SACRAMENTO – Today, California Surgeon General Dr. Diana Ramos unveiled, as part of the Strong Start & Beyond movement, the Preconception Medical Assessment (PreMA), a simple, eight-question tool designed to help Californians of reproductive age identify potential medical needs before choosing pregnancy.
“Healthcare goes beyond the doctor’s office,” said California Surgeon General Dr. Diana Ramos. “At anytime and anywhere, women and birthing people across California can take PreMA, an easy, free, and private quiz, to better understand their own health before pregnancy.”
Why This Matters
California has achieved the lowest maternal mortality rate in the nation. Yet, there is always more to be done. According to the Centers for Disease Control and Prevention, more than 80% of maternal deaths are preventable. Chronic health conditions play a significant role in these tragedies, with 1 in 3 women of reproductive age having at least one chronic condition. To help ensure the well-being of mothers, pregnant people, and their families, the Office of the California Surgeon General developed this simple yet transformative tool to help individuals identify chronic health conditions early—before pregnancy even begins.
The PreMA questionnaire will not only educate people about their health but also empower them to take proactive steps toward safer pregnancies and address any health challenges, especially ones that are preventable, before they become serious. This new approach will also help to foster a shift in maternal healthcare toward strategies that are more equitable and proactive—prioritizing prevention alongside intervention.
About PreMA
PreMA is a simple, easy-to-use quiz that asks people who are thinking about having a baby eight questions about their current health status and history, including heart problems, high blood pressure, diabetes, and other conditions. PreMA is meant to live in everyday spaces—community centers, churches, laundromats, and apps on our phone. Depending on the number of questions they answered yes, individuals are given a recommendation on how to have the healthiest pregnancy and baby. Everyone is encouraged to get a preconception visit, review medications, attend all prenatal and postpartum visits, create a pregnancy plan in partnership with their medical provider, and trust their body. The quiz also provides information to find local, state, and national health and human services resources available to them.
How We Got Here
PreMA employs a straightforward methodology using validated questions that quickly assess pre-existing medical conditions like hypertension, diabetes, and obesity that increase the possibility of complications during pregnancy. Developed through a collaborative expert review and a rigorous validation process, it empowers women and birthing people with knowledge about their health before pregnancy.
To validate PreMA, participants across California assessed the ease of responding to the eight questions. The validation process demonstrated robust inclusivity, ensuring applicability across diverse populations and in English and Spanish.
What They’re Saying
Across the state, partners from diverse backgrounds in the reproductive and maternal health space support the launch of PreMA.
- Hayley Miller, MD, Maternal-Fetal Medicine Specialist, American College of Obstetricians and Gynecologists District IX Public Health Co-Chair: “By engaging people in their healthcare before pregnancy, PreMA will lay the foundation for healthy mothers and babies.”
- Bernadette Lim, MD, MS, Founder and Executive Director of Freedom Community Clinic: “PreMA can help our communities plan ahead for safer, healthier, and happier futures. By being able to educate and raise awareness, individuals and families are able to feel empowered, proactive, and intentional in their birthing experiences.”
- Bertha Perez-Sanchez, MPA, Mom: “I wish the PreMA quiz had been available during my pregnancies. This free tool could have helped me be more proactive about my health before pregnancy with in-language and online access from the comfort of my home.”
Bigger Picture
In September of 2024, the Office of the California Surgeon General released California’s Maternal Health Blueprint and launched Strong Start & Beyond to reduce maternal mortality, educate and empower reproductive-age individuals, and save the lives of moms and pregnant people in California. This movement builds on the state’s efforts, including the California Department of Public Health and Department of Health Care Services, to improve the reproductive and maternal health of all Californians.
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