Pre-pregnancy counselling is a counselling session that can be conducted before you conceive. In the counselling session the doctor can discuss investigating possible risk factors during pregnancy to both yourself and the baby, and also to investigate and discuss medical issues you may have before you become pregnant.
Pre-pregnancy counselling can help to prepare for pregnancy by maximising physical and emotional health before conception. It provides an opportunity to discuss your concerns and address queries about the process of becoming pregnant and steps that can be taken to improve the pre-pregnancy and pregnancy experience. Subjects generally discussed during a pre-pregnancy counselling session include (but are not limited to):
Reproductive history: You doctor will discuss your obstetric history, menstrual cycle, use of contraceptives, sexually transmitted diseases, vaginal infections and Pap test results.
Medical and surgical history: You should inform the doctor about past and present health problems so that you are ready to manage them before and during pregnancy. Past surgeries or hospitalisations should also be brought to the doctor’s attention.
Current medications: Some medications are not good to take during pregnancy, and even leading up to conception. It is important to discuss any prescription, over-the-counter medications or herbal supplements that you are currently taking to give you an opportunity to adjust your medications as necessary to maximise pregnancy health.
Weight: It is best to be in a healthy weight range before you conceive. Gaining weight if you are underweight will reduce the risk of having a low birth-weight baby, and reducing weight if you are overweight will prevent the risk of high blood pressure during pregnancy. In a pre-pregnancy counselling session you can discuss strategies to get to a healthy weight before pregnancy and maintain it throughout.
Workplace and home environment: Your doctor will discuss potential hazards to conception and maintaining a pregnancy, such as exposure to lead or certain toxic solvents, radiation and animal waste.
Lifestyle: The effect of certain habits like alcohol consumption, smoking and use of recreational drugs on pregnancy will be discussed. You and/or your partner may be advised to stop these habits for a healthy pregnancy.
Exercise: Inform your doctor about the type of exercises you do, or if you do not usually exercise. Based on this, you may be advised to continue normal exercises during pregnancy until your doctor suggests otherwise.
Diet: Having good dietary habits is beneficial during pregnancy. You will be advised to consume food rich in folic acid, calcium, fibre and other nutrients, and reduce the intake of caffeine, which is present in coffee, chocolates, soft drinks and medications, before getting pregnant.
Family health history: Inform your doctor about the presence of hereditary medical conditions and multiple births in the family.
Prenatal vitamins: You should start taking folic acid supplements before you conceive, as folic acid reduces the chances of neural tube defects in your baby.
Advice for older women: Women older than 35 years of age will be advised on the risks of infertility, abnormalities in the child and pregnancy complications, such as miscarriage and labour problems.
Your doctor may also recommend:
- Physical examination of your abdomen, heart, breasts, thyroid and lungs
- Pap smear and pelvic examination
- Lab tests to screen for hepatitis, HIV, rubella, syphilis and other conditions
- Chart menstrual cycles to monitor ovulation and determine the most favourable time to get pregnant
- Advise appropriate vaccinations against rubella or chickenpox, and recommend delay in conception for a month
- Conduct genetic counselling for older mothers or those with a risk of hereditary diseases to help you understand the chances of birth defects or intellectual disability in the child