Preconception care: delivery strategies and packages for care

Abstract

The notion of preconception care aims to target the existing risks before pregnancy, whereby resources may be used to improve reproductive health and optimize knowledge before conceiving. The preconception period provides an opportunity to intervene earlier to optimize the health of potential mothers (and fathers) and to prevent harmful exposures from affecting the developing fetus. These interventions include birth spacing and preventing teenage pregnancy, promotion of contraceptive use, optimization of weight and micronutrient status, prevention and management of infectious diseases, and screening for and managing chronic conditions. Given existing interventions and the need to organize services to optimize delivery of care in a logical and effective manner, interventions are frequently co-packaged or bundled together. This paper highlights packages of preconception interventions that can be combined and co-delivered to women through various delivery channels and provides a logical framework for development of such packages in varying contexts.

Substance Use and Preconception Care: A Review of the Literature

“…Practitioners also must consider religious beliefs and preferences as they relate to birth control and childbearing, as some women subscribe to religious beliefs that do not promote birth control (82). Another critical component of family planning is education, which includes providing pertinent information about risks behaviors, adequate nutrition, supplements, and appropriate times to conceive between births and abortions to optimize health and birth outcomes (82).…”

“…Culturally sensitive PCC entails providing trained interpreters, bilingual practitioners, and translated forms; using open-ended questions; and active listening (84). Practitioners also must acknowledge the impact of culture on patients' beliefs regarding childbearing, contraception use, and family planning (38,39,43,44,81,82,84). The PEARLS (Partnership, Empathy, Apology, Respect, Legitimization, and Support) interviewing tool is useful in providing culturally sensitive PCC and strengthening the practitioner-patient relationship.…”

The Impact of Kidney Development on the Life Course: A Consensus Document for Action

“…Weight loss before pregnancy has in some studies been associated with a reduced pregnancy risk in overweight women [264]. Preconception care has been shown to improve pregnancy outcomes [264,265,266], although it is important to recognize that up to 65% of preterm births remain unexplained [267]. Counseling and optimization of maternal weight and nutrition, and avoidance of alcohol, tobacco, and caffeine before pregnancy, all have a positive impact on pregnancy outcomes.…”

Conhecimento Sobre Contracepção E Fatores Associados Ao Planejamento De Gravidez Na Adolescência*

“…Em geral, adolescentes que abandonam a escola têm maior probabilidade de engravidar, o que compromete o seu futuro e de sua prole, pois a educação para muitas dessas adolescentes é o único meio de inserção social e ascensão econômica, e a sua falta é caracterizada por um círculo vicioso de má instrução e pobreza. Ademais, é importante considerar que a pobreza e a exclusão social devem ser vistas não somente como causa, mas também como consequência da gravidez na adolescência (9,(13)(14) .…”

“…Vários fatores sociais e biológicos influenciam as chances de gravidez na adolescência, como exposição a condições adversas durante a infância e adolescência, história familiar de gravidez na adolescência, instabilidade familiar e baixos níveis educacionais. Considerase também que mães adolescentes são menos propensas a frequentar as consultas de pré-natal, aumentando o risco de partos prematuros (8)(9)(10) .…”