WOW Health | Gynaecology

Preconception Counseling & Care

When a couple is seen and counseled about pregnancy, its course and outcome before pregnancy actually starts is called preconception counseling. Unfortunately due to lack of awareness, a majority of pregnancies are unplanned, and only few people avail this facility.

The objective of this is to ensure that a woman enters pregnancy with optimal health which is best for her and her baby. During this examination, any risk factor that could affect both mother and baby is identified and at the same time care is provided to reduce or eliminate it.

If someone is planning for a pregnancy, it is a good idea to have preconception counseling. Most of the baby’s major organs and system complete their development by 10 weeks. Mother’s health and nutrition can affect this initial crucial development. Therefore, it is essential to correct it before embarking on pregnancy. This opportunity is lost if they plan to come for health check up only after they are pregnant.

During this visit a detailed history of the couple which includes their medical, personal, family and obstetrical history is taken. This helps in identifying any risk factors they have. Keeping that in mind, a thorough physical examination and relevant investigations are done and care is provided.

Optimal weight, blood pressure, hemoglobin level are all necessary for a normal pregnancy. Patients with medical complications can be educated about the effects of the disease on pregnancy and also effect of pregnancy on the disease. In extreme condition pregnancy can be discouraged. Pre-existing chronic disease (hypertension, diabetes, epilepsy) are stabilised in an optimal state. Drugs used before pregnancy are verified and changed if required avoiding any adverse effect on the formation of baby.

If someone has history of some inheritable disease, chances of passing that to the offspring can be discussed and arrangement for early detection can be done,
Women can be urged to stop smoking and drinking alcohol and change any risky behaviour. If she is not immunised for rubella, hepatitis, she has time to have these done.

Most important, thyroid dysfunction can be corrected before pregnancy and Folic Acid supplementation can be given to the would be mother. Both can affect the brain development of the baby.
Everyone wants to have a healthy baby. A time mother should also remain healthy throughout pregnancy and after it is over. Preconception counseling definitely increases chances of both.

Dr. Veena Shrivastava is a Professor in the Department of Obstetrics and Gynaecology, Nepal Medical College and Gynaecologist in Nepal International Clinic. Send her your queries at