In the past decades there has been an improvement in the medical treatment of children born preterm or with reduced foetal growth. This has resulted in a much higher survival rate of these children, but also in a higher number of surviving children with chronic conditions. These changes have, in turn, increased interest in investigating the connection between birth-characteristics and outcomes in later life. The overall aim of the present thesis was to study the relations between birth-characteristics, subsequent hospitalisations, and childbearing by means of data available in Swedish population-based registries. The study population in this thesis consisted of women (and men in Paper III) born in 1973-75 according to the Medical Birth Register and the Total Population Register. Information available in other registries, such as the Hospital Discharge Register, was obtained by individual record linkage. In Paper I, 148,281 women, alive and living in Sweden at 13 years of age, were included. Of the women, 4.1% were born preterm and 5.4% were born small for gestational age, and approximately 30% of all women had given birth between 13 and 27 years of age. We found that reduced foetal growth and possibly preterm birth were related to the likelihood of giving birth during the study period. The intergenerational effects of preterm birth and reduced foetal growth were investigated in Paper II and the study population consisted of 38,720 mother-offspring pairs. An intergenerational effect of reduced foetal growth was found, and reduced foetal growth in the mother also increased the risk for preterm birth in the child. Paper III was concerned with 304,275 men and women living in Sweden at 13 years of age. Of these men and women, 30% were hospitalised during adolescence and early adulthood (i.e. between 12 and 23 years of age). We found that men and women born small for gestational age or preterm were more likely to be hospitalised, and that those born small for gestational age seemed to be more at risk compared to those born preterm. Finally, in Paper IV, the relation between hospitalisations during adolescence and the likelihood of giving birth was studied in 142,998 women living in Sweden at 20 years of age. We found that a majority of the causes of hospitalisation during adolescence were positively connected to the likelihood of giving birth between 20 and 27 years of age. The relations presented in Papers I-IV were evident although socio-economic characteristics were adjusted for.

Progesterone metabolites as allopregnanolone, isoallopregnanolone and tetrahydrodeoxy-corticosterone (THDOC) are increased in the luteal phase of the menstrual cycle, throughout pregnancy and during stress. Allopregnanolone and THDOC are neurosteroids with 3α-hydroxy, 5α-configurations and positive modulating effect on the GABAA receptor. They have similar properties and effect, and share the same binding sites on the GABAA receptor. Isoallopregnanolone has a 3β-hydroxy, 5α-configuration and a diverse effect as a proposed antagonist to both allopregnanolone and THDOC. Neurosteroids are thought to exert their effect predominantly at extrasynaptic GABAA receptors, containing for example α4- or α5-subunits. Such receptors are involved in the tonic response. Different subunits have diverse distribution pattern in the brain and are involved in different functions. The α5-subunit, mainly expressed in the hippocampus, is involved in learning, while α4 is more widespread and involved in e.g. anxiety and anaesthesia. The aim of the present thesis was to contribute to the knowledge about selected progesterone metabolites and their effects on learning and tolerance development, as well as their metabolism. Also basic characteristics between different α-subunits of the GABAA receptor were evaluated. The thesis shows that the effect of bicuculline and pentobarbital is not dependent on the α-subunit isoform of the GABAA receptor expressed in oocytes. Acute tolerance developed after allopregnanolone-induced anaesthesia with a decrease at both mRNA and protein levels of the GABAA receptor α4-subunit in the thalamus VPM nucleus. A negative correlation between the α4 mRNA and the increased dose of allopregnanolone needed to maintain the anaesthesia level was also shown. In addition, allopregnanolone induces a learning impairment in the Morris water maze test, when high concentrations of allopregnanolone are present in the brain. This impairment is not possible to reverse by isoallopregnanolone. In α5β3γ2L-transfected HEK-293 cells THDOC induces a baseline shift of its own and also potentiate the GABA-current. Neither of those THDOC effects can be inhibited by isoallopregnanolone. Instead isoallopregnanolone shows an agonistic effect on the THDOC-potentiation of the GABA-response. The main allopregnanolone metabolites identified, 5α-DHP and isoallopregnanolone, as well as allopregnanolone itself are mainly localized to the brain after an i.v. injection. After an isoallopregnanolone injection there is a more even distribution of the given steroid and the metabolites between plasma and brain. There is an epimerisation between isoallopregnanolone and allopregnanolone and vice versa. In conclusion, the present thesis shows that the α4-subunit in the thalamus VPM nucleus is likely to be involved in the acute tolerance development against allopregnanolone and that allopregnanolone-induced learning impairment is likely to be hippocampus dependent. The lack of antagonistic effect of isoallopregnanolone on the THDOC-induced α5β3γ2L-GABAA response, together with epimerisation of isoallopregnanolone to allopregnanolone, could explain why isoallopregnanolone does not work as an antagonist to the allopregnanolone-induced learning impairment in a hippocampus dependent learning task.

