Why women do not ask for information on preconception health? A qualitative study

Abstract

BackgroundPreconception care involves health promotion to reduce risk factors that might affect women and couples of childbearing age. The risk factors of adverse reproductive outcomes include recognized genetic diseases in the family or the individual, previous congenital diseases, miscarriage, prematurity, fetal growth restriction, infertility, chronic maternal diseases, lifestyle, and occupational or environmental factors.Effective preconception care involves a range of preventive, therapeutic and behavioural interventions. Although in Italy there are national preconception care recommendations concerning the general population, they are usually encouraged informally and only for single risk factors. At present there is increasing interest in offering a global intervention in this field. The aim of this study was to investigate attitudes and behaviours of Italian women of childbearing age and healthcare professionals regarding preconception health.MethodsWe conducted a qualitative study among women of childbearing age and healthcare professionals between February 2014 and February 2015. Five focus groups were held: 2 with non-pregnant women aged 22 to 44 years and 3 with healthcare professionals. Discussion topics included women’s questions about preconception health, worries and barriers regarding preconception care interventions, attitudes and behaviours of women and healthcare professionals towards preconception health, women’s information sources. In the analysis of the focus groups priority was given to what was said by the women, supplemented by information from the healthcare professionals’ focus groups.ResultsFourteen women of childbearing age (8 nulliparae and 6 multiparae) and 12 healthcare professionals (3 nurses, 4 midwives, 5 doctors) participated in the focus groups. The results indicate the presence of many barriers and a lack of awareness of preconception health relating to women, healthcare professionals and policies. Women’s knowledge and attitudes towards primary preconception care information are described. The main reference source of information in this field for Italian women seems to be their obstetric-gynaecologist.ConclusionsThe study indicates that several barriers influence preconception care in Italy. Moreover, a lack of awareness of preconception health and care among Italian women of childbearing age and healthcare professionals emerges. The findings might contribute to strategies for the implementation of preconception care guidelines.

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

“…From its definition and identified components, PCC includes primary prevention strategies through screening, vaccinations and behavioural modification [2][3][4]. These services are provided mainly at the primary health care level although they are also available at the secondary and tertiary levels.…”

“…These services are provided mainly at the primary health care level although they are also available at the secondary and tertiary levels. PCC also includes treatment of pre-existing medical conditions [2][3][4]which are provided mainly at the tertiary and secondary level although with the two-way referral system, such services can be provided at the primary care level. Ibadan North Local Government Area (LGA), one of the five urban LGAs in Ibadan metropolis, Oyo State, southwest Nigeria was thus purposively selected because it has health facilities at the three levels of health care.…”

“…Negative attitudes towards PCC and poor conviction of its importance were also noted [1,9]. Other studies have also shown that confusion about who should provide PCC [3,10,11], perception of lack of opportunity to provide PCC [12] and lack of motivation to provide PCC are barriers to provision by health care workers [13]. On the other hand, good knowledge and having a positive attitude towards PCC have been identified as facilitators of provision of PCC services by health care workers [1,10,11,14].…”

“…vaccinations and genetic screening), therapeutic (treatment for chronic medical conditions) and behavioural (e.g. alcohol reduction and smoking cessation) interventions [3,4].…”

Preconception care for infertile couples: Nurses’ and midwives’ roles in promoting better maternal and birth outcomes

“…Preconception assessment presents an opportunity for identifying women with or at risk of these morbidities (Hemsing et al, 2017). However, current policies and guidance for preconception care for otherwise healthy couples are fragmented if not inconsistent (Bortolus et al, 2017;Shawe et al 2015) with little evidence of (a) why preconception care is not a priority for women and (b) why healthcare professionals do not routinely deliver preconception care (Goossens et al, 2016;Tuomainen, Cross-Bardell, Bhoday, Qureshi, & Kai, 2013).…”