Barriers and facilitators to the provision of preconception care by healthcare providers: A systematic review

Goossens, Joline; Roose, Marjon De; Hecke, Ann Van; Goemaes, Régine; Verhaeghe, Sofie; Beeckman, Dimitri

doi:10.1016/j.ijnurstu.2018.06.009

Cited by 75 publications

(83 citation statements)

References 42 publications

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“…One of the known barriers for providing preconception care for women is that they often do not consult their GP until after they have conceived [4]. And, in the case of men, they are less likely than women to seek primary health care [16] and rarely consult a GP in preparation for pregnancy [17].…”

Section: Discussionmentioning

confidence: 99%

“…General practitioners (GPs) and other primary health care professionals are ideally placed to opportunistically discuss pregnancy intention and promote pre-and inter-conception health optimisation with people of reproductive age. However, research shows that this is not routinely done and that health care providers' perceived barriers for doing this include time constraints, lack of knowledge and resources, being unaware of preconception care guidelines, patients not appreciating being asked about preconception health, and competing preventive priorities [3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Acceptability of screening for pregnancy intention in general practice: a population survey of people of reproductive age

Hammarberg¹,

Hassard²,

Silva³

et al. 2020

Preprint

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Background: Optimal parental preconception health benefits reproductive outcomes . However, preconception health promotion is not routinely offered in primary health care settings to people of reproductive age. The aim was to gauge the planned preconception health behaviours and attitudes towards being asked about pregnancy intention by a general practitioner (GP) among people of reproductive age in Australia. Method: The research was conducted on a single wave of Australia’s first and only probability-based online panel, Life in Australia™. Members of the Life in Australia™ panel are Australian residents aged 18 years or over. All active members between the ages of 18 and 45 years were eligible to participate. Eligible panel members were invited to complete a survey about fertility and childbearing. Data were collected from 18 February to 4 March 2019. Results: In all 965 female and male members of Life in Australia™ aged between 18 and 45 years were invited to complete the survey. Of these, 716 (74.2%) agreed. Most respondents indicated that if they were planning to have a child they would try to optimise their preconception health by adopting a healthier diet (80%), seeing a GP for a health check-up (78%), reducing alcohol consumption (78% of those consuming alcohol), getting fitter (73%), and stopping smoking (70% of smokers). Three in four (74%) stated that they would not mind if their GP asked them about their pregnancy intentions. Conclusion: Findings suggests that routinely asking people of reproductive age about their pregnancy intentions and advising those who are planning pregnancy about what they can do to ensure optimal preconception health would be acceptable to most people and may improve reproductive outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acceptability of screening for pregnancy intention in general practice: a population survey of people of reproductive age

Hammarberg¹,

Hassard²,

Silva³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…It is well known that the United States has rates of infant and maternal mortality that are higher than many countries in the world . Although in recent years, there has been increased awareness of the need for delivery of preconception care services, the provision of preconception care by health care professionals remains low . At the same time, the number of women of childbearing potential who have medical conditions requiring pharmacotherapy has been growing as women are increasingly older and have higher body mass indexes at the time of conception compared with previous decades …”

Section: Introductionmentioning

confidence: 99%

“…2 Although in recent years, there has been increased awareness of the need for delivery of preconception care services, the provision of preconception care by health care professionals remains low. 3 At the same time, the number of women of childbearing potential who have medical conditions requiring pharmacotherapy has been growing as women are increasingly older and have higher body mass indexes at the time of conception compared with previous decades. 4,5 Approximately 45% of pregnancies in the US are unintended, and about half of those occur among women using some form of contraception prior to conception.…”

Section: Introductionmentioning

confidence: 99%

Preconception care and contraception services: Opportunities for community pharmacists

