20th August 2018
This summer Public Health England published a paper on ‘Making the case for preconception care.’ The paper recognises that preconception health sets the foundation for a successful pregnancy and the lifelong health of the baby. It is therefore critical that efforts to improve health begin before pregnancy.
Preconception care is defined as:
“the provision of biomedical, behavioural and social health interventions to women and couples before conception occurs, aimed at improving their health status, and reducing behaviours and individual and environmental factors that could contribute to poor maternal and child health outcomes”.
Why does poor preconception health matter?
Good preconception health provides a better chance of becoming pregnant, having a safe and healthy pregnancy and giving birth to a healthy baby.
There are many risk factors that can impact maternal and child outcomes, including maternal weight, smoking, alcohol, folic acid intake, immunisations, previous pregnancy complications and maternal age.
Smoking and weight are two of the biggest modifiable risk factors for poor outcomes. Smoking causes up to 2,200 premature births, 5,000 miscarriages and 300 perinatal deaths per year. Overweight and obese women have a higher risk of poor birth outcomes and of their children being overweight or obese, and the prevalence of obesity in adults is predicted to reach 70% by 2034. Taking folic acid reduces the risk of neural tube defects, but only 31% of women take folic acid before pregnancy.
Mental health is also critical. 20% of women experience mental health issues in pregnancy and the first year after birth. If untreated maternal mental illness during the perinatal period can adversely affect: infant cognitive, emotional and behavioural outcomes; maternal-infant bonding and quality of parenting. Sadly suicide is one of the commonest causes of maternal mortality. Mental health and physical health must be treated at the same time and with equal importance.
Lack of knowledge and support
Women report a lack of knowledge and support when it comes to preconception care:
“I did plan to have a baby but I didn’t take the vitamins [folic acid] until I knew I was pregnant… It’s hard to know how long it will take to get pregnant”.
“You read up on all the stuff about being healthy during a pregnancy, but nothing really before that. It never occurred to me, we just started trying and a few months later, it happened”.
“I’ve been trying for 2 years so the idea that there are things I can do that have a big effect on getting pregnant would really interest me”.
“If I’d known the impact of carrying all this extra weight when I was pregnant, like getting pre-eclampsia and having a really difficult birth then I might have tried to lose weight before. They didn’t tell me. This time, the doctor said it would be good to lose weight but he didn’t explain why”.
A new approach
A new approach to preconception care is needed. One that promotes a holistic approach to reproductive health, lifestyle and emotional health – and one that is proactive improving health before conception. We’re proud to be developing a service that does just that. We’re taking a whole person approach, and will also be providing support on the importance of sperm health.
We’ll be launching in October, but in the meantime if you’re interested in what we are doing please do get in touch: email@example.com