Preconception
and Pregnancy
Knowledge Path
Introduction
This knowledge path about preconception
and pregnancy has been compiled by the Maternal
and Child Health Library at
Georgetown University. It offers a selection of current,
high-quality resources that analyze perinatal health
statistics, describe effective prenatal care programs,
and report on research aimed at improving access
to and quality of prenatal care and improving perinatal
health outcomes. A separate section lists consumer
health resources. The final part of the knowledge
path presents resources on specific aspects of preconception
and pregnancy: childbirth, depression, drug and alcohol
use, environmental concerns, fertility and infertility,
nutrition, oral health, and tobacco use. This knowledge
path will be updated periodically.
Related topics: Please see our knowledge paths
about adolescent
pregnancy prevention, community
services locator, depression
during and after pregnancy, infant
mortality and pregnancy loss, and oral
health for infants, children, adolescents, and
pregnant women. Also see the resource brief about home
visiting.
Resources for
Professionals
Web Sites:
A-Z
- Agency
for Healthcare Research and Quality (AHRQ):
Women's Health.
Provides clinical information about maternal
health and pregnancy.
Presents data from the Healthcare
Cost and Utilization Project (HCUP), National
Guideline Clearinghouse,
and National
Quality Measures Clearinghouse™
(NQMC).
AHRQ is the health services research
arm of the Department
of Health and Human Services (DHHS).
Recent publications include
Gestational
diabetes: Caring for women during and after pregnancy. (2009). [Clinician's guide].
Health
care expenditures
for uncomplicated
pregnancies.
(2007).
Primary
care interventions to promote breastfeeding. (2008).
Screening
for bacterial vaginosis in pregnancy. (2008).
Screening
for Human Immunodeficiency Virus infection,
rev. ed. (2007).
- American
College of Obstetricians and Gynecologists
(ACOG). Contains
brochures, booklets, policy statements, and
other materials about preconception and pregnancy
for health professionals. Topics include health
care for underserved women, perinatal HIV,
smoking cessation, and women with disabilities.
Also presents an online
directory of physicians.
Note: Many resources on the site are accessible
to members only.
- Association
of Maternal and Child Health Programs (AMCHP):
Women's Health.
Offers information and resources, including
slide presentations, fact sheets, and training
programs to help states build their capacity
to provide essential women's health services.
Project areas include health disparities; healthy
weight; infant mortality; perinatal HIV prevention;
reducing maternal illness, injury, and death;
tobacco use prevention and cessation; and other
emerging issues. Recent publications include
HIV
testing in pregnant women.
(2006).
Perinatal
HIV action learning lab: Summary report.
(2006).
Preconception
health and health care.
(2007).
Promoting
healthy weight among women of reproductive
age. (2006).
- Association
of Women's Health, Obstetric, and Neonatal
Nurses (AWHONN).
Offers clinical practice information and continuing-education
resources about preconception, pregnancy, labor
and delivery management, and postpartum care.
- Centers
for Disease Control and Prevention (CDC).
Contains information about preconception and
pregnancy. Resources and initiatives include
CDC's
Division of Reproductive
Health.
Contains links to reports,
data, and other resources
about pregnancy and prenatal
care, including maternal
morbidity and mortality;
smoking; alcohol use;
folic acid consumption;
violence; workplace hazards;
and racial and ethnic
disparities.
CDC's
Morbidity & Mortality Weekly Reports (MMWR).
Presents data based on weekly reports to CDC
by state health departments. Also offers online continuing-education
courses for health
professionals that coincide with several preconception
and pregnancy-related guidelines published
in MMWR. Recent reports about preconception
and pregnancy include
CDC's National
Center for Health Statistics (NCHS).
Provides data about preconception and pregnancy,
including
CDC's National
Center on Birth Defects and Developmental Disabilities
(NCBDDD). Offers
scientific publications and tools, guidelines,
educational materials, an electronic
discussion group,
and information about research projects and
public health campaigns to identify the causes
of birth defects. Preconception and pregnancy-related
topics include folic acid consumption, preventing
alcohol-exposed pregnancies, medication use
during pregnancy, and using family history
information in obstetrics and pediatrics.
Other resources and initiatives
about preconception and pregnancy from CDC:
Critical
needs in caring for pregnant women during times
of disaster for non-obstetric health care providers.
(2007).
Guidelines
for vaccinating pregnant women, rev. ed.
(2007).
Guide
to Community Preventive Services.
Contains information about a systematic review
of studies to develop recommendations for reducing
the number of pregnancies affected by neural
tube defects.
One
Test, Two Lives.
Provides resources for health professionals
and materials for their patients to help encourage
universal voluntary prenatal testing for HIV.
Also see CDC's Pregnancy
Risk Assessment Monitoring System (PRAMS), Pregnancy
Surveillance System (PNSS),
and VitalStats.
- Centers
for Medicare and Medicaid Services (CMS).
Contains program information, eligibility criteria,
publications, forms, and data about Medicaid,
which offers coverage for eligible pregnant
women. CMS administers Medicare, Medicaid,
and the State Children's Health Insurance Program
(SCHIP).
- CityMatCH.
Contains tools and resources for implementing the
Perinatal Periods of Risk (PPOR) approach for mobilizing
urban communities to reduce feto-infant mortality
in U.S. cities. Also presents publications about
perinatal HIV prevention in urban communities.
- Healthy
People 2010.
Offers information about this national health-promotion
and disease-prevention initiative. It is coordinated
by the Office
of Disease Prevention and Health Promotion
(ODPHP). Healthy
People contains
467 objectives, and 31 focus on pregnancy.
