Background:
North Carolina must focus on preconception health as the state is challenged with high rates of poverty, smoking, obesity, sexually transmitted infections, and with health disparities. A team of public health partners, including the North Carolina Division of Public Health, the March of Dimes, the UNC Center for Maternal and Infant Health, and national leaders in preconception health, have come together to improve women's and infants' health. North Carolina has reiterated its commitment to women's health before and in-between pregnancies as well as during pregnancy. An extensive data review of maternal and infant health indicators guides preconception health program planning in the state.

Objectives:
1. Learn about the process of developing a comprehensive, statewide preconception health plan in North Carolina. 2. Discover the challenges and benefits of developing a preconception plan with broad-based support.
3. Address preconception health issues in a systems-focused perspective.

Methods:
When the CDC Guidelines on Preconception Care were released, the North Carolina Folic Acid Campaign began the program planning process by commissioning a study of past and current preconception health work in NC entitled, "Looking Back, Moving Forward: NC's Path to Healthier Women and Babies," a 22-page booklet that provides an inventory of past and current preconception health activities, summarizes the CDC Guidelines, and presents ideas for action.

Results:
Following two statewide Think Tank meetings to gather and synthesize information on current preconception health work, all information was posted on the Web at www.mombaby.org so that all partners can participate in the planning process. Web postings include tools, meeting minutes, partners, and resources.

Conclusion and implications for practice:
Through this process, North Carolina has learned that preconception health program planning on the statewide level is a complex, time-consuming process. Partners are committed to an open, collaborative process which will result in a comprehensive plan with broad-based support. The goal is to develop and implement an evidence-based, comprehensive plan that can address needs in many areas for women's health in North Carolina and simultaneously improve birth outcomes.