Bid to fix preconception misconceptions about birth

Hundreds of women hoping to become mothers will participate in an Australian-first trial that aims to probe preconception health.

Sian Fourie at home in Melbourne: ‘I don’t think there’s really reliable information readily available’. Picture: Aaron Francis

Hundreds of women hoping to become mothers will participate in an Australian-first trial that aims to probe preconception health and its connection to birth complications and child health outcomes.

Health insurer Medibank has partnered with Monash University to conduct the OptimalMe study that will recruit 300 women aged 18-44, with issues such as weight management, folic acid and vitamin D levels, and physical activity levels under the spotlight.

The results of the study will look at how preconception health affects fertility, pregnancy complications including gestational diabetes, caesarean rates and neonatal admissions, and post-birth weight retention.

Medibank head of member health service design and strategy Catherine Keating said the insurer had noted in recent years its members were encountering more pregnancy complications, and wanted to explore the reasons. “We are seeing in our own data an increase in pregnancy and birth complications,” Dr Keating said. “Advice such as eating for two, which is still common in the Australian community, really may increase the risk for mothers and babies

“So Medibank’s goal, and the goal of the OptimalMe trial, is to offer women personalised advice and coaching to maintain a healthy lifestyle from when they are planning a pregnancy until after their baby is born.

“From a public health perspective, this is one of the most important times for investing in the health of Australians.”

Dr Keating said women remain confused about weight gain during pregnancy and what is healthy. A recent study revealed half of all women gain too much weight during pregnancy and a quarter gain too little.

Medibank’s data from 14,122 births in 2019 showed an increasing trend of pregnancy-related adverse health outcomes and gestational diabetes in one out of every eight pregnancies.

“We’ve also found out from customer research that women are finding it confusing and wanting more support around lifestyle approaches,” Dr Keating said.

Senior research fellow at the Monash Centre for Health Research and Implementation, Cheryce Harrison, said while women had close relationships with their doctors and caregivers on becoming pregnant, in the preconception period it could be extremely difficult to access women hoping to conceive. “Traditionally, women preconception are a hard-to-reach population,” Dr Harrison said. “We know preparing for pregnancy is often quite a private thing. Women are not necessarily signalling that they’re preparing for a pregnancy.”

But women often did contact their health insurer when thinking of having a baby to make sure they were covered. “We know, preconception, there’s a lot of information out there for women and they find it difficult to navigate, it can be very overwhelming trying to determine what’s evidence-based and what’s not.”

Melbourne woman Sian Fourie, 29, hopes to have a baby within the next year or so and is keen to participate in the study.

“You always hear about the pregnancy dos and don’ts but you don’t sort of hear much when it comes to preconception,” Ms Fourie said. “I can’t say that it’s really crossed my mind how important preconception would be in starting a family. I don’t think there’s really reliable information readily available.”

Dr Harrison said knowing more about health and wellbeing from the study’s pre-pregnancy group will have implications for all women hoping to have a child and pave the way for preconception support to become routine care in Australia. “It’s the first opportunity we’ve had to support women from preconception through to the delivery of their baby,” she said. “Supporting women to optimise healthy lifestyle behaviours before trying to conceive is the best way to start a pregnancy … Not only is it important for fertility, it increases the likelihood of healthy weight gain throughout pregnancy with benefits for both mother and baby.”