Uncovering barriers to preconception care: perspectives of healthcare professionals through a Q methodology study

Despite the established benefits of preconception care for both mothers and babies, its widespread provision faces significant challenges. Preconception care encompasses a range of interventions aimed at optimizing a woman’s health before pregnancy. This can significantly improve pregnancy outcomes and the health of the child. However, various obstacles hinder the effective delivery of preconception care services. This study sought to identify these barriers from the perspective of healthcare professionals, specifically midwives and OBGYNs. To understand the challenges to preconception care from the perspective of healthcare professionals directly involved in women’s health, this study interviewed 34 health professionals, including 29 midwives and 5 obstetrics and gynecology specialists (OB-GYNs). The participants were purposefully selected from a range of public health centers and hospitals to capture diverse professional experiences. A total of 48 potential barriers to preconception care were initially identified through arrative literature review, gray literature and semi-structured interviews with midwives and OB-GYNs. These barriers were then rated by participants on an 11-point Likert scale ranging from − 5 (strongly disagree) to + 5 (strongly agree). The data were analyzed with PQMethod 2.35 software to identify key themes and shared viewpoints. The analysis revealed five clusters of barriers perceived by midwives. These included: Access and affordability (18%), Provider-related issues (11%), Sociocultural and organizational factors (8%), Lack of awareness and prioritization (7%), and Structural and socioeconomic inequities (6%). This study offers valuable insights into the multifaceted nature of barriers to preconception care. By identifying these key challenges from the perspective of midwives, this research can inform the development of targeted interventions to improve access to and quality of preconception care services.