Importance of Pre Pregnancy Care for Women and Girls

According to a report by UNICEF (2011) the reproductive health of women is very critical in determining the future of humanity. Young girls and women should be equipped with necessary knowledge which will help them deal with motherhood responsibility effectively (Huang, Sauve, Birkett, Fergusson, & van Walraven, 2008). Pre pregnancy care includes all efforts and programs undertaken to protect the health of all females who are mature enough to get pregnancy with an intention of raising their health levels and those of young ones.

Sexual harassment and some cultural beliefs threaten the reproductive health of young women. It is so unfortunate that some communities in some parts of the world are still practicing female genital mutilation. Statistics from different health bodies shows that rape cases have increased significantly in the low and medium income countries in the recent years. Some women including those who are married are coerced into sexual activity. It has also been observed that some adolescent engage themselves in unprotected sex. All this incidences and activities may leads to contracting of diseases and early pregnancies (Frey, Navarro, Kotelchuck, & Lu, 2008). Pregnancies shut the educational future of young girls and also expose them to the risk of early marriages. World Health Organization report on adolescent pregnancy indicates that about a third of girls in the low income countries are married while still minors.

Reproductive planning is seen as solution to reproductive health challenges that many young women and girl undergo. It forms part of the pre pregnancy care given to young women and girls. Statistic indicates that reproductive planning can help cub unwanted pregnancies, abortion infant death rate among others (Kenny, et al, 2014). Results of a systematic review carried out to bring together the evidence for risks and interventions relating adolescent health and reproductive planning during pre pregnancy period are presented in this paper. This paper will discuss the benefits accrued from right birth spacing, and the risks of conceiving at an advanced.

Literatures published prior to 2011 were reviewed systematically to look for journal illustrating the effectiveness of pre pregnancy interventions and risks for adolescent health and reproductive planning on maternal newborn and child outcome (Molitoris, 2018). Searches with no restriction were also conducted in several electronic databases, that is, PubMed, Embase, and WHO Regional Database. Cochrane criteria were used to check for quality of the experimental studies while STROBE helped in checking the quality of observational studies. The software Review Manager helped in analyzing all the data collected.

Challenges to Reproductive Health and Solutions

The search produced 1097 results. After several screening was done, one hundred and sixty eight studies qualified to be used for abstraction and analysis. Findings of the review are discussed in the subsequent sections below.

Adolescents form part of the future generation (Wang, & Hong, 2015). At their tender age, many physiological processes take place in their reproductive system. They begin to understand themselves. At this time, proper advice and guidance will help in maintaining their health.

Several studies conducted indicate that efforts aimed at counseling and provision of contraceptives’ to the teenage have a little impact at preventing pregnancy. However Comprehensive programs like giving holiday support, sex education, sports activities and others cut the risks by nearly half. Guidance on parental care is seen to be helpful to those adolescents who already have children.

According to studies conducted, both short and long birth intervals have negative effects to the health of women. A further study indicates that an interval of between one year and two years is appropriate in maintaining good health.

Many women prefer aborting to seeking help after getting an unwanted pregnancy. After-abortion services are seen to have a positive impact to those who usually seek them. The after-abortion reduces trauma and more pregnancies to those who seek the service.

From the review conducted, women who conceived at an age above 35 years have a high risk of contracting so many health related complication. It noted that an ideal age for child bear is between 20 to 35 years.

Contraceptive use is seen as one method that will help improve the reproductive health of women. Unfortunately, many women especially those who come from low income countries do not have access to the modern methods of contraception (Eldredge, Markham, Ruiter, Kok, & Parcel, 2016). Some women also lack skills and knowledge on the right way of using contraceptives. This has led to so many unplanned pregnancies among women. There are several factors which have derailed the efforts to attaining good health. One of these factors is coerced pregnancy, cultures that support female genital mutilation and engagement in unprotected sex by girls. Statistics shows that majority of girls and boys engage in sexual activity before the age of twenty. This leads to adolescent pregnancy which leaves the future of young girls at stake.

Girls and women who get unwanted pregnancy in most cases do not seek hospital services. This threatens the health of the mother and that of the child. Such unwanted pregnancies lead to cases of abortion. Abortion may affect the ability of the mother to conceive in future.

Findings from Systematic Review

In order to improve the pre pregnancy health in women and girls, several factors should be considered and kept in mind. Access to contraceptive services is crucial in improving health of the people. It will ensure that births are planned (Shawe, et al 2015). Contraceptive services should be made available to the users. Women should be taught on how to use such contraceptive. 

Majority of adolescents and youths are mostly idle. Different development program should be put in place to empower the youths. These programs will engage them and therefore help to cub teenage pregnancy. Provision of reproductive health education is critical towards helping teenage in understanding themselves. They should be told of the dangers of engaging in unprotected sexual activities.

Both early pregnancy and delayed pregnancy have been found to increase health reproduction challenges such as child mortality, birth still and other related complications (Goossens, et al 2018). To prevent such complication, women should maintain the right pregnancy intervals, that is, not too close or not too long. Provision of more contraception services to countries like Africa is recommended as a way of improving pre pregnancy care.

Conclusion

Most health reproduction related complication such as premature birth and child death rate are often brought about by young girls entering marriage, in availability of contraception services, taking too long to give birth among other things (Brown, et al2017). Implementation of programs that prevent second pregnancy among teenagers and proper spacing of one child to the other is highly encouraged. It is so unfortunate that some communities in some parts of the world are still practicing female genital mutilation. Statistics from different health bodies shows that rape cases have increased significantly in the low and medium income countries in the recent years. Some women including those who are married are coerced into sexual activity. It has also been observed that some adolescent engage themselves in unprotected sex. Teenagers in school should be provided with sexual education and contraceptives should be provided to women. This will help in implementing the interventions.

References

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Canadian Medical Association Journal, 178(2), 165-172. Kenny, L. C., Black, M. A., Poston, L., Taylor, R., Myers, J. E., Baker, P. N., … & Rodems, K. (2014). Early pregnancy prediction of preeclampsia in nulliparous women, combining clinical risk and biomarkers: the Screening for Pregnancy Endpoints (SCOPE) international cohort study. Hypertension, 64(3), 644-652.

Eldredge, L. K. B., Markham, C. M., Ruiter, R. A., Kok, G., & Parcel, G. S. (2016). Planning health promotion programs: an intervention mapping approach. John Wiley & Sons.

Frey, K. A., Navarro, S. M., Kotelchuck, M., & Lu, M. C. (2008). The clinical content of preconception care: preconception care for men. American journal of obstetrics and gynecology, 199(6), S389-S395.

Goossens, J., De Roose, M., Van Hecke, A., Goemaes, R., Verhaeghe, S., & Beeckman, D. (2018). Barriers and facilitators to the provision of preconception care by healthcare providers: A systematic review. International Journal of Nursing Studies.

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Shawe, J., Delbaere, I., Ekstrand, M., Hegaard, H. K., Larsson, M., Mastroiacovo, P., … & Tydén, T. (2015). Preconception care policy, guidelines, recommendations and services across six European countries: Belgium (Flanders), Denmark, Italy, the Netherlands, Sweden and the United Kingdom. The European Journal of Contraception & Reproductive Health Care, 20(2), 77-87.

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Wang, W., & Hong, R. (2015). Levels and determinants of continuum of care for maternal and newborn health in Cambodia-evidence from a population-based survey. BMC pregnancy and childbirth, 15(1), 62.