title: Preconception care: an essential preventive strategy to improve children's and women's health.
abstract: Reproductive health has improved little in the last few decades. The Netherlands, particularly in large cities, has relatively high perinatal death rates compared with other European countries. Lack of improvement in reproductive outcomes despite improved quality of and better access to prenatal care strongly suggests that prenatal care alone is insufficient. We discuss how preconception care offers new strategies for improving reproductive health, how it usefully connects the life course of the affected individual and many health-care disciplines, and the benefits of combining a top-down policy structure and bottom-up organisation around caregivers. Given the likely benefits and cost savings calculated for The Netherlands, we conclude that failing to facilitate preconception care would reflect a breakdown of both professional and governmental responsibilities.
authors.affiliation: Department of Medical Ethics and Philosophy of Medicine, Room AE 3-42, Erasmus University Medical Centre, Rotterdam, CA 3000, The Netherlands. b.vanderzee@erasmusmc.nl
authors.forename: Boukje
authors.initials: B
authors.lastname: van der Zee
authors.forename: Inez
authors.initials: I
authors.lastname: de Beaufort
authors.forename: Sevilay
authors.initials: S
authors.lastname: Temel
authors.forename: Guido
authors.initials: G
authors.lastname: de Wert
authors.forename: Semiha
authors.initials: S
authors.lastname: Denktas
authors.forename: Eric
authors.initials: E
authors.lastname: Steegers
mesh_terms: D005260:Female; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D009426:Netherlands; D016742:Preconception Care / Q000458:organization & administration*; D011247:Pregnancy; D011256:Pregnancy Outcome; D060728:Reproductive Health; D034121:Reproductive Health Services / Q000458:organization & administration; D018570:Risk Assessment; D016387:Women's Health