Bakgrund: Lesbiska och bisexuella kvinnor har sämre fysisk och psykisk hälsa än heterosexuella kvinnor. De är en osynliggjord grupp inom vården. Inom kvinnosjukvården (gynekologi och obstetrik) finns en tradition av heterosexualitet i och med dess fokus på reproduktion. Tidigare studier har visat att lesbiska och bisexuella undviker gynekologisk vård på grund av dåligt bemötande. Obstetriken kommer framöver att få ta emot alltfler samkönade par. Det blir därför viktigt att förstå hur kvinnosjukvården upplevs av lesbiska och bisexuella kvinnor. Syftet är att belysa lesbiska och bisexuella kvinnors upplevelser av kvinnosjukvården. Metod: Litteraturöversikt av 13 forskningsstudier. Textanalys med beskrivande sammanställning av inkluderade studiers resultat. Teoretiska referensramar är vårdrelation och heteronormativitet. Resultat: Det finns heteronormativitet och homofobi inom kvinnosjukvården på både individuell och strukturell nivå. Brister i bemötandet handlade om att bli exkluderad, samt att mötas av fientlighet, omedvetenhet eller okunskap. Detta fick negativa konsekvenser för studiernas deltagare, och ledde till olika strategier för att hantera och förebygga negativa vårdsituationer. Positiva upplevelser av vården relaterades till medvetenhet och kunskap kring sexuell läggning i form av öppenhet och kommunikation, samt när vårdpersonal signalerade acceptans och positiva attityder. Små förändringar i bemötandet kunde göra stor skillnad i mötet. Diskussion: Förutsättningarna för en god vårdrelation försvåras av heteronormativitet, och vårdpersonal behöver bli medvetna om på vilka särskilda sätt som lesbiska och bisexuella kvinnor behöver bekräftelse i form av acceptans och inkluderande. Enskild vårdpersonal kan göra stor skillnad i upplevelsen av bemötandet, och på så sätt också vara del av en större förändring kring minskad heteronormativitet inom kvinnosjukvården. / Background. Lesbian and bisexual women have worse physical and mental health than heterosexual women. They are an invisible group in health care. Within women's health care, (gynecology and obstetrics) there is a tradition of heterosexuality due to the focus on reproduction. Previous studies have shown that lesbians and bisexuals avoid gynecological care due to the way they are received. Obstetrics will now be receiving more and more same-sex couples. That makes it important to understand how lesbian and bisexual women experience women’s health care. The aim is to highlight lesbian and bisexual women's experiences of women's health care. Method. Literature review of 13 research studies. Text analysis with descriptive summary of included studies' results. The theoretical frameworks are the nurse-patient relationship and heteronormativity. Results. Heteronormativity and homophobia exist within women's health care. Deficiencies in the the ways lesbians and bisexual women were received involved being excluded and encountering hostility, unawareness or ignorance. This led to the need for various strategies to manage and prevent adverse health situations. Positive experiences of care related to awareness and knowledge of sexual orientation in terms of openness and communication, as well as health professionals signaling acceptance and positive attitudes. Marginal changes in health professionals’ response could make a big difference for the lesbian and bisexual women. Discussions. The prospects of a good caring relationship is complicated by heteronormativity. Health professionals need to be aware of the specific ways in which lesbian and bisexual women may need confirmation. Individual health professionals can make a big difference to the way lesbian and bisexual women experience health care, and thereby also contribute to a wider improvement related to reduced heteronormativity in women’s healthcare.

