Preconception Counseling

What is preconception counseling?

Having a safe, healthy and happy pregnancy begins well before you have a positive result on a test. Caring for your health before you become pregnant helps you prepare for a pregnancy. Preconception counseling is a visit with your healthcare provider where you discuss many aspects of pregnancy and plan for a healthy pregnancy.

When should I schedule a preconception counseling appointment?

This appointment should happen at least three months before you start trying to get pregnant.

What will my provider discuss with me during a preconception counseling appointment?

During the visit, your healthcare provider will discuss the following topics:

• Family history: Your family history—and your partner’s family history—can provide insight about any genetic conditions or disorders that may be passed on to a child. Understanding your medical past can help your healthcare providers treat you and your child in the future. This information may also tell your healthcare provider if they need to perform extra tests or watch for the development of certain conditions during pregnancy. Specific parts of your family health history to share with your doctor could include a history of :
  • Hypertension (high blood pressure).
  • Diabetes.
  • Mental disorders.
  • Blindness.
  • Deafness.
  • Birth defects (congenital conditions).
  • Ethnicity-related diseases (Tay-Sachs, sickle trait/sickle cell disease).
  • Twins or multiples.
• Your general medical history: It is important for your provider to see the whole picture of your health before pregnancy. During your appointment, your caregiver will want to discuss:
  • Surgeries, hospitalizations or transfusions you may have had in the past.
  • Any pre-existing medical conditions.
  • Any allergies.
  • Any medications you may currently be taking.
• Your OB/GYN history: During the discussion of your medical history, your doctor will ask you about your OB/GYN history. Some STIs and vaginal infections can affect a woman’s ability to conceive. Your doctor may do cervical cultures or blood tests to make sure there are no infections that could cause issues during conception or pregnancy. Specific topics your provider may discuss include:
  • Any previous pregnancies.
  • Your menstrual history.
  • Contraceptive use.
  • Any sexually transmitted infections (STIs).
  • Any history of known uterine abnormalities.
  • Pap smears or any treatments for abnormal paps.
  • Vaginal infections.
• Lifestyle: A healthy lifestyle is very important during pregnancy. This includes a balanced and nutritious diet, exercise, and stopping any drug use and smoking, as well as exposure to any environmental hazards.

• Vaccination: Your provider may need to update or give you additional vaccinations before you become pregnant. Some of these vaccinations may require time between when they are given to you and when you become pregnant. Bring your vaccination records with you to your appointment.

What happens during my preconception counseling appointment?

During preconception counseling, your provider may do several tests. These tests may include:

• A physical exam: Your provider may do a physical exam during your preconception appointment. This exam may involve your caregiver:
  • Checking your heart, lungs, breasts, thyroid, and abdomen.
  • Doing a pelvic exam.
  • Checking your blood pressure.
  • Recording your weight.
• Lab tests: These tests are used to check for various diseases and conditions. Lab tests may include:
  • Testing for rubella.
  • Testing for hepatitis.
  • Complete blood count (CBC).
  • A pap smear.
  • Diabetes screening.
  • Testing for thyroid issues.
  • Testing for HIV.

Your provider may also discuss how to chart to your menstrual cycles and when you ovulate each month. You may be given a prenatal vitamin with 400 to 800 micrograms of folic acid. You should start taking this before you are pregnant. Your baby can benefit from a prenatal vitamin before you may even know you are pregnant.

What types of tests will my partner and I go through during preconception counseling?

Your doctor may suggest that both you and your partner go through genetic counseling before conceiving, especially if you have a family history of certain genetic conditions. This process will provide a lot of information to your healthcare team that could be helpful during your pregnancy. Genetic counseling can also pinpoint certain risk factors that your doctor will be able to discuss with you and plan for. You may also be tested for certain conditions like Tay-Sachs or sickle trait/sickle cell disease. These conditions can be passed down throughout families.

What happens after my preconception counseling appointment?

Your caregiver may make several suggestions after your appointment. These could be a mix of lifestyle changes and healthcare suggestions, including:

• Losing weight.
• Quitting smoking or drinking.
• Not taking medications that could be harmful to the pregnancy (always speak to your doctor before starting or stopping a medication).
• Updating your immunizations.
• Taking recommended vitamins (including prenatal vitamins).
• Avoiding extra stress.
• Seeing specialists for health problems before conceiving.

What other lifestyle changes should I keep in mind as I prepare for pregnancy?

During pregnancy, women can continue to exercise. Regular exercise (at least three times per week) is preferred over intermittent activity (altering between periods of being active and inactive). Pregnant women should stop exercising when fatigued and not exercise to exhaustion. It’s also very important to stay hydrated. Also, a good diet of healthy food is very important. Good nutrition during pregnancy is needed for your baby to grow and develop. During your pregnancy, you will need to consume about 300 more calories per day than you before pregnancy. Establishing a nutritious diet before you are pregnant can help you maintain good eating habits throughout all three trimesters.