates in the U.S., which have serious economic outcomes. In 2011, almost half of all pregnancies were unintended. Despite the CDC’s recent announcement of the national decline in teen pregnancies to roughly 22 births per 1,000 girls aged 15-19, of those births 75 percent were unintended. An unintended pregnancy can put both the mother and fetus at higher risk of complications during pregnancy, because the woman may not have discussed improving or maintaining health or received care to resolve or prevent issues prior to conception. Access to both pre- and interconception care is vital for improving the outcome for both the mother and fetus. CDC and the American College of Obstetricians and Gynecologists have recommended that health providers routinely discuss reproductive health plans with women and their partners, allowing them to discuss contraceptive options that would fit the woman’s lifestyle, like long-acting reversible contraception (LARC).        

Access to pre- and interconception care for adolescents

It is important to note that pre- and interconception care affects women of all ages, including adolescents. In 2010 only 43 percent of pregnant adolescents sought prenatal care within the first trimester. Studies link a late uptake in prenatal care to whether the pregnancy was unintended, the mother’s age, and the mother’s education level. Another barrier in seeking prenatal care among teen mothers is whether or not they can access prenatal care without parental consent. After pregnancy, due to a lack of interconception care for adolescent mothers, there is a high risk of adolescents having repeat pregnancies. The American Academy of Pediatrics cites studies showing that an adolescent mother’s uptake of prenatal care during subsequent pregnancies is even later than in the previous pregnancy.

National and state trends to increase pre- and interconception care rates

Infant mortality is a complex public health issue, with preconception and interconception care being key in helping to reduce the U.S. infant mortality rates. There is a need for an increase in parenting programs for adolescents during both prenatal and interconception care periods. These programs have been proven to help reduce repeat pregnancies, reduce infant mortality rates, and provide young mothers with positive parenting techniques. The CDC recently launched its “Show Your Love” campaign in order to promote planned pregnancies and encourage more women to access preconception care. ASTHO supports access to preconception services for all women of reproductive age.

Eighmey Zeeck

Eighmey Zeeck, MPH is an intern for maternal and child health at ASTHO. She graduated August 2015 with a Master of Public Health degree from George Washington University with a focus on global health. Zeeck supports ASTHO projects related to access to care for women and children.