What does preconception health mean to people? A public consultation on awareness and use of language

Introduction: There is growing scientific and policy recognition that optimising health before a potential pregnancy (preconception health) improves reproductive outcomes and the lifelong health of future children. However, public awareness on this topic is low. We conducted a public consultation to develop language recommendations and identify and prioritise approaches to inform research and improve public awareness of preconception health. Methods: A public consultation was undertaken with people of any gender aged 18-50 years living in the UK who were not currently expecting a child. Public contributors were recruited through patient and public involvement, community and support groups, an existing cohort study, and an LGBTQ+ charity. An initial round of online group discussions (February/March 2021) explored public contributors knowledge of preconception health, their recommendations for appropriate language, and ideas about public health approaches. In a subsequent discussion round (May 2021), language recommendations were refined, and suggested approaches prioritised. Discussions were summarised based on notes taken by two researchers. Results: 54 people joined the initial discussion round (66% women, 21% men, 13% non-binary or transgender; 55% aged 18-30 years, 30% 31-40 years, 15% 41-50 years). Of these, 36 people (67%) participated in the subsequent round. Very few had heard the term preconception health, understood what it means, or why and for whom it is important. They recommended avoiding unfamiliar terms without further explanation (e.g. preconception health, medical terms), using language that is positive, encouraging and gender-sensitive where possible, and using messages that are specific, non-judgmental and realistic. The phrases health and wellbeing during the childbearing years, health and wellbeing before pregnancy and parenthood and planning for parenthood resonated with most public contributors. School-based education, social media campaigns and the National Health Service emerged as priority approaches/settings for raising awareness. Conclusion: This public consultation produced recommendations from a diverse group of people of reproductive age in the UK to improve language and prioritise approaches that increase public understanding of preconception health in ways that are relevant and appropriate to them. This should begin in schools and will require adaptation of curricula, alongside co-development of public awareness campaigns and guidance for healthcare professionals.