Poor maternal health is one of the major risk factors related to adverse birth outcomes. Women entering pregnancy with poor health status are at higher risk of these outcomes. Prenatal care has been established as the standard prevention paradigm to reduce poor pregnancy outcomes. However, public health professionals are realizing that prenatal care alone is not sufficient to improve perinatal health and birth outcomes, and instead have emphasized the importance of preconception care (PCC). Evidence-based studies reveal that those who received PCC services have better pregnancy outcomes than those who did not. Most published research on preconception are clinical studies, little is known about women’s perception of preconception health and decision-making factor(s) to engage in preconception health practices. Existing research on preconception health behaviors have used retrospective designs, making them difficult to use in assessing the extent of women’s understanding of preconception health behaviors and its relationship to the practice of these behaviors. Thus, an exploratory qualitative study was needed to examine factors associated with preconception health behaviors. The objective of this study was to answer two research questions: (a) What are childbearing age women’s knowledge, beliefs, and perceptions of preconception health/care and how do these factors influence their preconception health behavior? (b) What are the perceived factors (facilitators and hindrances) associated with these women’s intention and decision-making regarding preconception health behaviors? Thirteen women were interviewed about their knowledge and perceptions about PCC and intention toward preconception health behavior practice. The results indicated that women believed PCC is important—using the analogy of preparing their house [body] for conception. Participants associated PCC with physical and nutritional behavior; few acknowledged the importance of mental health. While women believed PCC was important, the majority did not intend to engage in PCC until they became pregnant. The main motivator to engage in PCC was pregnancy. Self-described “laziness” was the most common reported perceived barrier to PCC. Implications of this study are that additional studies with improved designs are needed to clarify relationships among intentions and actual behaviors, and that health educators should focus on educating women about the importance of self-care before conception.

Among young adults at risk for unintended pregnancies, preconception health and prenatal care programs aimed at positive birth outcomes remain unaddressed. The purpose of this phenomenological study was to explore the lived experiences of young adults in terms of their willingness to use preconception health and prenatal care as a means for increasing both positive birth outcomes and overall health. All study participants met the following criteria: (a) young adult man or woman, (b) age 18 to 25, (c) at risk for unintended pregnancies, (d) sexually active, (e) single or in cohabiting partnerships, and (f) living in the greater Los Angeles, Calif., area. The researcher conducted individual, semi structured interviews with study participants, and analyzed the resulting transcripts using a modified van Kaam analysis. Data analysis yielded 3 major themes to address the study's 3 research questions. First, participants believed that parenthood is largely learned through witnessing the practices of their parents, family members, and friends. Second, participants believed in the necessity of healthy lifestyle choices for healthy preconception and optimal prenatal care. Third, the key obstacle to perinatal care was the lack of awareness of pregnancy and available health care resources. These findings may provide a guideline for improving preconception health and prenatal care programs for young adults who are at risk of unintended pregnancies.

