Womens Health

Preconception Counseling

Preconception counseling is now recommended for all women planning a pregnancy, especially those who have preexisting medical conditions. The main obstacle to preconception planning is the fact that not all pregnancies are planned. Nevertheless, whether you haven't yet reached the stage of trying to conceive or you've just found out that you're pregnant, you'll find useful some of the information below.

What's Involved?

The aim of preconception counseling is to give the mother the best possible pregnancy experience, to work towards an uncomplicated labor and delivery, and promote the health of baby and Mom post-birth. Couples are recommended to attend a preconception counseling appointment three to six months before they try to get pregnant. You may wish to attend up to a year before you start trying to conceive, particularly if you have some underlying health problems.

During preconception counseling, you'll be asked to provide blood and urine samples and answer questions about your lifestyle, family health history, and previous pregnancy history. If your relationship needs bolstering, you may be offered the chance to speak with a relationship advisor.

What Are They Looking For?

The medical professionals who offer preconception counseling are looking for anything that may cause problems either during your pregnancy, or for you or your baby after the birth. This doesn't mean, however, that if they find something abnormal they're going to tell you not to get pregnant. If testing does indicate some potential risks, your doctors will look for ways to eliminate or reduce those risks, in order to give your baby the best possible start in life. The type of things they are interested in are as follows:

Existing medical conditions (for example, diabetes or thyroid problems) - Have you been correctly diagnosed? Are your conditions well-managed? Do you need to change your medication routine? Will you require more/less or different medication during pregnancy? Do you have any undetected problems?

Potential fertility issues - do you have a regular menstrual cycle? Do you have any gynecological symptoms (irregular bleeding, abdominal pain, absence of periods)?

Your current use of contraception - are you taking the pill? Would you consider coming off the pill for a few cycles before trying to get pregnant? This will give your natural cycle a chance to reestablish itself. (Sometimes taking the pill can mask underlying gynecological issues - it's beneficial to have such problems investigated before pregnancy begins).

STDs - is there any possibility, no matter how small, that you could have an STD? If so, you should agree to screening and treatment, if necessary. Some STDs, such as Chlamydia, may present no symptoms but can impact on fertility. (Given that Chlamydia commonly lacks symptoms, people pass the disease on to others without knowing they that have it themselves - people even get married without realizing they have caught Chlamydia from a previous sexual partner).

Your Age - potential risks to your pregnancy, if there are any, change as you get older. Your preconception counselor will help you understand such risks, if they exist, and advise you as to how you can minimize them.

Lifestyle and relationship considerations - you'll be advised about diet, alcohol consumption, caffeine intake, exercise, drug use, medication use and anything that could influence your fertility and/or your pregnancy. If you need help to give up smoking, you can find out where to get support in achieving this. All these considerations will be relevant for your partner as well as to you, so both of you should attend these sessions.

But I'm Already Pregnant!

If you're pregnant but haven't gone for preconception counseling, there's no need to panic. Many of the considerations listed here will have already been taken into account by your doctor. If you haven't gone to see a doctor yet, do so as soon as possible. If you have reason to think your medical history or lifestyle may cause problems during pregnancy, be sure to raise this with your doctor and make sure he knows about any medical problems you already have. It's a good idea to make a list of your concerns before attending your appointment.

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