Syftet med denna litteraturstudie var att beskriva hur patienter upplever information inför gynekologiska ingrepp och undersökningar. Metoden som användes för att belysa syftet var beskrivande litteraturstudie. Data insamlades via två databaser, Medline och Cinahl. Andra sökstrategier var manuell sökning i valda källor. 15 vetenskapliga artiklar inkluderades i resultatet, dessa kvalitetsgranskades, analyserades och sammanställdes. Huvudresultat: Resultatet visade att vissa kvinnor saknade information om olika behandlingsalternativ, information om förberedelser samt information om postoperativa perioden. Många kvinnor tyckte dock att denna information varit bra. Många tyckte information angående indikationer för operation som bra, många ville inte ha för detaljerad information, vissa saknade information för att kunna ställa följdfrågor och kvinnor tyckte information om bl.a. kirurgisk teknik var bra. Kvinnorna var ofta nöjda med informationen och att lita till vårdpersonalen. Kvinnorna upplevde oftast den givna informationen som tillräcklig. Slutsats: Författarna anser att vidare forskning bör bedrivas inom området då det i studien framkommit att kvinnor många gånger saknar information kring sin undersökning samt ingrepp. Då upplevd informationsbrist kan göra att hela vårdupplevelsen blir lidande behövs vidare studier och då främst om hur informationen når patienten bäst då vi sett att information som finns hos personalen inte kommer patienten till nytta alla gånger. / The purpose of this study was to describe how patients perceive information prior gynecological surgery and examinations. Method: The method used to illuminate the purpose was descriptive literature. Data were collected via two databases, Medline and Cinahl. Other search strategies were manual search of selected sources. 15 numbers of articles were included in the result. Quality was reviewed, analyzed then summarized. Main results: Results showed that some women lacked information about treatment options, information about preparation and information about the postoperative period. Many felt that this information was good. Many thought that the information about indications for surgery were good, many women didn´t want the information to detailed, some lacked information to come up with additional questions and women thought that the information about such as surgical technique was good. Women were often satisfied with the information and with trusting the caregivers. Women usually experienced the given information to be adequate. Conlusion: The authors believe that further research should be conducted in the area where the study found that women often lack information about their investigation and intervention. This perceived lack of information can make the entire health care experience suffer, therefore further studies are needed, mainly on how to reach the patient with the information as we have seen that information given by the staff is not always received or recognized by the patient.

Background: Chlamydia trachomatis in women is a risk factor for tubal factor infertility and extra uterine pregnancies, but the impact of a C. trachomatis infection on male fertility is unclear. It is also hypothesized that persistent infection with C. trachomatis, or other microorganisms, might initiate/promote ovarian tumor development. The aims of the thesis were to study whether C. trachomatis serum antibodies in women and men had an impact on infertility diagnoses, semen characteristics, pregnancy rates and pregnancy outcomes; furthermore, to explore associations of C. trachomatis, and Mycoplasma genitalium, plasma antibodies with epithelial ovarian cancer and borderline ovarian tumors, as well as the presence of C. trachomatis bacteria, and other microorganisms, in ovarian tissues. Materials and methods: Papers I and II: 244/226 infertile couples were tested for serum C. trachomatis IgG, IgA, IgM and chlamydial Heat Shock Protein 60 (cHSP60) IgG antibodies. C. trachomatis IgG positive couples were also tested for C. trachomatis DNA in a urine sample. The follow-up period was 14-54 months. 244 spontaneously pregnant women were also tested for serum C. trachomatis IgG antibodies. Papers III and IV: Plasma samples from 291 women with epithelial ovarian cancer, borderline ovarian tumors and benign conditions, and plasma samples from 271 healthy controls, were analyzed for C. trachomatis IgG, IgA and cHSP60-1 IgG and M. genitalium IgG antibodies. Ovarian tissues from 186 women with benign ovaries, borderline ovarian tumors and epithelial ovarian cancer, as well as tissues from the contra lateral ovary in 126 women, were analyzed for the presence of C. trachomatis, M. genitalium, Neisseria gonorrhoeae, HPV and the polyoma viruses BKV and JCV with nucleic acid amplification tests. Results: Papers I and II: The prevalence of C. trachomatis IgG