Bright

Mager

2019

J Am Coll Clin Pharm

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There are multiple opportunities for community pharmacists to take on greater roles in the delivery of preconception care and contraceptive services, and pharmacists have indicated interest in developing and expanding such services. Therefore, the objective of this review is to summarize published literature related to community pharmacists' provision of preconception care and contraceptive interventions to help guide related service development and raise awareness about potential opportunities to further expand and integrate such services into practice. Two searches were performed on February 5, 2019 of Medline, Academic Search Complete, and the International Pharmaceutical Abstracts databases from database inception to December 31, 2018. The first search utilized the terms [([contraception or birth control or family planning or contraceptive] OR contraception education OR contraceptives OR contraceptive access) AND ([pharmacists or pharmacist] OR pharmacy OR community pharmacy OR community pharmacist)]; the second search utilized the terms [(preconception OR preconception care OR preconception counseling OR preconception health OR [“preconception care” or “pre‐pregnancy care” or “prepregnancy care”]) AND ([pharmacists or pharmacist] OR pharmacy OR community pharmacy OR community pharmacist)]. Inclusion criteria for the review were articles written in English describing a community pharmacist‐delivered service in the United States. Six articles detailed community pharmacists' roles in contraception, including prescribing hormonal and emergency contraception and administration of injectable contraception. Each study found high rates of patient uptake and satisfaction with these services. One article detailed community pharmacists' provision of preconception care services; again, there was rapid uptake of the service. These articles together highlighted the logistical ease, economic viability, and patient acceptance of such services. Opportunities to expand and integrate these services exist. Published data show that community pharmacists have demonstrated provision of contraceptive and preconception care services in the US, and opportunities exist to grow these programs.

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“…Preconception care (PCC) has been recommended by the World Health Organisation (WHO), the US Centres for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynaecologists (ACOG) for both women and men in the childbearing ages as a strategy for optimising parental health and improving maternal and neonatal outcomes [1]. PCC is defined as "the provision of biomedical, behavioural and social health interventions to women and couples before conception occurs.…”

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confidence: 99%

Perceptions about preconception care among health care providers in Ibadan, southwest Nigeria - A qualitative study

Ojifinni

Ibisomi

2019

Preprint

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Background: Preconception care (PCC) is a recognised strategy for optimising maternal health and improving maternal and neonatal outcomes. Research has shown that PCC services are minimally available and yet to be fully integrated into maternal health services in Nigeria. This study explored the perceptions about PCC services among health care providers in Ibadan, Nigeria. Methods: This was a case study research among 26 health care providers – 16 specialist physicians and nine nurses covering 10 specialties: Obstetrics/Gynaecology, Cardiology, Endocrinology among others at the primary, secondary and tertiary health care levels. In-depth interviews were digitally recorded, transcribed verbatim and analysed on MAXQDA using thematic analysis. Results: Six main themes were identified from the data – scope of PCC, people who require PCC, where PCC services can be provided, acceptability of PCC services, relevance of PCC to different specialties including gynaecologists, cardiologists, nephrologists, psychiatrists and possible benefits of PCC. PCC was viewed as care for women, men and couples before pregnancy to optimise health status and ensure positive pregnancy outcomes. Almost all participants stated that PCC services should be offered at all three levels of health care with referral when needed from the lower to higher levels. The prevailing opinion on the circumstances when PCC is required was that although all people of reproductive age would benefit, those who had medical problems such as hypertension, sickle cell disease, diabetes and infertility would benefit more. Participants opined that delayed health care seeking observed in the community may influence acceptability of PCC especially for people without known pre-existing conditions. All specialist physicians identified the relevance of PCC to their practice and identified potential benefits of PCC. The potential benefits outlined included opportunity to plan and prepare for pregnancy to ensure positive pregnancy outcomes. Conclusion: Preconception care is perceived as being more important for promoting positive pregnancy outcomes in people with known medical problems and is relevant to different specialities of medical practice. Provision of the service will however require establishment of guidelines and its uptake will depend on acceptability to people with known medical problems who will benefit from the service.

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Barriers and facilitators to the provision of preconception care by healthcare providers: A systematic review

Cited by 75 publications

References 42 publications

Acceptability of screening for pregnancy intention in general practice: a population survey of people of reproductive age

Acceptability of screening for pregnancy intention in general practice: a population survey of people of reproductive age

Preconception care and contraception services: Opportunities for community pharmacists

Perceptions about preconception care among health care providers in Ibadan, southwest Nigeria - A qualitative study

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