Preconception Care: An Essential Component of Primary and Reproductive Healthcare

Preconception care is an essential component of reproductive healthcare. Despite its importance, significant disparities in access to and quality of preconception care exist. This review aims to focus on the clinical content of dedicated preconception care visits: reproductive life goals discussion, medical comorbidities and medication review, mental healthcare, genetic counseling and screening, and preventive services. We aim to summarize the currently published guidelines and evidence, while highlighting important barriers to care and areas where significant biases, discrimination and disparities exist.

Dedicated preconception care visits, which can be done in the context of an annual exam, and optimization of health prior to pregnancy improve obstetric outcomes. Patients with chronic conditions and those from historically marginalized communities may benefit the most from preconception visits but face barriers to accessing care including discrimination.

Preconception care encompasses many basic preventive services that should be accessible to all people, regardless of pregnancy intention. Improving access to and quality of basic preconception care services is an important step in reducing maternal morbidity and mortality.