Title: Pre-Pregnancy Health and Care in England: Exploring Implementation and Public Health Impact
Funder: Department of Health (England)

Abstract: Background Good maternal & paternal health before and at conception can shape a child's future life course. This raises the importance of pre pregnancy care for screening, prevention & management of risk factors that affect pregnancy outcomes & the future health of families. There is little information about the provision of pre pregnancy care in England. Better understanding of the bio-psychosocial, cultural and economic factors affecting access to pre pregnancy care is needed if services are to be improved and more pregnancies planned. Only about 50% of pregnancies are planned. Holistic study of the complexity of health care before and between pregnancies is needed to identify interventions that are effective & acceptable to women & men, and the key contextual factors that enable health gain. Aims The overall aim of the study is to provide high quality evidence regarding the implementation & public health impact of pre pregnancy health & care for women & men in England in order to inform future policy and practice. The objectives are to: - Examine literature & analyse datasets to establish evidence, guidelines & factors relating to pre pregnancy care in England. - Holistically review current provision of pre pregnancy care in England and the impact for women & men across the lifespan. - Assess knowledge, attitudes and behaviours of men & women of childbearing age regarding planning pregnancy & pre pregnancy care, using quantitative and qualitative methods. - Synthesise the evidence obtained to inform policy and formulate a strategy to improve pregnancy care in England Plan of Investigation We will use mixed methodology to explore pre pregnancy health & care in England. We will review the literature on pre pregnancy issues, policy and care guidelines; address key questions by analysing data from two large population based studies; map service settings and information sources for pre pregnancy care in England using the World Wide Web and send questionnaires to targeted health professionals and community health workers in services providing pre pregnancy care. Knowledge, attitudes and behaviour regarding pre pregnancy issues will be explored through a large questionnaire survey of men & women attending antenatal and infertility services, and detailed insight will be gained through in depth interviews with respondents who have, and have not, invested in pre pregnancy care. Potential Impact The findings of this study are expected to have an impact on development of policy in this area by laying out the evidence base, mapping the provision of services and settings for pre pregnancy care and synthesising this information with primary research findings (from quantitative and qualitative enquiry of defined subpopulations of women and men) to formulate a strategy to improve provision, uptake and impact of pre-pregnancy care in England. In addition these findings will lead to an 'evidence-based' list of priority questions for future research.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: REPRODUCTIVE HEALTH AND CHILDBIRTH