Preconception care and family planning: Exploring the potential for integration

Background: Infant and maternal morbidity and mortality in the US continue to exceed national objectives. Offering preconception care in reproductive health programs is a promising strategy for reducing these poor pregnancy outcomes. Family planning clinics are well poised to provide preconception care if it is clearly defined and funded.

Methods: The California Family Health Council (CFHC) worked in partnership with three Title X Family Planning Clinics to investigate the feasibility of integrating preconception care in family planning settings. The Preconception Evaluation Project (PEP) included female family planning clients of reproductive age. The project involved a health history assessment and brief interventions that addressed five priority preconception issues: diabetes, obesity, folic acid intake, rubella immunization, and substance use. Clients completed a quantitative survey that was used in conjunction with a clinician log. Clinicians participated in a post-project interview to discuss their experience with the integration.

Results: The evaluation explored clients' receptivity to preconception messages during family planning visits, intentions for behavior change, and clinician experience with intervention integration. Results revealed that: 1) women were receptive to preconception messages within the context of family planning visits, 2) women were interested in making health changes to improve pregnancy outcomes, and 3) clinicians were supportive of integration.

Conclusions: The PEP intervention and evaluation were a starting point for exploring integration of preconception and family planning services. Results illustrate that family planning clinics have significant potential as a setting for delivery of preconception messages. Further development of preconception interventions for family planning clients is needed.