The Pregnancy Guide comes with a full color poster featuring Laurel
Burch’s “Kindred Spirits”, also known as the Beginnings Mothers.
Around the border are key health messages directly linked to pregnancy
outcomes. I provide the poster free for each mother as a way to introduce
the Guide and begin the health education process, and to keep the key messages
in front of the mother and her family.
Research studies have shown that women who recalled
learning something about each of these key messages
during pregnancy had bigger healthier babies. In contrast,
having or not having any of the standard prenatal care procedures
made no difference in outcomes (the one exception was regular
weight checks). This is why we say, It matters what a mother knows.
Trials of the Pregnancy Guide have shown that women who
received the Pregnancy Guide were significantly more likely
than women who obtained routine care from the same panel
of physicians to recall learning about the key messages,
especially difficult-to-discuss topics like abuse.
When you introduce the Pregnancy Guide, start with a reflective
conversation using the key messages poster. Remember, we are
looking for strengths to build on and opportunities to build confidence
First, we want the mother to envision in detail a healthy pregnancy,
a positive birth experience, and a healthy child. You can start wit
what will it look like? How will you feel? What will you see? Hear?
Now introduce the Pregnancy Guide using the key messages poster.
The conversation might go like this: There is a lot to learn about
pregnancy and parenting. You’ll be getting lots of information and
advice from me and your doctor and maybe from friends, family and TV.
It can be overwhelming and confusing. So I have a little gift for you.
Present the poster; point to the messages around the border.
These are the things that really matter when it comes to having a
healthy pregnancy and a healthy baby. Let’s go over them – please
read them aloud*.Good. Thanks. Which of these things are you
already doing? Which ones are you really good at? Praise each one.
Reflect back to her the strengths you notice.
Now which one do you think will be hardest for you? Let’s look on
the back of the poster for more information on that one. What might
make it difficult? What would make it easier? What support do you need?
Who can help you with this? How would you ask them for assistance?
What information do you need to feel more confident about this?
Now let’s think of a baby step or two you could take in the next
week to (for example) start cutting back on smoking. Where do you
want to hang your poster so you can see it every day?
During testing of this process, when we asked mothers the question,
Which of the key messages might be hardest for you? the most common
response was “none of them”, often followed by a comment like
“I would do anything for my baby”. Some mothers seemed surprised
that we would ask such a thing. (In that case, you can ask the mother to
choose one key message she wants to start working on.) Beyond that,
the answers were very mixed. The mother’s response tells you where to
begin building her knowledge and developing her health literacy, that is,
her ability to manage health and healthcare for herself and her child.
The poster has been updated for the 2011 8Edition with a new cell phone
symbol to replace the corded receiver. The message Don’t drink, is
changed to the more specific No alcohol – we really want women to drink lots
of water. On the back, the minimum weight gain for overweight mothers is
revised from 15 to 11 per the latest guideline. See blog from March 1.
*Reading aloud focuses attention and takes the learning deeper,
faster through eyes, ears, and muscles. Any hesitation alerts you
to the possibility of low literacy. Stay tuned for more on how to
respectfully identify parents at high risk for low literacy and refer
them to literacy enhancing services. Do you know the literacy programs
in your service area?