A report calling for would-be parents to consider delaying a pregnancy if they are stressed, dependent on drink or drugs, obese or affected by domestic violence, has been hailed by a leading US health expert.
Dr Sarah Verbiest, executive director of the Centre for Maternal and Infant Health at the University of North Carolina, said the study could make Scotland a world leader in pre-conception health.
Dr Verbiest, who is also a senior advisor to the US Centre for Disease Control, said: "If taken seriously and translated into action, this report has the potential to improve the health of generations of Scottish children, young adults and families, while setting a high bar of achievement internationally.
"I predict it will put Scotland on the map in terms of preconception health, education and care."
The report by Dr Jonathan Sher, an author and former policy director of Children in Scotland, reviewed international research on improving child health and concluded that in many pregnancies, harm has already been done to the child before advice is sought from medical professionals - and in many cases before conception has even occurred.
He is calling for a wide range of agencies, including NHS doctors and nurses, but also youth clubs, schools and churches, to be part of a push to change the culture so that people who may have a baby are asked regularly about their intentions and advised on any improvements they could make to ensure a potential child has the best chance of help.
He described most couples as "stunningly unprepared" to increase their chances of a healthy pregnancy, but said he did not want to shame or hector those considering a pregnancy.
Calls to focus on the period before pregnancy are gaining increasing attention around the world, including in the US where the CDC runs a national preconception healthcare initiative.
However Dr Verbiest said Dr Sher's report had done a "beautiful job" of presenting key issues in a readable manner, and added: "As highlighted in this report a variety of agencies, professionals and organisations addressing the social determinants of health is critically important for lasting change to occur."
The approach has also been backed by Scotland's Chief Medical Officer Dr Catherine Calderwood, who said the Scottish Government was actively looking at the issues. She said: "The Scottish Government has been clear for some time that preconception is an important period to focus on, in terms of improving diet and nutrition status. The emerging evidence, highlighted in Dr Sher’s report, has strengthened that view and creates an opportunity to focus on this period over the next five years of our Maternal and Infant Nutrition Framework."
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