Early Initiation of Preconception Counseling

Preconception Counseling
Imparts Seriousness to Sexual Behavior

Besides sex education, preconception counseling could impart seriousness to adolescent sexual behavior. Unintended pregnancies are most common among teenagers, and the consequences that follow are severe for them, their offspring and families, and for the society at large.

Tween, teens and youths shy away from visits to doctor’s clinic; more so for being guided on medical interventions needed for healthy childbearing in future. The concept of counseling on essential health needs associated with child birth is too far fetched for teenagers in love. They indulge in sexual activities without regarding the possibility of conceiving a baby.

Preconception counseling therefore need to be initiated for children
much before they attain puberty.

Preconception care before and between pregnancies

Sexual relationships and childbearing are crucial aspect of all living being.
Poor pregnancy outcomes adversely affect even the strongest.

Preconception counseling offers individualized interventions to minimize
the risks for the mother and her baby.

Social support and essential health care recommendations help couples to provide their forthcoming baby with best emotional, social and physical well being both before and after birth.

Health care recommendations before and between pregnancies:

Follow the latest recommendations of vaccination schedule:
These recommendations change frequently, depending on outbreaks and prevalence of diseases. It is therefore best to get periodic update on vaccines recommended at preconception counseling visits. Moreover, there are some vaccines that are contraindicated during pregnancy, while there are other that are recommended during pregnancy.
Prevention of unintended pregnancy:
a.) Intrauterine Device (IUD) and Morning After Pill are now recommended for teenagers.
b.) Condom use along with other birth control methods is encouraged because its barrier effect minimize the risk of sexually transmitted diseases and adds to the effectiveness of the birth control method used.
Planning of the pregnancy is crucial for a favorable outcome.
Minimize stress:
Stress hormone in mother jeopardizes fetal growth and can lead to premature birth.
Resolve emotional conflicts before planning a baby.
If required, do not hesitate to opt for professional help.
Encourage economic independence:
Both parents should be professionals with stable income to be able to emotionally and financially support the baby.
Identify the risk factors and get them treated.
a.) Smoking
b.) Alcohol consumption
c.) Drug abuse
d.) Consumption of coffee or other caffeine containing products.
e.) Risky sexual behavior
f.) Depression in mother
g.) Disturbed mental health of the father
Visit occupational medicine specialist:
Determine specific risks associated with your occupation.
Some of the known offenders are anesthetic gases, mercury, lead, organic solvents, radiation and vinyl chloride. However, in clinical practice the effects of these agents are rarely documented.

Diseases in the mother:
All women in reproductive age group need to be screened closely and treated effectively during preconception health care visits.
a.) Several hormones influence fetal development.
b.) Mother's prepregnancy weight influences her child's learning abilities.
c.) Inadequately controlled diabetes in the mother is a common cause of adverse outcome of pregnancy.
d.) Poor metabolic status at the time of conception and during early pregnancy can threaten fetal development. It is also the leading cause of birth defects. The incidence of congenital anomalies in infants of diabetic mothers is particularly high.
Genetic screening
To assess risk of genetic disorders before a couple attempts to conceive.
a.) Women over 35 years of age need to be screened for chromosomal abnormalities. The most common disorder is Trisomy 21, known as Down syndrome, where chromosome 21 has 3 copies instead of 2.
b.) Infertility
c.) History of spontaneous abortion, particularly if in the first 3 months of pregnancy and if occurred more than once.
d.) Unexplained developmental disorder in previous child or in family.
e.) Family history of a genetic disease.
f.) Father’s age more than 55 is believed to be associated with increased risk of chromosomal abnormalities but adequate clinical evidence to support the belief is lacking.
Details of all previous conceptions and their outcome
Incidence of high blood pressure, diabetes, placenta previa, multiple pregnancy, ectopic pregnancy, premature labor and cesarean section is significantly higher in women below 17 years or above 35 years of age.
Blood group incompatibilities
Domestic violence
Nutritional supplements advised during preconception counseling:
a.) Iron
b.) Iodine
c.) Folic acid
d.) Vitamins and Other trace elements
Avoid pollution:
a.) Dangers of passive smoking for child health.
b.) Effects of background television
c.) Electromagnetic pollution caused by excessive use of cell phone or laptops during pregnancy could adversely influence fetus.