To identify them, search the
objectives by selecting pregnancy under
Topic. Click on Submit. See Data2010 for
data about the Healthy
People 2010 pregnancy
objectives and the HP2010
Information Access Project for
access to published literature related to the Healthy
People 2010 objectives
about pregnancy and family planning. Also view
proposed Healthy
People 2020 objectives for family
planning and maternal,
infant, and child health.
- Kaiser
Family Foundation (KFF): Women's Health Policy.
Provides fact sheets, issue briefs, meeting
materials, data,
and news for
policymakers, journalists, advocates, and public
health professionals about women's reproductive
health and access to care, including pregnancy-related
care. KFF is an independent philanthropy focusing
on national health care issues. Recent publications
include
Maternity
care and consumer-driven
health plans.
(2007).
Medicaid's
role for women.
(2007).
- March
of Dimes (MOD).
Offers perinatal
statistics, continuing-education
modules, and medical reference information
on topics that include preconception, pregnancy,
prenatal screening, and genetics. Recent publications
include
Costs
of maternity and infant
care.
(2007).
Diabetes
in pregnancy. (2006).
Healthcare
costs of having a baby.
(2007).
HIV
and AIDS in pregnancy.
(2006).
- Maternal
and Child Health Bureau (MCHB).
Describes MCHB's projects and initiatives on
behalf of America's women, infants, children,
adolescents, and their families. Programs include
the Title V block grant to states (see the Title
V Information System for
state and federal budget and expenditure data
on prenatal care and information about states'
efforts to improve pregnancy outcomes). MCHB
has a fact
sheet about prenatal
care in English and Spanish that includes a
hotline number to help pregnant women find
prenatal care services in their communities.
The Maternal
and Child Health Library and
the Discretionary Grant Information
System (DGIS)offer additional information
about the initiatives and programs supported
by MCHB that pertain to prenatal care. MCHB
is part of the Health
Resources and Services Administration (HRSA).
Another recent resource is
Women's
health USA.
(2007). This data book
presents key facts and
figures about U.S. women.
It includes information
about population characteristics,
health status, and health
services utilization.
Topics include maternal
health.
- National
Birth Defects Prevention Network (NBDPN).
Presents a collection
of materials to
assist state program administrators and health
professionals in promoting birth defects prevention.
Each year, NBDPN selects a different theme
to highlight, and the 2009
theme is obesity
prevention and weight management before, during,
and after pregnancy. Preventing infections
in pregnancy, preconceptional health,
fetal
alcohol
spectrum
disorders, cardiac
defects,
neural
tube defects,
and cleft lip and cleft palate are themes for
earlier years for which there are materials.
- National
Healthy Start Association (NHSA).
Describes the Healthy Start program and provides
general information about infant mortality,
low-birthweight infants, and racial disparities
in perinatal outcomes. Includes a directory
of Healthy Start programs nationwide and a newsletter.
Funded by the Maternal
and Child Health Bureau (MCHB),
Healthy Start provides community-based, culturally
competent, family-centered, comprehensive perinatal
health services to women, infants, and their
families in communities with very high rates
of infant mortality. See the Discretionary
Grant Information System (DGIS)for
information about Healthy Start grantees. Also
see the Maternal and Child Health Library's Healthy
Start Collection Database for
a catalog of materials developed by Healthy
Start programs.
- National
Institute of Child Health and Human Development
(NICHD): Women's Health Research.
Contains research and grant information, publications,
and other resources on topics that include
preconception and prenatal care, miscarriage
and stillbirth, preterm labor and premature
birth, disorders of pregnancy, drug safety
in pregnant women, and reproductive health
among women with physical disabilities. NICHD
is part of the National
Institutes of Health (NIH).
Recent publications include
State-of-the-Science
Conference on cesarean
delivery on maternal
request.
(2006). A news release,
Webcast, program and
abstract booklet, and
literature review accompany
the consensus statement.
- National
Perinatal Association (NPA).
Offers a collection of position papers about
access to perinatal care, breastfeeding, domestic
violence, medical liability reform, substance
abuse in pregnancy, and transcultural perinatal
care. Also offers information about NPA's resource
guide and training program about transcultural
perinatal care.
- National
Sudden and Unexpected Infant/Child Death and
Pregnancy Loss Resource Center.
Includes resources about stillbirth and miscarriage
for health professionals, policymakers, and
families. The resource center and the Maternal
and Child Health (MCH) Library are
co-located at Georgetown University's National
Center for Education in Maternal and Child
Health and are supported with funding from
the Maternal
and Child Health Bureau (MCHB).
- UNC
Center for Maternal and Infant Health.
Presents preconception and pregnancy research
and program information, algorithms for the
management of high-risk pregnancies, a family
history questionnaire, and information about
cystic fibrosis, maternal age and pregnancy,
prenatal screening, and prenatal diagnosis.
Offers patient-education fact sheets in English
and Spanish on pregnancy topics, genetics,
and serious pregnancy and fetal conditions.
The Center is part of the University of North
Carolina at Chapel Hill School of Medicine.
Reports include
Looking
back, moving forward: North Carolina's path to
healthier women and babies. (2007). Meeting
materials and an executive summary accompany
the report.
- World
Health Organization (WHO): Partnership for
Maternal, Newborn, and Child Health.
Offers program information and resources in
English and five other languages about pregnancy,
childbirth, maternal mortality, and infant
and child mortality worldwide. Fact sheets,
press materials, an advocacy kit, presentations,
and reports are among the resources presented.
Additional
Electronic Publications
- Behrman RE, Butler AS, eds. 2007. Preterm
birth causes, consequences, and prevention.
