Opportunities for enhancing pregnancy planning and preconception health behaviours of Australian women

Problem and background: The preconception period provides a significant opportunity to engage women in healthy behaviour change for improved maternal and child health outcomes. However, there is limited research exploring women's pregnancy planning in Australia. Aim: This study investigated associations between pregnancy planning, socio-demographics and preconception health behaviours in Australian women. Methods: A retrospective cross-sectional survey of pregnant women >= 18-years-of-age recruited through a Victorian public maternity service and a national private health insurer. Results: Overall 317 women (30 +/- 4.7 years) participated (public: n=225, private: n=92). Planned pregnancies were reported by 74% of women and were independently associated with marital status (AOR= 5.71 95% CI 1.92-17.00, p = 0.002); having <= 2 children (AOR = 3.75 95% CI 1.28-11.05, p = 0.016); and having private health insurance (AOR =2.51 95% CI 1.08-5.81, p = 0.03). Overall, women reported preconception: any folic-acid supplementation (59%), up-to-date cervical screening (68%), weight management attempts (75%), accessing information from health professionals (57%) and immunisation reviews (47%). Pregnancy planners were more likely to use folic-acid (AOR =17.13 95% CI 7.67-38.26, p <0.001), review immunisations (AOR =2.09 95% CI 1.07-4.10, p = 0.03) and access information (AOR =3.24 95% CI 1.75-6.00, p < 0.001) compared to non-planners. Women <25-years-of-age were less likely to access information (AOR= 0.38 95% CI 0.16-0.89, p = 0.03) and take folic-acid (AOR= 0.23 95% CI 0.09-0.59, p = 0.002) and were more likely to smoke 3-months preconception (AOR= 6.68 95% CI 1.24-36.12, p = 0.03). Conclusions: Women with planned and unplanned pregnancies reported variable preconception health behaviour uptake and limited healthcare engagement. Opportunities exist to improve awareness and healthcare engagement for optimising preconception health and pregnancy planning benefits including collaborative health promotion. Population-based and targeted approaches reaching pregnancy planners and non-planners are required. (C) 2020 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.