Missing preconception support leaves parents unready for parenthood

A new report has found that mums and dads are being failed by the Government’s ‘outdated’ public health messages. Much more must be done in the preconception period to prepare people for pregnancy and parenthood, researchers say.

Tommy’s is among the expert organisations to contribute research about preconception care to a new report by the Children’s Alliance, an initiative which aims to improve politicians’ awareness of the health and wellbeing issues currently facing children in the UK. 

The report shows that because preconception care isn’t taught in schools, and frontline medical staff often do not pass on key research-backed messages about preparing for pregnancy and being pregnant, many parents are left in the dark about what to expect after birth.  

Researchers found that many women and men are unaware of how their personal health – including their weight, and smoking and drinking - can impact their babies’ early development. 

The report’s authors are now calling for preconception care in the UK, which supports parents before pregnancy, to be included at all stages of the Government’s health strategy. 

Data highlighted by the Children’s Alliance report, which was published on 26 May 2023 in partnership with the University of Southampton, found huge inequities between wealthy and disadvantaged families, with 24% of stillbirths linked to socioeconomic deprivation.   

They also found: 

  • Only 27 per cent of mothers take folic acid before conceiving

  • People from low-income families are 3 times more likely to smoke at the time of conception. 

  • Women living in deprived areas are nearly 2 times more likely to have a pre-existing mental health condition. 

Tommy’s preconception support 

At Tommy’s we developed our Planning for Pregnancy tool in 2018 to deliver personalised recommendations to women about risk factors they might have and then guide them to sources of support to address how many risks can be reduced. 

The aim was to encourage behaviour changes by supporting women and birthing people with tailored advice around the time they might want to start planning a pregnancy or between stopping contraception and becoming pregnant. 

In 5 years, more than half a million people have used the tool. Because data entered into the tool is anonymised, researchers have been able to use it to get a picture of preconception health and the issues that most people need better support with. 

Our research found that people were most interested in finding out information about BMI (55%), folic acid (33%), caffeine (29%) and mental health (24%). 

As we show in the Children’s Alliance report: currently, preconception mental health support is largely missing. 24% of our tool users said they have mental health issues, with 8% having a serious mental health illness. Yet at the time of using the tool, 58% of users with a serious mental illness had not talked to a health professional about their pregnancy plans. 

Deirdre de Barra, Tommy’s Head of Pregnancy Information says:

“The search demand for our Planning for Pregnancy tool and website visitor numbers show that people considering pregnancy have an enormous appetite for good information and using it to improve their health and their babies’ future health. Taking steps to become healthier at this stage has great potential to reduce complications in pregnancy and affect the lifelong health of the child.

“Therefore it’s concerning that preconception health messaging and support is not prioritised by our Government and given the resources it needs. This is a vital investment in the future. Many parents are getting the information they need too late, or not at all.” 

An action plan to improve pre-conception care 

The Children’s Alliance, with academics, health professionals and experts – including Tommy’s - have created a new Preconception Care Strategy to give babies and children the best chance of good health.  

The 5-point action plan for Government and health officials to improve the health of expectant parent suggests: 

  • Preconception care services must be available to everyone in the UK to tackle spiralling inequality. 

  • Incentivise GPs, maternity services and family hubs to normalise preconception care and improve pregnancy and post-natal care. 

  • Add preconception care to the curriculum to teach pupils the importance of healthy pregnancies. 

  • Move preconception healthcare into related health policies that address obesity and weight management, alcohol and smoking. 

  • Encourage large organisations – including the NHS – to give staff access to medical or health and wellbeing professionals before conception. 

Read the Preconception Care Strategy