Preventing Unintended Secondary Pregnancies in Women Receiving Women, Infants and Children (WIC) Services

Summary

Impact Statement: 
A local health department noted a high rate of early post-partum unintended pregnancies among women in the Women, Infants and Children (WIC) program, and used QI to identify three interventions to reduce the rate.
Summary: 

The Barron County Department of Health and Human Services Public Health Program was awarded a 2012 Strengthening the Community of Practice for Public Health Improvement (COPPHI) Quality Improvement (QI) Award Program Grant through the Robert Wood Johnson Foundation. Through this project, Barron County Public Health (BCPH) sought to increase access to family planning supplies and information for pregnant and postpartum women receiving Women, Infants and Children (WIC) services in an effort to decrease the percentage of women becoming pregnant less than 16 months from their last pregnancy. Data were collected from local medical providers and women receiving WIC services. Data confirmed inconsistencies in the provision of family planning information and services during the third trimester and postpartum period. An educational webinar, hosted by BCPH's medical advisor, was created. The webinar shared the emerging practice of interconception care in reducing unintended secondary pregnancies. Dual protection kits, which contained emergency contraception (EC) in advance of need, condoms, and educational materials were created. Posters were placed in WIC service areas that state "ask me how to get a dual protection kit today" and showed pictures of the components of the dual protection kits. All pregnant and postpartum women receiving WIC services are offered a dual protection kit and a visit with reproductive health staff. It will take time to evaluate the effectiveness of these interventions on reducing the percentage of women becoming pregnant less than 16 months postpartum. The physicians who watched the educational webinar responded positively on the post-webinar survey, and all have stated that they already do the practices listed or responded they are "much more likely" to implement the practice after watching the webinar. In the first month, 12 dual protection kits were distributed to clients.

Organization that conducted the QI initiative: 
Barron County Department of Health and Human Services
Citation: 

Engen, K. Public Health Quality Improvement Exchange. Preventing Unintended Secondary Pregnancies in Women Receiving Women, Infants and Children (WIC) Services. Thu, 04/16/2015 - 12:50. Available at https://www.phqix.org/content/preventing-unintended-secondary-pregnancies-women-receiving-women-infants-and-children-wic. Accessed August 15, 2018.

Submission Status: 
Completed
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Comments

Submitted by tzastava on

This is a really interesting project. I love the idea. I'm wondering how you got Health and Human Service Committe/County Board approval to provide the emergency contraception. Did you experience and road blocks with that?

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Submitted by Nancy Drake on

We manage our family planning program based on guidelines provided by the Wisconsin Family Planning and Reporductive Health Program, with approval of our Voluntary Medical Advisor, with support of the program by our board. This dispensing practice falls within those guidelines and clients who receive these services are enrolled as family planning clients.

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Submitted by amymurphy1 on

This abstract and report have been very helpful as the City of Milwaukee Health Department plans to integrate dual protection interventions into their WIC this fall. Thank you Barron County & Nancy Drake for the expert advice and information.

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Grace Gorenflo's picture
Submitted by Grace Gorenflo on

This is a very interesting initiative! Have you had an opportunity to collect any data yet on your future measures?

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Submitted by laura.sauve on

Pregnant women enrolled in our WIC program who had risk factor 332, "Concep 16 mo pp" was at 22.8% for the period of 10/1/12 to 9/30/13, this is down from the 1/1/12 to 12/31/12 time period which showed 30.85% of pregnant women with this risk factor. We started the dual protection kits/birth spacing messaging in November of 2012. We continue to monitor the data. Thanks for your interest!

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Submitted by laura.sauve on

Update on our project:  Data showed our WIC secondary pregnancy rate, (WIC risk factor 332, pregnancy spacing <16 months) decreased to 22.3% in 2013.  This was down from 31% in 2012.   

However, 2014 data show our WIC secondary pregnancy rate increased to 25.5% and our dual protection kit distribution fell by 12%.  

Lesson's learned:  We waited a full year to re-evaluate project outcomes and share this data with staff.  We need to re-evaluate and provide feedback to staff more frequently in order to keep this initiative at the forefront of our interventions.  We are looking at adding this as a performance measure to ensure quarterly attention. 

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Submitted by maralieg on

Thanks for sharing your experience! Our WIC is also concerned about birth spacing. That's great that you have reproductive health staff and resources. I am going to pass this along to our WIC directors to see if we can think of some possible solutions that could work with the resources we have (such as reaching out to local physicians, etc.)!Also, it

Also, it's tough to keep one initiative at the forefront of your minds and efforts with everything else going on, especially after completing the "project." Keep up the good work! :)

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