Abstract
Preconceptional health promotion is a proven strategy to impact reproductive outcomes. Despite energy to incorporate this prevention strategy into the care of women in this country, little evidence exists that the paradigm shift necessary to reframe the clinical care of women has occurred or that public awareness about critical opportunities for preventing reproductive casualties is high. This article reviews the rationale for preconceptional counseling, discusses progress in moving the agenda of prepregnancy wellness forward, and reveals some of the lessons learned from efforts to redesign prevention emphases for reproductive healthcare.