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We welcome the opportunity to respond to the letter from Chingara et al 1 written in response to our recent article published in this Journal.2 We appreciate many of the important points raised by these authors including the need for preconception care to be embedded into routine clinical care. We completely agree with Chingara et al 1 that there is significant work to be done to better develop preconception health interventions and education tools, and to target these appropriately. Not only are many people using contraceptive methods that do not require a consultation with a healthcare professional to stop or remove them, many pregnancies in the UK are unplanned or ambivalent, and further work is also needed to understand this.3 Our article2 aimed to provide practical education in the interim for clinicians to provide opportunistic preconception care in sexual and reproductive health consultations which, while aspirational, we believe is achievable in this specific setting.