Background Pregnancy preparation, to establish a healthy lifestyle within the preconception period, has been shown to reduce adverse maternal and neonatal outcomes. Despite its importance, we know very little about if and how people prepare for pregnancy in the UK. Methods As part of the P3 study, women in the UK were invited to complete an online survey about pregnancy preferences, including the Desire to Avoid Pregnancy (DAP) Scale. 274 participants were currently trying, thinking, or maybe thinking about getting pregnant and were asked about pregnancy preparations. The changes that women, and their partners, made in preparation for pregnancy, reasons for not preparing, and associations with sociodemographics were investigated in univariate and multivariate analyses. Results Of the 274 women, less than half (n=134, 49%) reported making any changes in preparation for pregnancy, with the most common changes being ′eating healthier′ (55%) and ′folic acid′ (54%). The main reason for not preparing was ′only thinking about getting pregnant′ (38%). 92 women answered questions about partner preparations; only 24% of partners were preparing, with the most common changes being ′eating healthier′ (64%) and ′reducing alcohol′ (50%). The main reason for partners not preparing was ′already healthy′ (51%). DAP score was the only significant factor affecting pregnancy preparation; every one-point increase in DAP score reduced the odds of a woman preparing for pregnancy by 78% (OR 0.22, 95%CI 0.15-0.34). Conclusion Interventions addressing pregnancy preparation for women, and their partners, are needed. These strategies should target women thinking about pregnancy, to ensure the full benefits of preconception care are received.

The authors have declared no competing interest.

The study was funded by an NIHR Advanced Fellowship held by JH (PDF-2017-10-021).

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