Assessing preconception health practices of women, primary care providers, agencies and health departments: An academic-community partnership

Background: To address the high rates of adverse birth outcomes affecting our region, our maternal child health coalition and academic researchers partnered to conduct an assessment of preconception health practices in our community, with a specific focus on low-income, minority women who have disproportionately higher rates of adverse pregnancy outcomes.

Methods: Three surveys targeting primary care providers, community agencies and women of childbearing age were developed and distributed to 500 community providers, 230 coalition member agencies and 500 women of reproductive age (18-44). Structured interviews were conducted with 17 state and local health department officials to identify preconception health initiatives targeting consumers and providers. Analysis was conducted using descriptive statistics.

Results: Most providers (57%) identified preconception care as specialty care specific to women planning a pregnancy, rather than routine care recommended for all reproductive age women. Only 28% indicated that sexually active women not using birth control should receive preconception risk assessments. 53% of consumers surveyed have not considered seeing a provider for preconception care and about half (48%) were not aware of the term. Only 30% of community agencies identified preconception care as part of their scope of services. While key preconception health services are provided or monitored by local public health departments, preconception health is not identified as a stand-alone priority for them.

Conclusions: Improving uptake of preconception care will require developing and implementing strategies to increase awareness of preconception health in women, and improve adoption of preconception health practices among providers, community agencies and local public health.