Background: Systematic reviews suggest preconception health interventions may be effective in improving maternal and infant outcomes. However, few studies have explored womens views on the types of support required for preconception health improvement, nor when and to whom this support should be provided. Methods: We purposively sampled women aged 18-48 years in the West of England from respondents to a survey, and conducted semi-structured in-depth interviews to explore their views on support needs in the preconception period and target populations for this support. We analyzed the data using a data-driven framework analysis. Results: The women we interviewed (N=20) broadly supported promoting greater awareness of preconception health and felt the limited focus on health before pregnancy downplays its importance relative to antenatal health. Some women opposed support services and structural interventions to improve preconception health, due to concerns these are less impactful than encouraging individual responsibility for health. Women who supported structural interventions highlighted broader determinants of health and socioeconomic barriers to preconception health improvement. Men were considered a key target population for preconception support, to help share the burden for preconception health improvement. Women broadly supported age-appropriate, school-based preconception health education, highlighting young women as an under-served group in need of additional preconception education. Conclusion: Our findings indicate a need to deliver early preventive support ahead of first pregnancy through services, interventions and policies co-produced with women and womens partners. Future research should explore how to increase public understanding of the socioeconomic, environmental and commercial determinants of preconception health.

The authors have declared no competing interest.

This work was supported in part by grant MR/N0137941/1 for the GW4 BIOMED DTP, awarded to the Universities of Bath, Bristol, Cardiff and Exeter from the Medical Research Council (MRC)/UKRI. This included funding for open access publication fees. The funding body had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.

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The South West-Frenchay Research Ethics Committee gave ethical approval for this work (reference: 19/SW/0235)

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