Delayed parenthood on the rise: A call for upstream preconception health promotion in Canada

Abstract

The trend toward delayed parenthood is on the rise across Canada. Societal emphasis on attaining higher education, career advancement and financial security may be some reasons why individuals delay becoming a parent; whatever the reason, this trend is linked to significant health and economic impacts. Many Canadians are unaware of the impact this may have on their fertility and potential birth outcomes. It is important that health care professionals apprise individuals in their reproductive years about these issues and the steps they can take to mitigate these risks. Implementing a health equity and broader determinants of health approach through social policy development may also prove beneficial. Such upstream approaches could enhance maternal and child health outcomes, and also help ensure that people of reproductive age are making an informed decision about delaying parenthood. This article calls for developing a comprehensive preconception health promotion and care strategy encompassing individual, community and population level approaches.KEY WORDS: Preconception care; health promotion; public health; Canada; fertility; health knowledge; attitudes; practices La traduction du résumé se trouve à la fin de l'article.

Validating PreCHAT: A Digital Preconception Health Risk Assessment Tool to Improve Reproductive, Maternal and Child Health

“…In Canada, increasing rates of chronic disease, obesity, mental illness, and substance use, as well as trends towards later parenthood pose unique challenges to optimizing reproductive health (Branchard et al, 2018; Mill et al, 2016; World Health Organization, 2013). This is further complicated by the fact that an estimated 50% of pregnancies are unplanned and individuals often do not seek prenatal care until after critical early periods for fetal development have passed (Finer & Henshaw, 2006; Moos & Bernstein, 2018).…”

Preconception health interventions delivered in public health and community settings: A systematic review

“…18 Such an approach highlights the roles of the social determinants of health, including income, employment, and social connectedness, which are known to have an impact on birth outcomes (e.g., preterm birth) 45 and also recognizes that many upstream social determinants of health are complex and involve factors outside of an individual's control (e.g., affordable housing). 46 A health equity approach to preconception health promotion and care is consistent with the Ontario Public Health Standards 19 and requires greater political awareness and support for preconception health. In Ontario, reproductive health is a recognized component of the mandates of the Ministry of Health and Long-Term Care and the Ministry of Children and Youth Services; however, a focus on preconception health is lacking.…”

Women’s Childbearing Age Associated with Optimal Fetal and Infant Outcomes: a population-based study

“…9 The nancial and social costs of the sequelae of delayed childbearing are signi cant but have not been well evaluated. 10 Numerous studies have examined the consequences of pregnancies in teenagers and advanced maternal age women, but few tried to directly answer what is the optimal maternal age associated with the best perinatal outcomes especially for rst-time mothers. Furthermore, selection bias due to decreasing fecundability with advancing woman's age and over-adjustment of mediation factors may be important methodological de ciencies that may have masked the total effects of advanced maternal age on pregnancy outcomes and child health.…”