The purpose of the study was to examine reproductive life planning practices among Title X family planning health care providers and clinical staff. Reproductive life planning is a program priority for Title X clinics, those that receive federal money for providing family planning services to low-income women and men. The goal of reproductive life planning is to decrease unwanted and unintended pregnancies and improve preconception health care however; this practice has not been described. First, a conceptual analysis was conducted to create a definition of reproductive life planning that was consistent with the literature. Reproductive life planning is a process that is centered on reproductive and other life goals and is personalized, collaborative, fluid, and focused on health-promotion. Second, a mixed methods design was used to examine reproductive life planning practices and qualitative interviews were conducted to explore barriers and facilitators to implementing reproductive life planning practices. Data were obtained from health care providers and clinical staff employed at Title X clinics in Illinois, Iowa, Minnesota, Missouri, Nebraska, and North Dakota. A total of 148 clinicians completed a web-based survey which was analyzed to describe which types of patients, the topics covered, and the frequency with which reproductive life planning was discussed during an office visit. Surveys were then examined to identify 20 providers to conduct qualitative interviews with to further explore reproductive life planning practices. The qualitative interviews were also performed to explore the barriers and facilitators clinicians face to practicing reproductive life planning. The results of the web-based questionnaire were examined mainly with medians and frequencies to examine reproductive life planning practices. Qualitative interviews were coded using a content analysis approach to two aims; one to examine how reproductive life planning was using during clinic visits and two, to identify the barriers and facilitators clinicians face when discussing reproductive life planning with patients. Findings from the survey and the interviews suggest that most clinicians are discussing pregnancy intentions with their patients. However, from the interviews, three types of scope of reproductive life planning emerged; those clinicians who screened their patients’ pregnancy intentions, those who planted the seed in the patient’s mind, and those who explored the context of a patient’s life and their goals to contextualize how pregnancy and childbearing would fit into their lives in order to clarify pregnancy intention and move toward the corresponding health behaviors. It is argued that the third group of providers is using reproductive life planning as intended by experts. Finally, barriers to RLP discussions were examined as well as approached providers used to overcome the barriers. In conclusion, many clinicians are practicing reproductive life planning as intended, however many are not. Improved training and protocols are needed to ensure clinicians are providing their patients with the best reproductive life planning discussions. Additionally, systemic structures, like access to quality family planning services, need to be improved to aid clinicians in helping their patient plan their families.

The intention-behavior gap between receiving professional health information and transitioning to improved health behaviors prior to conception is not well understood. In order to improve preconception health across the board, a more integrative understanding of the problem must present itself. This study combined elements from the theory of planned behavior, self-determination theory, and the bioecological model of human development as it's foundation. Qualitative phenomenology and semistructured face-to-face interviews were used to gain a deeper understanding of the ways in which nine overweight and obese women described preconception intentions and beliefs and the bioecological experiences leading to those beliefs. Interpretation of the results suggested socio-environmental conditions that affect the development of beliefs, intentions, and attitudes toward preconception health. Key discoveries regarding planning intention and behavior included laissez faire attitudes toward preconception planning, advice-seeking methods, perceived need to change behaviors, and ability to navigate the healthcare system and social programs. Future recommendations include using the more complex bioecological view to improve the global preconception health imperative. This study's potential for positive social change includes opportunities to hold important conversations about preconception health by disseminating study results locally and the expansion of knowledge in a field dedicated to the improvement of women and infant health worldwide through publication.

Foreign-born Black women giving birth in the United States have superior preterm birth outcomes compared to their U.S-born Black peers. Many studies have focused on tobacco use and medical risk factors, but few have focused solely on preconception health. The purpose of this study was to examine preconception health and preterm birth differences among U.S.-born and foreign-born Black women. Three theoretical frameworks guided this study: the life course theory, healthy migrant theory/immigrant paradox, and weathering theory. Primary research questions assessed (a) if there were an association between chronic preconception risk factors, prepregnancy obesity, diabetes, and hypertension, in U.S.-born and foreign-born Black women, (b) if U.S.-born Black women had a higher risk of having a preterm infant compared to foreign-born Black women, and (c) if weathering existed in U.S.-born and foreign-born Black women. A quantitative design using the 2017 Natality Public Use File was employed that included non-Hispanic Black women ages 15 to 44 years. Chi-square test and binary logistic regression were used for the data analysis. Key findings revealed (a) a statistically significant association between preterm birth and chronic preconception health risk factors in both groups of women, (b) U.S.-born women were roughly 1.4 times more likely to have a preterm infant than foreign-born women, and (c) both groups experienced weathering. This study might positively impact social change by offering an alternative perspective to the reproductive health advantage of foreign-born Black women. This perspective can aid in advancing policy and systems change strategies to address the root causes of racial and ethnic disparities in birth outcomes, advance health equity, and improve maternal health.

