Preconception care: who needs it, who wants it, and how should it be provided?

Abstract

BACKGROUND: Preconception care (PC) aims to identify and reduce a number of modifiable factors that can adversely affect pregnancy outcome. AIM: To ascertain both knowledge of the attitudes towards PC among members of primary health care teams (PHCTs) and registered women of childbearing age in a representative sample of general practices in Harrow. METHOD: A questionnaire survey was conducted in a randomly selected group of nine general practices in the London borough of Harrow. Subjects included all relevant health professionals and female patients of childbearing age registered with the practices. RESULTS: A total of 62/88 (70.5%) health professionals and 811 women (1 in 20 of the entire target population) completed the questionnaires. Nurses' knowledge matched that of the doctors, except in the area of genetics. Over 85% of all health professionals believed that PC could be of benefit to both mother and baby. Women were generally well informed; Asian women, those born outside the UK, those who had never been pregnant, and those who had not undertaken education beyond the age of 18 years were significantly less well informed. Health professionals considered PC to be best delivered opportunistically by nurses, and this method appeared to be acceptable to most female patients of childbearing age, although it was significantly less acceptable among Asians. CONCLUSION: Among health professionals and women of childbearing age, there is generally a good level of knowledge of PC, although certain groups are less well informed than others and could benefit from a targeted education approach. Widespread agreement that PC is worthwhile was found among PHCT members, but this view is less strongly held by the female public, with the acceptability of providing PC opportunistically differing significantly between ethnic groups.