Background:
In the past five years the interest in preconception care has been growing considerably in the Netherlands. With over 80% planned pregnancies, the government is looking for ways to better prepare future parents for the actual pregnancy. In addition, several independent preconception care projects have been launched.

Objectives:
This increasing interest led the Minister of Health to ask the Health Council of the Netherlands for advice on scientific state of the art and issues around the organisation of preconception care in the Dutch health care system, characterised by a “gate keeping” general practitioner and a compulsory basic health insurance, the content of which is determined by the Ministry of Health.

Methods:
A multidisciplinary committee developed a search strategy in collaboration with the Dutch Cochrane Centre, focusing on preconception care and systematic reviews. Thus, in principle only evidence of the highest level was included in the report. Based on the expert opinion of the committee subjects with lower evidence levels were included as well.

Results:
The resulting report gives an overview of the scientific state of the art with respect to nutrition, smoking and substance abuse, occupational hazards, diseases and medication and genetic factors, all specified to the preconception phase of reproduction. In addition, ethical and legal issues are discussed.

Conclusion and implications for practice:
Based on the scientific evidence and ethical considerations, the committee concludes that preconception care can no longer be withheld from women and couples who want to become pregnant. The committee recommends a national program for preconception care, in which several components (information, advice and, when appropriate, intervention on lifestyle, chronic disease, medication, hereditary factors etc.) are integrated. Furthermore, the committee recommends structural funding and a central coordination of the program, including monitoring and research. Coordination of the actual care could be done on a regional level.