Practitioners and researchers advocate for enhanced focus on pre-conception care to improve maternal and neonatal health

The George Institute for Global Health and DIWAS highlight the Critical role of pre-conception care in reducing risks and ensuring optimal pregnancy outcomes in India

The George Institute for Global Health in partnership with  DIWAS to organise a pivotal workshop today, addressing the crucial but often overlooked aspect of Pre-Conception Care (PCC) in maternal and neonatal health in India.

Recent studies underscore the importance of preconception care, highlighting its significant role in reducing the risk of preterm birth, low birth weight, maternal complications, and neonatal complications.

Advocating for Pre-Conception Care

Prof. Jane Hirst, Program Director of Women’s Health at The George Institute for Global Health, emphasised the importance of PCC, stating, “Preconception care is pivotal in promoting maternal health and ensuring optimal pregnancy outcomes. By managing chronic diseases, optimising maternal nutritional status, and promoting healthy lifestyle behaviors, healthcare providers can significantly mitigate adverse maternal and fetal outcomes.”

Dr Usha Sriram, founder of DIWAS and Head of Diabetes and Endocrinology at the Voluntary Health Services, Chennai said that” providing women of reproductive age , their partners , the community and their healthcare providers with the knowledge , tools and skills necessary to make decisions regarding timing, preparedness and interventions critical for healthy pregnancy outcomes and ensuring long term good health of mothers and their children is our objective”

Challenges

Despite the clear benefits, preconception care remains underutilised in many parts of India and South Asia. Women often lack the opportunity to plan their pregnancies or determine birth spacing, with decisions typically influenced by spouses or in-laws. This can lead to familial pressure and potential abuse if conception does not occur within the first year of marriage.

Engagement with the healthcare system before conception is rare unless women face difficulties conceiving. By the time pregnant women attend their first antenatal visit, critical stages of fetal organogenesis may have already passed, missing the opportunity for interventions to prevent birth defects and adverse outcomes.

Integrating Pre-Conception Care into the RMNCH+A Program

The Reproductive and Child Health and Adolescent program (RMNCH+A) in India aims to reduce maternal and neonatal mortality by 2030. While it prioritizes antepartum, intranatal, and postnatal care, preconception care is equally crucial. 

Preconception care promotes maternal health and optimises pregnancy outcomes by addressing pre-existing conditions, identifying risk factors, and implementing preventive measures. It also optimizes maternal nutrition, manages chronic diseases, and promotes healthy behaviors. Given the increasing burden of non-communicable diseases in our country, women may enter pregnancy with high metabolic risks, making quality preconception care essential to manage these risks prior to pregnancy. Dr Bharati Kulkarni , Scientist G and Head , Division of Reproductive and Child Health and Nutrition , ICMR  made very significant contributions to the deliberations. 

The scientific consultation on the 20th also brought in global experts like Dr Danielle Schoenaker, senior research fellow from the   University of Southampton , Dr Vani Sethi , regional nutrition expert from UNICEF [ ROSA} , Dr Chittaranjan Yajnik Director of diabetes at KEM hospital Pune,  Dr Monika Arora, Chair of the NCD Alliance, and Dr Hema Divakar , member of FIGO executive board among other regional experts. 

Conclusion

Today's workshop underscored the urgent need to integrate preconception care into the broader maternal and neonatal health framework in India. By raising awareness and providing the necessary resources, The George Institute for Global Health and DIWAS aims to improve health outcomes for mothers and their babies, ensuring healthier futures for families across the nation.

The recommendations from these workshops will be summarized and developed into a policy paper. This will be presented to the public health system and the Association of Obstetricians and Gynecologists of India to formulate a comprehensive preconception care policy.

The second part of this workshop will engage community members and healthcare workers to focus on acceptability, challenges, and facilitators of preconception care services.

Leads

• Professor Jane Hirst

  Chair in Global Women's Health, The George Institute for Global Health, Imperial College London