1. 1 University of California Postdoctoral Scholars Planning a Family? Information

2. 2 Decision Power Healthy Baby: Preconception, Prevention and Wellness  Online pregnancy resources including: preventive care guidelines; pregnancy news; view the nine months of development; mini-quizzes (e.g. baby’s height predictor, baby-proofing your home); downloads (e.g. birth plan, first prenatal visit); and sign-up for a free pregnancy newsletter  Online Health Risk Questionnaire includes an assessment of current pregnancy status and history of risk factors; an instant, interactive health summary; and relevant referrals to resources  Online Personal Health Record, a private and secure tool allows members to view, update, and share medical information gathered from across multiple, fragmented data sources into one accessible, secure location  27/4 access to wellness and clinical support through our inbound Health Coach line  Intensive Health Coaching education for smoking cessation including a series of health coach initiated sessions with unlimited inbound calls, follow up quit status, and smoking cessation toolkit Health Net’s Decision Power SM Health and Wellness Programs

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5. 5  All Health Net delegated medical groups provide routine obstetrical services. Risk assessment is conducted upon entering maternity care and again at the end of the second trimester beginning of the third trimester. The network obstetricians are free to select their screening tool of choice from among several charting tools that have been reviewed by the American College of Obstetrics and Gynecology (ACOG).  Many medical groups and hospitals provide prenatal classes  If a patient is considered high risk upon initial screening, the general obstetrician will call on any of the many resources that Health Net makes available  For co-morbid medical conditions, the obstetrician most often co-manages the patient with the appropriate medical specialist that is in the same provider group and can care for the patient when admitted to the hospital at which she is scheduled to deliver Maternity Care

6. 6 Maternity Care: Prenatal Classes Maternity Educational Services Provided by Top 10 Medical Groups based on Deliveries PPGMedical GroupAffiliated Hospitals with Programs Brown & Toland Medical Group yesCalifornia Pacific Medical Center UCSF Medical Center Alta Bates Medical GroupyesAlta Bates Summit UCLA Medical Groupat hospitalSanta Monica UCLA UCSD Healthcare NetworkyesUCSD Medical Center Scripps ClinicyesScripps Hospital Hill Physicians Medical GroupyesMultiple hospital affiliations Greater Newport Physiciansat hospitalHoag Memorial Monarch Healthcareavailable at some hospitalsMultiple hospital affiliations Sansum Clinicat hospitalCottage Hospital Riverside Medical Clinicat hospitalRiverside Community Hospital Parkview Community Hospital Santa Barbara Select IPAat hospitalCottage Hospital

7. 7 Modifiable known risk factors for preterm birth:  Smoking  Drinking alcohol particularly binge drinking  Obesity increases the risk of poor pregnancy outcomes because it can cause high blood pressure, and diabetes that contribute to prematurity and increased likelihood of C-section  Stress  Illicit drug use Other consistently identified risk factors:  A previous preterm birth  Multifetal pregnancy  Infection  Certain uterine and cervical abnormalities Risk Factors for Preterm Birth http://www.marchofdimes.comhttp://www.marchofdimes.com. 7/12/2009

8. 8 The specific causes of spontaneous preterm labor and delivery (leading to NICU admissions) are largely unknown. Research indicates they are likely due to a complex result of multiple risk factors rather than a single isolated risk factor. As one March of Dimes representative stated “if there was an easy way to prevent it, we would have found it by now, they need to be as healthy as possible and take care of themselves” Approximately 25% of all preterm births are the result of medical intervention and the remainder occur spontaneously. 1 PeriStats ® from the March of Dimes:  12.7% of births in the United States are preterm  Preterm births have been rising year over year  The rise in late preterm births has been linked to rising rates of early induction of labor and C-sections 2 Causes of Preterm Birth 1 Iams JD. The epidemiology of preterm birth. Clin Perinatol.2003;30:651-54 2 Bettegowda, VR, Dias D, Davidoff JM, et al. The relationship between cesarean delivery and gestational age among US singleton births. Clin Perinatol. 2008; 35:309-323

9. 9  For patients with severe or multiple co-morbid conditions, the general obstetrician will co-manage or refer the member to a Perinatologist (fetal- maternal medicine specialist)  Health Net and the delegated medical groups provide case managers to collaborate with the patient's physicians in providing education, support, and intra-visit telephonic monitoring. The case managers may be nurses in the Health Net offices or nurse-coaches who may be assisting with the patient's chronic disease such as asthma, congestive heart failure, diabetes, or COPD  For the patients with severe complications that require complete bed rest, Matria/Alere is Health Net's contracted home health provider. They provide home uterine monitoring, Intravenous (IV) tocolytics (preterm labor medications), IV fluids for hydration, and IV (parenteral) antibiotics among other services Maternity Care

10. 10 IF YOU NEED A HEADLINE, THIS IS IT. Take 5 with Decision Power Healthy Baby  Complimentary, web-based, on-demand member educational program.  Comprised of 5 topics to promote healthy pregnancy and healthy baby, presented one topic per week over 5 weeks.  Extensive member-level tracking; members who complete all 5 topics are entered into a raffle for prizes.  Take 5 topics include:  Your Health Net, an introduction to Health Net’s complimentary health and wellness programs, including smoking cessation resources  Your Exercise  Your Nutrition  Your Safety  Breastfeeding On Demand Educational Program – Coming This Fall! Members may choose to print the Quick Tip Sheet that accompanies each topic.