Pregnancy Planning, Prevention and Risk Evaluation Clinics: Rethinking the Traditional Preconception Consult.

Overview

The preconception consultation has traditionally centered pregnancy as desired and preordained. Separating preconception and contraceptive visits burdens patients and further fragments reproductive healthcare. We argue that the creation of a combined preconception and complex contraception clinic for individuals with significant medical and obstetric comorbidities is one approach to promoting reproductive autonomy. Pregnancy planning, prevention, and risk evaluation (PrePPARE) clinics are designed to review pregnancy related risks in the setting of patients' medical and obstetric comorbidities, recommend strategies to reduce risks, and, if desired, provide contraceptive methods. Consultations for pregnancy risk evaluation and pregnancy prevention should not be considered mutually exclusive. Combining these visits is critical for obstetrically and/or medically complex patients. Rethinking the traditional preconception consultation is a change in healthcare delivery that centers comprehensive reproductive healthcare.