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IMPLICIT Network

IMPLICIT Network

Innovations for Maternal and PerinataL Care ImprovemenT

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Interconception Care (ICC)

Preventing prematurity
one mother/birthing person at a time

ICC is a brief, innovative model that screens mothers/birthing people at well child visits from 0 – 24 months to address 4 modifiable risk factors.

The Four Risk Factors

Smoking

Only 20% of smokers quit during pregnancy, many see it as a “time limited restriction.” 70% who quit during pregnancy, started smoking again within 6 months. Prenatal smoking is associated with:

Prenatal smoking is associated with increased rates of:

  • Preterm births
  • Low birth weight infants
  • Sudden infant death syndrome (SIDS)

Depression

1 in 8 mothers/birthing people is affected by perinatal depression.

  • Major depression peaks 6 weeks after birth, but may occur at any time in between pregnancies.
  • Postpartum depression is one of the most underdiagnosed obstetric complications in America

Family Planning

Birth spacing of less than 18 months increases the risk of preterm birth and other adverse outcomes.

  • Over 40% of pregnancies are described as unintended
  • Patient-centered contraception counseling helps patients identify and obtain a contraceptive method that fits their values, preferences, and lifestyle

Multivitamin with Folic Acid

Preconception and interconception consumption of folic acid helps reduce neural tube defects

  • 70% of mothers/birthing people do not consume a multivitamin with folic acid in the month prior to pregnancy
  • It is recommended for all mothers/birthing people of reproductive age to take 400 mcg of folic acid each day

The Stats

of mothers/birthing people attend their child’s well child visit
of mothers/birthing people are willing to receive health advice from their child’s doctor
of mothers/birthing people screened positive for one or more ICC risk factors during a well child visit

Why ICC?

Interconception Care (ICC) is the care that is given to mothers/birthing people BETWEEN pregnancies. It allows us to identify and address risk factors prior to the next pregnancy. Early and adequate prenatal care is not enough to prevent premature and low birth weight infants.

For a 6 month old who I had been following since birth, I was completing the ICC with mom when she revealed she had been struggling with significant depression over the last few weeks. She had a history of depression prior to pregnancy and had come off her medications prenatally. She stated that she didn’t feel she had time to make an appointment for herself, but was very open to resuming medication and counseling which we discussed and orders placed during the baby’s visit in a separate encounter. She verbalized that she appreciated that we recognized her health as important to baby’s health.

~ IMPLICIT Provider


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Check out this recent article citing the IMPLICIT Check out this recent article citing the IMPLICIT Network as a collaborative that has developed and supported the implementation of the fourth trimester care model at 12 family medicine practices in Pennsylvania and New York. 

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Meet our Leadership Council - today we're highligh Meet our Leadership Council - today we're highlighting Dr. Narges Farahi!

Dr. Narges Farahi is a family medicine physician and longtime champion for person-centered and family-centered care. Dr. Farahi is a Professor at UNC, where she served as the Director of the Family Medicine Perinatal and Child Health Program for ten years. Her heart is in community health, and her outpatient practice is at Prospect Hill Community Health Center, a rural federally qualified health center. Prior to her current role, Dr. Farahi served as the medical director of the NC Farmworker Health Program. Her clinical interests include providing seamless care for people with the capacity for pregnancy across the continuum of care, including before, between and after pregnancies. Dr. Farahi is committed to providing trauma-informed care, supporting people and families to meet their reproductive goals, and using quality improvement strategies to help health care practices and systems better meet the needs of patients and families. She has been a leader in implementing enhanced access to comprehensive contraception options and the IMPLICIT interconception care model in the primary care setting. Dr. Farahi works to integrate community engagement and implementation science to transform care with a focus on patients with hypertensive disorders of pregnancy and polycystic ovary syndrome. Her goal is to center the voices of patients and families from marginalized communities and build partnerships with patients and communities to improve health.

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Juggling the responsibilities of life and parentho Juggling the responsibilities of life and parenthood often means less time to take care of yourself. Many mothers/birthing people (MBP) don't attend their own doctor's appointments, but almost ALL attend their child's doctor's appointments. 

Smoking/vaping status is one of the screening questions asked during both IMPLICIT Interconception Care (ICC) and 4th Trimester (4TM) models of care. Many times, MBPs who smoke or vape, see quitting during pregnancy as a time limited response and will start again after having the baby. 

IMPLICIT ICC screens mothers/birthing people at their child's Well Child Visits (WCV) from ages 0-24 months and offers the opportunity to meet MBPs where they are at, providing support in maintaining or starting their smoking/vaping cessation. 

IMPLICIT data showed that an overwhelming number of MBPs are willing to receive advice about their health from their child's provider. 

Identifying risks and providing interventions at WCVs in between pregnancies promotes not only healthier future pregnancies, but a healthier mother/birth person, child, and family. 

#IMPLICITNetwork #SmokinginPregnancy #VapinginPregnancy #MaternalandChildHealth #SmokingCessation #InterconceptionCare #IMPLICITICC #4thTrimester #4TM
Check out this recent article citing the IMPLICIT Check out this recent article citing the IMPLICIT Network as a learning collaborative that supports current and early career family physician's training in evidence-based pregnancy care.

Click the link in our bio to read the full article!

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