Abstract

Background: Maximizing women’s and men’s health prior to pregnancy may reduce the likelihood of adverse pregnancy outcomes including infant mortality, in part because many women recognize their pregnancy late in the first trimester. Low-income women and those without insurance may be at greatest risk for adverse pregnancy outcomes and may be difficult to reach for preconception care. This study aimed to measure the perceptions of preconception health and pregnancy preparation among women of low socioeconomic status.

Methods: Bilingual interviewers recruited and interviewed women of reproductive age (18-40 years) at three agencies that serve a low-income population. Women were asked about how they prepared for their past pregnancies, perceptions of preconception health, as well as recent health behaviors. Qualitative data were transcribed and analyzed thematically and categorized by type of pregnancy preparation.

Results: N=174 women were recruited for the study. Most were non-Hispanic White (42%) or Hispanic (43%) and did not have health insurance (54%). A majority of women (54%) did not prepare for their past pregnancies, and among those who did prepare, “financial” preparation was the most common (13%). Two and a half-times as many Hispanic women (p=0.02) felt no control over getting pregnant as compared to non-Hispanic women, despite having a similar proportion using contraception. Fewer Hispanic women reported using alcohol, tobacco, or marijuana than non- Hispanic women in the pre/interconception period (p=0.01).

Conclusion: It is important to assess the knowledge, perceptions and health behaviors of underserved populations when designing preconception health promotion programs targeted at these groups (Figure 1).

Figure 1: Key messages.

Keywords: Preconception health; Pregnancy preparation; Reproductive health