Maternal and Child Health Journal

, Volume 21, Issue 5, pp 1147–1155 | Cite as

Rethinking Preconception Care: A Critical, Women’s Health Perspective

  • Erika L. Thompson
  • Coralia Vázquez-Otero
  • Cheryl A. Vamos
  • Stephanie L. Marhefka
  • Nolan S. Kline
  • Ellen M. Daley
Article
First Online:

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.

Keywords

Gender Preconception health Medicalization Reproductive health 
This is a preview of subscription content, log in to check access.

References

  1. Almeling, R., & Waggoner, M. R. (2013). More and less than equal how men factor in the reproductive equation. Gender & Society, 27(6), 821–842. doi: 10.1177/0891243213484510.CrossRefGoogle Scholar
  2. American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. (2002). Guidelines for perinatal care (5th edn.). Washington, DC.Google Scholar
  3. American College of Obstetricians and Gynecologists. (2012). Well-woman visit. Committee Opinion No. 534. Obstetrics and Gynecology, 120, 421–424.CrossRefGoogle Scholar
  4. Atrash, H. K., Johnson, K., Adams, M., Cordero, J. F., & Howse, J. (2006). Preconception care for improving perinatal outcomes: The time to act. Maternal and Child Health Journal, 10(5 Suppl), S3–11. doi: 10.1007/s10995-006-0100-4.CrossRefPubMedGoogle Scholar
  5. Ayo, N. (2012). Understanding health promotion in a neoliberal climate and the making of health conscious citizens. Critical Public Health, 22(1), 99–105. doi: 10.1080/09581596.2010.520692.CrossRefGoogle Scholar
  6. Barker, K. K. (1998). A ship upon a stormy sea: The medicalization of pregnancy. Social Science & Medicine (1982), 47(8), 1067–1076. doi: 10.1016/S0277-9536(98)00155-5.CrossRefGoogle Scholar
  7. Coonrod, D. V., Bruce, N. C., Malcolm, T. D., Drachman, D., & Frey, K. A. (2009). Knowledge and attitudes regarding preconception care in a predominantly low-income Mexican American population. American Journal of Obstetrics and Gynecology, 200(6), 686 e681–687. doi: 10.1016/j.ajog.2009.02.036.Google Scholar
  8. Dibaba, Y., Fantahun, M., & Hindin, M. J. (2013). The effects of pregnancy intention on the use of antenatal care services: Systematic review and meta-analysis. Reproductive Health, 10(1), 50.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Evans, J., Frank, B., Oliffe, J. L., & Gregory, D. (2011). Health, illness, men and masculinities (HIMM): A theoretical framework for understanding men and their health. Journal of Men's Health, 8(1), 7–15.CrossRefGoogle Scholar
  10. Finer, L. B., & Zolna, M. R. (2014). Shifts in intended and unintended pregnancies in the United States, 2001–2008. American Journal of Public Health, 104(S1), S43–S48.CrossRefPubMedPubMedCentralGoogle Scholar
  11. Freda, M. C., Moos, M. K., & Curtis, M. (2006). The history of preconception care: Evolving guidelines and standards. Maternal and Child Health Journal, 10(5 Suppl), S43–S52. doi: 10.1007/s10995-006-0087-x.CrossRefPubMedGoogle Scholar
  12. Frey, K. A., & Files, J. A. (2006). Preconception healthcare: What women know and believe. Maternal and Child Health Journal, 10(5 Suppl), S73–S77. doi: 10.1007/s10995-006-0110-2.CrossRefPubMedGoogle Scholar
  13. Frey, K. A., Navarro, S. M., Kotelchuck, M., & Lu, M. C. (2008). The clinical content of preconception care: Preconception care for men. American Journal of Obstetrics and Gynecology, 199(6 Suppl 2), S389–395. doi: 10.1016/j.ajog.2008.10.024.
  14. International Conference on Population and Development. (1994). Programme of Action Retrieved July 20, 2015, from http://www.unfpa.org/sites/default/files/event-pdf/PoA_en.pdf.
  15. Johnson, K., Posner, S. F., Biermann, J., Cordero, J. F., Atrash, H. K., Parker, C. S., & Curtis, M. G. (2006). Recommendations to improve preconception health and health care—United States. MMWR. Recommendations and Reports: Morbidity and Mortality Weekly Report, 55(RR-6), 1–23.Google Scholar
