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An intervention in contraceptive counseling increased the knowledge about fertility and awareness of preconception health-a randomized controlled trial
Örebro University, School of Health Sciences. (Maternal Health Care Unit)ORCID iD: 0000-0003-2412-4676
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Obstetrics and Gynecology.ORCID iD: 0000-0002-2691-7525
Örebro University, School of Medical Sciences. Örebro University Hospital. (Clinical Epidemiology and Biostatistics)ORCID iD: 0000-0002-3552-9153
Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Center.ORCID iD: 0000-0002-2559-5456
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2019 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 124, no 3, p. 203-212Article in journal (Refereed) Published
Abstract [en]

Background: Reproductive life plan counseling (RLPC) is a tool to encourage women and men to reflect upon their reproduction, to avoid unintended pregnancies and negative health behavior that can threaten reproduction. The aim was to evaluate the effect of RLPC among women attending contraceptive counseling. Outcomes were knowledge about fertility and awareness of preconception health, use of contraception, and women's experience of RLPC.

Material and methods: Swedish-speaking women, aged 20-40 years, were randomized to intervention group (IG) or control group (CG). Participants (n = 1,946) answered a questionnaire before and two months after (n = 1,198, 62%) the consultation. All women received standard contraceptive counseling, and the IG also received the RLPC, i.e. questions on reproductive intentions, information about fertility, and preconception health.

Results: Women in the IG increased their knowledge about fertility: age and fertility, chances of getting pregnant, fecundity of an ovum, and chances of having a child with help of IVF. They also increased their awareness of factors affecting preconception health, such as to stop using tobacco, to refrain from alcohol, to be of normal weight, and to start with folic acid before a pregnancy. The most commonly used contraceptive method was combined oral contraceptives, followed by long-acting reversible contraception. Three out of four women (76%) in the IG stated that the RLPC should be part of the routine in contraceptive counseling.

Conclusions: Knowledge about fertility and awareness of preconception health increased after the intervention. The RLPC can be recommended as a tool in contraceptive counseling.

Place, publisher, year, edition, pages
Taylor & Francis, 2019. Vol. 124, no 3, p. 203-212
Keywords [en]
Contraceptive counseling, fertility, lifestyle factors, preconception care, preconception health, pregnancy, reproductive life plan
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:oru:diva-76430DOI: 10.1080/03009734.2019.1653407ISI: 000485618600001PubMedID: 31495254Scopus ID: 2-s2.0-85072052473OAI: oai:DiVA.org:oru-76430DiVA, id: diva2:1351720
Note

Funding Agencies:

Research, Development and Education (ALF) from Uppsala County Council  AS 2014-0831

Region Örebro County  OLL-640211 OLL-734371

Bayer AB 

Available from: 2019-09-16 Created: 2019-09-16 Last updated: 2024-01-02Bibliographically approved
In thesis
1. Preconception health in Sweden: The impact of lifestyle factors and the role of midwife's counselling
Open this publication in new window or tab >>Preconception health in Sweden: The impact of lifestyle factors and the role of midwife's counselling
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Preconception health is an important topic since women and men have a possibility to change lifestyle habits preceding pregnancies, to increase the chances of a healthy pregnancy and child. The aim of this thesis was to increase knowledge about fertility and awareness of preconception health. 

Studies I and II were based on a randomised controlled trial among women who visited midwives for contraceptives counselling. Questionnaires were used before and after an intervention with the Reproductive Life plan (RLP), which is a discussion tool for preconception health. Study I showed that women do not always use a contraceptive that is suitable for their reproductive intentions and Study II indicated that women´s knowledge about fertility and awareness of preconception health increased with RLP-counselling (RLPC). Study II also showed that women appreciated the RLPC by the midwives.

In studies III and IV, data from the Swedish Pregnancy Register were used. The main findings in Study III were that smoking, and use of snuff, in early pregnancy and risk consuming of alcohol the year preceding pregnancy were associated with spontaneous abortion (SA). Study IV showed that heavy alcohol consumption the year preceding pregnancy was associated with lower Apgar-score and might have been associated with lower birth weight. 

The studies contribute important new knowledge about lifestyle factors preceding pregnancy. It is important to highlight this new knowledge together with other factors about preconception health to midwives and other healthcare providers. Preconception counselling is also needed to increase women´s (and men´s) knowledge. There is still a lack of knowledge in the field, but it is a golden opportunity for midwives to start talking about reproductive health during contraception counselling.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2021. p. 81
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 235
Keywords
Preconception health, preconception counselling, preconception care, Reproductive life plan, pregnancy, alcohol, smoking, snuff, AUDIT
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-90319 (URN)978-91-7529-383-7 (ISBN)
Public defence
2021-05-21, Örebro universitet, Forumhuset, Hörsal F, Fakultetsgatan 1, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2021-03-09 Created: 2021-03-09 Last updated: 2024-01-02Bibliographically approved

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Skogsdal, Yvonne Rosalie ElisabethFadl, HelenaCao, YangKarlsson, Jan

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