First Trimester Health Care in the Air Force

1. First Trimester Health Care in the Air Force Jon R. Pearse Colonel, USAF Medical Corps Chief of Policy, Medical Operations Office of the Surgeon General

2. First Trimester Health Care Family Centered Care (FCC) initiative is a major DoD-TRICARE initiative to improve attractiveness of delivering ones child within our facilities Air Force Medical Service (AFMS) provides comprehensive first trimester health care to all Special consideration for potential occupational stresses and exposures for our service members Unique role of the New Parent Support Program for all of our beneficiaries

3. Summary of Family Centered Care Initiative Family Centered Care Initiative (FCC) program transforms care delivery from a provider-centered to a patient/family centered experience Obstetrical-FCC is the first DoD-TRICARE Management Activity initiative in this transformation Elements of the FCC program were derived directly from patient and staff responses to multiple survey instruments and information obtained from MTF convenience samples Our objective is to be the provider of choice for our families

4. Obstetrical-FCC Initiative within the Air Force Senior Air Force leadership is actively engaging all of our Medical Treatment Facilities (MTFs) Increased sensitivity and resources allocated to be more Family Centered focused Increased funding for staffing improvements Tool kits and central resources provided Without distinction between service members and dependant beneficiaries

5. IMPROVEMENTS SEEN� Many best practices at our facilities screening for: Post-partum depression Domestic violence Substance abuse, tobacco, alcohol Spring Garden Interactive CD-ROM and video Award winning pregnancy informational CD and video Over 10,000 distributed last year Eglin is distributing with prenatal vitamins at the pharmacy This practice being encouraged for all facilities Screening Ultrasounds for beneficiaries All facilities facilitating children to attend prenatal appointments

6. More Improvements Seen� DoD/VA uncomplicated pregnancy guideline implementation Nurse-educational visit by 6-8 weeks First provider visit by 10-12 weeks Streamlines visits and standardizes care Inline with all American College of Obstetrics and Gynecology guidelines Increasing continuity of care with provider Have seen no net loss of patients after the 2003 appropriation act The act provides same maternal-child benefits for those that opt for private sector care

7. After a Positive Pregnancy Test� A standard profile is performed Member is taken off of mobility status until 4 months post partum Wearing of certain military gear is restricted Gas Masks, Respirators, utility belts General duty performance restrictions applied

8. The Pregnancy Profile� Goal is optimal maternal-fetal health Duty restrictions balance: Utmost care in reducing occupational risks to fetal development Medical needs of the service member Member�s right to participate in unit functions

9. Adhere to Federal health and Safety Recommendations The Air Force follows the 1996 Newborns� and Mothers� Health Protection Act is the cornerstone OSHA-Occupational Safety and Health Administration guidelines followed NIOSH-National Institute of Occupational Safety and Health followed A worksite-occupational evaluation by skilled occupational experts occurs expediently when a service member becomes pregnant Safety information and restrictions for optimal maternal-fetal health Information is then provided to the member and to the member�s unit

10. New Parent Support Program Medical Program through Family Advocacy Staffed by contracted civilians at the MTF All new pregnancies contacted Parenting, nutrition, education, breast feeding, health classes offered To include a �Dads 101� Referrals made to Womens Infants and Children (WIC) programs CONUS and OCONUS Family Centered Care initiative is actively integrating the New Parent Support Program within all of our Air Force facilities

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