Washington, DC: National
Academies Press. This
report notes troubling disparities in preterm
birth rates among different racial and ethnic
groups. The report recommends a multidisciplinary
research agenda aimed at improving (1) the ability
to predict whether a woman is at risk for preterm
labor, (2) the ability to prevent preterm labor,
and (3) the understanding of the health and developmental
problems to which preterm infants are vulnerable.
- Campbell KP, ed. 2007. Investing
in maternal and child health: An employer's toolkit.
Washington, DC: National
Business Group on Health.
This toolkit provides employers with information
to design health-promoting and cost-effective
medical benefits for children, adolescents, and
pregnant women.
- Guyer B, Ma S, Grason H, Frick
K, Perry D, Wigton A, McIntosh J. 2008. Investments
to promote children's health: A systematic literature
review and economic analysis of interventions in
the preschool period.
Washington, DC: Partnership
for America's Economic Success.
This report examines the short- and long-term impacts
of health-promotion and disease-prevention interventions
on selected health problems in infants and young
children from birth to age 5. The report reviews
the patterns and monetary burden of poor child
health, the cost implications of preventing and
treating child health problems, and cost-benefit
analyses related to the interventions. Summaries
of studies of interventions during pregnancy that
report child health and economic outcomes are included.
Information on cost-benefit analyses for interventions
on tobacco use, obesity, unintentional injury,
and mental health problems is provided. Also see
the research brief, Early
childhood health problems and prevention strategies:
Costs and benefits (2008).
- Institute
of Medicine (IOM). 2009. Weight
gain during pregnancy: Reexamining the guidelines. Washington, DC: Institute of Medicine. This report examines weight gain during pregnancy and uses prepregnancy weight and body mass index to set a range for healthy weight gain. It makes recommendations to federal, state, and local organizations about using these updated guidelines to move women toward healthier pregnancies.
- Isaacs JB. 2007. Cost-effective
investments in children.
Washington, DC: Brookings
Institution. This
paper identifies four areas of investment in
children where there is sufficient evidence of
positive outcomes and sound benefit-cost ratios
to merit expanded federal funding. Target areas
are early-childhood-education programs, home-visiting
programs to promote sound prenatal care and the
healthy development of infants and young children,
school reform, and programs that reduce the incidence
of adolescent pregnancy.
- Ku L. 2007. Reducing
disparities in health coverage for legal immigrant
children and pregnant women, rev. ed.
Washington, DC: Center
on Budget and Policy Priorities (CBPP).
This fact sheet provides information about reducing
disparities in health coverage for legal immigrant
children and pregnant women. The fact sheet examines
the current health coverage of legal immigrants
and opportunities to restore equity to legal
immigrant children and pregnant women.
- Moiduddin E, Massey D. 2006. Segregation,
the concentration of poverty, and birth weight.
Princeton, NJ: Center
for Research on Child Wellbeing.
This paper examines the relationship between
neighborhood conditions experienced by pregnant
women of various racial and ethnic groups and
the weights of the infants they ultimately deliver,
controlling for individual and family characteristics.
- Thomson
Healthcare. 2007. Healthcare
costs of having a baby.
Santa Barbara, CA: Thomson Healthcare. This report
quantifies the overall costs of health care services
for having a baby, including all prenatal care
services, delivery-related services, and postpartum
services for the mother.
Databases
The databases listed below are excellent
tools for identifying data,
additional literature
and research, and programs about
preconception and pregnancy. Many of the entries
below contain tips on how to use the databases efficiently.
Please note that databases vary in how terms should
be entered; for example, some require quotation marks
and others don't. Enter search phrases as shown in
bold below.
- Data
- Child
Trends DataBank.
Reports on national trends and research on
over 80 key indicators of child and adolescent
well-being and offers information about the
types of programs and interventions that may
influence particular outcomes. Child Trends
is a nonprofit, nonpartisan research organization
providing research and data to inform decision-making
that affects children and adolescents. Recent
analyses about pregnancy and prenatal care
include
Conceptualizing
a "strong start": Antecedents
of positive child outcomes
at birth and into early
childhood.
(2007).
Men's
pregnancy intentions and prenatal behaviors:
What they mean for fathers' involvement with
their children.
(2007).
- Data2010:
The Healthy People 2010 Database.
Contains the most recent monitoring data for
tracking Healthy
People 2010. To
obtain data on the topic, click on the field,
Data by Focus Area. Under the field, Select
a Focus Area, choose 16 - Maternal, Infant,
and Child Health from the pop-up menu. Next,
click on the button for Include Related Objectives
From Other Focus Areas in the Table. Click
on the Submit button. Scan the report to identify
data about the many objectives related to preconception
and pregnancy. This data set is provided by
the National
Center for Health Statistics (NCHS) via CDC
Wonder.
- Discretionary
Grant Information System (DGIS). Contains
financial, national performance measure, and
abstract data collected annually from more
than 900 grants issued by the Maternal
and Child Health Bureau (MCHB),
including data from grants to improve pregnancy
outcomes.
- Healthcare
Cost and Utilization Project (HCUP): HCUPnet.
Provides access to health statistics and information
on hospital inpatient and emergency department
utilization at the national, regional, and
state levels. To identify data about hospital
use related to pregnancy and childbirth, select
National Statistics on All Stays or State Statistics
on All Stays. Select Researcher, medical professional.
