Preconception Health Toolkit
Welcome to the Toolkit
Preconception and interconception health services aim to identify and modify biomedical, behavioral, and social risks to an individual’s health or future pregnancy outcomes through prevention and management. These services promote the health of individuals of reproductive age before conception (preconception health services) or between births (interconception health services), which helps to reduce pregnancy-related adverse outcomes, such as maternal morbidity and mortality, low birth weight, preterm birth, and infant mortality.1 Preconception health services benefit all individuals of reproductive age, regardless of whether they are planning a pregnancy.2
This toolkit offers steps and supportive resources that sexual and reproductive health (SRH) agencies, including Title X family planning projects, can use to review and strengthen the quality of their preconception health services. SRH agencies can use this toolkit to improve preconception health knowledge, attitudes, and practices; strengthen preconception health services to support clients in attaining and maintaining optimal health; integrate contextual and environmental factors into preconception health services; and reduce disparities in maternal and pregnancy outcomes.
Want to see this toolkit content in action? Read this Grantee Spotlight on Integrating Family Planning and Chronic Disease Management for Performance Improvement in Georgia.
Use this toolkit as a guide to review and strengthen the quality of your agency’s preconception health services.
The toolkit proposes five steps to enhance preconception health services and activities:
- Assess your agency’s preconception health services
- Expand opportunities to engage staff in preconception health interventions
- Routinely conduct high-quality preconception health assessments
- Strengthen the quality and responsiveness of preconception health services
- Collaborate with community partners to improve preconception health
To learn more about how to use this toolkit, see the Advancing Preconception Health Services Webinar.
Preconception and interconception health services are essential components of family planning services. SRH agencies can improve outcomes in clients of reproductive age by implementing preconception health evidence-based guidelines and recommendations. As an initial step, SRH agencies should assess the preconception health services they provide and identify gaps between current and recommended practice. Using this analysis, conduct quality improvement over time.
| Action Steps | Supportive Resources |
|---|---|
|
Review current preconception health evidence-based guidelines and recommendations. |
|
|
Assess the extent to which preconception health policies and protocols reflect evidence-based guidelines and recommendations. |
|
|
Track preconception health measures over time to identify opportunities to expand preconception health services and make other related improvements. |
|
|
Include preconception health messaging informed by community members with diverse reproductive intentions and goals in Community Participation, Education, and Project Promotion (CPEP) plans. |
The conditions in which we are born, grow, live, work, and age—also referred to as social determinants of health—impact preconception and interconception health. To address pervasive health inequities, social determinants of health must inform strategies for improving sexual and reproductive health. SRH agencies should continue providing opportunities for clinicians and staff to analyze the root causes of maternal morbidity and mortality and give them resources and training to act to reduce racial inequities. This foundation will give staff both the motivation and skills to make changes.
| Action Steps | Supportive Resources |
|---|---|
|
Train staff, as needed, on the root causes of reproductive and sexual health inequities and ongoing harms experienced by communities of color. |
|
|
Train staff, as needed, on shared decision making and client-centered care. |
SRH agencies should incorporate life course theory into their preconception health assessments. Life course theory describes how contextual and environmental factors inform individuals’ health across their lifetimes and shape health and disease patterns across populations and communities. Before counseling a client about healthy behaviors, providers should routinely assess the client’s context and environment.
| Action Steps | Supportive Resources |
|---|---|
|
Assess all clients’ reproductive goals. |
|
|
Assess risk factors for adverse health and adverse pregnancy outcomes before conception. |
|
|
Assess and address social needs to support each client’s ability to engage in healthy behaviors. |
|
|
Optimize clinic flow to efficiently collect clients’ preconception health assessment data. |
|
Unique factors affect each client’s preconception and interconception health. SRH agencies should provide preconception health education, counseling, care, and referrals that align with evidence-based guidelines and take into account the goals, risks, social needs, and contextual and environmental factors gathered during a client’s preconception health assessment.
| Action Steps | Supportive Resources |
|---|---|
|
Provide clients with risk reduction strategies that reflect their preconception health assessment and evidence-based guidelines and recommendations. |
|
|
Provide clinical and non-clinical resources and referrals to support clients in reaching their general and reproductive health goals. |
|
|
Gather client satisfaction data and use results to enhance preconception health services. |
|
Although improving the quality of preconception and interception health services in the clinical setting is important, it is insufficient for reducing maternal morbidity and mortality at scale. Local and national agencies must work together to address social determinants of health, which drive health inequities within communities of color and increase their burden of poor health outcomes.3,4 Engaging in diverse collaborative community partnerships can help SRH agencies identify additional opportunities for improving maternal health outcomes.
| Action Steps | Supportive Resources |
|---|---|
|
Work with community partners to identify root causes of inequities in maternal morbidity and mortality. |
|
|
Build relationships with community partners that work toward improving health conditions for individuals of reproductive age. |
|
|
Collaborate with community partners to implement strategies that can address underlying causes of inequities in maternal morbidity and mortality. |
|
|
Integrate culturally appropriate wellness and healthy living messaging into community education and outreach activities. |
|
|
Collaborate across sectors (for example, health care, education, housing, law enforcement) to expand opportunities to advance health equity. |
|
Would you be willing to share your feedback with us? We want to hear from you! Participate in a 30-minute conversation with an RHNTC staff person about your experience, and we’ll send you a $75 Visa eGift card as a token of our appreciation. Fill out a brief form to express your interest.
- Gavin, L., Moskosky. S., Marion, C., Curtis, K., Glass, E., Godfrey, E.,...Zapata, L. (2014). Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs. Morbidity and Mortality Weekly Report, 63(4). Retrieved from https://www.cdc.gov/mmwr/pdf/rr/rr6304.pdf
- Ibid.
- Centers for Disease Control and Prevention. (2021, April 9). Working Together to Reduce Black Maternal Mortality. https://www.cdc.gov/healthequity/features/maternal-mortality/index.html
- Centers for Disease Control and Prevention. (2021, April 12). Racism and Health. https://www.cdc.gov/minorityhealth/racism-disparities/index.html
Share Your
Feedback