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Prenatal Care

Partner Violence, Seat-Belt Use Are Overlooked Issues in Prenatal Counseling

Although most 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.

"This 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.

"Poor 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.

To determine 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.

Other topics 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.

Also, for 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.

"Preventive 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.

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