Under type of query, select Statistics on specific
diagnoses or procedures. Select a year (e.g.,
2005). Select Diagnoses grouped by Clinical
Classifications Software (CCS). Select Principal
diagnosis. Under the field, Browse all CCS
categories, scroll to 11 Complications of Pregnancy,
Childbirth, and the Puerperium. Highlight the
category of interest (e.g., Normal pregnancy
and/or delivery). Hold the control key down
and click to make multiple selections. Click
on Next. Select the outcomes and measures of
interest (e.g., Number of discharges) and click
on Next. Select patient and hospital characteristics
(e.g., All patients in all hospitals) and click
on Next. View your results. HCUP is an initiative
of the Agency
for Healthcare Research and Quality (AHRQ).
HCUP statistical briefs include
Hospitalizations
related to childbirth,
2003.
(2006).
- Health
Data for All Ages.
Presents interactive online data tables on
pregnancy and birth, health conditions and
risk factors, health care access and use, and
mortality. Prenatal care data is presented
by maternal age, race/ethnicity, prenatal care
timing (i.e., first trimester, late, or none),
state, and for the United States overall. This
data warehouse is a service of the National
Center for Health Statistics (NCHS).
- National
Center for Health Statistics (NCHS): VitalStats.
Presents interactive maps and tables for over
100 public-use birth variables such as low
birthweight, gestation, pregnancy-associated
risk factors, and cesarean deliveries.
- National
Quality Measures Clearinghouse™
(NQMC). Contains evidence-based
health care quality measures and measure sets for
physicians, hospitals, and health plans to evaluate
and improve the quality of health care for consumers.
Identify measures on the topic by entering pregnancy in
the search box. Click on Search to get your results.
The database is sponsored by the Agency
for Healthcare Research and Quality (AHRQ).
- Office
on Women's Health (OWH) Quick Health Data Online.
Offers comparative, county-level health data
for all 50 states, the District of Columbia,
and U.S. territories and possessions. County,
state, regional and national data are available
and can be accessed by gender, race/ethnicity,
and age, concurrently. Maternal health is a
category.
- PeriStats.
Provides access to maternal- and infant-health-related
data at the national, state, county, and city levels.
Topics include the timing and adequacy of prenatal
care, tobacco use, childbirth method, preterm birth,
infant mortality, and health insurance coverage.
Over 60,000 graphs, maps, and tables are available.
PeriStats is a service of the March
of Dimes Perinatal Data Center.
- Pregnancy
Risk Assessment Monitoring System (PRAMS).
Presents state-specific, population-based data
on maternal attitudes and experiences before,
during, and immediately following pregnancy.
PRAMS is a surveillance project of the Centers
for Disease Control and Prevention (CDC) and
state health departments. Recent reports are
available via CDC's Division
of Reproductive Health.
- State
Health Facts Online.
Contains state-level data on women's health-related
Medicaid information, enrollment practices,
state insurance mandates, and refusal clauses.
Includes data about contraception, infertility
diagnosis and treatment, prenatal care, and
health care access. Information can be displayed
as tables, graphs, or color-coded maps. This
database is a service of the Kaiser
Family Foundation (KFF).
- Title
V Information System (Title V IS).
Contains data from annual Title V Block Grant
applications and reports submitted by all 59
U.S. states and jurisdictions. To learn about
states' efforts to improve pregnancy outcomes,
conduct several searches. Select Financial
Data to view state and federal budget and expenditure
data on prenatal care for pregnant women. Under
Program Data, find the number of pregnant women
served by Title V, health screening and treatment
information by states, Medicaid/non-Medicaid
comparison of prenatal care services, and eligibility
criteria for pregnant women for Medicaid and
SCHIP. Also view Measurement and Indicator
Data to learn about states' efforts to address
a core set of performance and outcome measures
that include services for pregnant women. Title
V IS is a service of the Maternal
and Child Health Bureau (MCHB).
Also see MCHB's Discretionary
Grant Information System (DGIS).
- Also see the Morbidity
& Mortality Weekly Reports (MMWR),
the National
Center for Health Statistics (NCHS),
the Pregnancy
Surveillance System (PNSS),
and Women's
health USA (2006).
- Literature
and Research Databases
- Clinical
Evidence. Describes
the best available evidence from systematic
reviews of the literature about the prevention
and treatment of clinical conditions. Topics
include pregnancy
and childbirth.
Clinical Evidence is available by subscription
only from the BMJ Publishing Group Limited,
located in the United Kingdom.
- Cochrane
Database of Systematic Reviews.
Presents systematic reviews of the effects
of health care interventions internationally.
Provides access to abstracts that can be browsed
by title or by topic such as pregnancy
and childbirth.
Access to the full-text article requires a
subscription. The database is published by
the Cochrane
Collaboration, an
international not-for-profit organization based
in the United Kingdom.
- Database
of Abstracts of Reviews of Effects (DARE).
Contains summaries of systematic reviews that
have met strict quality criteria. Included
reviews have to be about the effects of interventions.
Each summary also provides a critical commentary
on the quality of the review. The database
covers a broad range of health topics, including
pregnancy. To identify summaries on the topic,
type preconception pregnancy in the
search box, and click on Any of these words.
Click on Search to get your results. DARE is
produced and maintained by the Centre
for Reviews and Dissemination at
the University of York.
- HP2010
Information Access Project (HP2010 IAC).
Provides an automatic search mechanism for
published literature indexed in PubMed related
to the Healthy
People 2010 objectives
about maternal,
infant, and child health and family
planning. Also links
to a narrative for each objective and the complete
chapters about maternal, infant, and child
health and family planning in the text, Healthy
People 2010: Understanding and improving health,
2nd ed. (2000).
This service is provided by the Partners
in Information Access for the Public Health
Workforce, a collaboration
of federal agencies, public health organizations,
and health sciences libraries.
