Partner Violence, Seat-Belt Use Are Overlooked Issues in Prenatal Counseling
pregnant women receive counseling on a number of health topics, some
women with special risks are not getting the advice they need,
according to results of a new study.
suggests the need to individualize counseling for each patient
according to her personal behaviors and experiences," said Dr. Ruth
Petersen of the University of North Carolina, lead study author.
To date, few
studies have examined how often pregant women are asked about
preventive health topics. Prenatal care is a perfect time to provide
preventive health counseling, since most women receive some form of
prenatal care, Petersen said.
pregnancy outcomes can often be linked to a limited number of high-risk
behaviors such as substance abuse and poor diet, which can be modified
by behavioral changes," she said.
how often women were counseled on relevant health topics during
pregnancy, Petersen and colleagues analyzed data from a government
survey of nearly 25,000 postpartum women.
A majority of
topics were well covered by healthcare practitioners, the study found:
more than 80 percent of the surveyed women reported counseling on
cigarette and alcohol use, nutrition, breast-feeding, pre-term labor,
family planning after pregnancy, medication use during pregnancy, fetal
growth and development, and HIV testing.
relevant to pregnant women were less likely to be addressed, including
partner violence, with a counseling rate of 31 percent; seat-belt use,
53 percent; illegal drug use, 73 percent; and HIV risks, 51 percent,
according to the study.
certain topics, counseling was not targeted to the needs of individual
women. Those in higher need of counseling on breast feeding, partner
violence and pre-term labor, for example, received no more counseling
on these topics than other women. In contrast, pregnant women who
smoked and used alcohol were more likely to receive counseling on those
subjects than women who didn't smoke or drink, the researchers found.
health practice guidelines may need to include efficient, effective and
reliable ways to assess patients' risks and to provide focused
counseling according to those risks," said Petersen.