Prenatal Care Advised Before Conception

Women considering pregnancy should begin prenatal care long before conception to ensure a healthy baby, a federal advisory panel recommended Monday.

“Every woman . . . contemplating pregnancy within one year should consult a prenatal care provider,” the panel said. “Because many pregnancies are not planned, providers should include preconception counseling . . . in contacts with women and men of reproductive age.” The Public Health Service three years ago asked the panel, whose members are academics and other child-development experts, to assess prenatal care in the United States and make recommendations based on the outcome of its research.

The report said that “all women would benefit from preconception care. Such care should be available to all women and their partners and should be integrated into primary care services.”

Accessibility Criticized

The report added, however, that “unfortunately, women most likely to benefit from preconception care are often those least likely to have access to it.” Thus, it said, such care “should be available in all health care settings in convenient community locations.”

While urging early prenatal care, the panel also said that fewer visits to a doctor may be in order for low-risk pregnant women.

“For women considered to be healthy, visits with prenatal care providers should be scheduled for specific risk assessment or planned health promotion,” the report said. “When possible, (both) should be integrated into a single visit . . .”

The report noted that although the United States spends a higher proportion of its gross national product on health care than any other nation, it ranks 17th in infant mortality, with a rate of 10.4 deaths per 1,000 live births in 1986.

Racial Profiles Noted

Further, the report said that “the disparity between black and white infant mortality and low-birth weight rates (roughly double) is a source of concern.”

“Clearly,” it added, “something is wrong with the way we provide care to women to prevent pregnancy complications and ensure the best possible infant outcome.”

In addition to “traditional medical concerns,” prenatal care should be tailored to a pregnant woman’s social and psychological needs, the report said.