Preconception Health:
Clinical Guidance and Resources for Health Care Professionals

A one-stop shop for evidence-based preconception care.

Preconception health refers to the promotion, prevention, and management of health conditions before pregnancy to improve outcomes for parents and babies. Evidence shows that the majority of people of reproductive age have at least one modifiable risk factor that can adversely affect pregnancy outcomes, and that addressing these factors before conception is essential to reducing health inequalities and improving maternal and child health outcomes.

This website brings together key clinical guidance, tools, and practical resources to support health care professionals in delivering high-quality, inclusive preconception care across primary, community, and secondary care settings.

Equity Considerations in Preconception Care

Health inequities affecting pregnancy outcomes are often driven by structural and social determinants of health, rather than individual behaviours alone. Factors such as income, housing stability, racism, access to care, and social support can significantly influence reproductive health outcomes.

Health care providers can help reduce inequities by incorporating equity-oriented approaches into routine preconception care.

Key principles include:

  • Recognize the impact of social and structural determinants of health
  • Use trauma-informed and culturally safe care assumptions about health literacy, adherence, or patient priorities
  • Ask about barriers to accessing care, such as transportation, cost, or childcare
  • Support shared decision-making and reproductive autonomy
  • Connect patients with community resources and supports

Addressing these broader factors can help improve engagement with care and support healthier pregnancies.

Additional Preconception Health HUBs

Explore HUBs on key topics related to preconception health. Click a HUB to get started.

Equity-focused care for:

What Is Preconception Care?

Preconception care is the promotion, prevention, and management of health before or between pregnancies to improve fertility, pregnancy outcomes, and long-term parent and child health.

Preconception care may begin months or even years before pregnancy and represents a proactive and preventive approach to supporting healthy (healthier) pregnancies.

The ultimate goal is to identify and address modifiable risk factors and provide education, counselling, and timely interventions to optimizing health before conception.

Why Preconception Care Matters

Reproductive planning can signal desires for children, or not, well in advance. It also creates an opportunity to introduce preconception care.

This is an important time to identify and manage health risks and behaviours that can affect:

  • Relationships
  • Fertility and conception
  • Fetal development
  • Pregnancy outcomes
  • Long-term health

Preconception health influences maternal outcomes, infant health, and long-term population health.

Key considerations:

  • Up to 60% of pregnancies are unplanned
  • Many critical exposures occur before pregnancy recognition
  • Most people of reproductive age have ≥1 modifiable risk factor

Poor preconception health contributes to:

  • Increased maternal morbidity and mortality
  • Preterm birth and low birth weight
  • Widening health inequalities linked to deprivation, ethnicity, and migration status

Preconception care is not a single visit; it is a life-course approach embedded into routine care.

Who Needs Preconception Care

Preconception care is relevant for all people of reproductive potential, regardless of pregnancy intention. Some groups may benefit from more targeted support.

Patients with Chronic Conditions

Conditions such as diabetes, hypertension, thyroid disease, epilepsy, autoimmune disorders, and mental health conditions can affect fertility and pregnancy outcomes. Preconception care allows providers to stabilize disease, review medications, and coordinate specialist care before pregnancy.

Patients with Mental Health Conditions

Mental health conditions during the reproductive years can affect pregnancy outcomes and postpartum wellbeing. Preconception care supports symptom stabilization, medication review, and continuity of mental health care.

Patients with Substance Use Issues

Substance use -including alcohol, tobacco, cannabis, and opioids -can affect fertility and early fetal development. Preconception care supports non-judgmental screening, harm-reduction approaches, and connection to treatment services.

Adolescents and Youth

Many behaviours affecting reproductive health begin during adolescence. Preconception care for youth focuses on prevention, contraception counselling, and support for healthy behaviours.

Older Patients

Age can influence fertility, pregnancy complications, and genetic risks. Preconception counselling helps patients make informed decisions about pregnancy timing and reproductive options.

Gender-Diverse Individuals

Gender-diverse people may wish to conceive, carry a pregnancy, or build families. Inclusive care includes gender-affirming language, avoidance of assumptions about anatomy or reproductive goals, and access to supportive services.

Black Communities

Black communities in Canada experience higher rates of adverse maternal and perinatal outcomes due to systemic inequities and structural racism. Preconception care can help address health risks, improve access to care, and strengthen trust.

Indigenous Communities

Indigenous Peoples experience inequities in maternal and perinatal outcomes linked to the impacts of colonization and systemic barriers. Culturally safe, trauma- and violence-informed care and connection to community supports are essential components of equitable preconception care.

