Your role working with the public
Making every contact count
If you work with the public, then you have an important role to play.
You might have heard of the 'making every contact count' (MECC) approach to health and wellbeing. This simply means taking the chance, during any conversation you have, to talk about how people can make positive improvements to their health or wellbeing.
MECC uses the skills of asking questions and listening.
This does not mean every time you talk to someone you should talk about health and wellbeing, but it’s about spotting times when it could be good to do and recognising opportunities to talk to people about their wellbeing.
By including preconception health messages in regular appointments, people can start to understand the importance of pregnancy preparation.
Regular appointments can mean anything from dental check-ups and pharmacy consultations to housing and financial advice and social care appointments.
Consistent and repeated messages help to reinforce the importance of preconception health, making it a normal part of health conversations.
Providing leaflets and posters in your organisation means that people can find information about preconception health at their own convenience.
Joined Up Care Derbyshire offers support around making every contact count, through their quality conversations at Joined Up Care Derbyshire. The programme offers training and ongoing support to ensure quality communication across Derbyshire. It’s free for all staff across Derby and Derbyshire who work in primary care, community services, social care and voluntary Services.
By making sure that preconception health is linked into existing services, and emphasising the importance of planned pregnancies, we can improve health outcomes for parents and children, reduce health disparities and create a healthier future generation.
Promoting health equity
Giving everyone access to knowledge and resources to improve birth outcomes is essential for creating more equitable health outcomes across all Derbyshire residents regardless of their social or economic status.
Many communities in Derbyshire lack access to essential healthcare services, including reproductive health education and preconception care.
Making sure that everyone has equitable access to knowledge about preconception health is vital for improving the health outcomes of Derbyshire’s future generations.
When to promote preconception health
The period of reproductive health covers a wide age range, usually from 16 to 44 years.
Promoting healthy lifestyle choices during this time needs a careful approach, considering the various stages of life and related behaviours.
Reproductive health education starts in schools when children are around 10 years old and then builds on their knowledge year on year.
By understanding the specific challenges present at each life stage, we can create interventions that meet the needs of people at all stages of their reproductive life.
This ensures they are more effective, improve health outcomes, and encourage long-term healthy habits.
When to start talking about healthy habits
Adolescence
Adolescence is a time of physical, emotional, and psychological change.
During this stage young people are more vulnerable to peer pressure and may take part in risky behaviours, and unhealthy habits like smoking, poor diet, or substance abuse.
Concerns about body image and the need for independence can also affect health choices.
However, adolescence is also a great time to teach positive health habits that can benefit them throughout their lives, such as regular exercise, healthy eating, and managing stress.
Young adulthood
In this stage, people go through major transitions like starting a career, forming relationships, and thinking about family planning.
Time pressures, financial worries, and career demands can lead to unhealthy habits such as inactivity, poor diet, and stress-related health issues.
This period is ideal for promoting long-term health planning, especially around nutrition, mental health, and preconception care.
Preconception and family planning
At this stage, people may start planning for pregnancy. Health conditions, lifestyle factors like smoking or poor diet, and stress can affect fertility and pregnancy outcomes.
Access to healthcare and education about preconception health is crucial for ensuring a healthy pregnancy.
Preconception is a valuable time to make lifestyle changes that improve reproductive outcomes and reduce the risk of complications.
By promoting preconception health from the age of 10 and continuing through the reproductive years, and tailoring messages to different life stages, we can encourage healthier lifestyle choices and improve future pregnancy outcomes.
The impact of poor preconception health and key messages
Poor preconception health can negatively affect fertility, pregnancy outcomes, and the long-term health of both parents and child.
It is important to raise awareness about preconception health among those who are unsure about becoming pregnant (and so not actively preventing pregnancy).
Giving every child the best start in life involves addressing their physical, emotional, and developmental needs.
To reduce the risks of poor preconception health, several key messages should be shared with individuals of reproductive age, stressing the importance of preparing for pregnancy even before it is planned.
Being healthy before conception gives both the parents and baby the best chance for a healthy start in life and reduces the risk of complications.
