Perceptions of pregnancy preparation in women with a low to intermediate educational attainment

Objective: in the promotion of periconceptional health, appropriate attention has to be given to the perceptions of those who are most vulnerable, such as women with a relatively low socioeconomic status based on their educational attainment. The aim of this study was to explore these women's perceptions of pregnancy preparation and the role they attribute to healthcare professionals.
Design: we conducted semi-structured interviews with women with a low to intermediate educational attainment and with a desire to conceive, of which a subgroup had experience with preconception care. Thematic content analysis was applied on the interview transcripts.
Findings: the final sample consisted of 28 women. We identified four themes of pregnancy preparation perceptions: (i)”How to prepare for pregnancy?” which included health promotion and seeking healthcare; (ii) “Why prepare for pregnancy?” which mostly related to fertility and health concerns; (iii) “Barriers and facilitators regarding pregnancy preparation” such as having limited control over becoming pregnant as well as the health of the unborn; (iv) “The added value of preconception care” reported by women who had visited a consultation, which consisted mainly of reassurance and receiving information.
Key conclusions and Implications for practice: the attained insights into the perceptions of women with a low to intermediate education are valuable for adapting the provision of preconception care to their views. We recommend the proactive offering of preconception care, including information on fertility, to stimulate adequate preparation for pregnancy and contribute to improving perinatal health among women who are socioeconomically more vulnerable.