Pregnancy planning health information and service needs of women with chronic non-communicable conditions

What is pregnancy planning?

There is growing evidence about the importance of optimal health BEFORE conception for the health of the woman and the baby. Currently, pregnancy care begins once a woman is pregnant. However, the reality is that certain actions critical to a healthy pregnancy and positive birth outcomes can best – and sometimes only – be done before conception. Examples include folic acid (Vitamin B9) supplementation to prevent most Neural Tube Defects and transitioning off medications that adversely affect fetal development. 

How can primary care providers approach pregnancy planning with patients?

The solution is to routinely ask women of reproductive age about their pregnancy desire in primary care consultations, even if it is not the main reason for the appointment. This allows primary care providers to give advice about reliable contraception to avoid unintended pregnancy to those who don’t wish to be pregnant and preconception health advice to those who do or who are unsure.

The government-funded Your Fertility program has developed resources to help healthcare providers ask their patients about pregnancy plans.

Pregnancy planning for women living with chronic conditions

For women living with chronic non-communicable diseases (NCDs), pregnancy decision-making is more complex than for other women as they need to consider the additional potential risks of pregnancy on their own health and the health of the baby. For these women, pregnancy planning is essential to allow optimal disease control in preparation for pregnancy. To inform clinical care, we reviewed the literature on the pregnancy planning health information and service needs of women with NCDs.

The review revealed that women living with chronic conditions have unmet preconception health information and service needs. To improve pregnancy outcomes for women living with NCDs, the health professionals who care for them need to ask women of reproductive age proactively and routinely about their pregnancy intentions and provide them with personalised advice on how to avoid unplanned pregnancy and be in optimal health when they wish to conceive.  

Citation

Hammarberg, K., Stocker, R., Romero, L. et al. Pregnancy planning health information and service needs of women with chronic non-communicable conditions: a systematic review and narrative synthesis. BMC Pregnancy Childbirth 22, 236 (2022).

DOI: 10.1186/s12884-022-04498-1