Planning for better birth outcomes with a Reproductive Life Plan

Despite universal access to health care and advanced neonatal care, adverse outcomes during pregnancy and birth outcomes have continued in Ontario. One strategy to improve outcomes for mothers and babies is improving health before pregnancy (preconception health). When people are healthier before conception, their babies are likely to be healthier.  How can health before conception be improved if around 50% of are unplanned (either unintended or mistimed)?

A reproductive life plan is one tool that can boost preconception health. A reproductive life plan encourages people think about whether they want to have children and if so, when. The goal is for individuals to become more aware of risk factors to their fertility and the health of future children and to consider taking steps to reduce those risks before a pregnancy.  Reproductive life plans are relevant to everyone during their reproductive years – men, woman and people of all sexual orientations and gender identities.

Risk factors can include chronic health conditions (hypertension, diabetes, obesity), infectious diseases (STIs, varicella, rubella), certain medications, substance use, depression, intimate partner violence, lack of healthy nutrition, and lack of physical activity. Many of these risk factors can be addressed in the preconception period. The health of future pregnancies and birth outcomes can be improved by making changes such as taking folic acid, managing chronic diseases, reducing or stopping substance use, treating depression and addressing intimate partner violence.

Best Start Resource Centre has developed two reproductive life plans, one for youth and one for adults. The reproductive life plan for youth has been adopted by several boards of education as part of their curriculum. The newly released reproductive life plan for adults is intended for people who want to have children someday, but not now.

Reproductive life plans can be promoted by service providers from a variety of sectors including public health, primary health care, education, and early years. The tools can be used before conception or between pregnancies. In order to give all children the best possible start in life, it will take an array of sectors and service providers to normalize preconception health as part of reproductive health practices.

References and further reading:

http://www.opha.on.ca/Events-News-and-Media/News/SHIFT.aspx

https://www.cdc.gov/preconception/