- Maternal
and Child Health Library at
the National
Center for Education in Maternal and Child
Health (NCEMCH),
Georgetown University. Maintains several databases
to collect, manage, and disseminate knowledge
about maternal and child health, with special
emphasis on knowledge gained from initiatives
and programs supported by the Maternal
and Child Health Bureau (MCHB).
The library's bibliographic databases are
Healthy
Start Collection Database.
Comprises an online catalog
of over 2,000 items developed
by Healthy Start sites,
including brochures,
bylaws, curricula, marketing
materials, policies,
and national evaluation
reports along with other
material related to maternal
and infant health. Materials
are classified according
to the nine Healthy Start
models of intervention
that range from community-based
consortia to risk prevention
and reduction. Search the
database using the term prenatal,
and narrow your search
by selecting a model
of intervention, project
name, or additional terms.
MCHLine®.
Comprises an online catalog of materials in the Maternal
and Child Health Library.
Pregnancy-related bibliographies include Adolescent prenatal care, AIDS/HIV in pregnancy, Home visiting, Nutrition
during pregnancy, Prematurity, Prenatal care, Smoking during pregnancy,
and Substance
use during
pregnancy.
The Maternal and Child Health
Library also offers organizations and programs databases.
- National
Guideline Clearinghouse (NGC).
Contains evidence-based clinical practice guidelines
and related materials for health professionals.
Identify guidelines on the topic by entering preconception
OR prenatal in the search box. NGC is an
initiative of the Agency
for Healthcare Research and Quality (AHRQ).
- PubMed.
Contains more than 19 million citations
for biomedical articles from MEDLINE
and life science journals. Citations
may include links
to full-text articles from PubMed Central or publisher web sites.
To identify citations on the topic, enter preconception
care OR prenatal care OR pregnancy in
the search box. Click on Limits and make the following
selections on the page: select a date (e.g. Published
in the last 2 years); click on Languages: English;
Click on Species: Humans; and select Search Field
Tags: MeSH Major Topic. Click on Search to get
your results. To narrow your search further or
for additional searches, use the MeSH
(Medical Subject Headings) database to identify
terms (e.g., (preconception
care OR prenatal care OR pregnancy)
AND diabetes. PubMed
is a service of the National
Library of Medicine (NLM).
- Society
of Obstetricians and Gynaecologists of Canada:
Clinical Practice Guidelines.
Offers clinical practice guidelines published
in the peer-reviewed journal, Journal of Obstetrics
and Gynaecology of Canada. Select a pregnancy
topic to link to all available guidelines on
that topic.
- Also see the Household
Products Database and
the Food
and Nutrition Information Center (FNIC) Databases.
- Programs
Databases
- Health
Services Research Projects in Progress (HSRProj).
Provides information about ongoing health services
research and public health projects. To identify
projects on the topic, enter the search phrase preconception
OR pregnancy. Click on Search to get your
results. HSRProj is funded by the National
Library of Medicine (NLM).
- Maternal
and Child Health Library at
the National
Center for Education in Maternal and Child
Health (NCEMCH),
Georgetown University. Maintains two databases
to identify pregnancy-related organizations
and programs:
MCH
Organizations Database.
Lists over 2,000 government,
professional, and voluntary
organizations involved
in MCH activities, primarily
at a national level.
Several national organizations
offer information about
pregnancy and prenatal
care, and these appear
in a list produced
from the database.
MCH
Projects Database.
Comprises an online catalog of projects funded
by the Maternal
and Child Health Bureau (MCHB).
To identify projects that focus on the topic,
type prenatal in the abstract field
of the database
search form. Conduct additional
separate searches using the terms preconception, pregnant,
and perinatal. Final
reports are available
from several of these projects. Also see MCHB's Discretionary
Grant Information System (DGIS).
Electronic
Newsletters and Online Discussion Group
- Getting
Off to a Healthy Start.
This newsletter, published quarterly by the National
Healthy Start Association (NHSA),
informs Healthy Start staff and others in the
MCH community about successful community-based
approaches to reducing infant mortality and
improving perinatal outcomes. The newsletter
also highlights research and evaluation findings,
legislative activities, and conference announcements.
- Kaiser
Daily Women's Health Policy Report.
This electronic newsletter provides legislative,
political, legal, scientific, and business
news on women's health policy issues that include
pregnancy and childbirth.
- National
Birth Defects Prevention Network Listserv.
This electronic discussion group aims to enhance
communication among public health professionals
working at the state level in birth defects
surveillance and prevention. This group is
administered by the Centers
for Disease Control and Prevention (CDC).
- Text4baby
Tuesday. This weekly
electronic newsletter presents information
about Text4baby, which offers free weekly
messages by cell phone to help pregnant
women and new parents through pregnancy
and their baby's first year. Signup for
Text4baby Tuesday to receive news from the national campaign
and get program updates on partners' innovative
promotion across the country.
Text4baby is an educational program of the National Healthy Mothers, Healthy
Babies Coalition.
Resources for Consumers
Find Preconception
and Prenatal Care
- American
College of Obstetricians and Gynecologists
(ACOG) Physician Directory.
Presents an online directory of active ACOG
members. The directory is searchable by name,
state, and zip code.
- Health
Resources and Services Administration (HRSA): Find a Health Center. Search by address, city, state, or zip code to find a federally funded health center that provides free or low-cost care.
- Maternal
and Child Health Bureau (MCHB) Hotline.
Offers a hotline number to help pregnant women
and mothers with newborns identify free or
low-cost services for themselves and their
infants. Telephone: (800) 311-BABY (2229);
(800) 504-7081 (Spanish).
- National
Perinatal HIV Consultation and Referral Service.
