Preparing for Pregnancy with Preconception Counseling

Why you should have preconception counseling before getting pregnant

By Catherine M. Herway, M.D., FACOG September 8, 2017

Women of a reproductive age often don’t realize the importance of preconception, or pre-pregnancy, counseling. The goal of preconception care is to maximize good results for mother and baby by educating women before they conceive. Although most pregnancies proceed smoothly, some pregnancies can result in poor maternal and fetal outcomes. While some of these outcomes can’t be prevented, preconception care can help to reduce or eliminate the risk. For example, folic acid supplementation at least 1 month before pregnancy decreases the incidence of some severe fetal nervous system disorders. In the same way, adequate blood sugar control in women with diabetes before conception can decrease the risk of miscarriage and certain birth defects.

What are proper preconception screenings?

Approximately half of all pregnancies in the U.S. are unplanned. Therefore, it is very important to properly screen and educate not only those women who are trying to become pregnant, but also those who are not. The purpose of this education is to identify potential maternal and fetal risks before and between pregnancies. Preconception care should evaluate for and modify medical conditions (known or unknown), mental health disorders, substance use and other high-risk behaviors, immunizations, nutritional status, family history, occupational and environmental exposures, and social issues.

When should I prepare for preconception counseling?

Many national and international medical organizations and advocacy groups have emphasized the importance of preconception care. The American Congress of Obstetricians and Gynecologists recommends, “every reproductively capable woman create a reproductive health plan.” A reproductive health plan should address the woman's desire for a child or children, or not to have children. The preferred number and timing of children should be considered, along with age-related changes in fertility.