Objective: To use routinely-collected maternity healthcare data to 1) describe the prevalence of key preconception indicators (e.g., smoking, folic acid supplement use) and 2) explore differences in prevalence by area-based level of deprivation. Design: Retrospective population-based study. Setting: Northern Ireland (NI). Population: 255,177 pregnancies recorded in the Northern Ireland MATernity System (NIMATS). Methods: Anonymised NIMATS data recorded during antenatal booking appointments (2011-2021) were accessed through the Honest Broker Service and analysed using R. Prevalences were calculated for each indicator, overall and based on deprivation quintile. Logistic regression models explored the relationships between each preconception indicator and area-level deprivation quintiles. Patient and Public Involvement and Engagement representatives helped prioritise indicators to include in the study, in conjunction with consulting the current evidence base, availability in NIMATS, and indicator modifiability. Main Outcome Measures: Preconception indicators, including behavioural factors (e.g., planned pregnancy), pre-existing health conditions (e.g., severe mental health), and area-based deprivation. Results: A high proportion of women had sub-optimal preconception indicators (e.g., 21.3% living with obesity). Women living in the most deprived quintile generally had a higher prevalence of risk factors than women in the least deprived quintile (e.g., smoking prevalence was 25.7% in the most deprived quintile and 5.6% in the least deprived quintile). Conclusions: Population-based maternity data in NI highlight many areas of women’s preconception health that require improvement and support, especially for women living in the areas of greatest deprivation. Findings are an essential reference point to inform interventions, policy, and ongoing monitoring of preconception health in NI.

Objective: To inform, develop and evaluate Beyond the Bump (BtB); an online program to improve access to education and support physical activity in the postpartum. Design, Setting and Population: Three-phase mixed-methods design before, during and following a 10-week Australia-wide online pilot program during COVID-19 with women in their first year postpartum and health professionals. Methods: Phase-one: needs assessment focus groups and interviews postpartum women and heatlh professionals. Phase-two: program implementation pre-post health measures survey, attendance and engagement in BtB. Phase-three: program evaluation feedback surveys and interviews. Main Outcome Measures: Identify postpartum educational support needs, barriers and enablers of program attendance and physical activity. Mental health symptoms, wellbeing health behaviours and physical activity levels. Results: Women and health professsionals expressed strong need for a postpartum program with access to expert education on exercise, pelvic floor, sleep and baby nutrition. Despite BtB being developed from womens suggestions (including time-of-day ‘morning’), attendance to all ten sessions was poor (23% (n = 162) participated in first session and 5% in the last session). Barriers to attendance included ‘too busy’,‘forgot’ and ‘topic not relevant for age of child’. 88% of women reported education as the most enjoyable part of the program. 100% of women interviewed would recommend the program to a friend. Conclusions: There is a continuing need for postpartum support. Online programs with access to expert education and exercise were of significant interest and value. However, more research is needed to improve the uptake and value placed on mothers’ wellbeing and physical activity.