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Issue/problem Unplanned and unwanted pregnancies are an important issue in public health. Especially when parents already are in complex or vulnerable situations, for example being homeless, having an addiction, serious psychiatric- or financial problems or intellectual disabilities. Although most of these parents are in contact with several professionals, family planning and contraceptives are rarely discussed. Description of the problem In 2014 a pilot programme was developed to support vulnerable adults on family planning and adequate use of contraception. In a qualitative explorative case study the pilot was evaluated. Results The pilot showed a significant increase in postponed pregnancies by using appropriate contraceptives. Over eighty percent of this population started contraception on a voluntary basis. The study showed 5 determinants influencing contraception use: responsibility, knowledge, finance, emotion and social environment. If needed, the programme played a role on all different determinants. The method of working was the key element in the success: addressing family planning and contraceptive use through an outreach practise orientated presence approach and empowerment. Another important factor for success was the collaboration between public health and medical doctors. Lessons The successful pilot became regular care for vulnerable (potential) parents in Tilburg. The pilot was replicated in two other cities, Rotterdam and Nijmegen, with similar results. In 2018-2021 the programme will be implemented nationwide with financial support of the Ministry of Health, Welfare and Sports, coordinated by GGD GHOR Nederland (the Association of GGDs (Regional Public Health Services) and GHOR-(Regional Medical Emergency Preparedness and Planning) offices in the Netherlands). Key messages ‘Pregnant not now!’ successfully supports vulnerable people with family planning and contraceptives, helping them to gain control over their future and preventing unplanned and unwanted pregnancies. The programme is unique and preventive, its innovative character is applicable in other communities in the Netherlands and possibly across Europe.

Reproductive and contraceptive healthcare for vulnerable people in the Netherlands: Pregnant not now!