Offers a hotline number for free, 24-hour clinical
consultation and advice on the management of
HIV in pregnant women, HIV testing in pregnancy,
and the care of HIV-exposed infants. Callers
also can be linked with local perinatal HIV
specialists. Telephone: (888) 448-8765.
- Planned
Parenthood Federation of America (PPFA): Find
a Health Center.
Presents an online directory of PPFA health
center affiliates that offer sexual and reproductive
health care in each state. Search by state
and zip code from the PPFA Web site home page.
- Title
X Family Planning Provider Database.
Presents contact information for Title X-funded
health clinics that provide family planning
and reproductive health care to low-income
and uninsured people in the United States at
no cost or at a reduced cost. Search by city,
state, and zip code. The database is presented
by the Office
of Population Affairs (OPA).
- Also see Text4baby and the Community
Services Locator: An Online Directory for Finding
Community Services for Children and Families.
Web
Sites for Consumers
- American
College of Nurse-Midwives (ACNM): myMidwife.org.
Includes articles and information for women
about pregnancy, childbirth, postpartum care,
and infant care.
- CDC's
Pregnancy Information.
Includes information about healthy pregnancy
and healthy pregnancy planning to prevent birth
defects.
- Childbirth
Connection: For Women.
Includes information about pregnancy and its
stages, pictures of the week-by-week development
of a baby in utero, quotes from mothers about
childbirth, and information about the rights
of childbearing women. Presents links to recommended
pregnancy resources and a list of recommended
pregnancy books.
- Flu.gov:
What Pregnant Women Should Know About H1N1 (formerly
called swine flu) Virus. Answers
questions about pregnancy and the H1N1 virus.
- Food
and Drug Administration (FDA): Pregnancy.
Includes information about medications, medical
devices, and food safety for pregnant women.
- Health
Information: Pregnancy. Presents
fact sheets in English and Spanish on pregnancy,
childbirth, breastfeeding, genetics, and serious
pregnancy and fetal conditions.
- Life's
Greatest Miracle.
Presents microimagery of human development
from embryo through newborn. Includes a videotape
broadcast describing DNA and fetal development
from conception through birth, a pregnant mother's
journal, and information about prenatal testing,
stem cell technology, cell division, and how
sex is determined. Also includes links to additional
resources and a teacher's guide. This resource
is presented by NOVA
Online, part of
the Public
Broadcasting Service (PBS).
- March
of Dimes (MOD): Pregnancy and Newborn Health
Education Center.
Offers information in English and Spanish about
preconception and prenatal care, pregnancy
complications, labor and delivery, and newborn
care. Also offers a monthly electronic newsletter
and an online question-and-answer service in
English and Spanish.
- MedlinePlus:
Pregnancy. Includes
links to information in English and Spanish
about preconception and prenatal care. Links
to MedlinePlus pages on related topics, including prenatal
care; folic
acid; diabetes; high-risk
pregnancy; pregnancy
and substance abuse; prenatal
testing; twins,
triplets, multiple births; infant
and newborn care; and breastfeeding.
- Mothers of Supertwins (MOST). Presents
information and support during pregnancy, infancy,
and childhood for families who have or are expecting
triplets or higher numbers of babies.
- National
Healthy Mothers, Healthy Babies Coalition (HMHB).
Includes fact sheets, published interviews
with experts, and information in a question-and-answer
format about preconception planning, prenatal
care, and infant care. Use HMHB's new service:
Text4baby.
Offers free weekly messages by cell
phone in English and Spanish to help pregnant women
and new parents through pregnancy and their
baby's first year.
- Our
Bodies Ourselves Health Resource Center.
Provides articles, book excerpts, news briefs,
and Web site and book recommendations about
pregnancy, childbirth, infant care, miscarriage,
and infertility and assisted reproduction.
- Planned
Parenthood Federation of America (PPFA).
Gives information in English and Spanish about
planning for pregnancy, prenatal care, and
diet and healthy lifestyle choices during pregnancy.
- Through
the Looking Glass: National Resource Center
for Parents with Disabilities.
Presents resources for pregnant women with
disabilities, parents with disabilities, and
health professionals that include a catalog
of adaptive equipment for parents and a national
toll-free information and referral line.
- womenshealth.gov:
Healthy Pregnancy.
Offers information in English and Spanish about
preparing for pregnancy, what happens during
each of the three trimesters of pregnancy,
pregnancy complications, labor, childbirth,
and infant care.
- Also see the Agency
for Healthcare Research and Quality (AHRQ) guide, Gestational
diabetes: A guide for pregnant women (2009).
- Note: Many of the resources
presented in the following section of this knowledge
path, Resources
on Specific Aspects of Preconception and Pregnancy,
also contain resources for consumers.
Resources on Specific
Aspects of Preconception and Pregnancy
Childbirth
Depression
Drug and Alcohol
Use
Environmental
Concerns
Fertility
and Infertility
Genetics
Nutrition
Oral
Health
Tobacco Use
Childbirth
- American
College of Nurse-Midwives (ACNM).
Includes position statements, clinical bulletins,
state fact sheets, continuing-education tools,
and other resources about maternal and infant
health and midwifery. Also presents a national
directory of midwifery practices.
- Childbirth
Connection.
Provides evidence-based resources about childbirth
education, childbirth setting, labor support,
and perinatal care. The Childbirth Connection
promotes safe, effective, and satisfying evidence-based
maternity care. Resources include
Evidence
based maternity care:
What it is and what it
can achieve.
(2008).
Listening
to mothers II: Report of the second national
U.S. survey of women's childbearing experiences.
(2006).
