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One Key Question Spreads Across the Country

The campaign is aimed at helping women become healthier when they become pregnant to help avoid birth defects and eliminate health disparities.
October 8, 2014

Keeping women healthier, eliminating health disparities and saving taxpayer dollars are at the essence of a campaign designed by the Oregon Foundation for Reproductive Health.

It’s called the One Key Question – would you like to become pregnant in the next year?

Begun in Oregon barely five years ago, the campaign is spreading across the country due to the efforts of Michele Stranger-Hunter, executive director of the Oregon Foundation for Reproductive Health.

She’s even managed to convince national associations such as the American Association of Family Physicians to back the effort.

“We know unintended pregnancy has poor health outcomes – the best path is when a woman’s health is as optimal as possible before she becomes pregnant,” she said.

The One Key Question—would you like to become pregnant in the next year? --  is designed to start a conversation between a woman and her healthcare provider about her medical needs before conception occurs and is not focused on whether the woman is pregnant or is seeking contraceptive care.

In hundreds of interviews conducted among primary care providers, Stranger Hunter found that doctors didn’t discuss birth control with women because they assumed their needs were taken care of – and actually thought women were going elsewhere for reproductive health, which wasn’t the case.

She believes it’s important to identify women early who want to become pregnant. That way they can begin taking folic acid supplementation, which is known to prevent birth defects. Yet, only one-third of women who’ve given birth have actually taken the pill.

“When we looked at the percentage of unintended pregnancies and low-birth babies and pre-term babies and no folic acid, we wanted do something to support women,” Stranger Hunter said.

Now the one key question has the support of all the primary care associations in Oregon, and Stranger Hunter is focusing her energy on individual medical clinics throughout the state.

“We’re trying to make this as easy as possible and have developed an implementation tool kit and offer consultation with clinics to talk about who’s the best person on their team to ask questions and how to deliver the service. We stand ready to help them – to make it as easy as possible,” she added.

Currently providers in 12 states have adopted the One Key Question campaign, among them South Carolina and Vermont, while in Boston, it’s focused on reducing infant mortality.

“This will ultimately impact our maternal and child health outcomes,” Stranger Hunter said. “It’s particularly important for populations with even greater health disparities. Our next step is looking at cultural sensitivities such as Latinos where we’re doing focus groups. Unintended pregnancy is a decades old community health problem. Enough is enough. We have the experience and expertise to change the outcomes; now let’s change the system.”

Diane can be reached at [email protected].

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