Improving the uptake of periconceptional folate supplementation: What do women think?

Background
Evidence exists supporting preventive and management issues in preconception care. Despite relatively high knowledge in Australia of the association between folate supplementation and a reduction in neural tube defects, the proportion of women taking periconceptional folic acid supplements remains low.
Aim
To determine women's views of the barriers and enablers to the uptake of preconception care and periconceptional folate supplementation
Methods
Focus groups were undertaken with women living in both high and low socio-economic (SE) metropolitan areas and rural areas in Victoria and content analysis undertaken using NVIVO 7. 
Findings
Barriers to the uptake of preconception care and periconceptional folate supplementation
·         Women have to be thinking about pregnancy to be receptive to preconception care advice
·         Women don’t know preconception care is available
·         Confusion exists about folate dosage, timing, and efficacy of different brands
·         General Practitioners (GPs) do not routinely provide preconception care
·         Poor access to GPs
·         High cost of frequent medical care
·         Accessing alternative practitioners for preconception care instead of GP
·         Lack of continuity with the same GP
Enablers to the uptake of preconception care and periconceptional folate supplementation
·         Women will do whatever they can to ensure the best outcomes for their baby
·         GPs promoting the availability of preconception care during consultations
·         Provision of preconception care pamphlets in both waiting & consultation rooms
·         Posters promoting the availability of preconception care in GP waiting rooms
·         Mail outs to women of reproductive age promoting the availability of preconception care consultations
Benefits to the community
These findings have been used to inform the development of an intervention to assist in the implementation of preconception care guidelines in the general practice setting. Better delivery and uptake of preconception care advice has the ability to lead to improved pregnancy outcomes.