The papers in this special issue explore a range of issues and opportunities across the spectrum of sexual and reproductive health in primary care, including in relation to contraception access; support for unintended pregnancies; abortion care; preconception, pregnancy, postpartum and interconception care; and issues relating to informed consent. The special issue takes a reproductive life course perspective through consideration of both pregnancy prevention and pregnancy preparation.

Interconception care improves women’s postpartum journey, their health outcomes and the health of their future pregnancies and children. This scoping review examines models of interconception care delivered around the world at scheduled well-child visits, to determine the benefit combining these services can have for women and children, and the acceptability and feasibility of doing so. The review concludes that there is significant benefit for postpartum women to receive interconception care at well-child visits; however, time, funding and educational barriers may prevent successful implementation of this model of care.

The preconception period refers to the period before a woman becomes pregnant and there is evidence that maintaining optimal health during this period is important for the mother and baby. General practices in Australia are an appropriate setting to provide preconception care, which involves providing education to help improve health during the preconception period. In this article, we discuss the factors that hinder preconception care provision in Australian general practices and make recommendations on how access to preconception care services can be broadened in Australia, including the potential opportunity for general practice nurses to contribute to the provision of preconception care.

LARC uptake is low in Australia compared with less effective contraceptives. The ACCORd study found that GP online education and availability of rapid referral to LARC insertion clinics results in increased IUD uptake by women. In contrast to implants, few GPs insert IUDs. Most women will have their IUDs inserted in rapid referral clinics when these are made available. Establishing a network of such clinics could address training needs and increase LARC uptake in Australia.

Access to postpartum contraception can reduce unintended pregnancies and enhance interconception health. Findings from our study suggest there is no consistent provision of postpartum contraception counselling to women; however, women are interested in receiving this both antenatally and postnatally from GPs and midwives. Contraceptive uptake in the postpartum period may be promoted by ensuring consistent and routine provision of contraceptive counselling for women antenatally and postnatally by their maternity carers.

Most oral contraceptive pills (OCPs) require a doctor’s prescription in Australia, however, there are many models of over-the-counter (OTC) pharmacy access that have been successfully trialled internationally. This study produced new knowledge detailing women’s perspectives of OTC access to OCPs in Australia, in addition to describing their preferred attributes of different OTC models. Findings on women’s concerns with OTC OCP access (and how to address them) can shape any future OTC OCP trials in Australia.

Rural women in Australia are more likely to experience unintended pregnancy, yet little is known about how well local primary care services meet their needs. Our findings confirm rural women have clear, but often unmet expectations of the local care they receive, including provider knowledge about all pregnancy and contraception options, time efficiency, choice and aftercare. Improvements to rural reproductive health involve not only removing access barriers, but better equipping local rural primary care providers to offer woman-centred care.

Access to publicly funded abortion in Australia is limited, and there are no nationally reported data on service availability. Despite few remaining legal restrictions to abortion, this study found that many regions across Australia either do not have public abortion services or do not provide information about them. There is an urgent need for transparency around public abortion and commitment from State and Federal governments to expand the availability of accessible, no-cost abortion in Australia.

Around one-third of Australian women presenting to antenatal care report their pregnancies are unintended. Primary care is uniquely placed to prevent unplanned pregnancies and optimise preconception care, and the One Key Question® (OKQ®) is a tool that has been developed to facilitate this. General practitioners felt the OKQ® was easy to use and were comfortable using it, and patients generally found the screening tool to be acceptable and that it was applicable to their general health.

This study used data from two online surveys to understand how perinatal services relating to the prevention of vaccine-preventable diseases (influenza, pertussis and chronic hepatitis B) are delivered to pregnant women and their infants in Victoria, Australia. It provides knowledge and insights into system-level service delivery gaps for pregnant women and their infants. Coordinated and standardised care delivery improvements are required to reduce the burden of vaccine-preventable infections during pregnancy and in early infancy.

The increasing cultural and linguistic diversity of Australian society necessitates a better understanding of the practise of cross-cultural medicine. The findings from this study suggest that accepted Western culture-based practices for obtaining informed consent cannot be universally upheld as ideals. Practical insights from this paper help to inform Australian clinicians on how to optimise cross-cultural informed consent with women born in Burma.