1. Diana E. Ramos, MD, MPH Co-Chair Preconception Health Council of California Director, Reproductive Health Los Angeles County Public Health Assistant Professor, Keck USC School of Medicine Coauthors: Jeanne Conry, MD,PhD, Navi Sidhu, MD, MPH, Peyton Mason-Marti,MPH Improving the Healthcare of the Latina New Mother in California: Interconception Care Project of California

2. Presenter Disclosures Diana E. Ramos No relationships to disclose in relation to the content of this presentation.

3. California’s Births Comparable to Many Countries

4. Recommendations for The Post Partum Visit World Health Organization: –Recommend contact with the health care system “six hours, six days, six weeks and six months” post-delivery –offer comprehensive puerperal care to mothers and newborns Improved post partum care will not only improve the health and well being of the postpartum woman but will also improve outcomes of subsequent pregnancies

5. Recommendations for The Post Partum Visit ACOG: – Recommend four to six weeks postpartum – General assessment of physical and mental well-being

6. Postpartum Visit Issues Compliance Patients’ perceived need Barriers & Access

7. Interconception Care Project for California Joint March of Dimes/ ACOG Project & Preconception Health Council of California Goal: to create guidelines for the postpartum visit that address diagnoses that developed peri-nataly

8. 8 ACOG Interconception Care Logic Model

9. Review Committee Obstetrician /Gynecologists 11 Internal Medicine 1 Nurses 6 MSW 5 PhD 2 Masters Public Health 2 Analyst 1 28 in total

10. Interconception Care Project for California Focus Obesity/nutritional deficiencies Bleeding-associated disorders Hypertension/cardiovascular disorders  Gestational diabetes  Infections (UTI, STIs, Immunization) Mental disorders Intimate partner violence Preterm delivery Thyroid dysfunction Tobacco and other drug dependence Neurologic disorders

11. Interconception Care Project for California Prevailing Messages Folic acid Contraception Breastfeeding

12. Patient Brochures

13. Material Review 200 Health Professionals in California to review algorithms 100 patients to review patient brochures in Spanish 100 patients to review patient brochures in English

14. Provider Algorithms

15. Interconception Care Project for California Deliverables DVD and web-based summary of guidelines Patient handouts: Web-based format CME web based course

16. Interconception Care Project for California Health Insurers Patients Community Based Organizations

17. Just the Beginning Collaboration Maximize postpartum visit Improve maternal health and the outcomes of subsequent pregnancies

18. Thank you !