Preconception Counseling

Definition

Preconception counseling (or preconception care) refers to the care and guidance given to women or couples as they plan for pregnancy. It helps identify and modify biological, behavioral, and social risks to the woman’s health and future baby’s wellbeing.

Benefits of Preconception Counseling

• Ensures a woman enters pregnancy in the best possible health.
• Identifies medical conditions that may affect fertility or pregnancy.
• Prevents birth defects through early interventions (e.g., folic acid).
• Reduces pregnancy complications.
• Promotes healthy behaviors such as good nutrition and avoiding alcohol or smoking.

When to Seek Preconception Care

Every woman or couple considering pregnancy should start preconception care early, ideally months before conception.
This allows enough time to address medical issues, adjust medications, and adopt healthier habits.

Key Strategies for Effective Preconception Care

1. Make a Plan and Act Early

Early preparation allows the provider to:

• Review contraceptive history (some methods delay fertility).
• Stop or replace medications harmful during pregnancy.
• Promote preventive health care and lifestyle planning.

2. Review Medical and Pregnancy History

Your OBGYN will discuss:

• Chronic conditions (diabetes, hypertension, thyroid disorders, STIs).
• Past pregnancy complications.
• Current medications and those that need to be stopped or replaced.
• Lifestyle risks such as alcohol, smoking, drug use, or unsafe home/work environments.

TIP: Bring a written list of questions and concerns to your appointment.

3. Take 400 Micrograms of Folic Acid Daily

Folic acid taken at least one month before conception and during early pregnancy helps prevent major brain and spine birth defects.

4. Stop Alcohol, Smoking, and Harmful Drugs

Alcohol, tobacco, and certain drugs increase risks of Miscarriages, Preterm birth, Birth defects and Infant deaths.

Seek professional help if quitting is difficult.

5. Achieve and Maintain a Healthy Weight

Being overweight or underweight affects fertility and pregnancy outcomes.
Healthy weight management requires:

• Balanced diet
• Regular exercise
• Lifestyle changes rather than short-term diets

6. Get Help for Violence

Violence causes physical and emotional harm and can endanger pregnancy.
Support services, counseling, and legal protection are available—seek help if needed.

7. Learn Your Family Medical History

Family history may reveal risks such as:

• Genetic conditions
• Heart defects
• Sickle cell disease
• Recurrent miscarriages

This information helps determine whether genetic counseling is needed.

8. Protect Your Mental Health

Healthy emotional wellbeing improves fertility, pregnancy, and parenting.
Seek support if you experience:

• Anxiety
• Depression
• Stress overload

9. Ensure You Are Fully Vaccinated

Some vaccines should be given before pregnancy, others during or after.
Vaccination protects both mother and baby from serious infections.

10. Maintain Healthy Habits During Pregnancy

Once pregnant, continue:

• Healthy eating
• Avoiding harmful substances
• Taking folic acid
• Keeping prenatal appointments

WHO recommends a minimum of 8 antenatal visits for better outcomes.

Target Group

Preconception counseling is recommended for:

• Women and couples planning pregnancy
• Women with chronic illnesses
• Women taking long-term medication
• Women with previous complicated pregnancies
• Adolescents who are sexually active
• Any woman of reproductive age

References

• NIH, NHLBI Obesity Education Initiative. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults.
• Moos MK, et al. Healthier Women, Healthier Reproductive Outcomes: Recommendations for the Routine Care of All Women of Reproductive Age. AJOG 2008.