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TRAVANCORE COLLEGE OF
NURSING,KOLLAM
Preconception
Care And Preparing
For Parenthood
PRECONCEPTION CARE
DEFINITION
 When a couple is seen and counseled about
pregnancy , its course and outcome well
before the time of actual conception is called
preconception counseling.
 A set of interventions that aim to identify and
modify (biomedical, behavioral and social)
risks to a women’s health or pregnancy
outcome through prevention and
management(CDC 2006)
 The counseling should be done by primary
health care providers; the help of an
obstetrician, physician and geneticist can be
received.
GOALS
 Improve knowledge, attitude and behavior of
men and women related to preconception
care
 Ensure that all women of child bearing age
receive preconception care services that
enable them to enter pregnancy in optimum
health
 Reduce risks associated with the previous
adverse pregnancy outcome.
Vision:
improve
health and
pregnancy
outcome
Recommendation: Individual
responsibility ,service provision, Quality
assurance
Goals: Coverage, risk
reduction,
empowerment
Action steps: Research, Surveillance, Clinical
interventions
Guidelines for
preconception
care
COMPONENTS OF PRECONCEPTION
CARE
 Risk assessment
 Health promotion
 Intervention
1. Risk assessment
A. History
1.Reproductive History
h/o infant death
Still birth
Birth defects
Preterm births
Low birth weight babies
2. Medical History
RHD, Hypertention
Thromboembolism
Autoimmune disease
Diabetes
Thyroid disease
asthma
3.Medication Use
Category X: estrogen androgen and
thalidomide
Category D: phenytoin, valproic
acid,diazepam, Captopril, thiazides,
spirinolactones, Coumarine,
tetracycline,streptomycin, methotexate,
vinblastin, azathioprine
4.Substance Abuse
 Tobacco
 Alcohol
 Drug abuse
5.Toxins and teratogens
 Heavy metals
 Solvents
 Pesticides
 Allergents
B. Physical examination
 Nutritional assessments
 Periodontal
 Thyroid
 Heart
 Breast
 Pelvic examinations
C. Screening
 Infections and immunization
 Screen for peridontal, STD, Hepatitis C
infections
 Immunization – hepatitis-B, Rubella,
Varicella, HPV and influenza
 Genetic screening and family history of cystic
fibrosis, sickle cell anemia, thalassemia etc
 Psychosocial: screen for depression, anxiety,
domestic violence
 Lab tests:
CBC, urinalysis, blood type, and others
like syphilis, gonorrhea, Chlamydia, diabetes
HEALTH PROMOTION
 Family Planning
 Healthy weight and nutrition
 ideal BMI is 20-26kg/m2
 exercise and nutrition
 Healthy behaviors
 Nutrition, exercise, safe sex, effective
contraceptive use, dental flossing
 Discourage the use of alcohol, smoking,
substance abuse
 Avoid overuse ofV-A (limit-3000 IU/day)
 V-D (limit-400IU/day)
 Caffeine(limit to 2 cups)
 Healthy environment
 Interconception Care
INTERVENTIONS
 INTERVENTION
1. Follic acid
supplementation
2. Rubella vaccination
3. Diabetes
management
4. Hypothyroidism
management
 BENEFIT
 To prevent occurrence
of neural tube defects
 Protection against
congenital rubella
syndrome
 Reduce birth defects
 Proper neurological
development
 INTERVENTION
5. Hepatitis B vaccination
6. HIV screening and
treatment
7. STD screening and
treatment
 BENEFIT
 Prevents transmission of
infection to the infants
 Prevents transmission of
infection to the infants
 Reduce risk for chronic
pelvic pain, ectopic
pregnancy and infertility