Even if people are not planning a pregnancy, focusing on their health now can improve their chances of a healthy pregnancy in the future.
The choices people make today - like eating nutritious food, staying active, and avoiding harmful substances - can have a big impact on future pregnancies.
Encourage people to work on healthy habits now, even if they are not planning to get pregnant soon.
Improving preconception health
Preconception health is a woman's health before she becomes pregnant. It means knowing how health conditions and risk factors could affect a woman or her unborn baby if she becomes pregnant.
Barriers to preconception health
Challenges such as health literacy, lack of professional training, language barriers, and discrimination can make discussions about preconception health harder.
Engaging in conversations
You will need to approach preconception health discussions with sensitivity, framing it as part of routine care. This helps individuals reflect on their health and make informed decisions without pressure.
Motivational interviewing
Try to use open-ended questions, active listening, and reflection encourages a non-judgmental atmosphere where individuals feel supported.
Involving partners and family
Encouraging partners to participate in preconception health discussions creates a shared responsibility, benefiting both partners' health and future pregnancy outcomes.
Culturally sensitive approaches
Wherever possible, learn about the cultural norms and practices of the communities you serve and respect individual differences to build trust and improve communication.
Learn about the cultural norms, values, and beliefs related to reproductive health within the community you serve. This includes understanding traditional views on fertility, pregnancy, and family planning.
Many cultures have specific practices or beliefs surrounding conception and pregnancy. Be mindful that people may seek advice from cultural or religious leaders, rely on traditional medicine, or hold spiritual views about health.
Not everyone adheres strictly to cultural norms. It is essential to approach each person as an individual rather than making assumptions based on their cultural background.
Acknowledge that as a practitioner, you may not fully understand every aspect of a person’s culture and be open to learning from the individual or community.
Female genital mutilation and pregnancy
A midwife asks all pregnant women whether they have been cut regardless of their background or where they were born.
If someone you work with discloses that they have undergone FGM then there are additional things to consider. Some women with FGM may find it difficult to become pregnant, and those who do conceive can have problems in childbirth.
LGBT+
Find out about starting a family if someone Lesbian, Gay, Bisexual, Transgender, or Non-binary on the website: NHS - having a baby if you're LGBT+
Physical disability
If someone has a physical disability, they might need extra support when they are planning a pregnancy and during pregnancy. They should be advised to talk to their doctor about what they might need.
Information can be found on the website Birthrights - disability and long-term health conditions and maternity care.
If someone has a learning disability, they might need extra support when they are planning a pregnancy and during a pregnancy.
They should be advised to talk to their doctor about what they might need.
Action plan
When helping to achieve health goals, it is helpful to firstly think about small changes, for example, ask "What is one small change that could be made this month to improve their health?"
Provide resources, educational materials, and referrals to specialists or programs that can support their preconception health goals.
Ensure all information is in an accessible format and the correct language.
Consider people's 'health literacy'. The average reading age is between 9 and 11 years, so any information shared needs to take this into account.
Training and awareness for staff
Train staff, including non-clinical personnel, on the importance of health promotion and how to deliver key messages effectively.
Conduct awareness campaigns within your organisations to highlight the potential for health improvement in every interaction.
Referral pathways for specialised support
Your Sexual Health Matters
Your Sexual Health Matters provide sexual health information, clinical services with practical advice and support to people living in Derby. Email dchst.yoursexualhealthmatters@nhs.net or telephone 0800 328 3383.
Integrated sexual health service (Derby and Derbyshire)
Relationships and sexual health advice, free STI testing, contraception, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).
Brook
National Young Persons Sex and Relationships charity. They offer information and provide resources for relationships and sex education. Visit the Brook website.
Derbyshire Community Health Services (0 to 19 services)
The Derbyshire Family Health Service is delivered through the Healthy Child Programme. It offers a comprehensive programme of screening, immunisations, developmental reviews, information and guidance to support parenting and healthy choices which enhance a child or young person's life chances.
Visit Derbyshire Community Health Services -Children's services or the Derbyshire Community Health Services ( A-Z list of services).