Women's preferences for interconception care: a discrete choice experiment study.

Abstract

Background: Interconception care (ICC), provided between pregnancies, can improve women's health, pregnancy outcomes and infant health. Women face challenges in accessing and prioritising ICC due to issues including caring roles, transport and clinician availability. We aimed to elicit women's preferences for ICC engagement.

Methods: A discrete choice experiment (DCE) was conducted to assess women's preferences about ICC. Australian women who had experienced pregnancy completed an online survey in March 2024 comprised of questions about sociodemographic characteristics, ICC attitudes regarding informational needs, healthcare professional involvement and service location. We used a mixed logit model to analyse DCE responses, willingness to pay estimates for different attribute levels and applied latent class modelling to explore preference heterogeneity. Free text responses were grouped by key ideas.

Results: From 191 responses, numbers were similar across age categories, 46% had experienced pregnancy loss, and 87% had a child/children. Respondents preferred ICC provided by a nurse/midwife, offered during home visits or in-person consultations with a child-friendly waiting area, with appointments lasting 30 or 60 min, and at lower costs. There were no strong preferences regarding appointment wait times. Respondents favoured consultations scheduled up to 1 year after delivery. Follow-up questions indicated that most identified informational needs about emotional and mental health support (74.3%) as important, midwives were a preferred healthcare professional (71.7%) and general practice was the most favoured ICC location (64.9%).

Conclusions: Ensuring clinician and setting familiarity, longer appointment times and lower appointment costs will support women's access to ICC. Policy and funding support are needed for ICC provision.