antibodies was higher among infertile than fertile women, and there were 9 couples with ongoing C. trachomatis infections. In men, C. trachomatis IgG and IgA antibodies were associated with a reduced likelihood to achieve pregnancy for the couple, as well as lower sperm concentration, reduced sperm motility and vitality, increased teratozoospermia index and the occurrence of leukocytes. C. trachomatis IgG and cHSP60 IgG antibodies in infertile women were associated with tubal factor infertility, but not with reduced pregnancy rates or outcomes. Paper III: cHSP60-1 IgG antibodies were associated with ovarian cancer belonging to the postulated type II pathogenetic pathway when plasma samples obtained more than one year prior to diagnosis were analyzed. M. genitalium IgG antibodies were associated with borderline ovarian tumors; however a statistical type 1 error cannot be excluded. Paper IV: None of the microorganisms studied were found in the ovarian tissue samples. Conclusions: C. trachomatis IgG and IgA antibodies in the man substantially decreases the chances of the infertile couple to achieve pregnancy, and are associated with subtle negative changes in semen characteristics. C. trachomatis IgG and cHSP60 IgG antibodies in the woman are risk factors for tubal factor infertility. Prospective plasma cHSP60-1 IgG antibodies are associated with type II ovarian carcinomas, but C. trachomatis bacteria, or the other microorganisms studied, could not be detected in benign, borderline or malignant ovarian tissues.

Aim: To investigate gynecologists’ and midwives’ views and experiences regarding work in abortion care in Sweden. Methods: Questionnaire to gynecologists (n=269) and midwives (n=258 comprising 48 questions, response 85%. The quantitative studies (articles I-III) were supplemented by a qualitative study (article IV), consisting of focus-group interviews with gynecologists and midwives/nurses. Results: From the questionnaire studies it was apparent that all the gynecologists had worked in abortion care, whilst not all midwives had done so. The male gynecologists were older than both their female colleagues and the midwives; they had most years of experience but were now working least with abortion patients. Both groups considered it absolutely right, that Sweden have legal abortion and that the law was being followed. Most thought that women should be allowed to have an abortion even after they had felt fetal movements. The midwives were generally somewhat more restrictive than the gynecologists. Half of all thought that the work with abortion patients brought something positive with it. Those having worked longest and most extensively, especially during the previous year were most liberal. Both groups felt that there was a difference between working with surgical and late abortions compared with medical abortions. One in four had had misgivings when involved in surgical and medical abortions, and one in two with abortions after the 18th week. All were positive about the transition to medical abortions, and roughly two thirds of the midwives thought that the primary care sector should be able to take care of these, whereas less than half of the gynecologists thought this. The majority considered it important to receive further and continuing professional development and ongoing guidance. From the focus-group interviews it was clear that the experiences of the gynecologists were largely connected with the technical development of abortion methods and those of the midwives/nurses with improved pain relief. The work was sometimes described in paradoxical terms and was occasionally experienced as frustrating, especially in connection with repeat abortions. Neither of the two groups, however, had had any doubts about participating in abortion. The gynecologists described how women now expected to get an abortion, whereas previously they had asked for one. The midwife/nurse group maintained that the meetings with the women had become considerably more frequent. The interaction between the two professional groups was marked by great trust in each other’s professional competence. Conclusions: Gynecologists and midwives working in abortion care support Swedish abortion legislation and have no doubts about participating in abortions, despite the fact that they have frequently experienced complex and difficult work situations. The character of the work is experienced as contradictory and frustrating, but also as challenging and rewarding. The awareness that the two professional groups have of the importance of continuing professional development and ongoing guidance should be acted on. Furthermore, their collective views and experiences should be made use of, so that abortion care can be developed, not only in order to promote women’s health, but also to improve the work environment for the abortion staff.

