Maternal and Child Health Journal

, Volume 21, Issue 3, pp 387–392 | Cite as

One Key Question®: First Things First in Reproductive Health

  • Deborah Allen
  • Michele Stranger Hunter
  • Susan Wood
  • Tishra Beeson
Commentary

Abstract

Objectives Preconceptional health care is increasingly recognized as important to promotion of healthy birth outcomes. Preconceptional care offers an opportunity to influence pregnancy timing and intent and mother’s health status prior to conception, all predictors of individual outcomes and of inequality in birth outcomes based on race, ethnicity and class. Methods One Key Question, a promising practice developed in Oregon which is now attracting national interest, provides an entry point into preconceptional care by calling on providers to screen for pregnancy intent in well woman and chronic disease care for women of reproductive age. For women who choose not to become pregnant or are not definitive in their pregnancy intent, One Key Question provides an opportunity for provision of or referral to counseling and contraceptive care. Results Adoption of One Key Question and preconceptional care as standard practices will require important shifts in medical practice challenging the longstanding schism between well woman care generally and reproductive care in particular. Adoption will also require shifts in cultural norms which define the onset of pregnancy as the appropriate starting point for attention to infant health. Conclusions for Practice This commentary reviews the case for preconceptional care, presents the rationale for One Key Question as a strategy for linking primary care to preconceptional and/or contraceptive care for women, outlines what is entailed in implementation of One Key Question in a health care setting, and suggests ways to build community support for preconceptional health.

Keywords

One Key Question© Preconceptional health Family planning Well woman care 

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Child, Adolescent and Family HealthBoston Public Health CommissionBostonUSA
  2. 2.Oregon Foundation for Reproductive HealthPortlandUSA
  3. 3.Department of Health Policy and Management, Jacobs Institute of Women’s Health Services, Milken Institute School of Public HealthGeorge Washington UniversityWashingtonUSA
  4. 4.Department of Health, Educational Administration, and Movement StudiesCentral Washington UniversityEllensburgUSA

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