1. Consultant & Unit Head,
Dept. Of Obstetrics & Gynecology
PRECONEPTION CARE
Dr Nupur Gupta

2. WHAT IS PRE-CONCEPTION?
• Starts before conception
• Promoting health of women of
childbearing age
• Helps to improve maternal health
• Step towards desired outcome

3. WHAT IS PRE-CONCEPTION?
• Health of baby highly related to parents
health
• Trying to have a baby- understand it
• Prepare for safe pregnancy & a healthy baby
• Speak with the doctor about this
• Critical development period of baby- starts-
before mother know pregnancy

4. Mission of Preconception
• Improve & manage maternal
health conditions
• Improve & manage early fetal
development
• Encourage emotional well being
• Modify risk factors

5. Aim of Preconception Care
• Finding & taking care of any problems
• Steps to reduce risk of birth defects
• Care of health issues before pregnancy
• Prevent many future problems for mother
& baby

6. Planning your pregnancy
• Best thing to plan ahead
• Planning a pregnancy means
• To have a healthy baby
• Making decisions with partner
about future family

7. Planning your pregnancy
• Whether you are ready for
pregnancy?
• Life changes during pregnancy &
after delivery
• Planning for this- much easier to
handle it- both partners

8. Understanding your fertile period
• With regular cycles- D9-D16
• Timed intercourse- 1- 2 days prior to ovulation
• Best time to conceive-
• Life span of ovum is 24hrs, sperms is 3-5 days
• How to predict ovulation-
• Temperature chart
• LH kit

9. Effect of weight on fertility
• BMI
• Positive effect of weight loss (10%)

10. Effect of age
• Fertility goes down with age , specially after mid 30s
• Less chances of success in fertility treatment
Time to consult your doctor when
• Age >35 yrs- no conception till 6 months
• Age< 35yrs- no conception till 1 yr

11. Why is planning important?
• Help to have a healthy baby
• Planned babies are more healthy
than unplanned babies
• By more early & regular prenatal
care, we can achieve a healthier
pregnancy

12. How can you plan your pregnancy?
• Interact with your partner
• Decide number of children to have
• Spacing between two births
• Care for mother’s health

13. Things to consider
• Sexually active but one partner not ready -
use contraception
• Consult your doctor
• Think about what it is like to be a good
parent
• Becoming parent is a big responsibility

14. Financial Planning
• Talk to your partner freely about
having a baby
• Financial planning for your baby
• Having a baby can be expensive
• Look for health insurance & financial
schemes

15. Finding emotional readiness
• Why to have a baby?
• Are both partners ready for the changes
affecting your relationship?
• If you’re not in a relationship, are you
prepared to raise a child alone?
• How will a baby affect your education or
career plans?

16. Finding emotional readiness for newborn care
• How to take care of a child?
• Are you prepared to parent a child who is
sick or has special needs?
• Are you ready to have less free time for
yourself?
• Can you see yourself enjoying your time as a
parent?
• What do you want for your baby's childhood
that may have been missing from your
childhood?

17. Elements in Preconception care
• Visit to doctor ( 3-6 months prior to
conception)
• Risk assessment
• Education & health promotion
• Medical & psychosocial care

18. Components of Preconception Care
• Medical history
• Psychosocial issues
• Physical examination
• Investigations
• Family or genetic history
• Nutrition
• Occupational or environmental risk factors

19. Risk Assessment
• STD evaluation
• Genetic issues
• Domestic violence
• Substance abuse
 Alcohol, Tobacco
 Drugs

20. Environmental teratogens
• Exposure to hazardous materials
 Home, workplace, environment
• Physical or chemical hazards
 Ionizing radiation, lead, mercury,
hyperthermia, herbicides,
pesticides

21. Health Education
• Stop smoking
• Start intake of folic acid
• Multivitamins
• Genetic counselling
• Dietary & nutritional advice
• Rubella Immunisation

22. Things to control
• Weight
• Alternate medications
• Stop Alcohol/ tobacco
• Correction of cardiac problems
• Sugar control
• R/o safe anticonvulsants if epileptic
• Unhealthy diet & sedentary life style

23. Diseases that affect mother & baby
• Diabetes
• Hypertension
• Cardiac problems
• Epilepsy
• Thyroid disorders
• HIV infection/ STDs
• SLE
• Renal disorders
• Blood disorders & cancers

24. Interventions to be avoided during pregnancy
• Rubella & varicella vaccination
• Narcotic detoxification
• Certain radiological procedures
• Thyroid ablation with radioactive
iodine

25. Factors affecting conception
• Birth spacing
• Genetic diseases
• Diseases with poor prognosis ( HIV/AIDS)
• Life threatening diseases
• Poor maternal care
• Repeated fetal loss or abortions

26. Benefits of Preconception Care
• Improved outcome
• Decreases fetal or infant mortality &
morbidity
• Decreases maternal mortality & morbidity

27. Factors that lower birth defects
• Optimal glycaemic control
• No alcohol consumption
• No smoking
• Preconception rubella immunization
• Folic acid supplementation

28. Barriers to Preconception Care
• High rate of unintended pregnancies
• Unawareness about preconception health
• Ignorance about health issues
• Limited access to health services
• Inadequate knowledge

29. Preconception care for men
• Stop alcohol
 Causes physical & emotional
abuse
 Decrease fertility
• Genetic counselling
• Decrease fertility with age
• No hot bath, hot tub or sauna
• No tight undergarments
• Occupational hazards awareness
• Knowledge & information about
STDs, Syphilis, Herpes, HIV/AIDS

30. Overview of preconception care
• Take care of oral health
• Quit smoking and drinking
• Cut off caffeine intake
• Healthy nutritious diet
• Weight control, Up to date vaccine
• Care of medications
• Exercise

31. Early Signs of Pregnancy
• Missed period
• Frequency of urine
• Feeling of tiredness easily
• Nausea in the morning
• Breast tenderness & enlargement

32. THANK YOU