  16. Livingood, W. C., Brady, C., Pierce, K., Atrash, H., Hou, T., & Bryant, T., 3rd. (2010). Impact of pre-conception health care: evaluation of a social determinants focused intervention. Maternal and Child Health Journal, 14(3), 382–391. doi: 10.1007/s10995-009-0471-4.CrossRefPubMedGoogle Scholar
  17. Maskovsky, J. (2005). Do people fail drugs, or do drugs fail people?: The discourse of adherence. Transforming Anthropology, 13(2), 136–142. doi: 10.1525/tran.2005.13.2.136.CrossRefGoogle Scholar
  18. Mitchell, E. W., Levis, D. M., & Prue, C. E. (2012). Preconception health: awareness, planning, and communication among a sample of US men and women. Maternal and Child Health Journal, 16(1), 31–39. doi: 10.1007/s10995-010-0663-y.CrossRefPubMedGoogle Scholar
  19. O’Daniel, A. A. (2008). Pushing poverty to the periphery: HIV-positive African American women’s health needs, the Ryan White Care Act, and a political economy of service provision. Transforming Anthropology, 16(2), 112–127. doi: 10.1111/j.1548-7466.2008.00020.x.CrossRefGoogle Scholar
  20. Pascale, A., Beal, M. W., & Fitzgerald, T. (2016) Rethinking the well woman visit: A scoping review to identify eight priority areas for well woman care in the era of the Affordable Care Act. Women’s Health Issues, 26(2), 135–146. doi: 10.1016/j.whi.2015.11.003.CrossRefPubMedGoogle Scholar
  21. Riessman, C. K. (1983). Women and medicalization: A new perspective. Social Policy, 14(1), 3–18.PubMedGoogle Scholar
  22. Shaw, J. C. A. (2013). The medicalization of birth and midwifery as resistance. Health Care Women International, 34(6), 522–536. doi: 10.1080/07399332.2012.736569.CrossRefGoogle Scholar
  23. Univerisity of Wisconsin Green Bay. (2014). How can I tell if a website is credible? Retrieved December 5, 2016, from https://uknowit.uwgb.edu/page.php?id=30276.
  24. US Census Bureau. (2015). Current Population Survey, June 1976–2014.Google Scholar
  25. US Preventive Services Task Force. (2016). Final update summary: Cervical Cancer: Screening Retrieved December 6, 2016, from https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening.
  26. Verbiest, S., Malin, C. K., Drummonds, M., & Kotelchuck, M. (2016). Catalyzing a reproductive health and social justice movement. Maternal and Child Health Journal, 20(4), 741–748. doi: 10.1007/s10995-015-1917-5.CrossRefPubMedPubMedCentralGoogle Scholar
  27. Waggoner, M. (2013). Motherhood preconceived: the emergence of the Preconception Health and Health Care Initiative. Journal of Health Politics, Policy and Law, 38(2), 345–371. doi: 10.1215/03616878-1966333.CrossRefPubMedGoogle Scholar
  28. Waggoner, M. (2015). Cultivating the maternal future: Public health and the prepregnant self. Signs, 40(4), 939–962. doi: 10.1086/680404.CrossRefGoogle Scholar
  29. Wiener, R. C., & Wiener-Pla, R. (2014). Literacy, pregnancy and potential oral health changes: The internet and readability levels. Maternal and Child Health Journal, 18(3), 657–662. doi: 10.1007/s10995-013-1290-1.CrossRefPubMedPubMedCentralGoogle Scholar
  30. Wise, P. H. (2008). Transforming preconceptional, prenatal, and interconceptional care into a comprehensive commitment to women’s health. Women’s Health Issues, 18(6), S13–S18. doi: 10.1016/j.whi.2008.07.014.CrossRefPubMedGoogle Scholar
  31. World Health Organization. (2015). Women’s health Retrieved October 19, 2015, from http://www.who.int/topics/womens_health/en/.

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Erika L. Thompson
    • 1
    • 2
  • Coralia Vázquez-Otero
    • 1
  • Cheryl A. Vamos
    • 1
    • 2
  • Stephanie L. Marhefka
    • 1
    • 2
  • Nolan S. Kline
    • 1
    • 3
  • Ellen M. Daley
    • 1
    • 2
  1. 1.Department of Community and Family Health, College of Public HealthUniversity of South FloridaTampaUSA
  2. 2.The Chiles Center, College of Public HealthUniversity of South FloridaTampaUSA
  3. 3.Department of AnthropologyRollins CollegeWinter ParkUSA

Personalised recommendations