Objective: To assess the awareness, opinions on desirability and preconditions such as special knowledge with regard to the concept of preconceptional health counselling among general practitioners.
Design: Descriptive.
Setting: General practices in the Groot Gelre district of the Dutch General Practitioners Society.
Method: A representative sample of 100 general practitioners were asked by phone for permission to send a questionnaire; 89 out of the 94 general practitioners who were sent a questionnaire replied (response: 89%).
Results: Almost all general practitioners (88%) knew about the concept of preconceptional health counselling and most of them already gave some kind of preconceptional advice. 93% considered preconceptional health counselling part of their job responsibility and 91% were prepared to give more preconceptional health care in the future. 53% of all general practitioners, however, indicated that they lacked sufficient knowledge to give adequate advice. The advantages of preconceptional health care were considered to outweigh possible disadvantages such as medicalization of pregnancy.
Conclusion: The general practitioners knew about preconceptional health care and considered it part of their job. Many already provided preconceptional health care, although not in a structured way. General practitioners appeared to lack time and appropriate knowledge, which indicates a need for postgraduate training.
PIP: In April and May 1997, a total of 100 general practitioners (GPs) in the Groot Gelre district of the Dutch General Practitioners Society were surveyed by phone for permission to send a questionnaire. 89 of 94 GPs who were sent a questionnaire replied, yielding a response rate of 89%. 78 of 89 GPs (88%) knew about the concept of pre-pregnancy health (PH) counseling and most of them already gave some kind of preconceptional advice (98% about folic acid, 93% about smoking, 88% about alcohol, 94% about various other substances, and 73% about the prevention of infections--toxoplasmosis, rubella). 87% of GPs questioned the patients about hereditary/congenital diseases that the child might inherit, 76% about hereditary diseases in the family, and 62% about diabetes. Less frequently occurring hereditary diseases were much less often asked about, such as Huntington's disease (14%), cystic fibrosis (19%), and hemophilia (14%). If the woman expressed the desire to have a child, 25% of GPs took an expanded case history. If a GP indicated a risk factor with regard to a potential pregnancy, 75% of them identified the possible consequences and informed the patient about them. 93% considered PH counseling part of their job responsibility and 91% were prepared to provide more PH care in the future. 53% of all GPs, however, indicated that they lacked sufficient knowledge to give adequate advice. The advantages of PH care were considered to outweigh possible disadvantages, such as medicalization of pregnancy, according to 74% of GPs. GPs appeared to lack time and appropriate knowledge, which indicates a need for postgraduate training.