Reproductive Health Life Plan

Introduction

A reproductive health life plan (RHLP) is a set of personal goals about having or not having children and on the desired spacing between children. It also includes preconception counseling for general health and for specific health conditions and challenges. It helps to build positive health behaviors and eliminate or moderate certain medical risks for both men and women, whether or not a pregnancy is planned for the near future. Counseling women and men of childbearing age allows for an identification of individuals with risk factors for poor pregnancy outcomes and a possibility of moderating these risks.

Primary care physicians and other primary care professionals are in a unique position to lead health care changes and integrate preconception care and family planning into routine primary care visits, while stressing comprehensive counseling for health risks and challenges, including mental health issues; immunizations; medications; and lifestyle risks, such as tobacco, alcohol, or drug usage.

It is a goal that primary care physicians as well as other primary care professionals gain additional tools to work with women and their partners to improve health and address modifiable risk factors. By incorporating preconception counseling and RHLP into primary care, it is anticipated that this intervention may help decrease the number of unintended pregnancies that currently account for 50 percent of all pregnancies.

The following links include a list of resources for primary care providers to receive additional training for preconception counseling and the RHLP, and a two-page general handout serving as a guideline for engaging with patients about RHLP, including a general list of common medical conditions and the recommendations for preconception counseling and management.

Resources

Training Resources for Physicians and other Primary Care Providers on RHLP

Primary care visits can be an opportunity to work with women and their partners to improve preconception health and address modifiable risk factors. By incorporating the Reproductive Health Life Plan (RHLP) and preconception counseling into otherwise routine primary care visits, we can work to decrease the number of unintended pregnancies or pregnancies with short interpregnancy intervals, leading to healthier pregnancies, mothers, and babies.

The following links include a list of resources for primary care providers to receive additional training for preconception counseling and the RHLP:

The Preconception Health and Health Care Initiative at UNC Chapel Hill: https://beforeandbeyond.org/
- Links to the program’s newsletters and additional information - https://beforeandbeyond.org/pchimcoiin/coiinnewsletters/
- Program modules on preconception care and interconception care - https://beforeandbeyond.org/modules/module-1-preconception-care/ (available for CME)
- Preconception Health Research Highlights and other mobile and digital resources through the initiative:- https://myemail.constantcontact.com/PCHHC-June---July-2019-Newsletter-.html?soid=1110472552145&aid=GKSD9rst4P4
A more patient-oriented section of the Preconception Health program at UNC Chapel Hill: https://showyourlovetoday.com/
CDC recommendations for providing Quality Family Planning Svcs (2017): https://www.cdc.gov/mmwr/volumes/66/wr/mm6650a4.htm
SAMHSA training from the Center of Excellence for Integrated Health Solutions: https://www.thenationalcouncil.org/integrated-health-coe/training-events/
American Academy of Family Physicians (AAFP) position paper on preconception care: https://www.aafp.org/about/policies/all/preconception- care.html#Summary?utm_source=PCHHC%20January%20Newsletter%20-%202016&utm_campaign=PCHHC%20JAN&utm_medium=archive
American Family Physician Journal article on “Recommendations for Preconception Counseling and Care”: https://www.aafp.org/afp/2013/1015/p499.html
American College of Physicians (ACP) Internist Article: https://acpinternist.org/archives/2020/05/making-space-for-preconception-counseling-in-primary- care.htm
App created by the VA to provide information to support the integration of preconception care into comprehensive primary care: “Preconceptive Care” - https://mobile.va.gov/app/preconception-care
Physicians for Reproductive Health (PRH) website: https://prh.org/
PRH Reproductive Health Throughout a Lifespan Case Videos: https://prh.org/reproductive-sexual-health-needs-case-videos/
Family Planning National Training Centers (FPNTC) –“Putting the QFP into Practice Series: Integrating Reproductive Life Planning (RLP) into Your Family Planning Session” (Vimeo): https://player.vimeo.com/video/124050935

State Level Resources:

California:

Every Woman California (Health Care Professionals section) http://www.everywomancalifornia.org/content_display.cfm?categoriesID=97&contentID=360
Algorithms and patient handouts free to download, print, and distribute: http://www.everywomancalifornia.org/content_display.cfm?categoriesID=120&contentID=359

Colorado:

Printed guidelines, https://www.colorado.gov/pacific/sites/default/files/HTW_Preconception- Care-Guideline_12-30-2009.pdf

10/2/2020