Preconception care is important for a healthy baby. However, plenty of women have their first preconception visit only after the conception. You can infer why that might be problematic.
A preconception checkup helps the specialist determine whether there are any potential risks to your baby and yourself during pregnancy. In case you have any medical issues, they should be addressed before the pregnancy.
The goal is for you to become as healthy as you can be. Caring for yourself is the best way to ensure everything goes smoothly. The best way to start is by scheduling an appointment with your health care provider.
But, you may be wondering, “what happens there exactly?” To satisfy your curiosity and help you prepare, here is all of the most crucial info regarding preconception care.
Who?
Any women considering conceiving in the next three to six months should book a preconception appointment. Such visits are not reserved only for women with health issues.
Regardless of risk factors, everyone should have one. Chances are, you won’t know whether there are some risks to getting pregnant before your checkup.
Where?
You could go to your family doctor, midwife, nurse practitioner, or obstetrician. Certain healthcare providers (such as women’s health nurse practitioners, midwives, and OB/GYN doctors) are usually better prepared for preconception appointments.
In case you do not have a midwife or OB/GYN doctor, you can go to your general practitioner. It could also be a great chance to try out a new midwife or doctor. Consider it a trial run. You won’t have to keep coming back to the same specialist as you are not pregnant yet.
When?
It would be best to do it a couple of months before getting pregnant — ideally, three to six. Keep in mind; it might take a few months to get an appointment at a very popular practice. In case you need to make some necessary changes, you might need some time.
For example, it takes six weeks for thyroid medication to kick in. If the tests show your thyroid levels are low, your doctor might prescribe them. If you are on medication that is contraindicated in pregnancy, you’ll have to stop, and it could take some time to find a suitable replacement.
What?
There’s no better time to ask your doc about everything’s that is on your mind, no matter if it is about your genetics, prenatal vitamins, diet, or any other health concerns. However, the doctor will have a lot of questions for you as well. Here’s what they will check.
1. Your Medical History
This can be of tremendous help in identifying any risk factors. Even some health issue that you overcame a while ago might warrant further workup or a visit to a specialist. Any medical problem greater than a cold or the flu might interest your provider, so try to find any relevant reports from the past.
2. Family History
It’s essential in evaluating whether your baby will be at a higher risk of having a genetic disorder. If they deem that to be the case, they will likely refer you to a genetic counselor. The specialist will conduct further testing and explain the risks to you.
3. Social History
Identifying modifiable risk factors is also a part of the procedure. There are some things about your lifestyle that your provider would want to know about. Making some changes in your lifestyle can significantly reduce the chances of certain complications. These changes are:
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Smoking
When it comes to lifestyle questions, this is always their first item on the list. Tobacco use can be the cause of a lot of negative outcomes. Preterm birth and decreased fertility are some of them. If you are a smoker, your doctor might be able to help you quit.
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Alcohol
No amount of booze is safe. Just a sip or two of wine probably wouldn’t do any arm, but your doc will want to make sure that, if you like drinking, you will be able to quit once you conceive.
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Other Harmful Substances
Drugs might present many risks to your infant. Prescription or not, illicit or not – it doesn’t matter necessarily. Whether there is some danger to using marijuana while carrying a child has not yet been established. However, doing so might lead to loss of custody of your child. That’s why it’s important to disclose any drug use.
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Occupation
Some professions put expectant mommies at risk to certain exposures. For example, if you work in a hospital as a nurse, you might often be exposed to CMV, X-rays, and chemotherapy.
If that is the case, your physician will probably advise you to stay away from x-rays. They Could also suggest that you request not to work with oncology patients receiving chemotherapy and patients with CMV. Exposure to pesticides and cleaning products should also be disclosed.
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Living Situation
The physician will ask you about your support system, your current relationship, where you live, and will screen for any signs of abuse. They will want to make sure your family is safe.
4. Immunization History
Pregnant women have an extraordinary ability. They can pass on their immunity to the fetus through the placenta. So, when an expectant mommy gets a shot, she is protecting both herself and her baby.
Unfortunately, it’s a double-edged sword. A pregnant woman can also pass on an infection to the infant. Varicella (chicken pox) and Rubella (German measles) put the fetus at great risk.
CBS (Congenital Rubella Syndrome) in infants can lead to cognitive defects, blindness, and hearing loss. Although it’s extremely rare, congenital Varicella can also cause birth defects.
Most immunization occurs during early childhood, so it’s alright if you don’t remember all of your shots. Your doctor will order a blood test to check your immunity if you are unsure whether you have received the vaccine. In case you haven’t, you can receive one before conceiving.
The flu-vaccine is another important pre-pregnancy shot. An expectant mommy is more likely to have a serious case of the flu. The shot will protect you from getting the flu during pregnancy.
In case you have missed it before conceiving, you can get one during pregnancy. The Tdap shot comes only during pregnancy. It is best to receive it between twenty-seven and thirty-six weeks of pregnancy.
5. Medication
You would want to review all of your meds. You might need to stop or change the medication, depending on its effects on the fetus. You need to disclose everything you are taking – including vitamins, protein shakes, and any other supplements.
6. Preconception Check Up
Your doc will have your vital signs check. Specifically, they will want to make sure you do not have baseline hypertension. They will also check your BMI, and in some cases do a breast exam, pelvic exam, assess your thyroid, and listen to your heart and lungs.
7. Lab Tests
- STDs
- CMV, tuberculosis, lead level, toxoplasmosis screening in high-risk populations
- Hemoglobin A1C or Fasting Glucose in women with diabetes risk factors
- Genetic carrier testing
- Immunity titers – varicella, rubella
Conclusion
Preconception health should not be neglected. Your health in the months leading to pregnancy is very important for the baby’s development. Be sure to find a good doctor or midwife that will suit you, because you will be visiting them every one to four weeks once you get pregnant.
