Interconception care in Australian general practice: a qualitative study

Abstract

Background: General practitioners (GPs) provide care for women across the lifespan. This care currently includes preconception and postpartum phases of a woman’s life. Interconception care (ICC) addresses women’s health issues between pregnancies that then have impact on maternal and infant outcomes, such as lifestyle and biomedical risks, interpregnancy intervals and contraception provision. However, ICC in general practice is not well established. Aim: To explore GP perspectives about ICC. Design and setting: Qualitative interviews were undertaken with GPs between May and July 2018. Methods: 18 GPs were purposively recruited from south-eastern Australia. Audio-recorded semi-structured interviews were transcribed verbatim and analysed thematically using the Framework Method. Results: Most participants were unfamiliar with the concept of interconception care. Delivery was mainly opportunistic, depending on the woman’s presenting need. Rather than a distinct and required intervention, participants conceptualised components of ICC as forming part of routine practice. GPs described many challenges including lack of clarity about recommended ICC content and timing, lack of engagement and perceived value from mothers and time constraints during consultations. Facilitators included care continuity and the availability of patient education material. Conclusion: Findings indicate that ICC is not a familiar concept for GPs who feel that they have limited capacity to deliver such care. Further research to evaluate patient perspectives and potential models of care is required before ICC improvements can be developed, trialled and evaluated. These models could include the co-location of multidisciplinary services and services in combination with well child visits.

Family Planning and Preconception Care Service Management: The Key Role of Bulgarian GPs

“…They can significantly impact couples’ utilisation based on their extensive multidisciplinary skills and knowledge. GPs are responsible for staying up to date with evidence-based clinical practices related to FP and PCC and ensuring they have the most current knowledge to provide preconception counselling [ 18 , 19 , 20 , 21 , 22 , 23 ].…”