Australian primary health care nurses

The MidPIC study: Midwives' knowledge, perspectives and learning needs regarding preconception and interconception care

Preconception and interconception care improves health outcomes of women and communities. Little is known about how prepared and willing Australian midwives are to provide preconception and interconception care. The aim of this study was to explore midwives' knowledge, perspectives and learning needs, and barriers and enablers to delivering preconception and interconception care. We conducted a cross-sectional exploratory study of midwives working in any Australian maternity setting. An online survey measured midwives' self-rated knowledge; education needs and preferences; attitudes towards pre and interconception care; and views on barriers, enablers; and, future service and workforce planning. Quantitative data were analysed descriptively and demographic characteristics (e.g., years of experience, model of care) associated with knowledge and attitudes regarding pre- and interconception care were examined using univariate logistic regression analysis. Qualitative data were captured through open-ended questions and analysed using inductive content analysis. We collected responses from (n = 338) midwives working across all models of care (full survey completion rate 96%). Most participants (n = 290; 85%) rated their overall knowledge about pre and interconception health as excellent, above average or average. Participants with over 11 years of experience were more likely to report above average to excellent knowledge (OR 3.11; 95% CI 1.09, 8.85). Online e-learning was the most preferred format for education on this topic (n = 244; 72%). Most (n = 257; 76%) reported interest in providing pre and interconception care more regularly and that this is within the midwifery scope of practice (n = 292; 87%). Low prioritisation in service planning was the most frequently selected barrier to providing preconception and interconception care, whereas continuity models and hybrid child health settings were reported as enablers of pre and interconception care provision. Findings revealed that midwives are prepared and willing to provide preconception and interconception care. Pre and post registration professional development; service and funding reform; and policy development are critical to enable Australian midwives' provision of pre and interconception care.

Improving the provision of preconception care in Australian general practice through task-sharing with practice nurses

Preconception care (PCC) is effective in reducing modifiable risk factors and optimising maternal health. Primary care services such as general practices in Australia are an appropriate setting to provide PCC. However, PCC is not routinely provided in most of these settings, and many reproductive-aged women and men are not aware of the need for PCC. In this forum article, we discuss the factors that hinder PCC provision in Australian general practices and make recommendations on how access to PCC services can be broadened in Australia, including the potential opportunity for general practice nurses to contribute to the provision of PCC.

Preconception Health in the Workplace: An Opportunity to Support Equitable Access to Education

Preconception health is a key determinant of pregnancy and offspring outcomes, but challenges reaching people during preconception are frequently cited by health professionals. This article highlights the workplace as an important setting for promoting equitable access to preconception health-related information and education to support optimal well-being before pregnancy. Workplaces can support equitable access to education and knowledge for preconception health: (1) due to the high engagement of reproductive-age women in the workforce and (2) by reaching vulnerable or high-risk population groups who may otherwise face barriers to accessing preconception health information. Literature that explicitly investigates workplace delivery of preconception health promotion programs is scarce. However, workplace health promotion more broadly is associated with improved corporate competitiveness, productivity, and strengthened employee-employer relationships. Workplace health promotion activities may also address social determinants of health and improve employee well-being outcomes. The opportunity for workplaces to benefit from an increase in the bottom line makes workplace health promotion programs more attractive, but organizational support and stakeholder engagement are needed to facilitate the design and delivery of successful workplace preconception health education programs. Such programs have the potential to facilitate health gains for women and their families.