Interest in preconceptional healthcare was advanced by release of the recommendations of the Centers for Disease Control and Prevention (CDC) and its Select Panel on Preconception Care in 2006. With increasing interest, apprehension surfaced from healthcare professionals, women, and the public at large. The most common themes of concerns are that an emphasis on preconception care is pronatalist, unnecessary, exclusive of men, framed too narrowly, doomed to failure because of competing clinical demands and influences, and involves a vocabulary that is meaningless to the public. This article explores the themes and argues that none of them are fatal to moving forward with a preconception agenda-rather, they should stimulate thoughtful response, careful framing, and vigilance for unintended consequences related to restructuring the basic perinatal prevention paradigm from a prenatal care approach to a women's wellness model.