Addressing Social Determinants of Health in Preconception Care

Social determinants of health can shape preconception health risks, access to care, and the ability to follow through on treatment or counselling recommendations. Factors such as housing stability, food security, income, transportation, language, social support, and experiences of discrimination may all influence reproductive health outcomes.

Health care providers can help by incorporating brief, routine assessment of social context into preconception care.

Key actions include:

  • Ask about barriers to accessing care, medications, healthy food, or transportation
  • Consider the impact of housing instability, financial stress, and food insecurity on health
  • Use non-judgmental, person-centred communication
  • Avoid assuming that limited follow-up reflects a lack of motivation or engagement
  • Connect patients with social work, community services, or culturally appropriate supports when needed
  • Revisit social needs over time, as circumstances may change

Addressing social determinants of health can improve engagement with care, support health optimization before pregnancy, and help reduce inequities in maternal and infant outcomes.

Core Principles of Effective Preconception Care

Effective preconception care should be:

Life-course oriented: Supporting health well before pregnancy is planned.

Inclusive and person-centred: Recognizing diverse gender identities, family structures, and reproductive intentions.

Equity-focused: Addressing social determinants of health and structural barriers.

Opportunistic: Integrating preconception discussions into routine clinical care.

Collaborative: Connecting clinical care with public health and community services.

Supporting Reproductive Planning in Clinical Practice

Routine visits provide opportunities to discuss reproductive goals and health optimization.

Providers can begin with open-ended questions such as:

  • “Would it be helpful to talk about planning for pregnancy?”
  • “What do you already know about preconception health?”
  • “What are your goals for pregnancy or family building?”
  • “Who is in your circle of support?”

These conversations help identify health priorities and support informed decision-making.

Assessing Social Support

Relationships and social environments can influence health behaviours and pregnancy outcomes.

Supportive relationships may help individuals:

  • Adopt healthy behaviours
  • Navigate infertility or pregnancy loss
  • Engage with health services

However, unsupportive dynamics may involve:

  • Reproductive coercion
  • Interference with contraception
  • Increased stress or delayed care

Providers should explore support systems and offer referrals when needed.

Engaging Partners

Partners can influence fertility, pregnancy outcomes, and parenting experiences. When appropriate, preconception care may include partners in discussions about reproductive planning, sexual health, and lifestyle factors.

What to Address in Preconception Care

Health Behaviours

  • Nutrition and folic acid supplementation
  • Healthy weight and physical activity
  • Nicotine, alcohol, and substance use

Physical Health

  • Long-term conditions (e.g. diabetes, epilepsy, thyroid disease)
  • Medication review and optimisation
  • Immunizations and infectious disease risk

Mental Health

  • Common and severe mental illness
  • Psychotropic medication management
  • Childbirth anxiety
  • Trauma and violence-informed and culturally sensitive care

Reproductive Health

  • Fertility awareness and menstrual health
  • Contraception and pregnancy planning
  • Previous pregnancy complications or loss

Genetics and Family History

  • Health history of both genetic parents
  • Three-generation family history to identify inherited conditions
  • Reproductive carrier screening

Wider Determinants of Health

  • Social deprivation and housing insecurity
  • Migration status and language barriers
  • Domestic abuse and safeguarding concerns

Medication Review

Medication review is a key component of preconception care.

Why it matters

  • Organ development occurs before pregnancy recognition
  • Some medications are teratogenic or contraindicated
  • Stopping essential treatment can cause harm

What to do

  • Review all medications (including over-the-counter and supplements)
  • Optimise treatment regimens before conception
  • Balance medication risk vs untreated disease
  • Avoid abrupt discontinuation

Clinical tip: If pregnancy is not yet planned, support effective contraception while treatment is optimised.

Preconception Care: What You Can Do Today

Preconception health is an essential component of preventive care across the reproductive years. By addressing health conditions, lifestyle factors, mental health, medications, and social circumstances before pregnancy occurs, clinicians can support safer pregnancies and improved long-term health for parents and children.

These conversations do not need to be complex or time-intensive. Brief, patient-centred discussions during routine visits can help identify health priorities, support reproductive planning, and connect individuals with appropriate services and supports.

Start with:

  • Asking about reproductive goals and pregnancy intentions
  • Reviewing medications and chronic disease management
  • Promoting folic acid supplementation and healthy behaviours

Addressing nicotine, alcohol, and substance use. Considering mental health, safety, and social supports. Ensuring immunizations and preventive care are up to date. Routine attention to preconception health can help reduce preventable complications and contribute to more equitable maternal and child health outcomes.

