Preconception Care for People With Health Conditions: What Approaches Work, for Whom, and in What Circumstances? A Realist Review

Preconception care for people with chronic health conditions is recommended in view of the implications them and their offspring during pregnancy beyond. This realist review published grey literature explored factors that explain why seek or receive appropriate preconception counseling they engage behavior change prior to pregnancy. Fifty-two studies contributed phase one synthesis, 38 provided explanations two. Ten program theories were developed, explored, refined through iterative discussion coding. Causal ways which components contribute effective access prepregnancy identified. Beneficial included continuity carer (promoting trust), a partnership approach (empowering who feel valued), promoting an integrated across primary secondary care, offering psychological (recognizing link between physical psychosocial aspects living conditions), considering sexual reproductive as part routine normalizing conversations about (to reduce barrier created by social cultural norms). These key have been highlighted consideration when planning, implementing, improving services conditions.