lieves this is where it needs to focus its efforts because women need to know what questions to ask so that they can prompt their clinicians to engage in these important conversations.
Davis opened the floor to questions from workshop participants, but first noted that creating a maternal-centered medical home using a multidisciplinary team-based approach, an idea expressed in different ways by each of the panelists, could be a valuable opportunity for bringing together obstetricians/gynecologists (OB-GYNs), family physicians, pediatricians, nutritionists, and outside organizations such as WIC, La Leche League, and other maternal health community groups. The electronic health record could act as a linchpin in this approach by linking all the participants and providing a forum for ongoing communication.
One participant said that, from a life-course perspective, helping young pregnant women achieve and maintain a healthy weight can be seen as a way to capitalize on a window of opportunity in which the woman might be saying, “I want to make something of myself because I realize I want to be a good parent.” One suggestion was to put the guidelines on a sticker that goes on the bathroom scale so that the guidelines are literally at a woman’s feet. Ogunyemi and Cialone both agreed strongly that the life-course perspective provides a useful way of thinking about the issue and that pregnancy presents an opportunity to set a women on a healthy path. Cialone noted that the North Carolina health department has formed a group to look at how women’s and children’s health programs can focus on the life course. For example, when an adolescent comes into the clinic for well care, staff can start to have a conversation, not only about the specific purpose of the visit (an adolescent visit, school health visit, or permission to participate in athletics), but also more broadly about the young woman’s goals and what staff can do for her and with her to get her on a healthy life course.
Johnson noted the gap that currently exists between pediatric care and prenatal care. Many women come into prenatal care not having been seen by a clinician since they were children. Despite the fact that it is important to reach women before they become pregnant, the reality that providers face is that they miss that preconception period for a large percentage of their patients. Johnson expressed the hope for greater linkages between pediatricians and clinicians involved in women’s reproductive health care, which could encourage discussions on how best