A life course approach to women’s health should be adopted to tackle issues such as drinking, smoking and obesity which can affect women throughout their lives, say experts from the Royal College of Obstetricians and Gynaecologists (RCOG) in a new paper published today.
The RCOG’s Scientific Advisory Committee has released a new opinion paper entitled Why should we consider a life course approach to women’s health?
The paper is calling for a more unified and woman-centred approach to health promotion, disease prevention and management and says the current organisation of women’s healthcare is disjointed.
Women need consistent, accurate information to equip them at an early stage to make better decisions about their health, for example, how their fertility changes as they age, about healthy eating and exercise to avoid excess weight gain that adversely impacts their health and their children’s health.
The paper highlights smoking and alcohol as major concerns for women. They are both associated with poor pregnancy outcomes including miscarriage, preterm delivery and low birth weight and impaired fetal development. Alcohol affects a woman's ability to conceive and passive smoking puts children at increased risk of respiratory disease. In addition, drinking above recommended limits and smoking are risk factors for many chronic diseases in later life.
A life course approach also means understanding the link between past reproductive experiences and current or future health, and ensuring that clinicians are alert to the reproductive histories of their patients. For example, roughly half of women who experience gestational diabetes will develop type 2 diabetes within 10 years and women with hypertensive disorders in pregnancy are more likely to develop future cardiovascular disease.
The paper also highlights the need for greater integration of services across different sectors. For example, the traditional separation of contraceptive services and antenatal services hinders delivery of effective preconception care or postnatal contraception which are both key to achieving control of fertility and healthy pregnancies and children.
Professor Judith Stephenson, from the UCL Institute for Women’s Health and lead-author of the paper said:
“Current configuration of women’s healthcare reflects the interests of separate medical specialities and this may not meet the full spectrum of women’s healthcare needs.
“A life course view offers a more joined up approach with implications for long-term health gain and places the emphasis on education and early intervention.”
Professor Scott Nelson, from the University of Glasgow and co-author added:
“It is essential that patients and health professionals take a long term view to reproductive health, given our ability to identify early women at risk of pregnancy complications, diabetes and heart disease. Every health care interaction should ensure that women are in the best health for the next stage in their lives.”
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This paper ties in with the recent publication of the RCOG’s report, High Quality Women’s Health Care: A proposal for change, which called for a life course approach as part of its proposal for health care services to be restructured.
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In addition the life course perspective is evident in the Government’s white paper ‘Healthy Lives, Healthy People’ which considers the rationale for a life course approach to women’s health more broadly and the implications for health service delivery.
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