Many couples face issues when trying to have a baby. Which is why doctors suggest them to opt for preconception counselling as part of which the couple’s family history, risk factors, medical conditions, and lifestyle are discussed. Counselling will make sure that a woman has a safe, healthy, and happy pregnancy well before a positive result on a pregnancy test, said experts.
When does preconception counselling begin?
Preconception counselling begins three months before planning the pregnancy. “Now, patients are coming for preconception advice and that is a good change in the society. When a couple comes for the same, the preparation for a woman is divided between mental, physical, and medical parameters. Mental preparation helps in striking a balance between finances/career, and age factor. The ideal age of having a baby is between 22-29 years when the reproduction capacity is at its peak. After 30, the fertility declines but that doesn’t mean one cannot get pregnant. You may conceive easily, but sometimes you may need medical assistance. Psychological factor involves improving bonding with your partner and building a support system during and after delivery. Physical factors involve lifestyle changes and exercise. Medical factor involves taking a detailed family history of diseases and genetic disorders,” said Dr Madhuri Burande Laha, consultant obstetrician and gynaecologist, Motherhood Hospital, Pune.
Even counselling regarding nutrition and environmental and occupational hazards, immunity and immunisation status and physical examination is done. “All women should be tested for HIV and screened for sexually transmitted diseases (STDs) before planning pregnancy,” said Dr Karishma Dafle, gynaecologist, Nova IVF Fertility, Pune.
When it comes to males, preconception counselling involves self-preparation to embrace changes like supporting your wife emotionally and even in household chores. “Lifestyle modifications like quitting smoking as smoking itself may decrease quality and quantity of sperms. Also, passive smoking is not good for pregnant woman. Working in hot environments reduces the quality of sperms and causes infertility. A couple should start the pregnancy journey on a positive note,” added Dr Laha.
Why is preconception counselling required?
Preconception counselling intends to optimise a woman’s health before pregnancy. Pre-existing conditions affecting conception in pregnancy are identified and addressed. “Simple measures like taking folic acid supplements prior to conception can help in reducing the chances of birth defects in children. Managing diabetes mellitus, asthma, seizures, thyroid disorders, and hypertension can reduce the foetal effects by achieving strict metabolic control before conception and continue throughout pregnancy. Patients are counselled regarding benefits of exercising, reducing the weight before pregnancy if obese, and increasing the weight if underweight, and also to avoid pregnancy within a month of receiving a live attenuated vaccine,” said Dr Dafle.
Vaccination is offered to women found to be at risk for or susceptible to rubella, varicella and Hepatitis B prior to planning pregnancy.
What parameters should couples follow?
“Monitor vitamin D levels and manage haemoglobin by taking iron supplements. Women should eat a diet rich in fibre and low in fats, drink enough water and maintain an optimum weight. Have proper sleep. Cut down on stress, alcohol, smoking, and other forms of tobacco. Exercise daily. Follow intimate hygiene practices apart from getting screened for STDs. Take required vaccines as per doctor’s suggestion,”, said Dr Laha.