Opportunities for enhancing pregnancy planning and preconception health behaviours of Australian women

Abstract

Problem and Background:The preconception period provides a significant opportunity to engage women in healthy behaviour change for improved maternal and child health outcomes. However, there is limited research exploring women's pregnancy planning in Australia.Aim: This study investigated associations between pregnancy planning, socio-demographics and preconception health behaviours in Australian women.Methods: A retrospective cross-sectional survey of pregnant women ≥18-years-of-age recruited through a Victorian public maternity service and a national private health insurer.Results: Overall 317 women (30±4.7 years) participated (public: n=225, private: n=92). Planned pregnancies were reported by 74% of women and were independently associated with marital status (AOR=5.71 95%CI 1.92-17.00, p=0.002); having ≤2 children (AOR=3.75 95%CI 1.28-11.05, p=0.016); and having private health insurance (AOR=2.51 95%CI 1.08-5.81, p=0.03). Overall, women reported preconception: any folic-acid supplementation (59%), up-to-date cervical screening (68%), weight management attempts (75%), accessing information from health professionals (57%) and immunisation reviews (47%). Pregnancy planners were more likely to use folic-acid (AOR=17.13 95%CI 7.67-38.26, p<0.001), review immunisations (AOR=2.09 95%CI 1.07-4.10, p=0.03) and access information (AOR=3.24 95%CI 1.75-6.00, p<0.001) compared to non-planners. Women <25years-of-age were less likely to access information (AOR=0.38 95%CI 0.16-0.89, p=0.03) and take folic-acid (AOR=0.23 95%CI 0.09-0.59, p=0.002) and were more likely to smoke 3-months preconception (AOR=6.68 95%CI 1.24-36.12, p=0.03). Conclusions:Women with planned and unplanned pregnancies reported variable preconception health behaviour uptake and limited healthcare engagement. Opportunities exist to improve awareness

Preconception Health and Lifestyle Behaviours of Women Planning a Pregnancy: A Cross-Sectional Study

“…Our rigorously developed questionnaire assessed an extensive range of health and lifestyle behaviours in accordance with the majority of national PCC recommendations [21]. Our stratification by stage of pregnancy planning strengthens the understanding of PCC uptake by enabling differences in behaviour to be observed.…”

“…The questionnaire was adapted from existing tools to assess women's pregnancy planning and related health behaviours, risk perception and knowledge. Detailed information about this questionnaire has been published previously [21] and the questions analysed in the current study are provided as supplementary material. It was developed in consultation with multidisciplinary health and medical expertise across obstetrics, public health, social science, dietetics, exercise physiology and endocrinology, with cognitive interviewing and consumer testing performed as previously reported [15].…”

New frontiers in alcohol and gender: The role of health promotion policy and practice in Australia

“…In Australia, women who have a university education are more likely to drink during pregnancy [33], and women with private health insurance are significantly less likely to cease alcohol consumption 3‐months preconception [34]. Australian women have a low awareness of preconception care and a corresponding low presentation for this care [34]. Approximately one‐quarter of Australian women report an unintended pregnancy, with most (68%) of these pregnancies wanted [35].…”

Modeling Preconception Perceptions of Pregnancy and Birth: A Qualitative Study of Women Living in Italy

“…Preconception health has been de ned as "the provision of healthcare to women of reproductive age and their partners prior to conception in order to optimise a woman's physical, social and emotional wellbeing and to ensure optimal intra-uterine conditions for the developing fetus" (4). Preconception health planning may serve a bene cial role in understanding pregnancy needs and discussing pregnancy and birth options prior to pregnancy, though few women and providers demonstrate high awareness of preconception health, both internationally and in Italy (5)(6)(7)(8)(9)(10). Recent guidelines across European countries suggest preconception planning as one aspect of reproductive health provision to identify fertility timelines and optimize health status (10).…”

“…Thus, gaps persist in how best to communicate with women about their concerns, and how various information sources contribute to or reduce common misunderstandings. Accurate and balanced preconception attitudes and beliefs are important, as these factors may impact decisions during pregnancy and birth (5,(13)(14)(15). Risk perceptions may shape women's and providers' pregnancy perspectives (13,16).…”