- Choices
in Childbirth.
Presents surveys, statistics, reports, and
guides about the range of choices available
to women for maternity care and birth experiences.
- Coalition
for Improving Maternity Services (CIMS).
Presents the evidence-based Mother-Friendly
Childbirth Initiative guidelines for identifying
and designating
"mother-friendly" birth sites including hospitals,
birth centers, and home-birth services. The initiative
outlines 10 steps for mother-friendly care and
includes a guide for consumers. CIMS is a collaborative
effort of numerous individuals and more than 50
organizations with a mission to promote a wellness
model of maternity care that will improve birth
outcomes and substantially reduce costs.
- International
Childbirth Education Association (ICEA).
Offers information about certification programs
for childbirth educators, including postnatal
educators, doulas, and perinatal fitness educators.
Includes an order form for position papers,
books, teaching aids, and other materials.
- Lamaze
International.
Offers research summaries, teaching tools,
conference information, position papers, and
other materials for childbirth educators and
health professionals. Also offers resources
about pregnancy and childbirth and information
about Lamaze classes for expectant parents.
Recent publications include
Lamaze
Institute for Normal
Birth care practice papers,
rev. ed.
(2007). This set of six
papers is available in
English, Spanish, Russian,
and Mandarin.
- Also see the American
College of Obstetricians and Gynecologists (ACOG),
CDC's QuickStats:
Percentage of births attended by midwives --
United States, 2003 (2006),
CDC's Rates
of cesarean delivery among Puerto Rican women
-- Puerto Rico and the U.S. mainland, 1992-2002 (2006)
and the NICHD report, State-of-the-Science
Conference on cesarean delivery on maternal request (2006).
Depression
Drug
and Alcohol Use
- Fetal
Alcohol Spectrum Disorders (FASD) Center for
Excellence.
Presents a wealth of program information and
resources for health professionals, policymakers,
and consumers about preventing and treating
FASD. Includes fact sheets, brochures, posters,
Spanish-language materials, curricula, proceedings,
reports, and videotapes. The center is part
of the Substance
Abuse and Mental Health Services Administration
(SAMHSA).
- Kim J, Krall J. 2006. Literature
review: Effects of prenatal substance exposure
on infant and early childhood outcomes.
Berkeley, CA: National
Abandoned Infants Assistance Resource Center.
This report highlights recent findings from academic
literature concerning the debate about the consequences
of prenatal substance exposure on infants and
children.
- National
Institute on Alcohol Abuse and Alcoholism (NIAAA).
2006. Drinking
and your pregnancy, rev. ed.
Bethesda, MD: National Institute on Alcohol Abuse
and Alcoholism (NIAAA). This brochure for pregnant
women explains the dangers of drinking alcohol
while pregnant.
- National
Organization on Fetal Alcohol Syndrome (NOFAS).
Contains program information and resources
for pregnant women, health professionals, and
educators about the dangers of alcohol consumption
during pregnancy. Links to contact information
for addiction treatment centers. NOFAS is dedicated
to eliminating birth defects caused by alcohol
consumption during pregnancy and to improving
the quality of life for affected individuals
and families.
- Office
of the Surgeon General.
2005. Advisory
on alcohol use in pregnancy.
Rockville, MD: Office of the Surgeon General.
This advisory and press release urge women who
are pregnant or who may become pregnant to abstain
from consuming alcohol. The advisory includes
background information; research findings on
fetal alcohol syndrome, prenatal alcohol exposure,
and alcohol-related birth defects; and the Surgeon
General's recommendations for women and health
professionals.
- See MedlinePlus:
Pregnancy and substance abuse.
- See ACOG's tool, Drinking
and reproductive health: A fetal alcohol spectrum
disorders prevention tool kit for women's health
clinicians (2006).
- See the MCH Library's organizations resource
list, Substance use.
- Also see CDC's National
Center on Birth Defects and Developmental Disabilities
(NCBDDD), the National
Perinatal Association (NPA), PeriStats, the Pregnancy
Risk Assessment Monitoring System (PRAMS),
the Maternal
and Child Health Library, Motherisk,
and the Organization
of Teratology Information Specialists (OTIS).
Environmental
Concerns
- Allsopp M, Santillo D, Kallee U,
Hosjsik M. 2006. Fragile:
Our reproductive health and chemical exposure.
A review of the evidence for links between declines
in human reproductive health and our exposure to
hazardous chemicals.
Amsterdam, The Netherlands: Greenpeace International.
- Household
Products Database.
Links information for over 6,000 consumer brands
to health effects from Material Safety Data
Sheets (MSDS) provided by consumer-product
manufacturers. Researchers and consumers can
search by product, chemical ingredient, or
health effects as listed in the MSDS, including
fertility and pregnancy. This database is a
service of the National
Library of Medicine (NLM).
- Motherisk.
Provides evidence-based information for consumers
and health professionals about the safety or risk
of drugs, herbs, chemical exposures, and disease
during preconception, pregnancy, and breastfeeding.
Also offers information about current clinical
and laboratory research being conducted by Motherisk,
a service of the Hospital for Sick Children in
Toronto, Canada.
- National
Children's Study.
Contains information about this study to examine
the effects of environmental influences on
the health and development of more than 100,000
children and adolescents across the United
States, following them from before birth until
age 21. As part of the study, the Fertility
and Early Pregnancy Working Group is exploring
the link between a child's health and the parent's
fertility experience as well as parental exposures
before and/or in early pregnancy (often before
a woman knows she is pregnant). The Pregnancy
and the Infant Working Group is evaluating
the association of environmental exposures
during mid- and late pregnancy with pregnancy
outcomes and child health and development.
