Pre-conception counseling

Pre-conception counseling (also called pre-conceptual counseling) is a meeting with a health-care professional (generally a physician or midwife) by a woman before attempting to become pregnant. It generally includes a pre-conception risk assessment for any potential complications of pregnancy as well as modifications of risk factors, such as increasing folic acid intake to reduce the risk of neural tube defects and counseling on smoking cessation, alcohol reduction, and medications that may compromise fetal development. Physicians, midwives and baby experts recommend that a woman visit them as soon as the woman is contemplating having a child, and optimally around 3 to 6 months before actual attempts are made to conceive. This time frame allows a woman to better prepare her body for successful conception (fertilization) and pregnancy, and allows her to reduce any health risks which are within her control. Agencies such as the March of Dimes have developed screening tools that healthcare providers can use with their patients. In addition, obstetricians or midwives (see Obstetrics, Midwifery, General Practitioner) have developed comprehensive check-lists and assessments for the woman who is planning to become pregnant.

In one sense, pre-conception counseling and assessment can be compared to a well-baby visit in which a baby is screened for normal health, normal development, with the benefit of identifying emerging problems that may have gone unnoticed in an infant. For a woman, the Pre-Conception Counseling Assessment and Screening is intended to assess normal health of a child-bearing woman, while at the same time identifying:

A common obstacle to pre-conception counseling and assessment is that many pregnancies are still unplanned. Globally, 38% of pregnancies are unintended. For this reason, many experts recommend that all women of childbearing age be offered preconception care counseling regardless of intent to become pregnant.

Another common obstacle to pre-conception counseling and assessment is of women not knowing, realizing, or understanding the benefits of visiting their physician or midwife before trying to become pregnant. Most women still take for granted the biological aspects of becoming pregnant, and do not consider the value of pre-screening before becoming pregnant. Most women who want and anticipate having a baby are naturally prone to thinking in terms of having a well baby. In the majority of cases, women do not think about having a baby who has any kind of problem. Most women do not know how their own medical history could pose risks to a developing fetus. Likewise, they may not understand that pregnancy carries a certain number of risks as well. When family history risks and pregnancy risks are considered together, it may point to potential problems for that particular woman, or to her unborn baby once she becomes pregnant.

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