Delissaint, Dieula (2008-08). Exploring the factors associated with preconception health behaviors among women of childbearing age: a naturalistic inquiry. Doctoral Dissertation.
Poor maternal health is one of the major risk factors related to adverse birth outcomes. Women entering pregnancy with poor health status are at higher risk of these outcomes. Prenatal care has been established as the standard prevention paradigm to reduce poor pregnancy outcomes. However, public health professionals are realizing that prenatal care alone is not sufficient to improve perinatal health and birth outcomes, and instead have emphasized the importance of preconception care (PCC). Evidence-based studies reveal that those who received PCC services have better pregnancy outcomes than those who did not. Most published research on preconception are clinical studies, little is known about women's perception of preconception health and decision-making factor(s) to engage in preconception health practices. Existing research on preconception health behaviors have used retrospective designs, making them difficult to use in assessing the extent of women's understanding of preconception health behaviors and its relationship to the practice of these behaviors. Thus, an exploratory qualitative study was needed to examine factors associated with preconception health behaviors. The objective of this study was to answer two research questions: (a) What are childbearing age women's knowledge, beliefs, and perceptions of preconception health/care and how do these factors influence their preconception health behavior? (b) What are the perceived factors (facilitators and hindrances) associated with these women's intention and decision-making regarding preconception health behaviors? Thirteen women were interviewed about their knowledge and perceptions about PCC and intention toward preconception health behavior practice. The results indicated that women believed PCC is important--using the analogy of preparing their house [body] for conception. Participants associated PCC with physical and nutritional behavior; few acknowledged the importance of mental health. While women believed PCC was important, the majority did not intend to engage in PCC until they became pregnant. The main motivator to engage in PCC was pregnancy. Self-described "laziness" was the most common reported perceived barrier to PCC. Implications of this study are that additional studies with improved designs are needed to clarify relationships among intentions and actual behaviors, and that health educators should focus on educating women about the importance of self-care before conception.