 INTERVENTION
8. Maternal
phenylketonuria
9.Oral anticoagulants use
and management
 BENEFIT
 Prevent babies being
bone with PKU related
MR
 Changing to less
teratogenic treatment
regimen from
teratogenic Warfarin
 INTERVENTION
10.Antiepileptic drug use
and management
11.Smoking cessation
 BENEFIT
 Changing to less
teratogenic treatment
regimen.increase follic
acid intake
 Prevent preterm birth
and low birth weight
babies
 INTERVENTION
12.Eliminating alcohol use
13.Obesity Control
14.couple with history of
recurrent fetal loss
 BENEFIT
 Prevents fetal alcohol
syndrome
 Reduce risk of neural
tube defect, DM, LSCS,
hypertensive
thromboemblic diseases
 Investigation and
counselling helps in treat
the cause
BARRIERS TO PRECONCEPTION
CARE
Patient aspects
 High rate of unintended pregnancies
 Ignorance about importance of good
health habits prior to conception
 Limited access to health services in
general
Provider aspects
 Feeling of having inadequate
knowledge
 Perception of preconception care
being time consuming
BARRIERS TO PRECONCEPTION
CARE
Preparing For
Parenthood
Preparing For Parenthood
 Preparing for parenthood begins
with the decision to become
pregnant or the discovery of the
pregnancy in an unplanned
circumstance
Preparing For Parenthood
 Department of education and
science(DES) and Department
of health and social
security(DHSS) stressed the
importance of school in
preparing the young children
for adult life.
APPROACHES
Preparation for parenthood
in school setting
 Never enter into the unplanned
pregnancies as parenthood is a
lifelong commitment that needs
physical and psychosocial maturity.
 For successful parenthood, good
physical health healthy relationship
with parents and partner is required
 Financial stability
 Emosional readiness
Preparing For Parenthood
during pregnancy
 Prepare the pregnant women and the partner
for the birth of their child, through individual
and group counseling sessions
 5-10 classes emphasis on partner
relationship, family life, child care, sibling
rivalry on arrival of new baby
 Events and problems faced by the first time
parents and how can the parents make use of
the formal and informal support systems
Supportive services for the
parents during the early years
after the birth of children
 The problems experienced during
the post natal period and its effect
on mother and child relationship
 Problems related with when the
mother return to their job, and
how to solve these problems
Thank You

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Preconceptional councelling

  • 3. DEFINITION  When a couple is seen and counseled about pregnancy , its course and outcome well before the time of actual conception is called preconception counseling.  A set of interventions that aim to identify and modify (biomedical, behavioral and social) risks to a women’s health or pregnancy outcome through prevention and management(CDC 2006)
  • 4.  The counseling should be done by primary health care providers; the help of an obstetrician, physician and geneticist can be received.
  • 5. GOALS  Improve knowledge, attitude and behavior of men and women related to preconception care  Ensure that all women of child bearing age receive preconception care services that enable them to enter pregnancy in optimum health  Reduce risks associated with the previous adverse pregnancy outcome.
