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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


ICC Toolkit Download

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Preeclampsia is a hypertensive disorder that is a Preeclampsia is a hypertensive disorder that is a complication of pregnancy. It is characterized by high blood pressure and often the presence of protein in the urine. If left untreated, it can lead to serious complications for the mother/birthing person and baby. 

Low-dose aspirin (LDA), taken daily during pregnancy, can prevent or delay the onset of preeclampsia. If a mother/birthing person has risk factors for preeclampsia it is recommended, after consultation with the patient's provider, that daily LDA supplementation begins late in the first trimester. 

For providers, the Hypertension in Pregnancy Change Package (HPCP) can be utilized to put more efficient and effective systems in place to care for birthing people with hypertension in pregnancy. The HPCP outlines the evidence and indications of LDA use in pregnancy to prevent preeclampsia. 

#IMPLICITNetwork #HypertensiveDisorders #Preeclampsia #LowDoseAspirin
Every mother/birthing person should have access to Every mother/birthing person should have access to comprehensive and patient centered family planning.

IMPLICIT Interconception Care (ICC) screens mothers/birthing people (MBPs) for four risk factors, including family planning, at their child’s Well Child Visits from 0-24 months. ICC initiates conversations about family planning, connects MBPs to care to discuss options, and/or even provides birth control at that visit.

IMPLICIT 4th Trimester (4TM) promotes patient centered contraception counseling across the prenatal and postpartum time periods. Providers review options and make a plan with the MBP to choose a contraception method that aligns with the MBP’s values and preferences.

Identifying family planning needs, providing interventions, and connecting families to care promotes not only healthier future pregnancies (if desired), but also a healthier mother/birthing person, child, and family. 

#IMPLICITNetwork #FamilyPlanning #Contraception #PatientCenteredContraceptionCounseling
Providing professional development opportunities, Providing professional development opportunities, such as research opportunities and quality improvement projects, is at the cornerstone of the work the IMPLICIT Network seeks to provide to current and future physicians. 

This month, we will be highlighting student and residents who have partnered with the Network to conduct research projects utilizing IMPLICIT data. 

Today we are highlighting Anisha Willis! Anisha is a current undergraduate student at the University of Pennsylvania. She will be conducting a project focused on the effects of prenatal biomedical risks and intrapartum complications on mood disorders identified at the postpartum visit.

If you are a current student or resident interested in working with the IMPLICIT Network, please feel free to reach out to us! 

#IMPLICITNetwork #4thtrimester #research
August is recognized as National Breastfeeding Mon August is recognized as National Breastfeeding Month!

Breastfeeding offers important benefits for both babies and birthing people. It helps protect against diseases, supports the development of a strong immune system, and promotes bonding and emotional well-being. 

The IMPLICIT Network supports breastfeeding practices by connecting birthing people to lactation services through our 4th trimester model, and providing a space for birthing people to discuss lactation with their provider.

#IMPLICITNetwork #NationalBreastfeedingMonth #4thtrimester #breastfeeding
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