How preconception care is framed in online media?

Background: Preconception care (PCC) focuses on a variety of topics for reproductive-aged women that require adherence to individual behaviors, risk assessments and clinical interventions, with the intent of improving pregnancy and birth outcomes. This study examined the framing of PCC health messages, as little research has been conducted to examine how PPC content is presented on the Internet.

Methods: This exploratory study used a qualitative content analysis of websites on PCC. Three search engines were used for the search term, “preconception care.” Inclusion criteria: (1) English; (2) US-based; and (3) mention of PCC. Exclusion criteria: (1) blogs; and (2) journal articles. Two independent reviewers abstracted recommendations, and emerging topics and themes were identified.

Results: Fifty-three websites were included. The majority of PCC recommendations focused on: (1) lifestyle health behaviors for women (e.g., folic acid, diet, exercise, drinking, and smoking); (2) healthcare provider visits; and (3) evaluating personal medical risks. There were limited recommendations for contraception to assist with pregnancy planning. Overall, the messages primarily used biomedical language and rarely mentioned topics, such as social support and domestic violence.

Discussion: The current context of PCC medicalizes the pre-pregnancy period. It assumes positive pregnancy intention, defines pre-pregnancy as a biomedical condition, and requires individual lifestyle changes and healthcare provider interventions. Moreover, despite a major goal of PCC in assisting with pregnancy planning, recommendations to achieve this goal (e.g., contraception) were lacking. Future PPC efforts should include the multiple-levels of social-cultural influences, including partners, families, and social support networks.