Why is it important?
The intention of pre-parental counseling is to minimize the risk and complications of being pregnant and prioritize a comfortable pregnancy for the couple and the baby. Other than standard counseling, the mother, father, and the family know about the baby’s wellness and proper pregnancy tenure.
Pre-pregnancy counseling can be helpful in the following situations:
Identifying previously existing diseases that have been diagnosed or not diagnosed like diabetes, high blood pressure, epilepsy, etc. which can adversely affect maternal and fetal outcomes. These conditions can be managed and optimized so as to achieve good maternal and fetal outcomes.
Detecting complications and risks for women who have been pregnant. It is necessary for situations where the previous baby had a birth disorder, been a premature baby or the mother had a miscarriage or stillbirth.
Recognizing risks (if any) that may affect the growing baby if the woman becomes pregnant.
If there is a preexisting genetic condition in the family example thalassemias. It becomes more important in the case of marriages in close relatives (consanguinous marriages)
Who should go for it?
All those couples planning to initiate a pregnancy should be counseled, including heterosexual, lesbian, gay, bisexual, transgender, queer, intersex, asexual, and gender-nonconforming individuals.
The counseling prepares a couple mentally, emotionally, and physically towards a healthy self while taking the next big step into pregnancy.
What does pre-pregnancy counseling include?
Pre-pregnancy counselling should consist of a detailed evaluation of the patient’s medical history, anaemia and the patient’s immunization analysis report. Evaluation of infectious conditions as HIV, Hepatitis, and Sexually transmitted diseases as Syphilis.
Mothers with Rh-negative blood groups may face risks and complications. By pre-pregnancy counselling, one can be aware of the risks and reduce the difficulties associated with it.
The counsellor will measure your weight and BMI and advice the couple about maintaining a healthy lifestyle through a proper diet and daily exercise. The couple should very seriously abdicate themselves from smoking and alcohol consumption and follow the advice and take care of the medical tests that the counsellor recommends.
Counsellor starts folic acid tablets. This should ideally be started 3 months prior to conception. Folic acid deficiency is associated with defects in the development of the baby’s spinal cord, increased risk for abortions, anaemia etc. Hence folic acid supplementation is advisable whenever a lady is trying for conception.
Tests performed during preconception counselling
The counsellor may recommend specific tests that the couple should take seriously, as those tests can prepare the couple for the upcoming parenthood. Such tests include:
A pap smear
Complete blood count
Genetic testing
Diabetes screening
Testing for thyroid
HIV testing
Testing for hepatitis
Rubella testing
How to prepare for the visit?
There is no more mandatory preparation for the counseling you just have to make up your mind for pre-pregnancy counseling. Though there is some personal information that may be asked by the doctor for general inquiry. Such as about menstrual cycle, type of birth control to be used and for how long, diet and lifestyle schedule which is followed by the patient, medications that the patient take which the doctor can alter accordingly if he thinks any change is needed, any medical problem as well as the mental condition of concern that should be treated before pregnancy, recent travel plans to be informed, family history on the medical ground is to be recorded and reported as per asked. Nothing should be hidden, and all problems must be conveyed for a thorough diagnosis and a better pregnancy.
Is there any ideal time for planning a pregnancy?
There is no such ideal time for planning a pregnancy. But because of the increased risk for complications after 35 years, it is advisable to complete family before 35 years of age. The ideal gap between 2 pregnancies should be 2 years to allow for the complete care of the elder one including lactation and for the full recovery of the health of the mother.
Pre-pregnancy counselling for elderly women
If your first conception is after 40 years, then definitely you should have a health check-up and pre-pregnancy counselling before planning for pregnancy. This will tell whether you are healthy enough to carry a baby without causing grave complications to your health.
Age and Pregnancy
As age increases, women tend to be at increased risk for developing hypertension, diabetes etc. When you have such illnesses, a pre-pregnancy counselling visit ensures the optimal control of the pre-existing disease, modification of the medicines being taken, folic acid supplementation etc.
During pregnancy, elderly women tend to have an increased risk of developing pregnancy-induced hypertension, diabetes, premature labour etc.
Fibroid in pregnancy
Some women may have fibroids in their uterus which are probably first detected in their first scan in pregnancy. Fibroids in pregnancy can cause abortions, premature labour etc. Hence pre-pregnancy checkup can help in timely detection of any such pre existing condition and thus help in reducing the pregnancy complication due to the same.
