The challenge of preconception counseling: Using reproductive life planning in primary care

Abstract

Purpose A case study is used to explore barriers and challenges in the delivery of preconception care, and to highlight the future role of reproductive life planning in primary practice settings. Data sources Peer‐reviewed journal articles and clinical practice guidelines pertaining to preconception care. Conclusions Because of the high rate of unintended pregnancy, preconception care should be incorporated into routine primary care for women of reproductive age. Reproductive life plans are tools that help formalize contraceptive and preconception care for women across the life span. They may prove particularly useful for women with chronic diseases and for young, low‐income, and minority women. Implications for practice With their emphasis on holistic care and patient education, nurse practitioners are well suited to incorporate elements of preconception care into the routine care they provide patients. Clinicians can modify reproductive life plans to fit the unique needs of an individual, patient population, or clinical practice.

Planned, unplanned and in-between: the meaning and context of pregnancy planning for young people

“…These findings suggest that traditional family planning counseling approaches relying on binary operationalization of pregnancy planning, such as simply asking whether one wants to get pregnant or not (e.g., the One Key Question approach [38]) or assuming that patients’ intentions are clear and static (e.g., the Reproductive Life Planning approach [39]), may fail to uncover the perspectives of patients beyond the planned-unplanned binary. Moreover, while pregnancy ambivalence has been used to capture any pregnancies in the in-between or grey area, the concept actually captures conflicting or uncertain desires towards pregnancy [23,26], which is not reflected in our participant’s descriptions of the in-between status of pregnancy planning .…”

Preconception health behaviors among women with planned pregnancies

“…Because of the benefits of preconception care -such as reducing maternal and infant mortality (1)it should be incorporated into primary health care for all women of reproductive age, and primarily young women from low-income settings and chronic diseases. Nursing professionals are well-placed to incorporate preconception care into current healthcare practices (29) , thus contributing to effectively maximize gains in maternal and child health (1) .…”

Midwives' adoption of the reproductive life plan in contraceptive counselling: a mixed methods study

“…In accordance with the categorization of Fleuren et al (2004), these barriers were related to characteristics of the organization (lack of time, competing tasks, not being able to reach certain groups), characteristics of the user (importance of tactfulness and professionalism), characteristics of the innovation (difficulty approaching certain groups) and characteristics of the innovation strategy (initial hesitation, making RLP mandatory, documentation). The multifactorial characteristics of potential barriers have also been identified in an American context regarding implementation of preconception care in general (Coffey and Shorten, 2013). …”