Improving pregnancy outcomes, as well as reducing both maternal and infant mortality and morbidity, has long been a major public health goal made through efforts mainly focused on the health of women during pregnancy until delivery such as extending proper pre-natal care coverage over the past few decades. However, the numbers continue to be alarmingly higher than desired in spite of these endeavors. Just recently, preconception care has been introduced as an alternative additional approach to combat persistent adverse pregnancy outcomes worldwide. There is growing scientific evidence that shows improvements for both mothers and infants in many cases but only moderate progress in implementing these concepts into clinical practice. Preconception care encompasses health education and promotion, health screening, risk assessment, and behavioral and social interventions before pregnancy. Almost half of the 200 million pregnancies that occur annually worldwide are unplanned, so preconception counseling targeted at parents, with the collaboration of interprofessional healthcare team members, can help families identify risks and address those risks before pregnancy and thereby reduce the chances of poor perinatal outcomes (Atrash & Jack, 2020). Poor medical and/or obstetric history, too young or too old maternal age, low educational level, single marital status, lack of pregnancy intention, negative pregnancy experience, low income and socioeconomic status, individual health risks, environmental risks, problem behaviors, and a variety of other risk factors have been linked to poor birth outcomes by numerous studies. Poor medical history may include hypertension and diabetes mellitus, while poor obstetric history may consist of spontaneous abortions and a history of stillbirths. There are biomedical, behavioral, and social evidence-based interventions under preconception care that effectively lessen and even prevent many of these aforementioned health problems and risk factors. More so, preconception care addresses areas not covered by other interventions such as genetic conditions, interpersonal violence, environmental health, sexually-transmitted infections (STIs), vaccine-preventable diseases, mental health, among many others. However, a potential risk associated with preconception care that is not implemented properly would be the limitation of autonomy of women and the reinforcement of the notion that the focus of all efforts to improve the health of girls and women should be on improving maternal and child health outcomes rather than on improving the health of girls and women as individuals in their own right (as it should be). Nevertheless, by taking action on health issues and risks before pregnancy, mothers can prevent problems that might affect them or their baby later on.
Atrash, H., & Jack, B. (2020). Preconception Care to Improve Pregnancy Outcomes: The Science. Journal of Human Growth and Development, 30(3), 355–362. https://doi.org/10.7322/jhgd.v30.11064
Mason, E., Chandra-Mouli, V., Baltag, V. et al. Preconception care: advancing from ‘important to do and can be done’ to ‘is being done and is making a difference’. Reprod Health 11, S8 (2014). https://doi.org/10.1186/1742-4755-11-S3-S8