Background Preconception care is well situated within primary care settings where pregnancy intention and preconception risk screening can occur routinely, along with coordinating preconception health interventions. Implementing preconception care into primary care practices has been challenging, as health professionals report multiple barriers preventing effective preconception care. A clearer insight into the scope of preconception care within Australian primary care settings is needed. Therefore, this study aimed to explore the beliefs and attitudes towards preconception care and describe the preconception care practices of general practitioners, midwives, and naturopaths in Australia to identify opportunities for preconception care. Methods This study employed a qualitative methodology involving interviews and focus groups with primary care health professionals (n=18) in clinical practice (> 5 years) within Australia. General practitioners (GPs) (n=6), midwives (n=5), and naturopaths (n=7) were recruited through professional organisations between May and August 2021. The fieldwork explored participants beliefs and attitudes towards preconception care and their preconception care practice behaviours. A thematic framework approach applicable to health services research was employed for data analysis. Results The analysis identified three key themes about the participants perspectives on providing preconception care: Preconception health requires a population-level focus across the life stages (subthemes: public health focus on preconception health and care is insufficient, more public information on preconception health and care is needed, and public education on preconception health and care requires a life course approach), Men are being overlooked and women carry the burden of responsibility in preconception care (subthemes: men lack awareness of their role in preconception care, men are not usually a part of preconception care consultations, men have unique needs and require different approaches to engage in preconception care, and women are carrying the burden of responsibility in preconception care), and Coordination of preconception care among primary care providers (subthemes: GPs as primary care providers of preconception care, health professionals other than GPs as providers of preconception care, and health professionals other than GPs want greater coordination of preconception care). Conclusions Health professionals have identified that making the public more aware of preconception health and aligning clinical care and public health initiatives are important. Health professionals should think more carefully about engaging with men in preconception care. Encouraging men to participate in preconception care requires different information and approaches. While GPs are positioned in the healthcare system as responsible for the coordination of care, there are potential contributions to preconception care that other health professionals can make due to their position in the healthcare system, their skills and the populations they service. A complementary and collaborative whole healthcare system approach to preconception care is needed and may provide more opportunities to deliver preconception care to improve reproductive outcomes. Keywords Preconception care, primary care, health professionals, opportunities, qualitative study, Australia

AS has received funding from the Naturopaths and Herbalists Association of Australia for a research project unrelated to this topic.

This research was funded by a project grant from Endeavour College of Natural Health (Grant approval number: PRO19-7927). The first author, CC, received an Australian Government Research Training Program Scholarship. DS is supported by the National Institute for Health and Care Research (NIHR) through an NIHR Advanced Fellowship [NIHR302955] and the NIHR Southampton Biomedical Research Centre [I NIHR203319]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. AS is supported by an Australian Research Council Future Fellowship (FT220100610). Funding from Endeavour College of Natural Health supported the costs associated with the promotion of the study for participant recruitment and participant incentivisation and reimbursement for participation.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The research was approved by the University of Technology Sydney Human Research Ethics Committee (ETH20-5547).

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

The datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request.