Class 1: Concept Intros Flashcards
define reproduction
- process by which human beings produce a new individual
define antepartum/antenatal
- before birth
define intrapartum
- during labor & delivery/childbirth
define post-partum/postnatal/puerperium
- within 6 weeks after childbirth
define perinatal
- period immediately before and after birth
define fetus
- unborn offspring from an embryo
define maternal
- relating to a mother
Describe the scope of reproduction (5)
- preconception
- pregnancy (complicated and uncomplicated)
- labour and birth (complicated and uncomplicated)
- postpartum (complication and uncomplicated)
- reproductive choices
what are some individual risk factors (for both the fetus and pregnant person) throughout the scope of reproduction
- biophysical factors
- psychosocial factors
- sociodemographic factors
- enviro factors
- social determinants of health
define intersectionality
- when 2 or more oppressions overlap in the experiences of an individual or group, creating interconnected barriers and complex forms of discrimination that can be insidious, covert, and compounded
- causes certain groups to be highly stigmatized
describe the scope of sexuality
- positive sexual identity/function = wellbeing
- negative sexual identity/function = illness/dysfunction
what is a reproductive life plan
- protocol consisting of a set of questions to guide a conversation about if and when a person might want to become a parent
- involves determining if individual wants kids, what their reproductive goals are
preconception health promotion: who does it include? what does it aim to do? when is it done? where?
- who: all reproductive aged individuals (man and women, regardless of gender, sexual orientation)
- what” optimize health and reduce risks prior to conception
- when: done anytime a reproductive aged individual presents for care
- where: clinics, teen clinics, FMD/PCP, schools should all provide resources ( try to reduce access barrier)
why is preconception health promotion so important?
-important to support and promote healthy lifestyle and reduce risks prior to conception
what are some risks/barriers to healthy pregnancy (4)
- inadequate/insufficient/inaccessible care
- lack of culturally safe care
- lack of community services/supports
- financial stress/poverty
what are the social determinants of health (12)
- income and social status
- employment and working conditions
- education and literacy
- childhood experiences
- physical enviro
- social supports and coping skills
- healthy behaviors
- access to health services
- biology and genetic endowment
- gender
- culture
- race/racism
preconception care involves…
- any intervention that can identify and modify medical, psychosocial, behavioral, or enviro risks to male or female reproductive health and future pregnancies
- part of a continuum of care that promotes an overall commitment to health during the reproductive years, including the interception period
preconception care is based on
- Family-Centred Maternity and Newborn Care
list the 7 steps of preconception health promotion
- assess ideas/values/knowledge around pregnancy and sexual health
- identify modifiable risk factors (easier to address before pregnancy)
- encourage healthy lifestyle (including sexual health, physical activity, chronic disease management)
- offer early screening (ex. STIs)
- educate
- empower to be in charge of their reproductive health
- create a plan
what info should be obtained r/t preconception history (8)
- past medical and surgical history, chronic medical conditions
- current meds/OTC/herbal meds and supplements
- obstetrical history (prior pregnancies, births, miscarriages, abortions)
- gynecological history (ex. menses regular vs irregular?)
- genetic and family history
- mental health history
- social history
- infectious conditions
the preconception history we collect depends on..
- the individuals reproductive goals
ex. wanting to get pregnant in 5 vs 1 years
what should be assessed r/t social history when collecting preconception history (10)
- enviro exposure to toxins
- high risk jobs
- alcohol use
- drug use
- smoking
- physical activity
- stress
- abuse
- IPC
- exposure to teratogens
define: teratogen
- enviro substances or exposures that result in functional or structural disability
what info should be collected r/t infectious conditions when collecting preconception history (5)
- immunization history
- history of varicella or rubella infection
- STIs
- exposure to cat feces
- exposure to raw or undercooked meats
what preconception assessments & diagnostic tests should be compelted (5)
- height, weight, BMI
- blood pressure to establish baseline
- STI screening
- pap test
- other labs as required
STI screening should be offered to:
- all sexually active individuals
STI screening may include: (2)
- urine or cervical swab for gonorrhea and chlamydia
- serology for HIV, Hep B and C, syphilis
what is a pap test? when does screening start?
- test for precancerous or cancerous cells on the cervix
- screening starts at age 21 once individual has had sexual contact
what other labs may be required w preconception assessments? (three)
- varicella and rubella titres
- TB test
- CBC if history of anemia
(all depends on health history)
what is the goal of risk modification during preconception
- optimize health for pregnancy
what is included in risk modification during preconception (8)
- nutrition and physical activity
- healthy body weight
- screen for diseases (STI)
- update vaccines, discuss travel (ex. Zika virus)
- discuss alcohol, smoking, drug use –> support individual to quit prior to pregnancy
- discuss IPV, occupation, social support
- oral health
- consider currents meds and need to change or modify prior to conception
what supplements are recommended during preconception (5)
- folic acid
- prenatal vitamins
- iron supplementation, vitamin D, calcium (may not be needed if receive enough through diet)
describe folic acid supplementation during preconception
- folic acid 0.4-1mg in all individuals x 3 months prior to conception (ie. for all who may become pregnant in next 3 months) to end of first 3 months
- dose may vary for higher risk conditions
how much folic acid supplement is required during preconception for individuals w DM
- 1mg for 3 months prior to and at least 3 months into pregnancy
why is folic acid important during preconception
- to prevent neural tube defects
watch videos on anatomy and physiology review
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understand the concepts of sex, sexuality, and gender
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