This thesis aims to study the effects of endogenous and exogenous hormones and mammographic breast density (BD) on cellular markers in non-cancerous female breast tissue. Women on the waiting list for breast reduction plastic surgery were recruited (n = 79), and randomized to 2 months of hormone therapy or no therapy before surgery. The women had a mammogram and a needle biopsy 2 months before surgery and tissue samples were obtained at the operation. In premenopausal women, estrogen receptor (ER)α levels were associated with age (p = 0.0002), were similar in the follicular and luteal phases of the menstrual cycle and were higher in parous than in nulliparous women (p = 0.009). Current smokers had lower PR levels than non-smokers (p = 0.019). Women on oral contraception had lower ERα (p = 0.048) and PR (p = 0.007) levels than women in the follicular phase. The ERα levels did not differ significantly between postmenopausal estrogen and estrogen-progestogen users, but PR levels were lower among estrogen-progestogen users (p = 0.03). We found lower expression of the genes for decorin and syndecans 1 and 4 in the luteal phase than in the follicular phase, among parous women. Protein levels of the androgen receptor, syndecan-4 and decorin was lower in premenopausal women who were using oral contraceptives (OC) than in those in the follicular phase (p = 0.002 - 0.02), whereas no significant differences between OC use and the luteal phase were found. In premenopausal women, BD was negatively associated with age and body mass index but was similar for the menstrual phases. Breast density was associated with genetic expression of the androgen receptor and remained significant after adjustment for age (rs = 0.56; p = 0.04). After adjustement for age, breast density was also marginally associated with expression of the caspase 3 gene (0.55; 0.053). However, protein levels of caspase 3 was negatively associated (-0.61; 0.03).

Many studies have suggested a relationship between sex steroids and negative mental and mood changes in women. Allopregnanolone, a potent endogenous ligand of the GABA-A receptor and a metabolite of progesterone, is one of the most accused neuroactive steroids. Variations in the levels of neuroactive steroids that influence the activity of the GABA-A receptor cause a vulnerability to mental and emotional pathology. In women, there are physiological conditions in which allopregnanolone production increases acutely (e.g. stress) or chronically (e.g. menstrual cycle, pregnancy), thus exposing the GABA-A receptor to high allopregnanolone concentrations. In such conditions, tolerance to allopregnanolone probably develops. We have evaluated the 3β-hydroxy pregnane steroid UC1011 as a functional antagonist to allopregnanolone-induced negative effects in rats. In vivo, we used the Morris Water Maze (MWM) test of learning and, in vitro, we studied chloride ion uptake into cortical and hippocampal membrane preparations. The steroid UC1011 reduces the allopregnanolone-induced learning impairment in the MWM and the increase in chloride ion uptake induced by allopregnanolone. To detect whether chronic tolerance develops to an allopregnanolone-induced condition, male rats were pretreated with allopregnanolone injections for three or seven days. These rats were then tested in the Morris Water Maze for five days and compared with relevant controls. Rats with seven days’ allopregnanolone pretreatment experienced improved performance compared with the acutely allopregnanolone-exposed group, reflecting chronic tolerance development. To study the GABA-A receptor changes in acute allopregnanolone tolerance, we used the silent second (SS) anaesthesia threshold method. At acute tolerance, 90 minutes of anaesthesia, the abundance of the GABA-A receptor α4 subunit and the expression of the α4 subunit mRNA in the thalamus ventral-posteriomedial (VPM) nucleus were reduced. There was also a significant negative correlation between the increase in the allopregnanolone dose needed to maintain anaesthesia and the α4 mRNA in the VPM nucleus. We also investigated whether allopregnanolone tolerance was still present one or two days after the end of the anaesthesia-induced acute tolerance. Tolerance persisted to one day, but not two days, after the treatment and the α4 subunit mRNA expression in the VPM nucleus was negatively related to the allopregnanolone doses needed after one day. In conclusion, the current thesis shows that the substance UC1011 can reduce the allopregnanolone-induced negative effects in the water maze test. Chronic allopregnanolone tolerance can develop to the effects of allopregnanolone. Allopregnanolone tolerance persists one day after the induction of acute allopregnanolone tolerance. The GABA-A receptor α4 subunit in the thalamus might be involved in the development and persistence of acute tolerance to allopregnanolone.

