title: Rethinking Preconception Care: A Critical, Women's Health Perspective.
abstract: Objectives Preconception care aims to provide care to reproductive aged individuals in order to improve pregnancy and birth outcomes. Given that preconception care is a public health priority, it is important to evaluate the evolution of this health paradigm and the promotion of preconception messages that are obtained by the public. We identified online preconception health messages, which were critically assessed through a women's health perspective. Methods We searched for "preconception care" on three major search engines. Websites were included if they were U.S.-based, provided content in English, and mentioned preconception care. Blogs and journal articles were excluded. The final sample included 52 websites. Using a content analysis approach, we assessed the presence of gender bias and identified other emergent themes. Results The majority of websites focused on preconception care for women only (67%). The recommendations centered on: (1) health behaviors for women (e.g., folic acid, drinking, smoking); (2) visiting healthcare providers; and (3) evaluating medical risks. Moreover, most content implied that women desired, or should desire, pregnancy. Overall, the messages used biomedical language and rarely mentioned other important health topics, such as social support and violence. Conclusions The primary messages presented on preconception care websites emphasized biomedical aspects of women's health. The current context of preconception care medicalizes this pre-pregnancy period by defining it as a biomedical condition requiring lifestyle changes and interventions. Additionally, the biases presented in these messages assumed women want and are capable of pregnancies and excluded an integral factor for heteronormative reproduction-men.
authors.affiliation: Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA. ethomps1@health.usf.edu.|The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA. ethomps1@health.usf.edu.
authors.forename: Erika L
authors.initials: EL
authors.lastname: Thompson
authors.affiliation: Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.
authors.forename: Coralia
authors.initials: C
authors.lastname: Vázquez-Otero
authors.affiliation: Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.|The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: Vamos
authors.affiliation: Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.|The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Marhefka
authors.affiliation: Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.|Department of Anthropology, Rollins College, 1000 Holt Avenue, Winter Park, FL, 32789, USA.
authors.forename: Nolan S
authors.initials: NS
authors.lastname: Kline
authors.affiliation: Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.|The Chiles Center, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Daley
mesh_terms: D000328:Adult; D005260:Female; D006293:Health Promotion / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D000066505:Help-Seeking Behavior; D006801:Humans; D020407:Internet; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D016742:Preconception Care / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D060728:Reproductive Health / Q000592:standards* / Q000706:statistics & numerical data; D057386:Search Engine / Q000379:methods; D063507:Sexism / Q000706:statistics & numerical data
keywords: Gender; Medicalization; Preconception health; Reproductive health