Indiana University-Purdue University Indianapolis (IUPUI) / Advancement of preconception and interconception health is a key element to improve women’s health as well as pregnancy outcomes. Little is known about the preconception and interconception health status of rural Midwestern populations in the United States. The primary objective of this study was to determine the preconception and interconception health status as well as behaviors of reproductive age women living in a rural Midwestern area. Secondary objectives were to quantify process measures of health care access and barriers to care, as well as determine disparities in preconception and interconception health status among women in this rural area as compared to statewide estimates. As existing national or state secondary data sources often have limitations in data derived from areas with low population densities or insufficient sample sizes to generate reliable estimates, a cross-sectional study was performed using a 34- item survey. Data were collected from February to May 2019 from 315 non-pregnant women ages 18-45 years in a rural county in northwestern Ohio. Nearly all women surveyed had at least one risk factor associated with poor pregnancy outcomes, many of which were modifiable. Nearly half of all respondents reported at least one barrier to receipt of health care services. Women in this rural county fared worse for several preconception and interconception health measures when compared to statewide estimates derived from Behavioral Risk Factor Surveillance System and Ohio Pregnancy Assessment Survey data. These findings illustrate the need for continued development of interventions to improve preconception and interconception health for rural women as well as improved methods to capture and analyze data on important subpopulations at risk. / 2021-03-09

Bakgrund: Samhället ska värna sex- och samlevnadsundervisning, familjeplanering samt mödrahälsovård. Barnmorskan har en central roll att sprida kunskap inom området. Genom information till kvinnor och män om den prekonceptionella hälsans betydelse kan det skapas goda förutsättningar till familjebildning. Syfte: Att beskriva ungdomars kunskaper och inställningar om prekonceptionell hälsa samt vilken kunskap ungdomar efterfrågar angående detta. Metod: En kvalitativ intervjustudie med fokusgrupper genomfördes, varav en grupp med fem män i åldrarna 21-22 år samt en grupp med sju kvinnor som var 18 år. Datamaterialet analyserades med latent innehållsanalys.                                                                                                                         Resultat: Den kunskap ungdomarna hade om prekonceptionell hälsa var olika faktorers påverkan på fertiliteten. Fördelaktiga faktorer var varierad nyttig kost, träning och god sömn. Som negativ påverkan på fertilitet diskuterades tobak, alkohol, droger, mediciner, sjukdomar, ärftliga sjukdomar och cystor samt stress. Kunskap ungdomarna efterfrågade var att få information om prekonceptionell hälsa, vad de kunde påverka inför en eventuell framtida graviditet samt fakta om hur de olika faktorerna påverkade fertiliteten. Informationen ville de få av någon med  kunskap inom området. Slutsats: Information om prekonceptionell hälsa efterfrågades av ungdomarna, en ökad kunskap och medvetenhet om ämnet hos allmänheten skulle kunna generera positiva hälsoeffekter på individ- såväl som på samhällsnivå med en hälsosam befolkning som resultat. / Background: The society should be responsible for sexual education, family planning and maternal healthcare. The midwife has a central role when it comes to spreading knowledge within the area. By spreading information  to women and men about the importance of preconception health and care it could create good conditions to start a family.  Purpose: To describe young peoples knowledge and attitudes about preconception health and care and also about what kind of knowledge the youth asks about when it comes to it. Method: A qualitative interview study with focus groups was preformed which included a group of five men ages between 21-22 and a group of  seven women who all were 18 years old. The data was analyzed by latent content analysis. Results: The knowledge the young people had about preconceptional health and care were the effects of different factors on fertility. Beneficial factors were varied health diet, exercise and good sleep. As a negative influence on fertility, tobacco, alcohol, drugs, medicines, diseases, hereditary diseases and cysts were discussed as well as stress. Knowledge the young people asked for were information on preconceptional health and care, what could influence a possible future pregnancy and facts, how the various factors affected fertility. The youth wanted the information to be obtained from someone with knowledge within the field. Conclusion: Information on preconceptional health and care was asked about by the young people, increased awareness and awareness of the subject of  public could generate positive health effects at the individual- as well as at community level with a healthier population as a result.

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