Bakgrund: När en kvinna genomgår en graviditet och förlossning innebär det stora påfrestningar för hennes kropp. Vid en förlossning kan bristningar uppstå, vilket kan medföra besvär för kvinnan i olika utsträckning. Genom eftervårdsbesöket har barnmorskorna en möjlighet att identifiera problem som kan ha uppstått och upptäcka odiagnostiserade förlossningsskador. Syfte: Syftet var att beskriva barnmorskans erfarenheter av gynekologisk undersökning och att bedöma bäckenbottens strukturer vid eftervårdsbesök inom mödrahälsovården. Metod: Semistrukturerade intervjuer genomfördes med elva barnmorskor yrkesverksamma inom mödrahälsovården. Tematisk analys användes för att analysera materialet. Resultat: Ett huvudtema, tre organiserande teman samt tio basteman identifierades. Huvudtemat var: kvinnans behov i centrum. Organiserande teman var: att stödja genom sitt förhållningssätt; att verka hälsofrämjande och förbättringsområden. Basteman var: att vara lyhörd; att bekräfta; att se individuella behov; att motivera till undersökning; att motivera till egenvård; utbildning; struktur; dokumentation; tidsaspekten och uppföljning. Slutsats: Barnmorskor inom mödrahälsovården fyller en viktig funktion i att arbeta hälsofrämjande och arbetar med kvinnans behov i centrum. De försöker individanpassa varje besök och den information som ges ut men upplever att det kan finnas svårigheter att motivera kvinnor till gynekologisk undersökning. Mer utbildning, bättre och tydligare struktur för bedömning av bäckenbotten samt en förbättrad samtalsmetodik kring besvär som kan kvarstå efter förlossningen kan bidra till att kvinnor får den hjälp och vård de behöver. Klinisk tillämpbarhet: Studiens resultat belyser behov av mer kunskap, utbildning och struktur. Att detta uppmärksammas i denna studie kan leda till diskussion om vidareutveckling och att ämnet lyfts i den kliniska verksamheten. / Background: Undergoing pregnancy and childbirth, entails great strain on a woman’s body. When giving birth vaginally, tears may occur, which may cause problems for the woman to a different extent. Through the postpartum check-up, midwives have an opportunity to identify problems that may have occurred and detect undiagnosed perineal injuries. Aim: The aim was to describe the midwife’s experiences of pelvic examination and to assess pelvic floor structures at the postpartum check-up. Method: Semi-structured interviews were conducted with eleven midwives working in maternal health care. Thematic analysis was used to analyze the material. Results: One global theme, three organizing themes and ten basic themes were identified. The global theme was: the woman´s needs. The organizing themes were: to support through the approach; to promote health and areas for improvement. The basic themes were: to be responsive; to confirm; to see individual needs; to motivate for examination; to motivate selfcare; education; structure; documentation; time aspect and follow-up. Conclusion: Midwives in maternal health care play an important role in health promotion and working with women's needs. They try to personalize each visit and adapt the information given, but their experience is that there are difficulties in motivating women to undergo a pelvic examination. More education, a better and clearer structure for assessing the pelvic floor and an improved way of addressing problems that may persist after childbirth may enable women getting the help and care they need. Clinical application: The study results highlight an existing need for more knowledge, education and structure. Attention to this can lead to discussion of further development and the subject can also be raised among other healthcare providers.

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.