  • 6. Vision: improve health and pregnancy outcome Recommendation: Individual responsibility ,service provision, Quality assurance Goals: Coverage, risk reduction, empowerment Action steps: Research, Surveillance, Clinical interventions Guidelines for preconception care
  • 7. COMPONENTS OF PRECONCEPTION CARE  Risk assessment  Health promotion  Intervention
  • 9. A. History 1.Reproductive History h/o infant death Still birth Birth defects Preterm births Low birth weight babies
  • 10. 2. Medical History RHD, Hypertention Thromboembolism Autoimmune disease Diabetes Thyroid disease asthma
  • 11. 3.Medication Use Category X: estrogen androgen and thalidomide Category D: phenytoin, valproic acid,diazepam, Captopril, thiazides, spirinolactones, Coumarine, tetracycline,streptomycin, methotexate, vinblastin, azathioprine
  • 12. 4.Substance Abuse  Tobacco  Alcohol  Drug abuse
  • 13. 5.Toxins and teratogens  Heavy metals  Solvents  Pesticides  Allergents
  • 14. B. Physical examination  Nutritional assessments  Periodontal  Thyroid  Heart  Breast  Pelvic examinations
  • 15. C. Screening  Infections and immunization  Screen for peridontal, STD, Hepatitis C infections  Immunization – hepatitis-B, Rubella, Varicella, HPV and influenza  Genetic screening and family history of cystic fibrosis, sickle cell anemia, thalassemia etc  Psychosocial: screen for depression, anxiety, domestic violence
  • 16.  Lab tests: CBC, urinalysis, blood type, and others like syphilis, gonorrhea, Chlamydia, diabetes
  • 17. HEALTH PROMOTION  Family Planning  Healthy weight and nutrition  ideal BMI is 20-26kg/m2  exercise and nutrition  Healthy behaviors  Nutrition, exercise, safe sex, effective contraceptive use, dental flossing  Discourage the use of alcohol, smoking, substance abuse
  • 18.  Avoid overuse ofV-A (limit-3000 IU/day)  V-D (limit-400IU/day)  Caffeine(limit to 2 cups)  Healthy environment  Interconception Care
  • 19. INTERVENTIONS  INTERVENTION 1. Follic acid supplementation 2. Rubella vaccination 3. Diabetes management 4. Hypothyroidism management  BENEFIT  To prevent occurrence of neural tube defects  Protection against congenital rubella syndrome  Reduce birth defects  Proper neurological development
  • 20.  INTERVENTION 5. Hepatitis B vaccination 6. HIV screening and treatment 7. STD screening and treatment  BENEFIT  Prevents transmission of infection to the infants  Prevents transmission of infection to the infants  Reduce risk for chronic pelvic pain, ectopic pregnancy and infertility
  • 21.  INTERVENTION 8. Maternal phenylketonuria 9.Oral anticoagulants use and management  BENEFIT  Prevent babies being bone with PKU related MR  Changing to less teratogenic treatment regimen from teratogenic Warfarin
  • 22.  INTERVENTION 10.Antiepileptic drug use and management 11.Smoking cessation  BENEFIT  Changing to less teratogenic treatment regimen.increase follic acid intake  Prevent preterm birth and low birth weight babies
  • 23.  INTERVENTION 12.Eliminating alcohol use 13.Obesity Control 14.couple with history of recurrent fetal loss  BENEFIT  Prevents fetal alcohol syndrome  Reduce risk of neural tube defect, DM, LSCS, hypertensive thromboemblic diseases  Investigation and counselling helps in treat the cause
  • 24. BARRIERS TO PRECONCEPTION CARE Patient aspects  High rate of unintended pregnancies  Ignorance about importance of good health habits prior to conception  Limited access to health services in general
  • 25. Provider aspects  Feeling of having inadequate knowledge  Perception of preconception care being time consuming BARRIERS TO PRECONCEPTION CARE
  • 27. Preparing For Parenthood  Preparing for parenthood begins with the decision to become pregnant or the discovery of the pregnancy in an unplanned circumstance
  • 28. Preparing For Parenthood  Department of education and science(DES) and Department of health and social security(DHSS) stressed the importance of school in preparing the young children for adult life.
  • 30. Preparation for parenthood in school setting  Never enter into the unplanned pregnancies as parenthood is a lifelong commitment that needs physical and psychosocial maturity.  For successful parenthood, good physical health healthy relationship with parents and partner is required  Financial stability  Emosional readiness
  • 31. Preparing For Parenthood during pregnancy  Prepare the pregnant women and the partner for the birth of their child, through individual and group counseling sessions  5-10 classes emphasis on partner relationship, family life, child care, sibling rivalry on arrival of new baby  Events and problems faced by the first time parents and how can the parents make use of the formal and informal support systems
  • 32. Supportive services for the parents during the early years after the birth of children  The problems experienced during the post natal period and its effect on mother and child relationship  Problems related with when the mother return to their job, and how to solve these problems