title: Barriers in the Uptake and Delivery of Preconception Care: Exploring the Views of Care Providers.
abstract: Objectives To examine health care professionals' views of their role and responsibilities in providing preconception care and identify barriers that affect the delivery and uptake of preconception care. Methods Twenty health care professionals who provide preconception care on a regular basis were interviewed using semi-structured interviews. Results We interviewed twelve community midwives, three General Practitioners, three obstetricians, one cardiologist specialized in congenital heart diseases and one gastroenterologist.We identified four barriers affecting the uptake and delivery of preconception care (PCC): (1) lack of a comprehensive preconception care program; (2) limited awareness of most future parents about the benefits of preconception care, hesitance of GP's about the necessity and effectiveness of PCC; (3) poor coordination and organization of preconception care; (4) conflicting views of health care professionals on pregnancy, reproductive autonomy of patients and professional responsibility. Conclusion We have identified four barriers in the uptake and delivery of preconception care. Our findings support the timely implementation of a comprehensive program of PCC (already advocated by the Health Council of the Netherlands) and increasing awareness and knowledge of PCC from care providers and future parents. We emphasize the need for further research on how organizational barriers lead to suboptimal PCC and how interdisciplinary collaboration and referral can lead to optimally tailored intervention approaches.
authors.affiliation: Department of Medical Ethics and Philosophy of Medicine, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. h.ismailimhamdi@erasmusmc.nl.
authors.forename: Hafez Ismaili
authors.initials: HI
authors.lastname: M'hamdi
authors.affiliation: Division of Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Sabine F
authors.initials: SF
authors.lastname: van Voorst
authors.affiliation: Faculty of Life Sciences and Medicine, Hasselt University, 3500, Hasselt, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Pinxten
authors.affiliation: Department of Medical Ethics and Philosophy of Medicine, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Medard T
authors.initials: MT
authors.lastname: Hilhorst
authors.affiliation: Division of Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D000072096:Cardiologists / Q000523:psychology; D005260:Female; D058005:General Practitioners / Q000523:psychology; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009721:Nurse Midwives / Q000523:psychology; D016742:Preconception Care / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data*; D011247:Pregnancy; D011320:Primary Health Care / Q000379:methods / Q000592:standards; D036301:Qualitative Research; D000078329:Workforce
keywords: Barriers; Delivery; Preconception care; Preconception caregiver; Qualitative study; Uptake