The National
Institute of Child Health and Human Development
(NICHD) and a consortium
of federal agencies are conducting the study.
- National
Institute of Environmental Health Sciences
(NIEHS): Reproductive Health.
Presents information about health studies and
clinical trials on the effects of environmental
contaminants on reproductive outcomes.
- National
Toxicology Program: Center for the Evaluation
of Risks to Human Reproduction (NTP-CERHR).
Offers a monograph series, expert panel reports,
and public comments about potentially hazardous
effects of chemicals on human reproduction
and development. Also links to information
on common concerns about and exposures to substances
and their effect on fertility, pregnancy, and
the health of unborn children. NTP-CERHR is
part of the National
Institute of Environmental Health Sciences
(NIEHS).
- Organization
of Teratology Information Specialists (OTIS).
Offers a national toll-free telephone number
for questions regarding exposures to medications,
herbal products, infections and vaccines, maternal
medical conditions, illicit substances, and
other common exposures during pregnancy. Telephone:
(866) 626-OTIS (6847). Also presents a collection
of fact sheets to answer frequently asked questions
about exposures during pregnancy.
- See MyPyramid
for Pregnancy and Breastfeeding and
the report Food
safety: Eating fish while you are pregnant or
breastfeeding (2007).
- See MedlinePlus:
Environmental Health.
Fertility
and Infertility
- American
Society for Reproductive Medicine (ASRM).
Offers a wealth of resources for consumers
and professionals about infertility, menopause,
contraception, and sexuality. Includes a collection
of resources about preventing infertility.
Also offers contact information for ASRM member
physicians, endocrinologists, surgeons, assisted
reproductive technology clinics, and specialists
in male reproduction and urology.
- RESOLVE:
The National Infertility Association.
Offers information for people experiencing
infertility. Topics include treatment, diagnosis,
coping, adoption, and the costs of infertility
treatment. Also lists telephone helplines for
local and regional chapters and affiliates
in the United States.
- See the Maternal and Child Health
Library's guide, Assisted
Reproductive Technologies (ART) and families: Selected
resources, which presents
resources about the psychological and social impacts
of ART on children conceived via ART and on their
families. The list also provides resources related
to ethical and legal issues associated with ART.
- See MedlinePlus:
Reproductive health and MedlinePlus:
Infertility.
- See the CDC's reports, Assisted
reproductive technology success rates: National
summary and fertility clinic reports (2006), Assisted
reproductive technology surveillance -- United
States, 2006 (2009),
and Fertility,
family planning, and reproductive health of U.S.
women: Data from the 2002 National Survey of
Family Growth (2005).
- See the Mothers
of Supertwins (MOST) statement, Recommendations
for the responsible use of fertility treatments
to reduce the number
of high-risk multiple birth pregnancies (2007).
- Also see Our
Bodies Ourselves Health Resource Center.
Genetics
- American
College of Medical Genetics (ACMG).
Offers practice guidelines, policy statements,
and other resources on topics such as prenatal
diagnosis and newborn screening. Recent resources
include
Intermediate
management guides for
newborn screening.
(2006).
Newborn
screening: Toward a uniform screening panel
and system. (2006).
- Genetic
Alliance. Contains family history tools,
resources about genetic conditions, and information
on public policy issues such as a national
newborn screening policy, genetic testing,
and open access to federally funded genetic
research. The Genetic Alliance is a coalition
of genetic advocacy organizations, health professionals,
clinics, hospitals, and companies that promotes
the needs of individuals affected by genetic
disorders and their families.
- Genetics
Home Reference.
Presents information about the effects of genetic
variations on human health. Learn about genes,
chromosomes, genetic conditions, genetic counseling,
genetic testing, and genomic research. Includes
information and links to additional resources
about newborn screening. This Web site is a
service of the National
Library of Medicine (NLM).
- March
of Dimes (MOD): Genetics. Offers
continuing-education modules about genetic
testing and screening, family health and social
history, and referral to genetic services.
Lists resources for professionals and families
on topics that include genetic counseling,
preconception and prenatal genetic screening,
newborn screening, and birth defects and genetic
conditions. Recent publications include
Making
community partnerships work: A toolkit.
(2007).
Newborn
screening tests. (2008).
- National
Newborn Screening and Genetics Resource Center
(NNSGRC). Presents information and
links to resources about newborn screening
and genetics for health professionals, families,
and policymakers. Includes contact information
for state newborn screening and genetics programs
and commercial and non-profit organizations
offering expanded newborn screening tests.
Also presents a list of hearing
screening resources. NNSGRC is located
at the University of Texas Health Science Center
at San Antonio. Recent publications include
National
newborn screening status report, rev. ed.
(2008).
- See the MedlinePlus resources
about genetic
counseling, genetic
testing, prenatal
testing, and newborn
screening. Also see the American
College of Obstetricians and Gynecologists
(ACOG) pamphlet, Special
tests for monitoring fetal health (2009).
- Also see the Maternal and Child Health Library's resource brief, Genetics, and the screening section of the knowledge path, Children and youth with special health care needs.
Nutrition
Oral
Health
Tobacco
Use
Preconception and Pregnancy: Knowledge Path, 2nd ed.
(April 2008). (Updated: March 2010).
Author: Susan Brune Lorenzo, M.L.S.,
Maternal and Child Health Library.
Reviewers: Yvonne Beasley, M.N., R.N., C.N.A.A., Indianapolis
Healthy Start and Marion County Health Department;
Marie Godfrey, Ph.D., Genetizen; Olivia K. Pickett,
M.A., M.L.S., Maternal and Child Health Library.
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