Preconception counselling: Tips for pregnancy health

Thinking of starting a family? That's great news! Pregnancy is a beautiful journey and a new addition to your family can bring so much joy to your life. But before you embark on this new phase, it's important to consider preconception counselling. Don't worry, it's not as complicated as it sounds. Preconception counselling is an assessment of your overall health and involves making important changes in your lifestyle so that your body is prepared for a healthy pregnancy.

You can think of it as a friendly chat with your doctor to ensure you're in the best shape possible before you get pregnant. Let's break it down in the easiest way possible, shall we?

Preconception care is all about the healthcare advice and guidance that you receive before getting pregnant. The aim of preconception care is to support a healthy pregnancy and reduce the risk of complications for both you and the baby.

Preconception care includes lifestyle changes and medical check-ups, all working towards creating the best conditions for conception and the baby's development.

Now, let's talk about what goes into preconception care. It's not just one thing, but a combination of different steps that work together to get you pregnancy-ready:

• Health Check-ups: Your obstetrician and gynaecologist (OB/GYN) review your health history to identify any conditions that could affect your pregnancy. This includes conditions like diabetes and hypertension.
• Immunisations: Certain vaccines, like tetanus and rubella, protect you and your future baby from harmful diseases.
• Vitamins and Supplements: Folic acid is essential. The World Health Organization (WHO) recommends 400 micrograms (μg) of folic acid every day from the moment you start trying to conceive until 12 weeks of pregnancy.  
• Nutritional Planning: A balanced diet supports a healthy pregnancy and helps manage your weight.
• Understanding your Cycle: Knowing your cycle's length and fertile days improves your chances of conceiving.
• Avoiding Harmful Substances: Quitting smoking, cutting alcohol, eating well and exercising regularly prepares your body for pregnancy.
• Genetic Counselling: Knowing your family's medical history helps identify genetic risks and gives useful guidance for family planning.

Each of these components plays a crucial role in preparing your body for pregnancy. Let's dive deeper into the two key aspects: your medical history and lifestyle modifications.

Medical History and Health Assessments

One of the first things your doctor will do is take a thorough look at your medical history. This includes:

• Chronic medical conditions (like diabetes or hypertension)
• Previous pregnancies and their outcomes
• Family history of genetic disorders
• Immunisation status
• Current medications

Your doctor might also recommend certain tests. For example, they might check your rubella immunity, as contracting rubella during pregnancy can lead to serious birth defects. They might also screen for sexually transmitted infections (STIs) like HIV, syphilis, and hepatitis B, which can affect your pregnancy and your baby if left untreated. These assessments ensure that your body is ready for pregnancy and help identify any issues that need treatment before you start trying to conceive.

Lifestyle Modifications

Lifestyle changes can improve fertility in both you and your partner. After assessing your health, your doctor may recommend some adjustments. Simple routine changes can have a positive effect on your well-being. For example:

• If you're taking any teratogenic medications (drugs that can harm a developing foetus), your doctor might suggest safer alternatives.
• If you have a chronic condition like diabetes, they will work with you to achieve the best possible control before pregnancy.
• If you're overweight or underweight, they will help you develop a plan to reach a healthy Body Mass Index (BMI).

Modifying your lifestyle is not a difficult task.

• Maintaining a balanced diet rich in fruits, vegetables, and whole grains is also essential, as it supports fertility and overall health.
• Regular physical activity, such as walking or light exercise, helps manage weight and keeps the body active.
• Additionally, managing stress through relaxation techniques like yoga or meditation helps create a positive environment for conception.

You might be wondering, "Is all this really necessary? Can't I just get pregnant and figure it out later?" Well, here's the thing – preconception counselling is incredibly important because it sets the stage for a healthy pregnancy and a healthy baby. The American Academy of Family Physicians (AAFP) emphasises that preconception care can reduce maternal and foetal morbidity and mortality.

Preconception counselling is important because:

• It lowers the risk of infant and mother mortality
• It helps prevent complications during pregnancy
• Prevents stillbirth, preterm labour and preterm births
• Lowers the risk of low birth weight or neonatal infections
• Reduces the chances of children getting type 2 diabetes and heart diseases later in life.

Is it important to make your schedule for preconception early? Yes, you should schedule a preconception appointment at least three months before you plan to conceive. It will give you enough time to address any health concerns, make necessary lifestyle changes, and ensure your body is ready to conceive.

However, it's never too late to start taking care of yourself. Even if you're already trying to conceive, scheduling a preconception appointment can still be beneficial.

Now that you have made up your mind to schedule preconception counselling, it's time to choose the right OB/GYN [obstetrician and gynaecologist doctor] for your pregnancy journey. Keep these below points in mind when making your decision:

• Ask your family and friends to recommend a good doctor. Find out what they liked about them.
• Check online reviews. Look for the comments highlighting the caring attitude and professionalism of the doctor.
• Set up an appointment. Having a face-to-face conversation before you start the consultation. It will help you understand their approach and attitude towards the patients.
• Communication is important. See how the gynaecologists you are considering communicate with the patients. Are they compassionate or not?

You should find a doctor with whom you feel comfortable discussing your concerns.

Certain infections, like rubella, are harmful to the mother and the baby. At your preconception visit, your doctor may ask you to get vaccinated for flu, tetanus, etc. after assessing your health. The Centers for Disease Control and Prevention (CDC) recommends several vaccines before pregnancy, including:

• MMR (Measles, Mumps, Rubella)
• Tdap (Tetanus, Diphtheria, Pertussis)
• Varicella (Chickenpox)
• Influenza (Flu)

Note: Other vaccines, like the flu jab, are also safe to receive during pregnancy. Consult with your doctor thoroughly during your preconception counselling session.

Now, let's talk about getting your body baby-ready! This involves two main aspects: nutrition and weight management, and avoiding harmful substances. Taking this step ensures that your body is in the best condition to support a healthy pregnancy.  Let us take a look.

Nutrition and Weight Management

Maintaining a healthy diet and managing weight are key preconception care factors. Include plenty of green vegetables, fruits, whole grains, and proteins in your daily diet along with folic acid supplements and other vitamins. They help prevent congenital disabilities. Your doctor will prescribe these to you. The American College of Obstetricians and Gynaecologists (ACOG) recommends:

• Taking 400 micrograms of folic acid daily
• Eating balanced meals
• Limiting caffeine intake to 200 milligrams per day
• Avoiding fish high in mercury

Keeping your weight within a healthy range is equally important, as being underweight or overweight can lead to fertility issues and pregnancy complications. Aim to maintain a healthy Body Mass Index (BMI) before pregnancy.

Avoiding Harmful Substances

Certain substances can harm your baby at the early stages of pregnancy or even cause fertility issues. Quit smoking and limit your alcohol intake if you are planning to have a baby. Smoking affects fertility and increases the risk of premature birth, while alcohol can lead to developmental problems in the baby.

Additionally, you should avoid exposure to toxic chemicals. Making these changes at early stages creates a healthier environment for conception and pregnancy.

And there you have it – your guide to preconception counselling! Preconception care is the first step that you can take if you are planning to get pregnant. Remember, every woman's journey to motherhood is unique. What's important is that you're taking steps to be as healthy as possible. You're already being a great mum by thinking about these things now.

If you have any questions or concerns, don't hesitate to talk to your doctor. They're there to help you on this exciting journey. Wishing you all the best as you prepare for the amazing adventure of motherhood!