ORCID

Abstract

This realist evaluation explored how access to preconception care works for people with pre-existing health conditions, for whom, and in what contexts. Thirty one participants (women of reproductive age, partners, and healthcare professionals) were interviewed using qualitative realist methods. Iterative analysis refined 35 initial programme theories into 13 middle range theories. The theory reported here identifies healthcare professionals’ knowledge of sexual and reproductive health, understanding of pregnancy planning, and enquiry regarding pregnancy intention as key mechanisms. In the context of diagnosis or review, these resources support holistic and individualized preconception care, enabling improved preconception health and reduced adverse maternal and offspring outcome.

Publication Date

2026-02-16

Publication Title

Women's Reproductive Health

ISSN

2329-3691

Acceptance Date

2026-01-27

Deposit Date

2026-02-26

Funding

We thank all those who participated in interviews. This report is independent research supported by the National Institute for Health Researchers Applied Research Collaboration Southwest Peninsula. The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.

Keywords

Preconception care, chronic health conditions, good health and wellbeing, pregnancy planning, realist evaluation, reproductive health

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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1

Last Page

17

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