Background:
The reasons for embarking on this project were many:
•The Unintended Pregnancy rate at Kaiser Permanente in Northern California among women entering prenatal care is estimated to be at least 38% (varies from 29-52%), not including abortions.
•Underutilization of effective contraceptive methods such as ECPs and IUDs
•Neural tube defect rates have not lowered in KPNCR
•Prescribing teratogens in women 18-44 without effective contraception or EC as a back up is a missed prevention opportunity. Examples include Statins, Accutane, etc.
•Many women have their first visit for prenatal care at eight weeks of pregnancy or later, yet the time before the first prenatal visit carries the most risk to fetal development.
•Appropriate preconception health care improves pregnancy outcomes.



Objectives:
1. To improve the quality and consistency of clinical practice for women of reproductive age
2. To improve the health of women members of reproductive age
3.To provide information to women members of reproductive age about how to achieve and maintain optimal health and to decrease the risks of problems associated with pregnancy


Methods:
Development and implementation of 14 evidence-based clinician recommendations for women of reproductive age.


Results:
Completed development of 14 evidence-based preconception recommendations in the following categories:
•Folic Acid
•Smoking
•Alcohol and Drugs
•Developmental Toxicants
•Domestic Violence
•Healthy Eating
•Teratogens
•Obesity
•Physical Activity
•STDs
•Preventive Screening
•Genetic Screening and Testing
•Birth Control including IUDs and ECPs
•Pregnancy Termination
•KP Health Education Resources


Conclusion and implications for practice:
Kaiser Permanente Medical Care Program in Northern California is committed to providing the best, most current and evidence-based care to our members. To do so we developed Preventive Health Recommendations for Women of Reproductive Age to assure the provision of comprehensive, high quality, consistent, clinical and educational services for our young women members. The preventive health recommendations for women of reproductive age standardize current evidence and practice by improving the quality and consistency of clinical care.