What Is Pre-Pregnancy Counselling?
A consult with a doctor to discuss and plan for pregnancy is called pre-pregnancy counselling. Unplanned pregnancies lose out on the benefits of pre-pregnancy counselling.
What Are the Benefits of Preconception Counselling?
- Preconception counselling will help patients understand how pre-existing health conditions will affect conception and pregnancy.
- Women and their partners will be advised on how to prepare for pregnancy.
- Management of long-term health issues will be discussed.
- Preconception counselling will help identify couples who could possibly have babies with genetic conditions. The couple will also be counselled so that they can make informed decisions.
Advice for All Women
Timing of Pregnancy
Couples having regular sexual intercourse and not using contraception have over 80% chance of getting pregnant within one year. But women become less fertile as they get older.
Folic Acid
400 mcg/day is the advised dosage for women who are trying to become pregnant as well as for women in the first trimester of pregnancy. This helps minimize the risk of neural tube defects.
An increased dose of 5 mg/day might be prescribed for women who have an increased risk of neural tube defects.
Women should not rely only on diet for adequate folic acid intake.
Diet
Eating five portions of fruits and vegetables per day and consuming food rich in iron, calcium and vitamins is important.
Women should avoid the following:
- Meat, fish and eggs that aren’t well-cooked
- Unpasteurized milk
- Unripened soft cheese
- Unwashed fruits and vegetables
- Fishes with increased mercury content
- Liver and liver products
Exercises
- Regular exercise is very important
- Avoid high-impact sports, demanding racquet sports and scuba diving
Body Weight
Maintaining optimal weight is advised. Overweight or obese women should lose weight to avoid health complications. If women are underweight, getting pregnant might be difficult and the risk of complications too is higher.
Alcohol and Smoking
It is best to avoid alcohol and smoking throughout pregnancy as there is an increased risk of miscarriages, fetus growth restriction, facial anomalies, behavioural problems, premature birth, stillbirth (born dead) and sudden infant death.
Rubella
- Testing for immunity, and vaccinating if not immune, is very important as infection in 8-10 weeks of pregnancy can harm the baby.
- Women are advised not to get pregnant for a month after vaccination.
Medication Review
- Women on medications for other medical conditions should consult the doctor and may require a change in medication.
- The risks and benefits of taking medication while planning for pregnancy should be discussed and reviewed.
- There is little or no information on herbal medicines available.
- Avoid taking fish liver oils and supplements containing more than 700 mcg per day.
Risk from Environment
- Wash hands after gardening and avoid cleaning cat litter.
- Read product labels and warnings before using products.
- Avoid radiation exposure.
- Avoid exposure to hazardous chemicals.
Advice for Older Women
Nowadays, more and more women are choosing to get pregnant when they are older. While supporting them in what they choose, they should also be made aware of the associated health risks.
Older age is associated with difficulty in getting pregnant, increased risk of miscarriages, Down’s syndrome, twins, hypertension, diabetes in pregnancy, problems during labour and risk to the fetus.
Dr. Shruthi Sreedhar
Consultant Obstetrician and Gynaecologist,
Kauvery Hospital, Chennai
