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Random Facts Laughing lowers the stress hormones and strengthens the immune system. 6 year olds laugh an average of 300x a day. Adults only laugh 15 - 100x a day. Before, Between and Beyond Pregnancy Understanding Preconception and Interconceptional Health February 27, 2009

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random facts
Random Facts

Laughing lowers the stress hormones and

strengthens the immune system.

6 year olds laugh an average of 300x a day.

Adults only laugh 15 - 100x a day.


Before, Between and Beyond PregnancyUnderstanding Preconception and Interconceptional HealthFebruary 27, 2009

Interconceptional Care at WorkFrom Theory to Practice

Tamara Wrenn, MA, CCE

Consultant, Practice Matters , a subsidiary of

Northern Manhattan Perinatal Partnership, Inc

  • To define a Maternal Child Health Life Course Organization (MCHLCO)
  • To provide a visual step-by-step depiction of an organizational approach to moving the Life Course Framework from theory to practice
key points
Key Points
  • Successful implementation of the Life Course Theory requires MCH organizations to adopt strategies and policies that internalize the life course framework.
  • Day-to-day operations including; its approach to intakes, assessments and standard paperwork must reflect a life course framework.
  • Clients are encouraged and supported in taking the leadership role in developing a reproductive life plan.
  • External influences and systems must be identified and addressed as they impact MCH, health disparities and a woman’s lifespan.
The Northern Manhattan Perinatal Partnership, Inc. (NMPP) is a not-for-profit organization comprised of a network of public and private agencies, community residents, health organizations and local businesses. NMPP provides crucial services to women and children in Central, West and East Harlem and Washington Heights.
mission statement
Mission Statement

NMPP’s mission is to save babies and help women take charge of their reproductive, social and economic lives. We achieve this mission by offering a number of programs that help reduce the infant mortality rate and increase the self-sufficiency of poor and working class women throughout the above communities.

Infant Deaths and Infant Mortality Rate by Health Center District of ResidenceNew York City, 2001-2007

September 13, 2006

Bureau of Vital Statistics

New York City Department of Health and Mental Hygiene

traditional perinatal care continuum
Traditional Perinatal Care Continuum

Primary care

Labor and birth care

Preconception Period



antepartum labor and birth postpartum

Postpartum visit

Prenatal care

Well baby care

lifespan approach
Lifespan Approach

Birth Early childhood Pre-teen Teen Young adult Women 35> Seniors


A MCH Life Course Organization is an entity (local/state) that develops the capacity over time to deliver integrated, continuous and comprehensive health and social services and support to women and their family members from the womb to the tomb. MCH services are delivered from clinical and group care interventions all the way upstream to community and policy change interventions to reduce racial disparities in birth outcomes.

  • MCH Life Course Position
  • Family Workers (case management team)
  • Clients/Consumers
  • Strength based framework
  • Shift to working more with women in between pregnancies


  • Life Course training
  • Leadership training


  • Educational sessions
  • Goal setting
    • Vision planning
    • Short term planning, 3 month
    • Weekly action steps
  • Leadership training
  • Postpartum mood disorder screening
  • Referrals
  • Reproductive life plan
  • Strength based assessments
  • Support groups
short term outcomes
Short-term outcomes
  • Awareness of communication style
  • Circle of support
  • Engage fathers, male partners and spouses
  • Identification of baselines for health and wellness issues
  • Improvement of communication skills
  • Secured medical home
long term outcomes
Long-term outcomes
  • Birth spacing
  • Grassroots legislative involvement and advocacy
  • Improved interpersonal relationships
  • Improved self-efficacy
  • Ongoing support network
  • Planned pregnancies
  • Sustained healthcare
  • Life Course Ambassador

Transitioning into a MCH Life Course

Organization requires a top down approach which

shifts the organizational mindset and culture from:

  • present to future based;
  • deficit to strength based;
  • authoritarian to facilitator;
  • builds leadership capacity in both staff and clients; and identifies and incorporates opportunities for systems integration.

Tamara Wrenn, MA CCE

Practice Matters

c/o Northern Manhattan Perinatal

Partnership, Inc.

127 West 127th Street

Suite 305

New York, NY 10027