The Importance of Preconceptional Counselling

Rand Kitani and Dr Esha Chainani

Man and Woman Interlocking Index Fingers With Anchor Tattoos

Pregnancy is a wonderful journey for the partners and their families, therefore; it is necessary to have a pleasant experience.  To be ready facing any pregnancy-related complications and  make this journey enjoyable and amazing, it is always advisable to get preconception counseling from a family physician or a gynecologist.

Pregnancy is a long journey that lasts approximately  280 days, and it requires a lot of preparation with its many ups and downs.  Before planning to get pregnant, partners must have open communication and dialogue  about the new roles and responsibilities.  Career, family structure and lifestyle have changed a lot in  recent years, and therefore it may not be easy to accommodate a new responsibility. Pro-creation is a basic human instinct, and it can not be denied in spite of the pressure of our busy lives .As doctors, we will try to make this experience  comfortable and safe for you and  your new bundle of joy. .

Preconception counseling is also aimed to identify the behavioral and social risks  women face during and after  pregnancy. In the process of preparing for the pregnancy, certain lifestyle modifications are required and necessary to be made, such as quitting  smoking and substance abuse. These behaviors and substances  have  a direct toxic effect on the health of  the expecting mother and her unborn baby. Hectic work schedules may also have a direct negative impact on women’s health during pregnancy, and  options must be explored to make the experience less strenuous. As a rule of thumb, good health leads to a healthy mother and a healthy baby.

Baby in White Onesie

Is Preconception Counseling Advised?

Yes !!!! It is advised to go for preconception counseling. It aids the doctors and the expecting couple in identifying risk factors early in the process, if any,  that can negatively  impact the pregnancy.

 During the pregnancy planning phase, in preconception counseling we look at the following: blood pressure, weight and BMI,  spouse’s family history of hereditary disorders, diabetes, mental disorders,  and prior childbirth and related complications. . We then provide suggestions on  avoiding  certain risks that could  impact you and your baby. .

Recommend a title for this segment: maybe something like biological parameters and recommendations? 

Some basic tests to be carried out prior to conceiving include: hemogram, blood group and Rh, Hb electrophoresis, thyroid levels (TSH), fasting blood sugar, and rubella IgG (Rubella immunity).

Low or high BMI : i.e. low (<18) or high (>25) – optimizing  your weight before pregnancy is crucial in  reducing  pregnancy risks such as miscarriages, and it also maximizes maternal and child health post delivery. Start by creating a supportive environment   that promotes a healthy lifestyle. Diet modifications are also important in  weight management. You should start taking folic acid and B complex tablets as soon you start planning for pregnancy as this simple early intervention could reduce the risk of abnormalities in the baby by 2/3rds.

Hypothyroidism: if you are suffering from hypothyroidism,  your thyroid dosage needs to be adjusted for the baby’s proper neurological development .

Diabetes: if you are diabetic before pregnancy, there is a 3-fold increase in the prevalence of birth defects, which can  be reduced substantially through proper management of disease.

Heart disease: if you have any prevailing heart diseases, then it is wise to consult your cardiologist as in certain conditions pregnancy is a contraindication.If you are on blood thinners then your medications need to be changed to  safer options as routine anticoagulants cause birth defects.

Low hemoglobin: we need to check your iron stores as well as rule out blood disorders such beta-thalassemia minor. If iron levels are low, you need to take a therapeutic dosage of iron so as to avoid low birth weight in babies and/or preterm delivery. Even after delivery, anemia is a risk factor for postpartum depression.

Carrier of beta-thalassemia: A carrier is an individual who has the ability to pass on disorders to offspring without expressing or showing signs of the disease themselves. In such  cases  your partner also needs to be checked for this disorder . If both  partners are carriers, then a prenatal diagnosis of thalassemia major through  chorionic villus sampling (CVS) or amniocentesis is necessary.

Anti-epileptic medication? don’t forget to take folic acid with anti-epileptic medication, and consult a physician to switch over to  options   that are less harmful for the baby.

Acne treatment: If you are using any cream for acne  treatment, like isotretinoin, then it is better to avoid pregnancy during the duration of the treatment as this results in miscarriages and birth defects.

Rubella test: in case the rubella test is sero-negative, it is better to take rubella vaccination first, and avoid pregnancy in  the following 3 months  to avoid birth defects by rubella virus.It is always advisable  to get vaccinated against hepatitis B, and typhoid as well.

It is a wonderful opportunity to cultivate healthy habits before pregnancy. So exercise, meditate, eat healthy & be positive.

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1 thought on “The Importance of Preconceptional Counselling”

  1. This design is spectacular! You most certainly know how to keep a reader amused. Between your wit and your videos, I was almost moved to start my own blog (well, almost…HaHa!) Wonderful job. I really loved what you had to say, and more than that, how you presented it. Too cool!

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