2. WOULD YOU…?Leave a baby with no escape?

3. Cesarean
UNCONTROLLED DIABETES  ADVERSE
OUTCOMES
Congenital heart defects
Congenital heart defects
Sirenomelia syndrome
Sirenomelia syndrome
Miscarriage
Macrosomia
Macrosomia
Shoulder Dystocia
Shoulder Dystocia
Cesarean
Miscarriage
DEATH

4. BARRIERS?

5. WHAT PERCENT OF PREGNANCIES ARE
UNINTENDED?
• A: 80-85%
• B: 70-75%
• C: 20-45%
• D:10-15%
9
18
23
11
17
22
Non-Hispanic White Hispanic Non-Hispanic Black
Unwanted Mistimed
20%
35%
45%
Adapted from: Mosher WD, Jones J, Abma JC. Intended and unintended births in the United States: 1982–2010. National health statistics reports;
no 55. Hyattsville, MD: National Center for Health Statistics. 2012.

6. WHAT ABOUT PLANNED
PREGNANCIES?
Uncontrolled Diabetes
Nausea
Obesity
Cravings/A
versions

7. 0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
20.0
97 98 99 00 01 02 03 04 05 06 07 08 09 10 11
Pills only Insulin Only Both Insulin AND Pills Insulin or Pills No meds
Adapted from: CDC Diabetes Data & Trends: Number (in Millions) of Adults with Diabetes by Diabetes Medication Status, United States, 1997–2011
(PREVALENCEINMILLIONS)
DIABETES PREVALENCE (U.S.A)

8. RISING PREVALENCE OF DIABETES
CDC Estimate: By 2050, 1 in 3 adults will have diabetes, if current trends continue
Diabetes Report Card 2012. Center for Disease Control, National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation

9. WHERE DOES THE
PATIENT TURN?

10. Kozhimannil KB, Abraham JM, Virnig BA. National trends in health insurance coverage of pregnant and reproductive-age women, 2000 to 2009.
Womens Health Issues. 2012 Mar;22(2):e135-41.
HAS HEALTHCARE GOTTEN
BETTER FOR WOMEN? Uninsured
within 1 year
prior to study
enrollment, 2
5%
Uninsured if
NOT
pregnant, 19
%
Uninsured if
PREGNANT,
10%
Insured, 46%
1.5 % per year
over
10 years

12. A BETTER WAY…

13. FAMILY PLANNING
PRECONCEPTIONAL
COUNSELING
EDUCATION

14. PATHWAY TO PREGNANCY
HgA1C
GOAL!!!

15. Glucose Testing
Early Ultrasound
Ophthalmalogic Screening
Cardiac & Renal Evaluation
PATHWAY TO PREGNANCY

16. INCREASING AWARENESS
Community
Educators
Student
Groups
Parents
Doctors

17. Grocery
Chains
Local
Business

18. WHAT’S NEEDED…
PARTNERS

19. THANK YOUQUESTIONS?