Family Physicians to Increase Preconception Counseling

New position paper urges family physicians to counsel men and women

Friday, February 26, 2016

Megan Moriarty
American Academy of Family Physicians
(800) 274-2237, Ext. 6052

LEAWOOD, Kan. — Family physicians should consider more frequent preconception counseling for men and women. That’s the message of a preconception care position paper recently released by the American Academy of Family Physicians.

The AAFP’s preconception care position paper argues that preconception care -- individualized care that is focused on reducing maternal and fetal morbidity and mortality, increasing the chances of conception when pregnancy is desired, and providing contraceptive counseling to help prevent unintended pregnancies -- must be incorporated into routine primary care visits for women, and well-man visits.

If primary care physicians limit conversations about preconception care to well-woman visits, they may miss countless opportunities to discuss critical issues like family planning and pregnancy prevention, and leave men out of the conversation entirely.

“We sometimes hold these discussions until a patient comes in for an annual physical or well-woman visit, but for many patients, that could be too little, too late,” said Wanda Filer, MD, MBA, president of the American Academy of Family Physicians. “Family physicians conduct 214 million office visits every year. We’re in the perfect position to have these discussions on an ongoing basis, with women and men, and really impact the health of our nation.”

Data on infant mortality and women’s health show that the United States needs immediate action to reduce maternal and fetal morbidity and mortality, and prevent unintended pregnancies. The United States’ infant mortality rate is higher than the majority of other high-income countries and has remained relatively unchanged in the past decade. To make matters worse, U.S. women ages 18 to 44 have numerous risk factors that can negatively impact maternal and infant health; approximately five out of 10 of these women are overweight or obese, nearly two out of 10 are smokers, one out of 10 have hypertension, and three percent have diabetes. Individualized preconception care can educate women about how these risk factors can negatively impact pregnancy, and help them reduce their risk factors as they prepare for pregnancy.

Not only do we need to incorporate preconception health into routine visits for women who desire pregnancy, we must routinely encourage women to seek effective forms of birth control to prevent unintended pregnancies, which account for more than five out of 10 pregnancies.

“Preconception care is really about education and preparation. If I have a patient who wants to become pregnant, I need to start counseling her sooner rather than later about the changes she can make right now to ensure that she has a healthy family,” said David O’Gurek, MD, a member of the American Academy of Family Physicians’ Commission on Health of the Public and Science, and chairman of the workgroup that created the preconception care position paper.

“We can’t leave men out of this equation. A man’s lifestyle and health can have a tremendous impact on his partner’s pregnancy,” said Daniel Frayne, MD, assistant residency director, Mountain Area Health Education Center Asheville Family Medicine Residency Program and a member of the preconception care position paper workgroup. Frayne is also co-chair of The National Preconception Health and Health Care Initiative.

 Patient-facing information on pregnancy and fetal health is available at


Founded in 1947, the American Academy of Family Physicians represents 134,600 physicians and medical students nationwide, and it is the only medical society devoted solely to primary care.

Family physicians conduct approximately one in five of the total medical office visits in the United States per year – more than any other specialty. Family physicians provide comprehensive, evidence-based, and cost-effective care dedicated to improving the health of patients, families and communities. Family medicine’s cornerstone is an ongoing and personal patient-physician relationship where the family physician serves as the hub of each patient’s integrated care team. More Americans depend on family physicians than on any other medical specialty.

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