, defined here as the care that addresses a woman’s health care needs during the interval between one live birth or pregnancy loss and the start of the next pregnancy specifically, it will focus on this interval after a woman has transitioned from postpartum care.ĭuring Routine Health Care or Well-Woman or Pediatric Visits §Īssess whether the woman would like to become pregnant in the next year When reviewing international recommendations for birth spacing, the World Health Organization identified four intervals: 1) “interpregnancy interval” indicates the time a woman is not pregnant between one live birth or pregnancy loss and the next pregnancy 2) “birth-to-birth interval” is the time between a live birth and the subsequent live birth (this interval does not take into account any pregnancy losses in between births) 3) “interoutcome interval” describes the time between the outcome of one pregnancy and the outcome of the previous pregnancy and 4) “birth-to-conception interval” is the time between a live birth and the start of the next pregnancy 6. Interpregnancy care is the care provided to women of childbearing age who are between pregnancies with the goal of improving outcomes for women and infants 5. However, it should be acknowledged that not all women will want to or will have subsequent pregnancies or children.ĭefinition of Interpregnancy and Well-Woman Care Because the interpregnancy period is a continuum for overall health and wellness, all women of reproductive age who have been pregnant regardless of the outcome of their pregnancies (ie, miscarriage, abortion, preterm, full-term delivery), should receive interpregnancy care as a continuum from postpartum care (see the American College of Obstetricians and Gynecologists’ Committee Opinion Therefore, interpregnancy care aims to maximize a woman’s level of wellness not just in between pregnancies and during subsequent pregnancies, but also along her life course. The proposed long-term yield is improved long-term health for the woman. The yield of this effort is improved maternal health at the start of the next pregnancy, which leads to improved health outcomes for the infant. The interpregnancy period is an opportunity to address these complications or medical issues that have developed during pregnancy, to assess a woman’s mental and physical well-being, and to optimize her health along her life course. For women who become pregnant, pregnancy is recognized as a window to future health because complications during pregnancy, such as gestational diabetes mellitus, gestational hypertension, preeclampsia, and fetal growth restriction, are associated with risk of health complications later in life 1 2 3 4. Prepregnancy, postpartum, interpregnancy, and well-woman care are interrelated and can be defined by their relationship to the timing of pregnancy Figure 1. Prepregnancy, Postpartum, Interpregnancy, and Well-Woman Care: The Intersection For women who will not have any future pregnancies, the period after pregnancy also affords an opportunity for secondary prevention and improvement of future health. In women with chronic medical conditions, interpregnancy care provides an opportunity to optimize health before a subsequent pregnancy. The initial components of interpregnancy care should include the components of postpartum care, such as reproductive life planning, screening for depression, vaccination, managing diabetes or hypertension if needed, education about future health, assisting the patient to develop a postpartum care team, and making plans for long-term medical care.
Because the interpregnancy period is a continuum for overall health and wellness, all women of reproductive age who have been pregnant regardless of the outcome of their pregnancies (ie, miscarriage, abortion, preterm, full-term delivery), should receive interpregnancy care as a continuum from postpartum care. ABSTRACT: Interpregnancy care aims to maximize a woman’s level of wellness not just in between pregnancies and during subsequent pregnancies, but also along her life course.
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