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Introduction Prenatal health programs provide health education, reproductive care and related services to women. Programs may be administered individually or collaboratively by agencies including public health units, hospitals, health clinics, community and non-governmental organizations. Prenatal health disparities among populations at-risk may be reduced through the provision of accessible health education, services and resources to help women mitigate modifiable risks to pregnancy. Although standardized guidelines inform clinical screening, testing and maternity care, gaps exist regarding the design, implementation and evaluation for comprehensive prenatal health programs. Methods Using a multijurisdictional approach, prenatal health guidance documents released by clinical associations and regional governments across Canada, Australia, the United States, the United Kingdom and Ireland were systematically evaluated to identify standards and practices regarding the design, implementation and evaluation of prenatal health programs. Results Evidence-based, surveillance/monitoring, and expert/stakeholder collaborations were principles affirmed by guidance documents across all jurisdictions. Each jurisdiction described tailored strategies to optimize prenatal health in their respective communities. Divergence between jurisdictions was noted for patient care models and promotion of providers and companions of choice. Discussion A best practices model is proposed describing recommendations as follows: prenatal health programs should be grounded in a theoretical approach, fundamentally woman-centered and designed to address interacting prenatal health determinants across the lifespan. Accessible and inclusive prenatal health care can be achieved through provider training and community stakeholder collaborations. Identification of best practices for prenatal health program design, implementation and evaluation ensures that service standards are harmonized across communities, thereby optimizing maternal and child health.

Background: Prenatal health promotion includes the provision of evidence-based information and practical skills to optimize maternal–fetal outcomes. Increasingly, prenatal education is delivered by both healthcare professionals and allied childbirth educators, in community- or hospital-based group classes, targeted outreach programs, and online modules. Objectives: To better understand how prenatal health promotion relates to a diverse urban community, we assessed the perspectives of Ottawa, Canada prenatal key informants. Design: This is a qualitative research with key informant interviews. Methods: Semi-structured interviews were conducted with 11 prenatal key informants, responsible for the design, delivery, or promotion of publicly available prenatal health services. Interviews explored concepts and delivery of prenatal health promotion, strategies to address existing and emerging prenatal topics, identification of barriers to prenatal health services, and recommendations. Results: Key informants recommended a lifespan approach to prenatal health promotion, with an emphasis on healthy behaviors, emotional health, labor and delivery, and postpartum/early parenting. Recognizing community health disparities, key informants used community outreach, and intersectoral collaborations for Indigenous and other at-risk communities to mitigate barriers to prenatal service uptake. Conclusions: Ottawa key informants conceptualized prenatal health promotion as inclusive, comprehensive, and as an extension of preconception, school-based sexual education. Respondents recommended the design and delivery of prenatal interventions as culturally safe and trauma informed, using online modalities to complement in-person activities. The experience and intersectoral networks of community-based prenatal health promotion programs represent potential capacity to address emergent public health risks to pregnancy, particularly among at-risk populations. Plain Language Summary: A broad and diverse community of professionals deliver prenatal education to help people have healthy babies. We interviewed Ottawa, Canada experts in prenatal care/education to learn about the design and delivery of reproductive health promotion. We found that Ottawa experts emphasized healthy behaviors beginning before conception and through pregnancy. Community outreach was identified as a successful strategy to promote prenatal education to marginalized groups.

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BACKGROUND: Prenatal education provides opportunities for health promotion of healthy behaviors and risk reduction. Quality and coherence with prenatal health promotion best practices depend on an individual class instructor. The objective of our study was to document the experiences, practices, and perceptions of our diverse Ottawa, Canada community of prenatal educators. MATERIALS AND METHODS: In this quantitative, mixed methods e-survey conducted in Ottawa, Canada, prenatal educators were asked to describe their prenatal class settings, delivery formats, content, perceptions of pregnant women, and recommendations. Data were analyzed by descriptive statistics and thematic content analysis. RESULTS: Respondents included public health nurses and a diverse group of “allied childbirth educators” (ACE). Topics related to pregnancy, labor, and postpartum issues were well addressed; however, established and emerging risks to pregnancy were omitted. Nurses were more likely to discuss lifestyle risks to pregnancy and general prenatal health promotion, whereas ACE respondents emphasized informed consent and individualized counseling. Women marginalized by social exclusion including Indigenous women, immigrants, and women with disabilities were perceived as missing from prenatal educational settings. CONCLUSIONS: Heterogeneity of prenatal education provides opportunities for collaboration; however, established and emerging risk factors to pregnancy are neglected topics. Addressing the needs of diverse communities of pregnant women requires timely, evidence-based, inclusive, and culturally safe delivery of prenatal health promotion.