Condition-Specific “Clinical Quick-Read” Pages

Condition-Specific Clinical Quick-Read Pages provide concise, evidence-based guidance for managing common health conditions in the preconception period. Designed for rapid reference during busy clinical encounters, each page highlights key risks, priority actions, clinical tips and practical considerations specific to a condition. Together, these pages support timely, consistent decision-making and help clinicians integrate preconception care into routine practice with confidence.

QUICK REFERENCE TABLES

Chronic Disease:

Nutrition, Lifestyle, and Age:

Infectious Diseases and Immunization:

Gender-Diverse Communities:

QUICK-READ GUIDES

Preconception Health:

Chronic Disease:

Nutrition, Lifestyle, and Age:

Mental Health:

Substance Use:

Preconception Resources for Health Care Providers

Websites:

Optimizing Preconception Care, Public Health Agency of Canada
A national guidance resource outlining key components of preconception care, including risk assessment, health optimization, counselling, and preventive interventions before pregnancy.

Clinical Practice Guidelines:

Pre-pregnancy counselling (C-Obs 3a) (RANZCOG)
A clinical guidance document from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists that outlines key considerations for pre-pregnancy counselling to support healthy pregnancy planning.

Prepregnancy Counseling (ACOG)
A clinical guidance document from the American College of Obstetricians and Gynecologists that outlines key elements of prepregnancy counselling to support healthier pregnancies and improve maternal and infant outcomes.

Preconception Counseling and Care
A clinical review from the American Academy of Family Physicians that outlines key elements of preconception counselling and care to support healthier pregnancies and maternal outcomes.

Reports:

Preconception Care: Maximizing the gains for maternal and child health
A WHO policy brief that outlines the importance of preconception care and key interventions to improve maternal and child health outcomes.

Tools and Resources:

Core Clinical Checklists for Preconception Care
An SOGC developed set of practical clinical checklists to help health care providers deliver consistent, efficient, and person-centred preconception care across practice settings.

Preconception Health Care Tool
A clinical tool from the Centre for Effective Practice that supports health care providers in delivering evidence-informed preconception care.

Resource Guide for Clinicians
A clinician resource guide that supports evidence-informed preconception care, with practical tools tailored to a patient’s pregnancy intentions.

Reproductive Planning Quick Conversation Guide – A 60-Second Tool for Routine Visits
A brief clinician tool with practical prompts to start routine conversations about pregnancy intentions, readiness, support, and next steps in preconception care.

Webinar:

Preconception Care – Laying the Foundation for a Healthier Future
A free, 9-lesson FIGO webinar that highlights the latest recommendations on preconception care and its role in reducing health risks and supporting healthier pregnancies.

Printable Posters

The SOGC has developed new preconception posters (11X16)  for health care providers to display in their clinics, helping raise awareness and support informed conversations with patients.

Preconception Health - Thinking about having a baby now, later, or not at all?

Download

Preconception Resources for Patients

Websites:

Getting Started: Why Health Before Pregnancy Matters
An SOGC resource for preconception health, fertility, and pregnancy planning, with evidence-based information to help people prepare for a healthy pregnancy.

Planning your pregnancy
An NHS resource that provides practical information on planning for pregnancy, including steps people can take to support a healthy pregnancy before conception.

Good Health Before Pregnancy: Prepregnancy Care
An ACOG patient resource that explains prepregnancy care and the steps people can take before conception to support a healthy pregnancy.

Podcasts:

The Fertility Sisterhood: Cleaning Up Your Lifestyle for Future Generations
A podcast hosted by Dr. Carmen Messerlian, a Harvard epidemiologist and fertility expert, and Lara Messerlian that explores how lifestyle and environmental exposures may affect fertility and pregnancy planning.

Preconception Checklist: A Guide to Healthier Pregnancy with FIGO
A discussion on the FIGO Preconception Checklist that highlights key factors influencing pregnancy outcomes, including nutrition, supplementation, lifestyle, vaccination, and pre-existing conditions.

Tools and Resources:

Preconception Health Guide
An SOGC-developed practical guide to help people prepare for pregnancy by identifying steps they can take to support their health before conception.

Thinking about a family – now or later?
An SOGC and AMMI Canada resource that provides a general overview of preconception health and key steps people can take to prepare for a healthy pregnancy.

Sorting Fact from Fiction in the Preconception Period
An SOGC and Canadian Public Health Association resource that addresses health misinformation before pregnancy and supports informed preconception decision-making.

Your Reproductive Future
An SOGC resource that highlights the importance of family and spousal support before pregnancy and how supportive relationships can contribute to preconception well-being.

My Reproductive Life Plan
A Best Start resource that helps people create a reproductive life plan by reflecting on their goals, health, fertility, and future pregnancy intentions.

The Society of Obstetricians and Gynaecologists of Canada (SOGC)