Data to Action Success Story: South Carolina

The Every Woman South Carolina Campaign—A Collaboration with March of Dimes to Improve Preconception Health Planning

Problem Overview

If a woman is in poor health before becoming pregnant, her chances of having an optimal pregnancy and delivery are decreased greatly. Preconception care is intended to promote the health of women of reproductive age (18–44 years) before conception and improve pregnancy-related outcomes. In South Carolina (SC), there is a lack of state and local preconception health planning, which contributes to a high prevalence of poor pregnancy outcomes.

In 2008, SC PRAMS data showed that about 48% of live births were the result of unintended pregnancies (mistimed or unwanted). Among women who delivered live births but were not trying to get pregnant, about 56% were not using birth control. In addition, only about 27% of women delivering live births in SC in 2008 were taking a multivitamin or prenatal vitamin daily during the month before pregnancy. In 2008, the infant mortality rate in SC was 8 infant deaths per 1,000 live births, among one of the highest rates in the United States. Nearly 10% of all infants delivered in SC in 2008 had a low birthweight (<2,500 grams).

Program Activity Description

In an effort to improve pregnancy outcomes by improving the health of women before they get pregnant, SC PRAMS staff collaborated with the March of Dimes SC Chapter and physicians and hospital staff across the state to coordinate preconception health education and messaging through a project called Every Woman South Carolina. Resources were combined to build local infrastructure to facilitate, enable, and support programs and initiatives focusing on preconception health by establishing preconception health coalitions in each of the four SC Perinatal Regions (Piedmont, Midlands, Pee Dee, and Low Country). These preconception health coalitions develop and put into action programs and initiatives to address important issues at the local and community levels with support from the state. Regional coalition activities will be used to guide and support statewide and multistate initiatives to address preconception health issues.

Program Activity Outcomes

The Low Country Perinatal Region has decided to focus their resources on promoting family planning and reproductive life planning in the interconception period. Efforts are focused on Low Country Healthy Start participants and the SC Department of Health and Environmental Control (DHEC) Family Planning Clinic clients with previous preterm births. Their pre- and interconception health improvement plan includes providing Low Country Healthy Start and Family Planning Clinic staff with reproductive life planning booklets and materials that include educational information on preconception care, and a reproductive life planning workbook. These materials were developed by using a program called WISSH 4 Me (Women’s Interconception Strategies Support Health).

The level of success in establishing a preconception coalition in the four Perinatal Regions will be assessed by using the following index:

• No preconception coalition or activity.
• Preconception coalition established and meeting regularly.
• Coalition assesses regional preconception health needs.
• Coalition develops a preconception plan to address issues identified.
• Coalition implements at least one program targeting identified needs.
• Coalition evaluates program(s) developed and provides feedback to other regions and the state MCH Bureau.

This assessment will be done annually and is included as a State Performance Measure in the SC Title V Maternal and Child Health Block Grant. PRAMS, BRFSS (Behavioral Risk Factor Surveillance System), and Vital Records data will be used to monitor outcomes.