Abstract
The trend toward delayed parenthood is on the rise across Canada. Societal emphasis on attaining higher education, career advancement and financial security may be some reasons why individuals delay becoming a parent; whatever the reason, this trend is linked to significant health and economic impacts. Many Canadians are unaware of the impact this may have on their fertility and potential birth outcomes. It is important that health care professionals apprise individuals in their reproductive years about these issues and the steps they can take to mitigate these risks. Implementing a health equity and broader determinants of health approach through social policy development may also prove beneficial. Such upstream approaches could enhance maternal and child health outcomes, and also help ensure that people of reproductive age are making an informed decision about delaying parenthood. This article calls for developing a comprehensive preconception health promotion and care strategy encompassing individual, community and population level approaches.
Key Words: Preconception care, health promotion, public health, Canada, fertility, health knowledge, attitudes, practices
Résumé
La tendance à différer la condition parentale est en hausse au Canada. L’importance accordée par la société aux études supérieures, à l’avancement professionnel et à la sécurité financière pourrait expliquer pourquoi on retarde le moment de devenir parent; quelle qu’en soit la raison, cette tendance a d’importantes conséquences pour la santé et l’économie. De nombreux Canadiens et Canadiennes ignorent l’impact que cela pourrait avoir sur leur fécondité et sur les issues possibles de la grossesse. Il est important que les professionnels de la santé informent les personnes en âge de procréer de ces enjeux, et des mesures qu’elles peuvent prendre pour atténuer les risques. La mise en oeuvre d’une démarche axée sur l’équité en santé et sur les grands déterminants de la santé par l’élaboration de politiques sociales pourrait aussi s’avérer bénéfique. De telles démarches d’amont pourraient améliorer les résultats de santé maternelle et infantile et contribuer à faire en sorte que les personnes en âge de procréer prennent la décision de différer la condition parentale en connaissance de cause. Notre article préconise l’élaboration d’une stratégie globale de promotion de la santé et des soins préconceptionnels qui englobe des démarches individuelles, communautaires et populationnelles.
Mots Clés: soins préconceptionnels, promotion de la santé, santé publique, Canada, fécondité, connaissances, attitudes, pratiques en santé
Footnotes
Conflict of Interest: None to declare.
References
- 1.Statistics Canada. CANSIM Table 102-4503–Live Births, by Age of Mother, Canada, Provinces and Territories, Annual. 2013. [Google Scholar]
- 2.Statistics Canada. CANSIM Table 102-4504–Mean Age of Mother at Time of Delivery (Live Births), Canada, Provinces and Territories, Annual. 2013. [Google Scholar]
- 3.Ontario Ministry of HealthLong-Term Care, IntelliHealth Ontario. Ontario Live Birth Data. 2013. [Google Scholar]
- 4.Public Health Ontario. Snapshots: Ontario: Average Age of Mother at Birth. 2013. [Google Scholar]
- 5.Johnson J, Tough S. Delayed child-bearing. J Obstet Gynaecol Can. 2012;34(1):80–93. doi: 10.1016/S1701-2163(16)35138-6. [DOI] [PubMed] [Google Scholar]
- 6.Tough S, Benzies K, Fraser-Lee N, Newburn-Cook C. Factors influencing childbearing decisions and knowledge of perinatal risks among Canadian men and women. Matern Child Health J. 2007;11(2):189–98. doi: 10.1007/s10995-006-0156-1. [DOI] [PubMed] [Google Scholar]
- 7.Mills M, Rindfuss RR, McDonald P, te Velde E. Why do people postpone parenthood? Reasons and social policy incentives. Hum Reprod Update. 2011;17(6):848–60. doi: 10.1093/humupd/dmr026. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Ontario Public Health Association. Shift–Enhancing the Health of Ontarians: A Call to Action for Preconception Health Promotion and Care. Toronto, ON: OPHA; 2014. [Google Scholar]
- 9.Canadian Institute for Health Information. Patient Cost Estimator: Canada: Newborn/Neonate <2500 g & Gestational Age <37 wks. 2014. [Google Scholar]
- 10.Boggess KA, Berggren E. Preconception care has the potential for a high return on investment. Am J Obstet Gynecol. 2015;212(1):1–3. doi: 10.1016/j.ajog.2014.10.030. [DOI] [PubMed] [Google Scholar]
- 11.Richard-Tremblay AA, Sheehy O, Audibert F, Ferreira E, Bérard A. Concordance between periconceptional folic acid supplementation and Canadian clinical guidelines. J Popul Ther Clin Pharmacol. 2012;19(2):e150–59. [PubMed] [Google Scholar]
- 12.Choiriyyah I, Sonenstein FL, Astone NM, Pleack JH, Dariotis JK, Marcell AV. Men aged 15–44 in need of preconception care. Matern Child Health J. 2015;19(11):2358–65. doi: 10.1007/s10995-015-1753-7. [DOI] [PubMed] [Google Scholar]
- 13.Dubey V, Glazier R. Preventive Care Checklist Form©–Evidence-based tool to improve preventive health care during complete health assessment of adults. Can Fam Physician. 2006;52:48–55. [PMC free article] [PubMed] [Google Scholar]